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理解 RYR1 相关肌病的症状:基于参与者经验的混合方法分析。

Understanding Symptoms in RYR1-Related Myopathies: A Mixed-Methods Analysis Based on Participants' Experience.

机构信息

Neuromuscular Symptoms Unit, Tissue Injury Branch, National Institute of Nursing Research, National Institutes of Health, Building 60, Room 254, Bethesda, MD, 20892, USA.

出版信息

Patient. 2020 Aug;13(4):423-434. doi: 10.1007/s40271-020-00418-7.

Abstract

BACKGROUND

In rare diseases such as ryanodine receptor 1-related myopathies (RYR1-RM), health-related quality of life (HRQoL) measures are critically important so clinicians and researchers can better understand what symptoms are most important to participants, with the ultimate goal of finding tangible solutions for them.

OBJECTIVES

The main objective of this study was to characterize symptoms in individuals with RYR1-RM to inform future research. A secondary objective of this study was to analyze positive and negative sentiments regarding symptoms and treatment effects post N-acetylcysteine (NAC) administration in individuals with RYR1-RM.

METHODS

The study used a mixed-methods design applying methodological triangulation. Qualitative data were collected via semi-structured interviews at three visits to characterize symptoms in individuals with RYR1-RM and to analyze treatment effects. Qualitative data were then transformed into quantitative results to measure the frequency with which each symptom was mentioned by participants.

RESULTS

A total of 12 symptoms were identified as areas of interest to participants with RYR1-RM, highlighting fatigue and weakness as key symptoms. Data transformation categorized more than 1000 citations, reporting a greater number of positive comments for postintervention interviews than for baseline and preintervention visits and that NAC group participants stated more positive comments regarding treatment effect than did the placebo group.

CONCLUSIONS

We present a comprehensive characterization of symptoms in RYR1-RM and how those symptoms influence HRQoL. Furthermore, the introduction of mixed methods may be a valuable way to better understand patient-centered data in rare diseases to support affected individuals in coping with their symptoms.

摘要

背景

在罕见病,如兰尼碱受体 1 相关肌病(RYR1-RM),健康相关生活质量(HRQoL)的措施是至关重要的,所以临床医生和研究人员可以更好地了解哪些症状对参与者最重要,最终目标是为他们找到切实可行的解决方案。

目的

本研究的主要目的是描述 RYR1-RM 患者的症状,为未来的研究提供信息。本研究的次要目的是分析 N-乙酰半胱氨酸(NAC)治疗后 RYR1-RM 患者的症状和治疗效果的正负情绪。

方法

该研究采用混合方法设计,应用方法学三角测量。通过三次就诊的半结构式访谈收集定性数据,以描述 RYR1-RM 患者的症状,并分析治疗效果。然后,将定性数据转化为定量结果,以衡量每个症状被参与者提及的频率。

结果

确定了 12 个症状是 RYR1-RM 患者感兴趣的领域,突出了疲劳和无力是关键症状。数据转换对 1000 多条引用进行了分类,结果显示干预后访谈的积极评价比基线和干预前访问多,NAC 组患者对治疗效果的积极评价比安慰剂组多。

结论

我们提出了对 RYR1-RM 患者症状的全面描述,以及这些症状如何影响 HRQoL。此外,混合方法的引入可能是一种更好地理解罕见病患者为中心数据的有价值的方法,以支持受影响的个体应对他们的症状。

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本文引用的文献

1
Randomized controlled trial of -acetylcysteine therapy for -related myopathies.-乙酰半胱氨酸治疗相关肌病的随机对照试验。
Neurology. 2020 Mar 31;94(13):e1434-e1444. doi: 10.1212/WNL.0000000000008872. Epub 2020 Jan 15.

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