Royal Devon and Exeter NHS Foundation Trust, Exeter, UK; Health Services and Policy Research Group, University of Exeter, Exeter, UK; National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) South West Peninsula, University of Exeter Medical School, Exeter, UK.
Royal Devon and Exeter NHS Foundation Trust, Exeter, UK.
J Shoulder Elbow Surg. 2018 Apr;27(4):e98-e106. doi: 10.1016/j.jse.2017.12.027. Epub 2018 Feb 12.
Clinical rating systems are used as outcome measures in clinical trials and attempt to gauge the patient's view of his or her own health. The choice of clinical rating system should be supported by its performance against established quality standards.
A search strategy was developed to identify all studies that reported the use of clinical rating systems in the elbow literature. The strategy was run from inception in Medline Embase and CINHAL. Data extraction identified the date of publication, country of data collection, pathology assessed, and the outcome measure used.
We identified 980 studies that reported clinical rating system use. Seventy-two separate rating systems were identified. Forty-one percent of studies used ≥2 separate measures. Overall, 54% of studies used the Mayo Elbow Performance Score (MEPS). For arthroplasty, 82% used MEPS, 17% used Disabilities of Arm, Shoulder and Hand (DASH), and 7% used QuickDASH. For trauma, 66.7% used MEPS, 32% used DASH, and 23% used the Morrey Score. For tendinopathy, 31% used DASH, 23% used Patient-Rated Tennis Elbow Evaluation (PRTEE), and 13% used MEPS. Over time, there was an increased proportional use of the MEPS, DASH, QuickDASH, PRTEE, and the Oxford Elbow Score.
This study identified a wide choice and usage of clinical rating systems in the elbow literature. Numerous studies reported measures without a history of either a specific pathology or cross-cultural validation. Interpretability and comparison of outcomes is dependent on the unification of outcome measure choice. This was not demonstrated currently.
临床评分系统被用作临床试验中的结果测量指标，旨在评估患者对自身健康状况的主观感受。选择临床评分系统时，应参考其是否符合既定的质量标准。
制定了一种检索策略，以确定所有在肘部文献中报告使用临床评分系统的研究。该策略在 Medline、Embase 和 CINHAL 中从初始状态开始运行。数据提取确定了出版物日期、数据采集国家、评估的病理以及使用的结果测量指标。
我们确定了 980 项报告临床评分系统使用情况的研究。共确定了 72 种不同的评分系统。41%的研究使用了≥2 种单独的测量方法。总体而言，54%的研究使用了 Mayo 肘部功能评分（MEPS）。对于关节置换术，82%使用 MEPS，17%使用上肢功能障碍（DASH），7%使用快速 DASH（QuickDASH）。对于创伤，66.7%使用 MEPS，32%使用 DASH，23%使用 Morrey 评分。对于腱病，31%使用 DASH，23%使用患者自评网球肘评估（PRTEE），13%使用 MEPS。随着时间的推移，MEPS、DASH、QuickDASH、PRTEE 和牛津肘部评分的使用比例有所增加。
本研究确定了肘部文献中广泛选择和使用临床评分系统的情况。许多研究报告的测量方法没有特定病理或跨文化验证的历史。结果的可解释性和比较取决于结果测量指标选择的统一。目前尚未做到这一点。
