Jette Diane U, Stilphen Mary, Ranganathan Vinoth K, Passek Sandra, Frost Frederick S, Jette Alan M
D.U. Jette, PT, DSc, FAPTA, Physical Therapy Program, MGH Institute of Health Professions, 36 First Ave, Charlestown Navy Yard, Boston, MA 02129 (USA), and Rehabilitation and Movement Science, University of Vermont, Burlington, Vermont.
M. Stilphen, PT, DPT, Rehabilitation and Sports Therapy Department, Cleveland Clinic, Cleveland, Ohio.
Phys Ther. 2015 May;95(5):758-66. doi: 10.2522/ptj.20140174. Epub 2014 Dec 11.
The interrater reliability of 2 new inpatient functional short-form measures, Activity Measure for Post-Acute Care (AM-PAC) "6-Clicks" basic mobility and daily activity scores, has yet to be established.
The purpose of this study was to examine the interrater reliability of AM-PAC "6-Clicks" measures.
A prospective observational study was conducted.
Four pairs of physical therapists rated basic mobility and 4 pairs of occupational therapists rated daily activity of patients in 1 of 4 hospital services. One therapist in a pair was the primary therapist directing the assessment while the other therapist observed. Each therapist was unaware of the other's AM-PAC "6-Clicks" scores. Reliability was assessed with intraclass correlation coefficients (ICCs), Bland-Altman plots, and weighted kappa.
The ICCs for the overall reliability of basic mobility and daily activity were .849 (95% confidence interval [CI]=.784, .895) and .783 (95% CI=.696, .847), respectively. The ICCs for the reliability of each pair of raters ranged from .581 (95% CI=.260, .789) to .960 (95% CI=.897, .983) for basic mobility and .316 (95% CI=-.061, .611) to .907 (95% CI=.801, .958) for daily activity. The weighted kappa values for item agreement ranged from .492 (95% CI=.382, .601) to .712 (95% CI=.607, .816) for basic mobility and .251 (95% CI=.057, .445) to .751 (95% CI=.653, .848) for daily activity. Mean differences between raters' scores were near zero.
Raters were from one health system. Each pair of raters assessed different patients in different services.
The ICCs for AM-PAC "6-Clicks" total scores were very high. Levels of agreement varied across pairs of raters, from large to nearly perfect for physical therapists and from moderate to nearly perfect for occupational therapists. Levels of agreement for individual item scores ranged from small to very large.
两种新的住院患者功能简表测量方法，即急性后期护理活动测量（AM-PAC）“6次点击”基本移动性和日常活动评分的评分者间信度尚未确定。
本研究的目的是检验AM-PAC“6次点击”测量方法的评分者间信度。
进行了一项前瞻性观察研究。
四对物理治疗师对4个医院科室之一的患者的基本移动性进行评分，四对职业治疗师对患者的日常活动进行评分。每对中的一名治疗师是指导评估的主要治疗师，另一名治疗师进行观察。每位治疗师都不知道对方的AM-PAC“6次点击”评分。使用组内相关系数（ICC）、布兰德-奥特曼图和加权kappa评估信度。
基本移动性和日常活动总体信度的ICC分别为0.849（95%置信区间[CI]=0.784，0.895）和0.783（95%CI=0.696，0.847）。基本移动性方面，每对评分者的信度ICC范围为0.581（95%CI=0.260，0.789）至0.960（95%CI=0.897，0.983），日常活动方面为0.316（95%CI=-0.061，0.611）至0.907（95%CI=0.801，0.958）。项目一致性的加权kappa值，基本移动性范围为0.492（95%CI=0.382，0.601）至0.712（95%CI=0.607，0.816），日常活动范围为0.251（95%CI=0.057，0.445）至0.751（95%CI=0.653，0.848）。评分者分数之间的平均差异接近零。
评分者来自同一个医疗系统。每对评分者在不同科室评估不同患者。
AM-PAC“6次点击”总分的ICC非常高。评分者对之间的一致性水平各不相同，物理治疗师从高到几乎完美，职业治疗师从中等至几乎完美。单个项目评分的一致性水平从小到非常高不等。
