From the Reconstructive Surgery and Regenerative Medicine Research Group, the Patient and Population Health and Informatics, Institute of Life Science 2, Swansea University Medical School; The Welsh Centre for Burns and Plastic Surgery, Morriston Hospital; the Abertawe Bro Morgannwg University Health Board, Princess of Wales Hospital; and Oxford University Medical School.
Plast Reconstr Surg. 2019 Jan;143(1):255-268. doi: 10.1097/PRS.0000000000005112.
A patient's health-related quality of life can be significantly impacted by facial scarring and disfigurement. Facial soft-tissue reconstruction should aim to improve this, with outcomes measured from the patient's perspective using patient-reported outcome measures. This systematic review identifies patient-reported outcome measures for soft-tissue facial reconstruction and appraises their methodologic and psychometric properties using up-to-date methods.
A systematic search of the MEDLINE, Embase, PsychINFO, and Cochrane databases was performed. Identified patient-reported outcome measures were assessed using the updated Consensus-Based Standards for the Selection of Health Measurement Instruments checklist. Psychometric properties were also assessed and a modified Grading of Recommendation Assessment, Development and Evaluation analysis was performed to aid in recommendations for future questionnaire use.
Thirty-four studies covering nine patient-reported outcome measures were included. Methodologic quality and psychometric evidence were variable. FACE-Q, Skin Cancer Index, Patient Outcome of Surgery-Head/Neck, and the Derriford Appearance Scale 59/24 all demonstrated high enough evidence to be recommended as having potential for inclusion in future studies.
This is the first systematic review to identify and critically appraise patient-reported outcome measures for soft-tissue facial reconstruction using internationally accepted criteria. Four questionnaires were deemed to have adequate levels of methodologic and psychometric evidence, although further studies should be conducted before they are used routinely in patients undergoing facial reconstruction. Through the use of psychometrically well-validated questionnaires, it is hoped that patients' concerns can be truly appreciated, the level of care improved, and the quality of reconstructive options offered advanced.
面部疤痕和畸形会严重影响患者的生活质量。面部软组织重建的目的应该是改善这一点，使用患者报告的结果测量来衡量从患者角度得出的结果。本系统评价确定了用于软组织面部重建的患者报告结局测量，并使用最新方法评估其方法学和心理测量特性。
对 MEDLINE、Embase、PsychINFO 和 Cochrane 数据库进行了系统检索。使用更新的共识基础标准选择健康测量仪器清单评估确定的患者报告结局测量。还评估了心理测量特性，并进行了改良的推荐评估、制定和评估分析，以帮助推荐未来问卷的使用。
共纳入 34 项研究，涵盖 9 种患者报告结局测量。方法学质量和心理测量证据参差不齐。FACE-Q、皮肤癌指数、手术头颈部患者结果和德里福德外观量表 59/24 均具有足够高的证据，被推荐为可能纳入未来研究的工具。
这是首次使用国际公认标准确定和批判性评价软组织面部重建患者报告结局测量的系统评价。有四个问卷被认为具有足够的方法学和心理测量证据水平，但在常规用于面部重建患者之前，还应进行进一步的研究。通过使用心理测量学上良好验证的问卷，希望能够真正了解患者的关注点，提高护理水平，并提高所提供的重建方案的质量。
