McCreary C, Naliboff B, Cohen M
Division of Orthopedic Surgery, UCLA School of Medicine.
J Clin Psychol. 1989 Jul;45(4):560-70. doi: 10.1002/1097-4679(198907)45:4<560::aid-jclp2270450410>3.0.co;2-0.
Two methods of grouping MMPI scales were employed with 271 patients who were attending a Back Clinic at a university hospital. One method involved clinically derived decision rules, while the other utilized a multivariate clustering procedure. Five subgroups of patients were identified with each method. Both procedures showed subgroup differences in terms of pretreatment pain intensity, activity limitations, McGill affective scores, and physician ratings of degree of functional impairment; the elevated subgroups showed more dysfunction. Follow-up comparisons revealed that, regardless of the classification procedure used, the elevated subgroups showed poorer response to treatment. Only the clinically derived groupings had significant differences in chronicity of pain and total scores on the McGill Pain Questionnaire. On the other hand, only the statistically based system showed significant differences on age and marital status. Furthermore, only the statistical system identified subgroups of male patients that predicted followup pain intensity decreases in a manner that indicated clinical usefulness.
对一家大学医院背部诊所的271名患者采用了两种明尼苏达多相人格调查表（MMPI）量表分组方法。一种方法涉及临床得出的决策规则，另一种方法则采用多变量聚类程序。每种方法都确定了五个患者亚组。两种程序在治疗前疼痛强度、活动受限情况、麦吉尔情感评分以及医生对功能损害程度的评定方面均显示出亚组差异；评分较高的亚组表现出更多功能障碍。随访比较显示，无论使用何种分类程序，评分较高的亚组对治疗的反应都较差。只有临床得出的分组在疼痛慢性程度和麦吉尔疼痛问卷总分上存在显著差异。另一方面，只有基于统计学的系统在年龄和婚姻状况上显示出显著差异。此外，只有统计系统识别出的男性患者亚组能够以表明具有临床实用性的方式预测随访时疼痛强度的降低。
