Trent Oesophago-Gastric Unit, Nottingham University Hospitals NHS Trust, , City Hospital Campus, Hucknall Road, Nottingham, UK.
Gastrointestinal Surgery, Nottingham Digestive Diseases Centre and National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Queen's Medical Centre, Nottingham, UK.
World J Surg. 2022 Sep;46(9):2155-2165. doi: 10.1007/s00268-022-06588-9. Epub 2022 May 24.
The collection of patient-reported outcome measures (PROMs) has many benefits for clinical practice. However, there are many barriers that prevent them from becoming a part of routine clinical care. The aim of this feasibility study was to pilot the use of a digital platform to facilitate the routine collection of pre- and post-operative electronic PROMs (ePROMs) in participants undergoing elective laparoscopic cholecystectomy and to validate the use of existing patient-reported outcomes for our population.
Participants scheduled for elective laparoscopic cholecystectomy were asked to complete digital versions of the Otago gallstones Condition-Specific Questionnaire (CSQ), and the RAND 36-item health survey (SF36). An assessment of methodological quality of ePROM questionnaires was also performed.
Preoperative ePROMs were completed by 200 participants undergoing laparoscopic cholecystectomy. Post-operatively attrition was high (completion at 30 days, 3 months, and 6months: n = 61, 54, and 38, respectively) due to difficulties accessing our ePROMs portal. Of those able to complete, a significant improvement in quality of life was seen across all health domains post-operatively when compared with baseline preoperative values for both disease-specific and generic PROMs. Methodological quality was assessed as good to excellent in both digital questionnaires.
The collection of ePROMs is possible with current technological advances. Although it may be an acceptable, and convenient process for patients, and a useful measure of quality-of-life trends for clinicians, further developmental work is necessary to improve accessibility for patients, improve compliance, and reduce reporting bias from high attrition rates.
收集患者报告的结果测量（PROMs）对临床实践有很多好处。然而，有许多障碍阻止它们成为常规临床护理的一部分。本可行性研究的目的是试用数字平台来促进接受择期腹腔镜胆囊切除术的参与者常规收集术前和术后电子 PROM（ePROM），并验证我们人群中现有患者报告结果的使用。
计划接受择期腹腔镜胆囊切除术的参与者被要求完成奥塔哥胆囊疾病特定问卷（CSQ）和 RAND 36 项健康调查（SF36）的数字版本。还对 ePROM 问卷的方法学质量进行了评估。
200 名接受腹腔镜胆囊切除术的患者完成了术前 ePROM。由于难以访问我们的 ePROM 门户，术后失访率很高（30 天、3 个月和 6 个月的完成率分别为 n = 61、54 和 38）。对于那些能够完成的患者，与基线术前值相比，所有健康领域的生活质量在术后均显著改善，无论是针对特定疾病还是通用 PROM。两种数字问卷的方法学质量均评估为良好至优秀。
随着当前技术的进步，ePROM 的收集是可行的。尽管对于患者来说，这可能是一个可接受且方便的过程，并且是临床医生衡量生活质量趋势的有用指标，但需要进一步的开发工作来提高患者的可访问性、提高依从性，并降低高失访率导致的报告偏差。
