评估电子患者报告结局在癌症患者中的有效性：系统评价和荟萃分析。
Examining the Effectiveness of Electronic Patient-Reported Outcomes in People With Cancer: Systematic Review and Meta-Analysis.
机构信息
Christie Patient Centred Research, The Christie NHS Foundation Trust, Manchester, United Kingdom.
Division of Nursing Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine & Health, The University of Manchester, Manchester, United Kingdom.
出版信息
J Med Internet Res. 2024 Jul 31;26:e49089. doi: 10.2196/49089.
BACKGROUND
Electronic patient-reported outcomes (ePROs) are commonly used in oncology clinical practice and have shown benefits for patients and health resource use.
OBJECTIVE
The aim of this study was to compare the isolated effect of administering ePROs to patients with cancer versus a control condition.
METHODS
The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed. Randomized controlled trials evaluating ePRO interventions that aimed to improve health-related outcomes among patients with cancer were included. The primary outcome was health-related quality of life (HRQOL), and the secondary outcomes were symptoms, hospital admissions, unplanned visits, chemotherapy completion, survival, and satisfaction with care. The effect sizes of ePROs on health-related outcomes were analyzed as standardized mean differences (SMDs) with 95% CIs using a random effects model.
RESULTS
The search identified 10,965 papers, of which 19 (0.17%) from 15 studies were included. The meta-analysis showed an improvement in HRQOL at 3 months, measured by the Functional Assessment of Cancer Therapy-General (SMD 0.28, 95% CI -1.22 to 1.78), and at 6 months, assessed using various HRQOL measures (SMD 0.07, 95% CI -1.24 to 1.39). The results should be interpreted with caution, given the wide 95% CIs. Of the 15 studies, 9 (60%) reported a positive signal on HRQOL, with two-thirds of the studies (n=6, 67%) including tailored patient advice and two-thirds (n=6, 67%) using clinician alert systems.
CONCLUSIONS
The meta-analysis showed a potential improvement in HRQOL at 6 months and in Functional Assessment of Cancer Therapy-General scores at 3 months for studies that included tailored advice and clinician alerts, suggesting that these elements may improve ePRO effectiveness. The findings will provide guidance for future use and help health care professionals choose the most suitable ePRO features for their patients.
TRIAL REGISTRATION
PROSPERO CRD42020175007; https://tinyurl.com/5cwmy3j6.
背景
电子患者报告结局（ePROs）在肿瘤临床实践中被广泛应用，并显示出对患者和卫生资源利用的益处。
目的
本研究旨在比较为癌症患者提供 ePROs 与对照条件的单独效果。
方法
遵循 PRISMA（系统评价和荟萃分析的首选报告项目）指南。纳入了旨在改善癌症患者健康相关结局的 ePRO 干预措施的随机对照试验。主要结局是健康相关生活质量（HRQOL），次要结局是症状、住院、非计划就诊、化疗完成、生存和对护理的满意度。使用随机效应模型，使用 95%置信区间（CI）的标准化均数差（SMD）分析 ePROs 对健康相关结局的影响。
结果
搜索共确定了 10965 篇论文，其中有 19 篇（0.17%）来自 15 项研究被纳入。荟萃分析显示，在 3 个月时，使用癌症治疗功能评估-一般量表（SMD 0.28，95%CI -1.22 至 1.78）评估的 HRQOL 有所改善，在 6 个月时，使用各种 HRQOL 措施评估的 HRQOL 也有所改善（SMD 0.07，95%CI -1.24 至 1.39）。鉴于 95%CI 较宽，应谨慎解释这些结果。在 15 项研究中，有 9 项（60%）报告 HRQOL 有阳性信号，其中三分之二的研究（n=6，67%）包括针对患者的个性化建议，三分之二（n=6，67%）使用临床医生警报系统。
结论
荟萃分析显示，对于包括个性化建议和临床医生警报在内的研究，6 个月时 HRQOL 可能有所改善，3 个月时癌症治疗功能评估一般量表评分有所改善，这表明这些元素可能会提高 ePRO 的效果。研究结果将为未来的使用提供指导，并帮助医疗保健专业人员为患者选择最合适的 ePRO 功能。
试验注册
PROSPERO CRD42020175007；https://tinyurl.com/5cwmy3j6。
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