Development Of Liver Cirrhosis Doctors Reported Outcome Scale

ObjectiveThrough literature search and Delphy Fa expert investigation,we investigate the constitution of liver cirrhosis and form the outcome scale of the report of TCM liver cirrhosis report,and make the scale test and evaluation through the form of clinical examination and perfect the formal "report of the report of liver cirrhosis" for the clinical curative effect evaluation of Chinese medicine tool.Methods and objectsLooking up the relevant literature,analyzing and collecting the symptoms and signs of liver cirrhosis,the items of each symptom and physical sign are divided into unimportant,unimportant,general important,important and very important.At the same time,the quantitative description of the items is divided into four grades without,mild,moderate and severe;the Delphy method is used as the choice.Multiple rounds of liver cirrhosis experts from all over the country are selected to conduct multiple rounds of investigation to determine the retention items,review,modify and supplement the quantitative description of the reserved symptoms,and assess their feasibility,reliability,differentiated validity and responsiveness.ResultThree rounds of expert consultation are highly authoritative and scientific.The first round of expert consultation showed that 11 symptoms of liver cirrhosis included "liver pain,abdominal pain,depression,dry eyes,dizziness,tinnitus,fear of cold,dream,low back ache,dry mouth,oral pain" full score ratio(full consent rate)less than 75%,and the other 26 symptoms and physical signs were more than 75% in quantitative description.The coefficient of variation is between 0 and 0.250,and the coordination coefficient is 0.104 and P < 0.05.It shows that the experts have high agreement on the agreement degree evaluation of this part,and the result of the evaluation is reliable.The results of the second round of consultation showed that most of the symptoms of liver cirrhosis and the quantitative description of the level of physical signs were fully agreed,and the remaining 5 items were liver pain,abdominal pain,depression,abdominal distention,and the full score of 60 to 80% of epistaxis.The coefficient of variation is between 0 and 0.270,and the coordination coefficient is 0.154(higher than the first round value).P < 0.01.It shows that the consistency of the expert evaluation is higher than the first round,and the results of the evaluation are reliable.The third round of consultation showed that,except for 6 items,the full score of the liver area pain,abdominal pain,visual substance blurring,gingival bleeding,black stool and epistaxis was compared to 75 to 90%.The total 28 liver cirrhosis symptoms and the full score rate of the physical signs(expert complete consent rate)were more than 90%,the variation coefficient was 0 to 0.164,coordination department.The number is 0.155 higher than the last two rounds,P < 0.01,indicating that experts' opinions tend to be consistent.The results suggest that the scale has a good feasibility.The D value of the differential index between the total score and the high and low end groups is 0.39-0.96,and has a good discriminative validity.At the same time,the total score of the first and second scores and the items ICC had excellent evaluation reliability in 0.83-1.00,and P <0.05 showed that there was no statistical difference between the two reviews.Before and after the treatment,the results showed that there were 8 items(abdominal distention and discomfort,depression,irritability,fatigue,difficulty in sleeping,dry mouth,nausea,nausea),the ES value was above 0.8,the CR value 42-62% was highly reactive,the ES value of 19 items was 0.2-0.8,and the CR value was more than 33% to moderate reactivity.The rank sum test results showed no statistical significance between the doctors and patients before the treatment of 23 symptoms(P > 0.05),indicating that there was no difference in the severity of the 23 symptoms between the doctors and the patients.After treatment,there were significant differences between doctors and patients(P<0.05)except for 3 symptoms,"fatigue fatigue","dry eye dry" and "emotional depression"(P > 0.05).ConclusionIn order to establish a unified evaluation of curative effect,the grade of symptom and the standard of Fu,Delphi method was used.In the study of a large number of literature,the feasibility,reliability and reactivity were examined by three rounds of expert consultation and clinical investigation.The outcome scale of the report on the report of the doctor's liver cirrhosis was developed.The clinical evaluation of 34 symptoms and signs was carried out.The results showed that it was feasible,differentiated validity,interviewer reliability,evaluator's internal reliability,reactivity and so on.The scale could be used to evaluate the clinical efficacy of liver cirrhos.