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自我报告在确定脊髓损伤患者 S4-5 感觉和运动功能方面的诊断准确性。

The diagnostic accuracy of self-report for determining S4-5 sensory and motor function in people with spinal cord injury.

机构信息

Rehabilitation Studies Unit, Northern Clinical School, Sydney School of Medicine, University of Sydney, Sydney, New South Wales, Australia.

出版信息

Spinal Cord. 2012 Feb;50(2):119-22. doi: 10.1038/sc.2011.121. Epub 2011 Oct 11.

Abstract

STUDY DESIGN

A diagnostic accuracy study.

OBJECTIVES

The objective was to determine the ability of people with SCI to accurately self-report S4-5 sensory and motor function.

SETTING

Outpatient clinic, Sydney, Australia.

METHODS

A consecutive series of thirty-four people who had sustained a SCI more than 1 year before the study, and who were attending an outpatient medical clinic were recruited. They were assessed on two occasions. On the first occasion, ability to self-report S4-5 sensory and motor function was assessed with four questions. On the second occasion, a rehabilitation physician performed a physical examination to determine participants' S4-5 sensory and motor function. The rehabilitation physician was unaware of the results of participants' self-report. Participants' self-reports were compared with results from the physical examination using likelihood ratios.

RESULTS

The likelihood ratios (95% CI) associated with a positive response to the sensory and motor questions were 1.92 (1.0-3.6) and 2.4 (1.2-4.9), respectively. The likelihood ratios associated with a negative response to the sensory and motor questions were 0.1 (0.0-0.6) and 0.4 (0.1-1.2), respectively.

CONCLUSION

People with SCI are reasonably accurate at self-reporting S4-5 sensory and motor function, although there is a high rate of false positives for S4-5 motor in those with motor levels below T10. In some situations it may be appropriate to use self-report rather than a physical examination to determine S4-5 sensory and motor function.

摘要

研究设计

一项诊断准确性研究。

目的

旨在确定 SCI 患者准确自我报告 S4-5 感觉和运动功能的能力。

地点

澳大利亚悉尼的门诊诊所。

方法

连续招募了 34 名在研究前 1 年以上患有 SCI 且正在就诊的门诊患者。他们在两次就诊时接受评估。在第一次就诊时,使用四个问题评估他们自我报告 S4-5 感觉和运动功能的能力。在第二次就诊时,康复医师进行体格检查以确定参与者的 S4-5 感觉和运动功能。康复医师不知道参与者自我报告的结果。使用似然比将参与者的自我报告与体格检查的结果进行比较。

结果

与对感觉和运动问题的阳性反应相关的似然比(95%CI)分别为 1.92(1.0-3.6)和 2.4(1.2-4.9)。与对感觉和运动问题的阴性反应相关的似然比分别为 0.1(0.0-0.6)和 0.4(0.1-1.2)。

结论

SCI 患者在自我报告 S4-5 感觉和运动功能方面相当准确,但对于运动水平低于 T10 的患者,S4-5 运动的假阳性率较高。在某些情况下,使用自我报告而不是体格检查来确定 S4-5 感觉和运动功能可能是合适的。

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