患者报告结果测量信息系统（PROMIS）身体功能简表在脊柱疾病患者中表现优于Oswestry功能障碍指数（ODI）和36项简明健康状况调查（SF-36）身体功能领域。
PROMIS PF CAT Outperforms the ODI and SF-36 Physical Function Domain in Spine Patients.
作者信息
Brodke Darrel S, Goz Vadim, Voss Maren W, Lawrence Brandon D, Spiker William Ryan, Hung Man
机构信息
University of Utah School of Medicine, Department of Orthopaedics, Salt Lake City, UT.
出版信息
Spine (Phila Pa 1976). 2017 Jun 15;42(12):921-929. doi: 10.1097/BRS.0000000000001965.
STUDY DESIGN
The Oswestry Disability Index v2.0 (ODI), SF36 Physical Function Domain (SF-36 PFD), and PROMIS Physical Function CAT v1.2 (PF CAT) questionnaires were prospectively collected from 1607 patients complaining of back or leg pain, visiting a university-based spine clinic. All questionnaires were collected electronically, using a tablet computer.
OBJECTIVE
The aim of this study was to compare the psychometric properties of the PROMIS PF CAT with the ODI and SF36 Physical Function Domain in the same patient population.
SUMMARY OF BACKGROUND DATA
Evidence-based decision-making is improved by using high-quality patient-reported outcomes measures. Prior studies have revealed the shortcomings of the ODI and SF36, commonly used in spine patients. The PROMIS Network has developed measures with excellent psychometric properties. The Physical Function domain, delivered by Computerized Adaptive Testing (PF CAT), performs well in the spine patient population, though to-date direct comparisons with common measures have not been performed.
METHODS
Standard Rasch analysis was performed to directly compare the psychometrics of the PF CAT, ODI, and SF36 PFD. Spearman correlations were computed to examine the correlations of the three instruments. Time required for administration was also recorded.
RESULTS
One thousand six hundred seven patients were administered all assessments. The time required to answer all items in the PF CAT, ODI, and SF-36 PFD was 44, 169, and 99 seconds. The ceiling and floor effects were excellent for the PF CAT (0.81%, 3.86%), while the ceiling effects were marginal and floor effects quite poor for the ODI (6.91% and 44.24%) and SF-36 PFD (5.97% and 23.65%). All instruments significantly correlated with each other.
CONCLUSION
The PROMIS PF CAT outperforms the ODI and SF-36 PFD in the spine patient population and is highly correlated. It has better coverage, while taking less time to administer with fewer questions to answer.
LEVEL OF EVIDENCE
研究设计
前瞻性收集了1607名因背部或腿部疼痛就诊于某大学脊柱诊所的患者的Oswestry功能障碍指数v2.0（ODI）、SF36身体功能领域（SF - 36 PFD）和PROMIS身体功能计算机自适应测试v1.2（PF CAT）问卷。所有问卷均使用平板电脑以电子方式收集。
目的
本研究旨在比较同一患者群体中PROMIS PF CAT与ODI和SF36身体功能领域的心理测量特性。
背景数据总结
使用高质量的患者报告结局指标可改善基于证据的决策制定。先前的研究揭示了脊柱患者常用的ODI和SF36的缺点。PROMIS网络已开发出具有出色心理测量特性的指标。通过计算机自适应测试提供的身体功能领域（PF CAT）在脊柱患者群体中表现良好，不过迄今为止尚未与常用指标进行直接比较。
方法
进行标准的Rasch分析以直接比较PF CAT、ODI和SF36 PFD的心理测量学。计算Spearman相关性以检验这三种工具的相关性。还记录了施测所需时间。
结果
对1607名患者进行了所有评估。回答PF CAT、ODI和SF - 36 PFD中所有项目所需的时间分别为44秒、169秒和99秒。PF CAT的天花板效应和地板效应极佳（分别为0.81%和3.86%），而ODI（6.91%和44.24%）和SF - 36 PFD（5.97%和23.65%）的天花板效应较小，地板效应较差。所有工具之间均显著相关。
结论
在脊柱患者群体中，PROMIS PF CAT优于ODI和SF - 36 PFD且相关性高。它具有更好的覆盖范围，施测时间更短，需要回答的问题更少。
证据等级
2级。
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