捕捉现实世界罕见疾病患者的旅程:当前的方法论是否足以做出明智的医疗保健决策?
Kristen A Cribbs1,2, Lucas T A Blackmore1, Asia R Banks2
1Alkemi LLC, Manchester Center, Vermont, USA.
Journal of evaluation in clinical practice
|February 17, 2025
概括
了解罕见疾病患者的旅程是有限的. 这次审查发现,大多数研究都侧重于诊断,治疗坚持和护理人员负担存在差距,突出了对纵向研究的需求.
科学领域:
- 现实世界的证据.
- 患者为中心的结果.
- 罕见疾病研究研究.
背景情况:
- 医疗保健决策日益强调患者的观点和现实世界的结果.
- 了解罕见疾病患者的旅程至关重要,但由于数据的局限性而受到挑战.
研究的目的:
- 系统地审查研究设计,方法和现实世界罕见病患者旅程调查的结果.
- 确定罕见疾病患者旅程研究中常见的研究方法和报告结果.
主要方法:
- 在PubMed和谷歌学者 (2014-2024) 的系统文献综述.
- 包括罕见疾病患者,护理人员或提供者;关键词:"旅程"",路径"",奥德赛".
- 由两个独立审稿人进行的描述性和质量评估.
主要成果:
- 包括31项研究,涵盖600多种罕见疾病和296548名参与者.
- 主要是前性的观察和横截面设计;采访和调查是常见的.
- 专注于诊断前和诊断阶段;常见的结果:医疗保健资源利用率,症状,诊断时间 (平均) 11.8年) 的时间.
- 在报告治疗坚持,护理人员负担和生产力方面存在重大差距.
- 大多数研究 (97%) 被评为质量低或非常低.
结论:
- 目前的罕见病患者旅程研究严重依赖于早期阶段 (预诊断,诊断) 和定性方法.
- 对于治疗坚持,护理人员负担和生产力存在证据差距.
- 为了改善临床和政策决策,需要进行长度研究,以捕捉现实世界的护理和治疗负担,包括护理人员的意见.
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