Triano J J, McGregor M, Cramer G D, Emde D L
Spinal Ergonomics Laboratory, National College of Chiropractic, Lombard, IL 60148-4583.
J Manipulative Physiol Ther. 1993 Feb;16(2):67-73.
To compare the reliability, validity and change in patient clinical status over time with treatment for six potential outcome questionnaires in a defined population of patients.
Physician based, multidoctor teaching practice.
Three hundred thirty-five consecutive patients presenting with new complaints were solicited. One hundred eighty-six agreed to participate.
The six questionnaires being studied were administered to each of the participants on three separate occasions. They were: a) prior to clinical evaluation for their chief complaint, b) immediately after clinical evaluation and before treatment and c) 6 wk later.
Each instrument was scored following the prescribed methods of interpretation from the original literature describing it. Results were submitted for analysis by Pearson correlation and two-way analysis of variance as appropriate.
Differences were found in the mean value of the modified Zung with respect to both gender and time. An unexpected drop in patients' somatic perceptions in association with the process of clinical evaluation was found for the Modified Somatic Pain Questionnaire. Overall, the Oswestry and Visual Analogue Pain Scale were the most reliable and responsive to clinical change for musculoskeletal disorders.
This investigation demonstrated substantial differences in the validity and reliability of commonly referenced self-administered instruments for quantifying patient perceptions of pain and disability. The Oswestry and Visual Analogue Pain Scale were both more reliable and valid than other instruments.
在特定患者群体中，比较六种潜在结局问卷在治疗过程中随时间变化的可靠性、有效性及患者临床状态的改变。
以医生为基础的多医生教学实践。
招募了335例连续出现新症状的患者。186例同意参与。
对每位参与者在三个不同时间点分别使用六种正在研究的问卷。分别是：a）在对其主要症状进行临床评估之前；b）临床评估后且治疗前立即进行；c）6周后。
按照描述每种工具的原始文献中规定的解释方法进行评分。结果根据Pearson相关性和适当的双向方差分析进行分析。
改良Zung量表的平均值在性别和时间方面均存在差异。改良躯体疼痛问卷显示，患者的躯体感知在临床评估过程中意外下降。总体而言，Oswestry量表和视觉模拟疼痛量表对于肌肉骨骼疾病在量化患者疼痛和残疾感知方面是最可靠且对临床变化最敏感的。
本研究表明，在用于量化患者疼痛和残疾感知的常用自填式工具的有效性和可靠性方面存在显著差异。Oswestry量表和视觉模拟疼痛量表比其他工具更可靠且更有效。
