Davidson Megan
School of Physiotherapy, La Trobe University, Vic. 3058, Australia.
Man Ther. 2008 Jun;13(3):222-31. doi: 10.1016/j.math.2007.01.008. Epub 2007 Mar 23.
The purpose of the study was to explore the construct validity of three versions of the Oswestry Disability Questionnaire for low back pain using Rasch analysis. The three versions of the ODQ share 9 items and differ on one other. About 100 patients with non-specific low back pain seeking physiotherapy treatment at hospital outpatient departments and physiotherapy private practices completed the 12 Oswestry items as part of a battery of questionnaires. Rasch analysis revealed that four items (Personal Care, Standing, Sex Life and Social Life) had disordered response thresholds and one item (Walking) showed differential item functioning by age. The 10 standard Oswestry items and a modified version in which Sex Life is replaced by Work/Housework showed adequate overall fit to the Rasch model (chi(2)P>.01). The third version, in which Sex Life is replaced by Changing Degree of Pain, did not fit the model (chi(2)P=.006) and the Changing Degree of Pain item was misfitting (residual 2.34, P=.007). These findings suggest that either of the first two of the three versions of this widely used low back pain outcome measure should be selected over the third. Users should also be aware that for some items the rating scale steps do not perform as intended.
本研究的目的是使用拉施分析来探索三种版本的奥斯维斯特里腰痛残疾问卷的结构效度。奥斯维斯特里腰痛残疾问卷的三个版本共有9个项目,另一个项目不同。约100名在医院门诊部和私人理疗诊所寻求理疗的非特异性腰痛患者完成了12项奥斯维斯特里问卷项目,作为一系列问卷的一部分。拉施分析显示,四个项目(个人护理、站立、性生活和社会生活)的反应阈值无序,一个项目(行走)在年龄方面显示出项目功能差异。10个标准的奥斯维斯特里项目以及将性生活替换为工作/家务的修改版本总体上与拉施模型拟合良好(卡方检验P>.01)。第三个版本将性生活替换为疼痛程度变化,不符合该模型(卡方检验P=.006),且疼痛程度变化项目拟合不佳(残差2.34,P=.007)。这些发现表明,在这三种版本中,应选择前两种版本中的任何一种,而不是第三种。使用者还应意识到,对于某些项目,评分量表步骤的表现并不符合预期。