Further evidence supporting an SEM-based criterion for identifying meaningful intra-individual changes in health-related quality of life
Further evidence supporting an SEM-based criterion for identifying meaningful intra-individual changes in health-related quality of life
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DOI：
10.1016/s0895-4356(99)00071-2
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发表时间：
1999-09-01
影响因子：
7.2
通讯作者：
Wolinsky, FD
中科院分区：
文献类型：
--
作者：
Wyrwich, KW;Tierney, WM;Wolinsky, FD
本研究采用测量标准误差（SEM）来评估慢性呼吸疾病问卷（CRQ）和SF-36的个体内变化。在471名COPD门诊患者中分析了两种工具在基线时的信度和效度后，将SEM与三个CRQ维度的最小临床重要差异（MCID）标准进行了比较。一个SEM的值非常接近所有CRQ尺寸的MCID标准。然后，通过使用单sem标准和MCID标准对393名随访门诊患者的变化状态（改善、稳定或下降）进行交叉分类，验证了基于sem的标准。在所有三个CRQ维度上都取得了非常好的一致性。虽然没有为SF-36建立MCID标准，但在这些变化分数中探索了单sem标准。在SF-36量表中显示出可接受的可靠性和合理的方差，每个变化类别内的个体百分比与CRQ维度中所见的一致。这些结果重复了先前的发现，其中一个SEM的值也非常接近心血管门诊患者慢性心脏病问卷所有维度的MCIDs。应该在其他与健康相关的生活质量仪器中探索一个sem标准，并建立MCIDs。临床流行病学[J]；9:861 - 873, 1999。(C) 1999 Elsevier Science Inc.；
This study used the standard error of measurement (SEM) to evaluate intra-individual change on both the Chronic Respiratory Disease Questionnaire (CRQ) and the SF-36. After analyzing the reliability and validity of both instruments at baseline among 471 COPD outpatients, the SEM was compared to established minimal clinically important difference (MCID) standards for three CRQ dimensions. A value of one SEM closely approximated the MCID standards for all CRQ dimensions. This SEM-based criterion was then validated by cross-classifying the change status (improved, stable, or declined) of 393 follow up outpatients using the one-SEM criterion and the MCID standard. Excellent agreement was achieved for all three CRQ dimensions. Although MCID standards have not been established for the SF-36, the one-SEM criterion was explored in these change scores. Among SF-36 scales demonstrating acceptable reliability and reasonable variance, the percent of individuals within each change category was consistent with those seen in the CRQ dimensions. These results replicate previous findings where a value of one SEM also closely approximated MCIDs for all dimensions of the Chronic Heart Disease Questionnaire among cardiovascular outpatients. The one-SEM criterion should be explored in other health-related quality of life instruments with established MCIDs. J CLIN EPIDEMIOL 52;9:861-873, 1999. (C) 1999 Elsevier Science Inc.