Australian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, QLD, Australia; Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, Brisbane, QLD, Australia; NHMRC Centre for Research Excellence in Paediatric Bronchiectasis (AusBREATHE), Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.
European Lung Foundation, Sheffield, UK.
Lancet Respir Med. 2024 Jan;12(1):78-88. doi: 10.1016/S2213-2600(23)00233-3. Epub 2023 Dec 6.
Improving the treatment of non-cystic fibrosis bronchiectasis in children and adolescents requires high-quality research with outcomes that meet study objectives and are meaningful for patients and their parents and caregivers. In the absence of systematic reviews or agreement on the health outcomes that should be measured in paediatric bronchiectasis, we established an international, multidisciplinary panel of experts to develop a core outcome set (COS) that incorporates patient and parent perspectives. We undertook a systematic review from which a list of 21 outcomes was constructed; these outcomes were used to inform the development of separate surveys for ranking by parents and patients and by health-care professionals. 562 participants (201 parents and patients from 17 countries, 361 health-care professionals from 58 countries) completed the surveys. Following two consensus meetings, agreement was reached on a ten-item COS with five outcomes that were deemed to be essential: quality of life, symptoms, exacerbation frequency, non-scheduled health-care visits, and hospitalisations. Use of this international consensus-based COS will ensure that studies have consistent, patient-focused outcomes, facilitating research worldwide and, in turn, the development of evidence-based guidelines for improved clinical care and outcomes. Further research is needed to develop validated, accessible measurement instruments for several of the outcomes in this COS.
改善儿童和青少年非囊性纤维化性支气管扩张症的治疗需要高质量的研究,其研究结果需要符合研究目标,并对患者及其父母和照护者具有意义。由于缺乏系统评价或对儿科支气管扩张症应测量的健康结果达成共识,我们成立了一个由国际多学科专家组成的小组,制定了一个包含患者和家长观点的核心结局集(COS)。我们进行了一项系统评价,从中构建了一个包含 21 个结果的清单;这些结果被用于为家长和患者以及医疗保健专业人员的排名开发单独的调查。共有 562 名参与者(来自 17 个国家的 201 名家长和患者,来自 58 个国家的 361 名医疗保健专业人员)完成了调查。经过两次共识会议,达成了一个包含五个被认为是必不可少的项目的十项 COS:生活质量、症状、恶化频率、非计划性医疗保健就诊和住院治疗。使用这个基于国际共识的 COS 将确保研究具有一致的、以患者为中心的结果,从而促进全球范围内的研究,并最终为改善临床护理和结果制定基于证据的指南。还需要进一步研究来为这个 COS 中的几个结果开发经过验证的、易于使用的测量工具。