对临床医生和护理人员报告的 CDKL5 缺乏症患者临床严重程度评估进行心理计量学评估。

IF 6.6 1区 医学 Q1 CLINICAL NEUROLOGY
Epilepsia Pub Date : 2024-08-27 DOI:10.1111/epi.18094
Jacinta M. Saldaris, Peter Jacoby, Jenny Downs, Eric D. Marsh, Helen Leonard, Elia Pestana-Knight, Rajsekar Rajaraman, Judith Weisenberg, Bernhard Suter, Heather E. Olson, Dana Price, William Hong, Erin Prange, Tim A. Benke, Scott Demarest
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引用次数: 0

摘要

目的:CDKL5 临床严重性评估(CCSA)是一种综合性的、经过内容验证的测量工具,能够捕捉到细胞周期蛋白依赖性激酶样 5(CDKL5)缺乏症(CDD)的各种挑战:CDKL5 临床严重性评估(CCSA)是一种内容经过验证的综合测量工具,它能捕捉到细胞周期蛋白依赖性激酶样 5(CDKL5)缺乏症(CDD)的各种挑战,CDD 是一种由基因引起的发育性癫痫脑病(DEE)。CCSA分为临床医生报告评估(CCSA-Clinician)和护理人员报告评估(CCSA-Caregiver)。本研究旨在通过确证因子分析(CFA)评估这些测量指标的因子结构,并评估其有效性和可靠性:从国际 CDKL5 临床研究网络中招募参与者,参加诊所内 CCSA-临床医生评估(148 人)和/或完成 CCSA-护理人员问卷(198 人)。采用 CFA 方法确定领域,并对因子负荷和有效性进行评估。对于 CCSA-临床医师评估,由九名 CDD 经验丰富的临床医师通过 14 次预先录制的评估来评估评分者之间的可靠性。8 名临床医生在 4 周后重新观看视频并重新评分,以评估评分者内部的可靠性。2-4周后,34名护理人员再次完成了CCSA-护理人员问卷,以评估测试再测的可靠性:CFA得出了CCSA-临床医生的三个领域(运动和动作、交流、视力)和CCSA-护理人员的四个领域(癫痫发作、行为、警觉性、喂养),两个测量项目都有良好的项目负荷。两个量表的结构统计、内部一致性、判别效度和可靠性均令人满意,且已知组间的得分一致:本研究提供了强有力的证据,证明CCSA量表适用于评估CDD患者的临床严重程度,支持将其用于临床试验。计划在纵向评估中进一步评估其对变化的反应性。在类似的DEE中也可以使用,但需要在这些人群中进行验证。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Psychometric evaluation of clinician- and caregiver-reported clinical severity assessments for individuals with CDKL5 deficiency disorder

Objective

The CDKL5 Clinical Severity Assessment (CCSA) is a comprehensive, content-validated measurement tool capturing the diverse challenges of cyclin-dependent kinase-like 5 (CDKL5) deficiency disorder (CDD), a genetically caused developmental epileptic encephalopathy (DEE). The CCSA is divided into clinician-reported (CCSA-Clinician) and caregiver-reported (CCSA-Caregiver) assessments. The aim of this study was to evaluate the factor structure of these measures through confirmatory factor analysis (CFA) and evaluate their validity and reliability.

Methods

Participants were recruited from the International CDKL5 Clinical Research Network to take part in an in-clinic CCSA-Clinician evaluation (n = 148) and/or complete the CCSA-Caregiver questionnaire (n = 198). CFA was used to determine domains, and factor loadings and validity were assessed. For the CCSA-Clinician, inter-rater reliability was assessed by nine CDD experienced clinicians via 14 pre-recorded evaluations. Eight clinicians re-viewed and re-scored the videos after 4 weeks to evaluate intra-rater reliability. The CCSA-Caregiver was completed on a second occasion by 34 caregivers after 2–4 weeks to assess test–retest reliability.

Results

CFA resulted in three domains for the CCSA-Clinician (motor and movement, communication, vision) and four domains for the CCSA-Caregiver (seizures, behavior, alertness, feeding), with good item loadings across both measures. Structural statistics, internal consistency, discriminant validity, and reliability were satisfactory for both measures, and scores were consistent between known groups.

Significance

This study provides strong evidence that the CCSA measures are suitable to assess the clinical severity of individuals with CDD, supporting their use in clinical trials. Further evaluation of responsiveness to change in a longitudinal assessment is planned. Use may also be appropriate in similar DEEs but would require validation in those populations.

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来源期刊
Epilepsia
Epilepsia 医学-临床神经学
CiteScore
10.90
自引率
10.70%
发文量
319
审稿时长
2-4 weeks
期刊介绍: Epilepsia is the leading, authoritative source for innovative clinical and basic science research for all aspects of epilepsy and seizures. In addition, Epilepsia publishes critical reviews, opinion pieces, and guidelines that foster understanding and aim to improve the diagnosis and treatment of people with seizures and epilepsy.
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