Saunders Stina, Gomes-Osman Joyce, Jannati Ali, Ciesla Marissa, Banks Russell, Showalter John, Muniz-Terrera Graciela, Luz Saturnino, Ritchie Craig, Pascual-Leone Álvaro
Linus Health Inc., Boston, MA, United States.
Usher Institute, University of Edinburgh, Edinburgh, United Kingdom.
Front Neurol. 2024 Jun 5;15:1387206. doi: 10.3389/fneur.2024.1387206. eCollection 2024.
Incorporating person-centered outcomes into clinical trials for neurodegenerative diseases has been challenging due to a deficiency in quantitative measures. Meanwhile, the integration of personally meaningful treatment targets in clinical practice remains qualitative, failing to truly inform evaluations, therapeutic interventions and longitudinal monitoring and support. We discuss the current advances and future directions in capturing individualized brain health outcomes and present an approach to integrate person-centered outcome in a scalable manner. Our approach stems from the evidence-based electronic Person-Specific Outcome Measure (ePSOM) program which prompts an individual to define personally meaningful treatment priorities and report level of confidence in managing items that matter to the individual the most (e.g., "Do I feel confident in my ability to contribute to a conversation?"). Deployed either as a single version (person only) or a dyad version (person and care partner), our proposed tool could be used as an endpoint in clinical trials, offering proof of meaningful intervention benefits and in clinical practice, by establishing an anchor for the therapeutic objectives sought by the individual.
由于缺乏定量测量方法,将以患者为中心的结果纳入神经退行性疾病的临床试验一直具有挑战性。与此同时,在临床实践中整合具有个人意义的治疗目标仍然是定性的,未能真正为评估、治疗干预以及纵向监测和支持提供信息。我们讨论了在获取个性化脑健康结果方面的当前进展和未来方向,并提出了一种以可扩展方式整合以患者为中心的结果的方法。我们的方法源自基于证据的电子个人特定结果测量(ePSOM)计划,该计划促使个人定义具有个人意义的治疗优先级,并报告对管理对个人最重要的事项(例如,“我对自己参与对话的能力有信心吗?”)的信心水平。我们提出的工具可以作为单一版本(仅个人)或二元版本(个人和护理伙伴)部署,可在临床试验中用作终点,提供有意义的干预益处的证据,并且在临床实践中,通过为个人寻求的治疗目标建立一个锚点来发挥作用。