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肥胖症手术患者报告的结局:报告标准的系统评价

Patient-reported outcomes in bariatric surgery: a systematic review of standards of reporting.

作者信息

Coulman K D, Abdelrahman T, Owen-Smith A, Andrews R C, Welbourn R, Blazeby J M

机构信息

Centre for Surgical Research, School of Social and Community Medicine, University of Bristol, Bristol, UK; Department of Bariatric and Upper GI Surgery, Musgrove Park Hospital, Taunton and Somerset NHS Foundation Trust, Taunton, Somerset, UK.

出版信息

Obes Rev. 2013 Sep;14(9):707-20. doi: 10.1111/obr.12041. Epub 2013 May 3.

Abstract

Bariatric surgery is increasingly being used to treat severe obesity, but little is known about its impact on patient-reported outcomes (PROs). For PRO data to influence practice, well-designed and reported studies are required. A systematic review identified prospective bariatric surgery studies that used validated PRO measures. Risk of bias in randomized controlled trials (RCTs) was assessed, and papers were examined for reporting of (i) who completed PRO measures; (ii) missing PRO data and (iii) clinical interpretation of PRO data. Studies meeting all criteria were classified as robust. Eighty-six studies were identified. Of the eight RCTs, risk of bias was high in one and unclear in seven. Sixty-eight different PRO measures were identified, with the Short Form (SF)-36 questionnaire most commonly used. Forty-one (48%) studies explicitly stated measures were completed by patients, 63 (73%) documented missing PRO data and 50 (58%) interpreted PRO data clinically. Twenty-six (30%) met all criteria. Although many bariatric surgery studies assess PROs, study design and reporting is often poor, limiting data interpretation and synthesis. Well-designed studies that include agreed PRO measures are needed with reporting to include integration with clinical outcomes to inform practice.

摘要

减肥手术越来越多地被用于治疗重度肥胖,但对于其对患者报告结局(PROs)的影响却知之甚少。为了让PRO数据影响临床实践,需要精心设计并报告相关研究。一项系统评价确定了使用经过验证的PRO测量方法的前瞻性减肥手术研究。评估了随机对照试验(RCT)中的偏倚风险,并检查论文中关于以下方面的报告:(i)谁完成了PRO测量;(ii)PRO数据缺失情况;(iii)PRO数据的临床解读。符合所有标准的研究被归类为可靠研究。共识别出86项研究。在8项RCT中,1项偏倚风险高,7项不明确。共识别出68种不同的PRO测量方法,其中最常用的是简短健康调查(SF)-36问卷。41项(48%)研究明确指出测量由患者完成,63项(73%)记录了PRO数据缺失情况,50项(58%)对PRO数据进行了临床解读。26项(30%)符合所有标准。尽管许多减肥手术研究评估了PROs,但研究设计和报告往往较差,限制了数据的解读和综合。需要精心设计的研究,包括采用公认的PRO测量方法,并在报告中纳入与临床结局的整合,以为临床实践提供参考。

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