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评估结构化修改等级尺度验证研究的优点和局限性 - - 一个系统性审查
Shuait Nair1, Jordyn Hurly1, Deanna Saylor1
1Department of Neurology, Johns Hopkins University School of Medicine, USA.
概括
结构化修改的兰金尺度 (mRS) 调查问卷显示与面对面评估的一致程度中等至非常好,但对于极端结果的患者而言存在差异. 需要进一步的研究,特别是在像非洲这样代表性不足的地区.
科学领域:
- 神经学 神经学
- 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
背景情况:
- 结构化修改的兰金量表 (mRS) 问卷越来越多地用于评估中风的结果.
- 在不同文化和语言环境中表现的差异仍然被低估.
- 需要对结构化与非结构化mRS评估进行系统审查.
研究的目的:
- 系统地审查和评估结构化修改的排名表 (mRS) 问卷的表现,与面对面的非结构化mRS评估相比.
- 确定影响一致性的因素,如文化环境,自我评估模式和护理环境.
主要方法:
- 系统地在PubMed和Web of Science的文献中搜索相关的验证研究.
- 基于国家,mRS自我评估模式,护理环境和偏见风险的研究分析.
- 结构化mRS得分与非结构化mRS评估的比较.
主要成果:
- 在全球范围内确定了13项验证研究,不包括非洲;电话mRS最常见.
- 权重的卡帕协议范围从中等到非常好 (0.56-0.90),但未加权的卡帕协议较低 (0.27-0.68).
- 与临床医生的评分相比,在规模的极端处发现了差异,患者在良好的结果方面自我评价更好,在糟糕的结果方面自我评价更差.
结论:
- 结构化的mRS问卷通常显示出与面对面评估的良好一致性,但对于结果非常好或非常差的患者有显著的差异.
- 未来的研究应该尽量减少评估之间的时间,并调查分数差异的原因.
- 许多地区,特别是非洲,缺乏结构化mRS工具的有效性数据.
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