Weisscher N, Post B, de Haan R J, Glas C A W, Speelman J D, Vermeulen M
Department of Neurology, H2-236 Academic Medical Center, 1105 AZ Amsterdam, The Netherlands.
Neurology. 2007 Dec 4;69(23):2155-61. doi: 10.1212/01.wnl.0000295666.30948.9d.
The aim of this study was to examine the clinimetric properties of the AMC Linear Disability Score (ALDS), a new generic disability measure based on Item Response Theory, in patients with newly diagnosed Parkinson disease (PD).
A sample of 132 patients with PD was evaluated using the Hoehn and Yahr (H&Y), the Unified PD Rating Scale motor examination, the Schwab and England scale (S&E), the Short Form-36, the PD Quality of Life Questionnaire, and the ALDS.
The internal consistency reliability of the ALDS was good (alpha = 0.95) with 55 items extending the sufficient item-total correlation criterion (r > 0.20). The ALDS was correlated with other disability measures (r = 0.50 to 0.63) and decreasingly associated with measures reflecting impairments (r = 0.36 to 0.37) and mental health (r = 0.23 to -0.01). With regard to know-group validity, the ALDS indicated that patients with more severe PD (H&Y stage 3) were more disabled than patients with mild (H&Y stage 1) or moderate PD (H&Y stage 2) (p < 0.0001). The ALDS discriminated between more or less severe extrapyramidal symptoms (p = 0.001) and patients with postural instability showed lower ALDS scores compared to patients without postural instability (p = or< 0.0001). Compared to the S&E (score 100% = 19%), the ALDS showed less of a ceiling effect (5%).
The AMC Linear Disability Score is a flexible, feasible, and clinimetrically promising instrument to assess the level of disability in patients with newly diagnosed Parkinson disease.
本研究旨在检验AMC线性残疾评分（ALDS）的临床测量特性，ALDS是一种基于项目反应理论的新型通用残疾测量方法，用于新诊断的帕金森病（PD）患者。
使用Hoehn和Yahr（H&Y）量表、统一PD评定量表运动检查、Schwab和England量表（S&E）、简短健康调查问卷-36、PD生活质量问卷和ALDS对132例PD患者进行评估。
ALDS的内部一致性信度良好（α = 0.95），55个项目符合足够的项目-总分相关标准（r > 0.20）。ALDS与其他残疾测量方法相关（r = 0.50至0.63），与反映损伤的测量方法（r = 0.36至0.37）和心理健康（r = 0.23至 -0.01）的相关性逐渐降低。关于已知组效度，ALDS表明，重度PD（H&Y分期3期）患者比轻度（H&Y分期1期）或中度PD（H&Y分期2期）患者残疾程度更高（p < 0.0001）。ALDS能够区分或多或少严重的锥体外系症状（p = 0.001），与无姿势不稳的患者相比，有姿势不稳的患者ALDS得分更低（p =或< 0.0001）。与S&E量表（得分100% = 19%）相比，ALDS的天花板效应较小（5%）。
AMC线性残疾评分是一种灵活、可行且在临床测量方面有前景的工具，可用于评估新诊断帕金森病患者的残疾水平。
