Development and validation of a telephone questionnaire to characterize lymphedema in women treated for breast cancer
Development and validation of a telephone questionnaire to characterize lymphedema in women treated for breast cancer
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DOI：
10.1093/ptj/81.6.1192
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发表时间：
2001-06-01
期刊：
影响因子：
3.2
通讯作者：
McCorkle, R
中科院分区：
文献类型：
--
作者：
Norman, SA;Miller, LT;McCorkle, R
背景和目的。在人群发病率和风险研究中，需要对水肿进行准确和经济的描述。本研究的目的是开发和验证一个电话问卷表征水肿。科目研究对象为43名曾接受过乳腺癌治疗的妇女，她们是从物理治疗实践和癌症支持组织招募来的。方法.问卷评估的存在和程度的水肿进行了比较，物理治疗师的诊断，主要是基于圆周测量。43名受试者中的25名由2名物理治疗师独立测量，以评估观察者间的一致性。结果观察者间对水肿的存在和程度的临床评估一致性很高（20/25，加权kappa = 0.80）;所有的分歧都是在判断是否有水肿或轻度水肿之间。对于至少中度水肿（上肢周长差异大于2 cm）的诊断，问卷的灵敏度为0.86至0.92，特异性为0.90。然而，对于任何水肿的诊断，敏感性（从0.93到0.96不等）高于特异性（从0.69到0.75不等）。讨论和结论。一些简单的问题表现出与物理治疗师的评估非常一致，至少确定中度水肿。
Background and Purpose. Accurate and economical characterization of lymphedema is needed for population-based studies of incidence and risk. The purpose of this study was to develop and validate a telephone questionnaire for characterizing lymphedema. Subjects. Forty-three women who were treated previously for breast cancer and who were recruited from physical therapy practices and a cancer support organization were studied. Methods. Questionnaire assessment of the presence and degree of lymphedema was compared with physical therapists' diagnoses, based primarily on circumferential measurements. Twenty-five of the 43 subjects were measured independently by 2 physical therapists to assess interobserver agreement. Results. Interobserver agreement on clinical assessments of the presence and degree of lymphedema was high (20/25, weighted kappa = .80); all of the disagreements were between judgments of whether there was no lymphedema or mild lymphedema. For the diagnosis of at least moderate lymphedema (differential in the circumferences of the upper extremities greater than 2 cm), sensitivity of the questionnaire varied from 0.86 to 0.92 and specificity was 0.90. However, sensitivity (varying from 0.93 to 0.96) was higher than specificity (varying from 0.69 to 0.75) for the diagnosis of any lymphedema. Discussion and Conclusion. A few straightforward questions exhibited excellent agreement with physical therapists' assessments for identifying at least moderate lymphedema.