Yang Ping
Mayo Clinic College of Medicine and Science, Mayo Clinic Arizona, 13400 E. Shea Boulevard, Scottsdale, AZ, USA.
Precis Clin Med. 2019 Mar;2(1):8-12. doi: 10.1093/pcmedi/pbz001. Epub 2019 Mar 11.
An ultimate goal of precision medicine in lung cancer treatment is to restore patient health with maximized quality of life (QOL). Results from Mayo Clinic studies show that a significant improvement in fatigue, dyspnea, and pain scales could lead to better overall QOL. Although treatments and guidelines for clinical implementation to alleviate these key symptoms are available, few cancer patients receive adequate therapy, mostly because of limitations in current care delivery systems and unclear clinicians' roles. For optimal care of lung cancer survivors in different subpopulations, three barriers must be overcome: physicians' lack of knowledge, unwarranted practice variation, and uncertainty regarding care provider roles. Appropriate culturally adapted, tested and validated tools for QOL measures must be developed, rather than directly translating existing tools between different languages and across cultures or diverse subpopulations. Finally, lack of sensitive, adequate, and relevant tools in measuring health-related QOL (HRQOL) has long been an issue for effective data collection, demanding a global consensus on a set of core components that reflect the needs of all critical parties for the best cure and care, supporting patients to achieve optimal HRQOL.
肺癌治疗中精准医疗的最终目标是以最大化的生活质量(QOL)恢复患者健康。梅奥诊所的研究结果表明,疲劳、呼吸困难和疼痛量表的显著改善可带来更好的整体生活质量。尽管有缓解这些关键症状的治疗方法和临床实施指南,但很少有癌症患者得到充分治疗,主要原因是当前护理提供系统存在局限性以及临床医生的角色不明确。为了对不同亚群体的肺癌幸存者进行最佳护理,必须克服三个障碍:医生知识的缺乏、不必要的实践差异以及护理提供者角色的不确定性。必须开发经过文化适应、测试和验证的适当生活质量测量工具,而不是直接在不同语言、不同文化或不同亚群体之间翻译现有工具。最后,长期以来,缺乏敏感、充分和相关的工具来测量健康相关生活质量(HRQOL)一直是有效数据收集的一个问题,这需要就一组核心组成部分达成全球共识,这些核心组成部分反映了所有关键方对最佳治疗和护理的需求,支持患者实现最佳的健康相关生活质量。