健康评估问卷及其修订版在部分门诊类风湿关节炎患者中的天花板效应。
Ceiling effects of the Health Assessment Questionnaire and its modified version in some ambulatory rheumatoid arthritis patients.
作者信息
Stucki G, Stucki S, Brühlmann P, Michel B A
机构信息
Department of Rheumatology and Physical Medicine, University Hospital, Zürich, Switzerland.
出版信息
Ann Rheum Dis. 1995 Jun;54(6):461-5. doi: 10.1136/ard.54.6.461.
OBJECTIVE
To examine if the reduced number of items in the modified version of the Health Assessment Questionnaire (MHAQ) concerning difficulty of performing activities of daily living may lead to a reduced ability to detect clinical changes compared with the original HAQ.
METHODS
In 56 consecutive ambulatory patients with rheumatoid arthritis, we examined the mean change in clinical and laboratory parameters for those who recorded improved, unchanged, or worse MHAQ scores one year after a baseline assessment.
RESULTS
At baseline, about 50% of the patients had an MHAQ score < 0.3 and clustered at the normal end of the scale. Because of a ceiling effect, the MHAQ failed to detect clinical improvement in 18% of the patients. Changes in clinical and laboratory parameters were associated with improved, unchanged, or worse scores with the HAQ but not the MHAQ.
CONCLUSION
Although the format of the MHAQ has the advantage of eliciting a 'satisfaction' score, limitations in its sensitivity to detect clinical improvement in patients with relatively little difficulty in activities of daily living may not justify the use of this particular version of shorter questionnaire in certain clinical settings.
目的
探讨与原始健康评估问卷（HAQ）相比，改良版健康评估问卷（MHAQ）中关于日常生活活动困难程度的条目数量减少，是否会导致检测临床变化的能力降低。
方法
在56例连续的类风湿性关节炎门诊患者中，我们检查了那些在基线评估一年后记录MHAQ评分改善、不变或恶化的患者的临床和实验室参数的平均变化。
结果
在基线时，约50%的患者MHAQ评分<0.3，集中在量表的正常范围末端。由于天花板效应，MHAQ未能检测出18%患者的临床改善情况。临床和实验室参数的变化与HAQ评分的改善、不变或恶化相关，但与MHAQ评分无关。
结论
尽管MHAQ的形式具有得出“满意度”评分的优势，但在日常生活活动困难相对较小的患者中，其检测临床改善的敏感性存在局限性，这可能无法证明在某些临床环境中使用这个特定的较短问卷版本是合理的。
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