Mohamed N E, Gilbert F, Lee C T, Sfakianos J, Knauer C, Mehrazin R, Badr H, Wittmann D, Downs T, Berry D, Given B, Wiklund P, Steineck G
Department of Urology, Icahn School of Medicine at Mount Sinai , New York, NY, USA.
Unaffiliated.
Bladder Cancer. 2016 Apr 27;2(2):139-149. doi: 10.3233/BLC-160051.
Patient-reported outcomes (PRO), including health-related quality of life (HRQOL) measures, represent important means for evaluating patients' health outcomes and for guiding health care decisions made by patients, practitioners, investigators, and policy makers. In spite of the large number of studies examining HRQOL in patients with bladder cancer, very few review articles investigated this topic. Because these review studies report mixed results, incorporating bladder cancer HRQOL measures into standard urological practice is not a viable option. In this non-systematic review of the literature and commentary we note some general concerns regarding PRO research, but our primary focus is on the HRQOL methodology within the context of two types of bladder cancer: muscle invasive and non-muscle invasive bladder cancer. Considering bladder cancer HRQOL as the interaction of four areas of the assessment process (i.e., what model of HRQOL to choose, what instruments are available to fit the choice, how interpretation of the resulting data fits the model, and how to derive some utility from the chosen model) and the two types of disease (i.e., muscle invasive and non-muscle invasive) may move us toward a better understanding of bladder cancer HRQOL. Establishing a useful model of perceived general health or specific symptoms is the first and most important step in developing the responsive bladder cancer HRQOL measures necessitated by clinical settings.
患者报告结局（PRO），包括与健康相关的生活质量（HRQOL）指标，是评估患者健康结局以及指导患者、从业者、研究人员和政策制定者做出医疗保健决策的重要手段。尽管有大量研究探讨膀胱癌患者的HRQOL，但很少有综述文章研究这一主题。由于这些综述研究报告的结果不一，将膀胱癌HRQOL指标纳入标准泌尿外科实践并非可行选择。在本次非系统性文献综述及评论中，我们指出了一些关于PRO研究的普遍问题，但我们主要关注的是两种类型膀胱癌（肌层浸润性和非肌层浸润性膀胱癌）背景下的HRQOL方法。将膀胱癌HRQOL视为评估过程四个领域的相互作用（即选择何种HRQOL模型、有哪些工具适合该选择、如何解读所得数据以符合该模型以及如何从所选模型中获得一些效用）以及两种疾病类型（即肌层浸润性和非肌层浸润性），可能会使我们更好地理解膀胱癌HRQOL。建立一个有用的感知总体健康或特定症状模型，是开发临床环境所需的反应性膀胱癌HRQOL指标的首要也是最重要的一步。
