Bols E M J, Hendriks H J M, Berghmans L C M, Baeten C G M I, de Bie R A
Department of Epidemiology, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre, PO Box 616, 6200 MD Maastricht, The Netherlands.
Int Urogynecol J. 2013 Mar;24(3):469-78. doi: 10.1007/s00192-012-1886-9. Epub 2012 Jul 18.
This study aims to assess the responsiveness and interpretability of the Vaizey score, Wexner score, and the Fecal Incontinence Quality of Life Scale (FIQL) for use in the evaluation of patients with fecal incontinence (FI).
Eighty patients with FI with a mean age of 59.3 (SD ± 11.9) were enrolled in a randomized controlled trial. The patient-reported outcomes were tested for internal and external responsiveness, longitudinal construct validity, and interpretability.
All total scores proved to have both adequate to excellent responsiveness and longitudinal construct validity, and changes were in agreement with subjective improvement. Due to variability in minimally important change estimates (Vaizey score -5 to -3, Wexner score -3 to -2, FIQL 1.1 to 1.2), they should be used as indicators. All patient-reported outcomes showed psychometric or practical limitations.
The instruments available to date to evaluate severity and quality of life in FI do not yet attain the highest levels of psychometric soundness. As the focus of patients may differ from that of physicians, it is recommended that several measures should be included for evaluation. So far, there are suggestions that the Wexner score is most suitable for severity assessment and the FIQL for evaluating quality of life.
本研究旨在评估用于评估大便失禁（FI）患者的Vaizey评分、Wexner评分及大便失禁生活质量量表（FIQL）的反应性和可解释性。
80例平均年龄为59.3岁（标准差±11.9）的FI患者被纳入一项随机对照试验。对患者报告的结局进行内部和外部反应性、纵向结构效度及可解释性测试。
所有总分均显示出充分至优异的反应性和纵向结构效度，且变化与主观改善情况相符。由于最小重要变化估计值存在差异（Vaizey评分为-5至-3，Wexner评分为-3至-2，FIQL为1.1至1.2），故应将其用作指标。所有患者报告的结局均显示出心理测量或实际方面的局限性。
目前可用于评估FI严重程度和生活质量的工具尚未达到心理测量健全性的最高水平。由于患者的关注点可能与医生不同，建议纳入多种测量方法进行评估。到目前为止，有建议认为Wexner评分最适合用于严重程度评估，而FIQL适合用于评估生活质量。
