Duke University Medical Center, Durham, NC 27705, USA.
Am J Phys Med Rehabil. 2012 Jun;91(6):511-8. doi: 10.1097/PHM.0b013e3182555e4c.
This study examined the accuracy of new wheelchair user predictions about their future wheelchair use.
This was a prospective cohort study of 84 community-dwelling veterans provided a new manual wheelchair.
The association between predicted and actual wheelchair use was strong at 3 mos (ϕ coefficient = 0.56), with 90% of those who anticipated using the wheelchair at 3 mos still using it (i.e., positive predictive value = 0.96) and 60% of those who anticipated not using it indeed no longer using the wheelchair (i.e., negative predictive value = 0.60, overall accuracy = 0.92). Predictive accuracy diminished over time, with overall accuracy declining from 0.92 at 3 mos to 0.66 at 6 mos. At all time points, and for all types of use, patients better predicted use as opposed to disuse, with correspondingly higher positive than negative predictive values. Accuracy of prediction of use in specific indoor and outdoor locations varied according to location.
This study demonstrates the importance of better understanding the potential mismatch between the anticipated and actual patterns of wheelchair use. The findings suggest that users can be relied upon to accurately predict their basic wheelchair-related needs in the short-term. Further exploration is needed to identify characteristics that will aid users and their providers in more accurately predicting mobility needs for the long-term.
本研究旨在检验新轮椅使用者对未来轮椅使用情况的预测准确性。
这是一项前瞻性队列研究，纳入 84 名居住在社区的退伍军人，为他们提供新的手动轮椅。
3 个月时，预测与实际轮椅使用之间的相关性较强（φ系数=0.56），90%预计在 3 个月内使用轮椅的患者仍在使用（即阳性预测值=0.96），60%预计不使用轮椅的患者确实不再使用（即阴性预测值=0.60，总体准确性=0.92）。随着时间的推移，预测准确性逐渐下降，3 个月时的总体准确性为 0.92，6 个月时为 0.66。在所有时间点，对于所有类型的使用情况，患者对使用的预测优于对不使用的预测，相应地，阳性预测值高于阴性预测值。对特定室内和室外使用地点的使用预测的准确性因地点而异。
本研究表明，更好地理解预期和实际轮椅使用模式之间潜在不匹配的重要性。研究结果表明，在短期内，用户可以准确预测他们的基本轮椅相关需求。需要进一步探索以确定哪些特征将有助于用户及其提供者更准确地预测长期的移动需求。
