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手部和腕部疾病患者结局测量的标准集:国际健康结局测量联合会手部和腕部工作组的共识。

A Standard Set for Outcome Measurement in Patients With Hand and Wrist Conditions: Consensus by the International Consortium for Health Outcomes Measurement Hand and Wrist Working Group.

机构信息

Department of Plastic, Reconstructive and Hand Surgery, Department of Rehabilitation Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Center for Hand Therapy, Handtherapie Nederland Hand and Wrist Center, Xpert Clinics, the Netherlands.

the International Consortium for Health Outcomes Measurement, London, United Kingdom.

出版信息

J Hand Surg Am. 2021 Oct;46(10):841-855.e7. doi: 10.1016/j.jhsa.2021.06.004. Epub 2021 Jul 27.

Abstract

PURPOSE

To describe the principles, process, and results of creating the International Consortium for Health Outcomes Measurement (ICHOM) standard set for hand and wrist conditions.

METHODS

Following the standardized methods of ICHOM, an international working group of hand surgeons, therapists, and researchers was assembled to develop an evidence-based, patient-centered, standard set of outcome measures for patients with hand and wrist conditions. Multiple systematic reviews were performed to support our choices of outcome domains and tools for hand and wrist conditions. Fourteen video conferences were held between March 2018 and March 2020, and a modified Delphi process was used.

RESULTS

A consensus was reached on 5 measurement tracks: the thumb, finger, wrist, nerve, and severe hand trauma tracks, with a distinction between regular and extended tracks for which specific allocation criteria applied. The standard set contains a selection of outcome tools and predefined time points for outcome measurement. Additionally, we developed a hierarchy for using the tracks when there are multiple conditions, and we selected risk-adjustment, case-mix variables.

CONCLUSIONS

The global implementation of the ICHOM standard set for hand and wrist conditions may facilitate value-based health care for patients with hand and wrist conditions.

CLINICAL RELEVANCE

The ICHOM standard set for hand and wrist conditions can enable clinical decision making, quality improvement, and comparisons between treatments and health care professionals.

摘要

目的

描述为手部和腕部疾病创建国际健康结果测量协会 (ICHOM) 标准集的原则、过程和结果。

方法

按照 ICHOM 的标准化方法,召集了一组国际手外科医生、治疗师和研究人员组成的国际工作组,为手部和腕部疾病患者制定了基于证据、以患者为中心的标准结局测量集。进行了多次系统评价以支持我们对手部和腕部疾病的结局领域和工具的选择。2018 年 3 月至 2020 年 3 月期间举行了 14 次视频会议,并采用了改良 Delphi 流程。

结果

就 5 个测量轨道达成了共识:拇指、手指、手腕、神经和严重手部创伤轨道,并为适用特定分配标准的常规和扩展轨道做出了区分。标准集包含了一系列结局工具和预先设定的结局测量时间点。此外,我们制定了在存在多种疾病时使用这些轨道的层次结构,并选择了风险调整、病例组合变量。

结论

手部和腕部疾病的 ICHOM 标准集的全球实施可能有助于为手部和腕部疾病患者提供基于价值的医疗保健。

临床意义

手部和腕部疾病的 ICHOM 标准集可以实现临床决策、质量改进以及治疗方法和医疗保健专业人员之间的比较。

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