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患者和临床医生对关节炎的治疗结果有不同的看法。

Patients and clinicians have different perspectives on outcomes in arthritis.

作者信息

Hewlett Sarah A

机构信息

Academic Rheumatology, University of Bristol, Bristol Royal Infirmary, Bristol, UK.

出版信息

J Rheumatol. 2003 Apr;30(4):877-9.

Abstract

Outcome measurement in arthritis has undergone a major shift during the past 2 decades, moving from process measures (e.g., plasma viscosity) to patient-centered outcome measures (e.g., pain, function). However, while patients self-report many of these outcomes, it is clinicians who judge those reports to guide clinical decisions and define the efficacy of treatments in clinical trials. It is important to ascertain whether patient or professional views converge or diverge and also whether the outcomes being measured are those of importance to patients. This article reviews some of the available evidence on the congruence (or otherwise) of patient and professional views of outcome, and reports considerable variation between the 2 views. Reasons why views might differ are discussed (for example, disease activity might be assessed using different variables by patients and clinicians), and the possibility of the effect of the personal meaning or impact of an outcome for a patient is raised. Finally the significance of these discrepant views is addressed, posing the challenge of how we might incorporate a measure of the personal meaning of an outcome to a patient into our outcome measures.

摘要

在过去20年中,关节炎的疗效评估发生了重大转变,从过程指标(如血浆粘度)转向以患者为中心的疗效指标(如疼痛、功能)。然而,虽然许多这些疗效是由患者自我报告的,但指导临床决策并在临床试验中确定治疗效果的却是临床医生对这些报告的判断。确定患者与专业人员的观点是一致还是存在分歧,以及所测量的疗效是否是对患者重要的疗效,这一点很重要。本文回顾了一些关于患者与专业人员对疗效观点一致性(或不一致性)的现有证据,并报告了这两种观点之间存在相当大的差异。讨论了观点可能不同的原因(例如,患者和临床医生可能使用不同变量评估疾病活动度),并提出了疗效对患者的个人意义或影响可能产生作用的可能性。最后,探讨了这些不同观点的重要性,提出了如何将疗效对患者的个人意义纳入我们的疗效评估指标这一挑战。

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