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中国循证儿科杂志

中国循证儿科杂志 ›› 2022, Vol. 17 ›› Issue (5): 336-342.DOI: 10.3969/j.issn.1673-5501.2022.05.003

• 论著 • 上一篇    下一篇

基于共识选择健康测量工具对粗大运动功能评估88项和66项测量学属性的系统评价

王以文1，3,陈功勋1，3,朱登纳1,史惟2   

  1. 1郑州大学第三附属医院郑州，450052；2 复旦大学附属儿科医院上海，201102；3共同第一作者

  • 收稿日期:2022-11-25 修回日期:2022-11-25 出版日期:2022-10-25 发布日期:2022-10-25
  • 通讯作者: 朱登纳；史惟

Psychometric properties of gross motor function measure-88 and 66 based on consensusbased standards for the selection of health measurement instruments: A systematic review

WANG Yiwen1，3, CHENG Gongxun1，3, ZHU Dengna1, SHI Wei2   

  1. 1 The Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; 2 Children's Hospital of Fudan University, Shanghai 201102; 3 Co-first author
  • Received:2022-11-25 Revised:2022-11-25 Online:2022-10-25 Published:2022-10-25
  • Contact: ZHU Dengna,email: zhudengna@zzu.edu.cn;SHI Wei,email: shiweixiyi@163.com

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摘要： 背景：在儿童和青少年脑性瘫痪临床实践指南（CANDLE）中对不同维度选题提出的评估工具尝试基于共识选择健康测量工具（COSMIN）进行心理测量学特性评价，以此在CANDLE中建立评估工具的纳入和排除标准。 目的：使用COSMIN对粗大运动功能评估88项和66项（GMFM88和GMFM66）的测量学属性进行系统评价，明确其各测量特性的证据等级，并为其临床应用提供证据，探索使用COSMIN方法对现场评估类量表进行评价的价值。 设计：系统评价。 方法：检索 MEDLINE、Embase和SinoMed数据库，纳入有关GMFM88和GMFM66测量学属性研究文献，使用更新的COSMIN偏倚风险检查表对所有测量学属性的方法学质量研究进行评估，使用更新的良好测量学属性标准对每项测量学属性研究进行评分。证据质量等级采用COSMIN修订版的GRADE 方法。 主要结局指标:GMFM88和GMFM66的内容效度。 结果：GMFM88比GMFM66内容效度证据等级高，二者均有较高质量的信度研究。GMFM88在内部一致性、测量误差方面较GMFM66有更多证据支持，GMFM88缺乏结构效度研究。GMFM88和GMFM66均有高级别证据的平行效度和平行反应度，低证据级别或极低证据级别的区分效度和区分反应度，GMFM66比GMFM88有更高的效标反应度。 结论：使用COSMIN方法评价GMFM88和GMFM66的测量信度、内部一致性、假设检验效度为高级别证据。COSMIN方法可作为现场评估类量表测量学属性评估方法。

关键词: 粗大运动功能评估, 基于共识选择健康测量工具, 量表测量学属性, 内容效度

Abstract: Background：Based on consensusbased standards for the selection of health measurement instruments（COSMIN）, we evaluated the psychometric properties of the evaluation tools for topics in different domains of the clinical practice guideline for children and adolescents with cerebral palsy (CANDLE) and established the inclusion and exclusion criteria of evaluation tools in CANDLE. Objective：To systematically evaluate Gross Motor Function Measure88 and 66 (GMFM88 and GMFM66) based on COSMIN methods, clarify the evidence level of each psychometric property, provide evidence for its clinical practice, and explore the value of COSMIN methods in assessing field observation evaluation tools. Design：A systematic review. Methods：MEDLINE, Embase and SinoMed databases were searched for relevant research literature on GMFM88 and GMFM66 measurement properties. The updated COSMIN Risk of Bias checklist was used to evaluate the methodological quality of all measurement properties, and updated criteria for good measurement properties were used to score each measurement property study. The GRADE method of COSMIN revision was adopted to assess the evidence quality. Main outcome measures：The content validity of GMFM88 and GMFM66. Results：GMFM88 had better evidence for content validity than GMFM66, and both of them have highquality reliability research. GMFM88 had more evidence to support its internal consistency and measurement errors than GMFM66, but it lacked structural validity research. GMFM88/66 had highquality evidence in concurrent validity and concurrent responsiveness, and low or very lowquality evidence in discrimination validity and discrimination responsiveness. GMFM66 showed better criterion responsiveness than GMFM88. Conclusion：GMFM88/66 has highquality evidence in reliability, internal consistency, and construct validity. COSMIN methods could be useful for the assessment of field observation evaluation tools.

Key words: Gross motor function measurement, Consensus-based standards for the selection of health measurement instruments, Psychometric properties, Content validity