Boonen Annelies, Putrik Polina, Marques Mary Lucy, Alunno Alessia, Abasolo Lydia, Beaton Dorcas, Betteridge Neil, Bjørk Mathilda, Boers Maarten, Boteva Boryana, Fautrel Bruno, Guillemin Francis, Mateus Elsa F, Nikiphorou Elena, Péntek Márta, Pimentel Santos Fernando, Severens Johannes L, Verstappen Suzanne M M, Walker-Bone Karen, Wallman Johan Karlsson, Ter Wee Marieke M, Westhovens René, Ramiro Sofia
Division of Rheumatology, Maastricht University Medical Centre+ Internal Medicine, Maastricht, The Netherlands
Universiteit Maastricht Care and Public Health Research Institute, Maastricht, The Netherlands.
Ann Rheum Dis. 2021 Sep;80(9):1116-1123. doi: 10.1136/annrheumdis-2020-219523. Epub 2021 Apr 8.
Clinical studies with work participation (WP) as an outcome domain pose particular methodological challenges that hamper interpretation, comparison between studies and meta-analyses.
To develop Points to Consider (PtC) for design, analysis and reporting of studies of patients with inflammatory arthritis that include WP as a primary or secondary outcome domain.
The EULAR Standardised Operating Procedures were followed. A multidisciplinary taskforce with 22 experts including patients with rheumatic diseases, from 10 EULAR countries and Canada, identified methodologic areas of concern. Two systematic literature reviews (SLR) appraised the methodology across these areas. In parallel, two surveys among professional societies and experts outside the taskforce sought for additional methodological areas or existing conducting/reporting recommendations. The taskforce formulated the PtC after presentation of the SLRs and survey results, and discussion. Consensus was obtained through informal voting, with levels of agreement obtained anonymously.
Two overarching principles and nine PtC were formulated. The taskforce recommends to align the work-related study objective to the design, duration, and outcome domains/measurement instruments of the study (PtC: 1-3); to identify contextual factors upfront and account for them in analyses (PtC: 4); to account for interdependence of different work outcome domains and for changes in work status over time (PtC: 5-7); to present results as means as well as proportions of patients reaching predefined meaningful categories (PtC: 8) and to explicitly report volumes of productivity loss when costs are an outcome (PtC:9).
Adherence to these EULAR PtC will improve the methodological quality of studies evaluating WP.
以工作参与度(WP)作为结局领域的临床研究带来了特殊的方法学挑战,这阻碍了研究结果的解释、不同研究之间的比较以及荟萃分析。
为以WP作为主要或次要结局领域的炎症性关节炎患者研究的设计、分析和报告制定要点考量(PtC)。
遵循欧洲抗风湿病联盟(EULAR)标准化操作程序。一个由来自10个EULAR国家和加拿大的22名专家组成的多学科工作组,包括风湿病患者,确定了关注的方法学领域。两项系统文献综述(SLR)评估了这些领域的方法学。同时,对专业协会和工作组之外的专家进行的两项调查,寻找其他方法学领域或现有的实施/报告建议。工作组在展示SLR和调查结果并进行讨论后制定了PtC。通过非正式投票达成共识,以匿名方式获得一致同意程度。
制定了两项总体原则和九条PtC。工作组建议使与工作相关的研究目标与研究的设计、持续时间以及结局领域/测量工具保持一致(PtC:1 - 3);预先确定背景因素并在分析中加以考虑(PtC:4);考虑不同工作结局领域的相互依存关系以及工作状态随时间的变化(PtC:5 - 7);以均值以及达到预定义有意义类别的患者比例呈现结果(PtC:8),并且在成本作为结局时明确报告生产力损失的量(PtC:9)。
遵循这些EULAR PtC将提高评估WP的研究的方法学质量。