欧洲癌症结局的基准评估:对方法和案例组合调整的范围审查
J Thurell1,2, L Doppelbauer3, E M Verheul4
1Department of Oncology-Pathology, Karolinska Institutet, Solna, Sweden.
概括
欧洲癌症护理的基准测试需要准确的病例组合调整. 本次审查突出了当前实践中的差距,强调需要标准化,验证的模型,以确保公平的医院结果比较和改善患者护理.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 在瘤学瘤学.
- 医疗信息学 医疗信息学
背景情况:
- 医院结果的基准测试对于识别不平等和提高癌症护理质量至关重要.
- 准确的比较需要相关的结果和病例组合调整 (年龄,并发症,阶段).
- 如果没有调整,医院可能会根据患者人数而不是护理质量进行不公平的评估.
研究的目的:
- 审查欧洲癌症护理基准评估实践.
- 确定经常进行基准测试的健康结果.
- 检查案例组合因素,统计方法,以及在欧洲癌症护理基准测试中的模型开发/评估.
主要方法:
- 对OVID MEDLINE,科学网络和EMBASE的系统范围审查.
- 包括专注于欧洲癌症患者基准测试和健康结果的研究.
- 根据研究问题进行数据提取和合成.
主要成果:
- 在选4953个摘要后,包括了65项研究.
- 确定的缺陷:缺乏经过验证的案例组合模型,对长期结果的代表性不足,以及"过度调整".
- 回归建模是标准;需要在模型报告和评估上达成共识 (例如,TRIPOD指南).
结论:
- 标准化,验证的基准测试对于改善医疗保健至关重要.
- 严格的方法,报告标准和合作是关键.
- 有效的基准测试可以改变癌症护理质量和患者的治疗结果.
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