Williams J W, Holleman D R, Simel D L
Division of General Internal Medicine, University of Texas Health Sciences Center at San Antonio, USA.
J Rheumatol. 1995 Apr;22(4):727-32.
To extend the validity of the Shoulder Pain and Disability Index (SPADI) by (1) making it suitable for telephone administration; (2) determining its convergent validity with other health status measures; and (3) assessing the responsiveness of the SPADI to clinical change.
Consecutive primary care patients with shoulder discomfort were followed for 3 months. At enrollment, a detailed shoulder specific history was obtained by a trained research assistant, and the Health Assessment Questionnaire (HAQ), the Medical Outcomes Study SF-20 (SF-20), and numeric and visual analog versions of the SPADI were completed by the patient. At 2, 4, and 12 weeks the numeric scaled SPADI was administered by telephone and patients rated globally the change in shoulder discomfort.
One hundred and two subjects were enrolled; 96 completed at least one followup assessment and 75 completed all followup assessments. Subjects were men (98%), predominantly white (73%), with a median age of 60 years, and the majority had experienced shoulder discomfort for > 3 months (66%). At baseline the visual analog (VAS) and numeric scaled SPADI were highly concordant (intraclass correlation coefficient = 0.86), and the SPADI correlated substantially with the HAQ (r = 0.61) and the physical functioning (r = -0.50) and pain (r = -0.43) domains of the SF-20. The SPADI delta (baseline-followup) discriminated accurately between subjects who improved versus those who stayed the same or worsened [receiver operating characteristic cure, (ROC) = 0.91, likelihood ratio for improvement = 34].
The numerically scaled SPADI is highly correlated with the original VAS version of the SPADI and other measures of health status. The SPADI is responsive to change and accurately discriminates among patients who are improved or worsened.
通过以下方式扩展肩痛和功能障碍指数（SPADI）的有效性：（1）使其适用于电话管理；（2）确定其与其他健康状况测量方法的收敛效度；（3）评估SPADI对临床变化的反应性。
对连续的有肩部不适的初级保健患者进行3个月的随访。在入组时，由经过培训的研究助理获取详细的肩部特定病史，患者完成健康评估问卷（HAQ）、医学结局研究简明健康调查20项量表（SF - 20）以及数字和视觉模拟版本的SPADI。在第2、4和12周通过电话进行数字评分的SPADI评估，患者对肩部不适的变化进行整体评分。
共纳入102名受试者；96名完成了至少一次随访评估，75名完成了所有随访评估。受试者均为男性（98%），主要为白人（73%），中位年龄60岁，大多数人肩部不适超过3个月（66%）。在基线时，视觉模拟（VAS）和数字评分的SPADI高度一致（组内相关系数 = 0.86），SPADI与HAQ（r = 0.61）、SF - 20的身体功能（r = -0.50）和疼痛（r = -0.43）领域显著相关。SPADI差值（基线 - 随访）能准确区分改善的受试者与病情不变或恶化的受试者[受试者操作特征曲线下面积，（ROC） = 0.91，改善的似然比 = 34]。
数字评分的SPADI与原始VAS版本的SPADI以及其他健康状况测量方法高度相关。SPADI对变化有反应，能准确区分病情改善或恶化的患者。
