罗兰·莫里斯残疾问卷(RMDQ),疼痛强度的视觉模拟量表(VAS),和数值评定量表(NRS)是下腰痛干预试验中最常用的结局指标之一.它们以纸形式的使用已经很好地确立。关于电子对应物的公制属性的数据很少。
我们研究的目标是建立反应能力,最小重要变化(MIC)阈值,可靠性,以及电子版本RMDQ的95%水平(MDC95)的最小可检测变化,VAS,和NRS,通过iOS和Android应用程序和Web浏览器提供。
我们招募了患有腰痛的成人,他们去看了骨科医生。我们邀请参与者完成eRMDQ,eVAS,和基线时的eNRS,1周,和6周以及1周和6周的健康过渡问题。使用受试者操作者特征(ROC)曲线和ROC曲线下面积(AUC),将来自报告恢复的参与者的数据用于MIC和反应性分析。来自报告稳定性的参与者的数据用于可靠性分析(组内相关系数[ICC]协议)和MDC95。
我们包括442名参与者。在1周和6周,eRMDQ的ROCAUC分别为0.69(95%CI0.59至0.80)和0.67(95%CI0.46至0.87),eVAS的0.69(95%CI0.58至0.80)和0.74(95%CI0.53至0.95),eNRS为0.73(95%CI0.66至0.80)和0.81(95%CI0.69至0.92),分别。相关的MIC阈值估计为1(0至2)和2(-1至5),13(9至17)和7(-12至26),2(1到3)和1(0到2)分,分别。在1周的时间内,参与者使用过渡问题分类为“稳定”和“大约相同”,eRMDQ的ICC分别为0.87(95%CI0.66至0.95)和0.84(95%CI0.73至0.91),MDC95为4和5,eVAS为0.31(95%CI-0.25至0.71),MDC95为39和34的eVAS为0.52(95%CI0.14至0.77),NDC51为0.67(95%)。
eRMDQ是可靠的,具有足够的响应性。eNRS具有临界可靠性。虽然eVAS有足够的响应能力,它没有一个有吸引力的可靠性配置文件。因此,在测量疼痛强度方面,eNRS可能优于eVAS.观察到的电子结果测量值的度量特性在文献中报告的纸质对应物的值范围内,并且足以测量下背痛人群的变化。
The Roland Morris Disability Questionnaire (RMDQ), visual analog scale (VAS) of pain intensity, and numerical rating scale (NRS) are among the most commonly used outcome measures in trials of interventions for low back pain. Their use in paper form is well established. Few data are available on the metric properties of electronic counterparts.
The goal of our research was to establish responsiveness, minimally important change (MIC) thresholds, reliability, and minimal detectable change at a 95% level (MDC95) for electronic versions of the RMDQ, VAS, and NRS as delivered via iOS and Android apps and Web browser.
We recruited adults with low back pain who visited osteopaths. We invited participants to complete the eRMDQ, eVAS, and eNRS at baseline, 1 week, and 6 weeks along with a health transition question at 1 and 6 weeks. Data from participants reporting recovery were used in MIC and responsiveness analyses using receiver operator characteristic (ROC) curves and areas under the ROC curves (AUCs). Data from participants reporting stability were used for analyses of reliability (intraclass correlation coefficient [ICC] agreement) and MDC95.
We included 442 participants. At 1 and 6 weeks, ROC AUCs were 0.69 (95% CI 0.59 to 0.80) and 0.67 (95% CI 0.46 to 0.87) for the eRMDQ, 0.69 (95% CI 0.58 to 0.80) and 0.74 (95% CI 0.53 to 0.95) for the eVAS, and 0.73 (95% CI 0.66 to 0.80) and 0.81 (95% CI 0.69 to 0.92) for the eNRS, respectively. Associated MIC thresholds were estimated as 1 (0 to 2) and 2 (-1 to 5), 13 (9 to 17) and 7 (-12 to 26), and 2 (1 to 3) and 1 (0 to 2) points, respectively. Over a 1-week period in participants categorized as \"stable\" and \"about the same\" using the transition question, ICCs were 0.87 (95% CI 0.66 to 0.95) and 0.84 (95% CI 0.73 to 0.91) for the eRMDQ with MDC95 of 4 and 5, 0.31 (95% CI -0.25 to 0.71) and 0.61 (95% CI 0.36 to 0.77) for the eVAS with MDC95 of 39 and 34, and 0.52 (95% CI 0.14 to 0.77) to 0.67 (95% CI 0.51 to 0.78) with MDC95 of 4 and 3 for the eNRS.
The eRMDQ was reliable with borderline adequate responsiveness. The eNRS was responsive with borderline reliability. While the eVAS had adequate responsiveness, it did not have an attractive reliability profile. Thus, the eNRS might be preferred over the eVAS for measuring pain intensity. The observed electronic outcome measures\' metric properties are within the ranges of values reported in the literature for their paper counterparts and are adequate for measuring changes in a low back pain population.