Dept of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
Iberoamerican Cochrane Centre, CIBERESP-IIB Sant Pau, Barcelona, Spain.
Eur Respir J. 2018 Jul 19;52(1). doi: 10.1183/13993003.00222-2018. Print 2018 Jul.
Our objective was to summarise systematically all research evidence related to how patients value outcomes in chronic obstructive pulmonary disease (COPD).We conducted a systematic review (systematic review registration number CRD42015015206) by searching PubMed, Embase, PsycInfo and CINAHL, and included reports that assessed the relative importance of outcomes from COPD patients' perspective. Two authors independently determined the eligibility of studies, abstracted the eligible studies and assessed risk of bias. We narratively summarised eligible studies, meta-analysed utilities for individual outcomes and assessed the certainty of evidence using the Grading of Recommendations, Assessment, Development and Evaluations approach.We included 217 quantitative studies. Investigators most commonly used utility measurements of outcomes (n=136), discrete choice exercises (n=13), probability trade-off (n=4) and forced choice techniques (n=46). Patients rated adverse events as important but on average, less so than symptom relief. Exacerbation and hospitalisation due to exacerbation are the outcomes that COPD patients rate as most important. This systematic review provides a comprehensive registry of related studies.
我们的目标是系统总结所有与慢性阻塞性肺疾病(COPD)患者对结局的重视相关的研究证据。我们通过检索 PubMed、Embase、PsycInfo 和 CINAHL 进行了系统评价(系统评价注册编号 CRD42015015206),并纳入了评估 COPD 患者视角下结局相对重要性的报告。两位作者独立确定研究的合格性,提取合格研究并评估偏倚风险。我们对合格研究进行叙述性总结,对个别结局的效用进行荟萃分析,并使用推荐评估、制定与评价分级法评估证据的确定性。我们纳入了 217 项定量研究。研究人员最常使用结局的效用测量(n=136)、离散选择实验(n=13)、概率权衡(n=4)和强制选择技术(n=46)。患者认为不良事件很重要,但平均而言,不如症状缓解重要。COPD 患者认为加重和因加重导致的住院是最重要的结局。本系统评价提供了相关研究的全面注册。