评价 PROMIS 上肢在早期腕掌关节炎患者中对经过验证的患者报告结局的有效性。
Evaluation of the PROMIS Upper Extremity Against Validated Patient-Reported Outcomes in Patients With Early Carpometacarpal Osteoarthritis.
机构信息
Department of Orthopaedics, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, Providence, RI.
Robert A. Chase Hand & Upper Limb Center, Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA.
出版信息
J Hand Surg Am. 2022 Jul;47(7):621-628. doi: 10.1016/j.jhsa.2022.03.003. Epub 2022 May 5.
PURPOSE
Internal consistency, construct, and criterion validity of the Patient-Reported Outcomes Measurement Information System (PROMIS) upper extremity (UE) v1.2 were evaluated in patients with early-stage carpometacarpal (CMC) osteoarthritis (OA). We hypothesized that in patients with early CMC OA, PROMIS UE scores would: (1) be lower than those in asymptomatic controls; (2) correlate with established patient-reported outcomes; (3) correlate with pinch and grip strengths; and (4) not correlate with radiographic disease progression.
METHODS
Patients with early CMC OA (modified Eaton stage 0 or 1) and matched asymptomatic control patients completed the PROMIS UE, Australian and Canadian Osteoarthritis Hand Index, and Patient-Rated Wrist-Hand Evaluation at 2 time points. The PROMIS UE's internal consistency was evaluated by Cronbach's alpha, construct validity by Spearman correlation coefficients among the patient-reported outcome measures, and criterion validity using measures of strength. A floor or ceiling effect was indicated if more than 15% of patients achieved the lowest or highest possible score.
RESULTS
The PROMIS UE had high internal consistency. Patients with early CMC OA had a lower score than healthy controls (average, 42 vs 54, respectively). We observed moderate to high correlations between the PROMIS UEv1.2, Australian and Canadian Osteoarthritis Hand Index, and Patient-Rated Wrist-Hand Evaluation and good criterion validity when compared to key pinch and grip strengths. The PROMIS UE did not correlate to radiographic disease severity.
CONCLUSIONS
The PROMIS UE had a high correlation with Australian and Canadian Osteoarthritis Hand Index and a moderate correlation with Patient-Rated Wrist-Hand Evaluation. The PROMIS UE had high internal consistency and good criterion validity.
CLINICAL RELEVANCE
The PROMIS UE is a valid assessment for disability in patients with early CMC OA and can serve as a clinical adjunct to an outcome assessment.
目的
评估患者报告结局测量信息系统（PROMIS）上肢（UE）v1.2 版本在早期腕掌关节（CMC）骨关节炎（OA）患者中的内部一致性、结构和效标效度。我们假设，在早期 CMC OA 患者中，PROMIS UE 评分将：（1）低于无症状对照者；（2）与既定的患者报告结局相关；（3）与捏力和握力相关；（4）与影像学疾病进展无关。
方法
早期 CMC OA（改良 Eaton 分期 0 或 1）患者和匹配的无症状对照者在 2 个时间点完成 PROMIS UE、澳大利亚和加拿大骨关节炎手部指数和患者评定腕手评估。通过 Cronbach's alpha 评估 PROMIS UE 的内部一致性，通过 Spearman 相关系数评估患者报告结局之间的结构效度，通过强度测量评估效标效度。如果超过 15%的患者获得最低或最高可能分数，则表明存在地板或天花板效应。
结果
PROMIS UE 具有较高的内部一致性。早期 CMC OA 患者的评分低于健康对照组（平均分别为 42 分和 54 分）。我们观察到 PROMIS UEv1.2、澳大利亚和加拿大骨关节炎手部指数以及患者评定腕手评估之间存在中度至高度相关性，与关键捏力和握力相比具有良好的效标效度。PROMIS UE 与影像学疾病严重程度无关。
结论
PROMIS UE 与澳大利亚和加拿大骨关节炎手部指数具有高度相关性，与患者评定腕手评估具有中度相关性。PROMIS UE 具有较高的内部一致性和良好的效标效度。
临床相关性
PROMIS UE 是早期 CMC OA 患者残疾的有效评估方法，可以作为结局评估的临床辅助手段。
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