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首个以患者为中心的肌肉浸润性和转移性膀胱癌结局指标集的制定:一项多中心倡议。

Development of the First Patient-centred Set of Outcomes for Muscle-invasive and Metastatic Bladder Cancer: A Multicentre Initiative.

作者信息

Reesink Daan J, van de Garde Ewoudt M W, Somford Diederik M, Meijer Richard P, Los Maartje, Biesma Douwe H, Horenblas Simon, van Melick Harm H E, van der Nat Paul B

机构信息

Urology Department, St. Antonius Hospital, Utrecht/Nieuwegein, The Netherlands.

Clinical Pharmacy Department, St. Antonius Hospital, Utrecht/Nieuwegein, The Netherlands.

出版信息

Eur Urol Open Sci. 2021 Feb 15;26:18-26. doi: 10.1016/j.euros.2021.01.014. eCollection 2021 Apr.

Abstract

BACKGROUND

To improve and compare outcomes in healthcare, it is necessary to standardise outcome measurements. There are no widely accepted standardised outcome measures reflecting quality of care for bladder cancer (BCa) patients.

OBJECTIVE

The aim of this study was to create a standardised set of outcomes for patients with muscle-invasive or metastatic BCa, using the value-based healthcare principles.

DESIGN SETTING AND PARTICIPANTS

A multidisciplinary working group of 25 healthcare professionals and patient representatives was assembled, to develop the set.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS

We used an online RAND-modified Delphi process to prioritise, discuss, and reach consensus regarding the outcomes, case-mix variables, and treatment factors.

RESULTS AND LIMITATIONS

Recognising the heterogeneity of patients with BCa, the working group defined the scope as patients with muscle-invasive and metastatic BCa. A total of 24 outcomes, including ten patient-reported outcomes, were included in the standard set of outcomes, covering survival, complication rates, recurrence of disease, readmissions after treatment, and quality of life (QoL). Fourteen case-mix variables were included. The EQ-5D and European Organisation for Research and Treatment of Cancer quality of life (EORTC-QLQ) questionnaires were recommended to measure QoL.

CONCLUSIONS

We developed the first standardised set of patient-centred outcomes for muscle-invasive and metastatic BCa. The sue of this set enables institutions to monitor, compare, and improve the quality of BCa care, on an international level.

PATIENT SUMMARY

Our group of healthcare professionals and patient representatives recommended a standardised set of patient-centred outcomes to be followed during the treatment of patients with muscle-invasive or metastatic bladder cancer, in order to monitor, compare, and improve the quality of care.

摘要

背景

为了改善和比较医疗保健中的结果,有必要对结果测量进行标准化。目前尚无广泛接受的反映膀胱癌(BCa)患者护理质量的标准化结果测量指标。

目的

本研究的目的是运用基于价值的医疗保健原则,为肌肉浸润性或转移性BCa患者创建一套标准化的结果指标。

设计、设置和参与者:组建了一个由25名医疗保健专业人员和患者代表组成的多学科工作组来制定该指标集。

结果测量和统计分析

我们使用在线兰德改良德尔菲法对结果、病例组合变量和治疗因素进行优先级排序、讨论并达成共识。

结果与局限性

鉴于认识到BCa患者的异质性,工作组将范围定义为肌肉浸润性和转移性BCa患者。标准结果指标集中共纳入了24项结果,包括10项患者报告的结果,涵盖生存、并发症发生率、疾病复发、治疗后再入院以及生活质量(QoL)。还纳入了14个病例组合变量。推荐使用EQ - 5D和欧洲癌症研究与治疗组织生活质量(EORTC - QLQ)问卷来测量生活质量。

结论

我们为肌肉浸润性和转移性BCa制定了第一套以患者为中心的标准化结果指标。使用该指标集能够使各机构在国际层面上监测、比较并改善BCa护理质量。

患者总结

我们的医疗保健专业人员和患者代表小组推荐了一套以患者为中心的标准化结果指标,用于在肌肉浸润性或转移性膀胱癌患者的治疗过程中遵循,以便监测、比较并改善护理质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/061d/8317903/7006f0388f34/gr1.jpg

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