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Development and Validation of a Severity Scale for Leprosy Type 1 Reactions 英文参考文献
DevelopmentandValidationofaSeverityScalefor
LeprosyType1Reactions
StephenL.Walker1*,PeterG.Nicholls2,C.RuthButlin3,JoseAugustoC.Nery4,HemantoK.Roy3,
EmanuelRangel4,AnnaM.Sales4,DianaN.J.Lockwood1
1DepartmentofInfectiousandTropicalDiseases,LondonSchoolofHygieneandTropicalMedicine,London,UnitedKingdom,2SchoolofHealthSciences,Universityof
Southampton,UnitedKingdom,3DBLMHospital,Nilphamari,Bangladesh,4OswaldoCruzInstitute,RiodeJaneiro,Brazil
Abstract
Objectives:TodevelopavalidandreliablequantitativemeasureofleprosyType1reactions.
Methods:Ascalewasdevelopedfrompreviousscaleswhichhadnotbeenvalidated.Thefaceandcontentvaliditywere
assessedfollowingconsultationwithrecognisedexpertsinthefield.Theconstructvaliditywasdeterminedbyapplyingthe
scaletopatientsinBangladeshandBrazilwhohadbeendiagnosedwithleprosyType1reaction.Anexpertcategorized
eachpatient’sreactionasmildormoderateorsevere.Anotherworkerappliedthescale.Thiswasdoneindependently.Ina
subsequentstageofthestudytheagreementbetweentwoobserverswasassessed.
Results:ThescalehadgoodinternalconsistencydemonstratedbyaCronbach’salpha.0.8.Removalofthreeitemsfromthe
originalscaleresultedinbetterdiscriminationbetweendiseaseseveritycategories.CutoffpointsforType1reactionseverities
weredeterminedusingReceiverOperatingCharacteristiccurves.AmildType1reactionischaracterizedusingthefinalscale
byascoreof4orless.Amoderatereactionisascoreofbetween4.5and8.5.Aseverereactionisascoreof9ormore.
Conclusions:WehavedevelopedavalidandreliabletoolforquantifyingleprosyType1reactionseverityandbelievethis
willbeausefultoolinresearchofthiscondition,inobservationalandinterventionstudies,andinthecomparisonofclinical
andlaboratoryparameters.
Citation:WalkerSL,NichollsPG,ButlinCR,NeryJAC,RoyHK,etal.(2008)DevelopmentandValidationofaSeverityScaleforLeprosyType1Reactions.PLoSNegl
TropDis2(12):e351.doi:10.1371/journal.pntd.0000351
Editor:EdgarCarvalho,HospitalUniversita′rio, Brazil
ReceivedMay30,2008;AcceptedNovember30,2008;PublishedDecember23,2008
Copyright: ?
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