Abstract:
:The objective of this study was to compare the relative responsiveness of a condition-specific spinal stenosis measure and two generic health status measures for outcome assessment of surgery for degenerative lumbar spinal stenosis, and to examine whether responsiveness statistics and measures of the ability to distinguish clinically important improvement rank the instruments consistently. Physical function and symptom severity scales of the spinal stenosis measure were compared to the Sickness Impact Profile (SIP) and the Roland scale, which is derived from the SIP. Responsiveness was calculated with the standardized response mean, the effect size, and Guyatt's responsiveness statistic. The discriminative ability of the instruments to distinguish patients who improved from those who did not was assessed using satisfaction with surgery as an external criterion. Minimal clinically relevant improvement was estimated using patient satisfaction as the external criterion. All responsiveness statistics revealed the same order of responsiveness; the physical function scale (SRM = 1.07) and symptom severity scales (SRM = 0.96) were more responsive than the Roland scale (SRM = 0.77) which was only slightly more responsive than the SIP (SRM = 0.69). Strikingly, the physical dimension of the SIP (SRM = 0.62) was even less responsive than the global SIP. The shape of and the area under the ROC curves showed that the physical function and symptom severity scales discriminate better between satisfied and unsatisfied patients than the Roland scale and SIP. The sensitivity to detect clinically important changes was somewhat lower at the ends of the scales, especially for the SIP and the Roland scale. Statistical approaches that assess the ability to distinguish clinically important changes and overall responsiveness statistics ranked the measures consistently. On the basis of these findings, we suggest that a condition-specific spinal stenosis measure is preferable as the primary end point in evaluative studies of degenerative lumbar spinal stenosis.
journal_name
J Clin Epidemioljournal_title
Journal of clinical epidemiologyauthors
Stucki G,Liang MH,Fossel AH,Katz JNdoi
10.1016/0895-4356(95)00054-2subject
Has Abstractpub_date
1995-11-01 00:00:00pages
1369-78issue
11eissn
0895-4356issn
1878-5921pii
0895-4356(95)00054-2journal_volume
48pub_type
临床试验,杂志文章,多中心研究abstract:OBJECTIVES:The methodology for the critical assessment of medical interventions is well established. Regulatory agencies and institutions adhere, in principle, to the same standards. This consistency, however, is not always the case in practice. STUDY DESIGN AND SETTING:Using the evaluation of the CAPRIE (Clopidogrel ...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2009.10.009
更新日期:2010-12-01 00:00:00
abstract::Claims-based indices of comorbidity and severity, as well as other measures derived from routinely collected administrative data, are developed and tested. The extent to which risk adjustments using claims can be improved by adding information from one well-known measure based on chart review and patient examination (...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/0895-4356(89)90118-2
更新日期:1989-01-01 00:00:00
abstract:OBJECTIVES:To evaluate how the rank probabilities obtained from network meta-analysis (NMA) change with the use of increasingly stringent criteria for the relative effect comparing two treatments which ranks one treatment better than the other. STUDY DESIGN AND SETTING:Systematic survey and reanalysis of published dat...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2018.02.008
更新日期:2018-06-01 00:00:00
abstract:OBJECTIVE:To assess the consistency of an index of the scientific quality of research overviews. DESIGN:Agreement was measured among nine judges, each of whom assessed the scientific quality of 36 published review articles. ITEM SELECTION: An iterative process was used to select ten criteria relative to five key tasks...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,meta分析
doi:10.1016/0895-4356(91)90205-n
更新日期:1991-01-01 00:00:00
abstract:OBJECTIVES:To identify, describe, and map contemporary nutrition guidelines (NGs) from reviews that used the Appraisal of Guidelines, Research and Evaluation (AGREE) tool. STUDY DESIGN AND SETTING:We performed an overview of reviews that systematically assessed the quality of NGs using the AGREE tool. We searched MEDL...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,评审
doi:10.1016/j.jclinepi.2018.08.018
更新日期:2018-12-01 00:00:00
abstract::The aim of this paper was to evaluate the combined effect of alcohol, smoking habits and frequency of consumption of selected dietary items, which are the major sources of retinoids and beta-carotene in the Italian diet, on the risk of esophageal cancer (EC). The adequacy of the multiplicative structure for describing...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/0895-4356(92)90035-l
更新日期:1992-04-01 00:00:00
