MacIsaac Rachael L, Ali Myzoon, Taylor-Rowan Martin, Rodgers Helen, Lees Kennedy R, Quinn Terence J
From the Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom (R.L.M., M.A., M.T.-R., K.R.L., T.J.Q.); and Stroke Research Group Institute for Neuroscience and Institute for Ageing, Newcastle University, United Kingdom (H.R.).
Stroke. 2017 Mar;48(3):618-623. doi: 10.1161/STROKEAHA.116.014789. Epub 2017 Feb 2.
There may be a potential to reduce the number of items assessed in the Barthel Index (BI), and shortened versions of the BI have been described. We sought to collate all existing short-form BI (SF-BI) and perform a comparative validation using clinical trial data.
We performed a systematic review across multidisciplinary electronic databases to find all published SF-BI. Our validation used the VISTA (Virtual International Stroke Trials Archive) resource. We describe concurrent validity (agreement of each SF-BI with BI), convergent and divergent validity (agreement of each SF-BI with other outcome measures available in the data set), predictive validity (association of prognostic factors with SF-BI outcomes), and content validity (item correlation and exploratory factor analyses).
From 3546 titles, we found 8 articles describing 6 differing SF-BI. Using acute trial data (n=8852), internal reliability suggested redundancy in BI (Cronbach α, 0.96). Each SF-BI demonstrated a strong correlation with BI, modified Rankin Scale, National Institutes of Health Stroke Scale (all ρ≥0.83; <0.001). Using rehabilitation trial data (n=332), SF-BI demonstrated modest correlation with quality of life measures Stroke Impact Scale and 5 domain EuroQOL (ρ≥0.50, <0.001). Prespecified prognostic factors were associated with SF-BI outcomes (all <0.001). Our factor analysis described a 3 factor structure, and item reduction suggested an optimal 3-item SF-BI comprising bladder control, transfer, and mobility items in keeping with 1 of the 3-item SF-BI previously described in the literature.
There is redundancy in the original BI; we have demonstrated internal and external validity of a 3-item SF-BI that should be simple to use.
简化巴氏指数（BI）评估项目数量具有潜在可能性，已有相关简化版BI的报道。我们旨在整理所有现有的简化版BI（SF-BI），并利用临床试验数据进行比较验证。
我们对多学科电子数据库进行了系统综述，以查找所有已发表的SF-BI。我们的验证使用了VISTA（虚拟国际卒中试验档案库）资源。我们描述了同时效度（每个SF-BI与BI的一致性）、收敛效度和发散效度（每个SF-BI与数据集中其他可用结局指标的一致性）、预测效度（预后因素与SF-BI结局的关联）以及内容效度（项目相关性和探索性因子分析）。
从3546篇标题中，我们发现8篇文章描述了6种不同的SF-BI。利用急性试验数据（n = 8852），内部信度表明BI存在冗余（Cronbach α，0.96）。每个SF-BI与BI、改良Rankin量表、美国国立卫生研究院卒中量表均呈现出强相关性（所有ρ≥0.83；P < 0.001）。利用康复试验数据（n = 332），SF-BI与生活质量测量指标卒中影响量表和5维度欧洲五维度健康量表呈现出适度相关性（ρ≥0.50，P < 0.001）。预先设定的预后因素与SF-BI结局相关（所有P < 0.001）。我们的因子分析描述了一个三因子结构，项目简化表明一个最佳的3项SF-BI，包括膀胱控制、转移和移动项目，与文献中先前描述的3项SF-BI之一一致。
原始BI存在冗余；我们已证明一个3项SF-BI的内部和外部效度，该量表使用起来应该很简单。
