University Hospital Ramón y Cajal, Madrid, Spain.
Tech Coloproctol. 2013 Feb;17(1):67-71. doi: 10.1007/s10151-012-0884-8. Epub 2012 Aug 31.
The purpose of this study was to determine the probability of substituting two validated methods frequently used for scoring severity and quality of life of faecal incontinence (FI) by a single score represented in a visual analogue scale (VAS).
One hundred and three consecutive unselected patients affected by FI of different aetiologies were prospectively included in the study. Evaluation of the continence status and quality of life referred to the last month was scored by (1) Jorge-Wexner score, (2) Rockwood FIQL scale, (3) Visual Analogue Scale for Faecal Incontinence (VASFI), and (4) Visual Analogue Scale for Quality of Life (VASQL). Patients unable to respond accurately to one or more of the questionnaires were excluded. The Bland and Altman method was applied to evaluate the agreement between Jorge-Wexner and VASFI. Correlation between both the analogue scales (VASFI and VASQL) and each one with each of the four FIQL scale scores was first determined by an analysis of simple correlation with each subscale and thereafter by multiple regression analysis following the backward strategy.
Comparison of VASFI with the Jorge-Wexner score shows that the two methods are neither concordant nor interchangeable, and in a given patient, the differences between both may fluctuate between 5.4 and -10.6 (95 % confidence interval). Correlation of VASFI and VASQL shows that the correlation between both the analogue scales is middling (r (2) = 0.543, β coefficient -0.538). Correlation of VASFI and FIQL subscales shows that in simple regression analysis, VASFI correlates with lifestyle, coping/behaviour, and embarrassment, but after multiple regression analysis, VASFI correlates significantly only with embarrassment. Correlation of VASQL and FIQL subscales shows that in simple regression analysis, VASQL correlates with lifestyle, coping/behaviour, and embarrassment, but after multiple regression analysis, VASQL only correlates significantly with coping/behaviour.
This study shows that a VAS for FI cannot replace the Jorge-Wexner score and a VAS for quality of life cannot substitute all the four subscales of FIQL. Severity of FI and its impact on quality of life expressed in a VAS only have a fair correlation, showing that they do not assess the same issues, which is also supported by the finding that VASFI correlates significantly only with the embarrassment subscale of FIQL.
本研究旨在确定通过视觉模拟量表（VAS）表示的单一评分来替代两种常用于评分粪便失禁（FI）严重程度和生活质量的验证方法的可能性。
103 例不同病因的 FI 连续未选择患者前瞻性纳入研究。评估的控便状态和生活质量是指上个月的评分，评分方法分别为：（1）Jorge-Wexner 评分；（2）Rockwood FIQL 量表；（3）VASFI；（4）VASQL。排除无法准确回答一个或多个问卷的患者。采用 Bland 和 Altman 方法评估 Jorge-Wexner 和 VASFI 之间的一致性。首先通过与每个亚量表的简单相关分析，以及随后的向后策略的多元回归分析，确定两种模拟量表（VASFI 和 VASQL）之间以及与 FIQL 量表每个评分之间的相关性。
VASFI 与 Jorge-Wexner 评分的比较表明，两种方法既不一致也不可互换，在给定患者中，两者之间的差异可能在 5.4 到-10.6（95%置信区间）之间波动。VASFI 和 VASQL 的相关性表明，两种模拟量表之间的相关性中等（r(2)=0.543，β系数-0.538）。VASFI 与 FIQL 亚量表的相关性表明，在简单回归分析中，VASFI 与生活方式、应对/行为和尴尬相关，但在多元回归分析后，VASFI 仅与尴尬显著相关。VASQL 与 FIQL 亚量表的相关性表明，在简单回归分析中，VASQL 与生活方式、应对/行为和尴尬相关，但在多元回归分析后，VASQL 仅与应对/行为显著相关。
本研究表明，FI 的 VAS 不能替代 Jorge-Wexner 评分，而 VAS 对生活质量不能替代 FIQL 的所有四个亚量表。VAS 表示的 FI 严重程度及其对生活质量的影响仅具有中等相关性，表明它们不评估相同的问题，这也得到了 VASFI 仅与 FIQL 的尴尬亚量表显著相关的发现的支持。
