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一种基于新型患者报告结局(PROBE)的炎症性肠病患者生活质量评估。

A Novel Patient-Reported Outcome-Based Evaluation (PROBE) of Quality of Life in Patients With Inflammatory Bowel Disease.

机构信息

Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.

Multidisciplinary Center for Inflammatory Bowel Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.

出版信息

Am J Gastroenterol. 2019 Apr;114(4):640-647. doi: 10.14309/ajg.0000000000000177.

Abstract

OBJECTIVES

There is increased interest in measuring patient-reported outcomes (PROs) such as quality of life (QoL) among patients with inflammatory bowel disease (IBD). We aimed to create and validate a new measure of QoL to assess the psychosocial burden of IBD using publicly available assessment tools.

METHODS

Using the Crohn's & Colitis Foundation's IBD Partners cohort, we performed several cross-sectional and longitudinal analyses to create a new PRO-based evaluation (PROBE) of QoL among patients with Crohn's disease (CD) and ulcerative colitis (UC). We used factor analysis and Pearson correlation test to identify candidate questions for inclusion, Wilcoxon rank-sum test to examine responsiveness of the PROBE to changes in disease activity, and test-retest reliability assessments in patients with stable disease activity. We also compared the PROBE to the Short Inflammatory Bowel Disease Questionnaire to assess construct validity.

RESULTS

A total of 4,854 patients (64% CD, 36% UC) completed surveys with 6 items included in the final PROBE. Compared with baseline there was a significant decrease in PROBE scores at follow-up among patients who experienced a flare for UC (25.0 vs 22.2, P = 0.001) and CD (23.1 vs 21.0, P < 0.001). Among patients with stable disease activity, Cronbach alpha was 0.87 in CD and 0.82 in UC. The PROBE correlated well with the Short Inflammatory Bowel Disease Questionnaire in CD (r = 0.88) and UC (r = 0.86).

DISCUSSION

We created a novel measure to assess QoL in patients with IBD using publicly available survey items. This new PROBE can be used to facilitate clinical care, clinical and epidemiological research, and quality improvement.

摘要

目的

人们对炎症性肠病(IBD)患者的患者报告结局(PRO),如生活质量(QoL)的测量越来越感兴趣。我们旨在使用公开可用的评估工具,创建和验证一种新的 QoL 测量方法,以评估 IBD 的心理社会负担。

方法

利用克罗恩病和结肠炎基金会的 IBD 合作伙伴队列,我们进行了几项横断面和纵向分析,以创建一种新的基于 PRO 的克罗恩病(CD)和溃疡性结肠炎(UC)患者 QoL 评估方法(PROBE)。我们使用因子分析和 Pearson 相关检验来确定纳入的候选问题,Wilcoxon 秩和检验来检验 PROBE 对疾病活动变化的反应性,以及在疾病活动稳定的患者中进行测试 - 重测信度评估。我们还将 PROBE 与短炎症性肠病问卷进行比较,以评估结构效度。

结果

共有 4854 名患者(64% CD,36% UC)完成了包含 6 个项目的最终 PROBE 调查。与基线相比,UC(25.0 对 22.2,P = 0.001)和 CD(23.1 对 21.0,P < 0.001)患者病情加重时 PROBE 评分显著下降。在疾病活动稳定的患者中,CD 的 Cronbach alpha 为 0.87,UC 为 0.82。PROBE 与 CD(r = 0.88)和 UC(r = 0.86)的短炎症性肠病问卷相关性良好。

讨论

我们使用公开可用的调查项目创建了一种新的评估 IBD 患者 QoL 的方法。这种新的 PROBE 可用于促进临床护理、临床和流行病学研究以及质量改进。

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