The reliability and validity of the subjective peripheral neuropathy screen.
The reliability and validity of the subjective peripheral neuropathy screen.
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DOI：
10.1016/s1055-3290(98)80048-4
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发表时间：
1998-07-01
期刊：
影响因子：
--
通讯作者：
McArthur, J H
中科院分区：
文献类型：
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作者：
McArthur, J H
疼痛性感觉神经病变（PSN）是与艾滋病毒感染相关的最常见的神经系统疾病，影响多达30%的艾滋病毒阳性个体。PSN可能是由于HIV感染或抗逆转录病毒药物的毒性作用而发展的。虽然已经开发了几种工具来筛查PSN，但它们的有效性和可靠性尚未在艾滋病毒阳性患者中建立。主观周围神经病变筛查（SPNS）是一种简短的自我报告工具，目前正在艾滋病临床试验组中使用。本研究的目的是建立SPNS筛选工具的心理测量特性，以正确识别hiv阳性个体的PSN。具体而言，目的是确定SPNS检测PSN的信度、效度和诊断效率。数据摘自正在进行的自然史队列研究的受试者。SPNS用于39例hiv阳性PSN患者和44例hiv阳性对照。结果显示SPNS内部一致（Cronbach’s alpha = .86）。通过t检验评估的SPNS评分差异在hiv阳性组之间的副感觉、麻木和下肢疼痛的个体症状以及严重程度测量（临床严重程度等级和平均严重程度评分）方面存在显著差异（p < 0.05）。采用Spearman秩，神经系统检查与临床严重程度等级和平均严重程度评分、神经系统检查与振动定量感觉测试（QST）、严重程度措施与振动QST之间存在显著相关性。敏感性和特异性分析表明，下肢麻木是正确分类PSN效率最高的症状。因此，内部一致性、结构效度和标准相关效度与SPNS证实了hiv阳性个体PSN的正确分类。
Painful sensory neuropathy (PSN) is the most common neurological disorder associated with HIV infection and affects up to 30% of HIV-positive individuals. PSN may develop as a consequence of HIV infection or from the toxic effect of the antiretrovirals. Although several tools have been developed to screen for PSN, their validity and reliability has yet to be established among HIV-positive patients. The Subjective Peripheral Neuropathy Screen (SPNS) is a brief self-report tool that is currently being administered in the AIDS Clinical Trials Group. The objective of this study was to establish the psychometric properties of the SPNS screening tool for the correct identification of PSN in HIV-positive individuals. Specifically the goals were to determine the reliability, the validity, and the diagnostic efficiency of the SPNS in the detection of PSN. Data were abstracted on subjects enrolled in an ongoing natural history cohort. The SPNS was administered to a convenience sample of 39 HIV-positive individuals with PSN and 44 HIV-positive controls. Results showed the SPNS to be internally consistent (Cronbach's alpha = .86). SPNS score differences assessed by t-test were significantly different for individual symptoms of parasthesias, numbness, and pain of the lower extremities, and for severity measures (the Clinical Severity Grade, and the Average Severity Score) between the HIV-positive groups (p < .05). Using Spearman's rank, significant correlations were demonstrated between the neurological exam and the Clinical Severity Grade and the Average Severity Score, the neurological exam and vibratory quantitative sensory testing (QST) only, and the severity measures and vibratory QST only. Sensitivity and specificity analysis demonstrated that numbness of the lower extremities was the symptom with the highest efficiency for correctly classifying PSN. Thus, internal consistency, construct validity, and criterion related validity were confirmed with the SPNS for the correct classification of PSN in HIV-positive individuals.