Cargando…

Chinesisation, adaptation and validation of the Chelsea Critical Care Physical Assessment Tool in critically ill patients: a cross-sectional observational study

PURPOSE: To translate and adapt the Chelsea Critical Care Physical Assessment Tool (CPAx) into Chinese version (‘CPAx-Chi’), test the reliability and validity of CPAx-Chi, and verify the cut-off point for the diagnosis of intensive care unit-acquired weakness (ICU-AW). STUDY DESIGN: Cross-sectional...

Descripción completa

Detalles Bibliográficos
Autores principales: Zhang, Zhigang, Wang, Guoqiang, Wu, Yuchen, Guo, Jin, Ding, Nannan, Jiang, Biantong, Wei, Huaping, Li, Bin, Yue, Weigang, Tian, Jinhui
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8042994/
https://www.ncbi.nlm.nih.gov/pubmed/33837104
http://dx.doi.org/10.1136/bmjopen-2020-045550
_version_ 1783678231301324800
author Zhang, Zhigang
Wang, Guoqiang
Wu, Yuchen
Guo, Jin
Ding, Nannan
Jiang, Biantong
Wei, Huaping
Li, Bin
Yue, Weigang
Tian, Jinhui
author_facet Zhang, Zhigang
Wang, Guoqiang
Wu, Yuchen
Guo, Jin
Ding, Nannan
Jiang, Biantong
Wei, Huaping
Li, Bin
Yue, Weigang
Tian, Jinhui
author_sort Zhang, Zhigang
collection PubMed
description PURPOSE: To translate and adapt the Chelsea Critical Care Physical Assessment Tool (CPAx) into Chinese version (‘CPAx-Chi’), test the reliability and validity of CPAx-Chi, and verify the cut-off point for the diagnosis of intensive care unit-acquired weakness (ICU-AW). STUDY DESIGN: Cross-sectional observational study. METHODS: Forward and back translation, cross-cultural adaptation and pretesting of CPAx into CPAx-Chi were based on the Brislin model. Participants were recruited from the general ICU of five third-grade class-A hospitals in western China. Two hundred critically ill adult patients (median age: 53 years; 64% men) with duration of ICU stay ≥48 hours and Glasgow Coma Scale ≥11 were included in this study. Two researchers simultaneously and independently assessed eligible patients using the Medical Research Council Muscle Score (MRC-Score) and CPAx-Chi. RESULTS: The content validity index of items was 0.889. The content validity index of scale was 0.955. Taking the MRC-Score scale as standard, the criterion validity of CPAx-Chi was r=0.758 (p<0.001) for researcher A, and r=0.65 (p<0.001) for researcher B. Cronbach’s α was 0.939. The inter-rater reliability was 0.902 (p<0.001). The area under the receiver operating characteristic curves of CPAx-Chi for diagnosing ICU-AW based on MRC-Score ≤48 were 0.899 (95% CI 0.862 to 1.025) and 0.874 (95% CI 0.824 to 0.925) for researcher B. The best cut-off point for CPAx-Chi for the diagnosis of ICU-AW was 31.5. The sensitivity was 87% and specificity was 77% for researcher A, whereas it was 0.621, 31.5, 75% and 87% for researcher B, respectively. The consistency was high when taking CPAx-Chi ≤31 and MRC-Score ≤48 as the cut-off points for the diagnosis of ICU-AW. Cohen’s kappa=0.845 (p=0.02) in researcher A and 0.839 (p=0.04) for researcher B. CONCLUSIONS: CPAx-Chi demonstrated content validity, criterion-related validity and reliability. CPAx-Chi showed the best accuracy in assessment of patients at risk of ICU-AW with good sensitivity and specificity at a recommended cut-off of 31.
format Online
Article
Text
id pubmed-8042994
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher BMJ Publishing Group
record_format MEDLINE/PubMed
spelling pubmed-80429942021-04-27 Chinesisation, adaptation and validation of the Chelsea Critical Care Physical Assessment Tool in critically ill patients: a cross-sectional observational study Zhang, Zhigang Wang, Guoqiang Wu, Yuchen Guo, Jin Ding, Nannan Jiang, Biantong Wei, Huaping Li, Bin Yue, Weigang Tian, Jinhui BMJ Open Intensive Care PURPOSE: To translate and adapt the Chelsea Critical Care Physical Assessment Tool (CPAx) into Chinese version (‘CPAx-Chi’), test the reliability and validity of CPAx-Chi, and verify the cut-off point for the diagnosis of intensive care unit-acquired weakness (ICU-AW). STUDY DESIGN: Cross-sectional observational study. METHODS: Forward and back translation, cross-cultural adaptation and pretesting of CPAx into CPAx-Chi were based on the Brislin model. Participants were recruited from the general ICU of five third-grade class-A hospitals in western China. Two hundred critically ill adult patients (median age: 53 years; 64% men) with duration of ICU stay ≥48 hours and Glasgow Coma Scale ≥11 were included in this study. Two researchers simultaneously and independently