Punekar Yogesh Suresh, Riley John H, Lloyd Emily, Driessen Maurice, Singh Sally J
Health Outcomes, GlaxoSmithKline, Uxbridge.
MDC Global Clinical Development UK, Respiratory Research and Development, GlaxoSmithKline, Uxbridge.
Int J Chron Obstruct Pulmon Dis. 2017 Aug 22;12:2487-2506. doi: 10.2147/COPD.S100204. eCollection 2017.
Chronic obstructive pulmonary disease (COPD) is an increasingly common cause of death worldwide. Its cardinal symptoms include breathlessness and severely reduced exercise capacity. Several patient-reported outcome (PRO) measures are used to assess health-related quality of life (HRQoL), functional performance, and breathlessness in patients with COPD. Exercise testing is employed to measure functional performance objectively, which is generally believed to impact on overall HRQoL. However, the extent to which commonly used laboratory- and field-based exercise test results correlate with PROs has not been systematically assessed.
A search of Embase, MedLine, and the Cochrane Library identified primary publications in English that reported data on the correlations (Pearson's or Spearman's ) between the outcomes of exercise tests and HRQoL and breathlessness PROs. Studies reporting on the following tests were included: 6-minute walk test (6MWT), 12MWT, incremental and endurance shuttle walk tests, incremental and endurance cycle ergometer tests, and treadmill tests.
Of 3,205 articles screened, 28 were deemed eligible for inclusion. The most commonly reported HRQoL PRO measure was the St George's Respiratory Questionnaire (13 studies), and the most commonly reported breathlessness PRO measure was the Baseline Dyspnea Index (six studies). The St George's Respiratory Questionnaire appears to correlate very weakly to moderately with the 6MWT, and breathlessness PROs appear to be moderately to strongly associated with 6MWT outcomes. Across all studies, the 6MWT was the most commonly reported exercise test. Very few publications reporting associations between other exercise tests and PRO measures were found.
This review found evidence to support the association of 6MWT outcomes with HRQoL and breathlessness PROs. There were limited data showing correlations with the outcomes of other exercise tests. Further work is required to examine the associations between these PROs and exercise test outcomes.
慢性阻塞性肺疾病（COPD）在全球范围内已成为日益常见的死亡原因。其主要症状包括呼吸急促和运动能力严重下降。目前使用了几种患者报告结局（PRO）指标来评估COPD患者的健康相关生活质量（HRQoL）、功能表现和呼吸急促情况。运动测试用于客观测量功能表现，人们普遍认为它会影响整体HRQoL。然而，常用的基于实验室和现场的运动测试结果与PRO指标之间的关联程度尚未得到系统评估。
检索Embase、MedLine和Cochrane图书馆，找出以英文发表的关于运动测试结果与HRQoL及呼吸急促PRO指标之间相关性（Pearson或Spearman相关性）的数据的主要出版物。纳入了报告以下测试的研究：6分钟步行试验（6MWT）、12分钟步行试验、递增式和耐力穿梭步行试验、递增式和耐力自行车测力计试验以及跑步机试验。
在筛选的3205篇文章中，有28篇被认为符合纳入标准。最常报告的HRQoL PRO指标是圣乔治呼吸问卷（1个研究），最常报告的呼吸急促PRO指标是基线呼吸困难指数（6个研究）。圣乔治呼吸问卷与6MWT的相关性似乎非常弱至中等，而呼吸急促PRO指标与6MWT结果的相关性似乎为中等至强相关。在所有研究中，6MWT是最常报告的运动测试。发现很少有出版物报告其他运动测试与PRO指标之间的关联。
本综述发现有证据支持6MWT结果与HRQoL及呼吸急促PRO指标之间的关联。显示与其他运动测试结果相关性的数据有限。需要进一步开展工作来研究这些PRO指标与运动测试结果之间的关联。
