用于膝关节骨关节炎试验荟萃分析的患者报告结局层次结构:来自高影响力期刊调查的实证证据
A hierarchy of patient-reported outcomes for meta-analysis of knee osteoarthritis trials: empirical evidence from a survey of high impact journals.
作者信息
Juhl Carsten, Lund Hans, Roos Ewa M, Zhang Weiya, Christensen Robin
机构信息
Research Unit for Musculoskeletal Function and Physiotherapy, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230 Odense M, Denmark.
出版信息
Arthritis. 2012;2012:136245. doi: 10.1155/2012/136245. Epub 2012 Jun 26.
Objectives. To develop a prioritised list based on responsiveness for extracting patient-reported outcomes (PROs) measuring pain and disability for performing meta-analyses in knee osteoarthritis (OA). Methods. A systematic search was conducted in 20 highest impact factor general and rheumatology journals chosen a priori. Eligible studies were randomised controlled trials, using two or more PROs measuring pain and/or disability. Results. A literature search identified 402 publications and 38 trials were included, resulting in 54 randomised comparisons. Thirty-five trials had sufficient data on pain and 15 trials on disability. The WOMAC "pain" and "function" subscales were the most responsive composite scores. The following list was developed. Pain: (1) WOMAC "pain" subscale, (2) pain during activity (VAS), (3) pain during walking (VAS), (4) general knee pain (VAS), (5) pain at rest (VAS), (6) other composite pain scales, and (7) other single item measures. Disability: (1) WOMAC "function" subscale, (2) SF-36 "physical function" subscale, (3) SF-36 (Physical composite score), and (4) Other composite disability scores. Conclusions. As choosing the PRO most favourable for the intervention from individual trials can lead to biased estimates, using a prioritised list as developed in this study is recommended to reduce risk of biased selection of PROs in meta-analyses.
目的。制定一份基于反应性的优先列表,用于提取患者报告结局(PROs),以测量疼痛和残疾情况,从而在膝关节骨关节炎(OA)中进行荟萃分析。方法。对事先选定的20种影响因子最高的综合类和风湿病学杂志进行系统检索。符合条件的研究为随机对照试验,使用两种或更多测量疼痛和/或残疾的PROs。结果。文献检索确定了402篇出版物,纳入了38项试验,产生了54个随机对照比较。35项试验有关于疼痛的充分数据,15项试验有关于残疾的充分数据。WOMAC“疼痛”和“功能”子量表是反应性最强的综合评分。制定了以下列表。疼痛:(1)WOMAC“疼痛”子量表,(2)活动时疼痛(视觉模拟评分法[VAS]),(3)行走时疼痛(VAS),(4)膝关节总体疼痛(VAS),(5)静息时疼痛(VAS),(6)其他综合疼痛量表,以及(7)其他单项测量。残疾:(1)WOMAC“功能”子量表,(2)SF-36“身体功能”子量表,(3)SF-36(身体综合评分),以及(4)其他综合残疾评分。结论。由于从个别试验中选择对干预最有利的PROs可能导致有偏倚的估计,建议使用本研究中制定的优先列表,以降低荟萃分析中PROs选择有偏倚的风险。
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