量化治疗负担:患者负担得分在三个临床泌尿病情景中对758名患者进行了一项研究
Ofer N Gofrit1, S Nahum Goldberg2, Amitay Lorber2
1Departments of Urology, Radiology, and Oncology, Hadassah Hebrew University Hospital, P.O.Box 12000, Jerusalem, 91120, Israel. ogofrit@gmail.com.
World journal of urology
|November 27, 2024
概括
一个新的负担评分 (BS) 量化了治疗影响,包括并发症和辅助程序. 较少的侵入性选择,如质的皮肤切除和结石的尿路透镜,在较低的BS中提供了类似的成功.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 医学经济学 医学经济学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 泌尿病学的治疗决策往往涉及到平衡疗效与患者负担.
- 量化不同治疗选择的多方面的负担对于知情的患者-提供者讨论至关重要.
- 现有的指标可能无法完全捕捉治疗的综合影响,包括预期和意想不到的结果.
研究的目的:
- 开发和验证一个全面的负担评分 (BS),以衡量泌尿器科治疗的总负担.
- 为了比较特定泌尿病的不同治疗方式的BS.
主要方法:
- 一个专家小组开发了一种衡量治疗方面:住院,麻醉,手术和随访.
- 负担得分 (BS) 已被追溯计算为接受治疗质,膀癌和尿道结石的患者.
- 在每个临床场景中,在每个治疗方案之间进行了BS的比较分析.
主要成果:
- 对于小小的质,部分切除术 (PN) 的BS是皮肤穿切除术 (PA) 的两倍多 (27.3对12.5).
- 对于肌肉侵入性膀癌,三模式治疗 (TMT) 的BS明显低于激进囊切除术 (RC) (42.0对53.8).
- 对于上部尿路结石,尿路透镜的BS明显低于体外冲击波石 (SWL) (7.8比9.0).
结论:
- 穿皮切除,TMT和尿路透镜分别提供与PN,RC和SWL相比的成功率,但负担得分明显较低.
- 开发的BS为患者咨询提供了有价值的工具,当存在多种治疗选择时.
- 负担得分概念在各种医学领域都有潜在的适用性.
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