McCrary J Matt, Goldstein David, Boyle Frances, Cox Keith, Grimison Peter, Kiernan Matthew C, Krishnan Arun V, Lewis Craig R, Webber Kate, Baron-Hay Sally, Horvath Lisa, Park Susanna B
Prince of Wales Clinical School, UNSW Medicine, The University of New South Wales, Randwick, NSW, 2031, Australia.
Sydney Medical School, The University of Sydney, Sydney, NSW, 2006, Australia.
Support Care Cancer. 2017 Nov;25(11):3485-3493. doi: 10.1007/s00520-017-3772-y. Epub 2017 Jun 7.
BACKGROUND/PURPOSE: Chemotherapy-induced peripheral neuropathy (CIPN) is a prominent side effect of the treatment of cancer. Despite this frequent complication, there has been no comprehensive review and quality appraisal of CIPN assessments. The purpose of this study is to provide a definitive quality appraisal of CIPN assessment strategies for clinical use.
Relevant studies were identified through database searches of Medline, Embase, CINAHL, and Cochrane. CIPN assessment strategies from included articles were extracted and initially rated by an oncologist and neurophysiologist according to criteria related to assessment depth, comprehensiveness, appropriateness, and reliability. The six highest scoring assessment strategies were the focus of a two-round Delphi survey of a working party of 32 physicians, nurses, and consumers to achieve consensus on the highest rated assessments for each criterion.
The database search yielded 117 distinct CIPN assessments that were extracted from 2373 articles. Three patient-reported outcome surveys and three clinician-based assessments were included in the Delphi survey. No consensus was generated regarding the best overall CIPN assessment, although good (≥70%) consensus was achieved regarding the best assessment within each criterion. The Participant Neurotoxicity Questionnaire (PNQ) was rated the highest overall and patient-reported outcome (PRO) assessment, while the Total Neuropathy Score clinical version (TNSc) was the highest rated clinician-based assessment.
A diverse range of CIPN assessments currently exists. While several assessments assess CIPN symptoms with adequate comprehensiveness, depth, language, and feasibility, the consensus 'gold standard' clinical assessment remains to be established.
背景/目的：化疗引起的周围神经病变（CIPN）是癌症治疗中一种突出的副作用。尽管存在这种常见并发症，但尚未对CIPN评估进行全面的综述和质量评估。本研究的目的是对用于临床的CIPN评估策略进行权威的质量评估。
通过检索Medline、Embase、CINAHL和Cochrane数据库确定相关研究。从纳入文章中提取CIPN评估策略，并由一名肿瘤学家和一名神经生理学家根据与评估深度、全面性、适用性和可靠性相关的标准进行初步评分。六项得分最高的评估策略是对由32名医生、护士和患者组成的工作组进行两轮德尔菲调查的重点，以就每个标准中评分最高的评估达成共识。
数据库检索产生了从2373篇文章中提取的117种不同的CIPN评估。德尔菲调查包括三项患者报告结局调查和三项基于临床医生的评估。虽然对于最佳的总体CIPN评估未达成共识，但对于每个标准内的最佳评估达成了良好（≥70%）的共识。参与者神经毒性问卷（PNQ）在总体和患者报告结局（PRO）评估中得分最高，而总神经病变评分临床版（TNSc）是基于临床医生的评估中评分最高的。
目前存在多种CIPN评估方法。虽然有几种评估方法在全面性、深度、语言和可行性方面对CIPN症状进行了充分评估，但共识性的“金标准”临床评估仍有待确立。
Zotero 插件