Peripheral Nerve Injury Unit, Royal National Orthopaedic Hospital, Stanmore, London and Clinical Research Fellow, Centre for Nerve Engineering, University College London, London, UK.
Child Rehabilitation, Department of Physical Medicine and Rehabilitation, Ghent University Hospital, Ghent, Belgium.
Disabil Rehabil. 2024 Nov;46(22):5213-5219. doi: 10.1080/09638288.2023.2298708. Epub 2024 Jan 4.
Brachial plexus birth injuries (BPBI) can have lifelong effects on the development and functional use of the upper extremity. Currently there is no agreement with regards to what patient-reported outcome (PRO) measures should be used. Therefore, the ability to compare the effects of treatment between individuals and institutions is challenging. This study aimed to achieve consensus among clinicians on the use of PRO measures within this patient group to allow for improved comparison of treatments and outcomes in the future.
Online, a 3 round Delphi survey was completed by 35 international multi-disciplinary specialist centers.
All respondents (100%) agreed that PRO measures are useful for clinical evaluation and patient treatment. None of the outcome measures scored >75% agreement for ability to assess responsiveness and current state in children with BPBI as most outcome measures were judged as not specific for BPBI. Additionally, participant centers were asked their perspective on the best available PRO option for each of the 3 categories: functional use of the upper limb, quality of life and pain. This resulted in endorsement by the participant centers of the Brachial Plexus Outcome Measure - Self-Evaluation, the Pediatric Quality of Life Inventory, and Visual Analogue Scale/Brief Pain Inventory respectively.
International specialists in BPBI agree that PRO measures are important to use both clinically and in research in children aged 5 years and above.
臂丛神经出生损伤（BPBI）会对上肢的发育和功能使用产生终身影响。目前，对于应使用哪些患者报告的结果（PRO）测量方法尚无共识。因此，比较个体和机构之间治疗效果的能力具有挑战性。本研究旨在就该患者群体中使用 PRO 测量方法达成临床医生之间的共识，以便将来能够更好地比较治疗效果和结果。
通过 35 家国际多学科专业中心在线完成了 3 轮 Delphi 调查。
所有（100%）受访者均认为 PRO 测量方法对临床评估和患者治疗有用。由于大多数结果测量方法被认为对 BPBI 不具有特异性，因此没有任何结果测量方法在评估 BPBI 儿童的反应能力和当前状态方面的得分超过 75%的一致性。此外，参与者中心被要求就 3 个类别中的每一个类别提供最佳可用 PRO 选项：上肢功能使用、生活质量和疼痛。这导致参与者中心分别认可了臂丛神经损伤测量-自我评价、儿科生活质量量表和视觉模拟量表/简要疼痛量表。
BPBI 的国际专家一致认为，PRO 测量方法对于 5 岁及以上儿童的临床和研究都很重要。
