Carleo Beth, Anderson Kristian, Prevost Carol Parnell, Pohlman Katherine A
Palmer College of Chiropractic, 4777 City Center Parkway, Port Orange, FL, 32129, USA.
Performance Chiropractic, 4350 South Washington Street Suite 100, Grand Forks, ND, 58201, USA.
J Patient Rep Outcomes. 2021 Apr 1;5(1):31. doi: 10.1186/s41687-021-00305-1.
Patient-reported outcome measurements (PROM) are instruments that seek a patient's health or functional status. Inclusion of standardized PROMs in research studies and clinical practice provides a more comprehensive understanding of an intervention from the patient's viewpoint. This secondary analysis identified PROM usage and appropriateness of references for property measurements from clinical trials included in a recent systematic review of pediatric manual therapy.
All included manuscripts within a recent systematic review had two authors extract PROM and associated property measurement data, including the property measurements supporting citations. Inclusion criteria for the articles were published clinical trials (observational or experimental) of pediatric children receiving manual therapy (any profession) for any condition between 2001-March 2018. For each PROM's associated property measurement, two authors used the COSMIN study design checklist to appraise the quality of the cited study to evaluate the property measurement.
Of the 50 manuscripts included in the systematic review, 20 manuscripts reported the use of 52 PROMs. Of the 52 PROMs assessed, 31 did not make a statement about the instrument's property measurement, 7 PROMs had property measurements stated but not referenced, 4 PROMs stated that the property measurement information was unknown, and 10 had property measurement data with reference(s). These 10 PROMs with referenced property measurements were from 7 unique PROMs: constipation assessment scale, satisfaction visual analog scale (VAS), crying time diary, sleep diary, fear avoidance belief questionnaire (FABQ), pain VAS, and autism treatment evaluation checklist. The assessment of the referenced property measurements found that several property measurement's dimensions had not been assessed and those that had were evaluated were done so with poor or fair standards.
This secondary analysis finds that clinical studies of pediatric manual therapy lack consistent use of PROMs with high quality property measurements. Further research to establish and implement PROMs to be used in future research studies and in clinical settings should become a priority for professions using manual therapy in children.
患者报告结局测量（PROM）是用于了解患者健康或功能状况的工具。在研究和临床实践中纳入标准化的PROM能够从患者的角度更全面地理解干预措施。这项二次分析确定了PROM的使用情况以及近期一项儿科手法治疗系统评价中所纳入临床试验中属性测量参考文献的适用性。
近期一项系统评价中所有纳入的手稿由两位作者提取PROM及相关属性测量数据，包括支持引用的属性测量。文章的纳入标准为2001年至2018年3月期间发表的关于接受手法治疗（任何专业）的儿科患者（任何疾病）的临床试验（观察性或实验性）。对于每个PROM的相关属性测量，两位作者使用COSMIN研究设计清单来评估引用研究的质量以评价属性测量。
在系统评价纳入的50篇手稿中，20篇手稿报告使用了52种PROM。在评估的52种PROM中，31种未对工具的属性测量作出说明，7种PROM有属性测量说明但未引用参考文献，4种PROM表示属性测量信息未知，10种有属性测量数据及参考文献。这10种有引用属性测量的PROM来自7种不同的PROM：便秘评估量表、满意度视觉模拟量表（VAS）、哭闹时间日记、睡眠日记、恐惧回避信念问卷（FABQ）、疼痛VAS和自闭症治疗评估清单。对引用的属性测量的评估发现，几个属性测量维度未得到评估，而那些已评估的维度的评估标准较差或一般。
这项二次分析发现，儿科手法治疗的临床研究缺乏对具有高质量属性测量的PROM的一致使用。对于在儿童中使用手法治疗的专业人员而言，开展进一步研究以建立并实施可用于未来研究和临床环境的PROM应成为优先事项。
