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一份评估内分泌学家对内源性库欣综合征负担认知的医学图表审计报告。

A medical chart audit to assess endocrinologist perceptions of the burden of endogenous Cushing's syndrome.

机构信息

Division of Endocrinology, Columbia University Irving Medical Center, New York, NY, USA.

Trinity Life Sciences, Waltham, MA, USA.

出版信息

Pituitary. 2024 Apr;27(2):129-140. doi: 10.1007/s11102-023-01371-y. Epub 2024 Jan 8.

Abstract

PURPOSE

This study was undertaken to assess the unmet needs within the endogenous Cushing's syndrome (CS) care paradigm from the endocrinologist's perspective, including data abstracted from patient charts. The study evaluated endocrinologists' perceptions on burden of illness and treatment rationale along with the long-term clinical burden of CS, tolerability of CS treatments, and healthcare resource utilization for CS.

METHODS

Retrospective medical chart data from treated patients with a confirmed diagnosis of CS was abstracted using a cross-sectional survey to collect data from qualified endocrinologists. The survey included a case report form to capture patient medical chart data and a web-enabled questionnaire to capture practitioner-level data pertaining to endocrinologists' perceptions of disease burden, CS treatments, and treatment attributes.

RESULTS

Sixty-nine endocrinologists abstracted data from 273 unique medical charts of patients with CS. Mean patient age was 46.5 ± 13.4 years, with a 60:40 (female:male) gender split. The mean duration of endogenous CS amongst patients was 4.1 years. Chart data indicated that patients experienced a high burden of comorbidities and symptoms, including fatigue, weight gain, and muscle weakness despite multi-modal treatment. When evaluating treatments for CS, endocrinologists rated improvement in health-related quality of life (HRQoL) as the most important treatment attribute (mean score = 7.8; on a scale of 1 = Not at all important to 9 = Extremely important). Surgical intervention was the modality endocrinologists were most satisfied with, but they agreed that there was a significant unmet treatment need for patients with CS.

CONCLUSION

Endocrinologists recognized that patients with CS suffered from a debilitating condition with a high symptomatic and HRQoL burden and reported that improvement in HRQoL was the key treatment attribute influencing their treatment choices. This study highlights unmet needs for patients with CS. Patients with CS have a high rate of morbidity and comorbidity, even after treatment.

摘要

目的

本研究旨在评估从内分泌学家的角度来看,内源性库欣综合征(CS)治疗模式下的未满足需求,包括从患者病历中提取的数据。该研究评估了内分泌学家对疾病负担和治疗原理的看法,以及 CS 的长期临床负担、CS 治疗的耐受性以及 CS 的医疗资源利用情况。

方法

使用横断面调查从确诊 CS 的治疗患者的病历中提取回顾性医疗数据,以收集合格内分泌学家的数据。该调查包括一份病例报告表,以获取患者病历数据,以及一份网络启用的问卷,以获取与内分泌学家对疾病负担、CS 治疗和治疗属性的看法相关的医生水平数据。

结果

69 名内分泌学家从 273 名 CS 患者的 273 份病历中提取了数据。患者的平均年龄为 46.5±13.4 岁,性别比例为 60:40(女性:男性)。患者内源性 CS 的平均持续时间为 4.1 年。病历数据表明,尽管采用了多模式治疗,但患者仍存在多种合并症和症状的负担,包括疲劳、体重增加和肌肉无力。在评估 CS 的治疗方法时,内分泌学家将改善健康相关生活质量(HRQoL)评为最重要的治疗属性(平均评分为 7.8;在 1 分表示一点也不重要到 9 分表示非常重要的量表上)。手术干预是内分泌学家最满意的治疗方式,但他们一致认为 CS 患者存在显著的未满足治疗需求。

结论

内分泌学家认识到 CS 患者患有衰弱性疾病,症状和 HRQoL 负担沉重,并报告说改善 HRQoL 是影响他们治疗选择的关键治疗属性。这项研究强调了 CS 患者的未满足需求。即使在治疗后,CS 患者仍有很高的发病率和合并症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/228d/11009763/640b32c06a0d/11102_2023_1371_Fig1_HTML.jpg

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