目的确定膝骨关节炎患者全膝关节置换后美国特种外科医院膝关节评分(hospital for special surgery knee score,HSS)的最小临床重要差异(minimal clinically important difference,MCID)。方法回顾性分析2017年1月-2018年6月解放军总医...目的确定膝骨关节炎患者全膝关节置换后美国特种外科医院膝关节评分(hospital for special surgery knee score,HSS)的最小临床重要差异(minimal clinically important difference,MCID)。方法回顾性分析2017年1月-2018年6月解放军总医院第一医学中心关节外科诊断为膝骨关节炎并行单侧全膝关节置换治疗的患者。记录患者术前HSS评分、术后1年的HSS评分及术后1年满意度调查结果。采用锚法(Anchor-based approach)将患者满意度作为分组指标,简单线性回归分析确定HSS评分的MCID。结果413例患者的平均年龄(66.0±7.8)岁,男性93例(22.5%),女性320例(77.5%)。全膝关节置换后1年HSS评分平均提高34.33分(95%CI:33.11~35.54)。术后1年满意度评价极其满意59例,非常满意131例,满意177例,一般34例,不满意/糟糕12例;各组患者术前和术后1年HSS评分均有改变:极其满意组44.96(95%CI:42.51~47.41),非常满意组38.44(95%CI:36.74~40.14),比较满意组32.26(95%CI:30.71~33.81),一般组20.45(95%CI:17.35~23.55),不满意/糟糕组8.08(95%CI:2.83~13.34)。HSS评分的MCID为9.18(95%CI:6.37~11.98)。结论本研究确定了膝骨关节炎患者全膝关节置换后HSS评分的最小临床重要差异为9.18分,建议膝骨关节炎患者全膝关节置换治疗1年后HSS评分变化高于此分数作为有临床意义的评价阈值。展开更多
背景口服中药在慢性阻塞性肺疾病急性加重(AECOPD)的治疗中应用广泛,但相关临床试验的结局指标尚未得到统一和规范。目的通过筛选已发表的以口服中药为AECOPD治疗措施的随机对照试验(RCT),总结其文献特征和选用的结局指标情况,为中医药...背景口服中药在慢性阻塞性肺疾病急性加重(AECOPD)的治疗中应用广泛,但相关临床试验的结局指标尚未得到统一和规范。目的通过筛选已发表的以口服中药为AECOPD治疗措施的随机对照试验(RCT),总结其文献特征和选用的结局指标情况,为中医药治疗AECOPD临床试验设计和结局指标选择提供参考。方法计算机检索中国知网、万方数据知识服务平台、维普网、中国生物医学文献数据库、PubMed、Embase、Web of Science、Cochrane Library、ClinicalTrials.gov、中国临床试验注册中心,获取口服中药治疗AECOPD的RCT和临床试验注册方案,检索时限为2018年1月—2022年10月。由2位评价员独立筛选文献、提取资料后,采用定性分析的方法,对纳入研究的结局指标选择情况进行描述。结果纳入578篇文献,包含574篇已报告试验结果的RCT及4个临床试验注册方案。574篇RCT共纳入51508例患者。88篇文献在纳入标准中限定了患者的疾病分级,361篇文献在纳入标准中限定了中医证型,6篇文献报告了盲法,6篇文献提及了随访。纳入文献共涉及4030个结局指标,单篇文献结局指标数量范围为1~24个。按照结局指标的功能属性,将其归为8个指标域:中医症状/证候、症状/体征、理化检测、生活质量、远期预后、经济学评估、安全性评价、其他,报告率最高的指标域是理化检测,报告频次排名前5位的结局指标项目是:有效率(11.5%)、第1秒用力呼气容积(7.5%)、中医症状/证候评分(7.0%)、第1秒用力呼气容积/用力肺活量(6.8%)、用力肺活量(4.6%)。445篇文献报告了有效率的组成,报告率排名前5位的研究指标依次为症状(423篇)、体征(281篇)、中医证候评分(203篇)、实验室检查(89篇)、肺功能(71篇)。结论口服中药治疗AECOPD的RCT涉及的结局指标数量多、范围广,纳入的文献在不同程度上关注了口服中药对AECOPD患者的症状体征、理化检测展开更多
目的系统评价失智症老年人综合评估工具的方法学质量和测量学属性,为临床选择最佳评估工具提供依据。方法检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、PubMed、Embase、Web of Science、Cochrane Library、CINAHL、...目的系统评价失智症老年人综合评估工具的方法学质量和测量学属性,为临床选择最佳评估工具提供依据。方法检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、PubMed、Embase、Web of Science、Cochrane Library、CINAHL、ProQuest、Ovid及Scopus数据库,收集评价失智症老年人综合评估工具测量学属性的研究,检索时限均为建库至2024年1月4日。由2名研究者独立进行文献筛选和提取信息,采用达成共识遴选健康测量工具标准(COSMIN)指南对纳入的评估工具进行评价,形成最终推荐意见。结果共纳入14篇文献,包含9个失智症老年人综合评估工具。其中,阿尔茨海默病患者照护需求评估量表具有中等及以上证据证明其内容效度和内部一致性为"充分",故为A类强推荐。其余8个评估工具均为B类推荐。结论现存的失智症老年人综合评估工具中,阿尔茨海默病患者照护需求评估量表具有良好的信效度,该量表共4个维度,16个条目。但该量表在跨文化效度/测量等同性、稳定性、测量误差、假设检验、校标效度、反应度的测量学特性方面存在不确定和未提及。未来需要更多的证据将其进一步全面验证完善,为筛选出更有效、更全面、更高质量的失智症老年人综合评估工具提供基础。展开更多