abstract:OBJECTIVE:To assess the extent to which meta-analysis publications of drugs and biologics focus on specific named agents or even only a single agent, and identify characteristics associated with such focus. STUDY DESIGN AND SETTING:We evaluated 499 articles with meta-analyses published in 2010 and estimated how many d...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,评审
doi:10.1016/j.jclinepi.2012.10.014
更新日期:2013-04-01 00:00:00
abstract::Many longitudinal studies attempt to examine changes in outcome measures over time in groups of patients. Applying conventional analytic techniques, such as a single classical linear regression model, to these data will often not result in minimum variance estimates, and may affect the results of tests of significance...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/0895-4356(93)90038-3
更新日期:1993-07-01 00:00:00
abstract:OBJECTIVES:Constructs capturing health or functioning can have reflective and/or formative measurement models. Although a construct's measurement model has extensive implications on the construction, validation, and use of a measurement instrument, measurement models are frequently wrongly or not explicitly specified. ...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2018.07.007
更新日期:2018-11-01 00:00:00
abstract::Epidemiologists and health survey statisticians must be aware of their many responsibilities to study participants during all phases of the investigation. Safeguards for the subject's welfare and privacy must be considered during the planning of the study, recruitment of participants, conducting the interviews or exam...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/0895-4356(91)90179-d
更新日期:1991-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:There is a growing evidence base on methods to improve response rates in surveys among patients. This study aimed to determine the additional effect of two intensive follow-up procedures compared to a simple follow-up procedure. METHODS:Randomized controlled trial that compared repeated mailin...
journal_title:Journal of clinical epidemiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/j.jclinepi.2005.03.002
更新日期:2005-09-01 00:00:00
abstract::Recently, there has been a great deal of discussion regarding the use of administrative databases to study outcomes of medical care. A major issue in this discussion is how to classify patients in terms of characteristics such as disease-severity, comorbidities, resource needs, stability, etc. Different indices have b...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/0895-4356(94)00202-2
更新日期:1995-07-01 00:00:00
abstract::To identify characteristics of certifying physicians and the deceased that are associated with errors in death certificate completion in Taiwan, we retrospectively reviewed 4123 systematically sampled death certificates issued in 1994. Multivariate analyses were used to assess the associations of various characteristi...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/s0895-4356(00)00299-7
更新日期:2001-03-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Meta-analyses sometimes summarize results in the presence of substantial unexplained between-study heterogeneity. As GRADE criteria highlight, unexplained heterogeneity reduces certainty in the evidence, resulting in limited confidence in average effect estimates. The aim of this paper is to p...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2018.11.023
更新日期:2019-03-01 00:00:00
abstract::Studies predicting mortality after myocardial infarction (MI) usually rely on in-hospital data, and combine patients admitted for the first MI with recurrent MI patients. Since treatment decisions are often made or modified at the first outpatient clinic visit, this study was designed to evaluate the importance of pos...
journal_title:Journal of clinical epidemiology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/s0895-4356(96)00221-1
更新日期:1996-11-01 00:00:00
abstract:OBJECTIVE:The objective was to estimate the presence and extent to which potentially unnecessary and therefore maybe wasteful clinical trials regarding relevant interventions and outcomes in major clinical areas had been conducted. STUDY DESIGN AND SETTING:From current Cochrane collaboration systematic reviews in majo...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2016.11.003
更新日期:2017-02-01 00:00:00
abstract::The clinical correlates of advanced retinopathy were determined in a sample of 427 type II diabetic outpatients, aged 35 to 74 years, recruited in eight centers from all parts of France. The presence of retinopathy was assessed by fluorescein angiography with centralized interpretation. Advanced retinopathy (prolifera...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1016/0895-4356(95)00582-x
更新日期:1996-06-01 00:00:00
abstract::Indexes developed to measure physical functioning as an essential component of general health status are often based on sets of hierarchically-structured items intended to represent a broad underlying concept. Rasch Item Response Theory (IRT) provides a methodology to examine the hierarchical structure, unidimensional...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/0895-4356(94)90215-1
更新日期:1994-06-01 00:00:00
