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在国民保健制度中扩大使用 PROMs--在接受膝关节骨关节炎非手术治疗的患者中使用牛津膝关节评分:一项验证研究。

Extending the use of PROMs in the NHS--using the Oxford Knee Score in patients undergoing non-operative management for knee osteoarthritis: a validation study.

机构信息

Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre Nuffield Orthopaedic Centre, Oxford, UK.

出版信息

BMJ Open. 2013 Aug 21;3(8):e003365. doi: 10.1136/bmjopen-2013-003365.

DOI:10.1136/bmjopen-2013-003365
PMID:23965934
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3753511/
Abstract

OBJECTIVES

To assess the validity of the Oxford Knee Score (OKS) for use in patients undergoing non-operative management for their knee osteoarthritis (OA) within the National Health Service (NHS).

DESIGN

Observational cohort study.

SETTING

Single orthopaedic centre in England.

PARTICIPANTS

134 patients undergoing non-operative management for knee OA.

MAIN OUTCOME MEASURES

OKS, the Intermittent and Constant Osteoarthritis Pain (ICOAP), the Knee Injury and Osteoarthritis Score-Physical Function Short Form (KOOS-PS), at baseline and 3-month follow-up, transition item of change at 3 months.

RESULTS

The OKS summary scale and its pain and functional component subscales demonstrated good test-retest reliability (intraclass correlation coefficient 0.93, 0.91 and 0.92, respectively) and measurement precision which, allows its use with groups of patients with knee OA (research/audit) and with individuals (clinical practice). The results in this study were consistent with a priori set hypotheses about the relationship of OKS with other validated measures (KOOS-PS, ICOAP and short form 12 (SF-12)), which provided evidence of its construct validity and responsiveness. Confirmatory factor analysis confirmed the structural validity of OKS. However, there was a lack of satisfactory evidence of structural validity for ICOAP and KOOS. The minimum detectable change (MDC90) was ±6 for OKS (±16 for the Pain Component Score (OKS-PCS) and ±15 for the Functional Component Score (OKS-FCS)). Minimal important changes were ≈7 for OKS (≈17 for OKS-PCS and ≈11 for OKS-FCS) and minimal important differences were ≈6 for OKS (≈14 for OKS-PCS and ≈10 for OKS-FCS). These values were also calculated for ICOAP and KOOS-PS.

CONCLUSIONS

The OKS summary scale, together with its pain and functional component subscales, has excellent measurement properties when used with patients with knee OA undergoing non-operative treatment and is superior to ICOAP and KOOS-PS for this purpose. This evidence provides support for the validity of the use of OKS when used across the spectrum of knee OA disease severity, both in research and clinical practice.

摘要

目的

评估牛津膝关节评分(OKS)在英国国家医疗服务体系(NHS)中用于接受非手术治疗的膝关节骨关节炎(OA)患者的有效性。

设计

观察性队列研究。

设置

英格兰的一个单一骨科中心。

参与者

134 名接受膝关节 OA 非手术治疗的患者。

主要观察指标

OKS、间歇性和持续性骨关节炎疼痛(ICOAP)、膝关节损伤和骨关节炎评分-物理功能简化版(KOOS-PS),基线和 3 个月随访,3 个月时的变化项目。

结果

OKS 综合量表及其疼痛和功能分量表表现出良好的重测信度(组内相关系数分别为 0.93、0.91 和 0.92)和测量精度,这允许其用于 OA 膝关节患者的群体(研究/审核)和个体(临床实践)。本研究的结果与 OKS 与其他经过验证的测量方法(KOOS-PS、ICOAP 和短形式 12(SF-12))之间关系的先验假设一致,这为其结构有效性和响应性提供了证据。验证性因子分析证实了 OKS 的结构有效性。然而,ICOAP 和 KOOS 的结构有效性证据不足。最小可检测变化(MDC90)为 OKS±6(OKS-PCS 为±16,OKS-FCS 为±15)。OKS 的最小重要变化约为 7(OKS-PCS 约为 17,OKS-FCS 约为 11),OKS 的最小重要差异约为 6(OKS-PCS 约为 14,OKS-FCS 约为 10)。ICOAP 和 KOOS-PS 也计算了这些值。

结论

当用于接受非手术治疗的膝关节 OA 患者时,OKS 综合量表及其疼痛和功能分量表具有出色的测量特性,在这方面优于 ICOAP 和 KOOS-PS。这一证据为在膝关节 OA 疾病严重程度范围内使用 OKS 的有效性提供了支持,无论是在研究还是临床实践中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db92/3753511/bbe80c7acdcc/bmjopen2013003365f01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db92/3753511/bbe80c7acdcc/bmjopen2013003365f01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db92/3753511/bbe80c7acdcc/bmjopen2013003365f01.jpg

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