Moltaji Syena, Gallo Matteo, Wong Chloe, Murphy Jessica, Gallo Lucas, Waltho Daniel, Copeland Andrea, Karpinski Marta, Mowakket Sadek, Duku Eric, Thoma Achilleas
Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.
Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
J Hand Microsurg. 2020 Aug;12(2):85-94. doi: 10.1055/s-0040-1701324. Epub 2020 Apr 9.
There is a lack of consensus on what the critical outcomes in replantation are and how best to measure them. This review aims to identify all reported outcomes and respective outcome measures used in digital replantation. Randomized controlled trials, cohort studies, and single-arm observational studies of adults undergoing replantation with at least one well-described outcome or outcome measure were identified. Primary outcomes were classified into six domains, and outcome measures were classified into eight domains. The clinimetric properties were identified and reported. A total of 56 observational studies met the inclusion criteria. In total, 29 continuous and 29 categorical outcomes were identified, and 87 scales and instruments were identified. The most frequently used outcomes were survival of replanted digit, sensation, and time in hospital. Outcomes and measures were most variable in domains of viability, quality of life, and motor function. Only eight measures used across these domains were validated and proven reliable. Lack of consensus creates an obstacle to reporting, understanding, and comparing the effectiveness of various replantation strategies.
对于再植术中的关键结局是什么以及如何最好地衡量这些结局,目前尚无共识。本综述旨在确定数字再植术中所有报告的结局以及各自使用的结局指标。
确定了对至少有一项描述详尽的结局或结局指标的成年再植患者进行的随机对照试验、队列研究和单臂观察性研究。主要结局分为六个领域,结局指标分为八个领域。确定并报告了临床测量特性。共有56项观察性研究符合纳入标准。
总共确定了29个连续性结局和29个分类结局,并确定了87种量表和工具。最常用的结局是再植指存活、感觉和住院时间。结局和指标在存活能力、生活质量和运动功能领域变化最大。在这些领域中使用的措施中,只有八项经过验证且被证明可靠。
缺乏共识给报告、理解和比较各种再植策略的有效性造成了障碍。