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患者报告结局测量在足踝研究中的应用。

Use of patient-reported outcome measures in foot and ankle research.

机构信息

Department of Orthopaedic Surgery, Stanford University, 450 Broadway Street, MC 6342, Redwood City, CA 94063, USA.

出版信息

J Bone Joint Surg Am. 2013 Aug 21;95(16):e118(1-9). doi: 10.2106/JBJS.L.01476.

Abstract

BACKGROUND

In the orthopaedic literature, there is a wide range of clinical outcome measurement tools that have been used in evaluating foot and ankle procedures, disorders, and outcomes, with no broadly accepted consensus as to which tools are preferred. The purpose of this study was to determine the frequency and distribution of the various outcome instruments used in the foot and ankle literature, and to identify trends for use of these instruments over time.

METHODS

We conducted a systematic review of all original clinical articles reporting on foot and/or ankle topics in six orthopaedic journals over a ten-year period (2002 to 2011). All clinical patient-reported outcome rating instruments used in these articles were recorded, as were study date, study design, clinical topic, and level of evidence.

RESULTS

A total of 878 clinical foot and ankle articles that used at least one patient-reported outcome measure were identified among 16,513 total articles published during the ten-year period. There were 139 unique clinical outcome scales used, and the five most popular scales (as a percentage of foot/ankle outcome articles) were the American Orthopaedic Foot & Ankle Society (AOFAS) scales (55.9%), visual analog scale (VAS) for pain (22.9%), Short Form-36 (SF-36) Health Survey (13.7%), Foot Function Index (FFI) (5.5%), and American Academy of Orthopaedic Surgeons (AAOS) outcomes instruments (3.3%). The majority of articles described Level-IV studies (70.1%); only 9.4% reported Level-I studies.

CONCLUSIONS

A considerable variety of outcome measurement tools are used in the foot and ankle clinical literature, with a small proportion used consistently. The AOFAS scales continue to be used at a high rate relative to other scales that have been validated. Data from the present study underscore the need for a paradigm shift toward the use of consistent, valid, and reliable outcome measures for studies of foot and ankle procedures and disorders. It is not clear which existing validated outcome instruments will emerge as widely used and clinically meaningful.

CLINICAL RELEVANCE

These data support the need for a paradigm shift toward the consistent use of valid and reliable outcome measures for foot and ankle clinical research.

摘要

背景

在矫形外科文献中,有广泛的临床结果测量工具被用于评估足踝手术、疾病和结果,但没有广泛接受的共识,即哪些工具是首选的。本研究的目的是确定在足踝文献中使用的各种结果工具的频率和分布,并确定随着时间的推移这些工具的使用趋势。

方法

我们对六家矫形外科杂志在十年期间(2002 年至 2011 年)发表的所有报告足踝主题的原创临床文章进行了系统回顾。记录了这些文章中使用的所有临床患者报告的结果评估工具,以及研究日期、研究设计、临床主题和证据水平。

结果

在十年期间发表的 16513 篇总文章中,共确定了 878 篇使用至少一种患者报告结果测量的临床足踝文章。共使用了 139 种独特的临床结果量表,最受欢迎的五种量表(按足踝结果文章的百分比计算)为美国矫形足踝协会(AOFAS)量表(55.9%)、疼痛视觉模拟量表(VAS)(22.9%)、36 项简短健康调查(SF-36)(13.7%)、足功能指数(FFI)(5.5%)和美国矫形外科医师协会(AAOS)结果工具(3.3%)。大多数文章描述了四级研究(70.1%);只有 9.4%的文章报告了一级研究。

结论

在足踝临床文献中使用了大量的结果测量工具,只有一小部分被一致使用。AOFAS 量表的使用率相对较高,而其他经过验证的量表使用率较低。本研究的数据强调了需要向使用一致、有效和可靠的结果测量方法转变,以用于足踝手术和疾病的研究。目前尚不清楚哪些现有的经过验证的结果工具将被广泛使用并具有临床意义。

临床相关性

这些数据支持向使用一致、有效和可靠的足踝临床研究结果测量方法转变的需要。

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