《Cochin 手功能障碍量表的信度、效度和变化敏感性，以及在系统性硬化症中测试新的 6 项 Cochin 手功能障碍量表》

Reliability, Validity, and Sensitivity to Change of the Cochin Hand Functional Disability Scale and Testing the New 6-Item Cochin Hand Functional Disability Scale in Systemic Sclerosis.

机构信息

From the Internal Medicine and Rheumatology Department, Cantacuzino Clinical Hospital.

出版信息

J Clin Rheumatol. 2021 Apr 1;27(3):102-106. doi: 10.1097/RHU.0000000000001195.

DOI:10.1097/RHU.0000000000001195

PMID:31703022

Abstract

UNLABELLED

Systemic sclerosis (SSc) is a chronic autoimmune disease causing complex hand disability. A reliable tool for hand function assessment in SSc is the Cochin Hand Functional Disability Scale (CHFS). More recently, a short-form CHFS of 6 items (CHFS-6) has been developed.

OBJECTIVES

To validate the CHFS and the new CHFS-6 in Romanian patients with SSc.

PATIENTS AND METHODS

Consecutive patients with SSc who completed the CHFS were included. All patients were assessed according to the recommendations of the European Scleroderma and Research Trials and also completed the Scleroderma Health Assessment Questionnaire and the Hand Mobility in Scleroderma questionnaire. Finger range-of-motion distances were measured.

RESULTS

Seventy patients, 63 female and 7 male patients (age median, 53.0 years; interquartile range [IQR], 21.0 years), were included. Twenty seven had diffuse cutaneous involvement (dcSSc). Median CHFS and CHFS-6 at baseline were 25.0 (IQR, 37.0) and 8.0 (IQR, 13.0), respectively.The internal consistency (Cronbach α = 0.96, respectively, 0.90, in all 70 patients) and test-retest reliability (intraclass correlation coefficient = 0.98 for both, in 38 patients) of both CHFS and CHFS-6 were excellent. The CHFS-6 had a very high correlation with the CHFS. There were moderate to good correlations with Hand Mobility in Scleroderma, Scleroderma Health Assessment Questionnaire, and the anthropometric measurements (construct validity). In patients with early dcSSc with a second evaluation, we found good to moderate sensitivity to change (standardized response mean of 0.8 and effect size of 0.4 for CHFS, and standardized response mean of 1.1 and effect size of 0.6 for CHFS-6).

CONCLUSIONS

The CHFS and CHFS-6 are valid and easy-to-use tools for hand involvement in SSc, which can be used in clinical or research setting.

摘要

目的

验证 Cochin 手部功能残疾量表（CHFS）和新的 6 项 CHFS（CHFS-6）在罗马尼亚系统性硬化症（SSc）患者中的有效性。

方法

纳入完成 CHFS 评估的连续 SSc 患者。所有患者均根据欧洲硬皮病和研究试验的建议进行评估，还完成了硬皮病健康评估问卷（Scleroderma Health Assessment Questionnaire，SHAQ）和硬皮病手部活动度问卷（Hand Mobility in Scleroderma questionnaire，HMS）。测量手指活动度距离。

结果

共纳入 70 例患者，其中 63 例为女性，7 例为男性（年龄中位数为 53.0 岁，四分位距 [interquartile range，IQR]为 21.0 岁）。27 例患者为弥漫性皮肤型 SSc（dcSSc）。基线时 CHFS 和 CHFS-6 的中位数分别为 25.0（IQR，37.0）和 8.0（IQR，13.0）。在所有 70 例患者中，CHFS 和 CHFS-6 的内部一致性（Cronbach α 分别为 0.96 和 0.90）和重测信度（在 38 例患者中，内部一致性系数分别为 0.98）均极佳。CHFS-6 与 CHFS 高度相关，与 HMS、SHAQ 和人体测量学指标（结构效度）也具有中度至良好的相关性。在具有第二次评估的早期 dcSSc 患者中，我们发现 CHFS 和 CHFS-6 对变化的敏感性良好至中度（CHFS 的标准化反应均值为 0.8，效应量为 0.4；CHFS-6 的标准化反应均值为 1.1，效应量为 0.6）。