School of Physical Therapy, Department of Health and Rehabilitation Sciences, Western University, London, ON, Canada.
Western's Bone and Joint Institute, Collaborative Program of Musculoskeletal Health Research, Western University, London, ON, Canada.
Health Qual Life Outcomes. 2020 Sep 9;18(1):302. doi: 10.1186/s12955-020-01556-0.
The Australian/Canadian Osteoarthritis Hand Index (AUSCAN), the Patient-Rated Wrist/Hand Evaluation (PRWHE) and the Thumb Disability Exam (TDX) are patient-reported outcome measures (PROM) designed to assess pain and hand function in patients with hand arthritis, hand pain and disability, or thumb pathology respectively. This study evaluated the content validity of AUSCAN, PRWHE and TDX in people with hand arthritis.
This study enrolled participants with hand arthritis to rate the items of all 3 PROM in terms of relevance and clarity. The Content Validity Index (CVI) was computed for each item in each scale (I-CVI) as well as for the overall scale (S-CVI). Kappa was used to determine the inter-rater agreement among the raters.
Overall, 64 individuals with hand arthritis (27% with OA, 67% with rheumatoid arthritis and 6% with psoriatic arthritis) participated in the study. The I-CVI for all items and all scales were very high (I-CVI > 0.76) and the modified Kappa agreement among the raters demonstrated excellent agreement (k > 0.76). The S-CVI for all PROMs was very high for relevance (AUSCAN = 0.92, 95% CI 0.90 to 0.94; PRWHE = 0.85, 95% CI 0.82 to 0.88 and TDX = 0.87, 95% CI 0.85 to 0.89) and for clarity (AUSCAN = 0.99, 95% CI 0.98 to 1.00; PRWHE = 0.95, 95% CI 0.93 to 0.97 and TDX = 0.91, 95% CI 0.89 to 0.94), respectively.
This study demonstrated very high content validity indices for the AUSCAN, PRWHE and TDX; with strong consensus across raters. This augments prior studies demonstrating appropriate statistical measurement properties, to provide confidence that all three measures assess important patient concepts of pain and disability.
澳大利亚/加拿大骨关节炎手部指数（AUSCAN）、患者腕/手部评估（PRWHE）和拇指残疾检查（TDX）是患者报告结局测量（PROM），分别旨在评估手部关节炎、手部疼痛和残疾患者的疼痛和手部功能，以及拇指病理患者。本研究评估了 AUSCAN、PRWHE 和 TDX 在手部关节炎患者中的内容效度。
本研究招募了手部关节炎患者，让他们对所有 3 种 PROM 的项目进行相关性和清晰度评分。为每个量表中的每个项目计算内容效度指数（I-CVI），以及总体量表的内容效度指数（S-CVI）。Kappa 用于确定评分者之间的组内一致性。
总体而言，64 名手部关节炎患者（27%为 OA，67%为类风湿关节炎，6%为银屑病关节炎）参与了研究。所有项目和所有量表的 I-CVI 均非常高（I-CVI＞0.76），评分者之间的修正 Kappa 一致性表明存在极好的一致性（k＞0.76）。所有 PROM 的 S-CVI 在相关性方面均非常高（AUSCAN=0.92，95%CI 0.90 至 0.94；PRWHE=0.85，95%CI 0.82 至 0.88；TDX=0.87，95%CI 0.85 至 0.89）和清晰度方面（AUSCAN=0.99，95%CI 0.98 至 1.00；PRWHE=0.95，95%CI 0.93 至 0.97；TDX=0.91，95%CI 0.89 至 0.94）。
本研究表明，AUSCAN、PRWHE 和 TDX 的内容效度指数非常高；评分者之间具有强烈的一致性。这增加了先前研究的结果，证明了这些统计测量特性适当，从而有信心认为所有三种测量方法均评估了疼痛和残疾等重要的患者概念。