abstract::To have the "power" of avoiding undersized clinical trials, the customary statistical strategy used in the past few decades is aimed at rejecting both a null stochastic hypothesis and a contradictory alternative hypothesis. This approach gives a trial the "power" to confirm the "insignificance" of differences much sma...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/s0895-4356(98)00029-8
更新日期:1998-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Reference limits are widely used in anthropometry, the behavioral sciences, medicine, and clinical chemistry. They describe the distribution of a quantitative variable in a healthy population, and are often a smooth function of age or another determinant. Thus, instead of estimating reference l...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2006.09.004
更新日期:2007-06-01 00:00:00
abstract::During 1978-1990, 346 patients with sarcoidosis were enrolled in our institute. Of 346 patients, 295 patients were eligible for evaluation on the clinical course and prognosis. According of their clinical presentations, they were classified into 3 groups; severe, moderate and mild sarcoidosis. Of the 295 patients, 27 ...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/0895-4356(93)90150-y
更新日期:1993-04-01 00:00:00
abstract:BACKGROUND:Once a proposed topic has been identified for a systematic review and has undergone a question formulation stage, a protocol must be developed that specifies the scope and research questions in detail and outlines the methodology for conducting the systematic review. RATIONALE:Framework modifications are of...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2017.06.013
更新日期:2017-10-01 00:00:00
abstract:OBJECTIVE:To assess the effects of abbreviated literature searches on evidence syntheses conclusions. STUDY DESIGN AND SETTING:We randomly selected 60 Cochrane reviews of clinical interventions and repeated literature searches using 14 abbreviated approaches (combinations of MEDLINE, Embase, CENTRAL with and without s...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,meta分析
doi:10.1016/j.jclinepi.2018.05.022
更新日期:2018-10-01 00:00:00
abstract::Whereas over the last decade epidemiologic studies on exocrine pancreatic cancer (EPC) continued to show a remarkable heterogeneity in diagnostic criteria applied to define caseness, the actual magnitude and consequences of misclassification remain largely unexplored. The objectives were: (1) to estimate the degree of...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/0895-4356(94)90123-6
更新日期:1994-09-01 00:00:00
abstract:OBJECTIVES:To evaluate how estimated treatment effects agree between nonrandomized studies using causal modeling with marginal structural models (MSM-studies) and randomized trials (RCTs). STUDY DESIGN:Meta-epidemiological study. SETTING:MSM-studies providing effect estimates on any healthcare outcome of any treatmen...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,评审
doi:10.1016/j.jclinepi.2019.10.012
更新日期:2020-02-01 00:00:00
abstract:OBJECTIVES:The objective of the study was to identify determinants of external validity of prognostic models. STUDY DESIGN AND SETTING:We systematically searched for studies reporting prognostic models of heart failure (HF) and examined their performance for predicting 30-day death in a cohort of consecutive 3,452 acu...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2020.01.011
更新日期:2020-05-01 00:00:00
abstract::A standardized examination protocol was developed for the assessment of low back disorders in primary care. The protocol was found feasible in the occupational health service setting. The interexaminer repeatability between an occupational physician and an occupational physiotherapist was good for most items. The pred...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/s0895-4356(97)00266-7
更新日期:1998-03-01 00:00:00
abstract:OBJECTIVES:How often authors comment on applicability for primary care in systematic reviews of clinical trials. STUDY DESIGN AND SETTING:We selected 4% of the Cochrane Database for Systematic Reviews (CDSRs; January 2008 to October 2013). We excluded reviews when primary care trials were not eligible. We extracted wh...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2015.06.003
更新日期:2015-10-01 00:00:00
abstract:OBJECTIVE:To demonstrate how decision analytic models (DAMs) can be used to quantify impact of using a (diagnostic or prognostic) prediction model in clinical practice and provide general guidance on how to perform such assessments. STUDY DESIGN AND SETTING:A DAM was developed to assess the impact of using the HEART s...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2019.07.010
更新日期:2019-11-01 00:00:00
abstract::Dupuytren's disease or palmar fibromatosis is a common disabling hand disorder, mainly confined to Caucasians of northwestern European origin. The prevalence of Dupuytren's disease and possible risk factors related to the disease were evaluated in a random sample of 1297 males and 868 females, aged 46 to 74 years. Blo...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/s0895-4356(99)00145-6
更新日期:2000-03-01 00:00:00