Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, 3300 Thurston Building, CB #7280, Chapel Hill, NC 27599-7280; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC; Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, 3300 Thurston Building, CB #7280, Chapel Hill, NC 27599-7280; Health Services Research & Development, VA Medical Center, Durham, NC; Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Semin Arthritis Rheum. 2015 Oct;45(2):123-31. doi: 10.1016/j.semarthrit.2015.04.008. Epub 2015 Apr 10.
Although many treatment guidelines exist for hip and knee osteoarthritis (OA), uptake in clinical practice is typically low. Valid patient-reported outcome measures (PROs) that can be easily used in the clinic could aid implementation and evaluation of treatment recommendations, and the tracking of symptoms and function over time. This project responded to a 2012 Call to Action of the Chronic Osteoarthritis Management Initiative of the United States Bone and Joint Initiative; we aimed to develop a tiered list of recommended PROs that could be feasibly applied in common clinical settings, across four domains of pain, function, fatigue, and sleep.
PROs were identified through a focused literature review. Clinicians and researchers with OA expertise evaluated each measure' feasibility for use in routine clinical practice, followed by meaningfulness in assessing OA outcomes. Eligible PROs were categorized by domain and ranked into Tiers One (very brief measures for initial use in clinical settings), Two (brief measures with more in-depth assessment), and Three (most detailed assessment).
Total PROs identified were 172 for pain, 160 for function, 55 for fatigue, and 60 for sleep. Of these, 9 pain, 7 function, 7 fatigue, and 8 sleep PROs were ranked into one of three tiers.
This three-tiered list of recommended PROs provides a basis for tools to systematically track outcomes, facilitate provider-patient dialog, and guide treatment for hip or knee OA. Research is needed to test the utility and feasibility of systematic implementation of these measures in primary care and specialty clinical settings.
尽管有许多针对髋和膝关节骨关节炎（OA）的治疗指南，但在临床实践中的应用率通常较低。能够在临床中轻松使用的有效患者报告结局（PRO）可以帮助实施和评估治疗建议，并跟踪随时间推移的症状和功能。本项目响应了美国骨骼与关节倡议慢性骨关节炎管理倡议 2012 年的一项行动呼吁；我们旨在制定一个分层推荐的 PRO 列表，这些 PRO 可以在四个疼痛、功能、疲劳和睡眠领域中，在常见的临床环境中可行地应用。
通过重点文献回顾确定 PRO。具有 OA 专业知识的临床医生和研究人员评估了每个测量方法在常规临床实践中的可行性，然后评估其评估 OA 结局的意义。合格的 PRO 按域分类，并分为一级（在临床环境中初步使用的非常简短的措施）、二级（具有更深入评估的简短措施）和三级（最详细的评估）。
总共确定了 172 项疼痛 PRO、160 项功能 PRO、55 项疲劳 PRO 和 60 项睡眠 PRO。其中，9 项疼痛、7 项功能、7 项疲劳和 8 项睡眠 PRO 被分为三个等级之一。
该推荐 PRO 的三级列表为系统跟踪结果、促进医患对话和指导髋或膝关节 OA 治疗提供了基础。需要研究这些措施在初级保健和专业临床环境中系统实施的实用性和可行性。
