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在评估药物试验的方法学质量方面,PEDro量表具有可接受的高收敛效度、结构效度和评分者间信度。

The PEDro scale had acceptably high convergent validity, construct validity, and interrater reliability in evaluating methodological quality of pharmaceutical trials.

作者信息

Yamato Tie Parma, Maher Chris, Koes Bart, Moseley Anne

机构信息

School of Public Health, Sydney Medical School, The University of Sydney, Edward Ford Building (A27), Sydney, NSW 2006, Australia.

School of Public Health, Sydney Medical School, The University of Sydney, Edward Ford Building (A27), Sydney, NSW 2006, Australia.

出版信息

J Clin Epidemiol. 2017 Jun;86:176-181. doi: 10.1016/j.jclinepi.2017.03.002. Epub 2017 Mar 11.

Abstract

BACKGROUND AND OBJECTIVE

The Physiotherapy Evidence Database (PEDro) scale has been widely used to investigate methodological quality in physiotherapy randomized controlled trials; however, its validity has not been tested for pharmaceutical trials. The aim of this study was to investigate the validity and interrater reliability of the PEDro scale for pharmaceutical trials. The reliability was also examined for the Cochrane Back and Neck (CBN) Group risk of bias tool.

METHODS

This is a secondary analysis of data from a previous study. We considered randomized placebo controlled trials evaluating any pain medication for chronic spinal pain or osteoarthritis. Convergent validity was evaluated by correlating the PEDro score with the summary score of the CBN risk of bias tool. The construct validity was tested using a linear regression analysis to determine the degree to which the total PEDro score is associated with treatment effect sizes, journal impact factor, and the summary score for the CBN risk of bias tool. The interrater reliability was estimated using the Prevalence and Bias Adjusted Kappa coefficient and 95% confidence interval (CI) for the PEDro scale and CBN risk of bias tool.

RESULTS

Fifty-three trials were included, with 91 treatment effect sizes included in the analyses. The correlation between PEDro scale and CBN risk of bias tool was 0.83 (95% CI 0.76-0.88) after adjusting for reliability, indicating strong convergence. The PEDro score was inversely associated with effect sizes, significantly associated with the summary score for the CBN risk of bias tool, and not associated with the journal impact factor. The interrater reliability for each item of the PEDro scale and CBN risk of bias tool was at least substantial for most items (>0.60). The intraclass correlation coefficient for the PEDro score was 0.80 (95% CI 0.68-0.88), and for the CBN, risk of bias tool was 0.81 (95% CI 0.69-0.88).

CONCLUSION

There was evidence for the convergent and construct validity for the PEDro scale when used to evaluate methodological quality of pharmacological trials. Both risk of bias tools have acceptably high interrater reliability.

摘要

背景与目的

物理治疗证据数据库(PEDro)量表已被广泛用于调查物理治疗随机对照试验的方法学质量;然而,其在药物试验中的有效性尚未得到检验。本研究的目的是调查PEDro量表在药物试验中的有效性和评分者间信度。同时也对Cochrane背部与颈部(CBN)组偏倚风险工具的信度进行了检验。

方法

这是对先前一项研究数据的二次分析。我们纳入了评估用于慢性脊柱疼痛或骨关节炎的任何止痛药物的随机安慰剂对照试验。通过将PEDro评分与CBN偏倚风险工具的汇总评分进行相关性分析来评估收敛效度。使用线性回归分析来检验结构效度,以确定PEDro总分与治疗效应大小、期刊影响因子以及CBN偏倚风险工具汇总评分之间的关联程度。使用患病率和偏倚调整后的kappa系数以及95%置信区间(CI)来估计PEDro量表和CBN偏倚风险工具的评分者间信度。

结果

共纳入53项试验,分析中包括91个治疗效应大小。在调整信度后,PEDro量表与CBN偏倚风险工具之间的相关性为0.83(95%CI 0.76 - 0.88),表明具有很强的收敛性。PEDro评分与效应大小呈负相关,与CBN偏倚风险工具的汇总评分显著相关,与期刊影响因子无关。PEDro量表和CBN偏倚风险工具各项目的评分者间信度对于大多数项目(>0.60)至少为中度。PEDro评分的组内相关系数为0.80(95%CI 0.68 - 0.88),CBN偏倚风险工具的组内相关系数为0.81(95%CI 0.69 - 0.88)。

结论

有证据表明,当用于评估药物试验的方法学质量时,PEDro量表具有收敛效度和结构效度。两种偏倚风险工具都具有可接受的高评分者间信度。

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