Physical dysfunction and nonorganic signs in patients with chronic neck pain: exploratory study into interobserver reliability and construct validity.
Physical dysfunction and nonorganic signs in patients with chronic neck pain: exploratory study into interobserver reliability and construct validity.
复制标题
慢性颈痛患者的身体功能障碍和非器质性体征：观察者间可靠性和结构有效性的探索性研究。
DOI：
10.2519/jospt.2014.4715
复制
发表时间：
2014
期刊：
影响因子：
--
通讯作者：
M. Reneman
中科院分区：
文献类型：
--
作者：
W. Jorritsma;P. Dijkstra;G. E. de Vries;J. Geertzen;M. Reneman
研究设计
重复测量设计。
目标
探讨改良身体功能障碍严重程度 (mPDS) 作为颈椎损伤衡量指标和改良颈部非器质性体征 (mcNOS) 作为行为体征衡量指标的观察者间可靠性，并探讨 mPDS 和 mcNOS 的结构有效性。
背景
PDS 已用于评估初级保健对照试验中的治疗效果。颈部非器质性体征的开发是为了评估颈部疼痛患者的疾病行为。
方法
两名观察者独立评估了门诊三级康复机构中 51 名慢性颈部疼痛患者的 mPDS 和 mcNOS，评估间隔为 3 周。 mPDS 和 mcNOS 总分的观察者间可靠性表示为组内相关系数。各个 mcNOS 测试的观察者间一致性计算为绝对一致性和 Cohen kappa。结构效度表示为 mPDS 和 mcNOS 与颈部疼痛和残疾量表以及疼痛数字疼痛评级量表之间的 Spearman 相关性。
结果
mPDS 和 mcNOS 的观察者间可靠性的组内相关系数分别为 0.72 和 0.78。各个 mcNOS 测试的一致性范围为 63% 至 88%，kappa 值范围为 0.14 至 0.54。 mPDS 与颈部疼痛和残疾量表的相关性为 0.26，mcNOS 与颈部疼痛和残疾量表的相关性为 0.49，mPDS 与数字疼痛评定量表的相关性为 0.32，mcNOS 为 0.37。
结论
mPDS 和 mcNOS 的观察者间可靠性是可以接受的。各个 mcNOS 测试的观察者间一致性从较差到可接受。 mPDS 和 mcNOS 的构建有效性似乎令人满意。
STUDY DESIGN
Repeated-measurement design.
OBJECTIVES
To explore interobserver reliability of the modified physical dysfunction severity (mPDS) as a measure for impairment of the cervical spine and the modified cervical nonorganic signs (mcNOS) as a measure for behavioral signs, and to explore construct validity of the mPDS and mcNOS.
BACKGROUND
The PDS has been used for evaluation of treatment efficacy in controlled trials in primary care. The cervical nonorganic signs were developed to assess illness behavior in patients with neck pain.
METHODS
Two observers independently assessed the mPDS and mcNOS in 51 patients with chronic neck pain in an outpatient tertiary rehabilitation setting, with a 3-week interval between assessments. Interobserver reliability for total scores of the mPDS and mcNOS was expressed as an intraclass correlation coefficient. Interobserver agreement for individual mcNOS tests was calculated as absolute agreement and Cohen kappa. Construct validity was expressed as Spearman correlation between the mPDS and mcNOS with the Neck Pain and Disability Scale and numeric pain rating scale for pain.
RESULTS
The interobserver reliability of the mPDS and mcNOS had intraclass correlation coefficients of 0.72 and 0.78, respectively. Agreement for individual mcNOS tests ranged from 63% to 88%, and kappa values ranged from 0.14 to 0.54. Correlation with the Neck Pain and Disability Scale was 0.26 for the mPDS and 0.49 for the mcNOS, and the correlation with the numeric pain rating scale was 0.32 for the mPDS and 0.37 for the mcNOS.
CONCLUSION
Interobserver reliability of both the mPDS and mcNOS was acceptable. The interobserver agreement for the individual mcNOS tests ranged from poor to acceptable. Construct validity of the mPDS and mcNOS appeared satisfactory.