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如何为临床试验选择核心结局指标集:OMERACT 11批准了筛选标准2.0。

How to choose core outcome measurement sets for clinical trials: OMERACT 11 approves filter 2.0.

作者信息

Boers Maarten, Kirwan John R, Gossec Laure, Conaghan Philip G, D'Agostino Maria-Antonietta, Bingham Clifton O, Brooks Peter M, Landewé Robert, March Lyn, Simon Lee, Singh Jasvinder A, Strand Vibeke, Wells George A, Tugwell Peter

机构信息

From the Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands; University of Bristol, Academic Rheumatology Unit, Bristol Royal Infirmary, Bristol, UK; Université Pierre et Marie Curie (UPMC) - Paris 6, GRC-UMPC 08 (EEMOIS), Paris, France; APHP, Hôpital Pitié-Salpêtrière, Rhumatologie; University of Leeds and UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; Department of Rheumatology, APHP, Ambroise Paré Hospital, UPRES EA 2506 Université Versailles-Saint Quentin En Yvelines, Boulogne-Billancourt, France; Division of Rheumatology, Johns Hopkins University, Baltimore, Maryland, USA; Australian Health Workforce Institute, School of Population Health, University of Melbourne, Melbourne, Australia; Academic Medical Center University of Amsterdam and Atrium Medical Center Heerlen, Heerlen, The Netherlands; Institute of Bone and Joint Research and Sydney Medical School and School of Public Health, University of Sydney, and Department of Rheumatology, Royal North Shore, St. Leonards, NSW, Australia; SDG LLC, Cambridge, Massachusetts; University of Alabama at Birmingham; Veterans Affairs Medical Center, Birmingham, Alabama; Mayo Clinic College of Medicine, Rochester, Minnesota; Division of Immunology/Rheumatology, Stanford University School of Medicine, Palo Alto, California, USA; Department of Epidemiology and Community Medicine, and Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.

出版信息

J Rheumatol. 2014 May;41(5):1025-30. doi: 10.3899/jrheum.131314. Epub 2014 Mar 1.

Abstract

OBJECTIVE

The Outcome Measures in Rheumatology (OMERACT) initiative works to develop core sets of outcome measures for trials and observational studies in rheumatology. At the OMERACT 11 meeting, substantial time was devoted to discussing a conceptual framework and a proposal for a more explicit working process to develop what we now propose to term core outcome measurement sets, collectively termed "OMERACT Filter 2.0."

METHODS

Preconference work included a literature review, and discussion of preliminary proposals through face-to-face discussions and Internet-based surveys with people within and outside rheumatology. At the conference, 5 interactive sessions comprising plenary and small-group discussions reflected on the proposals from the viewpoint of previous and ongoing OMERACT work. These considerations were brought together in a final OMERACT presentation seeking consensus agreement for the Filter 2.0 framework.

RESULTS

After debate, clarification, and agreed alterations, the final proposal suggested all core sets should contain at least 1 measurement instrument from 3 Core Areas: Death, Life Impact, and Pathophysiological Manifestations, and preferably 1 from the area Resource Use. The process of core set development for a health condition starts by selecting core domains within the areas ("core domain set"). This requires literature searches, involvement (especially of patients), and at least 1 consensus process. Next, developers select at least 1 applicable measurement instrument for each core domain. Applicability refers to the original OMERACT Filter and means that the instrument must be truthful (face, content, and construct validity), discriminative (between situations of interest) and feasible (understandable and with acceptable time and monetary costs). Depending on the quality of the instruments, participants formulate either a preliminary or a final "core outcome measurement set." At final vote, 96% of participants agreed "The proposed overall framework for Filter 2.0 is a suitable basis on which to elaborate a Filter 2.0 Handbook."

CONCLUSION

Within OMERACT, Filter 2.0 has made established working processes more explicit and includes a broadly endorsed conceptual framework for core outcome measurement set development.

摘要

目的

风湿病疗效评估指标(OMERACT)计划致力于为风湿病的试验和观察性研究制定核心疗效评估指标集。在OMERACT 11会议上,花了大量时间讨论一个概念框架以及一项关于制定我们现在提议称为核心结局测量集(统称为“OMERACT Filter 2.0”)的更明确工作流程的提案。

方法

会前工作包括文献综述,以及通过与风湿病领域内外人员进行面对面讨论和基于互联网的调查来讨论初步提案。在会议上,5个互动环节(包括全体会议和小组讨论)从以往和正在进行的OMERACT工作的角度对提案进行了思考。这些考量在最后的OMERACT报告中汇总,以寻求对Filter 2.0框架的共识。

结果

经过辩论、澄清和商定的修改后,最终提案建议所有核心集应至少包含来自3个核心领域(死亡、生活影响和病理生理表现)的1种测量工具,最好还包含来自资源利用领域的1种测量工具。针对一种健康状况制定核心集的过程始于在这些领域内选择核心领域(“核心领域集”)。这需要进行文献检索、多方参与(尤其是患者)以及至少1次共识达成过程。接下来,开发者为每个核心领域选择至少1种适用的测量工具。适用性指的是最初的OMERACT Filter,意味着该工具必须真实可靠(表面效度、内容效度和结构效度)、具有区分性(在感兴趣的情况之间)且可行(易于理解且时间和金钱成本可接受)。根据工具的质量,参与者制定初步或最终的“核心结局测量集”。在最终投票中,96%的参与者同意“提议的Filter 2.0总体框架是详细制定Filter 2.0手册的合适基础”。

结论

在OMERACT范围内,Filter 2.0使既定的工作流程更加明确,并包括一个得到广泛认可的核心结局测量集开发概念框架。

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