Hull Royal Infirmary, Hull, UK.
Encephalitis Society, Malton, UK and honorary lecturer, University of Liverpool, Liverpool, UK.
Clin Med (Lond). 2022 Mar;22(2):145-148. doi: 10.7861/clinmed.2021-0505. Epub 2022 Feb 23.
Encephalitis is typically caused by infection or autoimmunity. Most survivors suffer complex neurological and psychiatric sequelae. Standardised outcome measures are needed for accurate interpretation of observational studies and clinical trials. Step one in this process is understanding the strengths and weaknesses of those in use.
We performed a systematic literature review searching six databases. One reviewer screened titles and abstracts, and two reviewers determined if shortlisted full-text articles met inclusion criteria. Key data were extracted from these papers and presented as a narrative summary.
Thirty-seven outcome measures were used for 3,133 patients across the 35 included papers, of which, only one was developed for encephalitis. The outcome measures used in most patients were the Glasgow Outcome Score used in 1,436 (46%), Barthel Index used in 1,173 (37%), Euro-QoL-5D used in 1,107 (35%) and modified Rankin Scale used in 1,034 (33%).
Most of the 37 measures assessed a single category of sequelae using 5-8-point scales and were not validated for use in encephalitis. Research is needed to develop a composite outcome measure for use in clinical practice and a core-outcomes set for use in clinical trials. For now, the Liverpool Outcome Score offers a good choice for clinicians.
脑炎通常由感染或自身免疫引起。大多数幸存者都有复杂的神经和精神后遗症。为了准确解释观察性研究和临床试验，需要使用标准化的结局测量方法。这一过程的第一步是了解现有方法的优缺点。
我们进行了系统的文献检索，检索了六个数据库。一位评审员筛选标题和摘要，两位评审员确定被列入的全文文章是否符合纳入标准。从这些论文中提取关键数据，并以叙述性摘要的形式呈现。
在 35 篇纳入的论文中，有 3133 名患者使用了 37 种结局测量方法，其中只有一种是专门为脑炎开发的。在大多数患者中使用的结局测量方法是格拉斯哥结局评分（Glasgow Outcome Score），有 1436 名患者（46%）使用；其次是巴氏指数（Barthel Index），有 1173 名患者（37%）使用；欧洲五维健康量表（Euro-QoL-5D），有 1107 名患者（35%）使用；改良 Rankin 量表（modified Rankin Scale），有 1034 名患者（33%）使用。
37 种测量方法中的大多数仅评估了单一后遗症类别，使用的是 5-8 分制量表，且未经验证可用于脑炎。目前需要开发一种综合结局测量方法，用于临床实践，并制定一个核心结局测量集，用于临床试验。目前，利物浦结局评分（Liverpool Outcome Score）是一个不错的临床选择。
