Department of Medicine for Older People, Amsterdam Public Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
Department of Medicine for Older People, Amsterdam Public Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
J Am Med Dir Assoc. 2021 Aug;22(8):1627-1632.e1. doi: 10.1016/j.jamda.2021.01.079. Epub 2021 Feb 26.
OBJECTIVES: To study the test-retest reliability and measurement error, construct validity, responsiveness, interpretability, and floor/ceiling effects of a Patient-Reported Outcomes Measurement Information System (PROMIS) short form designed to measure physical function in geriatric rehabilitation patients (PROMIS-PF-GR). DESIGN: Prospective cohort. SETTING AND PARTICIPANTS: Inpatient geriatric rehabilitation patients. METHODS: We evaluated the test-retest reliability by re-administering PROMIS-PF-GR 3 to 5 days after the admission measurement. The intraclass correlation coefficient (ICC) was calculated to determine test-retest reliability; an ICC of ≥0.70 was considered sufficient. Measurement error was established by calculating the standard error of measurement and smallest detectable change. Construct validity and responsiveness were determined by testing a priori formulated hypotheses (criterion: ≥75% hypothesis not rejected). Interpretability was evaluated by calculating the minimal important change using predictive modeling and a global rating as criterion for change. Floor/ceiling effects were established by calculating the percentage patients with the minimum/maximum raw score (criterion: ≤15%) at admission and discharge. RESULTS: A total of 207 patients participated in the study [mean ± standard deviation age (80 ± 8.3 years), 58% female]. More than one-half of patients (56%) reported to be improved during rehabilitation. The ICC was 0.79 (95% confidence interval 0.70-0.84), the standardized error of measurement was 3.8, and the smallest detectable change 10.6. None of the 4 hypotheses for construct validity were rejected; 2 out of 5 hypotheses for responsiveness were rejected. The minimal important change was 8.0 (95% confidence interval 4.1-12.5). No floor/ceiling effects were found. CONCLUSIONS AND IMPLICATIONS: The PROMIS-PG-GR showed sufficient test-retest reliability, measurement error, and construct validity. We did not find sufficient evidence for responsiveness, which may be due to the unexplained weak correlation between the PROMIS change score and the Global Rating Scale. We still recommend the use the PROMIS-PG-GR for measuring self-reported physical function in geriatric rehabilitation.
目的：研究专为老年康复患者设计的患者报告结局测量信息系统（PROMIS）短式问卷测量身体机能的重测信度、测量误差、结构效度、反应度、可诠释性以及界值/天花板效应。
设计：前瞻性队列研究。
地点和参与者：住院老年康复患者。
方法：我们在入院测量后 3 至 5 天重新进行 PROMIS-PF-GR 评估，以确定重测信度。通过计算组内相关系数（ICC）来确定重测信度，ICC≥0.70 被认为是充分的。通过计算测量误差和最小可检测变化来确定测量误差。通过检验事先制定的假设（标准：≥75%假设未被拒绝）来确定结构效度和反应度。通过使用预测模型和整体评分作为变化标准来计算最小重要变化来评估可诠释性。通过计算入院和出院时具有最小/最大原始分数的患者比例（标准：≤15%）来确定界值/天花板效应。
结果：共有 207 名患者参与了研究（平均年龄±标准差为 80±8.3 岁，58%为女性）。超过一半的患者（56%）报告在康复过程中有所改善。ICC 为 0.79（95%置信区间 0.70-0.84），标准化测量误差为 3.8，最小可检测变化为 10.6。没有一个结构效度的 4 个假设被拒绝；5 个反应度假设中有 2 个被拒绝。最小重要变化为 8.0（95%置信区间 4.1-12.5）。未发现界值/天花板效应。
结论和意义：PROMIS-PG-GR 表现出足够的重测信度、测量误差和结构效度。我们没有发现反应度的充分证据，这可能是由于 PROMIS 变化评分与总体评分量表之间的弱相关性无法解释。我们仍推荐在老年康复中使用 PROMIS-PG-GR 来测量自我报告的身体机能。
J Am Med Dir Assoc. 2018-11-16
J Patient Rep Outcomes. 2021-5-30
World J Radiol. 2023-2-28
J Am Med Dir Assoc. 2021-8
Zotero 插件