使用数据挖掘方法将功能独立性评定量表运动分数转换至改良巴氏指数分数

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目的:为了适应临床和科研的需要,建立和评估一种功能独立性评定量表(FIM)运动分数转换至改良巴氏指数(MBI)分数的方法.方法:回顾性分析2005—2016年香港某康复医院的卒中患者在刚接受作业治疗时FIM运动分数和MBI分数.采取数据挖掘方法,包括①订立数据规格条件;②检查和选取符合规定的数据;③将数据随机分组;④制订这2个量表的项目配对;⑤使用“秩不变量”方法对换数据;⑥校验数据对换方法.结果:将符合规定的6574例患者随机分成背景相仿的A、B 2组,A组的各项MBI分数与FIM运动分数显示两者有高度关联性(Kendall\'s tau-b值0.796~0.987,P<0.01).再依据“秩不变量”方法制定这2个量表项目的对换表.最后使用对换表将B组数据转换后再检查其关联性,其“单对单项”和“单对多项”的Co?hen\'s Kappa系数(k)为0.770~0.913.校验结果提示MBI分数与对换的MBI分数有高度的关联性.结论:该数据挖掘方法制订出的对换方法通过统计学的校验,且易于使用,适合处理或比较有关卒中康复的相关数据.“,”Objective:To meet both clinical and research needs, this study developed and evaluated a conver-sion method between the Modified Barthel Index (MBI) and the Functional Independence Measures (FIM). Methods:This was a retrospective analysis of both MBI&FIM assessment data, which were collected concur-rently in a local hospital for stroke patients attending rehabilitation programs in the period from 2005 to 2016. The scorings were rated at the beginning of the rehabilitation. Data mining procedures, which involved the fol-lowing steps:a) selection of appropriate samples, b) pre-processing of the dataset, c) transformation of the dataset, d) analyzing the data patterns, e) deriving the conversion based on“rank-invariant statistical method”, and, f) veri-fying the conversion method—were adopted for data analysis. Results:Six thousand five hundred and seventy-four cases, which were verified as “error-free”, were randomly allocated into two compatible subsets. Using the data from subset (A), we substantiated that all the total scores and every corresponding paired item scores be-tween the MBI and the FIM-motor were highly correlated (i.e. Kendall\'s tau-b Value ranged from 0.796 to 0.987, P<0.01). Based on“rank-invariant statistical method”an item-to-item conversion table was also developed. Using the data from subset (B) we found the Cohen\'s Kappa coefficients (k) for either“single-pair”items or“multiple-pair” items ranged from 0.770 to 0.913 — which indicated “substantial” to “almost perfect” agreement between the rated MBI scores and the derived MBI scores.Conclusion:A“user-friendly”and yet methodologically sound conversion method is recommended for application in stroke rehabilitation program.
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