Hermans C, Klamroth R, Richards M, de Moerloose P, Garrido R P
Haemostasis and Thrombosis Unit, Division of Haematology, Cliniques universitaires Saint-Luc, Catholic University of Louvain, Brussels, Belgium.
Klinik für Innere Medizin, Hämophiliezentrum, Vivantes-Klinikum in Friedrichhain, Berlin, Germany.
Haemophilia. 2017 Mar;23(2):222-229. doi: 10.1111/hae.13085. Epub 2016 Oct 27.
This study was conducted to evaluate the current implementation of outcome measures in routine clinical haemophilia practice and to explore and appreciate the perception of the relevance of such measures by treaters.
A survey was completed by 19 of the 26 physicians involved in the European Haemophilia Therapy Strategy Board (EHTSB). Employing an extensive inventory of outcome measures used in patients with haemophilia, information was collected about the frequency of data collection and the subjective appreciation of their importance during clinic review.
The survey revealed that most treaters currently collect data that are mainly related to the haemostatic treatment (consumption of concentrates) and the bleeding symptoms (number and location of bleeds) in a non-uniform and non-standardized way. By contrast, functional, physical and quality of life scorings are rarely used and show considerable heterogeneity between treaters. Also, many disparities emerged between practice and perception, in particular quality of life data that are perceived as being important but for most of the time are not collected.
This survey represents, in our view, the first attempt to evaluate the actual utilization of outcome measures in haemophilia care. While the value of outcome measures is appreciated, they are not assessed regularly. Therefore, there is a need to include appropriate performance indicators (outcome measures) of haemophilia care in routine clinical practice. Consensus recommendations to provide a framework for achieving this aim are provided.
本研究旨在评估血友病常规临床实践中结局指标的当前实施情况,并探讨和了解治疗人员对这些指标相关性的看法。
参与欧洲血友病治疗策略委员会(EHTSB)的26名医生中有19名完成了一项调查。利用血友病患者使用的大量结局指标清单,收集了有关数据收集频率以及在临床复查期间对其重要性的主观评价的信息。
调查显示,目前大多数治疗人员以不统一、不标准化的方式收集主要与止血治疗(凝血因子消耗量)和出血症状(出血次数和部位)相关的数据。相比之下,功能、身体和生活质量评分很少使用,并且不同治疗人员之间存在很大差异。此外,实践与认知之间也出现了许多差异,特别是生活质量数据,虽然被认为很重要,但大多数时候并未收集。
我们认为,这项调查是评估血友病治疗中结局指标实际应用情况的首次尝试。虽然结局指标的价值得到认可,但并未定期进行评估。因此,有必要在常规临床实践中纳入血友病治疗的适当绩效指标(结局指标)。本文提供了达成这一目标的共识性建议,以提供一个框架。