Health and Rehabilitation Sciences, University of Western Ontario, London, Ontario, Canada.
J Orthop Sports Phys Ther. 2013 Apr;43(4):263-74. doi: 10.2519/jospt.2013.4029. Epub 2013 Mar 13.
Prospective cohort study.
To evaluate the internal consistency, concurrent construct validity, longitudinal validity, sensitivity to change, and factor structure of the Patient-Rated Elbow Evaluation form (PREE), the patient-reported form of the American Shoulder and Elbow Surgeons Elbow Questionnaire (pASES-e), and the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH) in a diverse group of patients who had surgery for various elbow pathologies.
Measuring functional outcomes after surgical procedures of the elbow requires valid patient-reported pain and disability questionnaires. The PREE, the pASES-e, and the DASH are commonly used questionnaires. There is, however, insufficient evidence available concerning their validity and sensitivity to change.
Data were prospectively collected from 128 patients (mean ± SD age, 46.5 ± 12.8 years) post-elbow surgery. Patients completed the PREE, the pASES-e, the DASH, and the Medical Outcomes Study 36-Item Short-Form Health Survey at baseline (first visit after surgery) and 6 months postsurgery. Concurrent construct validity, longitudinal validity, sensitivity to change, and factor structure were analyzed.
Concurrent construct validity was demonstrated by confirmation of expected relationships; the strongest correlations were observed between the PREE pain score, the PREE total score, the pASES-e pain score, and the DASH score (r = 0.73-0.87). The pASES-e function score correlated the least with other constructs. Longitudinal validity demonstrated similar findings: the pASES-e pain change score and PREE change score were most strongly correlated, and the pASES-e function change score and DASH change score were moderately to weakly correlated. All 3 patient-reported questionnaires demonstrated a large effect size and standardized response means greater than 1.0. Structural validity was supported for the PREE (R2 = 77.2%, 4 factors) and the pASES-e (R2 = 74.4%, 4 factors), but not for the DASH (R2 = 71.3%, 5 factors).
The PREE, the pASES-e, and the DASH have acceptable validity and sensitivity to change. The pASES-e function subscale is the least sensitive to change and is less correlated to other measures.
前瞻性队列研究。
评估患者自评肘部评估表（PREE）、美国肩肘外科医师协会肘部问卷（pASES-e）患者报告表和手臂、肩部和手部残疾问卷（DASH）在接受各种肘部病变手术的患者中的内部一致性、同期构念效度、纵向效度、变化敏感性和结构效度。
测量肘部手术后的功能结果需要有效的患者报告疼痛和残疾问卷。PREE、pASES-e 和 DASH 是常用的问卷。但是，它们的有效性和变化敏感性的证据不足。
从 128 例肘部手术后患者（平均年龄 ± 标准差，46.5 ± 12.8 岁）前瞻性收集数据。患者在基线（手术治疗后首次就诊）和 6 个月时完成 PREE、pASES-e、DASH 和医疗结局研究 36 项简明健康调查问卷。分析了同期构念效度、纵向效度、变化敏感性和结构效度。
通过证实预期关系证明了同期构念效度；PREE 疼痛评分、PREE 总分、pASES-e 疼痛评分和 DASH 评分之间观察到最强的相关性（r = 0.73-0.87）。pASES-e 功能评分与其他结构的相关性最小。纵向效度也得出了相似的发现：pASES-e 疼痛变化评分和 PREE 变化评分相关性最强，而 pASES-e 功能变化评分和 DASH 变化评分呈中度至弱相关性。所有 3 种患者报告问卷的效应量较大，标准化反应均值均大于 1.0。PREE（R2 = 77.2%，4 个因素）和 pASES-e（R2 = 74.4%，4 个因素）支持结构效度，但 DASH（R2 = 71.3%，5 个因素）不支持。
PREE、pASES-e 和 DASH 具有可接受的有效性和变化敏感性。pASES-e 功能分量表对变化的敏感性最低，与其他测量方法的相关性也较低。
