Ohlund C, Eek C, Palmbald S, Areskoug B, Nachemson A
Department of Orthopaedics, Institute of Surgical Sciences, Sahlgrenska, University Hospital, Göteborg, Sweden.
Spine (Phila Pa 1976). 1996 May 1;21(9):1021-30; discussion 1031. doi: 10.1097/00007632-199605010-00005.
The criterion and construct validities of pain drawing, quantified by a simple total body area score of pain extent (area raw extent assessment score), were analyzed prospectively on consecutive patients (n = 103), drawn from a predefined blue collar worker population, all sick listed for 6 weeks as a result of low back pain.
To evaluate the validity of pain drawing as a screening tool in the secondary prevention of subacute low back pain.
Pain drawings have been used clinically for more than 40 years as a complement to a patient's verbal pain descriptions. The main objectives have been to differentiate functional pain from organic pain and to identify meaningful features in spatial-anatomic pain distribution. The ability of the pain drawing to delineate concurrent psychopathology correctly has been questioned. There is no consensus on which scoring method should be used.
The area raw extent assessment score was analyzed concurrently against the penalty point system and predictively against return to work and absenteeism over a period of 2 years. Content and construct validity assessed the relative influence of medical, psychologic, and subjective disability as well as psychosocial factors.
Criterion validation of the area raw extent assessment score showed significant correlations, both concurrently against the penalty point score (r = 0.86, P < 0.001, with explained variance R2 = 0.75, P < 0.001) and predictively against occupational handicap (r = 0.48, P < 0.001). In construct validation, the highest explained variance was shown for medical (R2 = 0.46, P < 0.001) and psychologic factors (R2 = 0.46, P < 0.001) and psychologic factors (R2 = 0.34, P < 0.001) and for subjective disability (R2 = 0.32, P < 0.001). Variance in the area raw extent assessment score also was explained by psychosocial factors (R2 = 0.19, P < 0.01).
Pain drawing quantification of the extent of pain shows high criterion and construct validity for the area raw extent assessment score. Content validity could be shown for significant clinical aspects of the disability experience--assets preferred for a screening tool in secondary prevention.
我们对连续纳入的103例患者进行了前瞻性分析，这些患者来自一个预先定义的蓝领工人群体，均因腰痛而病休6周，通过一种简单的疼痛范围全身面积评分（面积原始范围评估评分）对疼痛图的标准效度和结构效度进行分析。
评估疼痛图作为亚急性腰痛二级预防筛查工具的效度。
疼痛图在临床上已使用40多年，作为患者口头疼痛描述的补充。主要目的是区分功能性疼痛和器质性疼痛，并识别空间 - 解剖学疼痛分布中有意义的特征。疼痛图正确描绘并发精神病理学的能力受到质疑。对于应使用哪种评分方法尚无共识。
同时将面积原始范围评估评分与罚分系统进行分析，并对2年内的重返工作和缺勤情况进行预测性分析。内容效度和结构效度评估了医学、心理和主观残疾以及社会心理因素的相对影响。
面积原始范围评估评分的标准效度显示出显著相关性，与罚分评分同时分析时（r = 0.86，P < 0.001，解释方差R2 = 0.75，P < 0.001），对职业障碍进行预测性分析时（r = 0.48，P < 0.001）。在结构效度方面，医学因素（R2 = 0.46，P < 0.001）、心理因素（R2 = 0.46，P < 0.001）以及主观残疾（R2 = 0.32，P < 0.001）显示出最高的解释方差。面积原始范围评估评分的方差也由社会心理因素解释（R2 = 0.19，P < 0.01）。
疼痛范围的疼痛图量化对于面积原始范围评估评分显示出较高的标准效度和结构效度。对于残疾体验的重要临床方面可以显示出内容效度，这是二级预防筛查工具所青睐的特性。
