Kalyoncu U, Dougados M, Daurès J-P, Gossec L
Paris Descartes University, Medicine Faculty, Paris, France.
Ann Rheum Dis. 2009 Feb;68(2):183-90. doi: 10.1136/ard.2007.084848. Epub 2008 Mar 28.
Patient-reported outcomes (PROs) have been increasingly recognised as important in rheumatoid arthritis (RA). The objective of this study was to assess the frequency of use of different PROs in recently published RA articles and to compare the tools used through a systemic literature review.
(1) DATA SOURCE: In PUBMED MEDLINE database, articles reporting any type of clinical study for adult patients with RA, published between February 2005 and February 2007, and reporting any type of PRO. Articles were excluded if they did not concern adult RA or if they did not report any PROs. (2) DATA EXTRACTION: demographic characteristics of patients, study design, treatment assessed and all PROs. (3) DATA ANALYSIS: descriptive.
Of 109 reports, 50 (45%) were randomised controlled trials and 59 were other types of studies. A total of 63 questionnaires or tools for PROs were used, corresponding to 14 domains of health. Frequently reported domains (and most frequent tools) were: function, 83% (most frequent tool, health assessment questionnaire, HAQ); patient global assessment, 61% (most frequent tool, visual analogue scale, VAS); pain, 56% (VAS); and morning stiffness 27%. Domains such as fatigue, coping or sleep disturbance were infrequently reported.
PROs are reported with great heterogeneity in recently published trials in RA. Some domains that appear important from the patient's perspective are infrequently reported. Further work is needed in this field.
患者报告结局(PROs)在类风湿关节炎(RA)中的重要性已得到越来越多的认可。本研究的目的是评估近期发表的RA文章中不同PROs的使用频率,并通过系统文献综述比较所使用的工具。
(1)数据来源:在PUBMED MEDLINE数据库中,检索2005年2月至2007年2月期间发表的、报告针对成年RA患者的任何类型临床研究且报告了任何类型PROs的文章。如果文章不涉及成年RA或未报告任何PROs,则将其排除。(2)数据提取:患者的人口统计学特征、研究设计、评估的治疗方法以及所有PROs。(3)数据分析:描述性分析。
在109篇报告中,50篇(45%)为随机对照试验,59篇为其他类型的研究。总共使用了63种用于PROs的问卷或工具,对应14个健康领域。经常报告的领域(以及最常用的工具)为:功能,83%(最常用工具为健康评估问卷,HAQ);患者整体评估,61%(最常用工具为视觉模拟量表,VAS);疼痛,56%(VAS);晨僵,27%。诸如疲劳、应对或睡眠障碍等领域报告较少。
在近期发表的RA试验中,PROs的报告存在很大异质性。一些从患者角度看来很重要的领域报告较少。该领域需要进一步开展工作。