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制定帕金森病吞咽困难干预的核心结局集:一项国际德尔菲共识研究。

Developing a core outcome set for dysphagia interventions in Parkinson's disease: an international Delphi consensus study.

作者信息

Hirschwald Julia, Conroy Paul, Boyle Gary, Warnecke Tobias, Walshe Margaret

机构信息

Department of Clinical Speech and Language Studies, Trinity College Dublin, Dublin, Ireland

Department of Clinical Speech and Language Studies, Trinity College Dublin, Dublin, Ireland.

出版信息

BMJ Evid Based Med. 2025 Apr 30. doi: 10.1136/bmjebm-2024-113543.

Abstract

OBJECTIVES

To develop a core outcome set (COS) for oropharyngeal dysphagia (swallowing disorder) interventions in Parkinson's disease by agreeing core outcomes and definitions, outcome measurement instruments (OMIs) and time points of measurement for these core outcomes.

DESIGN

International online Delphi survey and consensus meetings.

PARTICIPANTS

Individuals living with oropharyngeal dysphagia and Parkinson's disease, family members and caregivers, healthcare professionals and researchers in the field of oropharyngeal dysphagia and Parkinson's disease.

METHODS

A long list of outcomes was generated previously through scoping reviews, online surveys and focus groups with key stakeholders. Building on this, an international three-round online Delphi survey was conducted where participants rated the importance of outcomes. In subsequent online consensus meetings, core outcomes, their definitions, OMIs and time points of measurement were agreed on.

RESULTS

90 participants from 21 countries completed all three rounds of the Delphi survey. Of these, 35 participated in a consensus meeting. Six outcomes were agreed as the core outcomes: 'penetration/aspiration', 'aspiration pneumonia', 'choking', 'oropharyngeal dysphagia severity', 'swallowing related quality of life' and 'post swallow pharyngeal residue'.

CONCLUSIONS

The use of a COS in future oropharyngeal dysphagia intervention studies in Parkinson's disease will facilitate comparative effectiveness research and ensure that outcomes are relevant to all key stakeholders. This should help improve the evidence base for oropharyngeal dysphagia interventions in Parkinson's disease.

REGISTRATION

The study was registered prospectively with the Core Outcome Measures in Effectiveness Trials Database on 24 September 2021 (www.comet-initiative.org, registration number: 1942).

摘要

目的

通过就核心结局和定义、结局测量工具(OMIs)以及这些核心结局的测量时间点达成一致,为帕金森病口咽吞咽困难(吞咽障碍)干预制定一套核心结局集(COS)。

设计

国际在线德尔菲调查和共识会议。

参与者

患有口咽吞咽困难和帕金森病的个体、家庭成员及照料者、口咽吞咽困难和帕金森病领域的医疗保健专业人员及研究人员。

方法

之前通过范围综述、在线调查以及与关键利益相关者的焦点小组讨论,生成了一份长长的结局清单。在此基础上,开展了一轮国际三轮在线德尔菲调查,参与者对结局的重要性进行评分。在随后的在线共识会议上,就核心结局、其定义、OMIs以及测量时间点达成了一致。

结果

来自21个国家的90名参与者完成了三轮德尔菲调查。其中,35人参加了共识会议。六个结局被确定为核心结局:“渗透/误吸”、“误吸性肺炎”、“呛噎”、“口咽吞咽困难严重程度”、“吞咽相关生活质量”和“吞咽后咽部残留”。

结论

在未来帕金森病口咽吞咽困难干预研究中使用COS将有助于比较效果研究,并确保结局与所有关键利益相关者相关。这应有助于改善帕金森病口咽吞咽困难干预的证据基础。

注册情况

该研究于2021年9月24日在有效性试验核心结局测量数据库中进行了前瞻性注册(www.comet-initiative.org,注册号:1942)。

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