用于手部和腕部疾病的患者报告结局指标：系统评价综述
Patient-reported outcome measures used for hand and wrist disorders: An overview of systematic reviews.
作者信息
Ziebart Christina, Bobos Pavlos, Furtado Rochelle, Dabbagh Armaghan, MacDermid Joy
机构信息
Department of Rehabilitation Sciences, Faculty of Health Science, Western University, London, Ontario, Canada; School of Physical Therapy, Faculty of Health Science, Western University, London, Ontario, Canada; Collaborative Program in Musculoskeletal Health Research, Bone and Joint Institute, Western University, London, Ontario, Canada.
Department of Rehabilitation Sciences, Faculty of Health Science, Western University, London, Ontario, Canada; School of Physical Therapy, Faculty of Health Science, Western University, London, Ontario, Canada; Collaborative Program in Musculoskeletal Health Research, Bone and Joint Institute, Western University, London, Ontario, Canada; Dalla Lana School of Public Health, Department of Clinical Epidemiology and Health Care Research, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
出版信息
J Hand Ther. 2023 Jul-Sep;36(3):719-729. doi: 10.1016/j.jht.2022.10.007. Epub 2023 Mar 11.
BACKGROUND
Multiple options for patient reported outcome measures are available to assess patients with hand, wrist and elbow impairments. This review of systematic reviews (overview) evaluated the evidence on these outcome measures.
METHODS
An electronic search of six databases (MEDLINE, Embase, CINAHL, ILC, the Cochrane Central Register of Controlled Trials (CENTRAL), and LILACS) was performed in September 2019, and updated in August 2022. The search strategy was designed to locate systematic reviews that addressed at least one clinical measurement property of PROMs used for patients with hand and wrist impairment. Two independent reviewers screened the articles and extracted the data. The AMSTAR tool was used to assess the risk of bias in the included articles.
RESULTS
Eleven systematic reviews were included in this overview. A total of 27 outcome assessments were assessed, with DASH, PRWE and MHQ assessed by five, four, and three reviews, respectively. We found high-quality evidence of good to excellent internal consistency (ICC = 0.88-0.97), poor content validity but high construct validity (r > 0.70), moderate- to high-quality evidence for the DASH. The reliability of the PRWE was excellent (ICC >0.80), the convergent validity was excellent (r > 0.75), but poor criterion validity compared to the SF-12. The MHQ also reported excellent reliability (ICC = 0.88-0.96), and good criterion validity (r > 0.70), but poor construct validity (r > 0.38).
CONCLUSION
Clinical decisions around which tool will depend on which psychometric property is most important for the assessment and whether global or specific condition assessment is needed. All of the tools demonstrated at least good reliability; therefore, the clinical decisions will rely on the type of validity for clinical application. The DASH has good construct validity, while the PRWE has good convergent validity, and the MHQ has good criterion validity.
背景
有多种患者报告结局测量方法可用于评估手部、腕部和肘部损伤患者。本系统评价的综述评估了这些结局测量方法的证据。
方法
于2019年9月对六个数据库（MEDLINE、Embase、CINAHL、ILC、Cochrane对照试验中央注册库（CENTRAL）和LILACS）进行了电子检索，并于2022年8月更新。检索策略旨在查找涉及用于手部和腕部损伤患者的患者报告结局测量工具至少一项临床测量属性的系统评价。两名独立的评审员筛选文章并提取数据。使用AMSTAR工具评估纳入文章的偏倚风险。
结果
本综述纳入了11项系统评价。共评估了27种结局评估方法，其中DASH、PRWE和MHQ分别有5项、4项和3项综述进行了评估。我们发现有高质量证据表明其内部一致性良好至优秀（ICC = 0.88 - 0.97），内容效度较差但结构效度较高（r > 0.70），关于DASH有中高质量证据。PRWE的信度极佳（ICC > 0.80），收敛效度极佳（r > 0.75），但与SF - 12相比，效标效度较差。MHQ也报告了极佳的信度（ICC = 0.88 - 0.96）和良好的效标效度（r > 0.70），但结构效度较差（r > 0.38）。
结论
围绕使用哪种工具的临床决策将取决于哪种心理测量属性对评估最为重要，以及是否需要进行整体或特定病情评估。所有工具均显示至少具有良好的信度；因此，临床决策将取决于临床应用的效度类型。DASH具有良好的结构效度，PRWE具有良好的收敛效度，MHQ具有良好的效标效度。
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