development and validation of a severity scale for leprosy type 1 reactions开发和验证的严重程度量表1型麻风反应.pdfVIP

Development and Validation of a Severity Scale for Leprosy Type 1 Reactions 1 2 3 4 3 Stephen L. Walker *, Peter G. Nicholls , C. Ruth Butlin , Jose Augusto C. Nery , Hemanto K. Roy , 4 4 1 Emanuel Rangel , Anna M. Sales , Diana N. J. Lockwood 1 Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom, 2 School of Health Sciences, University of Southampton, United Kingdom, 3 DBLM Hospital, Nilphamari, Bangladesh, 4 Oswaldo Cruz Institute, Rio de Janeiro, Brazil Abstract Objectives: To develop a valid and reliable quantitative measure of leprosy Type 1 reactions. Methods: A scale was developed from previous scales which had not been validated. The face and content validity were assessed following consultation with recognised experts in the field. The construct validity was determined by applying the scale to patients in Bangladesh and Brazil who had been diagnosed with leprosy Type 1 reaction. An expert categorized each patient’s reaction as mild or moderate or severe. Another worker applied the scale. This was done independently. In a subsequent stage of the study the agreement between two observers was assessed. Results: The scale had good internal consistency demonstrated by a Cronbach’s alpha .0.8. Removal of three items from the original scale resulted in better discrimination between disease severity categories. Cut off points for Type 1 reaction severities were determined using Receiver Operating Characteristic curves. A mild Type 1 reaction is characterized using the final scale by a score of 4 or less. A moderate reaction is a score of between 4.5 and 8.5. A severe reaction is a score of 9