Department of Orthopaedic Surgery, the University of Tokyo, Tokyo, Japan.
Department of Orthopaedics, Jichi Medical University, Shimotsuke, Japan.
Spine (Phila Pa 1976). 2019 May 15;44(10):691-697. doi: 10.1097/BRS.0000000000002928.
STUDY DESIGN: A retrospective analysis. OBJECTIVE: The aim of this study was to elucidate the psychometric properties of the original Japanese Orthopaedic Association (JOA) score, including the minimum detectable change (MDC), minimum clinically important difference (MCID), and patient-accepted symptom state (PASS). SUMMARY OF BACKGROUND DATA: Despite the worldwide popularity of modified JOA score (mJOA), the original JOA score is still commonly used in East Asian countries, including Japan. However, unlike mJOA score, the psychometric properties of JOA score remain poorly understood. METHODS: We retrospectively reviewed a consecutive series of laminoplasty for degenerative cervical myelopathy patients in a single academic institution. Pre- and postoperative JOA scores were collected, and the recovery rate was calculated. Anchor-based methods were used to determine the cut-off values by a receiver operating characteristic (ROC) curve analysis. The patients were also asked to answer an anchor question analyzing their postoperative health transition used for the MDC and another question assessing the patient satisfaction used for the MCID and PASS. RESULTS: A total of 101 patients were included in the analysis. The mean preoperative JOA score was 10.3 [standard deviation (SD): 2.4), and the mean postoperative JOA score was 13.4 (SD: 2.5). The mean recovery rate was 44%. A total of 68% of the patients admitted that their health condition was at least "somewhat better" than their preoperative condition, and 66% were at least "somewhat satisfied" with the treatment results. On the basis of ROC curve analyses, the MDC and MCID for JOA score in degenerative cervical myelopathy patients were calculated to be 2.5. The PASS was estimated to be 14.5, and the MCID for JOA recovery rate was 52.8%. CONCLUSION: The MDC, MCID, and PASS for JOA score for degenerative cervical myelopathy patients were reported by anchor-based ROC curve analyses. LEVEL OF EVIDENCE: 4.
研究设计:回顾性分析。
目的:本研究旨在阐明原始日本矫形协会(JOA)评分的心理测量特性,包括最小可检测变化(MDC)、最小临床重要差异(MCID)和患者可接受症状状态(PASS)。
背景数据概要:尽管改良 JOA 评分(mJOA)在全球范围内得到广泛应用,但原始 JOA 评分在包括日本在内的东亚国家仍被广泛使用。然而,与 mJOA 评分不同,JOA 评分的心理测量特性仍知之甚少。
方法:我们对一家学术机构的连续颈椎退行性脊髓病患者行椎板成形术的病例进行了回顾性研究。收集了术前和术后的 JOA 评分,并计算了恢复率。使用基于锚定的方法通过接收者操作特征(ROC)曲线分析来确定截断值。还要求患者回答一个锚定问题,分析他们术后健康状态的变化,用于确定 MDC,以及另一个评估患者对治疗结果满意度的问题,用于确定 MCID 和 PASS。
结果:共有 101 例患者纳入分析。平均术前 JOA 评分为 10.3(标准差:2.4),平均术后 JOA 评分为 13.4(标准差:2.5)。平均恢复率为 44%。68%的患者表示他们的健康状况至少“有所改善”,而 66%的患者对治疗结果至少“有些满意”。基于 ROC 曲线分析,退行性颈椎脊髓病患者 JOA 评分的 MDC 和 MCID 分别计算为 2.5。PASS 估计为 14.5,JOA 恢复率的 MCID 为 52.8%。
结论:基于锚定 ROC 曲线分析,报告了退行性颈椎脊髓病患者 JOA 评分的 MDC、MCID 和 PASS。
证据水平:4 级。