术后恢复如何评估？：腹部手术后患者报告结局测量特性的系统评价。

How Do We Value Postoperative Recovery?: A Systematic Review of the Measurement Properties of Patient-reported Outcomes After Abdominal Surgery.

机构信息

Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, QC, Canada.

Department of Surgery, McGill University Health Centre, Montreal, QC, Canada.

出版信息

Ann Surg. 2018 Apr;267(4):656-669. doi: 10.1097/SLA.0000000000002415.

DOI:10.1097/SLA.0000000000002415

PMID:28767559

Abstract

OBJECTIVE

To appraise the level of evidence supporting the measurement properties of patient-reported outcome measures (PROMs) in the context of postoperative recovery after abdominal surgery.

BACKGROUND

There is growing interest in using PROMs to support value-based care in abdominal surgery; however, to draw valid conclusions regarding patient-reported outcomes data, PROMs with robust measurement properties are required.

METHODS

Eight databases (MEDLINE, EMBASE, Biosis, PsycINFO, The Cochrane Library, CINAHL, Scopus, Web of Science) were searched for studies focused on the measurement properties of PROMs in the context of recovery after abdominal surgery. The methodological quality of individual studies was evaluated using the consensus-based COSMIN checklist. Evidence supporting the measurement properties of each PROM was synthetized according to standardized criteria and compared against the International Society of Quality of Life Research minimum standards for the selection of PROMs for outcomes research.

RESULTS

We identified 35 studies evaluating 22 PROMs [12 focused on nonspecific surgical populations (55%), 4 focused on abdominal surgery (18%), and 6 generic PROMs (27%)]. The great majority of the studies (74%) received only poor or fair quality ratings. Measurement properties of PROMs were predominantly supported by limited or unknown evidence. None of the PROMs fulfilled International Society of Quality of Life Research's minimum standards, hindering specific recommendations.

CONCLUSIONS

There is very limited evidence supporting the measurement properties of existing PROMs used in the context of recovery after abdominal surgery. This precludes the use of these PROMs to support value-based surgical care. Further research is required to bridge this major knowledge gap.

REVIEW REGISTRATION

International Prospective Register of Systematic Reviews (PROSPERO): CRD42014014349.

摘要

目的

评价支持腹部手术后恢复患者报告结局测量工具（PROMs）测量特性的证据水平。

背景

人们越来越感兴趣地使用 PROMs 来支持腹部手术的基于价值的护理；然而，为了对患者报告结局数据得出有效结论，需要具有可靠测量特性的 PROMs。

方法

8 个数据库（MEDLINE、EMBASE、Biosis、PsycINFO、Cochrane 图书馆、CINAHL、Scopus、Web of Science）被搜索，以寻找专注于腹部手术后恢复背景下的 PROMs 测量特性的研究。使用基于共识的 COSMIN 清单评估各个研究的方法学质量。根据标准化标准综合每个 PROM 的测量特性证据，并与国际生活质量研究学会选择用于结局研究的 PROMs 的最低标准进行比较。

结果

我们确定了 35 项研究，评估了 22 种 PROMs[12 项研究专注于非特异性手术人群（55%），4 项研究专注于腹部手术（18%），6 项通用 PROMs（27%）]。绝大多数研究（74%）仅获得较差或一般的质量评级。PROMs 的测量特性主要得到有限或未知证据的支持。没有一种 PROM 满足国际生活质量研究学会的最低标准，这阻碍了特定的建议。