American academy of orthopaedic surgeons lower limb outcomes assessment instruments - Reliability, validity, and sensitivity to change
American academy of orthopaedic surgeons lower limb outcomes assessment instruments - Reliability, validity, and sensitivity to change
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DOI：
10.2106/00004623-200405000-00003
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发表时间：
2004-05-01
影响因子：
5.3
通讯作者：
Richmond, J
中科院分区：
文献类型：
--
作者：
Johanson, NA;Liang, MH;Richmond, J
背景：美国骨科医师学会 (AAOS) 开发了一系列结果评估工具，旨在有效收集所有身体部位患有肌肉骨骼疾病的所有年龄段患者的结果数据。下肢器械是通过文献综述、建立共识和现场测试的过程开发的。方法：这些器械被分发给美国和加拿大 20 个骨科诊所的总共 290 名受试者。在 290 名患者中，各有 70 名患者在足部和脚踝、运动/膝盖以及髋部和膝盖类别中得到了诊断，而每名 40 名患者在创伤和康复类别中得到了诊断。第一次测试后二十四小时进行的重新测试被分配给每个仪器的患者子样本。共返回 71 份一年期随访问卷（25 份运动/膝盖、25 份足部和脚踝、16 份髋部和膝盖以及 5 份下肢核心仪器）。结果：下肢核心量表和髋部和膝关节核心量表，每个量表包含 7 个针对疼痛、僵硬和肿胀以及功能的项目，其表现处于可接受的水平。事实证明，其他运动/膝盖、脚部和脚踝模块的内部和重新测试可靠性为 0.80 或更高，与 Short Form-36 (SF-36) 等成熟测量值相当。所有新量表均与其他疼痛和功能测量指标存在中度至强相关性，例如医师评分、SF-36 以及西安大略大学和麦克马斯特大学骨关节炎指数 (WOMAC)。 71 名患者提供了后续信息以分析对变化的敏感性。研究发现，根据患者和医生对变化的评估，下肢核心独立有助于预测过渡评分。结论：用于结果评估的 AAOS 下肢仪器高度可靠，并且与类似结构的其他测量方法相关。他们对患者状况的变化也很敏感。下肢核心量表可用于将疼痛归因于下肢或特定关节或一侧，而不牺牲可靠性。与 SF-36 相结合，AAOS 结果评估仪器可全面、有效地测量下肢骨科患者的结果。
Background: The American Academy of Orthopaedic Surgeons (AAOS) has developed an array of outcomes assessment instruments designed for the efficient collection of outcomes data from patients of all ages with musculoskeletal conditions in all body regions. The Lower Limb Instruments were developed through a process of literature review, consensus-building, and field-testing.Methods: The instruments were distributed to a total of 290 subjects in twenty orthopaedic practices throughout the United States and Canada. Of the 290 patients, seventy each had a diagnosis in the categories of foot and ankle, sports/knee, and hip and knee and forty each had a diagnosis in the categories of trauma and rehabilitation. Retests to be taken twenty-four hours after the first test were distributed to subsamples of patients for each instrument. Seventy-one one-year follow-up questionnaires (twenty-five Sports/Knee, twenty-five Foot and Ankle, sixteen Hip and Knee, and five Lower Limb Core instruments) were returned.Results: The Lower Limb Core Scale and the Hip and Knee Core Scale, each consisting of seven items addressing pain, stiffness and swelling, and function, performed at an acceptable level. Additional Sports/Knee and Foot and Ankle Modules proved to have internal and retest reliability of 0.80 or better, comparable with the values for well-established measures such as the Short Form-36 (SF-36). All of the new scales were moderately to strongly correlated with other measures of pain and function, such as physician ratings, the SF-36, and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Seventy-one patients provided follow-up information for the analysis of sensitivity to change. The Lower Limb Core was found to contribute independently to the prediction of the transition score based on the patient and physician assessments of change.Conclusions: The AAOS Lower Limb Instruments for outcomes assessment are highly reliable and are correlated with other measures for similar constructs. They are also sensitive to change in patient status. The Lower Limb Core Scale may be used with attribution of pain either to the lower limb or to a specific joint or side without sacrificing reliability. Combined with the SF-36, the AAOS outcomes assessment instruments comprehensively and efficiently measure outcomes in orthopaedic patients with lower-limb conditions.