Background
Methods
Step 1 item generation
Literature review
Patient interviews
Cognitive debriefing and discussion with experts
Step 2 item selection
Sampling survey
Scale scoring
Statistical methods for item selection
Discrete trend
Discrimination analysis
Exploratory factor analysis (EFA)
Cronbach’s α if item deleted (CAID)
Correlation coefficient
Retest reliability
Item response theory (IRT)
Step 3 validation of the scale
Second Sampling Survey
Reliability analysis
Validity analysis
Construct validity
Discriminant validity
Feasibility analysis
Statistical software
Results
Generation of item pool
Literature review and patient interviews
Field | Dimension |
---|---|
Physical Domain(PSD) | Abdominal Symptoms (ABS) |
Skin Symptoms (SKS) | |
Appetite Symptoms (APS) | |
Cognitive Ability (COG) | |
Independence (IND) | |
Psychological Domain (PSD) | Anxiety and Depression (AND) |
Confidence (CON) | |
Disease Outcomes (DIO) | |
Social Domain (SOD) | Social Supports (SOS) |
Social Adaptation (SOA) | |
Therapeutic Domain (TRD) | Satisfaction (SAT) |
Compliance (COM) | |
Drug Side Effects (DSE) |
Cognitive debriefing and expert discussion
Item reduction
Participant characteristics
Variables | Liver Cirrhosis | Health Control |
t/χ
2
|
P
| |
---|---|---|---|---|---|
Age (years) | 55.46 ± 11.60 | 51.94 ± 15.02 | 1.462 | 0.149 | |
Gender | 1.149 | 0.284 | |||
Male | 82 | 25 | |||
Female | 50 | 22 | |||
Height (cm) | 167.46 ± 7.68 | 166.04 ± 7.53 | 1.091 | 0.277 | |
Weight (kg) | 62.83 ± 10.42 | 65.83 ± 12.79 | −1.596 | 0.112 | |
Drinking | never | 42 | 25/6/12/4 | 9.243 | 0.026 |
quit | 28 | 6 | |||
occasional | 32 | 12 | |||
always | 30 | 4 | |||
Smoking | never | 46 | 26 | 11.299 | 0.023 |
quit | 26 | 10 | |||
<10branches/d | 18 | 3 | |||
10branches/d~ | 14 | 6 | |||
20branches/d~ | 28 | 2 |
Item selection based on CTT and IRT
Dimension | Item | SD |
t
| Factor Loading | CAID | CITC | CC | Retest Reliability | IRT | Outcome | ||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
a
|
b
1
|
b
2
|
b
3
|
b
4
| ||||||||||
ABS | PHD1 | 1.18 | 0.001 | 0.619 | 0.736 | 0.579 | 0.713 | 0.858 | 1.83 | −1.07 | −0.02 | 0.91 | 2.20 | √ |
PHD2 |
0.90
| 0.001 |
0.474
a
| 0.774 |
0.348
|
0.484
| 0.860 | 1.06 |
−6.98
| −2.53 | −0.43 | 1.41 |
×
| |
PHD3 | 1.21 | 0.001 |
0.540
a
| 0.750 | 0.509 | 0.659 | 0.734 | 1.17 | −1.80 | −0.34 | 0.86 | 2.20 | √ | |
