Department of Dermatology and Academic Wound Healing, Division of Infection and Immunity, School of Medicine, Cardiff University, 3rd Floor Glamorgan House, Heath Park, Cardiff, CF14 4XN, U.K.
Centro de la Piel, Quito, Ecuador.
Br J Dermatol. 2017 Mar;176(3):577-593. doi: 10.1111/bjd.14788. Epub 2016 Oct 12.
Planners of interventional studies in psoriasis face the dilemma of selecting suitable quality-of-life (QoL) measures. Systematic reviews have the potential of identifying psychometrically sound measures in a given therapeutic area, while guiding the development of practice guidelines. The aim of this systematic review was to generate evidence of the use of QoL instruments in randomized controlled trials (RCTs) for interventions in psoriasis. The methodology followed the PRISMA guidelines. Six databases were searched with 388 search terms. Abstracts of articles were reviewed independently by two assessors, and a third adjudicator resolved any opinion differences. Risk of bias was assessed using the Jadad scale. Of 3646 screened publications, 99 articles (100 trials) met the eligibility criteria for inclusion, describing research on 33 215 patients. Thirty-three trials tested topical therapy, 18 systemic, 39 biologics, nine phototherapy and 10 other interventions. The Dermatology Life Quality Index (DLQI) was the most commonly used QoL instrument (83 studies, 83%), followed by the 36-Item Short Form Survey (SF-36) (31, 31%), EuroQoL-5D (EQ-5D) (15, 15%), Psoriasis Disability Index (14, 14%) and Skindex (five, 5%). There was widespread inconsistency in the way that QoL data were reported. Of the 100 trials identified, 37 reported minimal clinically important difference (MCID): 32 for DLQI, 10 for SF-36 and six for EQ-5D. QoL measurement is increasingly being reported in RCTs of psoriasis. Formal guidelines are needed for assessment and publishing of QoL data. Researchers should consider whether MCID information is available, and development of MCID data should be encouraged.
在银屑病的干预性研究中，规划者面临着选择合适的生活质量（QoL）测量方法的困境。系统评价有可能在特定的治疗领域中确定具有心理测量学意义的测量方法，同时指导实践指南的制定。本系统评价的目的是生成 QoL 工具在银屑病干预随机对照试验（RCT）中使用的证据。该方法遵循 PRISMA 指南。使用 388 个检索词对六个数据库进行了检索。文章的摘要由两名评估员独立审查，第三位裁决员解决任何意见分歧。使用 Jadad 量表评估偏倚风险。在 3646 篇筛选的出版物中，有 99 篇文章（100 项试验）符合纳入标准，共描述了 33215 名患者的研究。33 项试验测试了局部治疗，18 项系统治疗，39 项生物制剂，9 项光疗和 10 项其他干预措施。皮肤病生活质量指数（DLQI）是最常用的 QoL 工具（83 项研究，83%），其次是 36 项简短健康调查问卷（SF-36）（31 项，31%）、欧洲五维健康量表（EQ-5D）（15 项，15%）、银屑病残疾指数（14 项，14%）和 Skindex（5 项，5%）。QoL 数据的报告方式存在广泛的不一致。在所确定的 100 项试验中，有 37 项报告了最小临床重要差异（MCID）：DLQI 有 32 项，SF-36 有 10 项，EQ-5D 有 6 项。在银屑病的 RCT 中，越来越多地报告了 QoL 测量。需要制定评估和发布 QoL 数据的正式指南。研究人员应考虑是否有 MCID 信息可用，并应鼓励制定 MCID 数据。
