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基于价值的乳腺癌患者为中心的结局标准集:国际健康结果测量联合会(ICHOM)倡议。

A Standard Set of Value-Based Patient-Centered Outcomes for Breast Cancer: The International Consortium for Health Outcomes Measurement (ICHOM) Initiative.

机构信息

Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia2Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne Australia.

International Consortium for health outcomes Measurement, Cambridge, Massachusetts4Dutch Institute for Clinical Auditing, Leiden, the Netherlands.

出版信息

JAMA Oncol. 2017 May 1;3(5):677-685. doi: 10.1001/jamaoncol.2016.4851.

Abstract

A major challenge in value-based health care is the lack of standardized health outcomes measurements, hindering optimal monitoring and comparison of the quality of health care across different settings globally. The International Consortium for Health Outcomes Measurement (ICHOM) assembled a multidisciplinary international working group, comprised of 26 health care providers and patient advocates, to develop a standard set of value-based patient-centered outcomes for breast cancer (BC). The working group convened via 8 teleconferences and completed a follow-up survey after each meeting. A modified 2-round Delphi method was used to achieve consensus on the outcomes and case-mix variables to be included. Patient focus group meetings (8 early or metastatic BC patients) and online anonymized surveys of 1225 multinational BC patients and survivors were also conducted to obtain patients' input. The standard set encompasses survival and cancer control, and disutility of care (eg, acute treatment complications) outcomes, to be collected through administrative data and/or clinical records. A combination of multiple patient-reported outcomes measurement (PROM) tools is recommended to capture long-term degree of health outcomes. Selected case-mix factors were recommended to be collected at baseline. The ICHOM will endeavor to achieve wide buy-in of this set and facilitate its implementation in routine clinical practice in various settings and institutions worldwide.

摘要

基于价值的医疗保健面临的一个主要挑战是缺乏标准化的健康结果测量,这阻碍了在全球不同环境下对医疗保健质量进行最佳监测和比较。国际卫生结果测量联合会(ICHOM)召集了一个由 26 名医疗保健提供者和患者权益倡导者组成的多学科国际工作组,为乳腺癌(BC)制定了一套基于价值的以患者为中心的标准结果。工作组通过 8 次电话会议进行了会议,并在每次会议后完成了一次后续调查。采用改良的 2 轮 Delphi 方法就纳入的结果和病例组合变量达成共识。还进行了 8 次早期或转移性 BC 患者的患者焦点小组会议和 1225 名跨国 BC 患者和幸存者的在线匿名调查,以获取患者的意见。该标准集包括通过行政数据和/或临床记录收集的生存和癌症控制以及护理的不便利(例如,急性治疗并发症)结果。建议使用多种患者报告的结果测量(PROM)工具来捕捉长期健康结果的程度。建议在基线时收集选定的病例组合因素。ICHOM 将努力广泛接受这一套标准,并促进其在全球各种环境和机构的常规临床实践中的实施。

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