中文版胃肠道症状评定量表对不同疾病患者测量学特性比较研究
Comparison of Measurement Properties of the Chinese version of the Gastrointestinal Symptom Rating Scale in Patients with Different Diseases
背景 胃肠道症状作为临床常见评价指标需要通用的评价工具，胃肠道症状评定量表（GSRS）在国内研究中被广泛应用，但所用版本均非规范汉化版，其测量学性能未见报道。目的 对中文版GSRS的测量学性能进行研究，为该量表扩大应用提供客观依据。方法 于2021年11月-2022年3月，选取在全国45家医院消化内科或脾胃科就诊患者为研究对象，用中文版GSRS评价胃肠道症状；对中文版GSRS进行信、效度分析，应用配对Wilcoxon符号秩和检验比较患者治疗前后得分变化，使用效应值ES、标准化反应均数SMR和得分变化率CR比较量表的反应度。结果 中文版GSRS的Cronbach's α系数为0.896，Guttman折半系数为0.920，Spearman-Brown系数为0.926，两次重测结果组内相关系数（ICC）为0.589，Spearman相关系数为0.662。各条目内容效度指数为0.78~1.00，量表水平的全体一致内容效度指数为1，平均内容效度指数为0.96。探索性因子分析提取到特征值大于1的公因子共3个，累计方差贡献率为60.721%。验证性因子分析显示数据样本与初始模型M0拟合不理想，根据指标提示修正后得到模型M1的各拟合指标均在接受范围内。患者治疗前后GSRS总分比较，差异具有显著性意义（P<0.001），ES=1.03，SMR=1.01,CR=74.32%。结论 中文版GSRS具有较高的测量性能水平，其信效度、反应度良好，适用于对表现胃肠道症状的普遍人群进行测量及其治疗效果评估。
内科学医学研究方法
胃肠道症状评定量表信度效度反应度量表
王鑫,邸露瑶,岳俐宏 ,刘凤斌,葛志闪,邹梅梅,孙铭璘,赵天易,李洪皎,曹雪,邢颖,杨蕾,秦宇宁,赖科云,何丽云,刘松.中文版胃肠道症状评定量表对不同疾病患者测量学特性比较研究[EB/OL].(2022-12-01)[2025-11-02].https://chinaxiv.org/abs/202212.00007.点此复制
Background The Gastrointestinal Symptom Rating Scale (GSRS) is widely used in domestic research. However, the Mandarin translation of the current Chinese version of the scale is not standardized. In addition, the measurement performance test of the GSRS has not been reported in any literature. Objective To evaluate the reliability, validity and responsiveness of the Chinese version of the Gastrointestinal Symptom Rating Scale (GSRS) and to provide an objective basis for its clinical and scientific application. Methods Patients who accessed gastrointestinal departments in 45 hospitals across China from November 2021 to March 2022 were chosen in a random order using the convenience sampling method. Their gastrointestinal symptoms were evaluated with the Chinese version of GSRS. The Chinese version of GSRS was used for reliability and validity analyses, and the paired Wilcoxon rank sum test was applied to compare changes in patients' scale scores before and after treatment. The effect size (ES), standardized response mean (SRM) and score change rate (CR) were used to compare the responsiveness of GSRS among patient populations with different diseases. Results For reliability analysis, the Cronbach's alpha, Guttman Split-half coefficient and the Spearman-Brown coefficient of the Chinese version of the GSRS were 0.896, 0.920 and 0.926, respectively. The two retest result’s intraclass correlation coefficient (ICC) was 0.589, and the Spearman correlation coefficient was 0.662. The content validity index (CVI) for each item (I-CVI) ranged from 0.78 to 1.00 for the validity analysis, the CVI for scale level universal agreement was 1, and the average CVI (S-CVI/Ave) was 0.96. The results of the exploratory factor analysis indicated that with a cumulative variance contribution rate of 60.721%, three common factors were extracted, each of which had an eigenvalue larger than 1. The confirmatory factor analysis results demonstrated that the data samples did not fit the initial model M0 desirably created by EFA. However, after correction by the modification indicator hints, all of the obtained relevant indicators for the new model M1 were within the acceptable range. Before and two weeks after therapy, there was a significant difference in the GSRS score (P <0.001). The ES and SRM of the GSRS were, respectively, 1.03 and 1.01. The CR of the GSRS scores was 74.32%. Conclusion The Chinese version of the GSRS is well suited for measuring the general population who present with gastrointestinal symptoms and evaluating treatment efficiency because of its high degree of measurement properties, including good reliability, validity, and responsiveness.
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