甲状腺相关患者报告结局量表ThyPRO简版的开发。
Development of a Short Version of the Thyroid-Related Patient-Reported Outcome ThyPRO.
作者信息
Watt Torquil, Bjorner Jakob Bue, Groenvold Mogens, Cramon Per, Winther Kristian Hillert, Hegedüs Laszlo, Bonnema Steen Joop, Rasmussen Åse Krogh, Ware John E, Feldt-Rasmussen Ulla
机构信息
1 Department of Endocrinology, Copenhagen University Hospital Rigshospitalet , Copenhagen, Denmark .
2 Department of Internal Medicine F, Gentofte Hospital , Denmark .
出版信息
Thyroid. 2015 Oct;25(10):1069-79. doi: 10.1089/thy.2015.0209. Epub 2015 Aug 26.
BACKGROUND
Thyroid diseases affect quality of life (QoL). The Thyroid-Related Patient-Reported Outcome (ThyPRO) is an international comprehensive well-validated patient-reported outcome, measuring thyroid-related QoL. The current version is rather long--85 items. The purpose of the present study was to develop an abbreviated version of the ThyPRO, with conserved good measurement properties.
METHODS
A cross-sectional (N = 907) and a longitudinal sample (N = 435) of thyroid patients were analyzed. A graded item response theory (IRT) model was fitted to the cross-sectional data. Short-form scales with three items were aimed for, by selecting items with best fit according to the IRT model, avoiding cross-culturally noninvariant items. Seven scales measuring mental and social well-being and function as well as one overall QoL impact item were analyzed in a bifactor model, to develop a supplementary composite score. Short-form scales were linked to original scales with IRT-based summed-score-linking. Agreement between the short and long form was estimated by agreement plots, intraclass correlations, and mean score levels. Responsiveness was compared by relative validity indices, clinical validity by ability to detect clinically relevant differences, and test-retest reliability by intra-class correlation.
RESULTS
One four-item scale was not abbreviated and one two-item scale was omitted from the short-form. For the 11 scales undergoing abbreviation, 10 with three and one with four items were developed. A bifactor model with good overall fit was fitted to the composite score, including the single QoL item. Responsiveness and clinical validity of the short-form scales were preserved, as were test-retest reliability (0.75-0.89). Short- versus long-form intraclass correlations were high (0.89-0.98), and the mean scale levels were similar.
CONCLUSIONS
A 39-item version of the ThyPRO, with good measurement properties, was developed and is recommended for clinical use.
背景
甲状腺疾病会影响生活质量（QoL）。甲状腺相关患者报告结局（ThyPRO）是一项经过国际验证的全面的患者报告结局，用于衡量甲状腺相关的生活质量。当前版本相当长——有85个条目。本研究的目的是开发一个缩略版的ThyPRO，同时保留良好的测量属性。
方法
对甲状腺患者的横断面样本（N = 907）和纵向样本（N = 435）进行分析。将分级项目反应理论（IRT）模型应用于横断面数据。通过根据IRT模型选择拟合最佳的项目，避免跨文化非不变项目，旨在开发由三个项目组成的简表。在双因素模型中分析了七个测量心理和社会幸福感及功能的量表以及一个总体生活质量影响项目，以制定一个补充综合得分。通过基于IRT的总分链接将简表与原始量表联系起来。通过一致性图、组内相关性和平均得分水平来估计简表和长表之间的一致性。通过相对有效性指标比较反应性，通过检测临床相关差异的能力比较临床有效性，通过组内相关性比较重测信度。
结果
一个四项量表未被缩略，一个两项量表从简表中省略。对于进行缩略的11个量表，开发了10个三项量表和1个四项量表。一个总体拟合良好的双因素模型适用于综合得分，包括单个生活质量项目。简表的反应性和临床有效性得以保留，重测信度也得以保留（0.75 - 0.89）。简表与长表的组内相关性很高（0.89 - 0.98），平均量表水平相似。
结论
开发了一个具有良好测量属性的39项版ThyPRO，推荐用于临床。
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