Li Danyu, Huang Qingmei, Zhang Wen, Yuan Changrong, Wu Fulei
School of Nursing, Fudan University, Shanghai, China.
Asia Pac J Oncol Nurs. 2023 Aug 23;10(11):100297. doi: 10.1016/j.apjon.2023.100297. eCollection 2023 Nov.
This study aims to investigate the potential benefits of integrating patient-reported outcomes (PROs) into routine clinical practice for patients undergoing active anticancer treatment.
We conducted a comprehensive systematic review of randomized controlled trials involving cancer patients undergoing active anticancer treatment, spanning various cancer types and stages. The review covered four electronic databases (Medline, EMBASE, Cochrane Library, and CINAHL) up to September 2022. Key inclusion criteria focused on the incorporation of PROs as a routine intervention. Bias assessment followed the Cochrane collaboration's criteria, while the synthesis of results utilized effect size measurements (Cohen's d). The study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
Out of 1549 initially screened records, 16 published randomized controlled trials encompassing 5300 patients met the inclusion criteria. The interventions involved 18 different PROs measurements, with prominent tools being EORTC QLQ-C30 (utilized in four trials) and PRO-CTCAE (utilized in four trials). Measured endpoints included overall quality of life (12 trials), physical health (11 trials), mental health (7 trials), and social health (5 trials). Overall, the study revealed a limited number of statistically significant findings, with predominantly small to moderate effect sizes associated with the interventions.
The findings suggest that the routine integration of PROs into clinical practice does not yield definitive advantages in terms of PROs. It is apparent that further efforts are necessary to ascertain the impact of these interventions on patient health.
The review protocol was registered on PROSPERO (ID: CRD42022365456).
本研究旨在探讨将患者报告结局(PROs)纳入接受积极抗癌治疗患者的常规临床实践中的潜在益处。
我们对涉及接受积极抗癌治疗的癌症患者的随机对照试验进行了全面的系统评价,涵盖各种癌症类型和阶段。该评价涵盖了截至2022年9月的四个电子数据库(Medline、EMBASE、Cochrane图书馆和CINAHL)。关键纳入标准集中在将PROs作为常规干预措施纳入。偏倚评估遵循Cochrane协作组的标准,而结果的综合利用效应量测量(Cohen's d)。该研究遵循系统评价和Meta分析的首选报告项目指南。
在最初筛选的1549条记录中,16项发表的随机对照试验(涉及5300名患者)符合纳入标准。干预措施涉及18种不同的PROs测量方法,其中突出的工具是EORTC QLQ-C30(在四项试验中使用)和PRO-CTCAE(在四项试验中使用)。测量的终点包括总体生活质量(12项试验)、身体健康(11项试验)、心理健康(7项试验)和社会健康(5项试验)。总体而言,该研究揭示的具有统计学意义的发现数量有限,干预措施的效应量主要为小到中等。
研究结果表明,将PROs常规纳入临床实践在PROs方面并没有产生明确的优势。显然,需要进一步努力来确定这些干预措施对患者健康的影响。
该评价方案已在PROSPERO上注册(ID:CRD42022365456)。