Merola Aristide, Torres-Russotto Diego R, Stebbins Glenn T, Vizcarra Joaquin A, Shukla Aparna Wagle, Hassan Anhar, Marsili Luca, Krauss Joachim K, Elble Rodger J, Deuschl Günther, Espay Alberto J
Department of Neurology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, Nebraska, USA.
Mov Disord. 2020 Oct;35(10):1796-1801. doi: 10.1002/mds.28142. Epub 2020 Jun 20.
Limited tools are available for the assessment of orthostatic tremor severity and disability.
To develop and validate a self-administered orthostatic tremor scale.
After expert consensus and literature review generating a list of 42 items, the scale was developed and modified for validation after a patient focus group, multiple rounds of Delphi panels, and cognitive interviews. Clinimetric evaluations included assessing content validity, internal consistency, measurement error and reliability, construct validity, and concurrent validity anchored on the examiner's Clinical Global Impression score.
Eleven items ranked on a Likert scale from 0 (no disability/severity) to 5 (maximal disability/severity) were evaluated in 54 orthostatic tremor patients (16 men and 38 women; mean age: 69.17 ± 9.64 years; disease duration: 13.83 ± 11.24 years) to probe severity and disability over the preceding 1-week period. The 11-item scale showed good internal consistency (Cronbach's alpha = 0.863) and acceptable (>0.40) item-to-total correlation. However, one item was removed at the final Delphi panel because of significant floor effect, poor item-to-total correlation, and poor factor-loading, leaving the scale with 10 items (10-item Orthostatic Tremor Severity and Disability Scale). Test-retest reliability at 2 weeks was excellent (two-way random intraclass correlation coefficient > 0.90), and the individual item test-retest reliability showed good agreement, with a threshold weighted kappa >0.60 for all items. Exploratory factor analyses revealed a parsimonious two-factor construct accounting for 57.7% of the scale's variance. The 10-item Orthostatic Tremor Severity and Disability Scale scores correlated with the CGI.
The self-administered 10-item Orthostatic Tremor Severity and Disability Scale scale is valid and reliable for capturing orthostatic tremor-related severity and disability. © 2020 International Parkinson and Movement Disorder Society.
用于评估直立性震颤严重程度和残疾状况的工具有限。
开发并验证一种自我管理的直立性震颤量表。
在专家共识和文献回顾生成42项条目列表后，该量表经患者焦点小组、多轮德尔菲小组及认知访谈后进行开发和修改以进行验证。临床测量学评估包括评估内容效度、内部一致性、测量误差和信度、结构效度以及以检查者的临床总体印象评分为锚定的同时效度。
在54例直立性震颤患者（16例男性和38例女性；平均年龄：69.17±9.64岁；病程：13.83±11.24年）中对11项按李克特量表从0（无残疾/严重程度）到5（最大残疾/严重程度）进行排序的条目进行评估，以探究前1周内的严重程度和残疾状况。该11项量表显示出良好的内部一致性（克朗巴哈系数=0.863）和可接受的（>0.40）条目与总分相关性。然而，在最终的德尔菲小组中，由于显著的地板效应、较差的条目与总分相关性以及较差的因子负荷，一项条目被删除，最终量表为10项（10项直立性震颤严重程度和残疾量表）。2周时的重测信度极佳（双向随机组内相关系数>0.90），且各单项的重测信度显示出良好的一致性，所有条目的阈值加权kappa>0.60。探索性因子分析揭示了一个简约的双因子结构，占量表方差的57.7%。10项直立性震颤严重程度和残疾量表得分与临床总体印象相关。
自我管理的10项直立性震颤严重程度和残疾量表在获取与直立性震颤相关的严重程度和残疾状况方面是有效且可靠的。©2020国际帕金森病和运动障碍协会。
