基于COSMIN指南对中国腰痛患者罗兰-莫里残疾调查问卷测量性能证据的系统评价  

Roland-Morris Disability Questionnaire Measurement Performance Evidence in Chinese Patients with Low Back Pain:a Systematic Review Based on COSMIN Guidelines

作　　者：高艺轩 王锡友[2] 陈千吉 杨晓明[2] 郭俊明[2] 訾一路 翁志文[2] 马敬祎 章乃文 刘二杨 邵辉 孙亚男[4] 于长禾[2] GAO Yixuan;WANG Xiyou;CHEN Qianji;YANG Xiaoming;GUO Junming;ZI Yilu;WENG Zhiwen;MA Jingyi;ZHANG Naiwen;LIU Eryang;SHAO Hui;SUN Yanan;YU Changhe(The First Clinical Department,Beijing University of Chinese Medicine,Beijing 100700,China;Tuina and Pain Management Department,Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital,Beijing 100700,China;Shenzhen Luohu District Hospital of Traditional Chinese Medicine,Shenzhen 518001,China;Traditional Chinese Medicine Department,Xuanwu Hospital Capital Medical University,Beijing 100053,China)

机构地区：[1]北京中医药大学第一临床医学院,北京市100700 [2]北京中医药大学东直门医院推拿疼痛科,北京市100700 [3]广东省深圳市罗湖区中医院,518001 [4]首都医科大学宣武医院中医科,北京市100053

出　　处：《中国全科医学》2024年第29期3672-3678,共7页Chinese General Practice

基　　金：国家自然科学基金青年科学基金项目(81803956);北京市首发青年优才项目(2020-4-4195);首都临床特色应用研究(Z181100001718165)。

摘　　要：背景腰痛全球患病率逐步上升,而腰痛是致残、病休、失业的主要原因,对个人及社会均是沉重的负担。评估慢性腰痛患者的残疾程度对于评价临床干预疗效和临床流行病学至关重要。罗兰-莫里残疾调查问卷(RMDQ)是目前评估腰痛患者残疾的主要工具,但其测量性能在中国人群中的适用性尚不明确。目的评估RMDQ在中国腰痛人群中的适用性,为临床实践、临床研究的应用提供证据。方法计算机检索中国知网、万方数据知识服务平台、中国生物医学文献服务系统、PubMed、Embase及Web of Science等,检索时间为建库至2023-10-01,针对腰痛量表的性能研究建立文献库,再从中筛选RMDQ测量性能的研究。按照健康测量工具选择的共识标准(COSMIN)系统评价指南对RMDQ的测量学性能进行评价,并采用GRADE证据评价等级对证据分级。结果共纳入6篇RMDQ文献,RMDQ内容效度方法学质量为不足,测量性能为充分;内部一致性方法学质量存在非常好与不确定,测量性能为充分;重测信度方法学质量为不确定,测量性能为充分;测量误差方法学质量为不确定,测量性能为充分;校标效度方法学质量为不确定,测量性能为不充分;假设检验方法学质量存在非常好与不确定,测量性能存在充分与不确定;反应度方法学质量存在非常好、足够与不足,测量性能存在充分与不足。根据GRADE证据质量评级结果表明内容效度有低质量证据证明不确定,重测信度及内部一致性有中等质量证据证明充分;测量误差及反应度有低质量证据证明充分;以Oswestry功能障碍指数(ODI)和视觉模拟量表(VAS)为校标时,校标效度有非常低质量证据证明不充分;假设检验有中等质量证据证明不确定。结论RMDQ方法学质量不高,测量性能尚可,证据质量偏低,在中国腰痛临床实践或试验中需谨慎使用,重测信度与内部一致性虽被中等质量证据证明充分,�Background The global prevalence of low back pain is gradually increasing,and it is the main cause of disability,sick leave,and unemployment,posing a heavy burden on individuals and society.Assessing the degree of disability in patients with chronic low back pain is crucial for evaluating the efficacy of clinical interventions and clinical epidemiology.The Roland-Morris Disability Questionnaire(RMDQ)is currently the main tool for evaluating disability in patients with low back pain,but the applicability of its measurement performance in the Chinese population remains unclear.Objective To evaluate the applicability of RMDQ in the Chinese population with low back pain and provide evidence for clinical practice and research application.Methods CNKI,Wanfang Data Knowledge Service Platform,SinoMed,PubMed,Embase and Web of Science were searched from inception to 2023-10-01,to establish a literature base for the performance of the low back pain scale,and then select research on the measurement performance of RMDQ from it.The measurement performance of the RMDQ scale was evaluated according to the COSMIN system evaluation guidelines,and the evidence evaluation level was used to grade the evidence.Results A total of six RMDQ documents were included,with insufficient methodological quality for RMDQ content validity and adequate measurement performance.The quality of internal consistency methodology was very good with uncertainty and measurement performance was adequate;the methodological quality of retesting was uncertain,and the measurement performance was sufficient;the methodological quality of measurement error was uncertain,and the measurement performance was sufficient;the methodological quality of criterion validity was uncertain,and the measurement performance was insufficient;hypothesis testing methodological quality was very good with uncertain,and the measurement performance was sufficient and uncertain;the quality of reactivity methodology was very good,with sufficient and insufficient,while the measurement per

关 键 词：腰痛 罗兰-莫里残疾调查问卷 健康测量工具选择的共识标准 信度 效度 反应度 

分 类 号：R681.55[医药卫生—骨科学]