聚焦证据综述：慢性肌肉骨骼疼痛患者报告结局测量的心理测量学特性。
Focused Evidence Review: Psychometric Properties of Patient-Reported Outcome Measures for Chronic Musculoskeletal Pain.
机构信息
Center for Chronic Disease Outcomes Research (CCDOR), Minneapolis VA Health Care System, Minneapolis, MN, USA.
Section General Internal Medicine, Minneapolis VA Health Care System, Minneapolis, MN, USA.
出版信息
J Gen Intern Med. 2018 May;33(Suppl 1):61-70. doi: 10.1007/s11606-018-4327-8.
BACKGROUND
Developing successful interventions for chronic musculoskeletal pain requires valid, responsive, and reliable outcome measures. The Minneapolis VA Evidence-based Synthesis Program completed a focused evidence review on key psychometric properties of 17 self-report measures of pain severity and pain-related functional impairment suitable for clinical research on chronic musculoskeletal pain.
METHODS
Pain experts of the VA Pain Measurement Outcomes Workgroup identified 17 pain measures to undergo systematic review. In addition to a MEDLINE search on these 17 measures (1/2000-1/2017), we hand-searched (without publication date limits) the reference lists of all included studies, prior systematic reviews, and-when available-Web sites dedicated to each measure (PROSPERO registration CRD42017056610). Our primary outcome was the measure's minimal important difference (MID). Secondary outcomes included responsiveness, validity, and test-retest reliability. Outcomes were synthesized through evidence mapping and qualitative comparison.
RESULTS
Of 1635 abstracts identified, 331 articles underwent full-text review, and 43 met inclusion criteria. Five measures (Oswestry Disability Index (ODI), Roland-Morris Disability Questionnaire (RMDQ), SF-36 Bodily Pain Scale (SF-36 BPS), Numeric Rating Scale (NRS), and Visual Analog Scale (VAS)) had data reported on MID, responsiveness, validity, and test-retest reliability. Seven measures had data reported on three of the four psychometric outcomes. Eight measures had reported MIDs, though estimation methods differed substantially and often were not clinically anchored.
CONCLUSIONS
In this focused evidence review, the most evidence on key psychometric properties in chronic musculoskeletal pain populations was found for the ODI, RMDQ, SF-36 BPS, NRS, and VAS. Key limitations in the field include substantial variation in methods of estimating psychometric properties, defining chronic musculoskeletal pain, and reporting patient demographics.
TRIAL REGISTRATION
Registered in the PROSPERO database: CRD42017056610.
背景
开发慢性肌肉骨骼疼痛的成功干预措施需要有效的、敏感的和可靠的结果测量方法。明尼苏达州退伍军人事务部循证综合计划（Minneapolis VA Evidence-based Synthesis Program）对 17 种适合慢性肌肉骨骼疼痛临床研究的自我报告疼痛严重程度和与疼痛相关的功能障碍测量方法的关键心理测量学特性进行了重点证据回顾。
方法
退伍军人事务部疼痛测量结果工作组的疼痛专家确定了 17 种需要进行系统回顾的疼痛测量方法。除了对这 17 种测量方法进行 MEDLINE 搜索（2000 年 1 月至 2017 年 1 月）外，我们还对手头所有纳入研究、先前的系统综述以及（如有）专门用于每种测量方法的网站的参考文献列表进行了手工搜索（无出版日期限制）（PROSPERO 注册 CRD42017056610）。我们的主要结局指标是测量的最小重要差异（MID）。次要结局指标包括反应性、有效性和重测信度。通过证据映射和定性比较对结果进行了综合。
结果
在确定的 1635 篇摘要中，有 331 篇文章进行了全文审查，其中 43 篇符合纳入标准。有 5 种测量方法（Oswestry 残疾指数（ODI）、Roland-Morris 残疾问卷（RMDQ）、SF-36 身体疼痛量表（SF-36 BPS）、数字评分量表（NRS）和视觉模拟量表（VAS））报告了 MID、反应性、有效性和重测信度的数据。有 7 种测量方法报告了四个心理测量学结果中的三个数据。有 8 种测量方法报告了 MID，但估计方法有很大差异，而且通常没有临床依据。
结论
在本次重点证据回顾中，在慢性肌肉骨骼疼痛人群中，对 ODI、RMDQ、SF-36 BPS、NRS 和 VAS 的关键心理测量学特性的证据最多。该领域的主要局限性包括估计心理测量学特性、定义慢性肌肉骨骼疼痛和报告患者人口统计学特征的方法存在很大差异。
试验注册
在 PROSPERO 数据库中注册：CRD42017056610。
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