Caronni Antonio, Sciumè Luciana, Donzelli Sabrina, Zaina Fabio, Negrini Stefano
Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico, Via Dezza 48, 20144 Milano, Italy.
Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico, Via Dezza 48, 20144 Milano, Italy.
Spine J. 2017 Sep;17(9):1364-1372. doi: 10.1016/j.spinee.2017.05.022. Epub 2017 May 18.
Spinal deformities are commonly associated with poor health-related quality of life (HRQOL). Several questionnaires (eg, Scoliosis Research Society-24 [SRS-24] and Scoliosis Research Society-22 [SRS-22]) have been developed to evaluate HRQOL in these conditions. In adults as well as during growth, the HRQOL is considered one of the most relevant outcomes of both conservative and surgical treatments. Rasch analysis is a powerful statistical technique for developing high-quality and valid questionnaires. The SRS-24 and SRS-22 have been evaluated using the Rasch analysis but showed poor measurement properties. Thus, a proper measure of HRQOL in people with a spine condition is still missing.
This study aimed to develop a new questionnaire that is totally Rasch consistent for measuring the HRQOL in young people with a spine condition.
This is a cross-sectional study for developing a new HRQOL measure.
A total of 402 participants with adolescent idiopathic scoliosis or Scheuermann juvenile kyphosis were included in the study.
The outcome measure used was the Italian Spine Youth Quality of Life (ISYQOL) questionnaire.
The study consisted of different stages: a conventional approach content analysis, an opinion poll among clinicians trained in spine deformities, and the Rasch analysis (partial credit model).
The Rasch analysis showed that all items of the ISYQOL questionnaire had ordered thresholds and a good fit to the model. Differential item functioning was present for Item 1, with bracing only, and was solved with a conventional items splitting procedure. The ISYQOL item map spans an adequate range of HRQOL. The principal component analysis for Rasch residuals showed, in practical terms, the ISYQOL unidimensionality. The reliability of ISYQOL was high enough so that approximately three significantly different levels of HRQOL could be discerned. Two questionnaire versions were provided for patients with and without the brace, respectively.
ISYQOL is the first HRQOL questionnaire developed according to the Rasch analysis. It was developed in a conservative treatment setting for all types of spinal deformities, including also patients with surgical curves. Validation in many languages is already under way.
脊柱畸形通常与健康相关生活质量（HRQOL）较差有关。已经开发了几种问卷（例如，脊柱侧弯研究协会24项问卷[SRS - 24]和脊柱侧弯研究协会22项问卷[SRS - 22]）来评估这些情况下的HRQOL。在成年人以及生长发育过程中，HRQOL被认为是保守治疗和手术治疗最相关的结果之一。拉施分析是一种用于开发高质量和有效问卷的强大统计技术。SRS - 24和SRS - 22已使用拉施分析进行评估，但显示出较差的测量特性。因此，仍然缺少一种用于测量脊柱疾病患者HRQOL的合适方法。
本研究旨在开发一种全新的、完全符合拉施分析的问卷，用于测量患有脊柱疾病的年轻人的HRQOL。
这是一项用于开发新的HRQOL测量方法的横断面研究。
共有402名青少年特发性脊柱侧弯或休曼氏青少年驼背患者纳入本研究。
所使用的结果测量工具为意大利脊柱青少年生活质量（ISYQOL）问卷。
该研究包括不同阶段：传统的方法内容分析、对接受脊柱畸形培训的临床医生进行民意调查以及拉施分析（部分计分模型）。
拉施分析表明，ISYQOL问卷的所有项目都有有序的阈值，并且与模型拟合良好。仅针对支具治疗的第1项存在项目功能差异，通过传统的项目拆分程序得以解决。ISYQOL项目图涵盖了足够范围的HRQOL。拉施残差的主成分分析实际上表明了ISYQOL的单维度性。ISYQOL的可靠性足够高，以至于可以辨别出大约三个显著不同的HRQOL水平。分别为佩戴和未佩戴支具的患者提供了两个问卷版本。
ISYQOL是根据拉施分析开发的首个HRQOL问卷。它是在保守治疗环境中针对所有类型的脊柱畸形开发的，也包括手术治疗曲线的患者。多种语言的验证工作已经在进行中。
