Development of a tool for early referral of children and adolescents with signs and symptoms suggestive of chronic arthropathy to pediatric rheumatology centers
Development of a tool for early referral of children and adolescents with signs and symptoms suggestive of chronic arthropathy to pediatric rheumatology centers
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DOI：
10.1002/art.21983
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发表时间：
2006-06-15
期刊：
影响因子：
--
通讯作者：
Hil치rio, MOE
中科院分区：
文献类型：
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作者：
Len, CA;Terreri, MT;Hil치rio, MOE
客观的。开发一种简单、省时的工具来识别具有提示慢性关节病体征和症状的儿童和青少年，并评估其观察者间的再现性和可靠性。方法。该仪器使用了开发健康相关仪器所需的标准化技术，针对表面健康的 1-16 岁儿童和青少年的父母。一个多学科团队参与了仪器的设计。结果。每位健康专业人员针对他们认为最相关的肌肉骨骼疾病提出了 10-15 个问题。总共列出了 60 个问题。在缩减步骤中，每位卫生专业人员根据问题的相关性对问题从 1 到 4 进行评分。该工具包含 12 个问题，并针对 3 组的家长进行测试：幼年特发性关节炎患者 (JIA；n = 48)、弥漫性肌肉骨骼疼痛儿童 (n = 39) 和健康对照组 (n = 42)。 JIA 组得分最高，其次是弥漫性肌肉骨骼疼痛组和对照组。 48 名 JIA 患者中的 9 名 (18.7%) 和 39 名肌肉骨骼疼痛儿童中的 2 名 (5.1%) 得分为 5。观察者间的重现性得到证实。所有 12 个问题都包含在该工具的最终版本中。我们确定得分 >= 5 的儿童和青少年应进行风湿病学评估（聚类分析和逻辑回归）。结论。我们的问卷似乎是早期发现可能需要转诊进行风湿病评估的儿童肌肉骨骼问题的有用工具。
Objective. To develop an easy, time-efficient tool to identify children and adolescents with signs and symptoms suggestive of chronic arthropathies, and to evaluate its interobserver reproducibility and reliability.Methods. The instrument used standardized techniques as required for the development of health-related instruments, targeting parents of apparently healthy children and adolescents ages 1-16 years. A multidisciplinary team was involved in the design of the instrument.Results. Each health professional generated 10-15 questions addressing musculoskeletal complaints that they considered to be the most relevant. A total of 60 questions were listed. During the reduction step, each health professional scored questions from 1 to 4 according to the question's relevance. The tool comprised 12 questions and was administered to the parents of 3 groups: patients with juvenile idiopathic arthritis (JIA; n = 48), children with diffuse musculoskeletal pain (n = 39), and a healthy control group (n = 42). The JIA group achieved the highest scores, followed by the diffuse musculoskeletal pain group and the control group. Nine (18.7%) of 48 patients with JIA and 2 (5.1%) of 39 children with musculoskeletal pain had a score of 5. The interobserver reproducibility was confirmed. All 12 questions were included in the final version of the instrument. We determined that children and adolescents with a score >= 5 should be referred for a rheumatologic evaluation (cluster analysis and logistic regression).Conclusion. Our questionnaire seems to be a useful tool for the early detection of musculoskeletal problems in children that may need a referral for a rheumatologic evaluation.