PHD4 | 1.25 | 0.001 | 0.671 | 0.756 | 0.478 | 0.639 | 0.802 | 1.37 | −1.60 | −0.31 | 0.76 | 1.79 | √ | |
PHD5 |
0.97
| 0.001 | 0.697 | 0.752 | 0.505 | 0.628 | 0.817 | 1.15 |
−3.16
| −2.50 | −1.06 | 0.70 | √ | |
PHD6 | 1.21 | 0.001 |
0.510
a
| 0.771 |
0.392
|
0.566
|
0.644
| 0.91 | −2.58 | −0.74 | 0.58 | 2.38 |
×
| |
PHD7 | 1.20 | 0.001 | 0.620 | 0.747 | 0.525 | 0.670 | 0.886 | 1.47 | −1.99 | −0.97 | 0.07 | 1.24 | √ | |
PHD8 | 1.05 | 0.001 | 0.633 | 0.749 | 0.517 | 0.647 | 0.840 | 1.09 | −2.81 | −1.51 | 0.04 | 2.17 | √ | |
SKS | PHD9 | 1.13 | 0.001 | 0.673 | 0.529 |
0.382
| 0.706 | 0.779 |
0.59
|
−5.48
| −1.91 | 0.18 | 2.77 | √ |
PHD10 | 1.01 | 0.001 | 0.668 | 0.473 | 0.421 | 0.644 | 0.751 | 0.61 |
−6.19
|
−3.45
| −1.21 | 1.76 | √ | |
PHD11 | 1.12 | 0.001 |
0.543
a
| 0.483 | 0.411 |
0.451
|
0.649
| 1.07 |
−3.40
| −1.09 | 0.18 | 1.74 |
×
| |
APS | PHD12 | 1.09 | 0.001 |
0.603
a
| 0.519 | 0.535 | 0.718 | 0.732 | 1.21 |
−3.04
| −1.85 | −0.43 | 0.77 | √ |
PHD13 | 1.21 | 0.001 |
0.655
a
| 0.612 |
0.307
|
0.574
| 0.719 | 1.20 | −1.81 | −0.36 | 0.75 | 2.16 |
×
| |
PHD14 | 1.23 | 0.001 | 0.642 | 0.618 |
0.295
|
0.567
| 0.713 | 0.75 |
−3.40
| −1.55 | 0.06 | 1.89 |
×
| |
PHD15 | 1.03 | 0.001 | 0.672 | 0.584 |
0.376
|
0.589
| 0.767 | 0.92 |
−4.20
| −2.45 | −1.09 | 0.82 |
×
| |
PHD16 |
0.89
|
0.915
|
0.528
a
| 0.590 |
0.367
|
0.555
| 0.809 | 0.80 |
−5.28
|
−4.08
| −2.12 | −0.43 |
×
| |
PHD17 | 1.14 | 0.001 | 0.698 | 0.600 | 0.400 |
0.576
| 0.781 |
0.57
|
−4.35
| −1.35 | 0.81 |
3.86
| √ | |
COG | PHD18 | 1.20 | 0.001 | 0.816 | 0.438 | 0.567 | 0.831 |
0.692
| 1.15 | −2.22 | −0.93 | 0.13 | 1.82 | √ |
PHD19 | 1.14 | 0.001 | 0.848 | 0.419 | 0.585 | 0.829 | 0.727 | 0.87 |
−3.59
| −1.33 | 0.28 | 2.03 | √ | |
PHD20 | 1.12 | 0.001 |
0.584
a
|
0.779
|
0.302
| 0.657 | 0.840 | 0.87 | −2.74 | −0.94 | 0.68 |
3.15
|
×
| |
IND | PHD21 | 1.07 | 0.033 | 0.633 | 0.635 | 0.525 | 0.788 | 0.815 | 1.05 |
−3.25
| −2.23 | −0.80 | 0.81 | √ |
PHD22 | 1.14 | 0.002 | 0.708 | 0.582 | 0.566 | 0.824 | 0.813 | 1.18 | −2.92 | −1.67 | −0.40 | 0.82 | √ | |
PHD23 | 1.07 | 0.018 | 0.777 | 0.653 | 0.509 | 0.780 | 0.820 | 0.64 |
−5.93
| −2.96 | −0.93 | 1.40 | √ | |
AND | PSD1 | 1.19 | 0.001 |
0.504
a
| 0.807 | 0.532 | 0.645 | 0.774 | 1.54 | −1.26 | −0.26 | 0.77 | 2.33 | √ |
PSD2 | 1.07 | 0.001 | 0.704 | 0.805 | 0.558 | 0.656 | 0.768 | 1.33 | −2.85 | −1.11 | 0.33 | 1.62 | √ | |
