ORIJINAL ARAŞTIRMA
Toronto Klinik Skorlama Sisteminin Türkçe Versiyonunun Güvenirliliği ve Geçerliliği
The Validity and Reliability of the Turkish Version of the Toronto Clinical Scoring System
Received Date : 14 Feb 2019
Accepted Date : 19 Jun 2019
Serdar KAYMAZa, Sanem Aslıhan AYKANb, Sinem UYAR KÖYLÜa, Tuğba İKİZ KAYMAZc
aDepartment of Physical Medicine and Rehabilitation, Atatürk Training and Research Hospital, Ankara, TURKEY
bDepartment of Physical Medicine and Rehabilitation, Sultan Abdulhamıd Han Training and Research Hospital, İstanbul, TURKEY
cDepartment of Physical Medicine and Rehabilitation, Physical Medicine and Rehabilitation Training and Reseach Hospital,
Ankara, TURKEY
Doi: 10.31609/jpmrs.2019-65511 - Makale Dili: EN
J PMR Sci. 2019;22(2):41-7
ÖZET
Toronto klinik skorlama sistemi klinik çalışmalarda kullanım kolaylığı ve nöropatik
ağrının şiddetini klasifiye edebilme becerisinden dolayı tercih edilmiştir. Bu çalışmanın amacı
Toronto klinik skorlama sisteminin Türkçe versiyonunu Türk hastalara uygulamak ve skalanın
güvenirlilik ile geçerliliğini belirlemektir. Gereç ve Yöntemler: Bu çalışmaya diyabetik polinöropati
tanılı 39 hasta (diyabetik polinöropati, grup 1), Diabetes mellitus tanılı ancak diyabetik polinöropati
tanısı olmayan 32 hasta (grup 2) ve 32 sağlıklı birey (grup 3) olmak üzere toplam 103 hasta dahil
edildi. Cinsiyet, beden kitle indeksi, HgbA1c ve diyabet süresi sırayla kayıt edildi. Güvenirliliğini
belirlemek amacıyla TCSS sistemi Türkçe diline çevrildi. Leeds nöropatik belirti ve bulgu değerlendirmesi,
ağrı anketi ve Michigan nöropati tarama testi yapıldı. Toronto klinik skorlama sistemi
ve diğer üç nöropati tanı skalası arasındaki korelasyonlar ve bunların sinir ileti değeri verileri ile
ilişkisi değerlendirildi. Bulgular: Toronto klinik skorlama sistemi ile diğer nöropati tanı skalaları
arasında istatistiksel açıdan anlamlı bir ilişki ve güçlü bir pozitif korelasyon saptandı. Toronto klinik
skorlama sisteminin Türkçe versiyonunun ilk bölümünden “Üst ekstremite semptomları” hakkındaki
madde çıkarıldığında Cronbach alfa katsayısı 0,132’den 0,934’e yükseldi. Sinir ileti değerleri
verileri ile Toronto klinik skorlama sistemi sistemi arasında anlamlı bir ilişki vardı. Toronto klinik
skorlama sistemi ≥5 skorunun sensitivitesi ile spesifitesi sırasıyla %100 ve %96,88 olarak bulundu.
Sonuç: Toronto klinik skorlama sisteminin Türkçe versiyonu, Türkçe konuşan polinöropatili hastalarda
nöropatik ağrının ölçülmesinde güvenilir ve geçerli bir araçtır.
Anahtar Kelimeler: Toronto klinik ve skorlama sistemi; diyabetik polinöropati; sinir ileti değeri; Leeds nöropatik belirti ve bulgu değerlendirmesi; ağrı anketi; Michigan nöropati tarama testi
ABSTRACT
Objective: The Toronto Clinical Scoring System has been preferred in clinical trials
owing to its ease of use and its ability to classify the severity of neuropathic pain. The aim of this
study to apply the Turkish version of Toronto Clinical Scoring System to Turkish patients and to
determine its validity and reliability. Material and Methods: This study enrolled a total of 103 patients
including 39 with diabetic polyneuropathy (diabetic polyneuropathy, group 1), 32 with diabetes
mellitus but without diabetic polyneuropathy (group 2), and 32 healthy individuals (group 3).
The gender, body mass index, hemoglobin A 1c and duration of diabetes were recorded respectively.
The Toronto Clinical Scoring System was translated into Turkish language to determine the
validity. The Leeds Assessment of Neuropathic Symptoms and Signs, Pain Detect Questionnaire,
Michigan Neuropathy Screening Instrument were performed. Correlations between Toronto Clinical
Scoring System and the other 3 neuropathy diagnosis scales and their relationships with the
data of nerve conduction velocity were evaluated. Results: There was a strong positive correlation
and a statistically significant relationship between the Toronto Clinical Scoring System and the
other neuropathy diagnosis scales. When the item about “upper extremity symptoms” was removed
from the first part of the Turkish version of the Toronto Clinical Scoring System, Cronbach’s
Alpha coefficient increased from 0.132 to 0.943. There was a significant relationship between the
Toronto Clinical Scoring System and the nerve conduction velocity data. The sensitivity and specificity
of Toronto Clinical Scoring System score ≥5 were 100% and 96.88%, respectively. Conclusion:
Turkish version of the Toronto Clinical Scoring System is a reliable and valid instrument for
the measurement of neuropathic pain in Turkish speaking patients with polyneuropathy.
Keywords: Toronto clinical scoring system; diabetic polyneuropathy; nerve conduction velocity; the Leeds assessment of neuropathic symptoms and signs; pain detect questionnaire; michigan neuropathy screening instrument
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