Tel Aviv University, Tel Aviv, Israel.
Department IV, Spinal Rehabilitation, Loewenstein Rehabilitation Hospital, Raanana, Israel.
Spinal Cord. 2018 Jan;56(1):46-51. doi: 10.1038/sc.2017.97. Epub 2017 Sep 12.
Psychometric study.
The objective of this study was to examine the reliability of the Spinal Cord Independence Measure III (SCIM III) by interview and compare the findings with those of assessment by observation.
This study was conducted at Loewenstein Rehabilitation Hospital, Israel.
Thirty-five spinal cord lesion (SCL) patients who underwent rehabilitation at Loewenstein Rehabilitation Hospital in Israel were assessed during the last week before discharge with SCIM III by observation and by interview. Nineteen of the patients were also assessed by interview by a third rater to examine inter-rater reliability. Total agreement, kappa, Bland-Altman plots and intraclass correlation (ICC) were used for comparison between interviewers and between interviews and observations.
Total agreement between the interviewers' scores and between interviews and observations was low to moderate (kappa coefficient 0.11-0.80). Bland-Altman analysis revealed good agreement, with low mean difference for almost all SCIM III subscales and total scores, between pairs of interviewers (bias -4.15, limits of agreement -22.51 to 14.19, for total score) and between interviews and observations (bias 1.62, limits of agreement -20.55 to 23.81, for total score). ICC coefficients for the SCIM III subscales and total scores were high (0.637-0.916).
The findings of this study support the reliability and validity of SCIM III by interview, which appears to be useful for research of SCL patient groups. Individual scoring of SCIM III by interview, however, varied prominently between raters. Therefore, SCIM III by interview should be used with caution for clinical purposes, probably by raters whose scoring deviation, in relation to observation scores, is known.
心理计量研究。
本研究的目的是通过访谈来检验脊髓独立性测量量表第三版（SCIM III）的可靠性，并将评估结果与观察评估结果进行比较。
这项研究在以色列的洛伊文斯坦康复医院进行。
35 名在以色列洛伊文斯坦康复医院接受康复治疗的脊髓损伤（SCL）患者，在出院前的最后一周，通过观察和访谈进行 SCIM III 评估。其中 19 名患者还由第三位评估员通过访谈进行评估，以检验评估者间的可靠性。总一致性、kappa、Bland-Altman 图和组内相关系数（ICC）用于比较评估者之间、访谈之间和观察之间的一致性。
评估者之间的评分以及访谈与观察之间的总评分一致性为低至中度（kappa 系数为 0.11-0.80）。Bland-Altman 分析显示，几乎所有 SCIM III 子量表和总分的一致性都很好，配对评估者之间的平均差异较小（总分为 -4.15，一致性界限为-22.51 至 14.19），访谈与观察之间的平均差异也较小（总分为 1.62，一致性界限为-20.55 至 23.81）。SCIM III 子量表和总分的 ICC 系数较高（0.637-0.916）。
本研究的结果支持通过访谈进行 SCIM III 的可靠性和有效性，这对于 SCL 患者群体的研究似乎是有用的。然而，通过访谈对 SCIM III 进行个体评分，评估者之间存在明显的差异。因此，出于临床目的，通过访谈使用 SCIM III 时应谨慎，可能需要对评分与观察评分相关的偏差已知的评估者使用。
