Ramsenthaler Christina, Gao Wei, Siegert Richard J, Schey Steve A, Edmonds Poly M, Higginson Irene J
Department of Palliative Care, Policy and Rehabilitation, School of Medicine, Cicely Saunders Institute, King's College London, London, SE5 9PJ, UK.
Auckland University of Technology, Auckland, New Zealand.
Qual Life Res. 2017 Nov;26(11):2931-2947. doi: 10.1007/s11136-017-1660-z. Epub 2017 Jul 27.
The Myeloma Patient Outcome Scale (MyPOS) was developed to measure quality of life in routine clinical care. The aim of this study was to determine its longitudinal validity, reliability, responsiveness to change and its acceptability.
This 14-centre study recruited patients with multiple myeloma. At baseline and then every two months for 5 assessments, patients completed the MyPOS. Psychometric properties evaluated were as follows: (a) confirmatory factor analysis and scaling assumptions (b) reliability: Generalizability theory and Rasch analysis, (c) responsiveness and minimally important difference (MID) relating changes in scores between baseline and subsequent assessments to an external criterion, (d) determining the acceptability of self-monitoring.
238 patients with multiple myeloma were recruited. Confirmatory factor analysis found three subscales; criteria for scaling assumptions were satisfied except for gastrointestinal items and the Healthcare support scale. Rasch analysis identified limitations of suboptimal scale-to-sample targeting, resulting in floor effects. Test-retest reliability indices were good (R = > 0.97). Responsiveness analysis yielded an MID of +2.5 for improvement and -4.5 for deterioration.
The MyPOS demonstrated good longitudinal measurement properties, with potential areas for revision being the Healthcare Support subscale and the rating scale. The new psychometric approaches should be used for testing validity of monitoring in clinical settings.
骨髓瘤患者结局量表(MyPOS)旨在衡量常规临床护理中的生活质量。本研究的目的是确定其纵向效度、信度、对变化的反应性及其可接受性。
这项14中心研究招募了多发性骨髓瘤患者。在基线时以及随后每两个月进行5次评估时,患者完成MyPOS。评估的心理测量特性如下:(a)验证性因素分析和量表假设,(b)信度:概化理论和Rasch分析,(c)反应性和最小重要差异(MID),将基线与后续评估之间的得分变化与外部标准相关联,(d)确定自我监测的可接受性。
招募了238例多发性骨髓瘤患者。验证性因素分析发现了三个子量表;除胃肠道项目和医疗保健支持量表外,量表假设标准均得到满足。Rasch分析确定了量表与样本目标欠佳的局限性,导致出现地板效应。重测信度指标良好(R => 0.97)。反应性分析得出改善的MID为+2.5,恶化的MID为-4.5。
MyPOS显示出良好的纵向测量特性,需要修订的潜在领域是医疗保健支持子量表和评定量表。应采用新的心理测量方法来测试临床环境中监测的有效性。