Pouchot Jacques, Kherani Raheem B, Brant Rollin, Lacaille Diane, Lehman Allen J, Ensworth Stephanie, Kopec Jacek, Esdaile John M, Liang Matthew H
Arthritis Research Centre of Canada, Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada.
J Clin Epidemiol. 2008 Jul;61(7):705-13. doi: 10.1016/j.jclinepi.2007.08.016. Epub 2008 Mar 21.
To estimate the minimal clinically important difference (MCID) of seven measures of fatigue in rheumatoid arthritis.
A cross-sectional study design based on interindividual comparisons was used. Six to eight subjects participated in a single meeting and completed seven fatigue questionnaires (nine sessions were organized and 61 subjects participated). After completion of the questionnaires, the subjects had five one-on-one 10-minute conversations with different people in the group to discuss their fatigue. After each conversation, each patient compared their fatigue to their conversational partners on a global rating. Ratings were compared to the scores of the fatigue measures to estimate the MCID. Both nonparametric and linear regression analyses were used.
Nonparametric estimates for the MCID relative to "little more fatigue" tended to be smaller than those for "little less fatigue." The global MCIDs estimated by linear regression were: Fatigue Severity Scale, 20.2; Vitality scale of the MOS-SF36, 14.8; Multidimensional Assessment of Fatigue, 18.7; Multidimensional Fatigue Inventory, 16.6; Functional Assessment of Chronic Illness Therapy-Fatigue, 15.9; Chalder Fatigue Scale, 9.9; 10-point numerical Rating Scale, 19.7, for normalized scores (0-100). The standardized MCIDs for the seven measures were roughly similar (0.67-0.76).
These estimates of MCID will help to interpret changes observed in a fatigue score and will be critical in estimating sample size requirements.
评估类风湿关节炎中七种疲劳测量指标的最小临床重要差异（MCID）。
采用基于个体间比较的横断面研究设计。6至8名受试者参加一次会议，并完成七份疲劳问卷（共组织了9次会议，61名受试者参与）。问卷完成后，受试者与组内不同人员进行了5次一对一的10分钟交谈，以讨论他们的疲劳情况。每次交谈后，每位患者在整体评分中将自己的疲劳程度与交谈对象进行比较。将这些评分与疲劳测量指标的得分进行比较，以评估MCID。同时使用了非参数分析和线性回归分析。
相对于“稍多一点疲劳”的MCID的非参数估计值往往小于相对于“稍少一点疲劳”的估计值。通过线性回归估计的总体MCID为：疲劳严重程度量表，20.2；MOS-SF36活力量表，14.8；多维疲劳评估量表，18.7；多维疲劳量表，16.6；慢性病治疗功能评估-疲劳量表，15.9；查尔德疲劳量表，9.9；10分数字评分量表，19.7（针对标准化分数，范围为0-100）。这七种测量指标的标准化MCID大致相似（0.67-0.76）。
这些MCID估计值将有助于解释疲劳评分中观察到的变化，并且在估计样本量需求方面至关重要。
