检测患者哮喘知识：结果评价的系统综述
2010/02/02
背景：哮喘自我管理教育是哮喘治疗国际指南的重要组成部分。目前，尚无以患者为中心的疗效检测金标准检测患者的哮喘知识。本文旨在寻找高质量的、有效且可靠的，可用于研究和临床实践的结果评价检测法。
方法：采用系统综述寻找疗效检测法，以评价哮喘患者的哮喘知识。对MEDLINE、BNI、CINAHL、 CDSR、DARE、卫生技术评估、NHS 经济评估数据库、EMBASE、AMED、PsychInfo及ISI等电子数据库进行检索。同时检索灰色文献。若有文献研究哮喘认识的发展及心理计量学检测则入选。根据已出版的指南，评价疗效检测法质量。同时对检测法的内容效度、建构效度、效标效度、内部一致性、反应性、上限下限效应、重复性及解释性进行评价，并进行分级：阳性、中等、阴性。
结果：18个结果评价检测法符合入选标准。基于上述心理计量学特征，未发现有检测法归类于阳性等级。基于内容效度、建构效度、内部一致性及重复性，3个检测法归类于阳性或中间等级。所有文献均无充足的数据满足上限下限效应、反应性或解释性，上述三个特性在这些文献中不能进行评价。
结论：未能找到高质量的以患者为中心的哮喘认识结果评价检测法。因此，基于上述试验所得出的结论需谨慎阐释。
（林江涛 审校）
J Asthma. 2009 Dec;46(10):980-987.
Measuring patient knowledge of asthma: a systematic review of outcome measures.
Pink J, Pink K, Elwyn G.
Department of Primary Care and Public Health, Cardiff University, Cardiff, Wales, UK.
BACKGROUND: Asthma self-management education is a key component of international guidelines. No gold standard patient centred outcome measure exists for asthma knowledge. Our aim was to identify high-quality, validated, and reliable outcome measures suitable for use in either the research or clinical setting.
METHODS: A systematic review was performed to identify outcome measures able to assess asthma knowledge in people with asthma. An electronic database search was made of MEDLINE, BNI, CINAHL, CDSR, DARE, Health Technology Assessment, NHS Economic Evaluation Database, EMBASE, AMED, PsychInfo and ISI. A review of grey literature was also performed. Articles were included if they described the development and psychometric testing of an asthma knowledge measure. The quality of each outcome measure was assessed according to published guidance. Content validity, construct validity, criterion validity, internal consistency, responsiveness, floor and ceiling effects, reproducibility, and interpretability were evaluated and given a rating of either "positive," "intermediate," or "negative."
RESULTS: Eighteen outcome measures met the inclusion criteria. None of these had a positive rating for all eight psychometric properties. Three outcome measures achieved either a positive or intermediate rating for content validity, construct validity, internal consistency, and reproducibility. As none of the articles had sufficient data regarding floor and ceiling effects, responsiveness, or interpretability, these properties could not be assessed.
CONCLUSION: We have been unable to identify any high-quality patient-centered asthma knowledge outcome measures. Any conclusions drawn from trials using such measures should therefore be interpreted with caution.
J Asthma. 2009 Dec;46(10):980-7.
方法：采用系统综述寻找疗效检测法，以评价哮喘患者的哮喘知识。对MEDLINE、BNI、CINAHL、 CDSR、DARE、卫生技术评估、NHS 经济评估数据库、EMBASE、AMED、PsychInfo及ISI等电子数据库进行检索。同时检索灰色文献。若有文献研究哮喘认识的发展及心理计量学检测则入选。根据已出版的指南，评价疗效检测法质量。同时对检测法的内容效度、建构效度、效标效度、内部一致性、反应性、上限下限效应、重复性及解释性进行评价，并进行分级：阳性、中等、阴性。
结果：18个结果评价检测法符合入选标准。基于上述心理计量学特征，未发现有检测法归类于阳性等级。基于内容效度、建构效度、内部一致性及重复性，3个检测法归类于阳性或中间等级。所有文献均无充足的数据满足上限下限效应、反应性或解释性，上述三个特性在这些文献中不能进行评价。
结论：未能找到高质量的以患者为中心的哮喘认识结果评价检测法。因此，基于上述试验所得出的结论需谨慎阐释。
（林江涛 审校）
J Asthma. 2009 Dec;46(10):980-987.
Measuring patient knowledge of asthma: a systematic review of outcome measures.
Pink J, Pink K, Elwyn G.
Department of Primary Care and Public Health, Cardiff University, Cardiff, Wales, UK.
BACKGROUND: Asthma self-management education is a key component of international guidelines. No gold standard patient centred outcome measure exists for asthma knowledge. Our aim was to identify high-quality, validated, and reliable outcome measures suitable for use in either the research or clinical setting.
METHODS: A systematic review was performed to identify outcome measures able to assess asthma knowledge in people with asthma. An electronic database search was made of MEDLINE, BNI, CINAHL, CDSR, DARE, Health Technology Assessment, NHS Economic Evaluation Database, EMBASE, AMED, PsychInfo and ISI. A review of grey literature was also performed. Articles were included if they described the development and psychometric testing of an asthma knowledge measure. The quality of each outcome measure was assessed according to published guidance. Content validity, construct validity, criterion validity, internal consistency, responsiveness, floor and ceiling effects, reproducibility, and interpretability were evaluated and given a rating of either "positive," "intermediate," or "negative."
RESULTS: Eighteen outcome measures met the inclusion criteria. None of these had a positive rating for all eight psychometric properties. Three outcome measures achieved either a positive or intermediate rating for content validity, construct validity, internal consistency, and reproducibility. As none of the articles had sufficient data regarding floor and ceiling effects, responsiveness, or interpretability, these properties could not be assessed.
CONCLUSION: We have been unable to identify any high-quality patient-centered asthma knowledge outcome measures. Any conclusions drawn from trials using such measures should therefore be interpreted with caution.
J Asthma. 2009 Dec;46(10):980-7.
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伴和不伴自我管理计划的哮喘教育在住院患儿中的有效性
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