下背痛、上肢和下肢疾病患者变化量表总体评分的心理测量特性。一项荟萃分析的系统评价。
Psychometric properties of the global rating of change scales in patients with low back pain, upper and lower extremity disorders. A systematic review with meta-analysis.
作者信息
Bobos Pavlos, Ziebart Christina, Furtado Rochelle, Lu Ze, MacDermid Joy C
机构信息
Western's Bone and Joint Institute, School of Physical Therapy, Department of Health and Rehabilitation Sciences, Western University, London, Ontario, Canada.
Roth McFarlane Hand and Upper Limb Centre, St. Joseph's Hospital, London, ON, Canada.
出版信息
J Orthop. 2020 Feb 10;21:40-48. doi: 10.1016/j.jor.2020.01.047. eCollection 2020 Sep-Oct.
OBJECTIVE
The purpose of this systematic review was to critically appraise and synthesize the psychometric properties of the Global Rating of Change (GRoC) scales on the assessment of patients with low back pain (LBP), upper extremity and lower extremity disorders.
METHODS
A search was performed in 4 databases (MEDLINE, EMBASE, CINAHL, SCOPUS) until February 2019. Eligible articles were appraised using Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) checklist and the Quality Appraisal for Clinical Measurement Research Reports Evaluation Form.
RESULTS
The 8 eligible studies included participants with orthopedic lumbar spine impairments (n = 52,767), patients with work-related musculoskeletal disorders (n = 1944), patients with low back pain (n = 183) and individuals with upper extremity disorders (n = 151). Risk of bias was ranging from "adequate" to "very good" and quality was found excellent for all studies. Based on pooled data, test-retest reliability of 11-item GRoC for patients with low back pain was found excellent ICC = 0.84, 95% CI: 0.65 to 0.94. Test-retest reliability in patients with shoulder pain was found fair to good ICC of 0.62 in a 15-point GRoC scale. Seven studies (n = 7) examined the convergent validity between GRoC and another outcome measure. Minimum important change on the Portuguese version of Global Perceived Effect (GPE) for patients with LBP was 2.5 points out of 11 points.
CONCLUSIONS
The current pool of clinical measurement studies indicates that the GRoC has excellent test-retest reliability for patients with low back pain, shoulder pain and with lumbar spine disorders. However, the validity of it as a reference standard in responsiveness studies or as an accurate overall assessment of change has been questioned. While future studies might provide more insight into its measurement properties, this limitation is unlikely to change. Therefore, we suggest that future responsiveness in the studies that want a global indicator measure need to use an additional measure to mitigate recall bias.
PROSPERO REGISTRATION NUMBER
CRD 42020149122.
目的
本系统评价旨在严格评估和综合全球变化评分（GRoC）量表在评估腰痛（LBP）、上肢和下肢疾病患者方面的心理测量特性。
方法
截至2019年2月，在4个数据库（MEDLINE、EMBASE、CINAHL、SCOPUS）中进行了检索。使用基于共识的健康测量工具选择标准（COSMIN）清单和临床测量研究报告评价表的质量评估对符合条件的文章进行评估。
结果
8项符合条件的研究纳入了患有骨科腰椎损伤的参与者（n = 52767）、患有工作相关肌肉骨骼疾病的患者（n = 1944）、腰痛患者（n = 183）和上肢疾病患者（n = 151）。偏倚风险范围为“充分”至“非常好”，所有研究的质量均被评为优秀。基于汇总数据，发现11项GRoC量表对腰痛患者的重测信度极佳，ICC = 0.84，95%CI：0.65至0.94。在15分的GRoC量表中，肩部疼痛患者的重测信度为中等至良好，ICC为0.62。7项研究（n = 7）检验了GRoC与另一种结局测量之间的收敛效度。LBP患者的葡萄牙语版全球感知效应（GPE）的最小重要变化为11分中的2.5分。
结论
目前的临床测量研究表明，GRoC对腰痛、肩部疼痛和腰椎疾病患者具有出色的重测信度。然而，其作为反应性研究中的参考标准或作为对变化的准确总体评估的有效性受到了质疑。虽然未来的研究可能会对其测量特性提供更多见解，但这一局限性不太可能改变。因此，我们建议，在希望采用全球指标测量的研究中，未来的反应性研究需要使用额外的测量方法来减轻回忆偏倚。
PROSPERO注册号：CRD 42020149122。
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