Morris C, Kurinczuk J J, Fitzpatrick R, Rosenbaum P L
National Perinatal Epidemiology Unit, Old Road Campus, University of Oxford, Oxford OX3 7LF, UK.
Arch Dis Child. 2006 Aug;91(8):675-9. doi: 10.1136/adc.2005.090597. Epub 2006 Apr 25.
To determine the reliability of family assessment for the Gross Motor Function Classification System (GMFCS) for children with cerebral palsy in the UK.
Families of a complete geographically defined population of children with cerebral palsy between 6 and 12 years old were identified from the 4Child epidemiological database. Postal surveys were conducted with the families and any of the child's health professionals that were nominated by the families.
Families of 129/314 eligible children took part in the study (41%). The indices of agreement and reliability between families and professionals were also equivalent to those observed between the professionals (kappa = 0.5, ICC > or = 0.9). Reliability coefficients were higher when more of the professionals classified children using direct observation rather than only reviewing their clinical records.
Despite excellent reliability, families and professionals did not always agree exactly on a child's GMFCS level. Classifications may differ due to children's varying performance in different environments, in which case families will almost certainly know their children's ability in a broader range of settings. The indices of reliability of family assessment for the GMFCS meet the recommended criteria for use with individuals and groups, indicating that the method is suitable for use in research studies and clinical practice.
确定英国脑瘫儿童粗大运动功能分类系统（GMFCS）家庭评估的可靠性。
从4Child流行病学数据库中识别出6至12岁脑瘫儿童完整地理定义人群的家庭。对这些家庭以及家庭提名的儿童任何健康专业人员进行邮寄调查。
129/314名符合条件儿童的家庭参与了研究（41%）。家庭与专业人员之间的一致性和可靠性指标也与专业人员之间观察到的指标相当（kappa = 0.5，组内相关系数≥0.9）。当更多专业人员通过直接观察而非仅查看临床记录对儿童进行分类时，可靠性系数更高。
尽管可靠性极佳，但家庭和专业人员对儿童的GMFCS水平并不总是完全一致。分类可能因儿童在不同环境中的表现不同而有所差异，在这种情况下，家庭几乎肯定更了解孩子在更广泛环境中的能力。GMFCS家庭评估的可靠性指标符合针对个体和群体使用的推荐标准，表明该方法适用于研究和临床实践。
