Unité Rhumatologique des Affections de la Main (URAM), Hôpital Lariboisière, Assistance Publique Hôpitaux de Paris, Université Paris 7, Paris, France.
Arthritis Care Res (Hoboken). 2011 Oct;63(10):1448-55. doi: 10.1002/acr.20564.
To our knowledge, no functional outcome measure has been developed and validated for Dupuytren's disease. We aimed to develop and validate a patient-reported functional outcome measure for Dupuytren's disease.
Patients with Dupuytren's disease (n = 9) and medical experts (n = 7) provided input and opinions about limiting activities that were difficult to perform because of Dupuytren's disease for item generation. The provisional scale was studied in an independent sample of patients (n = 85) for item reduction according to response distribution, reliability, redundancy, and loading in a 1-factor solution. The final scale was evaluated as follows: reliability using Cronbach's alpha coefficient and test-retest intraclass correlation coefficient from the previous 85-patient population, and construct validity and responsiveness after needle aponeurotomy in another independent 53-patient sample. For construct validity, convergent validity and divergent validity were tested. The clinically important change was estimated relative to a 1-point categorical change on the Tubiana scale.
A 52-item provisional scale was generated and reduced to the final 9-item scale called the Unité Rhumatologique des Affections de la Main (URAM) scale (total score 0-45). The scale showed good to excellent reliability and suitable construct validity. The URAM score improved after needle aponeurotomy: the standardized effect size was 0.56. The estimated clinically important change of the URAM scale was 2.9 points.
We provide the first patient-reported functional measure for Dupuytren's disease. The URAM scale demonstrated suitable psychometric properties, and is short and convenient enough for easy use in daily practice and in clinical studies.
据我们所知，尚无针对掌腱膜挛缩症的功能结局测量方法。本研究旨在开发并验证一种掌腱膜挛缩症患者报告的功能结局测量方法。
掌腱膜挛缩症患者（n=9）和医学专家（n=7）为项目生成提供了因掌腱膜挛缩症而难以完成的限制活动的意见和建议。根据反应分布、可靠性、冗余度和 1 因素解中的载荷，对初步量表进行了独立样本患者（n=85）的项目减少研究。使用来自之前 85 例患者的 Cronbach's alpha 系数和测试-重测内部一致性系数评估最终量表的可靠性，使用另一独立的 53 例患者样本进行针切断腱后评估结构有效性和反应性。对于结构有效性，测试了收敛有效性和发散有效性。相对于 Tubiana 量表的 1 个分类变化，估计了临床重要变化。
生成了一个 52 项的初步量表，最后减少到最终的 9 项称为手部风湿病统一评定量表（URAM）（总分 0-45）。该量表显示出良好到优秀的可靠性和适当的结构有效性。针切断腱后 URAM 评分改善：标准化效应大小为 0.56。URAM 量表的估计临床重要变化为 2.9 分。
我们提供了第一个针对掌腱膜挛缩症的患者报告的功能测量方法。URAM 量表具有适当的心理测量特性，简短且便于使用，可在日常实践和临床研究中方便使用。
