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多发性硬化国际多学科以患者为中心的标准结局集的制定:S.O.S.MS项目

Development of an international, multidisciplinary, patient-centered Standard Outcome Set for Multiple Sclerosis: The S.O.S.MS project.

作者信息

Daniels K, Frequin S T F M, van de Garde E M W, Biesma D H, van der Wees P J, van der Nat P B

机构信息

Department of Value-Based Healthcare, St. Antonius Hospital, Utrecht/Nieuwegein, the Netherlands; Radboud university medical center, Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare (IQ healthcare), the Netherlands.

Department of Neurology, St. Antonius Hospital, Utrecht/Nieuwegein, the Netherlands.

出版信息

Mult Scler Relat Disord. 2023 Jan;69:104461. doi: 10.1016/j.msard.2022.104461. Epub 2022 Dec 16.

Abstract

BACKGROUND

Currently, outcomes of Multiple Sclerosis (MS) are not standardized and it is unclear which outcomes matter most to people living with MS. A consensus between patients and healthcare professionals on which outcomes to measure and how, would facilitate a move towards value-based MS care.

OBJECTIVE

to develop an internationally accepted, patient-relevant Standard Outcome Set for MS (S.O.S.MS).

METHODS

A mixed-method design was used, including a systematic literature review, four patient focus groups (n=30) and a RAND-modified Delphi process with seventeen MS experts of five disciplines from seven countries (the Netherlands, United States of America, Portugal, Ireland, India, New Zealand, Switzerland and Turkey).

RESULTS

A standard outcome set for MS was defined, consisting of fourteen outcomes divided in four domains: disease activity (n=3), symptoms (n=4), functional status (n=6), and quality of life (n=1). For each outcome, an outcome measure was selected and the measurement protocol was defined. In addition, seven case-mix variables were selected.

CONCLUSION

This standard outcome set provides a guideline for measuring outcomes of MS in clinical practice and research. Using this set to monitor and (inter)nationally benchmark real-world outcomes of MS can support improvement of patient value and ultimately guide the transition towards value-based MS care.

摘要

背景

目前,多发性硬化症(MS)的疗效评估尚未标准化,对于MS患者而言,哪种疗效最为重要尚不清楚。患者与医疗保健专业人员就测量哪些疗效以及如何测量达成共识,将有助于推动基于价值的MS护理。

目的

制定一个国际认可的、与患者相关的MS标准结局集(S.O.S.MS)。

方法

采用混合方法设计,包括系统文献综述、四个患者焦点小组(n = 30)以及与来自七个国家(荷兰、美利坚合众国、葡萄牙、爱尔兰、印度、新西兰、瑞士和土耳其)五个学科的17名MS专家进行的兰德改良德尔菲法。

结果

定义了一个MS标准结局集,由14个结局组成,分为四个领域:疾病活动(n = 3)、症状(n = 4)、功能状态(n = 6)和生活质量(n = 1)。为每个结局选择了一种结局测量方法并定义了测量方案。此外,还选择了七个病例组合变量。

结论

这个标准结局集为在临床实践和研究中测量MS结局提供了指导。使用这个结局集来监测MS的实际结局并进行(国际)基准比较,可以支持提高患者价值,并最终指导向基于价值的MS护理的转变。

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