Lucas Steven M, Kim Tae-Kyung, Ghani Khurshid R, Miller David C, Linsell Susan, Starr Jay, Peabody James O, Hurley Patrick, Montie James, Cher Michael L
Wayne State University, Department of Urology, Detroit, MI.
University of Michigan, Department of Urology, Ann Arbor, MI.
Urology. 2017 Sep;107:96-102. doi: 10.1016/j.urology.2017.04.058. Epub 2017 Jun 23.
To report on the establishment of a unified, electronic patient-reported outcome (PRO) infrastructure and pilot results from the first 5 practices enrolled in the web-based collection system developed by the Michigan Urological Surgery Improvement Collaborative.
Eligible patients were those undergoing radical prostatectomy of 5 academic and community practices. PRO was obtained using a validated 21-item web-based questionnaire, regarding urinary function, erection function, and sexual interest and satisfaction. Data were collected preoperatively, at 3 months, and 6 months postoperatively. Patients were provided a link via email to complete the surveys. Perioperative and PRO data were analyzed as reports for individual patients and summary performance reports for individual surgeons.
Among 773 eligible patients, 688 (89%) were enrolled preoperatively. Survey completion rate was 88%, 84%, and 90% preoperatively, at 3 months, and 6 months. Electronic completion rates preoperatively, at 3 months, and 6 months were 70%, 70%, and 68%, respectively. Mean urinary function scores were 18.3, 14.3, and 16.6 (good function ≥ 17), whereas mean erection scores were 18.7, 7.3, and 9.1 (good erection score ≥ 22) before surgery, at 3 months, and 6 months. Variation was noted for erectile function among the practices.
Collection of electronic PRO via this unified, web-based format was successful and provided results that reflect expected recovery and identify opportunities for improvement. This will be extended to more practices statewide to improve outcomes after radical prostatectomy.
报告建立统一的电子患者报告结局(PRO)基础设施以及密歇根泌尿外科手术改进协作组织开发的基于网络的收集系统首批纳入的5家医疗机构的试点结果。
符合条件的患者为5家学术和社区医疗机构中接受根治性前列腺切除术的患者。使用经过验证的21项基于网络的问卷获取PRO,内容涉及排尿功能、勃起功能以及性兴趣和满意度。在术前、术后3个月和6个月收集数据。通过电子邮件向患者提供链接以完成调查。围手术期和PRO数据作为个体患者报告以及个体外科医生的汇总绩效报告进行分析。
在773名符合条件的患者中,688名(89%)在术前登记入组。术前、术后3个月和6个月的调查完成率分别为88%、84%和90%。术前、术后3个月和6个月的电子完成率分别为70%、70%和68%。术前、术后3个月和6个月的平均排尿功能评分分别为18.3、14.3和16.6(排尿功能良好≥17),而术前、术后3个月和6个月的平均勃起功能评分分别为18.7、7.3和9.1(勃起功能良好评分≥22)。各医疗机构之间勃起功能存在差异。
通过这种统一的基于网络的格式收集电子PRO是成功的,所提供的结果反映了预期的恢复情况并确定了改进机会。这将推广到全州更多的医疗机构,以改善根治性前列腺切除术后的结局。