Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada.
Spine (Phila Pa 1976). 2010 Mar 1;35(5):568-77. doi: 10.1097/BRS.0b013e3181b9c9c0.
Cross-sectional measurement study.
To analyze the score distribution of the Scoliosis Research Society (SRS)-22 questionnaire domains and items for patients with idiopathic scoliosis (IS) of all ages.
Scoliosis-related quality-of-life questionnaires have demonstrated high ceiling effects in younger patients. However, the score distribution has not been examined thoroughly in other clinically relevant IS subgroups.
The SRS-22 was completed by 173 females with IS. The proportions of ceiling effects, floor effects, of patients scoring greater than or equal to 4 out of 5 and the box plots of the score distribution for each domain and item were compared between subgroups. Subgroups were formed based on age (k = 4), management (k = 6), curve severity (k = 3), and curve type (k = 4).
Domain ceiling effects varied between 0% and 23.1%. Domain floor effects were observed only for Self-image (<7%) and Satisfaction (<12%). Only Pain and Satisfaction showed moderate (>20%) ceiling effects. Ceiling effects for Pain and Mental Health decreased with increasing age (P < 0.05). Pain ceiling effects decreased and Satisfaction ceiling effects increased from least to most invasive management (P < 0.05), but no differences were found among Cobb severity or curve types subgroups. Of the 22 items, 9 had major (>or=50%) ceiling effects and 11 had moderate ceiling effects. Most subgroups (14/16) had 4 to 6 items with major ceiling effects. The following items had major ceiling effects in the majority of subgroups: Function, 9 and 15; Pain, 11 and 17; and Self-image, 14.
Most SRS-22 domains had acceptable levels of ceiling effects (<20%) in the majority of the subgroups examined. However, more sensitive measurements may be needed to supplement the SRS-22 in assessing Pain in patients below 18 years or Satisfaction after surgery.
横断面测量研究。
分析各年龄段特发性脊柱侧凸（IS）患者 Scoliosis Research Society（SRS）-22 问卷各领域和项目的评分分布。
脊柱相关生活质量问卷在年轻患者中表现出较高的天花板效应。然而，在其他临床相关 IS 亚组中，评分分布尚未得到充分研究。
173 名女性 IS 患者完成了 SRS-22。比较了各领域和项目的天花板效应比例、地板效应比例、评分大于等于 4 分的患者比例，以及各领域和项目的评分分布箱线图，亚组根据年龄（k = 4）、管理（k = 6）、曲线严重程度（k = 3）和曲线类型（k = 4）分组。
领域天花板效应在 0%到 23.1%之间变化。仅在自我形象（<7%）和满意度（<12%）领域观察到地板效应。仅疼痛和满意度有中度（>20%）天花板效应。随着年龄的增长，疼痛和心理健康的天花板效应降低（P < 0.05）。疼痛天花板效应从最少到最具侵入性的管理方式降低，满意度天花板效应增加（P < 0.05），但在 Cobb 严重程度或曲线类型亚组中没有差异。在 22 个项目中，有 9 个有较大（>或=50%）的天花板效应，11 个有中度天花板效应。大多数亚组（14/16）有 4 到 6 个项目有较大的天花板效应。以下项目在大多数亚组中具有较大的天花板效应：功能，9 和 15；疼痛，11 和 17；自我形象，14。
在大多数检查的亚组中，大多数 SRS-22 领域的天花板效应（<20%）处于可接受水平。然而，可能需要更敏感的测量来补充 SRS-22，以评估 18 岁以下患者的疼痛或手术后的满意度。
