COMPARISONS OF 5 HEALTH-STATUS INSTRUMENTS FOR ORTHOPEDIC EVALUATION
COMPARISONS OF 5 HEALTH-STATUS INSTRUMENTS FOR ORTHOPEDIC EVALUATION
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DOI：
10.1097/00005650-199007000-00008
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发表时间：
1990-07-01
期刊：
影响因子：
3
通讯作者：
LARSON, MG
中科院分区：
文献类型：
--
作者：
LIANG, MH;FOSSEL, AH;LARSON, MG
这项研究代表了一项长期的努力，以寻找最佳的技术来评估接受全关节置换术的患者的结果。五个健康状况问卷的敏感性进行了研究，在纵向评价骨科手术。对38例终末期关节炎患者进行关节炎影响测量量表（AIMS）、功能状态指数（FSI）、健康评估问卷（HAQ）、幸福感指数（IWB）和疾病影响量表（SIP）调查，分别于术前2周、术后3个月和术后12 ~ 15个月进行随访。响应值（即，患者内的变化）在四个尺度上计算：总体健康、疼痛、移动性和社会功能。在三个月的随访中，大多数仪器检测到全球健康，疼痛评分和移动性的大平均反应。在3个月和12至15个月之间发现这些尺度上的较小变化。在连续的随访中，社会功能表现出小到适度的改善。计算标准化反应平均值以评估检测变化的灵敏度。这些指数的置信区间采用折刀法构建，并通过配对选定的指数进行显著性检验。最后，研究预测了使用每种反应评估新疗法所需的样本量。这些统计工具便利了各种文书之间的比较，并可能证明在其他情况下是有用的。
This study represents a long-term effort to find optimal techniques for evaluating outcome in patients who have undergone total joint arthroplasty. Sensitivity of five health status questionnaires was studied in a longitudinal evaluation of orthopedic surgery. The questionnaires (Arthritis Impact Measurement Scales [AIMS], Functional Status Index [FSI], Health Assessment Questionnaire [HAQ], Index of Well Being [IWB], and Sickness Impact Profile [SIP]) were administered to 38 patients with end-stage arthritis at three points in time: two weeks befor hip or knee arthroplasty, and at three-month and 12- to 15-month follow-up. Response values (i.e., changes within patients) were calculated on four scales: global health, pain, mobility, and social function. By the three-month follow-up, most instruments detected large mean responses in global health, pain scores, and mobility. Smaller changes on these scales were found between three and 12 to 15 months. Social function showed small to modest gains at successive follow-ups. Standardized response means were calculated to assess sensitivity to detect changes. Confidence intervals for these indices were constructed using a jackknife procedure, and significance tests were performed by pairing selected indices. Finally, the study projected sample sizes required to assess a new therapy, using each response. These statistical tools facilitated comparisons among instruments and may prove useful in other settings.