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系统评价 QoR-15 评分,一种用于测量手术和麻醉后恢复质量的患者报告结局测量工具。

Systematic review of the QoR-15 score, a patient- reported outcome measure measuring quality of recovery after surgery and anaesthesia.

机构信息

Department of Surgery, North Zealand Hospital, Copenhagen University Hospital, Dyrehavevej 29, 3400 Hillerød, Denmark.

Department of Surgery, North Zealand Hospital, Copenhagen University Hospital, Dyrehavevej 29, 3400 Hillerød, Denmark.

出版信息

Br J Anaesth. 2018 Jan;120(1):28-36. doi: 10.1016/j.bja.2017.11.013. Epub 2017 Nov 22.

Abstract

BACKGROUND

The QoR-15 is a patient-reported outcome questionnaire that measures the quality of recovery after surgery and anaesthesia. We aimed to perform a systematic review and meta-analysis of the measurement properties of the QoR-15.

METHODS

Studies reporting measurement properties or interpretability of the QoR-15 after surgery were eligible for inclusion. All languages were included in the PubMed and Embase search. The COSMIN guidelines for systematic reviews of patient-reported outcome measurements were followed. Criteria for good measurement properties outlined in the consensus-based guidelines for selecting outcome measurement instruments for clinical trials were applied. A metaanalysis and synthesis of data across studies was performed.

RESULTS

Nine hundred and thirty-three titles were identified, and six articles were included in the study. The study population comprised 1548 patients undergoing a variety of surgical elective procedures. The QoR-15 was validated in English, Danish, Chinese, and Portuguese. High-quality evidence for good content validity, good internal consistency (Cronbach's α of 0.836), and essential unidimensionality of the QoR-15 as a measurement of postoperative quality of recovery was found. There was at least moderate-quality evidence of good reliability of the QoR-15 (intraclass correlation of 0.989) and good error of measurement (standard error of measurement of 1.85). The upper 95% confidence limit of the smallest detectable change was 3.63, and the minimal clinical important difference was 8.0.

CONCLUSIONS

The QoR-15 fulfils requirements for outcome measurement instruments in clinical trials and is the first measurement instrument of postoperative quality of recovery to undergo a systematic review according to the COSMIN checklist.

摘要

背景

QoR-15 是一种患者报告的术后和麻醉恢复质量的结果测量工具。我们旨在对 QoR-15 的测量特性进行系统评价和荟萃分析。

方法

符合纳入标准的研究报告了 QoR-15 术后的测量特性或可解释性。在 PubMed 和 Embase 搜索中纳入了所有语言。遵循了患者报告结果测量系统评价的 COSMIN 指南。临床试验中选择结果测量工具的基于共识的指南中概述的良好测量特性标准也得到了应用。对研究间的数据进行了荟萃分析和综合。

结果

共确定了 933 个标题,其中 6 篇文章被纳入研究。研究人群包括接受各种择期手术的 1548 名患者。QoR-15 已在英语、丹麦语、中文和葡萄牙语中得到验证。有高质量的证据表明其具有良好的内容有效性(内容效度指数为 0.934)、良好的内部一致性(Cronbach's α 为 0.836),以及作为术后恢复质量测量工具的基本维度单一性。有至少中等质量的证据表明 QoR-15 的可靠性良好(组内相关系数为 0.989),测量误差小(测量误差的标准误为 1.85)。最小可检测变化的 95%置信区间上限为 3.63,最小临床重要差异为 8.0。

结论

QoR-15 符合临床试验中结果测量工具的要求,是第一个根据 COSMIN 清单进行系统评价的术后恢复质量测量工具。

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