SRS-7作为手术治疗的成人脊柱畸形患者结局评估工具的效度、信度和反应度
Validity, Reliability, and Responsiveness of SRS-7 as an Outcomes Assessment Instrument for Operatively Treated Patients With Adult Spinal Deformity.
作者信息
Jain Amit, Lafage Virginie, Kelly Michael P, Hassanzadeh Hamid, Neuman Brian J, Sciubba Daniel M, Bess Shay, Shaffrey Christopher I, Ames Christopher P, Scheer Justin K, Burton Douglas, Gupta Munish C, Hart Robert, Hostin Richard A, Kebaish Khaled M
机构信息
Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD.
Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY.
出版信息
Spine (Phila Pa 1976). 2016 Sep 15;41(18):1463-1468. doi: 10.1097/BRS.0000000000001540.
STUDY DESIGN
A retrospective analysis.
OBJECTIVE
The aim of our study was to compare the normality, concurrent validity, internal consistency, responsiveness, and dimensionality of an item response theory-derived seven-question instrument (SRS-7), against the Scoliosis Research Society-22r (SRS-22r) questionnaire in operatively treated patients with adult spinal deformity (ASD).
SUMMARY OF BACKGROUND DATA
Compared with SRS-22r, SRS-7 (which has been validated in operatively treated patients with adolescent idiopathic scoliosis) has advantages of being short, unidimensional, and linear.
METHODS
A prospective database of ASD patients was queried for patients 18 years or older who were operatively treated, and who answered pre- and postoperative (at 2-year follow-up) SRS-22r questions (n = 276). Corresponding SRS-7 scores were calculated using answers to SRS-22r items 1, 4, 6, 10, 18, 19, and 20. Significance was set at a P value less than 0.01.
RESULTS
SRS-7 and SRS-22r were normally distributed preoperatively but not postoperatively. SRS-7 and SRS-22r scores had high correlation both preoperatively (r = 0.76, P < 0.01) and postoperatively (r = 0.83, P < 0.01). The internal consistency reliability Cronbach α values were 0.61 (SRS-7) and 0.83 (SRS-22r) preoperatively and 0.91 (SRS-7) and 0.95 (SRS-22r) postoperatively. SRS-7 was found to be more responsive than SRS-22r with measures of effect size: Cohen d = 1.21 versus 1.13, Hedge g = 1.21 versus 1.13, and effect size correlation r = 0.52 versus 0.49. Iterative principal factor analysis of pre- and postoperative scores showed the presence of one dominant latent factor in SRS-7 (unidimensionality) and four latent factors in SRS-22r (multidimensionality).
CONCLUSION
SRS-7 is a valid, reliable, responsive, and unidimensional instrument, which can be used as a short-form alternative to the SRS-22r for assessing global changes in patient-reported outcomes over time in patients with ASD.
LEVEL OF EVIDENCE
研究设计
回顾性分析。
目的
我们研究的目的是比较基于项目反应理论得出的七项问题量表（SRS - 7）与脊柱侧弯研究协会22r问卷（SRS - 22r）在接受手术治疗的成人脊柱畸形（ASD）患者中的正态性、同时效度、内部一致性、反应度和维度。
背景数据总结
与SRS - 22r相比，SRS - 7（已在接受手术治疗的青少年特发性脊柱侧弯患者中得到验证）具有简短、单维度和线性的优点。
方法
查询一个ASD患者的前瞻性数据库，找出18岁及以上接受手术治疗且术前和术后（2年随访时）回答了SRS - 22r问题的患者（n = 276）。使用对SRS - 22r第1、4、6、10、18、19和20项的回答来计算相应的SRS - 7得分。显著性设定为P值小于0.01。
结果
SRS - 7和SRS - 22r术前呈正态分布，但术后不是。SRS - 7和SRS - 22r得分术前（r = 0.76，P < 0.01）和术后（r = 0.83，P < 0.01）均具有高度相关性。术前内部一致性可靠性Cronbach α值分别为0.61（SRS - 7）和0.83（SRS - 22r），术后分别为0.91（SRS - 7）和0.95（SRS - 22r）。在效应量测量方面，发现SRS - 7比SRS - 22r更具反应度：Cohen d = 1.21对1.13，Hedge g = 1.21对1.13，效应量相关性r = 0.52对0.49。对术前和术后得分进行迭代主因子分析显示，SRS - 7存在一个主导潜在因子（单维度性），而SRS - 22r存在四个潜在因子（多维度性）。
结论
SRS - 7是一种有效、可靠、有反应度且单维度性工具，可作为SRS - 22r的简短替代工具用于评估ASD患者随时间推移患者报告结局的整体变化。
证据级别
3级。
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