Moreno-Montoya José, Alvarez-Nemegyei José, Trejo-Valdivia Belem, Peláez-Ballestas Ingris
Instituto Nacional de Salud Pública, Cuernavaca, Mexico.
Clin Rheumatol. 2014 May;33(5):631-6. doi: 10.1007/s10067-013-2367-3. Epub 2013 Aug 24.
This study aims to evaluate the structural validity of the Community-Oriented Program for the Control of Rheumatic Diseases (COPCORD) core instrument as a screening tool for rheumatoid arthritis (RA) by means of assessing the existence of domains in the questionnaire. The Mexican version of the COPCORD instrument was applied to individuals over18 years of age in five regions of the country through a probabilistic/convenience household survey. Clinical confirmation of RA diagnosis was used. The variables analyzed included self-reported comorbidities and manifestations of the disease, as well as sociodemographic characteristics. The statistical approach was based on polychoric exploratory factor analysis and confirmatory factor analysis by means of probit structural equation models. A total of 19,213 subjects were included in the analysis. The average age for the total sample was 42.89 years old; 40.64 % of the subjects were older than 45 years of age and 20.42 % older than 55. More than 80 % of the variation was related to three underlying factors: recent pain, historical pain, and disability. The findings verified the usefulness of the COPCORD instrument as a screening tool for RA. The results also allowed to characterize how the variation in terms of manifestations of the disease could be accounted for diagnosing the disease in the Mexican context and examined the capabilities of the instrument to measure correctly the main characteristics of patients suffering from RA.
本研究旨在通过评估问卷中各领域的存在情况,评价以社区为导向的风湿性疾病控制项目(COPCORD)核心工具作为类风湿关节炎(RA)筛查工具的结构效度。通过概率/便利入户调查,将墨西哥版的COPCORD工具应用于该国五个地区18岁以上的个体。采用RA诊断的临床确诊方法。分析的变量包括自我报告的合并症和疾病表现,以及社会人口学特征。统计方法基于多相探索性因素分析和通过概率结构方程模型进行的验证性因素分析。共有19213名受试者纳入分析。总样本的平均年龄为42.89岁;40.64%的受试者年龄超过45岁,20.42%的受试者年龄超过55岁。超过80%的变异与三个潜在因素有关:近期疼痛、既往疼痛和残疾。研究结果证实了COPCORD工具作为RA筛查工具的有效性。研究结果还能够描述在墨西哥背景下,如何根据疾病表现的变异来诊断疾病,并检验该工具正确测量RA患者主要特征的能力。