Validity and responsiveness of the Knee Society Clinical Rating System in comparison with the SF-36 and WOMAC
Validity and responsiveness of the Knee Society Clinical Rating System in comparison with the SF-36 and WOMAC
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DOI：
10.2106/00004623-200112000-00014
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发表时间：
2001-12-01
影响因子：
5.3
通讯作者：
Sledge, CB
中科院分区：
文献类型：
--
作者：
Lingard, EA;Katz, JN;Sledge, CB
背景资料：本研究的目的是验证膝关节协会临床评级系统（膝关节和功能评分），并将其反应性与西安大略和麦克马斯特大学骨关节炎指数（WOMAC）和医学结局研究简表-36（SF-36）进行比较。招募患者作为初次全膝关节置换术治疗以下疾病结局的前瞻性观察性研究的一部分：在美国的四个中心、英国的六个中心和澳大利亚的两个中心，每个研究中心的独立研究助理收集了膝关节协会的临床数据。WOMAC，SF-36，病人满意度，人口学数据与自填式questionnaire.Results：共招募了862名合格的患者，和完整的术前和12个月的数据，其中697（80.9%）。平均年龄为70岁（范围：38 - 90岁），大多数患者（58.9%）为女性。在两个评估时间，膝关节和功能评分的项目之间的相关性较低。膝关节协会疼痛和功能评分与WOMAC和SF-36的相应疼痛和功能领域具有中度至强相关性（r = 0.31至0.72）。标准化反应平均值的测量结果显示，膝关节协会膝关节评分（标准化反应平均值，2.2）比WOMAC（标准化反应平均值，疼痛2.0，功能1.4）和SF-36（标准化反应平均值，身体疼痛1.0，身体功能1.1）更具反应性。膝关节协会功能评分是反应最小的指标（标准化反应均值，0.8）。在12个月的患者报告的满意度和改善健康状况的分数的变化的相关性表明，WOMAC和SF-36是更敏感的比膝关节学会scores.Conclusions：有一个不良的相关性膝关节学会临床评分系统的项目之间，但评级系统有足够的收敛结构效度。WOMAC和SF-36是全膝关节置换术结局的更敏感指标。由于研究人员使用这些工具的劳动强度较低，并且使用这些工具消除了研究设计中的观察者偏倚，因此它们更适合用于膝关节置换术结局研究。
Background: The aim of this study was to validate the Knee Society Clinical Rating System (knee and function scores) and to compare its responsiveness with that of the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and the Medical Outcomes Study Short Form-36 (SF-36).Methods: Patients were recruited as part of a prospective observational study of the outcomes of primary total knee arthroplasty for the treatment of osteoarthritis in four centers in the United States, six centers in the United Kingdom, and two centers in Australia. Independent research assistants at each site collected the Knee Society clinical data. The WOMAC, SF-36, patient satisfaction, and demographic data were obtained with self-administered questionnaires.Results: A total of 862 eligible patients were recruited, and complete preoperative and twelve-month data were available for 697 (80.9%) of them. The mean age was seventy years (range, thirty-eight to ninety years), and the majority of the patients (58.9%) were women. Low correlations were found among the items of both the knee and the function score at both assessment times. The Knee Society pain and function scores had moderate-to-strong correlations with the corresponding pain and function domains of the WOMAC and SF-36 (r = 0.31 to 0.72). Measurement of the standardized response mean showed the Knee Society knee score to be more responsive (standardized response mean, 2.2) than the WOMAC (standardized response means, 2.0 for pain and 1.4 for function) and the SF-36 (standardized response means, 1.0 for bodily pain and 1.1 for physical functioning). The Knee Society function score was the least responsive measure (standardized response mean, 0.8). Correlation of changes in scores at twelve months with patient reports of satisfaction and improvement in health status showed the WOMAC and SF-36 to be more responsive than the Knee Society scores.Conclusions: There is a poor correlation among the items of the Knee Society Clinical Rating System, but the rating system has adequate convergent construct validity. The WOMAC and SF-36 are more responsive measures of outcome of total knee arthroplasty. As they are less labor-intensive for researchers to use and as use of these instruments removes observer bias from the study design, they are preferable for knee arthroplasty outcome studies.