慢性阻塞性肺疾病急性加重期患者报告结局测评工具研究现状

Research Status of Patient-reported Outcome Measurements for Acute Exacerbation of Chronic Obstructive Pulmonary Disease

慢性阻塞性肺疾病(COPD)是常见呼吸系统疾病之一,其急性加重作为一种急性事件,严重影响COPD患者生存质量。本研究检索PubMed、中国知网、万方数据知识服务平台、维普网和中国生物医学文献数据库,经纳排标准共筛出69篇代表性文献,发现目前国内外应用于COPD急性加重期患者报告结局的测评工具共23个,除COPD急性加重自我报告结局(EXACT-PRO)外均直接采用稳定期患者报告结局测评工具,可分为普适性、疾病特异性及症状特异性测评工具,主要涉及症状、生理领域、社会领域、心理情绪、日常活动等领域。建议未来COPD急性加重期患者生存质量研究重点关注以下几方面:加强特异性测评工具研究,重视经典测量理论、项目反应理论及概化理论联合应用,重视测评工具最小临床重要差值研究,合理选择测评工具。

Chronic obstructive pulmonary disease(COPD)is one of the common respiratory diseases,and the acute exacerbation of COPD is an acute event that severely reduces the quality of life in patients with COPD.We searched PubMed,CNKI,Wanfang Data Knowledge Service Platform,Vip.com and Chinese Biomedical Literature,sifted out 69 representative literatures according to the inclusion and exclusion criteria,and found that there were 23 patient-reported outcome(PRO)assessment tools used in patients with acute exacerbation of COPD.Except for the EXACT-PRO,all of them directly use PRO assessment tools of stable patients.These assessment tools are divided into general,disease-specific and symptom-specific assessment tools,mainly involving symptoms,physiological field,social field,psychological emotion,daily activities and other fields.The number of items is from one to 100,and the response scale is mostly in the form of Likert,and its development and assessment are based on classical test theory.It is suggested that future studies on quality of life of patients with acute exacerbation of COPD should focus on the following points:strengthening the research on specific assessment tools;attaching importance to the combined application of classical test theory,item response theory and generalizability theory;paying attention to the study of the minimal clinically important difference of assessment tools;selecting assessment tools appropriately.