School of Physical Therapy, Western University, London, ON, Canada.
Bone and Joint Institute, Western University, London, ON, Canada.
Eur J Pain. 2018 Aug;22(7):1351-1361. doi: 10.1002/ejp.1224. Epub 2018 May 21.
There are few patient-reported outcomes routinely used that capture frequency and interference of different pain-related symptoms on a single scale. The purpose of this study was to describe the development and initial validation of the new Multidimensional Symptom Index (MSI).
Items were generated from patient interviews of the experience of chronic pain. Health valuations were created from rankings of 82 healthy subjects for each of 120 symptom (×10) × frequency (×3) × interference (×4) combinations using preference-based health valuations (0-100). Ranks for each symptom combination were then used in scale scoring. A sample of 300 patients with acute or chronic pain subsequently completed the MSI and a battery of other tools. Exploratory (EFA) and Confirmatory (CFA) factor analyses were triangulated with theory to arrive at the factor structure. Convergent validity was tested against established measures.
Health rankings resulted in scores of 0-12 for each of the 10 symptom types. Factor analyses revealed two factors: MSI Somatic Symptoms and MSI Non-Somatic Symptoms. The MSI also quantified number of symptoms experienced (/10), mean frequency (/3) and mean interference (/4). The indices showed appropriate associations with the established PROs.
The MSI is a new symptom-focused PRO that allows patient phenotyping and may have value for screening, prognosis and evaluating change.
This article presents the development and psychometric properties of a new measure of pain and related symptom frequency and interference. This measure could aid clinicians in establishing clinically relevant pain phenotypes for screening, prognosis and treatment decisions.
目前很少有患者报告的结果能够在单一量表上捕捉到不同疼痛相关症状的频率和干扰。本研究的目的是描述新的多维症状指数（MSI）的开发和初步验证。
从慢性疼痛患者的访谈中生成项目。使用偏好为基础的健康评估方法（0-100），对 82 位健康受试者的每种症状（×10）×频率（×3）×干扰（×4）组合进行排名，从而生成健康评估值。然后，使用排名来对每个症状组合进行评分。随后，300 名患有急性或慢性疼痛的患者样本完成了 MSI 和其他一系列工具的评估。探索性（EFA）和验证性（CFA）因子分析与理论相结合，以确定因子结构。与已建立的测量方法进行收敛性验证。
健康评估排名为每种 10 种症状类型的 0-12 分。因子分析显示有两个因素：MSI 躯体症状和 MSI 非躯体症状。MSI 还量化了所经历的症状数量（/10）、平均频率（/3）和平均干扰（/4）。这些指数与已建立的 PRO 有适当的关联。
MSI 是一种新的以症状为重点的 PRO，可实现患者表型分析，可能对筛选、预后和评估变化具有价值。
本文介绍了一种新的疼痛及相关症状频率和干扰的测量方法的开发和心理测量特性。该测量方法可以帮助临床医生为筛选、预后和治疗决策建立具有临床相关性的疼痛表型。
