Department of Thoracic Surgery, Southern Medical University Nanfang Hospital, Guangzhou, China.
School of Nursing, Southern Medical University, Guangzhou, China.
Cancer Med. 2023 Dec;12(23):21240-21255. doi: 10.1002/cam4.6703. Epub 2023 Nov 21.
In China, individuals diagnosed with esophageal cancer are confronted with an elevated risk of nutritional inadequacy or malnutrition throughout the course of their disease, a condition that contributes to various adverse clinical outcomes. A vast corpus of data are burgeoning at an unprecedented rate, primarily due to the revolutionary growth of digitalization technologies and artificial intelligence, notably within the domains of health care and medicine. The purpose of this investigation is to initiate the development of a nutritional screening and assessment indicator framework for patients with esophageal cancer within the Chinese context. We seek to furnish an instrumental reference to facilitate preparations for the forthcoming era of advanced, "deep," evidence-based medicine.
An integrative methodology was employed to forge the preliminary draft of the nutritional screening and assessment indicator system for preoperative patients with esophageal cancer. This encompassed a rigorous literature survey, in-depth clinical practice investigation, and the facilitation of expert panel discussions. Thereafter, two iterative consultation phases were conducted using the Delphi method in China. The analytic hierarchy process was deployed to ascertain the weighting of each index within the definitive evaluation indicator system.
The effective response rates for the dual rounds of expert consultation were 91.7% and 86.4%, with commensurate authority coefficients of 0.97 and 0.91. The Kendall harmony coefficients were ascertained to be 0.19 and 0.14 (p < 0.01), respectively. The culminating nutritional screening and assessment indicator system for patients with esophageal cancer comprised 5 primary-level indicators and 38 secondary-level indicators.
The nutritional screening and assessment indicator system contrived for patients with esophageal cancer is underpinned by cogent theoretical principles, leverages an astute research methodology, and manifests dependable outcomes. This system may be appositely utilized as a meaningful reference for the nutritional screening and assessment process in patients afflicted with esophageal cancer.
在中国，食管癌患者在疾病过程中存在营养不足或营养不良的风险增加，这导致了各种不良的临床结局。由于数字化技术和人工智能的革命性发展，主要是在医疗保健和医学领域，大量数据以前所未有的速度涌现。本研究旨在为中国食管癌患者开发营养筛查和评估指标框架。我们旨在提供一个工具性参考，为即将到来的高级、“深入”循证医学时代做好准备。
采用综合方法初步制定术前食管癌患者营养筛查和评估指标体系。这包括严格的文献调查、深入的临床实践调查和专家小组讨论的促进。此后，在中国使用 Delphi 法进行了两轮迭代咨询。层次分析法用于确定最终评价指标体系中每个指标的权重。
两轮专家咨询的有效回复率分别为 91.7%和 86.4%，相应的权威系数分别为 0.97 和 0.91。肯德尔和谐系数分别为 0.19 和 0.14（p<0.01）。食管癌患者的营养筛查和评估指标体系由 5 个一级指标和 38 个二级指标组成。
为食管癌患者设计的营养筛查和评估指标体系具有坚实的理论基础，采用了敏锐的研究方法，结果可靠。该系统可作为食管癌患者营养筛查和评估过程的有意义参考。
