School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Center, Maastricht, The Netherlands.
Limburg Brain Injury Center, Maastricht, The Netherlands.
Health Qual Life Outcomes. 2020 Feb 17;18(1):30. doi: 10.1186/s12955-020-01286-3.
The lack of consistency in outcome measurement within the field of acquired brain injury (ABI) leads to incomparability of collected data and, consequently, reduced generalisation of findings. We aim to develop a set of standardised measures which can be used to obtain the minimum amount of data necessary to characterise ABI-patients across all healthcare sectors and disciplines and in every stage of recovery; i.e., an ABI-specific minimal dataset (MDS-ABI). The current study was conducted to identify the core outcome domains for adults with ABI (what to measure?) and to select the most suitable measurements within these domains (how to measure it?).
An initial comprehensive set of outcome domains and measurement instruments relevant for measuring the consequences of ABI was identified by a literature study. The selection of relevant domains was based on the International Classification of Functioning, Disability and Health framework. Measurement instruments were included in the Delphi procedure when they met pre-set requirements. A three-round Delphi study was conducted among Dutch experts (n = 48) using iterative web-based surveys to prioritise the proposed domains and instruments for the MDS-ABI. Throughout all rounds, participants could recommend additional or alternative domains and measurement instruments, and were fed back the collated group responses of the previous round.
Response rates ranged from 89 to 100%. After three rounds, the expert panel reached consensus (≥51%) on the inclusion of 12 outcome domains (demographics, injury characteristics, comorbidity, cognitive functioning, emotional functioning, energy, mobility, self-care, communication, participation, social support and quality of life), measured with six measurement instruments, two screening questions and a registry of demographic- and injury information. No consensus was reached on how to measure quality of life.
The current study achieved consensus on the content of a minimal dataset for patients with ABI. The current version of the MDS-ABI will be evaluated and optimised if necessary in the near future.
在获得性脑损伤(ABI)领域,结果测量缺乏一致性,导致数据不可比,因此研究结果的推广性降低。我们的目标是开发一套标准化的测量工具,用于获取尽可能少的数据,以描述所有医疗保健部门和学科以及每个康复阶段的 ABI 患者;即,特定于 ABI 的最小数据集(MDS-ABI)。本研究旨在确定成人 ABI 的核心结果领域(测量什么?),并在这些领域内选择最合适的测量方法(如何测量?)。
通过文献研究确定了一套与测量 ABI 后果相关的初始综合结果领域和测量工具。相关领域的选择基于国际功能、残疾和健康分类框架。当测量仪器符合预设要求时,将其纳入 Delphi 程序。一项涉及荷兰专家(n=48)的三轮 Delphi 研究使用迭代网络调查来确定 MDS-ABI 中拟议的领域和仪器的优先级。在所有轮次中,参与者都可以推荐其他领域和替代测量仪器,并对前一轮的汇总组回复进行反馈。
回应率从 89%到 100%不等。三轮过后,专家小组就纳入 12 个结果领域(人口统计学、损伤特征、合并症、认知功能、情绪功能、能量、移动性、自我护理、沟通、参与、社会支持和生活质量)达成一致(≥51%),使用 6 种测量仪器、2 个筛选问题和一个人口统计学和损伤信息注册表进行测量。关于如何测量生活质量,没有达成共识。
本研究就 ABI 患者最小数据集的内容达成了共识。如果有必要,目前版本的 MDS-ABI 将在不久的将来进行评估和优化。