Influence of response shift on early patient-reported outcomes following autologous chondrocyte implantation.
Influence of response shift on early patient-reported outcomes following autologous chondrocyte implantation.
复制标题
反应转变对自体软骨细胞植入后早期患者报告结果的影响。
DOI：
10.1007/s00167-013-2654-1
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发表时间：
2014
期刊：
影响因子：
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通讯作者：
Lattermann,Christian
中科院分区：
文献类型：
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作者：
Howard,JenniferS;Mattacola,CarlG;Mullineaux,DavidR;English,RobertA;Lattermann,Christian
目的反应转变是个人的评估标准随着时间的推移而变化的现象。本研究的目的是确定接受自体软骨细胞植入 (ACI) 的患者是否会经历反应转变。方法 48 名接受 ACI 的患者参与。 “然后测试”方法用于评估常用患者报告结果测量 (PROM) 中的反应变化——SF-36 身体成分量表 (SF-36 PCS)、WOMAC、IKDC 和 Lysholm。每个 PROM 均在手术前、手术后 6 个月和 12 个月完成。在第 6 个月和第 12 个月时，还完成了每份表格的附加“当时”版本。 “当时”的版本与原始版本相同，只是要求患者评估他们在 ACI 之前的情况。在 6 个月和 12 个月时计算传统变化、响应变化调整变化和响应变化幅度。T 检验 (p<0.05) 用于比较传统变化与响应变化调整变化，以及响应变化幅度值与先前建立的最小可检测变化。结果对于任何 PROM，传统变化和响应变化调整变化之间没有差异。 6 个月时 WOMAC 的平均响应偏移幅度值 (15 ± 14，p= 0.047) 大于先前建立的最小可检测变化 (10.9)。 12 个月时 SF-36 PCS 的平均响应偏移幅度值 (9.4 ± 6.8，p= 0.017) 也超过了先前确定的最小可检测变化 (6.6)。 结论 没有证据表明响应偏移存在群体水平效应。这些结果支持了评估治疗效果的前测试/后测试研究设计的有效性。然而，有证据表明，反应变化可能会因患者而异，尤其是 WOMAC 和 SF-36 的评分可能会受到反应变化的影响。证据级别II。
PurposeResponse shift is the phenomenon by which an individual’s standards for evaluation change over time. The purpose of this study was to determine whether patients undergoing autologous chondrocyte implantation (ACI) experience response shift.MethodsForty-eight patients undergoing ACI participated. The “then-test” method was used to evaluate response shift in commonly used patient-reported outcome measures (PROMs)—the SF-36 Physical Component Scale (SF-36 PCS), WOMAC, IKDC, and Lysholm. Each PROM was completed pre- and 6 and 12 months post-surgery. At 6 and 12 months, an additional “then” version of each form was also completed. The “then” version was identical to the original except that patients were instructed to assess how they were prior to ACI. Traditional change, response shift adjusted change, and response shift magnitude were calculated at 6 and 12 months.Ttests (p< 0.05) were used to compare traditional change to response-shift-adjusted change, and response shift magnitude values to previously established minimal detectable change.ResultsThere were no differences between traditional change and response-shift-adjusted change for any of the PROMs. The mean response shift magnitude value of the WOMAC at 6 months (15 ± 14,p= 0.047) was greater than the previously established minimal detectable change (10.9). The mean response shift magnitude value for the SF-36 PCS at 12 months (9.4 ± 6.8,p= 0.017) also exceeded the previously established minimal detectable change (6.6).ConclusionsThere was no evidence of a group-level effect for response shift. These results support the validity of pre-test/post-test research designs in evaluating treatment effects. However, there is evidence that response shifts may occur on a patient-by-patient basis, and scores on the WOMAC and SF-36 in particular may be influenced by response shift.Level of evidenceII.