Hand B N, Velozo C A, Krause J S
Department of Health Science and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC, USA.
Spinal Cord. 2017 Dec;55(12):1117-1122. doi: 10.1038/sc.2017.89. Epub 2017 Aug 1.
Secondary analysis of cross-sectional population-based self-report data.
To determine how well the Pain Medication Questionnaire (PMQ) measures risk of pain medication misuse and its precision in separating individuals with spinal cord injury (SCI) into meaningful classification categories.
Academic medical center in Southeastern United States.
Data were collected from a population-based registry of SCI (n=971). Eligible participants included adults with traumatic SCI with residual effects who were at least 1 year post injury and 18 years of age and who had PMQ data in which they reported active use of pain medication at the time of the study (n=745).
Most items (23/26) of the PMQ contributed to a single unidimensional construct. Rasch analysis results revealed that the rating scale, majority of persons (>93%), and majority of items (20/23) fit the Rasch measurement model. The PMQ demonstrated adequate reliability (person reliability =0.67) and separated persons into two strata-those likely to misuse pain medication and those with low liklihood of misusing pain medication.
Findings offer a deeper understanding of the measurement properties of the PMQ as a precursor for widespread population-based studies to elucidate the incidence of pain medication misuse in persons with SCI. Results also have important research and clinical implications for commonly used PMQ total score cut-offs, which may misclassify an individual's risk of pain medication misuse.
基于人群自我报告数据的横断面研究的二次分析。
确定疼痛药物问卷（PMQ）在测量疼痛药物滥用风险方面的效果，以及将脊髓损伤（SCI）患者分为有意义分类类别的准确性。
美国东南部的学术医疗中心。
从基于人群的SCI登记处收集数据（n = 971）。符合条件的参与者包括患有创伤性SCI且有残留影响的成年人，他们受伤至少1年且年龄在18岁以上，并且在研究时拥有报告正在使用疼痛药物的PMQ数据（n = 745）。
PMQ的大多数项目（23/26）促成了一个单一的一维结构。Rasch分析结果显示，评分量表、大多数人（>93%）和大多数项目（20/23）符合Rasch测量模型。PMQ显示出足够的信度（个人信度 = 0.67），并将人群分为两层——可能滥用疼痛药物的人和滥用疼痛药物可能性较低的人。
研究结果有助于更深入地理解PMQ的测量特性，作为广泛的基于人群的研究的先导，以阐明SCI患者中疼痛药物滥用的发生率。结果对于常用的PMQ总分临界值也具有重要的研究和临床意义，这些临界值可能会对个体疼痛药物滥用风险进行错误分类。
