确定苏黎世慢性中耳量表(ZCMEI-21-Chn)中文版的最小临床意义差异(MCID)和反应性:一项前瞻性多中心研究。

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY
Accounts of Chemical Research Pub Date : 2024-08-01 Epub Date: 2024-07-02 DOI:10.1097/MAO.0000000000004237
Ruizhe Yang, Ying Zhang, Guodong Feng, Weiju Han, Yi Li, Shan Li, Tao Pan, Jia Ke, Ke Zhang, Ying Xin, Yu Song, Qiang Zuo, Yanping Zhao, Na Zhou, Ziming Yao, Christof Röösli, Alexander M Huber, David Bächinger, Furong Ma, Zhiqiang Gao
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引用次数: 0

摘要

研究目的本研究旨在确定最小临床重要差异(MCID),并评估苏黎世慢性中耳量表(ZCMEI-21-Chn)中文版的反应性:前瞻性多中心研究:研究设计:前瞻性多中心研究:230名接受鼓室成形术的成年慢性中耳炎(COM)患者:患者需完成 ZCMEI-21-Chn,以测量术前和术后的健康相关生活质量。采用基于锚的方法,将全球变化评分问卷作为锚,以确定衍生队列的 MCID。在验证队列中使用接收器操作特征曲线分析法对 MCID 估计值的通用性和与功能结果的一致性进行了外部检验:结果:分别有 161 名和 69 名患者被纳入衍生队列和验证队列。术前和术后 ZCMEI-21-Chn 总分的平均值分别为 28.4(标准差 [SD] 14.5)和 17.5(标准差 12.6)。ZCMEI-21-Chn 评分的平均变化为 10.9(标准差 14.3,P < 0.001)。据估计,ZCMEI-21-Chn 改善和恶化的 MCID 分别为 13(标实 13.0)和 -7(标实 12.9)。对于健康相关生活质量有所改善的患者,气导听阈升高的临界值为 15.6 dB HL。然而,根据 MCID 和日本耳科学会标准判断的临床重要性的变化并不一致,尤其是在验证队列中的 Cohen's kappa (κ) 为 0.14(p = 0.21):本研究首次确定了中文 COM 专项问卷的 MCID。结论:本研究首次确定了中文 COM 专项问卷的 MCID 值,对于接受手术干预的 COM 患者,建议将病情改善的 MCID 值定为 13,病情恶化的 MCID 值定为-7。该结果经过外部验证,可在全国范围内推广使用,但又能与听力学标准区分开来。通过对 ZCMEI-21-Chn 的评分变化进行有临床意义的解释,MCID 值的可用性大大提高了 ZCMEI-21-Chn 的临床实用性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Determining the Minimal Clinically Important Difference (MCID) and Responsiveness of the Chinese Version of Zurich Chronic Middle Ear Inventory (ZCMEI-21-Chn): A Prospective Multicenter Study.

Objectives: This study aimed to establish the minimal clinically important difference (MCID) and assess the responsiveness of the Chinese version of Zurich Chronic Middle Ear Inventory (ZCMEI-21-Chn).

Study design: Prospective multicenter study.

Setting: Four Chinese tertiary referral centers admitting patients nationwide.

Patients: 230 adult patients with chronic otitis media (COM) undergoing tympanoplasty.

Intervention: Patients were required to complete the ZCMEI-21-Chn to measure health-related quality of life both preoperatively and postoperatively. An anchor-based method was used to determine the MCID of the derivative cohort by including the Global Rating of Change Questionnaire as an anchor. The generalizability and consistency with functional outcomes of the MCID estimates were externally examined in a validation cohort using a receiver operating characteristic curve analysis.

Results: A total of 161 and 69 patients were included in the derivative and validation cohort. The mean preoperative and postoperative ZCMEI-21-Chn total scores were 28.4 (standard deviation [SD] 14.5) and 17.5 (SD 12.6). The mean change in ZCMEI-21-Chn score was 10.9 (SD 14.3, p < 0.001). The MCIDs of the ZCMEI-21-Chn for improvement and deterioration were estimated at 13 (SD 13.0) and -7 (SD 12.9), accordingly. For patients who have reported an improved health-related quality of life, a cutoff value of 15.6 dB HL for elevation of the air-conducted hearing threshold was noticed. However, change of clinical importance judged according to MCID and Japan Otological Society criteria disagreed with each other, notably with a Cohen's kappa ( κ ) of 0.14 ( p = 0.21) in the validation cohort.

Conclusion: This study is the first to establish the MCID of a COM-specific questionnaire in Chinese. For the COM population undergoing surgical intervention, MCID values of 13 for improvement and -7 for deterioration are recommended. The results were externally validated to be generalizable to nationwide usage, yet distinguishable from the audiological criteria. The availability of the MCID greatly adds to the clinical utility of the ZCMEI-21-Chn by enabling a clinically meaningful interpretation of its score changes.

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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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