Multicriteria decision analysis methods with 1000Minds for developing systemic sclerosis classification criteria
Multicriteria decision analysis methods with 1000Minds for developing systemic sclerosis classification criteria
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DOI：
10.1016/j.jclinepi.2013.12.009
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发表时间：
2014-06-01
影响因子：
7.2
通讯作者：
Khanna, Dinesh
中科院分区：
文献类型：
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作者：
Johnson, Sindhu R.;Naden, Raymond P.;Khanna, Dinesh
目标：系统性硬化症 (SSc) 的分类标准正在制定中。目标是开发一种用于整理案例数据并评估其敏感性的工具；使用强制选择方法来减少和衡量标准；并探讨专家之间关于案例被分类为 SSc 的概率的一致意见。 研究设计和设置：使用标准化工具进行敏感性测试。该工具应用于 20 个病例，涵盖了每个病例均出现 SSc 的一系列概率。专家按概率从最高到最低对有序案例进行排序；使用强制选择方法减少和加权标准；并对案例进行了重新排序。使用类内相关系数 (ICC) 评估排名的一致性。结果：专家认可清晰度 (83%)、可理解性 (100%)、表面和内容有效性 (100%)。加权标准（分）：手指皮肤增厚（14-22）、指尖病变（9-21）、摩擦（21）、手指屈曲挛缩（16）、肺纤维化（14）、SSc相关抗体（15）、雷诺现象（13）、钙质沉着（12）、肺动脉高压（11）、肾危象（11）、毛细血管扩张（10）、甲襞异常毛细血管 (10)、食道扩张 (7) 和浮肿的手指 (5)。专家间的 ICC 为 0.73 [95% 置信区间 (CI)：0.58, 0.86]，并提高至 0.80（95% CI：0.68, 0.90）。结论：使用合理的工具和强制选择方法，标准数量减少了 39%（范围，23-14）并进行加权。我们的方法反映了测量科学的严谨性，并可作为制定分类标准的模板。 (C) 2014 Elsevier Inc. 保留所有权利。
Objectives: Classification criteria for systemic sclerosis (SSc) are being developed. The objectives were to develop an instrument for collating case data and evaluate its sensibility; use forced-choice methods to reduce and weight criteria; and explore agreement among experts on the probability that cases were classified as SSc.Study Design and Setting: A standardized instrument was tested for sensibility. The instrument was applied to 20 cases covering a range of probabilities that each had SSc. Experts rank ordered cases from highest to lowest probability; reduced and weighted the criteria using forced-choice methods; and reranked the cases. Consistency in rankings was evaluated using intraclass correlation coefficients (ICCs).Results: Experts endorsed clarity (83%), comprehensibility (100%), face and content validity (100%). Criteria were weighted (points): finger skin thickening (14-22), fingertip lesions (9-21), friction rubs (21), finger flexion contractures (16), pulmonary fibrosis (14), SSc-related antibodies (15), Raynaud phenomenon (13), calcinosis (12), pulmonary hypertension (11), renal crisis (11), telangiectasia (10), abnormal nailfold capillaries (10), esophageal dilation (7), and puffy fingers (5). The ICC across experts was 0.73 [95% confidence interval (CI): 0.58, 0.86] and improved to 0.80 (95% CI: 0.68, 0.90).Conclusions: Using a sensible instrument and forced-choice methods, the number of criteria were reduced by 39% (range, 23-14) and weighted. Our methods reflect the rigors of measurement science and serve as a template for developing classification criteria. (C) 2014 Elsevier Inc. All rights reserved.