Atkinson Thomas M, Andreotti Charissa F, Roberts Kailey E, Saracino Rebecca M, Hernandez Marisol, Basch Ethan
Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Ave, 7th Floor, New York, NY, 10022, USA.
University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Support Care Cancer. 2015 Dec;23(12):3645-52. doi: 10.1007/s00520-015-2923-2. Epub 2015 Aug 28.
The process of assessing patient symptoms and functionality using patient-reported outcomes (PROs) and functional performance status (FPS) is an essential aspect of patient-centered oncology research and care. However, PRO and FPS measures are often employed separately or inconsistently combined. Thus, the purpose of this study was to conduct a systematic review of the level of association between PRO and FPS measures to determine their differential or combined utility.
A systematic search was conducted using five databases (1966 to February 2014) to identify studies that described an association between PRO and FPS. Studies were excluded if they were non-cancer specific, did not include adults aged 18 or older, or were review articles. Publications were selected for review by consensus among two authors, with a third author arbitrating as needed.
A total of 18 studies met inclusion criteria. FPS was primarily assessed by clinicians using the ECOG Performance Status or Karnofsky Performance Status measures. PROs were captured using a variety of measures, with numerous domains assessed (e.g., pain, fatigue, and general health status). Concordance between PROs and FPS measures was widely variable, falling in the low to moderate range (0.09-0.72).
Despite consistency in the method of capture of PROs or FPS, domain capture varied considerably across reviewed studies. Irrespective of the method of capturing PROs or FPS, the quantified level of association between these two areas was moderate at best, providing evidence that FPS and PRO assessments offer unique information to assist clinicians in their decision-making.
使用患者报告结局（PROs）和功能表现状态（FPS）来评估患者症状和功能的过程，是肿瘤学以患者为中心的研究和护理的一个重要方面。然而，PRO和FPS测量方法常常单独使用或组合方式不一致。因此，本研究的目的是对PRO和FPS测量方法之间的关联程度进行系统评价，以确定它们各自的或联合的效用。
通过检索五个数据库（1966年至2014年2月）进行系统搜索，以识别描述PRO和FPS之间关联的研究。如果研究不是针对癌症的、未纳入18岁及以上成年人或为综述文章，则将其排除。由两位作者通过共识选择纳入综述的出版物，必要时由第三位作者进行仲裁。
共有18项研究符合纳入标准。FPS主要由临床医生使用东部肿瘤协作组（ECOG）体能状态或卡氏（Karnofsky）体能状态测量方法进行评估。PROs通过多种测量方法获取，评估了多个领域（如疼痛、疲劳和总体健康状况）。PROs和FPS测量方法之间的一致性差异很大，处于低到中等范围（0.09 - 0.72）。
尽管在获取PROs或FPS的方法上具有一致性，但在纳入综述的研究中领域获取差异很大。无论获取PROs或FPS的方法如何，这两个领域之间量化的关联程度充其量为中等，这表明FPS和PRO评估提供了独特的信息，以协助临床医生进行决策。
