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腹部大型肿瘤手术后患者报告结局与并发症的前瞻性多中心队列研究(PATRONUS)——一项CHIR-Net学生发起的德国医学审计研究(CHIR-Net SIGMA研究)的研究方案

Prospective multicentre cohort study of patient-reported outcomes and complications following major abdominal neoplastic surgery (PATRONUS) - study protocol for a CHIR-Net student-initiated German medical audit study (CHIR-Net SIGMA study).

作者信息

Fink Christoph A, Friedrich Mirco, Frey Pia-Elena, Rädeker Lukas, Leuck Alexander, Bruckner Thomas, Feisst Manuel, Tenckhoff Solveig, Klose Christina, Dörr-Harim Colette, Neudecker Jens, Mihaljevic André L

机构信息

University of Heidelberg, Faculty of Medicine, Im Neuenheimer Feld 346, 69120, Heidelberg, Germany.

Institute of Medical Biometry and Informatics, University of Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany.

出版信息

BMC Surg. 2018 Oct 29;18(1):90. doi: 10.1186/s12893-018-0422-3.

Abstract

BACKGROUND

One of the most important aspects of designing a clinical trial is selecting appropriate outcomes. Patient-reported outcomes (PROs) can provide a personal assessment of the burden and impact of a malignant disease and its treatment. PROs comprise a wide range of outcomes including basic clinical symptom scores and complex metrics such as health-related quality of life (HRQoL). There is limited data on how postoperative complications following cancer surgery affect symptoms and HRQoL. For this reason the primary aim of the PATRONUS study is to investigate how perioperative complications affect cancer-related symptoms and HRQoL in patients undergoing abdominal cancer surgery. The PATRONUS study is designed and will be initiated and conducted by medical students under the direct supervision of clinician scientists based on the concept of inquiry-based learning.

METHODS

PATRONUS is a non-interventional prospective multicentre cohort study. Patients undergoing elective oncological abdominal surgery will be recruited at regional centres of the clinical network of the German Surgical Society (CHIR-Net) and associated hospitals. A core set of 12 cancer associated symptoms will be assessed via the PRO version of the Common Terminology Criteria for Adverse Events. The cancer-specific HRQoL will be measured via the computerised adaptive testing version of the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30. PROs will be measured eight times over a period of six months. The short-term clinical outcome measure is the rate of postoperative complications (grade II to V) within 30 days according to the Clavien-Dindo classification. The long-term clinical outcome is overall survival within six months postoperative.

DISCUSSION

PATRONUS will provide essential insights into the patients' assessment of their well-being and quality of life in direct relation to clinical outcome parameters following abdominal cancer surgery. Furthermore, PATRONUS will investigate the feasibility of multicentre student-led clinical research.

TRIAL REGISTRATION

German Clinical Trials Register: DRKS00013035 (registered on October 26, 2017). Universal Trial Number (UTN): U1111-1202-8863.

摘要

背景

设计一项临床试验最重要的方面之一是选择合适的结局指标。患者报告结局(PROs)能够对恶性疾病及其治疗的负担和影响提供个人评估。PROs包含广泛的结局指标,包括基本临床症状评分以及诸如健康相关生活质量(HRQoL)等复杂指标。关于癌症手术后的术后并发症如何影响症状和HRQoL的数据有限。因此,PATRONUS研究的主要目的是调查围手术期并发症如何影响接受腹部癌症手术患者的癌症相关症状和HRQoL。PATRONUS研究基于基于问题的学习概念进行设计,将由医学生在临床科学家的直接监督下启动和开展。

方法

PATRONUS是一项非干预性前瞻性多中心队列研究。将在德国外科学会临床网络(CHIR-Net)的区域中心及相关医院招募接受择期肿瘤腹部手术的患者。将通过不良事件通用术语标准的PRO版本评估一组12种与癌症相关的核心症状。将通过欧洲癌症研究与治疗组织(EORTC)QLQ-C30的计算机自适应测试版本测量癌症特异性HRQoL。将在六个月的时间内对PROs进行八次测量。短期临床结局指标是根据Clavien-Dindo分类在30天内的术后并发症发生率(II至V级)。长期临床结局是术后六个月内的总生存率。

讨论

PATRONUS将为患者对其腹部癌症手术后与临床结局参数直接相关的幸福感和生活质量的评估提供重要见解。此外,PATRONUS将调查多中心学生主导的临床研究的可行性。

试验注册

德国临床试验注册中心:DRKS00013035(于2017年10月26日注册)。通用试验编号(UTN):U1111-1202-8863。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ffe/6206710/95e20f39aa31/12893_2018_422_Fig1_HTML.jpg

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