Changes From Baseline in Patient- Reported Outcomes at 1 Year Versus 2 Years After Rotator Cuff Repair: A Systematic Review and Meta-analysis.
Changes From Baseline in Patient- Reported Outcomes at 1 Year Versus 2 Years After Rotator Cuff Repair: A Systematic Review and Meta-analysis.
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DOI：
10.1177/03635465211023967
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发表时间：
2022-07
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大多数骨科期刊目前要求报告术后至少2年的手术干预结果，但在这方面还没有严格的研究。各种患者报告的预后（PRO）测量（PROMs）已被用于评估肩袖修复（RCR）后的肩部状态。我们假设平均肩部特异性PROMs在1年后比基线显著改善，但在RCR后平均1年和2年PROMs之间没有临床意义的差异。荟萃分析;证据等级2。我们对已发表的随机对照试验（rct）和前瞻性队列研究（证据水平1和2）进行了系统回顾，这些研究报告了在基线、RCR后1年和2年的肩部特异性美国肩关节外科医生（ASES）、Constant或Western Ontario Rotator Cuff （WORC）指数评分。评估了研究的方法学质量。此外，对术后第一年和第二年的PROMs变化进行随机效应荟萃分析。纳入15项研究（n = 11项rct； n = 4项队列研究），共1371例患者。研究是高度异质性的，但没有观察到主要发表偏倚的视觉证据。基线PROMs的加权平均值为：as评分46.2分，Constant评分46.4分，WORC指数38.8分。第一年的总增量为：as评分41.1 （95% CI, 36.0-46.2）点，Constant评分34.2 （95% CI, 28.8-39.6）点，WORC指数42.9 （95% CI, 37.3-48.4）点。相比之下，第二年的总增量为asa评分2.3 （95% CI, 1-3.6）点，Constant评分3.2 （95% CI, 1.9-4.4）点，WORC指数2 （95% CI,−0.1至4）点。从基线到1年，所有PROMs均有显著改善，但在RCR后1年和2年期间，仅观察到低于最小临床重要差异的非常小的增益。本研究没有发现任何证据表明RCR后需要至少2年的随访才能发表PROs。我们的研究结果表明，关注RCR后1年的prom可以促进更及时的报告，更好地控制选择偏差，更好地分配研究资源。
Most orthopaedic journals currently require reporting outcomes of surgical interventions for at least 2 postoperative years, but there have been no rigorous studies on this matter. Various patient-reported outcome (PRO) measures (PROMs) have been used to assess the status of the shoulder after rotator cuff repair (RCR). We hypothesized that the mean shoulder-specific PROMs at 1 year improve substantially over baseline but that there is no clinically meaningful difference between the mean 1- and 2-year PROMs after RCR. Meta-analysis; Level of evidence, 2. We conducted a systematic review of published randomized controlled trials (RCTs) and prospective cohort studies (level of evidence 1 and 2) reporting the shoulder-specific American Shoulder and Elbow Surgeons (ASES), the Constant, or the Western Ontario Rotator Cuff (WORC) Index scores at baseline, 1 year, and 2 years after RCR. The methodologic quality of studies was assessed. Also, the random effects meta-analyses of changes in PROMs for each of the first and second post-operative years were conducted. Fifteen studies (n = 11 RCTs; n = 4 cohort studies) with a total of 1371 patients were included. Studies were highly heterogeneous, but no visual evidence of major publication bias was observed. The weighted means of the baseline PROMs were 46.2 points for the ASES score, 46.4 points for the Constant score, and 38.8 points for the WORC Index. The first-year summary increments were 41.1 (95% CI, 36.0–46.2) points for the ASES score, 34.2 (95% CI, 28.8–39.6) points for the Constant score, and 42.9 (95% CI, 37.3–48.4) points for the WORC Index. In contrast, the second-year summary increments were 2.3 (95% CI, 1–3.6) points for the ASES score, 3.2 (95% CI, 1.9–4.4) points for the Constant score, and 2 (95% CI, −0.1 to 4) points for the WORC Index. All PROMs improved considerably from baseline to 1 year, but only very small gains that were below the minimal clinically important differences were observed between 1 year and 2 years after RCR. This study did not find any evidence for requiring a minimum of 2 years of follow-up for publication of PROs after RCR. Our results suggest that focusing on 1-year PROMs after RCR would foster more timely reporting, better control of selection bias, and better allocation of research resources.
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影响因子：
4.8
作者：
Cai, You-Zhi;Zhang, Chi;Chen, Jian-De
通讯作者：
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影响因子：
3
作者：
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影响因子：
2.6
作者：
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影响因子：
3
作者：
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通讯作者：
Zorzi, Claudio
DOI：
10.1016/j.arthro.2007.07.023
发表时间：
2008-01-01
影响因子：
4.7
作者：
Charousset, Christophe;Grimberg, Jean;Kalra, Kunal
通讯作者：
Kalra, Kunal