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提高癌症临床试验中患者报告结局测量的完成率:探索对试验设计影响的范围综述。

Improving completion rates of patient-reported outcome measures in cancer clinical trials: Scoping review investigating the implications for trial designs.

机构信息

Quality of Life Department, EORTC, Brussels, Belgium.

Quality of Life Department, EORTC, Brussels, Belgium.

出版信息

Eur J Cancer. 2024 Nov;212:114313. doi: 10.1016/j.ejca.2024.114313. Epub 2024 Sep 18.

Abstract

BACKGROUND

Patient-reported outcomes (PROs) play a crucial role in cancer clinical trials. Despite the availability of validated PRO measures (PROMs), challenges related to low completion rates and missing data remain, potentially affecting the trial results' validity. This review explored strategies to improve and maintain high PROM completion rates in cancer clinical trials.

METHODOLOGY

A scoping review was performed across Medline, Embase and Scopus and regulatory guidelines. Key recommendations were synthesized into categories such as stakeholder involvement, study design, PRO assessment, mode of assessment, participant support, and monitoring.

RESULTS

The review identified 114 recommendations from 18 papers (16 peer-reviewed articles and 2 policy documents). The recommendations included integrating comprehensive PRO information into the study protocol, enhancing patient involvement during the protocol development phase and in education, and collecting relevant PRO data at clinically meaningful time points. Electronic data collection, effective monitoring systems, and sufficient time, capacity, workforce and financial resources were highlighted.

DISCUSSION

Further research needs to evaluate the effectiveness of these strategies in various context and to tailor these recommendations into practical and effective strategies. This will enhance PRO completion rates and patient-centred care. However, obstacles such as patient burden, low health literacy, and conflicting recommendations may present challenges in application.

摘要

背景

患者报告的结局(PROs)在癌症临床试验中起着至关重要的作用。尽管有经过验证的 PRO 测量工具(PROMs),但仍存在完成率低和数据缺失等相关挑战,这可能会影响试验结果的有效性。本综述探讨了提高和保持癌症临床试验中 PROM 高完成率的策略。

方法

在 Medline、Embase 和 Scopus 以及监管指南中进行了范围综述。将关键建议综合为利益相关者参与、研究设计、PRO 评估、评估方式、患者支持和监测等类别。

结果

综述从 18 篇论文(16 篇同行评议文章和 2 份政策文件)中确定了 114 条建议。这些建议包括将全面的 PRO 信息纳入研究方案、在方案制定阶段和教育中增强患者参与度、以及在有临床意义的时间点收集相关的 PRO 数据。强调了电子数据收集、有效的监测系统,以及充足的时间、能力、劳动力和财力资源。

讨论

需要进一步研究评估这些策略在不同环境下的有效性,并将这些建议转化为实用有效的策略。这将提高 PRO 的完成率和以患者为中心的护理。然而,患者负担、低健康素养和相互矛盾的建议等障碍可能会在应用中带来挑战。

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