Schmitt John, Di Fabio Richard P
College of St. Catherine, Minneapolis, MN, USA.
Arch Phys Med Rehabil. 2005 Dec;86(12):2270-6. doi: 10.1016/j.apmr.2005.07.290.
To assess the validity of retrospective versus prospective criterions of change.
Single cohort pretest-posttest design.
Physical or occupational therapy outpatient clinics.
Volunteer sample of 211 patients with upper-extremity musculoskeletal problems.
Not applicable.
Disabilities of the Arm, Shoulder, and Hand questionnaire, the Shoulder Pain and Disability Index, the Patient-Rated Wrist Evaluation, the Medical Outcomes Study 12-Item Short-Form Health Survey; global disability rating (GDR), retrospective global rating of change (GRC), and patient satisfaction.
Correlations were calculated among the baseline, 3-month follow-up, and change scores for each outcome measure with the change criterion instruments. Retrospective GRC and patient satisfaction ratings showed moderate correlations with the 3-month follow-up scores, but nonsignificant correlations with baseline scores. By contrast, the prospective GDR criterion showed significant correlations with both baseline and 3-month follow-up scores ranging between 0.3 and 0.4 (absolute value).
Retrospective self-report measures of change do not accurately reflect true change over time. The retrospective GRC and patient satisfaction were heavily influenced by current (posttreatment) status whereas the prospective global change measure reflected both baseline and posttreatment status equally and thus appeared to be a more valid measure of change over time. This study demonstrates the need for an alternative criterion for establishing true individual change.
评估回顾性与前瞻性变化标准的有效性。
单队列前后测设计。
物理治疗或职业治疗门诊。
211名上肢肌肉骨骼问题患者的志愿者样本。
不适用。
手臂、肩部和手部残疾问卷、肩痛和残疾指数、患者评定的腕关节评估、医学结局研究12项简短健康调查；整体残疾评定（GDR）、回顾性整体变化评定（GRC）和患者满意度。
计算了每个结局指标的基线、3个月随访和变化分数与变化标准工具之间的相关性。回顾性GRC和患者满意度评分与3个月随访分数呈中度相关，但与基线分数无显著相关性。相比之下，前瞻性GDR标准与基线和3个月随访分数均呈显著相关，绝对值在0.3至0.4之间。
回顾性自我报告的变化测量不能准确反映随时间的真实变化。回顾性GRC和患者满意度受当前（治疗后）状态的严重影响，而前瞻性整体变化测量同样反映了基线和治疗后状态，因此似乎是随时间变化的更有效测量方法。本研究表明需要一种替代标准来确定个体的真实变化。
