Department of Surgery, Letterkenny University Hospital and Donegal Clinical Research Academy, Donegal, Ireland.
University of Limerick School of Medicine, University of Limerick, Limerick, Ireland.
BJS Open. 2022 May 2;6(3). doi: 10.1093/bjsopen/zrac062.
Healthcare requires patient feedback to improve outcomes and experience. This study undertook a systematic review of the depth, variability, and digital suitability of current patient-reported outcome measures (PROMs) in patients undergoing laparoscopic cholecystectomy.
A PROSPERO-registered (registration number CRD42021261707) systematic review was undertaken for all relevant English language articles using PubMed version of MEDLINE, Scopus, and Web of Science electronic databases in June 2021. The search used Boolean operators and wildcards and included the keywords: laparoscopic cholecystectomy AND patient outcome OR patient-reported outcome OR patient-reported outcome measure OR PRO OR PROM. Medical Subjects Heading terms were used to search PubMed and Scopus. Articles published from 1 January 2011 to 2 June 2021 were included.
A total of 4960 individual articles were reviewed in this study, of which 44 were found to evaluate PROMs in patients undergoing laparoscopic cholecystectomy and underwent methodological index for non-randomized studies (MINORS) grading. Twenty-one articles spanning 19 countries and four continents met all inclusion criteria and were included in the qualitative data synthesis. There was significant heterogeneity in PROMs identified with eight different comprehensive PROM tools used in the 21 studies. There was wide variation in the time points at which PROMs were recorded. Fourteen of 21 studies recorded PROMs before and after surgery, and 7 of 21 recorded PROMs only after surgery. Follow-up intervals ranged from 3 days to 2 years after surgery.
This study identified that while post-laparoscopic cholecystectomy PROMs are infrequently measured currently, tools are widely available to achieve this in clinical practice. PROMs may not capture all the outcomes but should be incorporated into future cholecystectomy outcome research. The EQ-5D™ (EuroQoL Group, Rotterdam, the Netherlands) provides a simple platform for the modern digital era.
医疗保健需要患者反馈来改善结果和体验。本研究对接受腹腔镜胆囊切除术的患者目前的患者报告结局测量(PROM)的深度、变异性和数字适用性进行了系统评价。
于 2021 年 6 月,使用 PubMed 版本的 MEDLINE、Scopus 和 Web of Science 电子数据库,对所有相关英文文章进行了 PROSPERO 注册(注册号:CRD42021261707)系统评价。该搜索使用了布尔运算符和通配符,并包含了关键词:腹腔镜胆囊切除术和患者结局或患者报告结局或患者报告结局测量或 PRO 或 PROM。使用医学主题词(MeSH)术语搜索 PubMed 和 Scopus。纳入了 2011 年 1 月 1 日至 2021 年 6 月 2 日期间发表的文章。
本研究共对 4960 篇文章进行了综述,其中有 44 篇文章评估了接受腹腔镜胆囊切除术患者的 PROM,并进行了非随机研究方法学指数(MINORS)分级。21 篇文章跨越 19 个国家和四大洲,符合所有纳入标准,并纳入定性数据综合分析。确定的 PROM 存在显著异质性,21 项研究中使用了 8 种不同的综合 PROM 工具。记录 PROM 的时间点也存在很大差异。14 项研究记录了术前和术后的 PROM,7 项研究仅记录了术后的 PROM。随访间隔范围为术后 3 天至 2 年。
本研究发现,虽然目前很少测量腹腔镜胆囊切除术后的 PROM,但在临床实践中已经广泛提供了用于实现这一目标的工具。PROM 可能无法捕捉所有结果,但应纳入未来胆囊切除术结局研究。EQ-5D(EuroQoL Group,荷兰鹿特丹)为现代数字时代提供了一个简单的平台。