Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, USA.
Arch Phys Med Rehabil. 2009 Dec;90(12):2116-24. doi: 10.1016/j.apmr.2009.06.020.
Cheville AL, Basford JR, Troxel AB, Kornblith AB. Performance of common clinician- and self-report measures in assessing the function of community-dwelling people with metastatic breast cancer.
To characterize the performance of common clinician- and self-report measures of function in assessing community-dwelling people with metastatic breast cancer.
Cross-sectional study.
A tertiary medical center outpatient cancer clinic.
A consecutive sample of community-dwelling patients (N=163) with stage IV breast cancer.
Not applicable.
Medical Outcomes Study 36-Item Short-Form Physical Functioning (PF-10) and Role Physical subscales; the Older Americans Resource Study (OARS) activities of daily living (ADL) and instrumental ADL subscales; Karnofsky Performance Scale (KPS); and the FIM Total and FIM Mobility scores.
With the exception of the PF-10 and Role Physical subscales, which demonstrated floor effects, ceiling effects were detected in all the measures and were particularly persistent in the OARS ADL subscale. Instrument and item score distributions varied markedly across KPS-defined subgroups with FIM Mobility, FIM Total, and OARS subscale score distributions deviating least from the normal in the lowest performing (KPS 40-50) participants. Correlations between self-reported (Role Physical subscales, PF-10, OARS ADL subscales) and the clinician-rated (KPS and FIM scales) scales were moderate to high (r=.55-.82); however, clinician-reported scores were more consistently associated with the presence of physical impairments.
In this population with stage IV breast cancer, ceiling effects limit the discriminatory capacity of the common functional scales assessed in this study. Instruments and items, particularly when ADL based, tend to perform better at lower levels of function (KPS 40-50) and less well at higher levels. Clinician-rated outcomes may have greater capacity to discriminate the presence of physical impairments.
Cheville AL、Basford JR、Troxel AB、Kornblith AB。评估社区居住的转移性乳腺癌患者功能的常用临床医生和自我报告措施的表现。
描述评估社区居住的转移性乳腺癌患者功能的常用临床医生和自我报告措施的表现。
横断面研究。
三级医疗中心门诊癌症诊所。
连续样本的社区居住患者（N=163）患有 IV 期乳腺癌。
不适用。
医疗结果研究 36 项简短形式物理功能（PF-10）和角色物理子量表；老年人资源研究（OARS）日常生活活动（ADL）和工具性 ADL 子量表；卡诺夫斯基表现量表（KPS）；以及 FIM 总分和 FIM 运动评分。
除了 PF-10 和角色物理子量表表现出地板效应外，所有测量都检测到天花板效应，并且在 OARS ADL 子量表中特别持久。仪器和项目得分分布在 KPS 定义的亚组之间差异很大，FIM 移动性、FIM 总分和 OARS 子量表得分分布在表现最差的（KPS 40-50）参与者中与正态分布偏差最小。自我报告（角色物理子量表、PF-10、OARS ADL 子量表）与临床医生评定（KPS 和 FIM 量表）量表之间的相关性为中度至高度（r=.55-.82）；然而，临床医生报告的评分更一致地与身体损伤的存在相关。
在患有 IV 期乳腺癌的人群中，天花板效应限制了本研究中评估的常用功能量表的区分能力。仪器和项目，特别是基于 ADL 的，在功能较低的水平（KPS 40-50）表现较好，而在较高水平表现较差。临床医生评定的结果可能更有能力区分身体损伤的存在。
