Bristol Centre for Surgical Research, Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, UK.
Bristol Medical School, University of Bristol, Bristol, UK.
BJS Open. 2021 Mar 5;5(2). doi: 10.1093/bjsopen/zraa072.
Little is known about the electronic collection and clinical feedback of patient-reported outcomes (ePROs) following surgical discharge. This systematic review summarized the evidence on the collection and uses of electronic systems to collect PROs after discharge from hospital after surgery.
Systematic searches of MEDLINE, Embase, PsycINFO, CINAHL and Cochrane Central were undertaken from database inception to July 2019 using terms for 'patient reported outcomes', 'electronic', 'surgery' and 'at home'. Primary research of all study designs was included if they used electronic systems to collect PRO data in adults after hospital discharge following surgery. Data were collected on the settings, patient groups and specialties, ePRO systems (including features and functions), PRO data collected, and integration with health records.
Fourteen studies were included from 9474 records, including two RCTs and six orthopaedic surgery studies. Most studies (9 of 14) used commercial ePRO systems. Six reported types of electronic device were used: tablets or other portable devices (3 studies), smartphones (2), combination of smartphones, tablets, portable devices and computers (1). Systems had limited features and functions such as real-time clinical feedback (6 studies) and messaging service for patients with care teams (3). No study described ePRO system integration with electronic health records to support clinical feedback.
There is limited reporting of ePRO systems in the surgical literature, and ePRO systems lack integration with hospital clinical systems. Future research should describe the ePRO system and ePRO questionnaires used, and challenges encountered during the study, to support efficient upscaling of ePRO systems using tried and tested approaches.
对于手术后出院后患者报告结局(PROs)的电子采集和临床反馈,知之甚少。本系统评价总结了使用电子系统在手术后从医院出院后采集 PROs 的证据。
从数据库建立到 2019 年 7 月,使用“患者报告结局”、“电子”、“手术”和“在家”的术语,对 MEDLINE、Embase、PsycINFO、CINAHL 和 Cochrane Central 进行了系统搜索。如果使用电子系统在手术后出院后收集成年人的 PRO 数据,将纳入所有研究设计的原始研究。收集的信息包括设置、患者群体和专业、电子 PRO 系统(包括功能)、收集的 PRO 数据以及与健康记录的整合。
从 9474 条记录中纳入了 14 项研究,包括 2 项 RCT 和 6 项矫形外科研究。大多数研究(14 项中的 9 项)使用商业电子 PRO 系统。报告使用了 6 种类型的电子设备:平板电脑或其他便携式设备(3 项研究)、智能手机(2 项)、智能手机、平板电脑、便携式设备和计算机的组合(1 项)。系统具有有限的功能,如实时临床反馈(6 项研究)和患者与护理团队的消息服务(3 项研究)。没有研究描述电子 PRO 系统与电子健康记录的集成,以支持临床反馈。
外科文献中对电子 PRO 系统的报道有限,电子 PRO 系统缺乏与医院临床系统的整合。未来的研究应该描述使用的电子 PRO 系统和电子 PRO 问卷,以及在研究过程中遇到的挑战,以支持使用经过验证的方法有效地扩大电子 PRO 系统的规模。