择期髋关节置换术后患者报告结局指标（PROMs）轨迹：潜在类别与生长混合分析
Patient reported outcomes measures (PROMs) trajectories after elective hip arthroplasty: a latent class and growth mixture analysis.
作者信息
Golinelli Davide, Grassi Alberto, Tedesco Dario, Sanmarchi Francesco, Rosa Simona, Rucci Paola, Amabile Marilina, Cosentino Monica, Bordini Barbara, Fantini Maria Pia, Zaffagnini Stefano
机构信息
Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum - University of Bologna, Via San Giacomo 12, 40126, Bologna, Italy.
IIa Clinica Ortopedica e Traumatologica, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136, Bologna, Italy.
出版信息
J Patient Rep Outcomes. 2022 Sep 9;6(1):95. doi: 10.1186/s41687-022-00503-5.
BACKGROUND
Patient-reported outcome measures (PROMs) are an extensively used tool to assess and improve the quality of healthcare services. PROMs can be related to individual demographic and clinical characteristics in patients undergoing hip arthroplasty (HA). The aim of this study is to identify distinct subgroups of patients with unique trajectories of PROMS scores and to determine patients' features associated with these subgroups.
METHODS
We conducted a prospective, cohort study in which PROMs questionnaires (Euro Quality 5 Dimensions 3L, EQ-5D-3L, Euro-Quality-Visual-Analytic-Score, EQ-VAS, Hip disability and Osteoarthritis Outcome Score, HOOS-PS) were administered to patients undergoing elective HA pre-operatively, and at 6 and 12 months after surgery. For each measure, latent class growth analysis and growth mixture models were used to identify subgroups of patients with distinct trajectories of scores. Demografic and clinical predictors of the latent classes in growth mixture model were identified using a 3-step approach.
RESULTS
We found three distinct trajectories for each PROM score. These trajectories indicated a response heterogeneity to the HA among the patients (n = 991). Patient's gender, ASA score, and obesity were significantly associated with different PROMs trajectories.
CONCLUSIONS
We identified three distinct trajectories for each of the three PROMs indicators. Several demographic and clinical characteristics are associated with the different trajectories of PROMs at 6 and 12 months after HA and could be used to identify groups of patients with different outcomes following HA surgery. These findings underline the importance of patient-centered care, supporting the usefulness of integrating PROMs data alongside routinely collected healthcare records for guiding clinical care and maximizing patients' positive outcomes.
TRIAL REGISTRATION
Protocol version (1.0) and trial registration data are available on the platform www.
CLINICALTRIAL
gov with the identifier NCT03790267, posted on December 31, 2018.
背景
患者报告结局测量（PROMs）是一种广泛用于评估和改善医疗服务质量的工具。PROMs可能与接受髋关节置换术（HA）患者的个体人口统计学和临床特征相关。本研究的目的是识别具有独特PROMs评分轨迹的不同患者亚组，并确定与这些亚组相关的患者特征。
方法
我们进行了一项前瞻性队列研究，术前、术后6个月和12个月对接受择期HA的患者进行PROMs问卷调查（欧洲五维健康量表3L版，EQ-5D-3L；欧洲视觉模拟评分量表，EQ-VAS；髋关节功能障碍和骨关节炎疗效评分，HOOS-PS）。对于每项测量，使用潜在类别增长分析和增长混合模型来识别具有不同评分轨迹的患者亚组。使用三步法确定增长混合模型中潜在类别的人口统计学和临床预测因素。
结果
我们发现每个PROM评分有三种不同的轨迹。这些轨迹表明患者（n = 991）对HA的反应存在异质性。患者的性别、美国麻醉医师协会（ASA）评分和肥胖与不同的PROMs轨迹显著相关。
结论
我们为三个PROMs指标中的每一个都识别出了三种不同的轨迹。几个人口统计学和临床特征与HA术后6个月和12个月时PROMs的不同轨迹相关，可用于识别HA手术后具有不同结局的患者群体。这些发现强调了以患者为中心的护理的重要性，支持将PROMs数据与常规收集的医疗记录相结合以指导临床护理并最大化患者积极结局的有用性。
试验注册
方案版本（1.0）和试验注册数据可在平台www.CLINICALTRIAL.gov上获取，标识符为NCT03790267，于2018年12月31日发布。
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