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住院康复设施患者评估仪器的同时验证1.4版本;GG,B和C部分
Erin Y Harmon1, Matthew B Sonagere2
1James A. Eddy Memorial Foundation Research Institute, Sunnyview Rehabilitation Hospital, Schenectady, NY 12308, USA.
Archives of physical medicine and rehabilitation
|August 3, 2023
概括
医疗保险和医疗补助服务中心住院康复设施患者评估仪器 (CMS-IRF PAI) 部分GG,B和C与功能独立度量 (FIM) 分数相关,但可能高估了患者的能力. 需要进一步的研究来确认GG部分.
科学领域:
- 康复医学 康复医学 康复医学
- 医疗保健服务研究 医疗服务研究
- 生物统计学 生物统计学
背景情况:
- 医疗保险和医疗补助服务中心的住院康复设施患者评估仪器 (CMS-IRF PAI) 对于患者的评估至关重要.
- 将其组件与已建立的措施 (如功能独立性措施 (FIM)) 进行验证,对于准确的结果报告至关重要.
研究的目的:
- 为了验证CMS-IRF PAI版本1.4的GG部分 (自我护理和移动性评估),B部分 (听力,言语和视觉) 和C部分 (认知模式).
- 将这些部分与FIM运动子级 (FIMm) 和认知子级 (FIMc) 进行比较.
主要方法:
- 对1296名入院于单一住院康复设施的患者进行了回顾性队列研究.
- 使用斯皮尔曼相关性和布兰德-阿尔特曼分析来比较CMS-IRF PAI部分与FIM子尺度.
- 组合的部分B和C (B+C尺度) 的内部有效性使用Cronbach的alpha进行了评估.
主要成果:
- 部分GG和FIMm显示高相关性 (ρ=0.919-0.929),但部分GG表现出更高的得分和更大的感知功能收益.
- B+C尺度表现出良好的内部有效性 (克朗巴赫α=0.868) 和与FIMc (ρ=0.745) 相关性良好,但也显示出更高的认知评分和天花板效应.
- 部分GG和B+C等级都显示出显著的上限效应,可能限制它们在更高的功能或认知水平上进行歧视的能力.
结论:
- 虽然CMS-IRF PAI的GG,B和C部分与FIM分量表现出相关性,但它们倾向于对患者进行更高的评价,并且可能具有显著的上限效应.
- 这些上限效应可能会限制高水平认知和功能独立的精确测量.
- 需要进一步调查,以确定GG部分作为结果测量和长期结果预测器的临床效用.
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