Department of Occupational Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
School of Physical Therapy, Department of Health and Rehabilitation Sciences, University of Western Ontario. Roth McFarlane Hand and Upper Limb Centre, St. Joseph's Hospital, London, ON, Canada.
Breast Cancer. 2022 May;29(3):377-393. doi: 10.1007/s12282-022-01340-6. Epub 2022 Mar 1.
To identify currently used patient-reported outcome measures (PROMs) to evaluate disability in breast cancer survivors (BC) and critically evaluate their content and measurement properties.
Four electronic databases (PubMed, EMBASE, CINAHL, Scopus and Google Scholar) were searched from 2001 to February 2021. PRISMA guidelines were followed. The content of the included PROM was evaluated by linking the items of the questionnaires to the International Classification of Functioning, Disability and Health (ICF) Core Set for BC using standard linking rules. Methodological quality and measurement properties were assessed using the COSMIN checklist. Qualitative synthesis was used to summarize the evidence on content validity and measurement properties. The overall quality of evidence on each measurement property was provided using GRADE principles.
Ten eligible studies reported measurement properties of seven PROMs. The content of included PROMs mostly focused on disability (70% of items), and less on body function and structure (23%) or environmental factors (6%). There was high linkage to The Comprehensive Core Set for BC, Q-DASH (100%), UEFI (95%) and DASH (92%). The Core Set Unique Disability Representation for DASH, and WHODAS2 was 39% and BCSQ-BC, Lymph-ICF was 34%. BCSQ-BC, and Lymph-ICF represented 32, and 20% of the content of the Core Set for BC, respectively, however, the other questionnaires covered less than 20% of the content of the Core Set. High quality of evidence supports sufficient results for internal consistency, testretest, and measurement error for BCSQ-BC, Lymph-ICF, DASH and WHODAS2.
Despite a lack of evidence on all-important clinical measurement, two generic (DASH and WHODAS2) and two disease-specific (BCSQ-BC, Lymph-ICF) PROM demonstrated emerging evidence of adequate measurement properties. The stronger alignment of the BCSQ-BC to the breast cancer ICF core set makes it preferable is a disease-specific measure. The Lymph-ICF is recommended where lymphedema is a specific focus. The DASH and WHODAS2 might be most useful where patients with a variety of upper extremity conditions, including breast cancer survivors, are being evaluated in the clinic or research study.
确定目前用于评估乳腺癌幸存者（BC）残疾的患者报告结局测量（PROM），并对其内容和测量特性进行严格评估。
从 2001 年至 2021 年 2 月，在四个电子数据库（PubMed、EMBASE、CINAHL、Scopus 和 Google Scholar）中进行了搜索。遵循 PRISMA 指南。使用标准链接规则，将问卷的项目与国际功能、残疾和健康分类（ICF）BC 核心集相链接，以评估纳入的 PROM 的内容。使用 COSMIN 清单评估方法学质量和测量特性。使用定性综合来总结内容有效性和测量特性的证据。使用 GRADE 原则提供关于每种测量特性的证据的总体质量。
10 项符合条件的研究报告了 7 种 PROM 的测量特性。纳入的 PROM 内容主要集中在残疾（70%的项目），较少涉及身体功能和结构（23%）或环境因素（6%）。与全面的 BC 核心集、Q-DASH（100%）、UEFI（95%）和 DASH（92%）高度相关。DASH 的独特残疾代表核心集、WHODAS2 为 39%，BCSQ-BC、Lymph-ICF 为 34%。BCSQ-BC 和 Lymph-ICF 分别代表了 BC 核心集的 32%和 20%的内容，而其他问卷仅涵盖了核心集内容的 20%以下。高质量的证据支持 BCSQ-BC、Lymph-ICF、DASH 和 WHODAS2 的内部一致性、重测和测量误差的充分结果。
尽管所有重要的临床测量都缺乏证据，但两种通用（DASH 和 WHODAS2）和两种疾病特异性（BCSQ-BC、Lymph-ICF）的 PROM 都显示出了足够的测量特性的新兴证据。BCSQ-BC 与乳腺癌 ICF 核心集的更强一致性使其成为一种疾病特异性的测量方法更具优势。如果淋巴水肿是一个特定的关注点，则推荐使用 Lymph-ICF。如果上肢有多种疾病的患者需要评估，包括乳腺癌幸存者，DASH 和 WHODAS2 可能在诊所或研究中最有用。
