Belloni Silvia, Magon Arianna, Giacon Chiara, Savioni Francesca, Conte Gianluca, Caruso Rosario, Arrigoni Cristina
Department of Public Health, Experimental and Forensic Medicine, Section of Hygiene, University of Pavia, 27100 Pavia, Italy.
Health Professions Research and Development Unit, IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milan, Italy.
Curr Oncol. 2024 Dec 6;31(12):7828-7851. doi: 10.3390/curroncol31120577.
Although the literature on patient-reported outcomes (PROMs) continues to expand, challenges persist in selecting reliable and valid instruments for assessing peripheral neuropathy (PN) in patients with cancer. This systematic review aimed to identify all validated self-report PN scales and critically appraise their measurement properties. This review was conducted using the COSMIN methodology for PROMs and the PRISMA statement. Five databases were searched from inception to August 2024, identifying 46 eligible studies and 16 PROMs. Evidence quality ranged from "very low" to "moderate", with notable inconsistencies in the content and structural validity phases of most instruments. Instruments such as the Chemotherapy-induced peripheral neuropathy assessment tool and the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity demonstrated moderate quality and potential utility in clinical practice, while others, including the Location-based assessment of sensory symptoms in cancer and the Measure of Ovarian Symptoms and Treatment, had insufficient evidence to support their use. Importantly, all PROMs focused on chemotherapy-induced peripheral neuropathy, highlighting a significant gap in instruments addressing other PN causes, such as radiotherapy or tumor-related nerve damage. Further research should prioritize developing and validating instruments for distinct cancer populations, ensuring robust psychometric properties and clinical applicability.
尽管关于患者报告结局（PROMs）的文献不断增多，但在为评估癌症患者的周围神经病变（PN）选择可靠且有效的工具方面，挑战依然存在。本系统评价旨在识别所有经过验证的自我报告PN量表，并严格评估其测量属性。本评价采用了用于PROMs的COSMIN方法和PRISMA声明。对五个数据库从创建至2024年8月进行了检索，共识别出46项符合条件的研究和16种PROMs。证据质量从“极低”到“中等”不等，大多数工具在内容和结构效度阶段存在显著不一致。化疗引起的周围神经病变评估工具和癌症治疗功能评估/妇科肿瘤学组-神经毒性等工具显示出中等质量和在临床实践中的潜在效用，而其他工具，包括癌症感觉症状的基于部位评估和卵巢症状与治疗测量工具，证据不足，无法支持其使用。重要的是，所有PROMs都聚焦于化疗引起的周围神经病变，凸显了针对其他PN病因（如放疗或肿瘤相关神经损伤）的工具存在重大差距。未来的研究应优先为不同癌症人群开发和验证工具，确保强大的心理测量特性和临床适用性。