PSD3 | 1.39 | 0.001 | 0.606 | 0.814 | 0.481 | 0.622 |
0.628
| 0.97 | −1.96 | −0.61 | 0.61 | 1.41 | √ | |
PSD4 | 1.21 | 0.001 | 0.680 | 0.797 | 0.624 | 0.721 | 0.829 | 2.16 | −0.91 | 0.09 | 0.95 | 1.86 | √ | |
PSD5 | 1.19 | 0.001 | 0.611 | 0.809 | 0.517 | 0.633 | 0.814 | 1.04 | −2.64 | −0.97 | 0.17 | 1.85 | √ | |
PSD6 | 1.36 | 0.001 | 0.699 | 0.804 | 0.555 | 0.679 | 0.781 | 1.19 | −1.24 | −0.23 | 0.64 | 1.96 | √ | |
PSD7 | 1.20 | 0.001 | 0.658 | 0.809 | 0.513 | 0.631 | 0.817 | 1.17 | −2.78 | −1.24 | −0.20 | 0.99 | √ | |
PSD8 | 1.36 | 0.001 | 0.589 | 0.809 | 0.516 | 0.648 |
0.626
| 1.17 | −1.74 | −0.51 | 0.34 | 1.44 | √ | |
PSD9 | 1.16 | 0.001 |
0.597
a
| 0.813 | 0.476 |
0.596
| 0.858 | 1.45 | −2.31 | −0.34 | 0.42 | 1.74 | √ | |
CON | PSD10 | 1.34 | 0.001 | 0.691 |
0.624
|
0.237
|
0.511
| 0.830 | 0.78 | −1.59 | 0.05 | 1.45 | 2.85 | √ |
PSD11 |
0.94
| 0.001 |
0.623
a
| 0.590 |
0.328
|
0.509
| 0.844 | 0.68 |
−5.55
|
−4.47
| −2.09 | 0.33 |
×
| |
PSD12 | 1.43 | 0.001 | 0.650 | 0.611 |
0.283
|
0.564
| 0.722 | 0.60 | −2.71 | 1.20 | 0.21 | 1.95 | √ | |
PSD13 |
0.93
| 0.001 | 0.676 | 0.591 |
0.326
|
0.505
| 0.860 | 0.61 |
−7.67
|
−4.43
| −1.99 | 0.69 |
×
| |
PSD14 | 1.02 | 0.001 |
0.632
| 0.546 | 0.471 | 0.640 | 0.804 | 1.24 |
−4.19
| −1.87 | −0.43 | 0.85 | √ | |
PSD15 | 1.03 | 0.001 | 0.634 | 0.551 | 0.454 | 0.629 | 0.776 | 0.85 |
−4.51
| −2.66 | −1.29 | 0.70 | √ | |
PSD16 | 1.25 | 0.001 |
0.504
a
| 0.587 |
0.334
|
0.571
| 0.721 | 0.95 | −2.97 | −1.23 | −0.20 | 1.19 |
×
| |
DIO | PSD17 | 1.16 | 0.001 | 0.749 | - | 0.461 | 0.836 | 0.736 | 1.20 | −2.17 | −0.65 | 0.66 | 2.05 | √ |
PSD18 | 1.31 | 0.001 | 0.686 | - | 0.461 | 0.873 | 0.782 | 1.25 | −1.40 | −0.23 | 0.82 | 1.85 | √ | |
SOS | SOD1 |
0.85
|
0.836
| 0.719 | 0.476 | 0.480 | 0.702 | 0.854 | 1.23 |
−6.39
| −2.98 | −1.00 | 0.55 |
×
|
SOD2 |
0.95
|
0.492
|
0.606
a
| 0.567 |
0.336
| 0.628 | 0.842 | 0.89 |
−7.79
| −2.62 | −1.43 | 0.58 |
×
| |
SOD3 |
0.90
|
0.480
| 0.767 | 0.462 | 0.489 | 0.720 | 0.855 | 0.60 |
−6.92
|
−5.35
| −2.33 | 0.36 |
×
| |
SOD4 | 1.26 | 0.036 |
0.579
a
|
0.636
|
0.296
| 0.690 | 0.785 | 0.94 | −2.47 | −0.44 | 0.73 | 2.05 | √ | |
SOA | SOD5 | 1.06 | 0.001 | 0.786 | 0.797 | 0.543 | 0.646 | 0.731 |
0.44
|
−6.55
|
−4.41
| −1.26 | 2.72 | √ |
SOD6 | 1.27 | 0.001 | 0.835 | 0.792 | 0.576 | 0.692 | 0.741 |
0.25
|
−8.24
|
−4.67
