School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK.
Department of Psychology, School of Social Sciences, Leeds Beckett University, Leeds, LS1 9HE, UK.
Patient. 2019 Apr;12(2):213-222. doi: 10.1007/s40271-018-0337-1.
The aim of this study was to identify themes that determine health-related quality of life (HRQoL) in patients with carotid artery stenosis and identify the patient-reported outcome measures (PROMs) that best cover the identified themes.
A systematic review of the main six databases from inception to September 2018 was undertaken to identify primary qualitative studies reporting on the HRQoL of patients with carotid artery stenosis. The quality of studies was assessed using the Critical Appraisal Skills Programme (CASP) criteria. Findings from the included studies were analysed using framework analysis methodology. The identified themes were mapped against the items/domains from the PROMs used previously in patients with carotid artery stenosis.
The systematic review identified four papers that fulfilled the inclusion criteria. The included papers reported the views of 62 patients with symptomatic carotid artery stenosis; 24 of the patients were awaiting assessment for intervention, 26 had carotid endarterectomy, and 12 were turned down for intervention and received best medical therapy. The overall quality of the included studies was good based on CASP criteria. Framework analysis identified 16 themes that were divided into five main domains: anxiety, impact on personal roles and activities, effect on independence, psychological impact, and symptoms. The best-fit generic and disease-specific PROMs were the Medical Outcomes Study 36-Item Short Form (SF-36) and the Carotid Stenosis Specific Outcome Measure (CSSOM), respectively. None of the PROMs covered all the themes identified in the qualitative systematic review.
The findings from the review identified the important themes that affect patients with carotid stenosis disease. The current generic and disease-specific PROMs do not cover all themes that impact the HRQoL of patients suffering with this disease. The proposed themes can be used to develop a new disease-specific PROM to measure HRQoL.
本研究旨在确定影响颈动脉狭窄患者健康相关生活质量（HRQoL）的主题，并确定能充分涵盖所确定主题的患者报告结局测量（PROM）。
系统检索了从创建到 2018 年 9 月的六个主要数据库，以确定报告颈动脉狭窄患者 HRQoL 的主要定性研究。使用关键评估技能计划（CASP）标准评估研究质量。使用框架分析方法对纳入研究的结果进行分析。将确定的主题与先前在颈动脉狭窄患者中使用的 PROM 的项目/领域进行映射。
系统评价确定了 4 篇符合纳入标准的论文。纳入的论文报告了 62 例有症状颈动脉狭窄患者的观点；24 例患者正在等待评估以进行干预，26 例接受颈动脉内膜切除术，12 例因干预而被拒绝，接受最佳药物治疗。根据 CASP 标准，纳入研究的总体质量良好。框架分析确定了 16 个主题，分为五个主要领域：焦虑、对个人角色和活动的影响、对独立性的影响、心理影响和症状。最佳的通用和疾病特异性 PROM 分别是医疗结局研究 36 项简短量表（SF-36）和颈动脉狭窄特定结局测量（CSSOM）。没有任何 PROM 涵盖定性系统评价中确定的所有主题。
该综述的结果确定了影响颈动脉狭窄患者的重要主题。目前的通用和疾病特异性 PROM 并未涵盖影响患有这种疾病的患者 HRQoL 的所有主题。拟议的主题可用于开发一种新的疾病特异性 PROM 来衡量 HRQoL。
