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国际卵巢癌随机对照试验方案中的患者报告结局内容。

The patient-reported outcome content of international ovarian cancer randomised controlled trial protocols.

作者信息

Mercieca-Bebber Rebecca, Friedlander Michael, Kok Peey-Sei, Calvert Melanie, Kyte Derek, Stockler Martin, King Madeleine T

机构信息

Central Clinical School, Sydney Medical School, University of Sydney, Sydney, NSW, 2006, Australia.

Quality of Life Office, Psycho-oncology Co-operative Research Group, School of Psychology, University of Sydney, Level 6 North, Chris O'Brien Lifehouse C39Z, Sydney, NSW, 2006, Australia.

出版信息

Qual Life Res. 2016 Oct;25(10):2457-2465. doi: 10.1007/s11136-016-1339-x. Epub 2016 Jun 13.

Abstract

PURPOSE

Patient-reported outcomes (PROs) provide the patient's perspective of the impact of treatment. Evidence suggests that PRO content of randomised controlled trials (RCTs) protocols is generally sub-optimal. This study aimed to describe and evaluate the PRO-specific content of ovarian cancer RCT protocols.

METHODS

Published, phase III, ovarian cancer RCTs with PRO endpoints were identified following a systematic search of Medline and Cochrane databases (Jan 2000 to Feb 2016). Corresponding RCT protocols were downloaded (if published) or obtained by contacting authors. Two investigators independently assessed adherence of PRO-specific content of included protocols to a checklist of 58 recommended PRO protocol items currently being developed by the International Society for Quality of Life Research. Discrepancies were resolved with a third investigator.

RESULTS

Of 41 eligible trials identified, 26 protocols were assessed (developed 1995-2010). We were unable to obtain the remaining 15 protocols. Protocols addressed a mean of 28 % PRO checklist items (range 8-66 %). Fifteen (58 % of assessed protocols) provided a rationale for PRO assessment, 8 (31 %) described a PRO objective, 24 (92 %) included a PRO assessment schedule, but only 6 (23 %) justified timing of PRO assessments. Twelve protocols (46 %) provided staff data collection instructions, 4 (15 %) included plans for monitoring PRO compliance, and 16 (62 %) included a PRO analysis plan.

CONCLUSIONS

On average, protocols addressed less than one-third of PRO protocol checklist items. In some cases, key guidance regarding PRO administration was lacking, which may lead to inconsistent and sub-optimal PRO methodology. Efforts are needed to improve PRO protocol content in cancer trials.

摘要

目的

患者报告结局(PROs)提供了患者对治疗影响的看法。有证据表明,随机对照试验(RCTs)方案中的PRO内容通常不够理想。本研究旨在描述和评估卵巢癌RCT方案中特定于PRO的内容。

方法

在对Medline和Cochrane数据库进行系统检索(2000年1月至2016年2月)后,确定了已发表的、III期、具有PRO终点的卵巢癌RCT。下载相应的RCT方案(如果已发表),或通过联系作者获取。两名研究人员独立评估纳入方案中PRO特定内容对国际生活质量研究协会目前正在制定的58项推荐PRO方案项目清单的依从性。分歧由第三名研究人员解决。

结果

在确定的41项符合条件的试验中,评估了26项方案(制定于1995 - 2010年)。我们无法获得其余15项方案。方案平均涉及PRO清单项目的28%(范围为8% - 66%)。15项(58%的评估方案)提供了PRO评估的理由,8项(31%)描述了PRO目标,24项(92%)包括PRO评估时间表,但只有6项(23%)对PRO评估的时间安排进行了说明。12项方案(46%)提供了工作人员数据收集说明,4项(15%)包括监测PRO依从性的计划,16项(62%)包括PRO分析计划。

结论

平均而言,方案涉及的PRO方案清单项目不到三分之一。在某些情况下,缺乏关于PRO管理的关键指导,这可能导致PRO方法不一致且不够理想。需要努力改进癌症试验中PRO方案的内容。

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