| −0.42 |
4.89
| √ | |
SOD7 | 1.22 | 0.001 |
0.438
a
| 0.804 | 0.481 | 0.611 | 0.771 |
0.38
|
−5.95
| −2.52 | 0.75 |
3.99
| √ | |
SOD8 | 1.26 | 0.001 |
0.385
| 0.803 | 0.488 | 0.621 | 0.849 |
0.57
|
−3.06
| −0.25 | 1.91 |
3.49
| √ | |
SOD9 | 1.26 | 0.001 | 0.821 | 0.809 | 0.433 |
0.566
| 0.742 |
0.46
|
−6.51
| −2.60 | −0.23 | 2.69 | √ | |
SOD10 | 1.19 | 0.001 | 0.630 | 0.793 | 0.575 | 0.685 |
0.638
| 0.79 |
−3.19
| −1.53 | 0.32 | 2.02 | √ | |
SOD11 | 1.18 | 0.017 | 0.693 | 0.803 | 0.490 | 0.614 | 0.757 | 0.67 |
−4.33
| −1.78 | −0.01 | 2.18 | √ | |
SOD12 | 1.28 | 0.015 | 0.748 | 0.799 | 0.525 | 0.653 | 0.915 |
0.49
|
−4.45
| −1.79 | 0.52 | 2.82 | √ | |
SOD13 | 1.17 | 0.001 | 0.713 | 0.796 | 0.545 | 0.659 | 0.832 |
0.41
|
−5.81
| −2.58 | 0.77 |
4.31
| √ | |
SAT | TRD1 | 1.03 | 0.001 | 0.755 | 0.505 | 0.434 | 0.752 | 0.739 | 0.88 |
−4.05
| −1.27 | 0.92 | 2.53 | √ |
TRD2 |
0.98
| 0.009 | 0.722 | 0.498 | 0.441 | 0.742 | 0.759 |
0.58
|
−7.28
| −2.96 | 0.05 | 3.16 | √ | |
TRD3 | 1.13 | 0.001 | 0.720 | 0.552 | 0.406 | 0.765 | 0.878 |
0.46
|
−4.13
| −0.88 | 2.86 |
5.24
| √ | |
COM | TRD4 | 1.03 |
0.537
| 0.794 | 0.524 | 0.449 | 0.767 | 0.825 |
0.42
|
−8.59
|
−5.10
| −2.36 | 1.43 | √ |
TRD5 | 1.11 | 0.039 | 0.617 | 0.587 | 0.413 | 0.771 | 0.728 | 0.61 |
−6.83
| −2.68 | −1.25 | 1.19 | √ | |
TRD6 |
0.89
| 0.043 | 0.778 | 0.499 | 0.479 | 0.747 | 0.834 |
0.49
|
−9.49
|
−5.76
|
−3.07
| 0.59 | √ | |
DSE | TRD7 | 1.23 | 0.001 | 0.801 | 0.444 | 0.494 | 0.744 | 0.716 | 1.06 | −2.04 | −0.57 | 0.80 | 2.10 | √ |
TRD8 | 1.26 | 0.001 | 0.683 | 0.504 | 0.417 | 0.701 |
0.632
| 0.61 |
−3.48
| −0.34 | 1.12 |
3.19
| √ | |
TRD9 | 1.23 | 0.005 |
0.487
a
| 0.564 |
0.338
| 0.640 |
0.669
| 0.95 | −2.00 | −0.86 | 0.77 | 2.42 |
×
| |
TRD10 | 1.28 | 0.006 | 0.631 | 0.602 |
0.290
| 0.618 | 0.702 | 0.82 | −1.93 | −0.03 | 1.32 | 2.66 | √ |
Domain | Dimension | Item |
---|---|---|
Physical Domain (PHD) | Abdominal Symptoms (ABS) | 1-,2-,3-,4-,5-,6- |
Skin Symptom (SKS) | 7-,8- | |
Appetite Symptoms (APS) | 9-,10-,11-,12-,13- | |
Cognitive Ability (COG) | 14-,15- | |
Independence (IND) | 16+,17+,18+ | |
Psycological Domain (PSD) | Anxiety and Depression (AND) | 1-,2-,3-,4-,5-,6-,7-,8-,9- |
Confidence (CON) | 10-,11-,12-,13-,14- | |
Disease Outcomes (DIO) | 15-,16- | |
Social Domain (SOD) | Social Supports (SOS) | 1+,2+,3+ |
