The SF-36 arthritis-specific health index (ASHI) I. Development and cross-validation of scoring algorithms
The SF-36 arthritis-specific health index (ASHI) I. Development and cross-validation of scoring algorithms
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DOI：
10.1097/00005650-199905001-00004
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发表时间：
1999-05-01
期刊：
影响因子：
3
通讯作者：
Kong, SXD
中科院分区：
文献类型：
--
作者：
Ware, JE;Keller, SD;Kong, SXD
SF-36 健康调查的关节炎特定健康指数 (ASHI) 是通过研究其对关节炎严重程度临床指标变化的反应而制定的。对参与四项安慰剂对照试验的 1,076 名患者的纵向数据进行了分析。所有患者都有至少 6 个月的中度至重度骨关节炎或膝关节或髋关节类风湿关节炎病史。在基线评估之前，所有人都经历了 3 至 14 天的清除期，以导致骨关节炎或类风湿性关节炎症状出现突发状态。他们的平均年龄为 60 岁，其中 72% 是女性。八个量表 SF-36 健康概况（急性版）和五种关节炎特异性疾病严重程度测量（负重时的膝盖疼痛、步行 50 英尺的时间、医生对症状严重程度和影响的总体评估、患者对症状严重程度和影响的总体评估以及疼痛强度视觉模拟量表）的变化评分是通过从两周随访时的评分中减去治疗前的评分来计算的。使用规范相关方法得出 SF-36 量表变化的权重，以对单个指数 (ASHI) 进行评分，从而最大限度地提高其与关节炎严重程度的五种临床测量值变化的相关性。用于对 ASHI 进行评分的权重在前两项骨关节炎试验的 25% 坚持组 (N = 144) 以及另外两项骨关节炎和类风湿性关节炎试验 (N = 530) 中进行了交叉验证。只有一个 SF-36 典型变量 (ASHI) 与作为关节炎严重程度变化“标准”测量的临床典型变量显着相关（F = 4.69，P < 0.0001）。 ASHI 和临床典型变量的变化在发育样本中（r = 0.628，P < 0.0001）和交叉验证（r = 0.629，P < 0.0001）显着相关。临床典型变量与除五项临床测量之一（50 英尺步行；r = 0.41）之外的所有变化高度相关（r = 0.75-0.88）。 SF-36 量表变化与 ASHI 之间的相关性模式表明，ASHI 主要衡量身体疼痛 (r = 0.92) 以及身体和角色功能及幸福感的其他方面（极体身体 r = 0.69，身体功能 r = 0.68，社会功能 r = 0.52，r = 0.51 活力）。 SF-36 量表和 ASHI 之间的相关性模式在发育和交叉验证样本中非常相似。这项研究证明了根据 SF-36 健康调查的反应变化进行单一 ASHI 评分的可行性和普遍性。通用 SF-36 健康状况已被证明可用于将关节炎与其他疾病和治疗进行比较，还可以进行专门评分，使其在骨关节炎和类风湿关节炎的研究中更有用。
An arthritis-specific health index (ASHI) for the SF-36 Health Survey was developed by studying its responsiveness to changes in clinical indicators of arthritis severity. Longitudinal data from 1,076 patients participating in four placebo-controlled trials were analyzed. All had at least a 6-month history of moderate to severe osteoarthritis or rheumatoid arthritis of the knee or hip. All had undergone a washout period of 3 to 14 days before baseline assessment to bring about a flare state in osteoarthritis or rheumatoid arthritis symptoms. Their average age was 60 years and 72% were female. Change scores for the eight-scale SF-36 health profile (acute version) and five arthritis-specific measures of disease severity (knee pain on weight bearing, time to walk 50 feet, physician global evaluation of symptom severity and impact, patient global evaluation of symptom severity and impact, and pain intensity visual analogue scale) were computed by subtracting scores before treatment from scores at two-week follow-up. Canonical correlation methods were used to derive weights for changes in SF-36 scales to score a single index (ASHI) that maximized its correlation with changes in the set of five clinical measures of arthritis severity. The weights used to score the ASHI were cross-validated in a 25% holdout group (N = 144) from the first two osteoarthritis trials and in two additional osteoarthritis and rheumatoid arthritis trials (N = 530). Only one SF-36 canonical variate (ASHI) correlated significantly (F = 4.69, P < 0.0001) with the clinical canonical variate that served as the "criterion" measure of change in the severity of arthritis. Changes in the ASHI and clinical canonical variate were substantially correlated in the developmental sample (r = 0.628, P < 0.0001) and on cross-validation (r = 0.629, P < 0.0001). The clinical canonical variate correlated highly (r = 0.75-0.88) with changes in all but one of the five clinical measures (50-foot walk; r = 0.41). The pattern of correlations between changes in SF-36 scales and the ASHI indicated that ASHI is primarily a measure of bodily pain (r = 0.92) and other aspects of physical and role functioning and well-being (r = 0.69 for Pole-Physical, r = 0.68 for Physical Functioning, r = 0.52 for Social Functioning, and r = 0.51 Vitality). The patterns of correlations between SF-36 scales and the ASHI were very similar across developmental and cross-validation samples. This research demonstrates the feasibility and generalizability of a single ASHI scored from changes in responses to the SF-36 Health Survey. The generic SF-36 health profile, which has already been shown to be useful in comparing arthritis with other diseases and treatments, can also be scored specifically to make it more useful in studies of osteoarthritis and rheumatoid arthritis.