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患者报告结局测量信息系统(PROMIS)测量方法在成人神经纤维瘤病患者中的首次应用。

First use of patient reported outcomes measurement information system (PROMIS) measures in adults with neurofibromatosis.

作者信息

Talaei-Khoei Mojtaba, Riklin Eric, Merker Vanessa L, Sheridan Monica R, Jordan Justin T, Plotkin Scott R, Vranceanu Ana-Maria

机构信息

Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Department of Psychiatry, Benson-Henry Institute of Mind Body Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

出版信息

J Neurooncol. 2017 Jan;131(2):413-419. doi: 10.1007/s11060-016-2314-7. Epub 2016 Nov 29.

Abstract

The patient reported outcomes measurement information system (PROMIS) provides clinicians and researchers access to reliable, validated measures of physical, mental, and social well-being. The use of PROMIS can facilitate comparisons among clinical subpopulations and with the U.S. general population. We report on the first study using PROMIS measures in patients with neurofibromatosis (NF). Eighty-six adult patients (mean age = 44; 55% female; 87% white; 50% NF1, 41% NF2 and 9% schwannomatosis) completed a battery of PROMIS computerized adaptive tests (CATs). Across all PROMIS instruments, mean scores for each CAT were between 48.97 and 52.60, which is within ±0.5 SD of the U.S. general population norms. However, scores were distributed across a broad range for each PROMIS measure (±3 SDs). Clinically meaningful scores (defined >1 SD impairment) were observed in 20% (pain interference), 17% (pain behavior), 16% (physical function), 16% (anxiety), 16% (depression), 15% (satisfaction with social roles), 13% (fatigue), 6% (anger), and 5% (satisfaction with discretionary social activities) of the sample. All PROMIS measures were highly interrelated in bivariate analysis (P ≤ .001). There were no differences in PROMIS scores by disease type (NF1, NF2 and schwannomatosis), or self reported learning disabilities, or compared with the US population. Scores suggest a broad continuum of symptoms and functioning in patients with NF that is not affected by NF type, as well as interrelation among the physical and psychosocial domains as measured by PROMIS. PROMIS measures may be useful in clinical practice to monitor changes in symptoms and functioning over time, as well as in clinical trials to determine patient reported changes during drug and psychosocial clinical trials.

摘要

患者报告结局测量信息系统(PROMIS)为临床医生和研究人员提供了获取有关身体、心理和社会福祉的可靠、经过验证的测量方法的途径。使用PROMIS有助于临床亚组之间以及与美国普通人群进行比较。我们报告了第一项在神经纤维瘤病(NF)患者中使用PROMIS测量方法的研究。86名成年患者(平均年龄 = 44岁;55%为女性;87%为白人;50%为NF1型,41%为NF2型,9%为神经鞘瘤病)完成了一系列PROMIS计算机自适应测试(CAT)。在所有PROMIS工具中,每个CAT的平均得分在48.97至52.60之间,这在美国普通人群规范的±0.5个标准差范围内。然而,每个PROMIS测量指标的得分分布范围都很广(±3个标准差)。在样本的20%(疼痛干扰)、17%(疼痛行为)、16%(身体功能)、16%(焦虑)、16%(抑郁)、15%(对社会角色的满意度)、13%(疲劳)、6%(愤怒)和5%(对自主社交活动的满意度)中观察到具有临床意义的得分(定义为>1个标准差的损害)。在双变量分析中,所有PROMIS测量指标都高度相关(P≤0.001)。PROMIS得分在疾病类型(NF1、NF2和神经鞘瘤病)、自我报告的学习障碍方面没有差异,与美国人群相比也没有差异。得分表明NF患者存在广泛的症状和功能连续体,不受NF类型影响,以及PROMIS所测量的身体和心理社会领域之间的相互关系。PROMIS测量方法在临床实践中可能有助于监测症状和功能随时间的变化,以及在临床试验中确定患者在药物和心理社会临床试验期间报告的变化。

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