British Journal of Anaesthesia ( IF 9.8 ) Pub Date : 2021-07-28 , DOI: 10.1016/j.bja.2021.05.037 Jessica Spence 1 , Jackie Bosch 2 , Edward Chongsi 3 , Shun Fu Lee 3 , Lehana Thabane 4 , Pablo Mendoza 4 , Emilie Belley-Côté 5 , Richard Whitlock 6 , Kate Brady 3 , William F McIntyre 5 , Andre Lamy 6 , P J Devereaux 5
Background
Different instruments have been used to assess ability to perform everyday functional activities, such as activities of daily living (ADL) and instrumental activities of daily living (IADL). No measures of functional activity have been validated in cardiac surgery. We assessed the reliability and validity of the Standardized Assessment of Global activities in the Elderly (SAGE) scale.
Methods
We undertook an observational sub-study of VISION Cardiac Surgery. Patients were assessed post-discharge after cardiac surgery using SAGE and comparator measures to determine convergent validity. A blinded independent assessor administered SAGE by phone within 7 days to determine test–retest reliability. We sought to demonstrate a correlation of ≥0.5 between SAGE and each corresponding measure. We also sought to define the SAGE score corresponding to severe functional disability, defined using the World Health Organisation Disability Assessment Schedule (WHODAS).
Results
There were 152 patients included. Inter-rater reliability was excellent (intra-class correlation coefficient=0.99; 95% confidence interval [CI], 0.98–0.99). Convergent validity was evident, ranging from adequate for the overall SAGE score (0.54; 95% CI, 0.42–0.65) to very good for the SAGE mobility sub-score (0.80; 95% CI, 0.73–0.85). SAGE was initially poorly correlated with the IADL index (–0.24) but increased to –0.60 after post-hoc adjustment of SAGE scoring. A SAGE score ≥7 was associated with severe functional disability and occurred in 42/152 (27.6%) of patients.
Conclusion
These results demonstrate the reliability and validity of the SAGE scale as a measure of global function in patients discharged home after cardiac surgery.
Clinical trial registration
NCT01842568.
中文翻译:
成人心脏手术患者老年人全球活动量表的标准化评估
背景
已使用不同的工具来评估执行日常功能活动的能力,例如日常生活活动 (ADL) 和工具性日常生活活动 (IADL)。没有在心脏手术中验证功能活动的测量。我们评估了老年人全球活动标准化评估 (SAGE) 量表的信度和效度。
方法
我们对 VISION Cardiac Surgery 进行了观察性子研究。在心脏手术后使用 SAGE 和比较方法对患者进行评估,以确定收敛效度。一位不知情的独立评估员在 7 天内通过电话管理 SAGE,以确定重测信度。我们试图证明 SAGE 与每个相应措施之间的相关性≥0.5。我们还试图定义与使用世界卫生组织残疾评估表 (WHODAS) 定义的严重功能障碍相对应的 SAGE 评分。
结果
包括152名患者。评分者间的可靠性非常好(类内相关系数 = 0.99;95% 置信区间 [CI],0.98-0.99)。收敛效度很明显,范围从总体 SAGE 评分足够(0.54;95% CI,0.42–0.65)到非常好(0.80;95% CI,0.73–0.85)。SAGE 最初与 IADL 指数的相关性较差 (–0.24),但在SAGE 评分的事后调整后增加到 –0.60 。SAGE 评分≥7 与严重的功能障碍相关,发生在 42/152 (27.6%) 的患者中。
结论
这些结果证明了 SAGE 量表作为心脏手术后出院患者整体功能测量的信度和效度。
临床试验注册
NCT01842568。