科斯莫斯:一个新型结果测量方法的Interrater和Intrarater可靠性研究
Mayank Goyal1,2,3, Aravind Ganesh1,4,3, Salome L Bosshart1,5
1Calgary Stroke Program, Department of Clinical Neurosciences, Foothills Medical Centre (M.G., A.G., S.L.B., A.S., B.K.M., S.B.C., J.M.O., M.A.Almekhlafi, J.K., P.C., K.J.R., M.M., B.S., M.A.AlShamrani, B.A., A.K., I.A.S., K.H.D.I., M.W., S.G., C.K., A.M.D., M.D.H.), University of Calgary, AB, Canada.
Stroke
|June 23, 2025
概括
患有轻度中风的患者往往有未满足的需求,尽管结果很好. 新的加拿大轻微中风结局量表 (COSMOS) 显示了高可靠性,用于评估这一群体的功能结局.
科学领域:
- 神经学 神经学
- 康复医学 康复医学 康复医学
- 临床结果测量临床结果测量
背景情况:
- 轻微中风患者经常报告对结果的不满,尽管在修改的兰金尺度等传统尺度上得分很好.
- 现有的结果指标可能无法完全捕捉轻微中风后个体所经历的功能限制和对生活追求的影响.
研究的目的:
- 开发和评估一种新的功能性结局指标的可靠性,即加拿大轻微中风结局量表 (COSMOS),专门为轻微中风患者设计.
- 为了评估COSMOS尺度的interrater和intrarater可靠性.
主要方法:
- 加拿大轻微中风结果尺度 (COSMOS) 是一个7点的尺度,旨在评估日常生活基本活动之外的功能结果.
- 创建了100个测试案例小组,33名中风临床医生 (医生,研究员,研究护士/工作人员) 在洗期后两次对20个病例进行了分级.
- 使用百分比协议,科恩 κ,加权 κ和类内相关系数来评估interrater和intrarater的可靠性.
主要成果:
- 在COSMOS尺度表现出相当大的interrater可靠性 (80.5%的协议,科恩 κ=0.77) 和几乎完美的intrarater可靠性 (87.1%的协议,科恩 κ=0.85).
- 权衡的 κ 值表明,对于interrater (0.88) 和intrarater (0.92) 可靠性,几乎完全一致.
- 使用类内相关系数的整体机会调整一致率为0.95,在不同的临床医生子组中得到一致的结果.
结论:
- 新开发的加拿大轻微中风结局量表 (COSMOS) 显示出相当大的interrater和intrarater可靠性.
- 科斯莫斯尺度是评估轻微中风患者功能结果的有希望的工具,需要在临床试验和队列研究中进一步调查.
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