Establishing the minimal clinically important difference of the Barthel Index in stroke patients
Establishing the minimal clinically important difference of the Barthel Index in stroke patients
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DOI：
10.1177/1545968306294729
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发表时间：
2007-05-01
影响因子：
4.2
通讯作者：
Hsieh, Ching-Lin
中科院分区：
文献类型：
--
作者：
Hsieh, Yu-Wei;Wang, Chun-Hou;Hsieh, Ching-Lin
背景。由于尚未确定其最小临床重要差异 (MCID)，因此在后续或结果研究中对 Barthel 指数 (BI) 变化分数的解释受到了阻碍。客观的。本文旨在确定中风患者 BI 的 MCID。方法。基于锚点和基于分布的方法都用于建立 MCID。在基于锚定的方法中，43 名中风住院患者参与了一项后续研究，该研究旨在使用患者在 15 点李克特量表上对日常生活功能活动的总体评分来确定 BI 的 MCID。 MCID 组 BI 20 分制的平均变化分数（基于患者对 Likert 型量表的评分）作为 MCID 的第一个估计值。在基于分布的方法中，56 名慢性中风患者参与了重测可靠性研究，以确定 BI 的 MCID。测量标准误差 (SEM) 作为 MCID 的第二个估计值。选择 2 个估计值中较大的 MCID 值作为 BI 的 MCID。结果。在基于锚的研究中，MCID组有20名患者，平均变化分数为1.85分（即第一个MCID估计值）。在基于分布的研究中，基于重测一致性的SEM为1.45分（即第二次MCID估计）。中风患者的 BI MCID 估计为 1.85 分。结论。作者的结果在其设计的限制内表明，如果在一项研究中中风组内的平均 BI 变化评分达到 1.85 分，则患者可以认为 BI 的机会评分很重要并且超出了测量误差（即，这样的变化评分在临床上很重要）。
Background. The interpretation of the change scores of the Barthel Index (BI) in follow-up or outcome studies has been hampered by the fact that its minimal clinically important difference (MCID) has not been determined. Objective. This article was written to establish the MCID of the BI in stroke patients. Methods. Both anchor-based and distribution-based methods were used to establish the MCID. In the anchor-based method, 43 stroke inpatients participated in a follow-up study designed to determine the MCID of the BI using patients' global ratings of the activities of daily living function on a 15-point Likert-type scale. The mean change scores on the 20-point scale of the BI of the MCID group, based on the patients' ratings on the Likert-type scale, served as the first estimate of the MCID. In the distribution-based method, 56 chronic stroke patients participated in the test-retest reliability study to determine the MCID of the BI. One standard error of measurement (SEM) served as the second estimate for the MCID. The larger MCID value of the 2 estimates was chosen as the MCID of the BI. Results. In the anchor-based study, there were 20 patients in the MCID group, with a mean change score of 1.85 points (ie, the first MCID estimate). In the distribution-based study, the SEM based on test-retest agreement was 1.45 points (ie, the second MCID estimate). The MCID of the BI in stroke patients was estimated to be 1.85 points. Conclusion. The authors' results, within the limitations of their design, suggest that if the mean BI change score within a stroke group has reached 1.85 points in a study, the chance score on the BI can be perceived by patients as important and beyond measurement error (ie, such a change score is clinically important).