Schropp Ludo, Cats Roos B, de Kleijn Robert J C M F, van Hattum Eline S, Middeldorp Saskia, Nijkeuter Mathilde, Westerink Jan, Petri Bart-Jeroen, de Borst Gert J
Department of Vascular Surgery, University Medical Center Utrecht, The Netherlands.
Department of Internal Medicine & Radboud Institute of Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
Res Pract Thromb Haemost. 2023 Jan 19;7(1):100051. doi: 10.1016/j.rpth.2023.100051. eCollection 2023 Jan.
In upper extremity thrombosis research, the occurrence of upper extremity postthrombotic syndrome (UE-PTS) is commonly used as the main outcome parameter. However, there is currently no reporting standard or a validated method to assess UE-PTS presence and severity. In a recent Delphi study, consensus was reached on a preliminary UE-PTS score, combining 5 symptoms, 3 signs, and the inclusion of a functional disability score. However, no consensus was reached on which functional disability score to be included.
The aim of the current Delphi consensus study was to determine the specific type of functional disability score to finalize UE-PTS score.
This Delphi project was designed as a three-round study using open text questions, statements with 7-point Likert scales, and multiple-choice questions. The CREDES recommendations for Delphi studies were applied. In this context, a systematic review was conducted before the start of the Delphi rounds to identify the available functional disability scores as available in the literature and present these to the expert panel.
Thirty-five of 47 initially invited international experts from multiple disciplines completed all the Delphi rounds. In the second round, consensus was reached on the incorporation of the quick disabilities of the arm, shoulder, and hand (QuickDASH) in the UE-PTS score, rendering the third round obsolete.
Consensus was reached that the QuickDASH should be incorporated in the UE-PTS score. The UE-PTS score will need to be validated in a large cohort of patients with upper extremity thrombosis before it can be used in clinical practice and future research.
在上肢血栓形成研究中,上肢血栓形成后综合征(UE-PTS)的发生情况通常被用作主要结局参数。然而,目前尚无评估UE-PTS的存在及严重程度的报告标准或经过验证的方法。在最近一项德尔菲研究中,就初步的UE-PTS评分达成了共识,该评分结合了5种症状、3种体征,并纳入了一项功能障碍评分。然而,对于应纳入哪种功能障碍评分尚未达成共识。
当前这项德尔菲共识研究的目的是确定用于完善UE-PTS评分的功能障碍评分的具体类型。
该德尔菲项目设计为一项三轮研究,采用开放式文本问题、带有7分李克特量表的陈述以及多项选择题。应用了德尔菲研究的CREDES建议。在此背景下,在德尔菲轮次开始前进行了一项系统评价,以确定文献中可用的功能障碍评分,并将其呈现给专家小组。
最初邀请的来自多个学科的47名国际专家中有35名完成了所有德尔菲轮次。在第二轮中,就将手臂、肩部和手部快速功能障碍量表(QuickDASH)纳入UE-PTS评分达成了共识,使得第三轮不再必要。
已达成共识,即应将QuickDASH纳入UE-PTS评分。在UE-PTS评分能够用于临床实践和未来研究之前,需要在一大群上肢血栓形成患者中对其进行验证。