Widnall James, Ralte Peter, Selvan Dave, Molloy Andy
University Hospital Aintree, Lower Lane, Liverpool, Merseyside L9 7AL, UK.
University Hospital Aintree, Lower Lane, Liverpool, Merseyside L9 7AL, UK.
Foot (Edinb). 2014 Mar;24(1):28-30. doi: 10.1016/j.foot.2014.02.005. Epub 2014 Mar 12.
Patient reported outcome measures are becoming more popular in their use. Retrospective scoring is not yet a validated method of data collection but one that could greatly decrease the complexity of research projects. We aim to compare preoperative and retrospective scores in order to assess their correlation and accuracy.
36 patients underwent elective foot and ankle surgery. All patients were scored preoperatively using the SF-12 (including both the physical and mental subsets) and FFI. Patients then recorded both PROMs at the 3-month follow up (av. 139 days). Results were then analyzed for statistical significance.
36 patients (av. age 54.6): completed both sets of questionnaires. There were 15 hindfoot and 21 forefoot procedures. No retrospective scores were identical. The mean percentage difference between the preoperative scores was -7.9% (-17.3 to 1.6%, 95% CI) for Physical Component of SF12, -3.2% (-10.3 to 3.9%, 95% CI) for mental component of SF12 and 40.7% (25.3 to 56.1%, 95% CI) for FFI. This retrospective accuracy was statistically significant (p<0.001). When the scores were plotted against each other, the outcome measurements showed positive correlations (Physical SF 12 p=0.48, Mental SF 12 p=0.80 and FFI p=0.81). With both PROMs mean percentage differences combined, patients undergoing hindfoot procedures (3.5%; -5.0 to 12.1%, 95% CI) were more accurate with retrospective scoring than their forefoot counterparts (17.5%; 5.0 to 30.0%, 95% CI). This was not statistically significant (p=0.07). Using regression analysis, we found no significant statistical difference in the retrospective accuracy when compared against both time to retrospective scoring and the outcome measure at 3 months post operatively.
Retrospective scoring appears to lack accuracy when compared to prospective methods. However, our data shows the SF12 is recalled more accurately than the FFI (p<0.001) and both the mental and physical components are recalled to within 10% of the pre-operative score. These results show patients tend to recall their symptoms at a worse level preoperatively than originally described, especially those with forefoot problems.
患者报告结局测量方法的应用越来越广泛。回顾性评分尚未成为一种经过验证的数据收集方法，但它可能会大大降低研究项目的复杂性。我们旨在比较术前评分和回顾性评分，以评估它们的相关性和准确性。
36例患者接受了择期足踝手术。所有患者术前均使用SF-12（包括身体和心理亚组）和FFI进行评分。然后患者在3个月随访时（平均139天）记录这两种患者报告结局测量。随后对结果进行统计学显著性分析。
36例患者（平均年龄54.6岁）完成了两组问卷。有15例后足手术和21例前足手术。没有回顾性评分是相同的。SF12身体成分术前评分的平均百分比差异为-7.9%（-17.3%至1.6%，95%CI），SF12心理成分术前评分的平均百分比差异为-3.2%（-10.3%至3.9%，95%CI），FFI术前评分的平均百分比差异为40.7%（25.3%至56.1%，95%CI）。这种回顾性准确性具有统计学显著性（p<0.001）。当将评分相互绘制时，结局测量显示出正相关（身体SF12 p=0.48，心理SF12 p=0.80，FFI p=0.81）。将两种患者报告结局测量的平均百分比差异合并后，接受后足手术的患者（3.5%；-5.0%至12.1%，95%CI）回顾性评分比接受前足手术的患者（17.5%；5.0%至30.0%，95%CI）更准确。这没有统计学显著性（p=0.07）。使用回归分析，我们发现与回顾性评分时间和术后3个月的结局测量相比，回顾性准确性没有显著统计学差异。
与前瞻性方法相比，回顾性评分似乎缺乏准确性。然而，我们的数据显示，SF12的回忆比FFI更准确（p<0.001），心理和身体成分的回忆均在术前评分的10%以内。这些结果表明，患者倾向于回忆其术前症状比最初描述的更严重，尤其是那些有前足问题的患者。
