Mellor Katie, Hind Daniel, Lee Matthew J
Clinical Trials Research Unit, School of Health and Related Research, Sheffield, UK.
Medical School, University of Sheffield, Sheffield, UK; Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
J Surg Res. 2018 Sep;229:41-50. doi: 10.1016/j.jss.2018.03.044. Epub 2018 Apr 16.
Small bowel obstruction (SBO) is a condition which is commonly treated by general surgeons. The evidence base for treatment of this condition is limited in part by variable reporting of outcomes in the literature. The aim of this study was to identify commonly used outcomes in research on SBO.
This review was reported in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and registered with PROSPERO (CRD42017065538). Searches were performed of MEDLINE, Embase, and Cochrane Central Register of Controlled Trials databases to identify prospective cohort or randomized trials reporting outcomes of interventions in SBO. Studies addressing diagnostics, pediatric populations, and SBO due to malignancy were excluded. Studies were screened for inclusion. Study and outcome characteristics were extracted into a -predesigned pro forma and mapped onto the Outcome Measures in Rheumatology (OMERACT) framework.
A total of 1222 studies were screened for eligibility, 74 full text articles retrieved, and 51 studies included for synthesis. A total of 50 different outcomes were used. Duration of hospital stay was the most frequently reported outcome (n = 21 studies). Resolution of SBO was reported in 12 studies but only defined in eight studies which used six different definitions. Patient-reported outcomes were reported in only four studies.
There is a high degree of variation in the outcomes reported in SBO research. There is a clear need for a core outcome set. Development of a patient-reported outcome measure for this condition should also be explored.
小肠梗阻(SBO)是普通外科医生常治疗的一种疾病。该疾病治疗的证据基础部分受到文献中结果报告不一致的限制。本研究的目的是确定SBO研究中常用的结果指标。
本综述按照系统评价和Meta分析的首选报告项目指南进行报告,并在国际前瞻性系统评价注册库(PROSPERO,注册号:CRD42017065538)登记。检索了MEDLINE、Embase和Cochrane对照试验中央注册库数据库,以识别报告SBO干预结果的前瞻性队列研究或随机试验。排除涉及诊断、儿科人群以及恶性肿瘤所致SBO的研究。对研究进行纳入筛选。将研究和结果特征提取到预先设计的表格中,并映射到风湿病结局测量(OMERACT)框架。
共筛选了1222项研究的合格性,检索到74篇全文文章,纳入51项研究进行综合分析。共使用了50种不同的结果指标。住院时间是最常报告的结果指标(n = 21项研究)。12项研究报告了SBO的缓解情况,但只有8项研究进行了定义,使用了6种不同的定义。只有4项研究报告了患者报告的结果。
SBO研究中报告的结果指标存在高度差异。显然需要一个核心结局指标集。还应探索针对该疾病开发患者报告的结局测量指标。