选择用于评估大便失禁治疗效果的结局指标。

Selecting an outcome measure for evaluating treatment in fecal incontinence.

作者信息

Deutekom Marije, Terra Maaike P, Dobben Annette C, Dijkgraaf Marcel G W, Felt-Bersma Richelle J F, Stoker Jaap, Bossuyt Patrick M M

机构信息

Department of Clinical Epidemiology and Biostatistics, Academic Medical Center, Amsterdam, The Netherlands.

出版信息

Dis Colon Rectum. 2005 Dec;48(12):2294-301. doi: 10.1007/s10350-005-0162-1.

DOI:10.1007/s10350-005-0162-1

PMID:16400514

Abstract

PURPOSE

Various outcome measures exist to evaluate treatment in fecal incontinence, including descriptive, severity (fecal incontinence scoring systems), and impact (quality-of-life questionnaires) and diagnostic measures. We studied associations between changes after treatment for a number of outcome measures and compared them to patients' subjective perception of relief.

METHODS

We analyzed data of 66 patients (92 percent female; mean age, 62 years) (Vaizey score, Wexner score, two impact scales, utility, resting pressure, and maximal incremental squeeze pressure) at baseline and after physiotherapy. In a standardized interview by phone, we asked patients to compare their situation before and after treatment. Correlations between changes in outcome measures were calculated. These changes were compared with patients' subjective perception.

RESULTS

There was a high correlation between the changes in the Vaizey and the Wexner scores (r = 0.94, P < 0.01). Changes in Vaizey and Wexner scores correlated moderately with changes in maximum incremental squeeze pressure (r = -0.29, -0.30, both P < 0.05). Changes in utility and resting pressure were not correlated with changes in any of the other measurements (all r values between -0.086 and 0.18). Average severity scores (Vaizey and Wexner) were 1 point lower for patients who rated their situation as worse or equal (62 percent), 4 points lower for patients who reported their situation to be better (21 percent), and 9 points lower in patients who rated their situation much better (17 percent) (P < .05).

CONCLUSION

Severity measures are best related to patients' subjective perception of relief.

摘要

目的

存在多种结局指标来评估大便失禁的治疗效果，包括描述性指标、严重程度（大便失禁评分系统）、影响（生活质量问卷）以及诊断指标。我们研究了多种结局指标治疗后的变化之间的关联，并将其与患者对缓解情况的主观感受进行比较。

方法

我们分析了66例患者（92%为女性；平均年龄62岁）在基线时以及接受物理治疗后的数据（Vaizey评分、Wexner评分、两个影响量表、效用、静息压力和最大增量挤压压力）。在一次标准化电话访谈中，我们要求患者比较治疗前后的情况。计算结局指标变化之间的相关性。将这些变化与患者的主观感受进行比较。

结果

Vaizey评分和Wexner评分的变化之间存在高度相关性（r = 0.94，P < 0.01）。Vaizey评分和Wexner评分的变化与最大增量挤压压力的变化中度相关（r = -0.29，-0.30，P均< 0.05）。效用和静息压力的变化与其他任何测量指标的变化均无相关性（所有r值在-0.086至0.18之间）。将自身情况评为更差或相同的患者，平均严重程度评分（Vaizey评分和Wexner评分）低1分（62%）；报告情况有所改善的患者，平均严重程度评分低4分（21%）；将自身情况评为改善很多的患者，平均严重程度评分低9分（17%）（P <.05）。