Riddle D L, Stratford P W, Binkley J M
Department of Physical Therapy, Virginia Commonwealth University, Medical College of Virginia, Richmond 23298-0224, USA.
Phys Ther. 1998 Nov;78(11):1197-207. doi: 10.1093/ptj/78.11.1197.
One purpose of this study was to determine whether the Roland-Morris Back Pain Questionnaire (RMQ) could be used to detect clinically meaningful change in individual patients. The construct that served as the basis for this study was that RMQ change scores should be greater for patients meeting their treatment goals than for patients who did not meet their goals. The second purpose of the study was to determine whether sensitivity to change (STC) varies depending on the magnitude of the initial RMQ score.
Of the 143 patients with low back pain who completed the study, 104 patients achieved their goals and 39 patients did not achieve their goals. Receiver operating characteristic (ROC) curve analysis and likelihood ratios were used to determine the RMQ change scores that best classify patients as having met or not met their goals.
The area under the ROC curve for the entire RMQ scale was 0.68, while the curve areas for smaller RMQ intervals varied from 0.80 to 0.97.
The STC for the entire RMQ scale was poor for the construct examined in this study. The likelihood ratios for smaller RMQ intervals support the construct validity of the RMQ for assessing change in disability. Initial RMQ score magnitudes must be taken into account to improve the rate of making correct predictions about whether meaningful change in disability will occur following treatment.
本研究的一个目的是确定罗兰 - 莫里斯背痛问卷(RMQ)是否可用于检测个体患者临床上有意义的变化。本研究的基础构想是,达到治疗目标的患者的RMQ变化分数应高于未达到目标的患者。该研究的第二个目的是确定变化敏感度(STC)是否因初始RMQ分数的大小而异。
在完成该研究的143例腰痛患者中,104例患者达到了他们的目标,39例患者未达到目标。采用受试者操作特征(ROC)曲线分析和似然比来确定能最佳区分患者是否达到目标的RMQ变化分数。
整个RMQ量表的ROC曲线下面积为0.68,而较小RMQ区间的曲线面积在0.80至0.97之间变化。
对于本研究中所检验的构想而言,整个RMQ量表的STC较差。较小RMQ区间的似然比支持RMQ在评估残疾变化方面的结构效度。必须考虑初始RMQ分数的大小,以提高对治疗后残疾是否会发生有意义变化做出正确预测的比率。