足踝外科领域患者报告结局的研究进展  

Research progress on patient-reported outcomes in foot and ankle surgery

作　　者：王嘉正 施忠民[1] Wang Jiazheng;Shi Zhongmin(Department of Orthopaedics,Shanghai Jiaotong University Affiliated Sixth People's Hospital,Shanghai 200233,China)

机构地区：[1]上海交通大学附属第六人民医院骨科,上海200233

出　　处：《中华骨科杂志》2023年第2期143-148,共6页Chinese Journal of Orthopaedics

基　　金：上海交通大学"交大之星"计划医工交叉研究基金(YG2022ZD018)。

摘　　要：患者报告结局(patient-reported outcomes,PRO)指直接来自于患者自身健康状态任何方面的信息。足踝外科临床传统的患者报告结局测量工具(patient-reported outcome measures,PROM)包括美国足踝外科协会系列量表、视觉模拟评分、健康调查简表-36(SF-36)、足踝结局量表和健康调查简表-12(SF-12)等。在使用过程中,上述PROM因存在受医生的主观影响、只能对特定疾病或一般健康状况有响应、问卷过于冗长引起测试疲劳等问题而不能准确反映患者的感受,最终影响结果的信度和效度。由美国国立卫生研究院研发的患者报告结局测量信息系统(patient-reported outcome measurement information system,PROMIS)的各项量表经验证具有良好的信度、效度和响应度,其结果真实可靠,有很高的临床参考意义。PROMIS包含简表、简表合集和计算机自适应测试(computerized adaptive test,CAT)等形式,其中PROMIS CAT依靠更科学的项目反应理论建成,每一题的选择都与受试者的潜在特质高度相关,PRO的准确性和可信度大幅提高。PROMIS评分已应用于足踝外科(包括外翻、平足症、距骨颈骨折等)的临床实践,表现出良好、稳定的术前预估和预后评价能力。通过介绍PROMIS及其应用进展既可增加患者在医疗活动中的参与度,又可指导足踝外科医生的临床决策。Patient-reported outcomes(PROs)are information that comes directly from any aspect of a patient's own health status.The traditional patient-reported outcome measures(PROMs)used in foot and ankle surgery include the American Association of Foot and Ankle Surgery series scale,the visual analogue scale,the medical outcomes study 36-item short form of health survey(SF-36),the foot and ankle outcome scale and the medical outcome study 12-item short form of health survey(SF-12).In the process of use,these PROMs can not accurately reflect the patient's feelings because of the subjective influence of doctors,only responding to specific diseases or general health conditions,and the test fatigue caused by too long questionnaires,which ultimately affect the reliability and validity of the results.The scales of the patient-reported outcome measurement information system(PROMIS)led by National Institutes of Health have been verified to have good reliability,validity and responsiveness,and its results are true and reliable,and have high clinical reference significance.The PROMIS includes short forms,short form collection and computerized adaptive test(CAT),of which the PROMIS CAT is built on scientific item response theory,with the selection of each question highly correlated with the underlying trait of the patient,and the accuracy and credibility of PROs significantly improved.The PROMIS score has been applied in clinical practice in foot and ankle surgery(including hallux valgus,flatfoot and talar neck fractures,etc.)and has demonstrated excellent and stable preoperative prediction and prognosis evaluation ability.The presentation of PROMIS and its application progress can enhance the participation of patients of foot and ankle surgery in medical activities and guide clinical decision-making in foot and ankle surgery.

关 键 词：足 踝关节 患者报告结局评价 

分 类 号：R658.3[医药卫生—外科学]