再现性：肩袖疾病患者中西安大略肩袖指数简版（Short-WORC）的可靠性和一致性
Reproducibility: Reliability and agreement of short version of Western Ontario Rotator Cuff Index (Short-WORC) in patients with rotator cuff disorders.
作者信息
Dewan Neha, MacDermid Joy C, MacIntyre Norma, Grewal Ruby
机构信息
School of Rehabilitation Sciences, McMaster University, Canada.
School of Rehabilitation Sciences, McMaster University, Canada; Hand and Upper Limb Center, St. Joseph's Hospital, London, ON, Canada; Department of Physical Therapy, University of Western Ontario, Canada; Department of Surgery, University of Western Ontario, Canada.
出版信息
J Hand Ther. 2016 Jul-Sep;29(3):281-91. doi: 10.1016/j.jht.2015.11.007. Epub 2015 Dec 21.
INTRODUCTION
Recently, a shorter version of Western Ontario Rotator Cuff Index (Short-WORC) was proposed as a subset of 7 items from the original 21-item WORC. However, the reproducibility of the Short-WORC has not been established.
PURPOSE OF THE STUDY
To determine reproducibility (reliability and agreement) of the Short-WORC among patients with rotator cuff disorders (RCDs).
METHODS
Patients (n = 153) diagnosed with RCD completed the WORC at baseline and at 3 months post-operatively (n = 146). The Short-WORC was extracted from the full version of WORC. From this retrospective cohort, 43 patients were retested within 5 weeks, if they remained stable. Cronbach's alpha (α) and intra class correlation coefficients (ICC2,1) were used to assess internal consistency and test-retest reliability respectively. Standard error measurement (SEM), minimal detectable change (MDC90) and Bland Altman (BA) plots were used to assess agreement.
RESULTS
No floor and ceiling effects were reported for either the Short-WORC or WORC. Cronbach's α were 0.84 and 0.90 at baseline and 0.89 and 0.95 at 3 month of follow up for Short-WORC and WORC respectively. The ICC2,1 were 0.89 and 0.91 for the Short-WORC and WORC respectively. The agreement parameters for the Short-WORC were: SEMagreement = 8.8, MDC90individual = 20.3, MDC90group = 5.1. We found substantial agreement between the two versions of WORC on BA plots with minimal (mean difference (d) <1) systematic differences between them. The limits of agreement (LOA) between two versions of WORC were similar across sessions and fell within range of -11.7 to 13.2 points at test and -14.7 to 14.7 points at retest.
CONCLUSION
Short-WORC and WORC demonstrates strong reproducibility and can be used for group and individual comparison of health-related quality of life (HRQoL) among patients with RCD. Wider LOA may be expected when using the Short-WORC for individual patient assessment. Reproducibility data is essential, but should be supplemented by validation of actual Short-WORC with samples representing the spectrum of RCD.
LEVEL OF EVIDENCE
N/A.
引言
最近，有人提出了西安大略肩袖指数的简短版本（Short-WORC），它是原始21项WORC中的7项子集。然而，Short-WORC的可重复性尚未得到证实。
研究目的
确定Short-WORC在肩袖疾病（RCD）患者中的可重复性（可靠性和一致性）。
方法
153例被诊断为RCD的患者在基线时和术后3个月完成了WORC（n = 146）。Short-WORC是从WORC的完整版本中提取的。在这个回顾性队列中，如果43例患者病情保持稳定，则在5周内对其进行重新测试。分别使用Cronbach's α和组内相关系数（ICC2,1）来评估内部一致性和重测可靠性。使用标准误差测量（SEM）、最小可检测变化（MDC90）和Bland Altman（BA）图来评估一致性。
结果
Short-WORC和WORC均未报告地板效应和天花板效应。Short-WORC在基线时和随访3个月时的Cronbach's α分别为0.84和0.89，WORC分别为0.90和0.95。Short-WORC和WORC的ICC2,1分别为0.89和0.91。Short-WORC的一致性参数为：SEMagreement = 8.8，MDC90个体 = 20.3，MDC90组 = 5.1。我们发现WORC的两个版本在BA图上有高度一致性，它们之间的系统差异最小（平均差（d）<1）。WORC两个版本之间的一致性界限（LOA）在各次测试中相似，测试时在-11.7至13.2分范围内，重测时在-14.7至14.7分范围内。
结论
Short-WORC和WORC具有很强的可重复性，可用于RCD患者健康相关生活质量（HRQoL）的组间和个体比较。在对个体患者进行评估时，使用Short-WORC可能会有更宽的LOA。可重复性数据至关重要，但应以代表RCD范围的样本对实际Short-WORC进行验证作为补充。
证据水平
无。
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