Laas Enora, Zacharopoulou Chrysoula, Montanari Giulia, Seracchioli Renato, Abrão Mauricio S, Bassi Marco A, Ballester Marcos, Daraï Emile
Department of Obstetrics and Gynecology, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Université Pierre et Marie Curie Paris VI, Paris, France.
Minimally Invasive Gynaecological Surgery Unit, S'ant Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
J Minim Invasive Gynecol. 2015 Mar-Apr;22(3):378-83. doi: 10.1016/j.jmig.2014.06.005. Epub 2014 Jun 13.
To evaluate the external validity of the validated French model of the quality-of-life questionnaire (QOL) SF-36 in predicting improvement after colorectal resection for endometriosis.
Italian and Brazilian cohort studies (Canadian Task Force classification II-3).
Tertiary referral university hospital in Brazil and expert center in endometriosis in Italy.
Patients with colorectal endometriosis from an Italian population (n = 63) and a Brazilian population (n = 151).
Laparoscopic colorectal resection for treatment of endometriosis.
Preoperative and postoperative evaluations of the Physical Component Summary (PCS) and the Mental Component Summary (MCS) of the SF-36 were performed. Substantial improvement in PCS and MCS was observed after colorectal resection in both populations. In the Brazilian population, the receiver operating curve (ROC) (area under the curve [AUC]) was 0.83 (95% confidence interval [CI], 0.77-0.89) for MCS and 0.78 (95% CI, 0.71-0.83) for PCS, demonstrating good discrimination performance. The mean difference between the predicted and calibrated probabilities was 19.6% for MCS and 32.8% for PCS. In the Italian population, the ROC curve (AUC) was 0.65 (95% CI, 0.52-0.78) for PCS and 0.67 (95% CI, 0.55-0.78) for MCS. The model demonstrated poor discrimination and calibration performance for PCS (p < .001) and MCS (p = .003). The mean difference between the predicted and calibrated probabilities was 17.5% for MCS and 21.8% for PCS.
Despite the use of validated translations of the SF-36, our results underline the limits of this tool in selection of patients for colorectal resection due to underestimation of predicted quality of life, possibly because of variations in epidemiologic characteristics of the populations.
评估经过验证的法国生活质量问卷（QOL）SF - 36模型在预测子宫内膜异位症结直肠切除术后改善情况方面的外部有效性。
意大利和巴西队列研究（加拿大工作组分类II - 3）。
巴西的三级转诊大学医院和意大利的子宫内膜异位症专家中心。
来自意大利人群（n = 63）和巴西人群（n = 151）的结直肠子宫内膜异位症患者。
采用腹腔镜结直肠切除术治疗子宫内膜异位症。
对SF - 36的身体成分总结（PCS）和精神成分总结（MCS）进行术前和术后评估。在两个群体中，结直肠切除术后PCS和MCS均有显著改善。在巴西人群中，MCS的受试者工作特征曲线（ROC）（曲线下面积[AUC]）为0.83（95%置信区间[CI]，0.77 - 0.89），PCS为0.78（95% CI，0.71 - 0.83），显示出良好的辨别性能。预测概率与校准概率之间的平均差异，MCS为19.6%，PCS为32.8%。在意大利人群中，PCS的ROC曲线（AUC）为0.65（95% CI，0.52 - 0.78），MCS为0.67（95% CI，0.55 - 0.78）。该模型在PCS（p <.001）和MCS（p =.003）方面显示出较差的辨别和校准性能。预测概率与校准概率之间的平均差异，MCS为17.5%，PCS为21.8%。
尽管使用了经过验证的SF - 36翻译版本，但我们的结果强调了该工具在因预测生活质量被低估而选择结直肠切除术患者时的局限性，这可能是由于人群流行病学特征的差异所致。
