From the Department of Plastic Surgery, University Medical Center Groningen, University of Groningen.
Plast Reconstr Surg. 2023 Nov 1;152(5):867e-875e. doi: 10.1097/PRS.0000000000010515. Epub 2023 Apr 11.
Web-based patient-reported outcome measures (PROMs) could help surgeons remotely assess the need for examination and subsequent treatment of patients with Dupuytren disease (DD). The authors studied whether the Unité Rhumatologique des Affections de la Main (URAM) and the Michigan Hand Questionnaire (MHQ) could predict DD treatment.
In this prospective cohort study, the authors compared MHQ and URAM scores of treated patients with those of untreated patients. For the treatment group, the authors selected a score closest to 1 year before treatment. For controls, the authors randomly selected a score. The authors also tested the predictive value of a 1-year change score between 15 months and 6 weeks before treatment. The primary outcome measure was DD treatment. The predictive value was determined using the area under the curve (AUC). An AUC greater than 0.70 was considered good predictive ability; 0.70 to 0.50, poor predictive ability; and less than 0.50, no predictive ability.
The authors included 141 patients for the MHQ analysis and 145 patients for the URAM analysis. The AUC of the MHQ and URAM scores measured 1 year before treatment were 0.80 (95% CI, 0.71 to 0.88) and 0.75 (95% CI, 0.68 to 0.82), respectively. The 1-year change score resulted in an AUC less than 0.60 for both questionnaires.
The results show that both the MHQ and URAM score measured around 1 year before treatment can predict treatment for DD. If future studies show that telemonitoring of patients with DD with PROMs is also cost-effective, web-based PROMs could optimize patient care and effectiveness of DD treatment.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, III.
基于网络的患者报告结局测量（PROMs）可以帮助外科医生远程评估需要对患有掌腱膜挛缩症（DD）的患者进行检查和后续治疗。作者研究了 URAM 和密歇根手问卷（MHQ）是否可以预测 DD 的治疗。
在这项前瞻性队列研究中，作者比较了接受治疗的患者与未接受治疗的患者的 MHQ 和 URAM 评分。对于治疗组，作者选择了最接近治疗前 1 年的评分。对于对照组，作者随机选择了一个评分。作者还测试了治疗前 15 个月至 6 周内的 1 年变化评分的预测价值。主要结局测量指标为 DD 治疗。预测值通过曲线下面积（AUC）确定。AUC 大于 0.70 被认为具有良好的预测能力；0.70 到 0.50，预测能力差；小于 0.50，没有预测能力。
作者纳入了 141 例 MHQ 分析患者和 145 例 URAM 分析患者。治疗前 1 年 MHQ 和 URAM 评分的 AUC 分别为 0.80（95%CI，0.71 至 0.88）和 0.75（95%CI，0.68 至 0.82）。两个问卷的 1 年变化评分的 AUC 均小于 0.60。
结果表明，治疗前 1 年左右测量的 MHQ 和 URAM 评分都可以预测 DD 的治疗。如果未来的研究表明，使用 PROM 对 DD 患者进行远程监测也具有成本效益，那么基于网络的 PROM 可以优化患者的护理和 DD 治疗的效果。
临床问题/证据水平：风险，III 级。
