Measurement properties of the Inclusion Body Myositis Functional Rating Scale.

IF 8.7 1区 医学 Q1 CLINICAL NEUROLOGY Journal of Neurology, Neurosurgery, and Psychiatry Pub Date : 2025-01-16 DOI:10.1136/jnnp-2024-333617
Sharfaraz Salam, Tara Symonds, Helen Doll, Sam Rousell, Jason Randall, Lucy Lloyd-Price, Stacie Hudgens, Christina Guldberg, Laura Herbelin, Richard J Barohn, Michael G Hanna, Mazen M Dimachkie, Pedro M Machado
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Abstract

Objectives: To evaluate the validity, reliability, responsiveness and meaningful change threshold of the Inclusion Body Myositis (IBM) Functional Rating Scale (FRS).

Methods: Data from a large 20-month multicentre, randomised, double-blind, placebo-controlled trial in IBM were used. Convergent validity was tested using Spearman correlation with other health outcomes. Discriminant (known groups) validity was assessed using standardised effect sizes (SES). Internal consistency was tested using Cronbach's alpha. Intrarater reliability in stable patients and equivalence of face-to-face and telephone administration were tested using intraclass correlation coefficients (ICCs) and Bland-Altman plots. Responsiveness was assessed using standardised response mean (SRM). A receiver operator characteristic (ROC) curve anchor-based approach was used to determine clinically meaningful IBMFRS change.

Results: Among the 150 patients, mean (SD) IBMFRS total score was 27.4 (4.6). Convergent validity was supported by medium to large correlations (rs modulus: 0.42-0.79) and discriminant validity by moderate to large group differences (SES=0.51-1.59). Internal consistency was adequate (overall Cronbach's alpha: 0.79). Test-retest reliability (ICCs=0.84-0.87) and reliability of telephone versus face-to-face administration (ICCs=0.93-0.95) were excellent, with Bland-Altman plots showing good agreement. Responsiveness in the worsened group defined by various external constructs was large at both 12 (SRM=-0.76 to -1.49) and 20 months (SRM=-1.12 to -1.57). In ROC curve analysis, a drop in at least two IBMFRS total score points was shown to represent a meaningful decline.

Conclusions: When administered by trained raters, the IBMFRS is a reliable, valid and responsive tool that can be used to evaluate the impact of IBM and its treatment on physical function, with a 2-point reduction representing meaningful decline.

Trial registration number: NCT02753530.

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包涵体肌炎功能评定量表的测量特性。
目的评估包涵体肌炎(IBM)功能评定量表(FRS)的有效性、可靠性、反应性和有意义变化阈值:方法:采用一项为期 20 个月的大型多中心、随机、双盲、安慰剂对照试验的数据。使用与其他健康结果的斯皮尔曼相关性测试了收敛效度。使用标准化效应大小(SES)评估判别(已知群体)有效性。内部一致性采用 Cronbach's alpha 进行测试。使用类内相关系数 (ICC) 和 Bland-Altman 图测试了稳定期患者的类内可靠性以及面对面和电话施测的等效性。响应性采用标准化响应平均值 (SRM) 进行评估。采用基于接收者操作者特征曲线(ROC)锚定法来确定有临床意义的 IBMFRS 变化:结果:在 150 名患者中,IBMFRS 总分的平均值(标清)为 27.4 (4.6)。中度至高度相关性(rs 模量:0.42-0.79)和中度至高度群体差异(SES=0.51-1.59)支持了收敛效度和区分效度。内部一致性良好(总体 Cronbach's alpha:0.79)。测试再测可靠性(ICCs=0.84-0.87)以及电话与面对面施测的可靠性(ICCs=0.93-0.95)都非常好,布兰-阿尔特曼图显示出良好的一致性。在 12 个月(SRM=-0.76 至-1.49)和 20 个月(SRM=-1.12 至-1.57)时,由各种外部结构定义的病情恶化组的反应性较大。在ROC曲线分析中,IBMFRS总分下降两分即代表有意义的下降:IBMFRS由训练有素的评分员进行评分,是一种可靠、有效、反应灵敏的工具,可用于评估IBM及其治疗对身体功能的影响,总分下降2分代表有意义的下降:NCT02753530.
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来源期刊
CiteScore
15.70
自引率
1.80%
发文量
888
审稿时长
6 months
期刊介绍: The Journal of Neurology, Neurosurgery & Psychiatry (JNNP) aspires to publish groundbreaking and cutting-edge research worldwide. Covering the entire spectrum of neurological sciences, the journal focuses on common disorders like stroke, multiple sclerosis, Parkinson’s disease, epilepsy, peripheral neuropathy, subarachnoid haemorrhage, and neuropsychiatry, while also addressing complex challenges such as ALS. With early online publication, regular podcasts, and an extensive archive collection boasting the longest half-life in clinical neuroscience journals, JNNP aims to be a trailblazer in the field.
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