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患者报告的结局指标在心脏移植受者的临床研究中很少使用。

Patient reported outcomes measures are infrequently used in clinical studies of heart transplant recipients.

作者信息

Austin Melissa A, Chuzi Sarah, Cascino Thomas M, Vest Amanda R, Reza Nosheen

机构信息

Division of Cardiovascular Medicine, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.

Division of Cardiovascular Medicine, Department of Medicine, Feinberg School of Medicine at Northwestern University, Chicago, Illinois.

出版信息

JHLT Open. 2023 Dec;2. doi: 10.1016/j.jhlto.2023.100019. Epub 2023 Nov 14.

Abstract

BACKGROUND

Clinical trials in heart transplantation (HT) recipients have largely focused on objective outcomes such as survival; however, there is a paucity of data regarding the use of patient-reported outcome measures (PROMs) in these studies. We aimed to characterize the use of PROMs in registered clinical studies of HT recipients.

METHODS

All clinical studies of adult HT recipients were queried from ClinicalTrials.gov and stratified by inclusion of PROMs. Studies reporting PROMs were identified via specific search terms using the "outcomes measures" field. Summary statistics compared characteristics of studies with and without PROMs.

RESULTS

Between November 1999 and August 2022, 227 studies of HT recipients were registered on ClinicalTrials.gov. PROMs were included in 11% ( = 24/227) of studies. Studies reporting PROMs were more likely to be conducted outside of the United States (91.7% vs 54.2%, < 0.001) and report a greater number of primary/secondary outcomes (PROMs: median 7 [interquartile ranges (IQR): 4, 9] vs no PROMs: median 3 [IQR: 2, 6]; < 0.001). The majority of studies reporting PROMs (58.3%) were initiated after 2020. Twenty-one distinct PROM tools/domains were reported as outcome measures, with the Short Form Health Survey 36 being most frequently used ( = 10/24). Thirteen of the 21 PROMs included questions assessing mental health, whereas only 3 PROM tools were cardiac-specific.

CONCLUSIONS

About 1 in 10 registered clinical trials of HT recipients includes PROMs, and mental health is the most commonly assessed PROM domain. Development and validation of PROM tools is needed to fully assess health-related quality of life in HT recipients.

摘要

背景

心脏移植(HT)受者的临床试验主要集中在诸如生存等客观结果上;然而,在这些研究中,关于患者报告结局测量指标(PROMs)使用的数据却很少。我们旨在描述HT受者注册临床研究中PROMs的使用情况。

方法

从ClinicalTrials.gov查询所有成年HT受者的临床研究,并根据是否纳入PROMs进行分层。通过使用“结局测量指标”字段中的特定搜索词来识别报告了PROMs的研究。汇总统计数据比较了纳入和未纳入PROMs的研究特征。

结果

在1999年11月至2022年8月期间,ClinicalTrials.gov上注册了227项HT受者研究。11%(n = 24/227)的研究纳入了PROMs。报告了PROMs的研究更有可能在美国境外进行(91.7%对54.2%,P < 0.001),并且报告的主要/次要结局数量更多(PROMs:中位数为7 [四分位间距(IQR):4, 9],未使用PROMs:中位数为3 [IQR:2, 6];P < 0.001)。大多数报告了PROMs的研究(58.3%)是在2020年之后启动的。有21种不同的PROM工具/领域被报告为结局测量指标,其中健康调查简表36使用最为频繁(n = 10/24)。21种PROMs中有13种包括评估心理健康的问题,而只有3种PROM工具是针对心脏的。

结论

约十分之一的HT受者注册临床试验纳入了PROMs,心理健康是最常评估的PROM领域。需要开发和验证PROM工具,以全面评估HT受者与健康相关的生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc38/11935333/120358bfc654/gr1.jpg

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