Symptom severity of osteoarthritis of the knee: A patient-based measure developed in the Veterans Health Study
Symptom severity of osteoarthritis of the knee: A patient-based measure developed in the Veterans Health Study
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DOI：
10.1093/gerona/53a.5.m351
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发表时间：
1998-09-01
影响因子：
5.1
通讯作者：
Kazis, LE
中科院分区：
文献类型：
--
作者：
Clark, JA;Spiro, A;Kazis, LE
背景：我们的目标是开发一种以患者为基础的膝关节骨关节炎严重程度的测量方法，重点放在症状学上，可以与健康相关的生活质量测量一起用于监测门诊患者的健康状况。我们对波士顿地区退伍军人事务医疗中心的男性门诊患者进行了随机抽样，根据三个问题的筛选，他们被确认患有膝骨性关节炎。结构化访谈包括12个项目，涵盖5个症状领域(全球严重程度，4项；伴随活动的疼痛，3项；休息时疼痛，2项；活动障碍，2项；以及克隆感，1项)，这些来自临床文本，共识声明，和先前开发的严重程度指数。采访还包括详细的病史。采用健康状况调查量表(SF-36)测量与健康相关的生活质量。采用因子分析和多属性量表评价方法评价症状五个领域之间及其内部的结构关系。我们在1770名接受筛查的门诊患者中确定了415名患有膝骨性关节炎。这五个领域的内部一致性从0.50到0.72不等，各领域之间基本趋同。这12个项目构成了一个内部一致性很高(阿尔法=0.88)的汇总指数。总体严重度定义为标准化后12个条目的平均值，与SF-36各组成部分的总分呈中等相关：r=-0.48，r=-.30。我们的测量提供了一个可靠的指数，代表膝关节骨关节炎的症状严重程度，这可能有助于比较患者组和评估健康结果；子量表可能有助于表征时间变化，包括对治疗的反应。
Background, Our objective was to develop a patient-based measure of the severity of osteoarthritis of the knee, focusing on symptomatology, that may be used in conjunction with measures of health-related quality of life in monitoring the health status of outpatients.Methods. We surveyed a random sample of male outpatients at Boston-area Veterans Affairs medical centers who were identified as having osteoarthritis of the knee according to a three-question screen. Structured interviews included 12 items covering five domains of symptoms (global severity, 4 items; pain with activity, 3 items; pain at rest, 2 items; impaired mobility, 2 items; and sensations of crepitus, 1 item), which were derived from clinical texts, consensus statements, and previously developed severity indices. Interviews also included a detailed medical history. Health-related quality of life was measured by the Medical Outcomes Study Health Status Survey (SF-36). Factor analysis and evaluation of multiattribute scales were used to evaluate the structural relationships between and within the five domains of symptoms.Results. We identified 415 of the 1770 screened outpatients as having osteoarthritis of the knee. Internal consistencies of the five domains ranged from .50 to.72, with substantial convergence between domains. The 12 items comprise a summary index with high internal consistency (alpha = .88). Overall severity, defined as the mean of the 12 items after standardization, was moderately correlated with the SF-36 component summaries: r = -.48 for physical; r = -.30 for mental.Conclusions. Our measure provides a reliable index that represents symptomatic severity of osteoarthritis of the knee, which may be useful in comparing patient groups and assessing health outcomes; subscales may help characterize temporal changes, including responses to treatment.