Michael G. DeGroote Institute for Pain Research and Care, Hamilton, Ontario, Canada.
School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada.
Pain Med. 2019 Apr 1;20(4):799-809. doi: 10.1093/pm/pny202.
The purpose of this study was to conduct classical psychometric evaluation and Rasch analysis on the Neuropathic Qualities subscale of the Short-Form McGill Pain Questionnaire-2 utilizing scores from persons with complex regional pain syndrome to consider reliability and person separation, validity (including unidimensionality), and responsiveness in this population.
Secondary analysis of longitudinal data from persons with acute complex regional pain syndrome was utilized for analysis of the psychometric properties and fit to the Rasch model of the Neuropathic Qualities subscale. We followed an iterative process of Rasch analysis to evaluate and address data fitting challenges.
Repeated measures from 59 persons meeting the Budapest criteria were used for analysis. Both item-total correlations and unidimensionality analyses supported theoretical construct validity; all convergent construct validity hypotheses were also supported. Responsiveness was demonstrated comparing baseline and one-year data at d = 0.92, with a standardized response mean of 0.97. Data were able to fit the Rasch model, but all Neuropathic Qualities items had disordered thresholds that required rescoring. Additionally, local dependency and differential item function were addressed by "bundling," suggesting that no further item reduction would be possible.
This study provided preliminary support for the validity and responsiveness of the Neuropathic Qualities subscale in persons with complex regional pain syndrome. Rasch analysis further endorses use of the Neuropathic Qualities subscale as a "stand-alone" measure for neuropathic features, but with substantial background data transformations. Replication with larger samples is recommended to increase confidence in these findings.
本研究旨在利用复杂区域疼痛综合征患者的评分，对短格式麦吉尔疼痛问卷-2 的神经病理性特征子量表进行经典心理计量学评估和 Rasch 分析，以考虑该人群的可靠性和个体分离度、有效性（包括单维性）和反应度。
对急性复杂区域疼痛综合征患者的纵向数据进行二次分析，以分析神经病理性特征子量表的心理计量学特性和对 Rasch 模型的拟合情况。我们采用 Rasch 分析的迭代过程来评估和解决数据拟合挑战。
满足布达佩斯标准的 59 名患者的重复测量数据用于分析。项目总分相关性和单维性分析均支持理论结构效度；所有收敛结构效度假设也得到支持。与基线相比，在 d=0.92 时比较一年期数据，具有 0.97 的标准化反应均值，证明了反应度。数据能够拟合 Rasch 模型，但所有神经病理性特征子量表的项目阈值都存在紊乱，需要重新评分。此外，通过“捆绑”解决了局部依赖性和差异项目功能问题，表明不可能进一步减少项目。
本研究为复杂区域疼痛综合征患者神经病理性特征子量表的有效性和反应度提供了初步支持。Rasch 分析进一步支持将神经病理性特征子量表作为神经病理性特征的“独立”测量工具使用，但需要大量背景数据转换。建议使用更大的样本进行复制，以提高对这些发现的信心。
