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慢性阻塞性肺疾病急性加重管理的核心结局集:COS-AECOPD欧洲呼吸学会工作组研究方案

Core outcome set for the management of acute exacerbations of chronic obstructive pulmonary disease: the COS-AECOPD ERS Task Force study protocol.

作者信息

Mathioudakis Alexander G, Abroug Fekri, Agusti Alvar, Bakke Per, Bartziokas Konstantinos, Beghe Bianca, Bikov Andras, Bradbury Thomas, Brusselle Guy, Cadus Cordula, Coleman Courtney, Contoli Marco, Corlateanu Alexandru, Corlateanu Olga, Criner Gerard, Csoma Balazs, Emelyanov Alexander, Faner Rosa, Romero Gustavo Fernandez, Hammouda Zeineb, Horváth Peter, Huerta Arturo Garcia, Jacobs Michael, Jenkins Christine, Joos Guy, Kharevich Olga, Kostikas Konstantinos, Lapteva Elena, Lazar Zsofia, Leuppi Joerg D, Liddle Carol, López-Giraldo Alejandra, McDonald Vanessa M, Nielsen Rune, Papi Alberto, Saraiva Isabel, Sergeeva Galina, Sioutkou Agni, Sivapalan Pradeesh, Stovold Elizabeth, Wang Hao, Wen Fuqiang, Yorke Janelle, Williamson Paula R, Vestbo Jørgen, Jensen Jens-Ulrik

机构信息

Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.

The North West Lung Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK.

出版信息

ERJ Open Res. 2020 Sep 14;6(3). doi: 10.1183/23120541.00193-2020. eCollection 2020 Jul.

Abstract

Randomised controlled trials (RCTs) on the management of COPD exacerbations evaluate heterogeneous outcomes, often omitting those that are clinically important and patient relevant. This limits their usability and comparability. A core outcome set (COS) is a consensus-based minimum set of clinically important outcomes that should be evaluated in all RCTs in specific areas of health care. We present the study protocol of the COS-AECOPD ERS Task Force, aiming to develop a COS for COPD exacerbation management, that could remedy these limitations. For the development of this COS we follow standard methodology recommended by the COMET initiative. A comprehensive list of outcomes is assembled through a methodological systematic review of the outcomes reported in relevant RCTs. Qualitative research with patients with COPD will also be conducted, aiming to identify additional outcomes that may be important to patients, but are not currently addressed in clinical research studies. Prioritisation of the core outcomes will be facilitated through an extensive, multi-stakeholder Delphi survey with a global reach. Selection will be finalised in an international, multi-stakeholder meeting. For every core outcome, we will recommend a specific measurement instrument and standardised time points for evaluation. Selection of instruments will be based on evidence-informed consensus. Our work will improve the quality, usability and comparability of future RCTs on the management of COPD exacerbations and, ultimately, the care of patients with COPD. Multi-stakeholder engagement and societal support by the European Respiratory Society will raise awareness and promote implementation of the COS.

摘要

关于慢性阻塞性肺疾病(COPD)急性加重期管理的随机对照试验(RCT)评估的结果存在异质性,常常遗漏那些具有临床重要性且与患者相关的结果。这限制了它们的实用性和可比性。核心结局集(COS)是基于共识的最小临床重要结局集,应在医疗保健特定领域的所有RCT中进行评估。我们展示了慢性阻塞性肺疾病急性加重期管理核心结局集(COS-AECOPD)欧洲呼吸学会工作组的研究方案,旨在制定一个用于COPD急性加重期管理的COS,以弥补这些局限性。为了制定这个COS,我们遵循COMET倡议推荐的标准方法。通过对相关RCT中报告的结局进行方法学系统评价,汇总出一份全面的结局清单。还将对COPD患者进行定性研究,旨在识别可能对患者很重要但目前临床研究未涉及的其他结局。将通过广泛的、具有全球影响力的多利益相关方德尔菲调查促进对核心结局的优先排序。将在一次国际多利益相关方会议上最终确定选择。对于每个核心结局,我们将推荐一种特定的测量工具和标准化的评估时间点。工具的选择将基于循证共识。我们的工作将提高未来关于COPD急性加重期管理的RCT的质量、实用性和可比性,并最终改善COPD患者的护理。欧洲呼吸学会的多利益相关方参与和社会支持将提高对该COS的认识并促进其实施。

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