Dawson J, Fitzpatrick R, Murray D, Carr A
University of Oxford, England, UK.
J Bone Joint Surg Br. 1998 Jan;80(1):63-9. doi: 10.1302/0301-620x.80b1.7859.
We have developed a 12-item questionnaire for patients having a total knee replacement (TKR). We made a prospective study of 117 patients before operation and at follow-up six months later, asking them to complete the new questionnaire and the form SF36. Some also filled in the Stanford Health Assessment Questionnaire (HAQ). An orthopaedic surgeon completed the American Knee Society (AKS) clinical score. The single score derived from the new questionnaire had high internal consistency, and its reproducibility, examined by test-retest reliability, was found to be satisfactory. Its validity was established by obtaining significant correlations in the expected direction with the AKS scores and the relevant parts of the SF36 and HAQ. Sensitivity to change was assessed by analysing the differences between the preoperative scores and those at follow-up. We also compared change in scores with the patients' retrospective judgement of change in their condition. The effect size for the new questionnaire compared favourably with those for the relevant parts of the SF36. The change scores for the new knee questionnaire were significantly greater (p < 0.0001) for patients who reported the most improvement in their condition. The new questionnaire provides a measure of outcome for TKR that is short, practical, reliable, valid and sensitive to clinically important changes over time.
我们为接受全膝关节置换术（TKR）的患者开发了一份包含12个条目的问卷。我们对117例患者进行了前瞻性研究，在术前及术后6个月的随访时，让他们填写这份新问卷以及SF36表格。一些患者还填写了斯坦福健康评估问卷（HAQ）。一名骨科医生完成了美国膝关节协会（AKS）临床评分。新问卷得出的单一评分具有较高的内部一致性，通过重测信度检验其可重复性令人满意。通过与AKS评分以及SF36和HAQ的相关部分在预期方向上获得显著相关性，确定了其效度。通过分析术前评分与随访评分之间的差异来评估对变化的敏感性。我们还将评分变化与患者对自身病情变化的回顾性判断进行了比较。新问卷的效应量与SF36相关部分的效应量相比更具优势。对于报告病情改善最大的患者，新膝关节问卷的变化评分显著更高（p < 0.0001）。新问卷为TKR提供了一种对结局的测量方法，该方法简短、实用、可靠、有效且对临床上重要的随时间变化敏感。