Introduction and Objectives: COVID-19 has been reported to cause long-term sequela including persistent fatigue and Chronic Fatigue Syndrome (CFS) in the general population. However, it remains to be seen if similar e...Introduction and Objectives: COVID-19 has been reported to cause long-term sequela including persistent fatigue and Chronic Fatigue Syndrome (CFS) in the general population. However, it remains to be seen if similar effects are observed in an athlete population. The aetiology and pathophysiology are poorly understood but is thought to be multi-factorial. Patient reported outcome measures are commonly used to improve patient-centred outcomes (PROMs). They are essential to assess patient quality of life post-COVID infection. This paper aims to assess the effect of COVID-19 on athletes’ long-term fatigue and CFS and identify the PROMs used to characterise this. Methodology: Articles were selected for extraction based on the eligibility criteria and PRISMA guidelines. The inclusion criteria required papers to assess competitive athletes over eighteen years of age who were clinically diagnosed with COVID-19. Articles were extracted to assess different variables including type of sport, type of athlete and ethnicity. Key terms were obtained using MeSH trees and utilised with Web of Science and NCBI Pubmed. Papers were graded by quality using the Hawker quality assessment tool. Results and Discussion: Forty articles (N = 40) were identified for full-text screening (N = 8). Eight were selected for extraction based on the eligibility criteria. Data was obtained on athlete characteristics, sport characteristics, properties of PROM measurement techniques and fatigue presentation. Male athletes were found to be 10% - 50% more likely than female athletes to suffer from persistent fatigue symptoms (N = 2). Persistent fatigue was present in 9% - 10% Athletes from mixed backgrounds and genders (N = 2). Initial fatigue was documented to be between 47% - 56% (N = 2). A heterogenous range of PROMs were utilised to assess symptoms including fatigue and excluded emotional or mental fatigue. Conclusion: COVID-19 is associated with signs of persisting fatigue and potentially CFS in athlete populations. More work needs to be done to d展开更多
文摘目的确定膝骨关节炎患者全膝关节置换后美国特种外科医院膝关节评分(hospital for special surgery knee score,HSS)的最小临床重要差异(minimal clinically important difference,MCID)。方法回顾性分析2017年1月-2018年6月解放军总医院第一医学中心关节外科诊断为膝骨关节炎并行单侧全膝关节置换治疗的患者。记录患者术前HSS评分、术后1年的HSS评分及术后1年满意度调查结果。采用锚法(Anchor-based approach)将患者满意度作为分组指标,简单线性回归分析确定HSS评分的MCID。结果413例患者的平均年龄(66.0±7.8)岁,男性93例(22.5%),女性320例(77.5%)。全膝关节置换后1年HSS评分平均提高34.33分(95%CI:33.11~35.54)。术后1年满意度评价极其满意59例,非常满意131例,满意177例,一般34例,不满意/糟糕12例;各组患者术前和术后1年HSS评分均有改变:极其满意组44.96(95%CI:42.51~47.41),非常满意组38.44(95%CI:36.74~40.14),比较满意组32.26(95%CI:30.71~33.81),一般组20.45(95%CI:17.35~23.55),不满意/糟糕组8.08(95%CI:2.83~13.34)。HSS评分的MCID为9.18(95%CI:6.37~11.98)。结论本研究确定了膝骨关节炎患者全膝关节置换后HSS评分的最小临床重要差异为9.18分,建议膝骨关节炎患者全膝关节置换治疗1年后HSS评分变化高于此分数作为有临床意义的评价阈值。
文摘背景口服中药在慢性阻塞性肺疾病急性加重(AECOPD)的治疗中应用广泛,但相关临床试验的结局指标尚未得到统一和规范。目的通过筛选已发表的以口服中药为AECOPD治疗措施的随机对照试验(RCT),总结其文献特征和选用的结局指标情况,为中医药治疗AECOPD临床试验设计和结局指标选择提供参考。方法计算机检索中国知网、万方数据知识服务平台、维普网、中国生物医学文献数据库、PubMed、Embase、Web of Science、Cochrane Library、ClinicalTrials.gov、中国临床试验注册中心,获取口服中药治疗AECOPD的RCT和临床试验注册方案,检索时限为2018年1月—2022年10月。由2位评价员独立筛选文献、提取资料后,采用定性分析的方法,对纳入研究的结局指标选择情况进行描述。结果纳入578篇文献,包含574篇已报告试验结果的RCT及4个临床试验注册方案。574篇RCT共纳入51508例患者。88篇文献在纳入标准中限定了患者的疾病分级,361篇文献在纳入标准中限定了中医证型,6篇文献报告了盲法,6篇文献提及了随访。纳入文献共涉及4030个结局指标,单篇文献结局指标数量范围为1~24个。按照结局指标的功能属性,将其归为8个指标域:中医症状/证候、症状/体征、理化检测、生活质量、远期预后、经济学评估、安全性评价、其他,报告率最高的指标域是理化检测,报告频次排名前5位的结局指标项目是:有效率(11.5%)、第1秒用力呼气容积(7.5%)、中医症状/证候评分(7.0%)、第1秒用力呼气容积/用力肺活量(6.8%)、用力肺活量(4.6%)。445篇文献报告了有效率的组成,报告率排名前5位的研究指标依次为症状(423篇)、体征(281篇)、中医证候评分(203篇)、实验室检查(89篇)、肺功能(71篇)。结论口服中药治疗AECOPD的RCT涉及的结局指标数量多、范围广,纳入的文献在不同程度上关注了口服中药对AECOPD患者的症状体征、理化检测
