研究动态
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癌症护理中患者报告的结果测量:更新的系统评价和荟萃分析。

Patient-Reported Outcome Measures in Cancer Care: An Updated Systematic Review and Meta-Analysis.

发表日期:2024 Aug 01
作者: Amaris K Balitsky, Daniel Rayner, Joanne Britto, Anath C Lionel, Lydia Ginsberg, Wanjae Cho, Ann Mary Wilfred, Huda Sardar, Nathan Cantor, Hira Mian, Mark N Levine, Gordon H Guyatt
来源: JAMA Network Open

摘要:

患者报告的结果测量 (PROM) 直接来自患者,无需临床医生解释,以提供以患者为中心的视角。了解 PROM 融入癌症护理与患者相关、治疗相关和医疗保健利用结果的关联. 搜索包括印刷前、处理中和其他非索引引文的 MEDLINE 和 MEDLINE Epub; Embase 数据库(OvidSP);心理信息;中央;和 CINAHL 从 2012 年 1 月 1 日到 2022 年 9 月 26 日。随机临床试验 (RCT),纳入患有活动性癌症的成年患者(18 岁及以上),使用 PROM 作为干预措施接受抗癌治疗。成对的综述作者,使用预试验形式,独立提取试验特征、疾病特征和干预细节。遵循系统评价和荟萃分析报告指南的首选报告项目。进行了随机效应分析。总体死亡率、健康相关生活质量 (HRQoL) 指标和医院利用率结果。从 1996 年到 2022 年,包括 13661 名参与者在内的 45 项随机对照试验探讨了 PROM 与对患者重要的结果之间的关联。添加 PROM 可能会降低总体死亡风险(HR,0.84;95% CI,0.72-0.98;中等确定性),改善 12 周时的 HRQoL(范围 0-100)(平均差 [MD],2.45;95) % CI,0.42-4.48;中等确定性)。 24 周时 HRQoL 的改善并不显着(MD,1.87;95% CI,-1.21 至 4.96;低确定性)。 48 周时添加 PROM 与 HRQoL 之间没有关联。添加 PROM 与减少急诊就诊次数(OR,0.74;95% CI,0.54-1.02;低确定性)或住院次数(OR,0.86;95% CI,0.73-1.02;低确定性)无关。 研究结果这项研究表明,将 PROM 纳入癌症护理可能会提高总体生存率和生活质量。
Patient-reported outcome measures (PROMs) come directly from the patient, without clinician interpretation, to provide a patient-centered perspective.To understand the association of PROM integration into cancer care with patient-related, therapy-related, and health care utilization outcomes.Searches included MEDLINE and MEDLINE Epub ahead of print, in-process, and other nonindexed citations; Embase databases (OvidSP); PsychINFO; CENTRAL; and CINAHL from January 1, 2012 to September 26, 2022.Randomized clinical trials (RCTs) that enrolled adult patients (ages 18 years and older) with active cancer receiving anticancer therapy using a PROM as an intervention.Pairs of review authors, using prepiloted forms, independently extracted trial characteristics, disease characteristics, and intervention details. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guideline was followed. Random-effects analyses were conducted.Overall mortality, health-related quality of life (HRQoL) measures, and hospital utilization outcomes.From 1996 to 2022, 45 RCTs including 13 661 participants addressed the association of PROMs with outcomes considered important to patients. The addition of a PROM likely reduced the risk of overall mortality (HR, 0.84; 95% CI, 0.72-0.98; moderate certainty), improved HRQoL (range 0-100) at 12 weeks (mean difference [MD], 2.45; 95% CI, 0.42-4.48; moderate certainty). Improvements of HRQoL at 24 weeks were not significant (MD, 1.87; 95% CI, -1.21 to 4.96; low certainty). There was no association between the addition of a PROM and HRQoL at 48 weeks. The addition of a PROM was not associated with reduced ED visits (OR, 0.74; 95% CI, 0.54-1.02; low certainty) or hospital admissions (OR, 0.86; 95% CI, 0.73-1.02; low certainty).The findings of this study suggest that the integration of PROMs into cancer care may improve overall survival and quality of life.