assessed eligible patients using the Medical Research Council Muscle Score (MRC-Score) and CPAx-Chi. RESULTS: The content validity index of items was 0.889. The content validity index of scale was 0.955. Taking the MRC-Score scale as standard, the criterion validity of CPAx-Chi was r=0.758 (p<0.001) for researcher A, and r=0.65 (p<0.001) for researcher B. Cronbach’s α was 0.939. The inter-rater reliability was 0.902 (p<0.001). The area under the receiver operating characteristic curves of CPAx-Chi for diagnosing ICU-AW based on MRC-Score ≤48 were 0.899 (95% CI 0.862 to 1.025) and 0.874 (95% CI 0.824 to 0.925) for researcher B. The best cut-off point for CPAx-Chi for the diagnosis of ICU-AW was 31.5. The sensitivity was 87% and specificity was 77% for researcher A, whereas it was 0.621, 31.5, 75% and 87% for researcher B, respectively. The consistency was high when taking CPAx-Chi ≤31 and MRC-Score ≤48 as the cut-off points for the diagnosis of ICU-AW. Cohen’s kappa=0.845 (p=0.02) in researcher A and 0.839 (p=0.04) for researcher B. CONCLUSIONS: CPAx-Chi demonstrated content validity, criterion-related validity and reliability. CPAx-Chi showed the best accuracy in assessment of patients at risk of ICU-AW with good sensitivity and specificity at a recommended cut-off of 31. BMJ Publishing Group 2021-04-09 /pmc/articles/PMC8042994/ /pubmed/33837104 http://dx.doi.org/10.1136/bmjopen-2020-045550 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Intensive Care
Zhang, Zhigang
Wang, Guoqiang
Wu, Yuchen
Guo, Jin
Ding, Nannan
Jiang, Biantong
Wei, Huaping
Li, Bin
Yue, Weigang
Tian, Jinhui
Chinesisation, adaptation and validation of the Chelsea Critical Care Physical Assessment Tool in critically ill patients: a cross-sectional observational study
title Chinesisation, adaptation and validation of the Chelsea Critical Care Physical Assessment Tool in critically ill patients: a cross-sectional observational study
title_full Chinesisation, adaptation and validation of the Chelsea Critical Care Physical Assessment Tool in critically ill patients: a cross-sectional observational study
title_fullStr Chinesisation, adaptation and validation of the Chelsea Critical Care Physical Assessment Tool in critically ill patients: a cross-sectional observational study
title_full_unstemmed Chinesisation, adaptation and validation of the Chelsea Critical Care Physical Assessment Tool in critically ill patients: a cross-sectional observational study
title_short Chinesisation, adaptation and validation of the Chelsea Critical Care Physical Assessment Tool in critically ill patients: a cross-sectional observational study
title_sort chinesisation, adaptation and validation of the chelsea critical care physical assessment tool in critically ill patients: a cross-sectional observational study
topic Intensive Care
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8042994/
https://www.ncbi.nlm.nih.gov/pubmed/33837104
http://dx.doi.org/10.1136/bmjopen-2020-045550
work_keys_str_mv AT zhangzhigang chinesisationadaptationandvalidationofthechelseacriticalcarephysicalassessmenttoolincriticallyillpatientsacrosssectionalobservationalstudy
AT wangguoqiang chinesisationadaptationandvalidationofthechelseacriticalcarephysicalassessmenttoolincriticallyillpatientsacrosssectionalobservationalstudy
AT wuyuchen chinesisationadaptationandvalidationofthechelseacriticalcarephysicalassessmenttoolincriticallyillpatientsacrosssectionalobservationalstudy
AT guojin chinesisationadaptationandvalidationofthechelseacriticalcarephysicalassessmenttoolincriticallyillpatientsacrosssectionalobservationalstudy
AT dingnannan chinesisationadaptationandvalidationofthechelseacriticalcarephysicalassessmenttoolincriticallyillpatientsacrosssectionalobservationalstudy
AT jiangbiantong chinesisationadaptationandvalidationofthechelseacriticalcarephysicalassessmenttoolincriticallyillpatientsacrosssectionalobservationalstudy
AT weihuaping chinesisationadaptationandvalidationofthechelseacriticalcarephysicalassessmenttoolincriticallyillpatientsacrosssectionalobservationalstudy
AT libin chinesisationadaptationandvalidationofthechelseacriticalcarephysicalassessmenttoolincriticallyillpatientsacrosssectionalobservationalstudy
AT yueweigang chinesisationadaptationandvalidationofthechelseacriticalcarephysicalassessmenttoolincriticallyillpatientsacrosssectionalobservationalstudy
AT tianjinhui chinesisationadaptationandvalidationofthechelseacriticalcarephysicalassessmenttoolincriticallyillpatientsacrosssectionalobservationalstudy