School of Health and Related Research, University of Sheffield, Sheffield, UK.
School of Social Sciences, Leeds Beckett University, Leeds, UK.
Br J Surg. 2017 Mar;104(4):317-327. doi: 10.1002/bjs.10407. Epub 2016 Dec 9.
The aim was to identify and evaluate existing patient-reported outcome measures (PROMs) for use in patients with an abdominal aortic aneurysm (AAA) to inform the selection for use in surgical practice.
Two reviews were conducted: a systematic review to identify valid, reliable and acceptable PROMs for patients with an AAA, and a qualitative evidence synthesis to assess the relevance to patients of the identified PROM items. PROM studies were evaluated for their psychometric properties using established assessment criteria, and for their methodological quality using the COSMIN checklist. Qualitative studies were synthesized using framework analysis, and concepts identified were then triangulated using a protocol with the item concepts of the identified PROMs.
Four PROMs from three studies were identified in the first review: Short Form 36, Australian Vascular Quality of Life Index, Aneurysm Dependent Quality of Life (AneurysmDQoL) and Aneurysm Symptoms Rating Questionnaire (AneurysmSRQ). None of the identified PROMs had undergone a rigorous psychometric evaluation within the AAA population. Four studies were included in the qualitative synthesis, from which 28 concepts important to patients with an AAA were identified. The AneurysmDQoL and AneurysmSRQ together provided the most comprehensive assessment of these concepts. Fear of rupture, control, ability to forget about the condition and size of aneurysm were all concepts identified in the qualitative studies but not covered by items in the identified PROMs.
Further research is needed to develop PROMs for AAA that are reliable, valid and acceptable to patients.
本研究旨在识别和评估现有的用于腹主动脉瘤（AAA）患者的患者报告结局测量（PROM）工具，以为手术实践中的选择提供信息。
进行了两项综述：一项系统综述旨在识别用于 AAA 患者的有效、可靠和可接受的 PROM，另一项定性证据综合评估确定的 PROM 项目与患者的相关性。使用既定的评估标准评估 PROM 研究的心理测量特性，并使用 COSMIN 清单评估其方法学质量。使用框架分析对定性研究进行综合，并使用与确定的 PROM 项目概念相关的协议对确定的概念进行三角测量。
在第一项综述中，从三项研究中确定了四项 PROM：简短表格 36 项、澳大利亚血管生活质量指数、AAA 相关生活质量（AneurysmDQoL）和 AAA 症状评分问卷（AneurysmSRQ）。在 AAA 人群中，没有一项确定的 PROM 经过严格的心理测量评估。定性综合纳入了四项研究，从中确定了 28 个对 AAA 患者重要的概念。AneurysmDQoL 和 AneurysmSRQ 共同提供了对这些概念的最全面评估。破裂恐惧、控制感、忘记病情的能力和动脉瘤大小均为定性研究中确定的概念，但未包含在确定的 PROM 项目中。
需要进一步研究开发可靠、有效和可被患者接受的 AAA PROM。
