Evaluation of 21-Numbered Circle and 10-Centimeter Horizontal Line Visual Analog Scales for Physician and Parent Subjective Ratings in Juvenile Idiopathic Arthritis
Evaluation of 21-Numbered Circle and 10-Centimeter Horizontal Line Visual Analog Scales for Physician and Parent Subjective Ratings in Juvenile Idiopathic Arthritis
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DOI：
10.3899/jrheum.091474
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发表时间：
2010-07-01
影响因子：
3.9
通讯作者：
Ravelli, Angelo
中科院分区：
文献类型：
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作者：
Filocamo, Giovanni;Davi, Sergio;Ravelli, Angelo
Objective.比较21号圆形视觉模拟评分法（VAS）和传统10 cm水平线VAS对幼年特发性关节炎（JIA）患儿的医生和家长主观评分的测量特性。我们研究了2例患者样本，其中使用传统的10 cm水平线VAS（n = 397）或21号圆形VAS（n = 471）进行了医生对总体疾病活动性的总体评分、父母对儿童总体健康状况的总体评分和父母对儿童疼痛强度的评分。通过评估结构效度、评分分布、随时间变化的反应性和最小临床重要差异（MCID）来检查2种VAS格式的测量性能。21号圆形VAS与其他JIA结局指标的大多数斯皮尔曼相关性大于10 cm水平线VAS，表明圆形VAS格式具有更好的结构效度。天花板效应（即，评分= 0），在21号圆形VAS上，医生和父母总体评分分别为43.7%和32.9%，在10 cm水平线VAS上，分别为31.6%和35.3%。在医生或父母分别归类为改善或恶化的患者中，21号圈VAS的反应性为良好（标准化反应均值> 0.8）或中度（标准化反应均值> 0.6）。总体而言，21号圆形VAS的MCID值在恶化时往往大于改善时。21号圆圈VAS是10 cm水平线VAS的合适替代方案，可便于在标准临床实践中纳入医生和家长主观评分。（2010年6月15日首次发布; J Rheumol 2010;37：1534-41; doi：10.3899/jrheum.091474）
Objective. To evaluate the measurement properties of 21-numbered circle visual analog scales (VAS) and traditional 10-cm horizontal line VAS for physician and parent subjective ratings in children with juvenile idiopathic arthritis (JIA).Methods. We studied 2 patient samples in whom physician global rating of overall disease activity, parent global rating of the child's overall well-being, and parent rating of intensity of child's pain were performed using traditional 10-cm horizontal line VAS (n = 397) or 21-numbered circle VAS (n = 471). The measurement performances of the 2 VAS formats were examined by assessing construct validity, score distribution, responsiveness to change over time, and minimal clinically important difference (MCID).Results. Most Spearman correlations with other JIA outcome measures yielded by 21-numbered circle VAS were greater than those obtained with 10-cm horizontal line VAS, revealing that the circle VAS format has better construct validity. Ceiling effects (i.e., score = 0) for physician and parent global ratings were 43.7% and 32.9%, respectively, on 21-numbered circle VAS, and 31.6% and 35.3%, respectively, on 10-cm horizontal line VAS. Responsiveness of 21-numbered circle VAS was good (standardized response mean > 0.8) or moderate (standardized response mean > 0.6) among patients classified as improved or worsened, respectively, by the physician or the parent. Overall, MCID values for 21-numbered circle VAS tended to be greater for worsening than for improvement.Conclusion. The 21-numbered circle VAS are a suitable alternative to the 10-cm horizontal line VAS and may facilitate incorporation of physician and parent subjective ratings in standard clinical practice. (First Release June 152010; J Rheumatol 2010;37:1534-41; doi:10.3899/jrheum.091474)