银屑病患者相关结局的系统评价。

Dermatology Research Unit, Ghent University, Ghent, Belgium.

Department of Dermatology, Ghent University Hospital, Ghent, Belgium.

JAMA Dermatol. 2022 Jul 1;158(7):806-811. doi: 10.1001/jamadermatol.2022.1756.

IMPORTANCE

There is a need to define which outcomes matter to patients with psoriasis to deliver value for the patient when managing their condition.

OBJECTIVES

To generate a comprehensive overview of all outcomes relevant in the management of psoriasis as defined by patients.

EVIDENCE REVIEW

A systematic review was performed by searching 3 databases (MEDLINE, Embase, and Web of Science) from August 1, 2019, until March 27, 2021, using a comprehensive search strategy consisting of 4 concepts including psoriasis, patients, outcomes, and relevance. A (citing) reference search was also performed of all retrieved articles. Two independent reviewers screened the retrieved records by title/abstract against the eligibility criteria. Studies were eligible for inclusion if they reported on the importance of outcomes for patients with psoriasis. No language restrictions were used. Data extraction and quality assessment were also performed independently. Quality assessment was done using the QUALSYST tool.

FINDINGS

In total, 10 365 records were screened for eligibility, of which 24 studies were included for synthesis. A total of 23 317 patients were evaluated, and 273 (154 unique) items were retrieved. These items were aggregated into 23 outcomes: (almost) complete clearance; symptom control; difficult location clearance; time to clearance; treatment efficacy, sustainability, safety, tolerability, and convenience; comorbidity control; daily and social activity; emotional well-being; intimate relationships; productivity; health-related quality of life; confidence in care; control of disease; communication with care professional; information from other sources than care professional; and cost of care (societal and for the patient). These were then further grouped into 4 core areas: physical/clinical, life impact, resource use, and adverse effects. The mean overall quality of the studies was 75.6% (range, 35.7%-100%).

CONCLUSIONS AND RELEVANCE

This systematic review analyzed patient-relevant outcomes reported in patients with psoriasis to aid in the transition to a value-based treatment approach.

重要性

在管理银屑病患者的病情时，需要定义对患者有价值的治疗结果。

目的

生成一份全面的银屑病管理相关结果综述，这些结果由患者定义。

证据回顾

从 2019 年 8 月 1 日至 2021 年 3 月 27 日，通过搜索 3 个数据库（MEDLINE、Embase 和 Web of Science），采用包含 4 个概念（银屑病、患者、结果和相关性）的综合检索策略，进行了系统评价。还对所有检索到的文章进行了参考文献检索。两名独立审查员根据纳入标准对检索到的记录进行了标题/摘要筛选。如果研究报告了银屑病患者对结果的重要性，则符合纳入标准。未使用语言限制。还独立进行了数据提取和质量评估。使用 QUALSYST 工具进行质量评估。

发现

共筛选了 10365 条记录以确定其是否符合纳入标准，其中 24 项研究被纳入进行综合分析。共评估了 23317 名患者，共提取了 273 个（154 个为独特）项目。这些项目被汇总为 23 个结果：（几乎）完全清除；症状控制；难以清除的部位；清除时间；治疗效果、可持续性、安全性、耐受性和便利性；合并症控制；日常和社会活动；情绪健康；亲密关系；生产力；健康相关生活质量；对护理的信心；疾病控制；与护理专业人员的沟通；护理专业人员以外的其他来源的信息；护理成本（社会和患者）。这些结果随后被进一步分为 4 个核心领域：身体/临床、生活影响、资源利用和不良反应。研究的总体平均质量为 75.6%（范围为 35.7%-100%）。