Monticone Marco, Ambrosini Emilia, Rocca Barbara, Foti Calogero, Ferrante Simona
Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
Physical Medicine and Rehabilitation Unit, Scientific Institute of Lissone, Salvatore Maugeri Foundation, Institute of Care and Research (IRCCS), Lissone, Italy.
Spine (Phila Pa 1976). 2017 Jun 1;42(11):E672-E679. doi: 10.1097/BRS.0000000000001923.
Single-center, prospective study.
Evaluating the responsiveness and minimal important changes (MICs) for the Scoliosis Research Society-22 Patient Questionnaire (SRS-22) in adolescent idiopathic scoliosis (AIS) and adult idiopathic scoliosis (AS).
Despite the SRS-22 properties have been investigated in various different languages, there is still a lack of information concerning responsiveness and MIC, limiting the use of SRS-22 for clinical and research purposes.
At the beginning and end of multidisciplinary rehabilitation programs, 149 subjects with mild AIS (Cobb angle <25°) and 140 subjects with moderate AS (Cobb angle <35°) completed the SRS-22. Upon completing the programs, subjects also performed the global perceived effect (GPE) scales test, which was divided to produce a dichotomous outcome (improved vs. stable). Responsiveness was calculated for all SRS-22 domains but satisfaction with management by distribution (effect size; standardized response mean) and anchor-based methods (receiver operating characteristic [ROC] curves; correlations between change scores of the SRS-22 and GPE). ROC curves were also used to compute the MICs.
The effect size ranged from 1.23 to 1.50 in AIS and from 1.02 to 1.37 in AS. The standardized response mean ranged from 0.95 to 1.27 in AIS and from 0.66 to 0.90 in AS. The ROC analyses revealed the following MIC values (area under the curve; sensitivity; specificity): function, 0.70 (0.739;66;70) for AIS and 0.60 (0.842;84;76) for AS; pain, 0.70 (0.731;71;70) for AIS and 0.40 (0.817;81;70) for AS; mental health, 0.50 (0.708;83;58) for AIS and 0.55 (0.750;69;78) for AS; self-perceived image, 0.40 (0.609;79;42) for AIS and 0.60 (0.751;61;82) for AS. Correlations between change scores of the SRS-22 domains and GPE were low to moderate, ranging from -0.347 to -0.667.
The SRS-22 was sensitive in detecting clinical changes in subjects with adolescent and adult scoliosis. We recommend taking the MICs provided into account when assessing patients' improvement or planning studies in these clinical contexts.
单中心前瞻性研究。
评估脊柱侧凸研究学会22项患者问卷（SRS - 22）在青少年特发性脊柱侧凸（AIS）和成人特发性脊柱侧凸（AS）中的反应度及最小重要变化（MIC）。
尽管已在多种不同语言中对SRS - 22的特性进行了研究，但仍缺乏有关反应度和MIC的信息，这限制了SRS - 22在临床和研究中的应用。
在多学科康复项目开始和结束时，149例轻度AIS（Cobb角<25°）患者和140例中度AS（Cobb角<35°）患者完成了SRS - 22问卷。完成项目后，受试者还进行了整体感知效果（GPE）量表测试，该测试结果分为二分结果（改善与稳定）。计算了所有SRS - 22领域的反应度，但通过分布法（效应量；标准化反应均值）和基于锚定的方法（受试者操作特征[ROC]曲线；SRS - 22变化分数与GPE之间的相关性）评估了对治疗管理的满意度。ROC曲线也用于计算MIC。
AIS的效应量范围为1.23至1.50，AS为1.02至1.37。AIS的标准化反应均值范围为0.95至1.27，AS为0.66至0.90。ROC分析得出以下MIC值（曲线下面积；敏感度；特异度）：功能，AIS为0.70（0.739；66；70），AS为0.60（0.842；84；76）；疼痛，AIS为0.70（0.731；71；70），AS为0.40（0.817；81；70）；心理健康，AIS为0.50（0.708；83；58），AS为0.55（0.750；69；78）；自我认知形象，AIS为0.40（0.609；79；42），AS为0.60（0.751；61；82）。SRS - 22领域变化分数与GPE之间的相关性为低到中度，范围为 - 0.347至 - 0.667。
SRS - 22在检测青少年和成人脊柱侧凸患者的临床变化方面具有敏感性。我们建议在评估这些临床情况下患者的改善情况或规划研究时考虑所提供的MIC。
3级。
