Lavigne John V
Department of Child and Adolescent Psychiatry, Ann & Robert H. Lurie Children's Hospital of Chicago, Feinberg School of Medicine, Northwestern University, and Mary Ann and J. Milburn Smith Child Health Research Program, Children's Hospital of Chicago Research Center
J Pediatr Psychol. 2016 Aug;41(7):715-34. doi: 10.1093/jpepsy/jsv161. Epub 2016 Jan 6.
This report examined limitations in our ability to assess clinically significant change (CSC) in randomized controlled trials of treatments of self-reported pediatric chronic pain intensity.
The following were reviewed: (a) approaches to assessing CSC; (b) approaches to assessing CSC used in psychological treatment studies of self-reported pediatric chronic pain intensity included in a recent systematic review; (c) the role of test-retest reliability in distribution-based CSC measures; (d) the test-retest reliability of recommended chronic pain measures.
Existing studies do not assess whether a CSC occurred or use procedures that did not account for measurement error and true score fluctuations unrelated to treatment, possibly resulting in overestimating CSCs. Distribution-based approaches to assessing CSCs that address these problems require knowing test-retest reliability of the chronic pain measure at appropriate intervals. Available information raises concern about our ability to estimate CSC reliably. Recommendations are made for future research.
本报告探讨了在自报的儿童慢性疼痛强度治疗随机对照试验中，我们评估临床显著变化（CSC）能力的局限性。
对以下内容进行了综述：（a）评估CSC的方法；（b）近期一项系统评价中纳入的自报儿童慢性疼痛强度心理治疗研究中使用的评估CSC的方法；（c）重测信度在基于分布的CSC测量中的作用；（d）推荐的慢性疼痛测量方法的重测信度。
现有研究未评估是否发生了CSC，也未采用考虑测量误差和与治疗无关的真分数波动的程序，这可能导致高估CSC。解决这些问题的基于分布的评估CSC的方法需要了解在适当间隔下慢性疼痛测量的重测信度。现有信息引发了对我们可靠估计CSC能力的担忧。为未来研究提出了建议。