文摘目的系统评价失智症老年人综合评估工具的方法学质量和测量学属性,为临床选择最佳评估工具提供依据。方法检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、PubMed、Embase、Web of Science、Cochrane Library、CINAHL、ProQuest、Ovid及Scopus数据库,收集评价失智症老年人综合评估工具测量学属性的研究,检索时限均为建库至2024年1月4日。由2名研究者独立进行文献筛选和提取信息,采用达成共识遴选健康测量工具标准(COSMIN)指南对纳入的评估工具进行评价,形成最终推荐意见。结果共纳入14篇文献,包含9个失智症老年人综合评估工具。其中,阿尔茨海默病患者照护需求评估量表具有中等及以上证据证明其内容效度和内部一致性为"充分",故为A类强推荐。其余8个评估工具均为B类推荐。结论现存的失智症老年人综合评估工具中,阿尔茨海默病患者照护需求评估量表具有良好的信效度,该量表共4个维度,16个条目。但该量表在跨文化效度/测量等同性、稳定性、测量误差、假设检验、校标效度、反应度的测量学特性方面存在不确定和未提及。未来需要更多的证据将其进一步全面验证完善,为筛选出更有效、更全面、更高质量的失智症老年人综合评估工具提供基础。
文摘Introduction and Objectives: COVID-19 has been reported to cause long-term sequela including persistent fatigue and Chronic Fatigue Syndrome (CFS) in the general population. However, it remains to be seen if similar effects are observed in an athlete population. The aetiology and pathophysiology are poorly understood but is thought to be multi-factorial. Patient reported outcome measures are commonly used to improve patient-centred outcomes (PROMs). They are essential to assess patient quality of life post-COVID infection. This paper aims to assess the effect of COVID-19 on athletes’ long-term fatigue and CFS and identify the PROMs used to characterise this. Methodology: Articles were selected for extraction based on the eligibility criteria and PRISMA guidelines. The inclusion criteria required papers to assess competitive athletes over eighteen years of age who were clinically diagnosed with COVID-19. Articles were extracted to assess different variables including type of sport, type of athlete and ethnicity. Key terms were obtained using MeSH trees and utilised with Web of Science and NCBI Pubmed. Papers were graded by quality using the Hawker quality assessment tool. Results and Discussion: Forty articles (N = 40) were identified for full-text screening (N = 8). Eight were selected for extraction based on the eligibility criteria. Data was obtained on athlete characteristics, sport characteristics, properties of PROM measurement techniques and fatigue presentation. Male athletes were found to be 10% - 50% more likely than female athletes to suffer from persistent fatigue symptoms (N = 2). Persistent fatigue was present in 9% - 10% Athletes from mixed backgrounds and genders (N = 2). Initial fatigue was documented to be between 47% - 56% (N = 2). A heterogenous range of PROMs were utilised to assess symptoms including fatigue and excluded emotional or mental fatigue. Conclusion: COVID-19 is associated with signs of persisting fatigue and potentially CFS in athlete populations. More work needs to be done to d
