脊髓型颈椎病JOA指数的客观和精确信度调查

Objective and precise reliability of JOA scoring system for cervical spondylotic myelopathy

目的:中文版脊髓型颈椎病JOA指数已广泛用于对颈椎病的量化评估。现就其临床应用的可靠性进行分析。方法:研究于2003-02/2003-12在解放军总医院骨科完成。将英文版脊髓型颈椎病JOA指数译为中文,并用汉化JOA指数对60例脊髓型颈椎病患者进行重复评估。所获数据进行可靠性检验,用组内相关系数(IC)C表示可靠程度,用Kappa值表示各项结果的一致性。结果:观察者间和每一观察者自身的ICC值分别为0.9345,0.9416均>0.75。医生的临床经验对评价无影响。评分系统内各单项的一致性高,Kappa值最大为0.751,最小为0.379,躯干感觉功能和上肢运动功能评定易混淆。结论:中文版JOA指数简单易操作,有较高的可靠性,可用于临床对脊髓型颈椎病进行疗效评价。

AIM:To analyze the clinical reliability of JOA scoring system in Chinese for c ervical spondylotic myelopathy(CSM)based on its extensive application in evaluat ing cervical syndrome quantificationally. METHODS:The study was completed in the Orthopaedics,General Hospital of Chines e PLA.The JOA scoring system in English for CSM was translated into Chinese to e valuate CSM 60 patients.The reliabilities of the obtained scores for all categor ies were examined,and the reliability degree was evaluated by the intraclass cor relation coefficient(ICC).The extension of the Kappa coefficient was calculated for each category to assess the concordance of multivariate categorical data. RESULTS:The ICC value of inter observer reliability of the total score was 0. 934 5 and that of the intra observer reliability of the total score was 0.941 6 ,both of which were more than 0.75.The clinical experience to observer did not a ffect the reliability of modified scoring system in Chinese. The Kappa values of each category were in high concordance,the maximum 0.751 and the minimum 0.379, but the assessment of upper extremity motor function and trunk sensory function was undistinguishable. CONCLUSION:The reliability of JOA scoring system in Chinese is easy and simple to operate with high reliability,so it is suitable to clinically evaluate the t herapeutic effects on CSM.