Merenda Michelle, Earnest Arul, Ruseckaite Rasa, Tse Wai Chung, Elder Elisabeth, Hopper Ingrid, Ahern Susannah
Aesthet Surg J Open Forum. 2024 Mar 16;6:ojae015. doi: 10.1093/asjof/ojae015. eCollection 2024.
Little is known about the methods and outcomes of patient-reported outcome measure (PROM) use among high-risk medical device registries. The objective of this scoping review was to assess the utility and predictive ability of PROMs in high-risk medical device registries. We searched Ovid Medline, Embase, APA PsychINFO, Cochrane Library, and Scopus databases for published literature. After searching, 4323 titles and abstracts were screened, and 262 full texts were assessed for their eligibility. Seventy-six papers from across orthopedic ( = 64), cardiac ( = 10), penile ( = 1), and hernia mesh ( = 1) device registries were identified. Studies predominantly used PROMs as an outcome measure when comparing cohorts or surgical approaches ( = 45) or to compare time points ( = 13) including pre- and postintervention. Fifteen papers considered the predictive ability of PROMs. Of these, 8 treated PROMs as an outcome, 5 treated PROMs as a risk factor through regression analysis, and 2 papers treated PROMs as both a risk factor and as an outcome. One paper described PROMs to study implant survival. To advance methods of PROM integration into clinical decision-making for medical devices, an understanding of their use in high-risk device registries is needed. This scoping review found that there is a paucity of studies using PROMs to predict long-term patient and clinical outcomes in high-risk medical device registries. Determination as to why PROMs are rarely used for predictive purposes in long-term data collection is needed if PROM data are to be considered suitable as real-world evidence for high-risk device regulatory purposes, as well as to support clinical decision-making.
对于高风险医疗设备注册登记中患者报告结局测量(PROM)的使用方法和结果,人们了解甚少。本范围综述的目的是评估PROM在高风险医疗设备注册登记中的效用和预测能力。我们在Ovid Medline、Embase、APA PsychINFO、Cochrane图书馆和Scopus数据库中检索已发表的文献。检索后,筛选了4323篇标题和摘要,并评估了262篇全文的合格性。确定了来自骨科(=64)、心脏(=10)、阴茎(=1)和疝修补网片(=1)设备注册登记的76篇论文。在比较队列或手术方法(=45)或比较时间点(=13)(包括干预前后)时,研究主要将PROM用作结局指标。15篇论文考虑了PROM的预测能力。其中,8篇将PROM视为结局,5篇通过回归分析将PROM视为风险因素,2篇论文将PROM既视为风险因素又视为结局。一篇论文描述了用PROM来研究植入物存活情况。为了推进将PROM整合到医疗设备临床决策中的方法,需要了解其在高风险设备注册登记中的使用情况。本范围综述发现,在高风险医疗设备注册登记中,使用PROM来预测患者长期结局和临床结局的研究很少。如果要将PROM数据视为适用于高风险设备监管目的的真实世界证据,并支持临床决策,就需要确定为什么在长期数据收集中很少将PROM用于预测目的。