Warshaw Erin M, Traywick Carmen A, Hoffman Allison A, Lilly Kia K, Koshnick Rebecca L, Robinson Janet W, Suwattee Pitiporn, Foster Jovonne K, Chen Suephy C
Department of Dermatology, University of Minnesota, Minneapolis, MN 55417, USA.
Mycoses. 2008 Jan;51(1):14-20. doi: 10.1111/j.1439-0507.2007.01444.x.
A valid and reliable measure that captures onychodystrophy disease severity is important for both clinical and research applications. Three hundred and twenty-two patients at two Veterans Affairs Medical Centers with clinical evidence of onychodystrophy suggesting onychomycosis (at least 25% in a distal subungual pattern) were examined using Naildex parameters. Naildex scores were calculated by a combination of: per cent of each nail infected, area of each nail and number of infected nails. Patients also completed a nail-specific quality of life questionnaire (NailQoL) and nail samples were collected and examined mycologically. Data was analysed for all enrolled patients (n = 322) and patients with mycologically-confirmed onychomycosis (n = 243). Inter-rater reliability was calculated from two examiners who each evaluated 17 patients with mycologically-confirmed onychomycosis. Significant correlations (P < 0.01) between Naildex and NailQoL as well as proxy measures (duration of infection) indicated construct validity of the instrument for all patients as well as mycologically-confirmed cases. Strong correlation (r = 0.754, P < 0.01, n = 17) indicated high inter-rate reliability. This pilot evaluation suggests that Naildex is a valid and reliable measure of onychomycosis severity.
一种有效且可靠的、能够反映甲营养不良疾病严重程度的测量方法对于临床和研究应用都很重要。在两个退伍军人事务医疗中心，对322例有甲营养不良临床证据提示甲癣（至少25%为远端甲下型）的患者使用Naildex参数进行了检查。Naildex评分通过以下因素综合计算得出：每只指甲的感染百分比、每只指甲的面积以及感染指甲的数量。患者还完成了一份特定于指甲的生活质量问卷（NailQoL），并采集了指甲样本进行真菌学检查。对所有入组患者（n = 322）和真菌学确诊为甲癣的患者（n = 243）的数据进行了分析。两名检查者对17例真菌学确诊为甲癣的患者进行了评估，并计算了评分者间信度。Naildex与NailQoL以及替代指标（感染持续时间）之间存在显著相关性（P < 0.01），表明该工具对所有患者以及真菌学确诊病例均具有结构效度。强相关性（r = 0.754，P < 0.01，n = 17）表明评分者间信度较高。这项初步评估表明，Naildex是一种有效且可靠的甲癣严重程度测量方法。
