最小临床重要性差值在医学量表中应用的分析和思考  

Analysis and reflection on the application of minimum clinical importance difference in medical scale

作　　者：姚思梦 胡启彦 刘凤斌[3] 潘静琳 王珏莲 侯政昆[3] YAO Si-meng;HU Qi-yan;LIU Feng-bin;PAN Jing-lin;WANG Jue-lian;HOU Zheng kun(First School of Clinic Medicine,Guangzhou University of Chinese Medicine,Guangzhou 510405,China;Guangzhou University of Chinese Medicine,Guangzhou 510000,China;The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405,China;Department of Spleen and Gastric Hepatology of Hainan Hospital of Traditional Chinese Medicine,Haikou 570100,China;Guangdong Provincial Hospital of Chinese Medicine,Guangzhou 510000,China)

机构地区：[1]广州中医药大学第一临床医学院,广州510405 [2]广州中医药大学,广州510000 [3]广州中医药大学第一附属医院,广州510405 [4]海南省中医院脾胃肝病科,海口570100 [5]广东省中医院,广州510000

出　　处：《中华中医药杂志》2022年第10期5690-5694,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金项目(No.81774450,No.81774264)。

摘　　要：最小临床重要性差值(MCID)是量表临床转化的关键,但目前我国MCID的制定研究较少,制定方法相对不成熟。笔者通过检索中国知网、维普、万方三大数据库从建库以来关于医学量表MCID制定的文献,从MCID最终取值方法、锚法应用相关问题、分布法应用相关问题3个方面对其进行整理。分析发现,我国医学量表MCID的制定多以锚法和分布法相结合为主;锚法中最常选用的锚是主观非临床的,多从患者的角度出发;0.5倍标准差法是分布法中最常用的方法,其次是1倍测量标准误。目前,我国仅有极少数量表制定了MCID,且研制方法存在明显的主观性,无统一规范方法。运用较合理公认的方法制定量表的MCID,是促进量表临床转化和中医疗效评价发展亟需解决的问题。Minimum clinical importance difference(MCID)is the key to scale clinical transformation,but there are few studies on the formulation of MCID in China,and the formulation method is relatively immature.In this article,literature on the formulation of MCID of the medical scale was retrieved from the three major databases of CNKI,VPCS and WanFang since the establishment.It is sorted out from three aspects:the final value method of MCID,problems related to the application of anchor method and problems related to the application of distribution method.The analysis shows that the establishment of MCID in China is mainly based on the combination of anchor and distribution method.The most common anchors used in the anchor-based methods are subjective and non-clinical,usually from the perspective of the patient.0.5 times standard deviation method is the most commonly used method in distribution method,followed by 1 times measurement standard error.At present,only a small number of scales in China have formulated MCID,and the development method is obviously subjective,and there is no unified standard method.It is an urgent problem to promote the clinical transformation of scale and the development of TCM efficacy evaluation to develop MCID with more reasonable and accepted methods.

关 键 词：最小临床重要性差值 医学量表 解释度 疗效评价 

分 类 号：R24[医药卫生—中医临床基础]