Chaudhury Azraa S, Bernstein David N, Harper Carl M, Hammert Warren C, Rozental Tamara D
Department of Medical Education, Northwestern University Feinberg School of Medicine, Chicago, IL.
Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Combined Orthopaedic Residency Program, Boston, MA.
J Hand Surg Glob Online. 2022 Aug 16;5(4):492-497. doi: 10.1016/j.jhsg.2022.06.005. eCollection 2023 Jul.
As health care systems globally shift toward optimizing value, defined as health outcomes achieved per dollar spent across a full cycle of care, there has been increasing focus on using patient-reported outcome measures (PROMs) to gauge success. Patient-reported outcome measures are validated questionnaires that allow patients to share their health status across several domains (eg, pain or physical function). This trend has been particularly notable in hand surgery, with PROM use investigated for many common hand conditions, including carpal tunnel syndrome, Dupuytren contracture, trigger finger, osteoarthritis, and wrist ganglion. The purpose of this article is to review recent developments in the use of PROM instruments, including the Boston Carpal Tunnel Questionnaire; Michigan Hand Outcomes Questionnaire; Disabilities of the Arm, Shoulder, and Hand; and Patient-Reported Outcomes Measurement Information System, for the evaluation and treatment of patients with carpal tunnel syndrome. The considerable progress in establishing PROMs for use in carpal tunnel syndrome is reviewed, and future improvements are proposed to standardize PROM use and bring PROMs into day-to-day clinical practice for individualized patient treatment decision-making and counseling.
随着全球医疗保健系统朝着优化价值的方向转变,价值被定义为在整个护理周期中每花费一美元所实现的健康结果,人们越来越关注使用患者报告结局测量指标(PROMs)来评估成功与否。患者报告结局测量指标是经过验证的问卷,可让患者在多个领域(例如疼痛或身体功能)分享他们的健康状况。这一趋势在手部外科手术中尤为显著,人们对许多常见手部疾病(包括腕管综合征、杜普伊特伦挛缩症、扳机指、骨关节炎和腕部腱鞘囊肿)使用PROMs进行了研究。本文的目的是回顾PROM工具使用方面的最新进展,包括波士顿腕管问卷、密歇根手部结局问卷、手臂、肩部和手部功能障碍问卷以及患者报告结局测量信息系统,用于腕管综合征患者的评估和治疗。本文回顾了在建立用于腕管综合征的PROMs方面取得的重大进展,并提出了未来的改进措施,以规范PROMs的使用,并将PROMs纳入日常临床实践,用于个体化患者治疗决策和咨询。