癌症护理中的患者报告结果措施:更新的系统性审查和元分析
Amaris K Balitsky1,2,3, Daniel Rayner4, Joanne Britto1,2
1Department of Oncology, McMaster University, Hamilton, Ontario, Canada.
JAMA network open
|August 13, 2024
概括
将患者报告的结果措施 (PROM) 整合到癌症护理中,可能会改善患者的生存率和生活质量. 这一系统性审查分析了45项随机临床试验,涉及超过13,000名参与者.
科学领域:
- 在瘤学瘤学.
- 医疗保健服务研究 医疗服务研究
- 以患者为中心的护理
背景情况:
- 患者报告的结果测量 (PROM) 在临床环境中提供了直接的患者视角.
- 将PROM整合到癌症护理中旨在增强以患者为中心的结果.
研究的目的:
- 评估PROM整合在癌症护理和患者治疗结果之间的关联.
- 评估PROMs对患者相关,治疗相关和医疗保健利用指标的影响.
主要方法:
- 1996年至2022年间发表的45项随机临床试验 (RCT) 的系统综述和元分析.
- 从2012年到2022年,在多个数据库 (MEDLINE,Embase,PsychINFO,CENTRAL,CINAHL) 中进行搜索.
- 使用PRISMA指南提取了关于试验和疾病特征,干预细节和结果的数据;采用随机效应分析.
主要成果:
- PROM与潜在的整体死亡率降低有关 (HR,0.84;中度确定性).
- 与健康相关的生活质量 (HRQoL) 在12周显著改善 (MD,2.45;中等确定性),但在24周或48周没有明显改善.
- 在使用PROM和减少急诊室访问或入院之间没有发现显著的关联.
结论:
- 将PROM整合到癌症治疗中,有望改善整体存活率和HRQoL.
- 虽然PROM显示出潜在的益处,但需要进一步的研究来澄清它们对医疗保健利用的影响.
- PROMs是捕捉患者观点和指导癌症护理决策的宝贵工具.
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