Social Adaptation (SOA) | 4-,5-,6-,7-,8-,9-,10-,11+,12- | |
Therapeutic Domain (TRD) | Satisfaction (SAT) | 1+,2+,3+ |
Compliance (COM) | 4+,5+,6+ | |
Drug Side Effects (DSE) | 7-,8-,9- |
Validation of LC-PROM
Demographic characteristics
Variables | Liver Cirrhosis | Health Control |
t/χ
2
|
P
| |
---|---|---|---|---|---|
Age (Years) | 55.62 ± 11.06 | 53.81 ± 11.38 | 1.547 | 0.123 | |
Gender | Male | 283 | 64 | 0.558 | 0.455 |
Female | 181 | 48 | |||
Height (cm) | 166.96 ± 7.76 | 167.73 ± 6.98 | −0.967 | 0.334 | |
Weight (kg) | 62.08 ± 10.34 | 66.66 ± 9.95 | −4.241 | 0.001 | |
Drinking | Never | 146 | 62 | 29.968 | 0.001 |
Quit | 104 | 10 | |||
Occasional | 127 | 32 | |||
Always | 87 | 8 | |||
Smoking | Never | 186 | 51 | 23.232 | 0.001 |
Quit | 162 | 21 | |||
<10branches/d | 48 | 7 | |||
10branches/d~ | 32 | 20 | |||
20branches/d~ | 36 | 13 |
Reliability analysis
Domain | The number of item | Cronbach’s α coefficient |
---|---|---|
Physical | 18 | 0.923 |
Psychological | 16 | 0.930 |
Social | 12 | 0.840 |
Therapeutic | 9 | 0.698 |
Total | 55 | 0.952 |
Validity analysis
Domain | Dimension | Item | Standard Factor Loading | Nonstandard Factor Loading | SE |
t
|
---|---|---|---|---|---|---|
PHD | ABS | PHD1 | 0.81 | 0.95 | 0.04 | 22.79 |
PHD2 | 0.86 | 0.99 | 0.04 | 25.34 | ||
PHD3 | 0.83 | 0.99 | 0.04 | 23.77 | ||
PHD4 | 0.75 | 0.63 | 0.03 | 20.54 | ||
PHD5 | 0.63 | 0.61 | 0.04 | 16.19 | ||
PHD6 | 0.74 | 0.79 | 0.04 | 20.18 | ||
SKS | PHD7 | 0.91 | 0.97 | 0.04 | 23.98 | |
PHD8 | 0.76 | 0.78 | 0.04 | 19.59 | ||
APS | PHD9 | 0.51 | 0.50 | 0.04 | 12.06 | |
PHD10 | 0.63 | 0.63 | 0.04 | 15.66 | ||
PHD11 | 0.69 | 0.77 | 0.04 | 17.52 | ||
PHD12 | 0.71 | 0.72 | 0.04 | 18.17 | ||
PHD13 | 0.65 | 0.65 | 0.04 | 16.17 | ||
COG | PHD14 | 0.89 | 0.89 | 0.03 | 25.82 | |
PHD15 | 0.93 | 0.91 | 0.03 | 27.43 | ||
IND | PHD16 | 0.76 | 0.69 | 0.04 | 19.38 | |
PHD17 | 0.61 | 0.60 | 0.04 | 14.70 | ||
PHD18 | 0.82 | 0.75 | 0.04 | 21.13 | ||
PSD | AND | PSD1 | 0.83 | 0.95 | 0.04 | 23.99 |
PSD2 | 0.65 | 0.69 | 0.04 | 17.07 | ||
PSD3 | 0.89 | 1.04 | 0.04 | 27.23 | ||
PSD4 | 0.80 | 0.91 | 0.04 | 22.71 | ||
PSD5 | 0.69 | 0.72 | 0.04 | 18.65 | ||
PSD6 | 0.76 | 0.87 | 0.04 | 21.22 | ||
PSD7 | 0.66 | 0.72 | 0.04 | 17.59 | ||
PSD8 | 0.67 | 0.72 | 0.04 | 17.92 | ||
PSD9 | 0.83 | 0.95 | 0.04 | 23.91 | ||
CON | PSD10 | 0.80 | 0.93 | 0.04 | 22.46 | |
PSD11 | 0.87 | 0.95 | 0.04 | 25.62 | ||
