Gallizzi Michael, Gagnon Christine, Harden R Norman, Stanos Steven, Khan Anjum
Center for Pain Studies, Rehabilitation Institute of Chicago, Northwestern University, Chicago, Illinois 60611, USA.
Pain Pract. 2008 Jan-Feb;8(1):1-4. doi: 10.1111/j.1533-2500.2007.00163.x.
We report an internal validation of the Medication Quantification Scale (MQS III) using a chronic pain population. The MQS was designed as a methodology of quantifying different drug regimens in 1992, updated in 1998 (MQS II), and again updated in 2003 (MQS III) using "detriment" weights determined by surveying physician members of the American Pain Society. The MQS has been used as a unitary clinical and research outcome.
A retrospective chart review was collected from 400 patients in an interdisciplinary outpatient chronic pain clinic. A linear regression equation was developed using the patients' composite MQS III score, and those values were used in a Pearson correlation analysis.
The correlation between the subjects' computed regression detriment weights and the corresponding MQS III detriment weights yielded a significant result (r = 0.962, P < 0.01; two-tailed).
Our chronic pain sample-derived detriment weights did differ in some drug classes from that of the physician consensus, most notably the selective serotonin reuptake inhibitor, Opioid Schedule II, and NSAID class detriment. It is necessary to periodically resurvey large groups of physicians in order to control and modify the detriment weights of our categories in light of new information about detrimental effects (eg, COX-2 inhibitors), or to accommodate medical or political changes in prescribing habits (eg, more liberal opioid prescribing in the later years). This work suggests it may also be important to assess patients' perspective on detriment, as well as statistical and empiric use patterns.
我们报告了使用慢性疼痛患者群体对药物量化量表（MQS III）进行的内部验证。MQS于1992年设计为一种量化不同药物治疗方案的方法，1998年进行了更新（MQS II），并于2003年再次更新（MQS III），使用了通过对美国疼痛学会医生会员进行调查确定的“损害”权重。MQS已被用作单一的临床和研究结果。
从一家跨学科门诊慢性疼痛诊所收集了400例患者的回顾性病历。使用患者的综合MQS III评分建立线性回归方程，并将这些值用于Pearson相关分析。
受试者计算的回归损害权重与相应的MQS III损害权重之间的相关性产生了显著结果（r = 0.962，P < 0.01；双侧）。
我们从慢性疼痛样本得出的损害权重在某些药物类别上与医生共识有所不同，最明显的是选择性5-羟色胺再摄取抑制剂、阿片类药物附表II和非甾体抗炎药类别的损害。有必要定期对大量医生进行重新调查，以便根据有关有害影响的新信息（例如COX-2抑制剂）控制和修改我们类别的损害权重，或适应处方习惯的医学或政策变化（例如，后期阿片类药物处方更加宽松）。这项工作表明，评估患者对损害的看法以及统计和经验性使用模式也可能很重要。
