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《自报告尿症状综合评估:下尿路症状患者亚型研究的新工具》

The Comprehensive Assessment of Self-Reported Urinary Symptoms: A New Tool for Research on Subtypes of Patients with Lower Urinary Tract Symptoms.

机构信息

Duke University Medical Center , Durham , North Carolina.

Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University , Chicago , Illinois.

出版信息

J Urol. 2019 Jun;201(6):1177-1183. doi: 10.1097/JU.0000000000000140.

Abstract

PURPOSE

To improve the potential for finding clinically important subtypes of patients with lower urinary tract symptoms we developed the CASUS (Comprehensive Assessment of Self-reported Urinary Symptoms). We used it to present data on the experiences of lower urinary tract symptoms in treatment seeking women and men from a prospective observational cohort.

MATERIALS AND METHODS

We created an initial list of lower urinary tract symptoms that were confirmed in 22 qualitative interviews with providers, and 88 qualitative interviews with care seeking and noncare seeking women and men with lower urinary tract symptoms. Items from extant measures were adopted and revised, and new items were developed. All items were evaluated for understanding in 64 cognitive interviews. Items were administered to a prospective cohort of female and male patients with lower urinary tract symptoms who were seeking care. Analyses were done to describe item response distributions and correlations among item responses separately for women and men.

RESULTS

A total of 444 males and 372 females provided responses to the CASUS. Several sets of items showed different relationships for women compared to men. In particular the associations between sensation related items and incontinence related items were generally positive among females but often negative among males.

CONCLUSIONS

After using an intensive development process the CASUS addresses a wide range of lower urinary tract symptoms. It should help identify clinically important subtypes of patients. Further, item collection can provide the foundation for shorter measures for use in the clinic and as trial end points.

摘要

目的

为了提高发现具有下尿路症状的临床重要亚组患者的潜力,我们开发了 CASUS(自我报告下尿路症状综合评估)。我们使用它来展示来自前瞻性观察队列的寻求治疗的女性和男性患者的下尿路症状体验数据。

材料和方法

我们创建了一个初步的下尿路症状清单,该清单在与提供者的 22 次定性访谈和 88 次有下尿路症状的寻求治疗和非治疗的女性和男性的定性访谈中得到了证实。采用并修改了现有措施中的项目,并开发了新的项目。在 64 次认知访谈中对所有项目进行了理解评估。将这些项目施用于有下尿路症状的寻求治疗的女性和男性患者的前瞻性队列中。分别对女性和男性进行了分析,以描述项目反应分布和项目反应之间的相关性。

结果

共有 444 名男性和 372 名女性对 CASUS 做出了回应。对于女性来说,有几类项目的反应与男性相比存在不同的关系。特别是,对于女性来说,感觉相关项目和尿失禁相关项目之间的关联通常是阳性的,但对于男性来说,这种关联往往是负面的。

结论

经过密集的开发过程,CASUS 涵盖了广泛的下尿路症状。它应该有助于识别具有临床重要意义的患者亚组。此外,项目收集可以为在诊所使用和作为试验终点的更简短措施提供基础。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f06/6573020/a28af7e4fba1/nihms-1011363-f0001.jpg

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