Center for Evidence Synthesis in Health, Brown University School of Public Health, Providence, Rhode Island.
Dry Eye Company LLC, Poulsbo, Washington.
JAMA Ophthalmol. 2018 Oct 1;136(10):1170-1179. doi: 10.1001/jamaophthalmol.2018.3352.
Dry eye is a common ocular surface condition with significant influence on patient quality of life and societal economic burden. There is an urgent need to prioritize new research for dry eye.
To identify and rank research questions and outcomes important to patients with dry eye.
DESIGN, SETTING, AND PARTICIPANTS: This study was conducted using the following 6 steps: (1) identifying research questions from a previous survey of clinicians who treat patients with dry eye; (2) identifying outcomes from existing research (systematic reviews and their cited clinical trials in the Cochrane Eyes and Vision US Satellite database of eyes and vision reviews, and National Eye Institute-funded clinical trials registered on ClinicalTrials.gov) as of June 13, 2017; (3) identifying a sample of patients with dry eye from the email subscribers to the online newsletter KeratoScoop; (4) and (5) conducting a 2-round Delphi survey of those patients online in November and December 2017, respectively; and (6) designating and ranking questions and outcomes as important.
Importance assigned to research questions and outcomes for dry eye. A research question or outcome ranked by at least 75% of patients as 6 or higher on a scale of 0 to 10 was considered important.
Among the 420 patients from 15 countries who completed both rounds of the Delphi survey, most were 60 years of age or older (233 [56%]), female (348 [83%]), white (393 [94%]), and of non-Hispanic ethnicity (398 [95%]). Among the 12 questions that clinicians had previously prioritized, patients rated 8 as important. The top 3 questions pertained to effectiveness of patient education, environmental modifications, and topical anti-inflammatory eye drops for dry eye. Among the 109 outcomes identified in existing research on dry eye, patients rated 26 as important. Ten of these 26 were unpopular in existing research, with fewer than 10% of 158 studies reporting these outcomes. Of the 10 most important outcomes, 9 were associated with symptoms or quality of life. The 3 outcomes rated most important by patients were ocular burning or stinging, ocular discomfort, and ocular pain.
This study identified research questions and outcomes important to patients with dry eye. A considerable gap was noted between outcomes in existing research on dry eye and outcomes patients consider important. Future research on dry eye should consider addressing the important research questions and outcomes identified herein, taking into account the patient perspective.
干眼症是一种常见的眼表疾病，对患者的生活质量和社会经济负担有重大影响。因此，优先开展干眼症的新研究迫在眉睫。
确定并对干眼症患者重视的研究问题和结果进行排序。
设计、设置和参与者：本研究共分 6 个步骤：（1）从治疗干眼症患者的临床医生的先前调查中确定研究问题；（2）从现有的研究中确定结果（系统评价及其在考科蓝眼与视觉美国卫星数据库的引用临床试验，以及美国国立卫生研究院资助的在 ClinicalTrials.gov 上注册的临床试验），截至 2017 年 6 月 13 日；（3）从在线新闻通讯 KeratoScoop 的电子邮件订阅者中确定干眼症患者样本；（4）和（5）分别于 2017 年 11 月和 12 月在网上对这些患者进行两轮 Delphi 调查；（6）对研究问题和结果进行指定和排序。
干眼症患者对研究问题和结果的重视程度。至少有 75%的患者在 0 到 10 的量表上对研究问题或结果的重视程度达到 6 或更高，即被认为是重要的。
在来自 15 个国家的 420 名完成两轮 Delphi 调查的患者中，大多数为 60 岁或以上（233 [56%]）、女性（348 [83%]）、白人（393 [94%]）和非西班牙裔（398 [95%]）。在临床医生之前优先考虑的 12 个问题中，患者将 8 个评为重要。前 3 个问题与干眼症患者教育的有效性、环境改善和局部抗炎眼药水有关。在现有的干眼症研究中，确定了 109 个结果，患者将其中 26 个评为重要。这 26 个结果中有 10 个在现有研究中不受欢迎，只有不到 158 项研究报告了这些结果。在 10 个最重要的结果中，9 个与症状或生活质量有关。患者评定最重要的 3 个结果是眼烧灼感或刺痛、眼部不适和眼部疼痛。
本研究确定了干眼症患者重视的研究问题和结果。现有的干眼症研究结果与患者重视的结果之间存在较大差距。未来的干眼症研究应考虑解决本文确定的重要研究问题和结果，并考虑到患者的观点。
