Predictive Validity and Responsiveness of Patient-Reported and Performance-Based Measures of Function in the Boston RISE Study
Predictive Validity and Responsiveness of Patient-Reported and Performance-Based Measures of Function in the Boston RISE Study
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DOI：
10.1093/gerona/glu227
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发表时间：
2015-05-01
影响因子：
5.1
通讯作者：
Bean, Jonathan F.
中科院分区：
文献类型：
--
作者：
Beauchamp, Marla K.;Jette, Alan M.;Bean, Jonathan F.
背景患者报告和基于表现的测量（PBM）通常用于测量老年人研究中的身体功能。选择适当的措施，以解决具体的研究问题是复杂的，需要相关的心理特性的知识。本研究的目的是检查广泛使用的患者报告的措施，晚年功能和残疾工具（LLFDI）的不良后果和反应的预测有效性，与PBMs. Methods相比。我们分析了来自Boston RISE的2年随访数据，这是一项包括430名年龄≥ 65岁的初级保健患者的队列研究。Logistic和线性回归模型用于检查不良结局的预测有效性，计算效应大小和最小可检测变化评分以检查反应性。以运动能力为基础的功能测量包括短期身体机能成套测验、400米步行、步态速度和爬楼梯功率测试。LLFDI和PBMs对自我评价较差的健康状况、住院和残疾表现出较高的预测效度。LLFDI功能量表是预测福尔斯的唯一指标。LLFDI的绝对效应量估计值范围为0.54至0.64，PBM为0.34至0.63。从基线到2年，LLFDI量表变化>=最小可检测变化的参与者百分比最大（46-59%），其次是短体能测试（44%）、步态速度（35%）、400米步行（17%）和爬楼梯功率测试（9%）。患者报告的LLFDI显示出与PBM相当的心理测量特性。我们的研究结果支持使用LLFDI作为老年学研究的主要成果。
Background. Patient-reported and performance-based measures (PBMs) are commonly used to measure physical function in studies of older adults. Selection of appropriate measures to address specific research questions is complex and requires knowledge of relevant psychometric properties. The aim of this study was to examine the predictive validity for adverse outcomes and responsiveness of a widely used patient-reported measure, the Late-Life Function and Disability Instrument (LLFDI), compared with PBMs.Methods. We analyzed 2 years of follow-up data from Boston RISE, a cohort study of 430 primary care patients aged >= 65 years. Logistic and linear regression models were used to examine predictive validity for adverse outcomes and effect size and minimal detectable change scores were computed to examine responsiveness. Performance-based functional measures included the Short Physical Performance Battery, 400-m walk, gait speed, and stair-climb power test.Results. The LLFDI and PBMs showed high predictive validity for poor self-rated health, hospitalizations, and disability. The LLFDI function scale was the only measure that predicted falls. Absolute effect size estimates ranged from 0.54 to 0.64 for the LLFDI and from 0.34 to 0.63 for the PBMs. From baseline to 2 years, the percentage of participants with a change >= minimal detectable change was greatest for the LLFDI scales (46-59%) followed by the Short Physical Performance Battery (44%), gait speed (35%), 400-m walk (17%), and stair-climb power test (9%).Conclusions. The patient-reported LLFDI showed comparable psychometric properties to PBMs. Our findings support the use of the LLFDI as a primary outcome in gerontological research.