Singh Anoushka, Tetreault Lindsay, Casey Adrian, Laing Rodney, Statham Patrick, Fehlings Michael G
Department of Neurosurgery, Toronto Western Hospital, University of Toronto, 399 Bathurst St. W, 4F412, Toronto, ON, M5T 2S8, Canada.
Eur Spine J. 2015 Apr;24 Suppl 2:209-28. doi: 10.1007/s00586-013-2935-x. Epub 2013 Sep 5.
One of the objectives of this review is to summarize the important features of a good scale. A second aim is to conduct a systematic review to identify scales that can detect the presence of cervical myelopathy and to determine their psychometric properties including validity, reliability and responsiveness.
A thorough literature search was performed using MEDLINE, MEDLINE in process, EMBASE, and Cochrane Central Register of Controlled Trials. Articles were included in this study if they compared scale measurements between a control and a myelopathic patient population or if they discussed any psychometric property of a scale.
An ideal scale should be one that is quantifiable, valid, sensitive, responsive and easy to perform, has high inter/intra-rater reliability, internal consistency and a suitable distribution, and is one-dimensional and relevant. In the context of cervical spondylotic myelopathy, it is essential that the scale also addresses the pathophysiology, its key signs and symptoms as well as its natural history. For the systematic review, the search yielded 5,745 citations. Of these, 37 met inclusion criteria, 10 explored the ability of a scale to detect myelopathy, 23 examined validity by assessing correlation between scales, 10 reported reliability, 8 analyzed responsiveness, and 6 discussed internal consistency. The most frequently reported scale was short form-36 (n = 16) followed by Nurick grade (n = 14), Japanese Orthopaedic Association (n = 13), (modified) Japanese Orthopaedic Association (n = 7) and grip and release test (n = 6). Four studies each presented results on the Cooper, Harsh and 30-m walking test.
This review summarizes outcome measures used to assess the presence and severity of cervical myelopathy. It includes several validation studies as well as those that have reported the responsiveness and reliability of various measures.
本综述的目标之一是总结良好量表的重要特征。第二个目标是进行系统综述，以识别能够检测脊髓型颈椎病的量表，并确定其心理测量学特性，包括效度、信度和反应度。
使用MEDLINE、MEDLINE正在进行中的数据库、EMBASE和Cochrane对照试验中央注册库进行全面的文献检索。如果文章比较了对照组和脊髓型患者群体之间的量表测量结果，或者讨论了量表的任何心理测量学特性，则纳入本研究。
理想的量表应具备可量化、有效、敏感、反应度好且易于实施的特点，具有较高的评分者间/评分者内信度、内部一致性和合适的分布，并且是单维度且相关的。在脊髓型颈椎病的背景下，该量表还必须涉及病理生理学、其关键体征和症状以及自然病史。对于系统综述，检索共获得5745条引文。其中，37篇符合纳入标准，10篇探讨了量表检测脊髓型颈椎病的能力，23篇通过评估量表之间的相关性来检验效度，10篇报告了信度，有8篇分析了反应度，6篇讨论了内部一致性。报告最频繁的量表是简短健康调查问卷简表36（n = 16），其次是努里克分级（n = 14）、日本矫形外科学会评分（n = 13）、（改良）日本矫形外科学会评分（n = 7）和握力与松开试验（n = 6）。四项研究分别给出了库珀、哈什和30米步行试验的结果。
本综述总结了用于评估脊髓型颈椎病的存在和严重程度的结局指标。它包括多项效度研究以及那些报告了各种测量方法的反应度和信度的研究。
