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评估临床意义的测量对患者报告的总关节关节整形术的结果测量:系统性审查
Carissa L Finley1, Chancellor F Gray2, Hari K Parvataneni2
1University of Florida, Gainesville, Florida, USA.
The Journal of arthroplasty
|January 23, 2026
概括
这次审查发现,在关节置换手术中,患者报告的结果指标 (PROM) 如MCID,SCB和PASS的计算方法存在显著的变化. 标准化这些方法对于在全关节整形术 (TJA) 中更好地评估结果至关重要.
科学领域:
- 整形外科和运动医学
- 健康 结果 研究 研究 结果
- 生物统计学 生物统计学
背景情况:
- 医疗保险和医疗补助服务中心 (CMS) 现在要求患者报告的结果测量 (PROMs) 对于初级全关节关节置换术 (TJAs).
- 在关节置换手术后,PROM对于评估临床结果和患者满意度至关重要.
- 这项研究的重点是关节置换 (HOOS JR) 的关节残疾和骨关节炎结局得分和关节置换 (KOOS JR) 的膝盖损伤和骨关节炎结局得分.
研究的目的:
- 系统地审查关键PROM值的计算方法:最小临床重要差异 (MCID),实质性临床益处 (SCB) 和患者可接受的症状状态 (PASS).
- 调查用于推导HOOS JR和KOOS JR这些PROM指标的题.
- 为了确定初级TJA的PROM值推导的变化.
主要方法:
- 对2000年至2025年间发表的研究的数据库进行系统的文献搜索.
- 收录标准:使用HOOS JR或KOOS JR的初级TJA获得MCID,SCB和/或PASS的英语文章.
- 两个独立审稿人的研究特征,PROM值和导出方法的提取.
主要成果:
- 分析了包括44,935名患者在内的17项研究.
- 对于HOOS JR,MCID在3.9-11.0 (基于分布) 和14.8-38.1 (基于) 之间;SCB为22,PASS在73.5-81.0.0之间.
- 对于KOOS JR,MCID在4.0-8.7 (基于分布) 和14.0-30.7 (基于) 之间;SCB为20,PASS在63.7-71.0.之间.
结论:
- 在用于计算关节置换PROM的MCID,SCB和PASS得分的方法中存在显著的变化.
- 这种变异性阻碍了在全关节关节整形术后对患者结果的一致和准确评估.
- 标准化PROM计算和利用方法对于改善临床结果评估至关重要.
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