临床医生实施的与改良家长实施的House-Brackmann量表在贝尔麻痹患儿中的一致性
Agreement of Clinician-Administered and Modified Parent-Administered House-Brackmann Scales in Children with Bell's Palsy.
作者信息
Babl Franz E, Eapen Nitaa, Herd David, Borland Meredith L, Kochar Amit, Zhang Michael, Oakley Ed, Hopper Sandy M, Berkowitz Robert G, Wilson Catherine L, Williams Amanda, Mackay Mark T, Lee Katherine J, Hearps Stephen
机构信息
Emergency Department Royal Children's Hospital Parkville Victoria Australia.
Clinical Sciences, Murdoch Children's Research Institute Parkville Victoria Australia.
出版信息
OTO Open. 2023 Mar 24;7(1):e44. doi: 10.1002/oto2.44. eCollection 2023 Jan-Mar.
OBJECTIVE
Currently there is no parent administered scale for facial nerve function in children. We set out to assess the agreement between a newly developed parent-administered modified version of the House-Brackmann (HB) scale and the standard clinician-administered HB scale in children with Bell's palsy.
STUDY DESIGN
Secondary analysis of a triple-blind, randomized, placebo-controlled trial of corticosteroids to treat idiopathic facial paralysis (Bell's palsy) in children (6 months to <18 years).
SETTING
Multicenter study at pediatric hospitals with recruitment in emergency departments.
METHODS
Children were recruited within 72 hours of symptom onset and assessed using the clinician-administered and the parent-administered modified HB scales at baseline, and at 1, 3, and 6 months until recovered. Agreement between the 2 scales was assessed using intraclass coefficient (ICC) and a Bland-Altman plot.
RESULTS
Data were available for 174 of the 187 children randomized from at least 1 study time point. The mean ICC between clinician and parent HB scores across all time points was 0.88 (95% confidence interval, CI: 0.86, 0.90). The ICC for the data collected at baseline was 0.53 (95% CI: 0.43, 0.64), at 1 month was 0.88 (95% CI: 0.84, 0.91), at 3 months was 0.80 (95% CI: 0.71, 0.87) and at 6 months was 0.73 (95% CI: 0.47, 0.89). A Bland-Altman plot indicated a mean difference between the 2 scores (clinician-reported minus parent-reported) of only -0.07 (95% limits of agreement -1.37 to 1.23).
CONCLUSION
There was good agreement between the modified parent-administered and the clinician-administered HB scales.
目的
目前尚无用于评估儿童面神经功能的家长自评量表。我们旨在评估新开发的家长自评改良版House-Brackmann（HB）量表与标准的临床医生评定的HB量表在贝尔麻痹患儿中的一致性。
研究设计
对一项治疗儿童（6个月至未满18岁）特发性面神经麻痹（贝尔麻痹）的皮质类固醇三联盲、随机、安慰剂对照试验进行二次分析。
研究地点
多中心研究，在儿科医院急诊科招募患者。
方法
在症状出现后72小时内招募儿童，并在基线时以及第1、3和6个月直至恢复时使用临床医生评定的和家长自评的改良HB量表进行评估。使用组内相关系数（ICC）和Bland-Altman图评估两种量表之间的一致性。
结果
从至少1个研究时间点随机分组的187名儿童中，有174名儿童的数据可用。所有时间点临床医生和家长HB评分之间的平均ICC为0.88（95%置信区间，CI：0.86，0.90）。基线时收集数据的ICC为0.53（95%CI：0.43，0.64），1个月时为0.88（95%CI：0.84，0.91），3个月时为0.80（95%CI：0.71，0.87），6个月时为0.73（95%CI：0.47，0.89）。Bland-Altman图显示，两个评分（临床医生报告减去家长报告）之间的平均差异仅为-0.07（一致性界限的95%为-1.37至1.23）。
结论
改良的家长自评HB量表与临床医生评定的HB量表之间具有良好的一致性。
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