Beaton D E, Richards R R
Upper Extremity Reconstructive Service, St. Michael's Hospital, Toronto, Ontario, Canada.
J Bone Joint Surg Am. 1996 Jun;78(6):882-90. doi: 10.2106/00004623-199606000-00011.
Measures of both generic and disease-specific health status are being developed and used with increasing frequency for the appraisal of musculoskeletal conditions. The purpose of this study was to compare prospectively the validity of five questionnaires in the assessment of function of the shoulder. Ninety subjects who had various problems related to the shoulder agreed to enter the study. All of the subjects completed a questionnaire package that included the Shoulder Pain and Disability Index, the Simple Shoulder Test, the Subjective Shoulder Rating Scale, the Modified American Shoulder and Elbow Surgeons Shoulder Patient Self-Evaluation Form, and the Shoulder Severity Index as well as a measure of generic health status (the acute version of the Short Form 36 [SF-36]) and two questions that asked the patient to rate the severity of the problem and his or her over-all health. Frequency distributions were created and compared among questionnaires. Spearman rank correlations were calculated to compare the questionnaires with each other and with other assessments. One-way analysis of variance was used to determine the ability of the questionnaires to discriminate between self-rated severity of the problem and over-all health. The frequency distributions were similar among the five shoulder questionnaires, but those of the five shoulder questionnaires differed from that of the SF-36. The correlations were good (0.73 < or = r < or = 0.80) among all of the five shoulder questionnaires except the Subjective Shoulder Rating Scale; they were lower with the Subjective Shoulder Rating Scale and the physical function dimension of the SF-36 (0.12 < or = r < or = 0.60). The shoulder questionnaires discriminated between levels of severity (p < 0.0001) but not between levels of over-all health (0.10 < or = p < or = 0.86). In this concurrent comparison of measures of shoulder-specific outcome in the same subjects, the shoulder questionnaires performed similarly, both in describing function of the shoulder and in discriminating between levels of severity. The shoulder questionnaires performed differently than the SF-36, which confirms the need to use both disease-specific and generic health-status measures to evaluate patients who have a problem related to the shoulder.
针对肌肉骨骼疾病的评估，通用和特定疾病健康状况的测量方法正得到越来越频繁的开发和使用。本研究的目的是前瞻性地比较五份问卷在评估肩部功能方面的有效性。90名患有各种肩部相关问题的受试者同意参与该研究。所有受试者都完成了一套问卷，其中包括肩部疼痛和残疾指数、简易肩部测试、主观肩部评分量表、改良美国肩肘外科医师协会肩部患者自我评估表、肩部严重程度指数，以及一项通用健康状况测量指标（简短健康调查问卷36项急性版[SF - 36]），还有两个问题，要求患者对问题的严重程度和其整体健康状况进行评分。创建了各问卷之间的频率分布并进行比较。计算斯皮尔曼等级相关性，以相互比较问卷以及与其他评估指标进行比较。采用单因素方差分析来确定问卷区分自我评定问题严重程度和整体健康状况的能力。五份肩部问卷的频率分布相似，但这五份肩部问卷的频率分布与SF - 36的不同。除主观肩部评分量表外，所有五份肩部问卷之间的相关性良好（0.73≤r≤0.80）；主观肩部评分量表与SF - 36的身体功能维度的相关性较低（0.12≤r≤0.60）。肩部问卷能够区分严重程度水平（p<0.0001），但不能区分整体健康水平（0.10≤p≤0.86）。在对同一受试者的肩部特定结局测量指标进行的同步比较中，肩部问卷在描述肩部功能和区分严重程度水平方面表现相似。肩部问卷的表现与SF - 36不同，这证实了需要同时使用特定疾病和通用健康状况测量指标来评估患有肩部相关问题的患者。
