Criterion validity of the GMFM-66 item set and the GMFM-66 basal and ceiling approaches for estimating GMFM-66 scores
Criterion validity of the GMFM-66 item set and the GMFM-66 basal and ceiling approaches for estimating GMFM-66 scores
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DOI：
10.1111/dmcn.12120
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发表时间：
2013-06-01
影响因子：
3.8
通讯作者：
Rosenbaum, Peter L.
中科院分区：
文献类型：
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作者：
Avery, Lisa M.;Russell, Dianne J.;Rosenbaum, Peter L.
目的本研究的目的是比较两种简化的方法来估计粗大运动功能测量66（GMFM-66）的分数与完整的GMFM-66的准确性，并探讨其优势和局限性。方法利用现有的1 ~ 13岁儿童数据集（n=224），平均年龄6岁11个月，标准差4岁6个月; 132名男性，采用粗大运动功能分类系统（GMFCS）各级别脑性瘫痪（CP）患者92例，比较项目集版本的效度（GMFM-66-IS）和具有完整GMFM-66评分的基础和天花板版本（GMFM-66-B&C）。1年随访评估（n=109）允许评价单个时间点的变化评分和准确性。结果两种简化测量的横断面一致性非常好（所有组内相关系数[ICC] >0.98）。当测量随时间的变化时，GMFM-66-IS和GMFM-66-B&C在双侧CP儿童中显示出良好的一致性（ICC>0.9）。然而，GMFM-66-IS评估单侧CP儿童1年内的变化比GMFM-66-B&C更准确（ICC=0.89 vs ICC=0.58; 95%置信区间不重叠）。解释估计GMFM-66评分的两种方法在单个时间点都是准确的。如果评估的主要目标是衡量变化，则仍应将完整的GMFM-66视为准则标准。GMFM-66-IS应该是单侧CP儿童的首选缩短测量。
Aim The aim of this study was to compare the accuracy of two abbreviated approaches for estimating Gross Motor Function Measure 66 (GMFM-66) scores against the full GMFM-66 and to explore their strengths and limitations. Method An existing dataset (n=224) comprising children aged 1 to 13years (mean age 6y 11mo, SD 4y 6mo; 132 males, 92 females) with cerebral palsy (CP) of all Gross Motor Function Classification System (GMFCS) levels was used to compare the validity of the item set version (GMFM-66-IS) and the basal and ceiling version (GMFM-66-B&C) with the full GMFM-66 scores. Follow-up assessment at 1year (n=109) allowed evaluation of change scores and accuracy at a single point in time. Results The cross-sectional agreement was excellent for both abbreviated measures (all intraclass correlation coefficients [ICCs] >0.98). When measuring change over time, both the GMFM-66-IS and the GMFM-66-B&C showed good agreement for children with bilateral CP (ICCs >0.9). However, the GMFM-66-IS assessed change over 1year more accurately than the GMFM-66-B&C in children with unilateral CP (ICC=0.89 vs ICC=0.58; 95% confidence intervals do not overlap). Interpretation Both approaches for estimating GMFM-66 scores are accurate at a single point in time. If the primary goal of assessment is to measure change, the full GMFM-66 should still be regarded as the criterion standard. The GMFM-66-IS should be the preferred shortened measure for children with unilateral CP.