中文版SANDE与OSDI干眼问卷信度和效度比较  

Comparison of the reliability and validity between the Chinese version of SANDE and OSDI dry eye questionnaires

作　　者：林丰 蔡羽莹 王艺敏 刘焰[1] Lin Feng;Cai Yuying;Wang Yimin;Liu Yan(Department of Ophthalmology,Shanghai General Hospital,Shanghai Jiaotong University School of Medicine,National Clinical Research Center for Eye Diseases,Shanghai Key Laboratory of Ocular Fundus Diseases,Shanghai Engineering Center for Visual Science and Photomedicine,Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases,Shanghai 200080,China)

机构地区：[1]上海交通大学附属第一人民医院眼科,国家眼部疾病临床医学研究中心,上海市眼底病重点实验室,上海眼视觉与光医学工程技术研究中心,上海市眼科疾病精准诊疗工程技术研究中心,上海200080

出　　处：《中华实验眼科杂志》2022年第2期144-150,共7页Chinese Journal Of Experimental Ophthalmology

基　　金：国家重点研发计划项目(2019YFC0840607)。

摘　　要：目的以眼表疾病指数(OSDI)量表作为参照,评估中文版干眼症状评估(SANDE)问卷在人群中的适用性。方法采用横断面研究方法,于2020年6月将上海市虹口区某中学323名在校高中生纳入研究。采用OSDI问卷及中文版SANDE问卷进行干眼症状评估并计算评分。根据OSDI评分分为正常对照组87人、轻度干眼组82人、中度干眼组87人和重度干眼组67人。采用Cronbachα系数评估2种问卷的内部一致性;采用Kruskal-Wallis检验分析不同严重程度干眼组间的SANDE问卷评分差异以评价区分效度;采用Spearman秩相关分析评估SANDE问卷和OSDI问卷总分的相关性以评价效标效度;采用因子分析评价结构效度;绘制受试者工作特征曲线(ROC),计算ROC曲线下面积(AUC),找到SANDE问卷的诊断阈值。结果SANDE问卷评分和OSDI问卷评分的Cronbachα系数分别为0.856和0.829。依照OSDI问卷评分进行干眼严重等级划分后,正常对照组的SANDE问卷评分为7.0(2.5,16.9),轻度干眼组为17.0(8.4,31.0),中度干眼组为29.2(14.6,49.4),重度干眼组为49.1(24.4,60.7),评分依次升高,总体比较差异有统计学意义(H=113.213,P<0.001),组间两两比较差异均有统计学意义(均P<0.05)。2种问卷评分得分呈中度正相关(r s=0.615,P<0.001)。因子分析结果显示,SANDE问卷2个题目在公共因子上的因子负荷均较高(>0.5),其中干眼症状发作频率为0.936,严重程度为0.936。SANDE问卷AUC为0.815(P<0.001,95%CI:0.770~0.860),干眼诊断阈值为23,对应的敏感度为60.59%,特异度为88.51%。结论中文版SANDE问卷具有良好信度、效度及干眼鉴别能力,虽然其敏感度较低,但作为一种简单的症状评估问卷,其在人群中仍有很好的适用性及临床应用价值。Objective To assess the applicability of the Chinese version of the symptom assessment in dry eye(SANDE)questionnaire refer to the ocular surface disease index(OSDI)questionnaire.Methods A cross-sectional study was conducted.Three hundred and twenty-three students from a senior high school in Hongkou District in Shanghai were enrolled in June 2020.The Chinese version of the SANDE and the OSDI questionnaires were answered by the students to assess the dry eye symptom and were collected on-site.Scores of the two questionnaires were calculated.According to the OSDI score,the students were divided into the normal control group(n=87),mild dry eye group(n=82),moderate dry eye group(n=87)and severe dry eye group(n=67).Cronbachαwas obtained to evaluate the internal consistency.Kruskal-Wallis test was used to analyze the difference in SANDE scores among dry eye groups with different severities and evaluate the discriminative validity.Correlation between the total scores of the two questionnaires was analyzed by using Spearman rank correlation analysis to evaluate the criterion validity.Factor analysis was used to evaluate the construct validity.Receiver operating characteristic curve(ROC)was drawn to obtain the area under the ROC curve(AUC)and cut-off point to evaluate the diagnostic threshold for dry eye.This study protocol adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Shanghai General Hospital(No.2020KY026).Written informed consent was obtained from guardians of each subject.Results The Cronbachαof the SANDE and OSDI questionnaires were 0.856 and 0.829,respectively.SANDE score of the four groups classified according to the OSDI score was 7.0(2.5,16.9)for the normal control group,17.0(8.4,31.0)for the mild dry eye group,29.2(14.6,49.4)for the moderate dry eye group and 49.1(24.4,60.7)for the severe dry eye group,respectively,which was increased in turn.There was a statistically significant overall difference in the SANDE score among the four groups(H=113.213,P<0.001),and statisticall

关 键 词：干眼 症状评估 问卷调查 信度 效度 

分 类 号：R777.34[医药卫生—眼科]