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下肢重建手术中患者报告结局测量的评估。

An evaluation of patient-reported outcome measures in lower limb reconstruction surgery.

机构信息

Centre for Health and Social Care Research, Sheffield Hallam University, Montgomery House, Collegiate Campus, Sheffield S10 2BP, UK.

出版信息

Qual Life Res. 2012 Dec;21(10):1731-43. doi: 10.1007/s11136-011-0090-6. Epub 2011 Dec 18.


DOI:10.1007/s11136-011-0090-6
PMID:22179990
Abstract

PURPOSE: To assess the measurement properties (acceptability, validity, reliability and responsiveness), of the MOS 36-Item Short-Form Health Survey (SF-36), the EQ-5D, the Short-Form McGill Pain Questionnaire (SF-MPQ) and the Musculoskeletal Functional Assessment Instrument (MFA), in patients who have undergone limb reconstruction surgery (LRS). METHODS: Four instruments measuring patient-reported outcome were completed at baseline and 12 months from surgery. RESULTS: 101 LRS patients were recruited with 95 responding at baseline and 71 at a 12-month follow-up. Response rates at baseline were over 94%. In three instruments, there was evidence of floor or ceiling effect, the exception being the EQ-5D. Cronbach's α statistics of internal consistency reliability were acceptable at ≥ 0.80 for all dimensions of the MFA, the SF-MPQ PRI(S) and seven of the SF-36 dimensions. When comparing mean changes in scores between baseline and 12 months, the most responsive measure was the SF-36 with an average Standardised Response Mean of 0.48 for those who reported their health as better. Statistically significant differences were observed between the health change groups ('worse', 'better' and 'same') for four dimensions of the SF-36, the two summary scores and the SF-6D. CONCLUSIONS: Variation and poor performance of some of the instruments resulted in a recommendation of using the SF-36 and the SF-6D for LRS patients.

摘要

目的:评估 MOS 36 项简短健康调查问卷(SF-36)、EQ-5D、简短麦吉尔疼痛问卷(SF-MPQ)和肌肉骨骼功能评估工具(MFA)在接受肢体重建手术(LRS)的患者中的测量特性(可接受性、有效性、可靠性和反应性)。 方法:在基线和手术 12 个月时,使用四种测量患者报告结果的工具进行评估。 结果:共招募了 101 名 LRS 患者,其中 95 名在基线时应答,71 名在 12 个月时随访。基线时的应答率超过 94%。在三种工具中,存在地板或天花板效应的证据,EQ-5D 除外。MFA 的所有维度、SF-MPQ PRI(S) 和 SF-36 的七个维度的内部一致性可靠性的 Cronbach's α 统计值均在≥0.80 时可接受。在比较基线和 12 个月时的评分平均变化时,SF-36 是最敏感的测量工具,对于报告健康状况改善的患者,其平均标准化反应均值为 0.48。在 SF-36 的四个维度、两个综合评分和 SF-6D 中,观察到健康变化组(“更差”、“更好”和“相同”)之间的统计学显著差异。 结论:一些工具的变异性和较差表现导致建议使用 SF-36 和 SF-6D 来评估 LRS 患者。

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