Department of Clinical Science and Education, Section of Orthopedics, Karolinska Institute, Södersjukhuset, Stockholm, Sweden.
Qual Life Res. 2011 May;20(4):513-21. doi: 10.1007/s11136-010-9784-4. Epub 2010 Nov 12.
The aim of this study was to evaluate the internal and external responsiveness of the Short Musculoskeletal Function Assessment (SMFA), i.e. the instrument's ability to capture clinically important changes, in patients with hip fractures within the context of a randomized controlled trial.
To evaluate the internal responsiveness of the SMFA, the observed change and the standardized response mean (SRM) in relation to the change in the Dysfunction Index and the Bother Index were calculated. In order to calculate external responsiveness, an external criterion (EC) was constructed by using the Harris hip score. Receiver operating characteristic (ROC) curves and logistic regression analysis were used in the evaluation.
Both the Bother and the Dysfunction SMFA indices displayed good internal responsiveness as expressed by significant change scores and by moderate and large SRMs, 0.76 and 0.96, respectively. The ROC curve and logistic regression analyses showed that both indices had acceptable external responsiveness and were able to discriminate between patients with a less good outcome versus a moderately good or good outcome based on the EC while the ability to differ between patients with moderately good versus a good outcome was limited. The percentage of correctly classified cases was 64% (good/moderately good), 80% (good/less good), and 74% (moderately good/less good) for both the Dysfunction and Bother Indices.
The SMFA had good overall responsiveness in patients with hip fractures and, based on our results, we conclude that the SMFA can be recommended for use as one of the measures to evaluate the outcome after a hip fracture.
本研究旨在评估短期肌肉骨骼功能评估（SMFA）的内部和外部反应能力，即在一项随机对照试验中，该仪器捕捉髋部骨折患者临床重要变化的能力。
为了评估 SMFA 的内部反应能力，计算了与功能障碍指数和困扰指数变化相关的观察到的变化和标准化反应均值（SRM）。为了计算外部反应能力，使用 Harris 髋关节评分构建了外部标准（EC）。在评估中使用了接收者操作特征（ROC）曲线和逻辑回归分析。
困扰和功能障碍 SMFA 指数都表现出良好的内部反应能力，表现为显著的变化分数和中等至大的 SRM，分别为 0.76 和 0.96。ROC 曲线和逻辑回归分析表明，这两个指数都具有可接受的外部反应能力，能够根据 EC 区分预后较差的患者与预后较好或中等的患者，而区分预后较好与预后中等的患者的能力有限。基于 EC，正确分类病例的百分比为 64%（良好/中等良好）、80%（良好/较差）和 74%（中等良好/较差），对于功能障碍和困扰指数都是如此。
SMFA 在髋部骨折患者中具有良好的整体反应能力，根据我们的结果，我们得出结论，SMFA 可以推荐作为评估髋部骨折后结果的措施之一。