PSD12 | 0.61 | 0.52 | 0.03 | 15.39 | ||
PSD13 | 0.59 | 0.51 | 0.03 | 14.82 | ||
PSD14 | 0.86 | 0.99 | 0.04 | 24.79 | ||
DIO | PSD15 | 0.80 | 0.95 | 0.05 | 19.76 | |
PSD16 | 0.83 | 0.99 | 0.05 | 20.54 | ||
SOD | SOS | SOD1 | 0.62 | 0.51 | 0.06 | 8.42 |
SOD2 | 0.59 | 0.49 | 0.06 | 8.31 | ||
SOD3 | 0.35 | 0.37 | 0.06 | 6.26 | ||
SOA | SOD4 | 0.57 | 0.59 | 0.04 | 14.39 | |
SOD5 | 0.86 | 0.96 | 0.04 | 24.93 | ||
SOD6 | 0.66 | 0.77 | 0.05 | 17.14 | ||
SOD7 | 0.70 | 0.91 | 0.05 | 18.57 | ||
SOD8 | 0.52 | 0.51 | 0.04 | 12.67 | ||
SOD9 | 0.72 | 0.80 | 0.04 | 19.26 | ||
SOD10 | 0.72 | 0.73 | 0.04 | 19.40 | ||
SOD11 | 0.67 | 0.72 | 0.04 | 17.38 | ||
SOD12 | 0.64 | 0.73 | 0.04 | 16.40 | ||
TRD | SAT | TRD1 | 0.83 | 0.70 | 0.04 | 19.34 |
TRD2 | 0.66 | 0.59 | 0.04 | 15.54 | ||
TRD3 | 0.66 | 0.69 | 0.04 | 15.44 | ||
COM | TRD4 | 0.59 | 0.50 | 0.04 | 11.34 | |
TRD5 | 0.69 | 0.69 | 0.06 | 12.43 | ||
TRD6 | 0.56 | 0.42 | 0.04 | 11.00 | ||
DSE | TRD7 | 0.79 | 0.87 | 0.05 | 18.92 | |
TRD8 | 0.80 | 0.86 | 0.04 | 19.56 | ||
TRD9 | 0.63 | 0.70 | 0.05 | 14.99 |
RMSEA
|
RMR
|
NFI
|
NNFI
|
CFI
|
IFI
| |
---|---|---|---|---|---|---|
PHD | 0.06 | 0.05 | 0.97 | 0.98 | 0.98 | 0.98 |
PSD | 0.07 | 0.06 | 0.97 | 0.98 | 0.98 | 0.98 |
SOD | 0.09 | 0.05 | 0.95 | 0.95 | 0.96 | 0.96 |
TRD | 0.02 | 0.03 | 0.98 | 0.99 | 1.00 | 1.00 |
Total | 0.06 | 0.06 | 0.91 | 0.93 | 0.94 | 0.94 |
Liver Cirrhosis (n = 464) | Health Controls (n = 112) |
t
|
P
| |
---|---|---|---|---|
Physical | 63.68 ± 11.12 | 80.74 ± 3.11 | 28.73 | <0.001 |
Psychological | 52.26 ± 10.00 | 73.29 ± 2.76 | 39.52 | <0.001 |
Social | 42.29 ± 7.47 | 50.78 ± 3.81 | 17.01 | <0.001 |
Therapeutic | 30.77 ± 4.53 | 36.19 ± 2.61 | 16.73 | <0.001 |
Total | 189.00.24 ± 24.79 | 241.01 ± 6.76 | 39.51 | <0.001 |
<1 year | 1 year~ | 3 ~ years | 5 ~ years |
F
|
P
| |
---|---|---|---|---|---|---|
(n = 97) | (n = 133) | (n = 136) | (n = 98) | |||
Physical | 67.62 ± 9.70 | 66.23 ± 10.65 | 62.15 ± 10.25 | 58.46 ± 11.87 | 15.83 | <0.001 |
Psychological | 53.82 ± 9.38 | 53.29 ± 10.59 | 51.98 ± 9.17 | 49.70 ± 10.49 | 3.49 | 0.016 |
Social | 42.40 ± 6.52 | 43.41 ± 7.69 | 41.22 ± 7.42 | 42.13 ± 7.99 | 1.95 | 0.120 |
Therapeutic | 32.07 ± 3.75 | 31.20 ± 4.81 | 30.32 ± 4.25 | 29.50 ± 4.83 | 6.32 | <0.001 |
Total | 195.92 ± 21.53 | 194.13 ± 25.10 | 185.67 ± 21.69 | 179.80 ± 27.91 | 10.32 | <0.001 |