Lindeboom Robert, Sprangers Mirjam A, Zwinderman Aeilko H
Department of Clinical Epidemiology, Academic Medical Center, Amsterdam, The Netherlands.
Health Qual Life Outcomes. 2005 Feb 3;3:8. doi: 10.1186/1477-7525-3-8.
Since the mid eighties, responsiveness is considered to be a separate property of health status questionnaires distinct from reliability and validity. The aim of the study was to assess the strength of the relationship between internal consistency reliability, referring to an instrument's sensitivity to differences in health status among subjects at one point in time, and responsiveness referring to sensitivity to health status changes over time.
We used three different datasets comprising the scores of patients on the Barthel, the SIP and the GO-QoL instruments at two points in time. The internal consistency was reduced stepwise by removing the item that contributed most to a scale's reliability. We calculated the responsiveness expressed by the Standardized Response Mean (SRM) on each set of remaining items. The strength of the relationship between the thus obtained internal consistency coefficients and SRMs was quantified by Spearman rank correlation coefficients.
Strong to perfect correlations (0.90-1.00) was found between internal consistency coefficients and SRMs for all instruments indicating, that the two can be used interchangeably.
The results contradict the conviction that responsiveness is a separate psychometric property. The internal consistency coefficient adequately reflects an instrument's potential sensitivity to changes over time.
自20世纪80年代中期以来，反应度被认为是健康状况问卷区别于信度和效度的一种独立属性。本研究的目的是评估内部一致性信度（指一种工具在某一时刻对受试者健康状况差异的敏感性）与反应度（指对健康状况随时间变化的敏感性）之间关系的强度。
我们使用了三个不同的数据集，这些数据集包含了患者在两个时间点上在巴氏指数、疾病影响量表（SIP）和生活质量总体问卷（GO-QoL）上的得分。通过逐步去除对量表信度贡献最大的项目来降低内部一致性。我们计算了每组剩余项目的标准化反应均值（SRM）所表示的反应度。通过斯皮尔曼等级相关系数对由此获得的内部一致性系数与SRM之间关系的强度进行量化。
所有工具的内部一致性系数与SRM之间均发现强至完全相关（0.90 - 1.00），这表明两者可以互换使用。
结果与反应度是一种独立的心理测量属性这一观点相矛盾。内部一致性系数充分反映了一种工具对随时间变化的潜在敏感性。
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