测量严重中风:对RCT的范围审查
Katrin Roesner1,2, Hanna Brodowski1, Nicole Strutz3
1Department of Physiotherapy, Pain and Exercise Research Luebeck, Institute of Health Sciences, Universität zu Lübeck, Lübeck, Germany.
这次审查发现,在临床研究中,中风的严重程度有显著的变化,这影响了患者的可比性. 未来的研究应该解决一贯应用国家卫生研究院中风量表 (NIHSS) 的挑战.
科学领域:
- 神经科学是一个神经科学.
- 康复医学 康复医学 康复医学
- 临床研究方法论 临床研究方法论
背景情况:
- 卒中严重程度是住院时间和康复后功能恢复的关键决定因素.
- 建立关于中风严重程度的标准基线数据对于准确的研究和临床实践至关重要.
- 脑卒中恢复和康复圆桌会议 (SRRR) 建议国家卫生研究院脑卒中量表 (NIHSS) 用于评估2017年严重脑卒中.
研究的目的:
- 提供对临床研究中用于评估严重中风的各种测量工具的全面概述.
- 分析最近中风恢复研究中使用的测量工具和切断点数的变化.
- 确定推的中风严重程度评估尺度的一致应用中的差距和挑战.
主要方法:
- 在主要数据库 (PubMed,CENTRAL,SSCI,ICTRP) 进行了对RCT和CCT的系统搜索,寻找2018年1月至2024年9月期间发表的文章.
- 包括专注于重度中风的成年患者 (≥18岁) 康复干预的研究,分析了测量工具和切断点数.
- 总共有1004篇出版物最初被确定,其中35篇研究符合资格标准.
主要成果:
- 确定了11种不同的措施来评估严重中风,NIHSS是最常用的 (n=14).
- 其他常用的指标包括修改的兰金尺度 (mRS,n=6),Fugl-Meyer评估 (FMA) 上肢 (n=4),原始FMA (n=4),和巴特尔指数 (BI,n=3).
- 报告了NIHSS的七个不同的切断分数,突出显示即使在最常见的尺度内也存在变化.
结论:
- 在测量中风严重程度和在研究中应用截止分数方面存在实质性的异质性,限制了患者的可比性.
- 对NIHSS的不一致和部分使用表明需要调查对其标准化应用的障碍.
- 未来的研究应优先解决这些挑战,以提高临床试验中中风严重程度数据的可靠性和可比性.
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