用于颈部疾病的患者报告结局测量：系统评价概述。

Patient-Reported Outcome Measures Used for Neck Disorders: An Overview of Systematic Reviews.

出版信息

J Orthop Sports Phys Ther. 2018 Oct;48(10):775-788. doi: 10.2519/jospt.2018.8131. Epub 2018 Jun 22.

DOI:10.2519/jospt.2018.8131

Abstract

BACKGROUND

The evaluation of patient-reported outcome measures for the neck from multiple systematic reviews will provide a broader view of, and may identify potential conflicting or consistent results for, their psychometric properties.

OBJECTIVES

The purpose of this study was to conduct an overview of systematic reviews and synthesize evidence to establish the current state of knowledge on psychometric properties of patient-reported outcome measures for patients with neck disorders.

METHODS

In this overview of systematic reviews, an electronic search of 6 databases (MEDLINE, Embase, CINAHL, ILC, the Cochrane Central Register of Controlled Trials, and LILACS) was conducted to identify reviews that addressed at least one measurement property of outcome measures for people with neck pain. Only systematic reviews with patient-reported outcome measures were included in the analysis. Risk of bias was assessed with A MeaSurement Tool to Assess systematic Reviews (AMSTAR). Data on measurement properties were extracted from each systematic review.

RESULTS

From 13 systematic reviews, 8 patient-reported outcome measures were evaluated in 2 or more reviews. Risk-of-bias scores ranged from moderate (5-7) to high (4 and lower). Findings on internal consistency, test-retest reliability, construct validity, responsiveness to change, and content and structural validity were synthesized for the Neck Disability Index (NDI) in 11 systematic reviews; the Northwick Park Neck Pain Questionnaire and Neck Pain and Disability scale (NPDS) in 6 systematic reviews; the Copenhagen Neck Functional Disability Scale in 5 systematic reviews; the Neck Bournemouth Questionnaire in 4 systematic reviews; the Core Neck Pain Questionnaire and Patient-Specific Functional Scale in 3 systematic reviews, and the Whiplash Disability Questionnaire in 2 systematic reviews.

CONCLUSION

High-quality evidence was found of good to excellent internal consistency and moderate to excellent test-retest reliability for the NDI. Moderate-quality evidence was found of good to excellent internal consistency and good test-retest reliability for the Northwick Park Neck Pain Questionnaire. High-quality evidence was found of excellent test-retest reliability and good to strong construct validity with pain scales for the Copenhagen Neck Functional Disability Scale. Moderate-quality evidence was found of unclear to excellent internal consistency and moderate to strong concurrent associations with the NDI and global assessment of change for the Neck Pain and Disability scale. Moderate-quality evidence was found of excellent internal consistency for the Whiplash Disability Questionnaire and of high test-retest reliability for the Patient-Specific Functional Scale. J Orthop Sports Phys Ther 2018;48(10):775-788. Epub 22 Jun 2018. doi:10.2519/jospt.2018.8131.

摘要

背景

对来自多个系统评价的颈部患者报告结局测量指标进行评估，将为其心理测量学特性提供更广泛的视角，并可能发现潜在的冲突或一致的结果。

目的

本研究旨在进行系统评价综述，综合证据，以确定颈部疾病患者的患者报告结局测量指标的心理测量学特性的现有知识状态。

方法

在本次系统评价综述中，对 6 个数据库（MEDLINE、Embase、CINAHL、ILC、Cochrane 对照试验中心注册库和 LILACS）进行了电子检索，以确定至少评估过颈部疼痛患者的结局测量指标的一个测量特性的综述。仅纳入包含患者报告结局测量指标的系统评价进行分析。采用 AMSTAR 量表评估系统评价的偏倚风险。从每项系统评价中提取测量特性的数据。

结果

在 13 项系统评价中，8 项患者报告结局测量指标在 2 项或更多项研究中进行了评估。偏倚风险评分范围为中度（5-7 分）到高度（4 分及以下）。11 项系统评价中综合了颈残障指数（NDI）的内部一致性、重测信度、结构效度、反应度和内容效度和结构效度；6 项系统评价中综合了颈痛和残疾量表（NPDS）的内部一致性和重测信度；5 项系统评价中综合了哥本哈根颈功能障碍量表的内部一致性和重测信度；4 项系统评价中综合了颈 Bournemouth 问卷的内部一致性和结构效度；3 项系统评价中综合了核心颈痛问卷和患者特定功能量表的内部一致性和结构效度；2 项系统评价中综合了颈性眩晕问卷的重测信度和结构效度。

结论

高质量证据表明，颈残障指数具有良好到极好的内部一致性和中度到极好的重测信度。中高质量证据表明，颈痛问卷具有良好到极好的内部一致性和良好的重测信度。高质量证据表明，哥本哈根颈功能障碍量表与疼痛量表具有极好的重测信度和良好到强的结构效度。中高质量证据表明，颈痛和残疾量表具有不明确到极好的内部一致性和与 NDI 和整体变化评估的中度到强的相关性。中高质量证据表明，颈性眩晕问卷具有极好的内部一致性，患者特定功能量表具有高度的重测信度。J Orthop Sports Phys Ther 2018;48(10):775-788. Epub 22 Jun 2018. doi:10.2519/jospt.2018.8131.