ASSESSING THE RESPONSIVENESS OF FUNCTIONAL SCALES TO CLINICAL-CHANGE - AN ANALOGY TO DIAGNOSTIC-TEST PERFORMANCE
ASSESSING THE RESPONSIVENESS OF FUNCTIONAL SCALES TO CLINICAL-CHANGE - AN ANALOGY TO DIAGNOSTIC-TEST PERFORMANCE
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DOI：
10.1016/0021-9681(86)90038-x
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发表时间：
1986-01-01
期刊：
影响因子：
--
通讯作者：
CENTOR, RM
中科院分区：
文献类型：
--
作者：
DEYO, RA;CENTOR, RM
较新的健康或功能状态量表的一个特征是，随着时间的推移，它们对临床变化的反应能力，这一点很少受到关注。在一定程度上，这是因为评估这一特征的方法很粗糙，也没有很好的标准化。我们建议将量表视为区分改善和未改善患者的“诊断测试”。从这个角度来看，人们可以构建受试者工作特征(ROC)曲线，描述S使用某种外部标准发现改善(或没有改善)的能力。这种方法是用来自急性下腰痛研究的数据来说明的，比较了疾病影响概况及其主要子量表，以及更短、更具疾病特异性的量表。结果表明，在评估量表反应性方面，ROC方法比简单的治疗前和治疗后的分数比较有优势。它们也表明，简短的疾病特异量表比较长的“通用”SIP量表有一些优势。
One characteristic of newer health or functional status scales which has received little attention is their responsiveness over time to clinical change. In part, this is because methods for assessing this characteristic are crude and not well standardized. We suggest that scales be viewed as "diagnostic tests" for discriminating between improved and unimproved patients. With this perspective, one may construct receiver operating characteristic (ROC) curves describing a scale''s ability to detect improvement (or failure to improve) using some external criterion. This method is illlustrated using data from a study of acute low back pain, comparing the Sickness Impact Profile, its major subscales, and a shorter, more disease-specific scale. The results demonstrate an advantage of the ROC approach over simple pre- and post-treatment score comparisons in assessing scale responsiveness. They also suggest some advantage for a brief disease-specific scale over the lengthier "generic" SIP.