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基于经验采样法的功能性消化不良患者报告结局测量量表的心理测量学评价。

Psychometric evaluation of an experience sampling method-based patient-reported outcome measure in functional dyspepsia.

机构信息

Division of Gastroenterology-Hepatology, Department of Internal Medicine, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre+, Maastricht, The Netherlands.

Department of Clinical and Experimental Medicine, Translational Research Centre for Gastrointestinal Disorders (TARGID), University of Leuven, Leuven, Belgium.

出版信息

Neurogastroenterol Motil. 2021 Sep;33(9):e14136. doi: 10.1111/nmo.14136. Epub 2021 May 2.

Abstract

BACKGROUND

Due to important biases, conventional end-of-day and end-of-week assessment methods of gastrointestinal symptoms in functional dyspepsia (FD) are considered suboptimal. Real-time symptom assessment based on the experience sampling method (ESM) could be a more accurate measurement method. This study aimed to evaluate validity and reliability of an ESM-based patient-reported outcome measure (PROM) for symptom assessment in FD.

METHODS

Thirty-five patients with FD (25 female, mean age 44.7 years) completed the ESM-based PROM (a maximum of 10 random moments per day) and an end-of-day symptom diary for 7 consecutive days. On day 7, end-of-week questionnaires were completed including the Nepean Dyspepsia Index (NDI) and Patient Assessment of Gastrointestinal Symptom Severity Index (PAGI-SYM).

KEY RESULTS

Experience sampling method and corresponding end-of-day scores for gastrointestinal symptoms were significantly associated (ICCs range 0.770-0.917). However, end-of-day scores were significantly higher (Δ0.329-1.031) than mean ESM scores (p < 0.05). Comparing ESM with NDI and PAGI-SYM scores, correlations were weaker (Pearson's r range 0.467-0.846). Cronbach's α coefficient was good for upper gastrointestinal symptoms (α = 0.842). First half-week and second half-week scores showed very good consistency (ICCs range 0.913-0.975).

CONCLUSION AND INFERENCES

Good validity and reliability of a novel ESM-based PROM for assessing gastrointestinal symptoms in FD patients was demonstrated. Moreover, this novel PROM allows to evaluate individual symptom patterns and can evaluate interactions between symptoms and environmental/contextual factors. ESM has the potential to increase patients' disease insight, provide tools for self-management, and improve shared decision making. Hence, this novel tool may aid in the transition toward personalized health care for FD patients.

摘要

背景

由于存在重要的偏倚,功能性消化不良(FD)的传统日内和周末胃肠道症状评估方法被认为并不理想。基于经验采样法(ESM)的实时症状评估可能是一种更准确的测量方法。本研究旨在评估基于 ESM 的患者报告结局测量(PROM)用于 FD 症状评估的有效性和可靠性。

方法

35 例 FD 患者(25 名女性,平均年龄 44.7 岁)连续 7 天完成 ESM 基 PROM(每天最多 10 个随机时刻)和日内症状日记。第 7 天,完成包括 Nepean 消化不良指数(NDI)和患者胃肠道症状严重程度指数(PAGI-SYM)在内的周内问卷。

主要结果

ESM 和相应的日内胃肠道症状评分具有显著相关性(ICC 范围 0.770-0.917)。然而,日内评分显著高于平均 ESM 评分(p < 0.05)。与 NDI 和 PAGI-SYM 评分相比,ESM 评分的相关性较弱(Pearson r 范围 0.467-0.846)。上胃肠道症状的 Cronbach's α 系数为 0.842。前半周和后半周评分具有很好的一致性(ICC 范围 0.913-0.975)。

结论

新型基于 ESM 的 PROM 用于评估 FD 患者的胃肠道症状具有良好的有效性和可靠性。此外,这种新型 PROM 可以评估个体症状模式,并评估症状与环境/背景因素之间的相互作用。ESM 有可能增加患者对疾病的了解,为自我管理提供工具,并改善共同决策。因此,这种新型工具可能有助于 FD 患者向个性化医疗的转变。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8ca/8519073/4fe9e1d8bd8f/NMO-33-e14136-g002.jpg

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