Wong Kevin, Piraquive Jacquelyn, Troiano Chelsea A, Sulibhavi Anita, Grundfast Kenneth M, Levi Jessica R
Boston University School of Medicine, 72 East Concord Street, Boston, MA 02118, United States; Department of Otolaryngology-Head and Neck Surgery, Boston Medical Center, 830 Harrison Ave, Boston, MA 02118, United States.
Boston University School of Medicine, 72 East Concord Street, Boston, MA 02118, United States; Department of Otolaryngology-Head and Neck Surgery, Boston Medical Center, 830 Harrison Ave, Boston, MA 02118, United States.
Int J Pediatr Otorhinolaryngol. 2018 Feb;105:63-71. doi: 10.1016/j.ijporl.2017.12.009. Epub 2017 Dec 8.
Review the pediatric otolaryngology literature to 1) identify studies in which children completed patient-reported outcome (PRO) measures and 2) appraise the psychometric quality and validity of these PROs as they apply to pediatrics.
In October 2016, a systematic review was performed by two reviewers on PubMed/MEDLINE and EMBASE for all otolaryngology-related studies that utilized PROs in children. Inclusion criteria included articles that required children (age<18) to complete PROs. Exclusion criteria included validation studies, reviews, and abstracts. Interreviewer agreement was determined using Cohen's kappa. Quality and rigor of validation testing for included PROs was determined using the COnsensus-based Standards for selection of health status Measurement Instruments.
Interrater agreement was very good (κ = 0.91; 95% CI, 0.85-0.98). Out of 316 articles retrieved, 11 met inclusion criteria. Eight PROs were identified. Six PROs were tested for validity and three of these PROs were tested for validity specifically within children. The most frequently utilized PRO was the Pediatric Rhinoconjunctivitis Quality of Life Questionnaire. Two studies (18.2%) utilized PROs within the scope of their validation. Seven studies (63.6%) used PROs outside the scope of their validation. Two studies (18.2%) used non-validated PROs.
Patient-reported outcomes have become an integral part of research and quality improvement. There is a relative paucity of PROs directed towards children in pediatric otolaryngology and some studies utilized PROs that were not validated or not validated for use in this age group. Future efforts to design and validate more instruments may be warranted.
回顾儿科耳鼻咽喉科文献，以1）确定儿童完成患者报告结局（PRO）测量的研究，以及2）评估这些PRO应用于儿科时的心理测量质量和有效性。
2016年10月，两名评审员对PubMed/MEDLINE和EMBASE进行了系统综述，以查找所有在儿童中使用PRO的耳鼻咽喉科相关研究。纳入标准包括要求儿童（年龄<18岁）完成PRO的文章。排除标准包括验证研究、综述和摘要。使用Cohen's kappa确定评审员间的一致性。使用基于共识的健康状况测量工具选择标准确定纳入的PRO的验证测试的质量和严谨性。
评分者间一致性非常好（κ = 0.91；95% CI，0.85 - 0.98）。在检索到的316篇文章中，11篇符合纳入标准。确定了8种PRO。对6种PRO进行了有效性测试，其中3种PRO专门在儿童中进行了有效性测试。使用最频繁的PRO是《小儿鼻结膜炎生活质量问卷》。两项研究（18.2%）在其验证范围内使用了PRO。七项研究（63.6%）在其验证范围外使用了PRO。两项研究（18.2%）使用了未经验证的PRO。
患者报告结局已成为研究和质量改进的一个组成部分。儿科耳鼻咽喉科针对儿童的PRO相对较少，一些研究使用的PRO未经验证或未针对该年龄组进行验证。未来可能需要努力设计和验证更多的工具。
