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肌肉衰减症筛查五项评分量表中文版的建立及其用于老年人肌肉衰减症筛查的多中心验证性研究

The establishment and validation of the Chinese version of SARC-F scale for sarcopenia screening among elderly population: a multicenter study

摘要目的:采用标准化方法建立肌肉衰减症筛查5项评分量表【包括肌肉力量(strength)、辅助行走(assistance in walking)、座椅起身(rise from a chair)、爬楼梯(climb stairs)、跌倒次数(falls),简称SARC-F量表】中文版,并验证其用于老年人肌肉衰减症筛查的信度和有效性。方法:根据世界卫生组织提出的量表工具翻译流程指南及欧洲老年医学学会肌肉衰减症特殊兴趣组方法学报告的规范,按照正向翻译-专家小组讨论修改-反向翻译-预测试-形成最终版本的步骤进行量表的中文翻译。通过预试验对SARC-F中文版量表进行重测信度、评分者间信度和内部一致性信度的评价。通过诊断试验进行临床验证,于2021年12月至2022年10月,通过在社区和医院进行连续招募北京和天津的社区居住老年人群。采用调查问卷、人体测量和身体成分测定进行资料收集,以SARC-F中文版量表评分≥4分为阳性,分别对欧洲老年肌肉衰减症工作组修订后的和亚洲老年肌肉衰减症工作组2019定义的肌肉衰减症进行诊断试验并绘制受试者工作特征曲线,以灵敏度、特异度、阳性预测值、阴性预测值和曲线下面积来表示。结果:SARC-F中文版获得了原作者授权,并被认可充分且正确表达其含义。信度验证显示SARC-F中文版量表具有良好的重测信度( ICC=0.914)、评分者间信度( r=0.726)和内部一致性信度(α=0.729)。临床验证共纳入社区居住老年人1882例。根据欧洲老年肌肉衰减症工作组修订后的和亚洲老年肌肉衰减症工作组2019的肌肉衰减症诊断标准,SARC-F中文版量表具有偏低的灵敏度(13.6%和16.0%)、阳性预测值(44.6%和35.4%)和偏高的特异度(95.1%和94.7%)、阴性预测值(79.0%和86.2%),曲线下面积分别为0.619和0.616(二者均为 P<0.001),具有较好的筛查有效性。 结论:SARC-F中文版具有良好的信度和筛查有效性,其在社区或初级卫生保健场所的应用将促进肌肉衰减症的早期发现。

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abstractsObjective:To establish the Chinese version of (strength, assistance with walking, rise from a chair, climb stairs and falls, SARC-F) scale using the standardized methods and to validate the reliability and validity for sarcopenia screening among elderly population.Methods:Following the recommended procedure by World Health Organization and European Union Geriatric Medicine Society Sarcopenia Special Interest Group, the translation process included forward translation, expert panel, back-translation, pre-testing and cognitive interviewing to generate the final version. In the pilot study, the test-retest reliability, inter-rater reliability, and internal consistency of the Chinese version of SARC-F scale were assessed. In the diagnostic test for clinical validation, the participants were consecutively recruited from communities and hospitals in Beijing and Tianjin between December 2021 and October 2022. The scale administration, anthropometry, and body composition measurement were conducted by trained investigators. Participants with the SARC-F score ≥ 4 were considered at risk of sarcopenia. Diagnostic tests and receiver operating characteristic curve analysis were performed against the definitions of sarcopenia according to European Working Group on Sarcopenia in Older People (EWGSOP2) and Asian Working Group for Sarcopenia (AWGS2019), and the sensitivity, specificity, positive predictive value, negative predictive value and the area under curve were displayed.Results:The Chinese version of SARC-F scale was approved by the author that the translation has expressed the original meaning correctly. The Chinese version of SARC-F had good test-retest reliability (ICC = 0.914), inter-rater reliability ( r = 0.726), and internal consistency ( α = 0.729). There were altogether 1 882 participants included in the clinical validation. According to the diagnostic criteria of EWGSOP2 and AWGS2019, the Chinese version of SARC-F scale had low sensitivity (13.6% and 16.0%) and positive predictive value (44.6% and 35.4%), high specificity (95.1% and 94.7%) and negative predictive value (79.0% and 86.2%), and moderate AUC of 0.619 and 0.616 (all P < 0.001) for sarcopenia screening. Conclusions:The Chinese version of SARC-F scale was of good reliability and validity. The application of SARC-F in the primary healthcare settings would contribute to the early diagnosis of sarcopenia.

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中华临床营养杂志

2023年31卷2期

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