在肩部不稳定性手术中临床重要变化的标准化结果值的高可变性:系统性审查
Ignacio Pasqualini1, Luciano A Rossi2, Xuankang Pan3
1Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio, U.S.A..
概括
肩部不稳定性手术PROM的最小临床重要差异 (MCID) 和患者可接受的满意状态 (PASS) 值是有限的,并且在研究之间存在显著差异. 需要更多的研究来确定患者报告结果措施 (PROM) 的可靠结果值.
科学领域:
- 整形外科手术 整形外科手术
- 患者报告的结果
- 临床试验方法论 临床试验方法论
背景情况:
- 患者报告的结果测量 (PROM) 对于评估肩部不稳定性手术结果至关重要.
- 最小临床重要差异 (MCID) 和患者可接受的满意状态 (PASS) 值为解释PROM结果提供了必要的基准.
- 这些值的变化可能会使临床决策和结果评估复杂化.
研究的目的:
- 系统地审查肩部不稳定性手术 (Bankart,Latarjet,Remplissage) 后PROMs报告的MCID和PASS值.
- 根据手术程序来评估这些值的变化.
- 描述用于导出MCID/PASS的方法及其在文献中的使用频率.
主要方法:
- 在遵守PRISMA指南的基础上进行系统审查.
- 在Embase,PubMed和CENTRAL数据库 (1985-2023) 搜索了关于Bankart,Latarjet和Remplissage程序的研究.
- 包括报告PROM的MCID或PASS的研究;提取了患者/干预特征和结果的数据;分析了中位数/范围的连续数据和百分比的分类数据.
主要成果:
- 包括八项研究,所有研究报告了MCID,但仅在两项中报告了PASS.
- 在多个PROM中报告了各种MCID和PASS值,包括ASES,SANE,VAS,WOSI和Rowe分数.
- 在报告的MCID和PASS值中观察到显著的研究间变化,没有研究报告了显著的临床益处或最大改善.
结论:
- 尽管有各种PROMs可用,但肩部不稳定性手术的临床显著结果值 (MCID,PASS) 是有限的,并表现出相当大的变化.
- 确定可靠的MCID和PASS值对于解释PROM结果和了解患者临床显著改善至关重要.
- 需要进一步的研究来规范报告和 MCID 和 PASS 值在肩部不稳定性手术结果的推导.
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