Smith Sean R, Vargo Mary, Zucker David S, Henderson Maryanne, Shahpar Samman, Wisotzky Eric M, Custodio Christian, Basford Jeffrey, Jay Gina, Gerber Lynn, Cheville Andrea
Department of Physical Medicine and Rehabilitation, Michigan Medicine, Ann Arbor, MI, United States.
Case Western Reserve University, Cleveland, OH, United States.
Front Oncol. 2021 Feb 3;10:625700. doi: 10.3389/fonc.2020.625700. eCollection 2020.
A primary objective stated at the Cancer Rehabilitation Symposium at the National Institutes of Health was to improve outcome measurement. The purpose of this project was for the Cancer Rehabilitation Medicine Metrics Consortium (CRMMC) to develop an assessment tool to evaluate function in cancer patients via a data-driven and methodologically sound process. There is no agreed-upon measure of physical and cognitive function for cancer patients, making it difficult to demonstrate the value of rehabilitation interventions. Cancer patients are a particularly challenging population, with many tumor- and treatment-related variables impacting function.
Investigators from nine different cancer rehabilitation programs participated in a modified-Delphi process to delineate necessary aspects of an ideal patient assessment tool, including instrument type, domains evaluated, applicability across a range of patient traits, clinical feasibility, and item response characteristics. This involved numerous meetings, data review, and analysis of items involved in patient assessment.
The CRMMC developed a 21-item patient-reported outcome measure based on item response theory. The process by which the short form was developed was documented and provides a framework for other clinicians to follow.
This document provides a framework for rehabilitation providers to follow when developing an assessment tool. This process is described in a stepwise fashion for reproducibility even in different, non-cancer populations.
美国国立卫生研究院癌症康复研讨会上提出的一个主要目标是改善结果测量。本项目的目的是让癌症康复医学指标联盟(CRMMC)通过数据驱动且方法合理的流程开发一种评估工具,以评估癌症患者的功能。目前尚无针对癌症患者身体和认知功能的公认测量方法,这使得难以证明康复干预措施的价值。癌症患者是一个特别具有挑战性的群体,许多与肿瘤和治疗相关的变量都会影响功能。
来自九个不同癌症康复项目的研究人员参与了改良德尔菲法流程,以确定理想患者评估工具的必要方面,包括工具类型、评估领域、对一系列患者特征的适用性、临床可行性以及项目反应特征。这涉及多次会议、数据审查以及对患者评估中涉及项目的分析。
CRMMC基于项目反应理论开发了一种包含21个条目的患者报告结局测量方法。开发简表的过程有记录,为其他临床医生提供了遵循的框架。
本文档为康复提供者在开发评估工具时提供了遵循的框架。该过程以逐步方式描述,即使在不同的非癌症人群中也具有可重复性。