Utilization of a novel interactive mobile health platform to evaluate functional outcomes and pain following septoplasty and functional endoscopic sinus surgery.
Utilization of a novel interactive mobile health platform to evaluate functional outcomes and pain following septoplasty and functional endoscopic sinus surgery.
复制标题
利用新型交互式移动健康平台来评估鼻中隔成形术和功能性内窥镜鼻窦手术后的功能结果和疼痛。
DOI：
10.1002/alr.22273
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发表时间：
2019
影响因子：
6.4
通讯作者：
Conley,DavidB
中科院分区：
文献类型：
--
作者：
Khanwalkar,AshokeR;Shen,Jasper;Kern,RobertC;Welch,KevinC;Smith,StephanieS;Tan,BruceK;Conley,DavidB
无论是研究还是质量改进，术后生活质量结果的评估在可靠的数据收集方面都面临着挑战。典型的协调员主导的研究引用的响应率从35%到70%。本研究评估了数字患者参与平台的效用，以跟踪中隔成形术和功能性内窥镜鼻窦手术（FESS）后患者报告的结果测量（PROMs）。方法于2017年1月至2018年3月在某三级保健中心招募前瞻性队列。一个手机应用程序传递了PROMs，包括疼痛（每隔一天以0到10的视觉模拟量表[VAS]评估，持续2周，以及患者报告的结果测量信息系统[PROMIS]疼痛干扰短表4a在基线，2周和3个月）和返回工作的时间。结果288例入组患者中，249例（86.5%）提供了临床资料，其中208例接受了鼻中隔成形术或FESS。195名患者提交的颗粒VAS评分显示，80%的患者在术后第8天达到最小疼痛。通过手术缓解疼痛的天数增加趋势无统计学意义：鼻中隔成形术（平均值±标准差[SD]， 3.60±2.44），FESS(3.96±3.25)，FESS合并鼻中隔成形术（4.40±3.04），FESS合并钻孔（4.86±3.68）。在整个过程中，PROMIS疼痛干扰在2周时增加（9.17±4.15），在3个月时减少（5.32±2.61），与基线（7.09±4.63）相比，FESS亚组在3个月时有更大的改善。无论手术方式如何，患者平均7.1天恢复工作。结论移动数字患者参与平台具有较高的响应率，可以有效地跟踪术后结果，并有可能减少样本偏差。
BackgroundWhether for research or quality improvement, assessment of postoperative quality of life outcomes faces a challenge in reliable data collection. Typical coordinator‐led studies cite response rates from 35% to 70%. This study evaluates the utility of a digital patient engagement platform to track patient‐reported outcome measures (PROMs) following septoplasty and functional endoscopic sinus surgery (FESS).MethodsA prospective cohort was recruited at a tertiary care center from January 2017 to March 2018. A mobile phone application relayed PROMs, including pain (assessed on a 0 to 10 visual analogue scale [VAS] every other day for 2 weeks, as well as the patient‐reported outcome measure information system [PROMIS] pain interference short form 4a at baseline, 2 weeks, and 3 months) and timing of return to work.ResultsOf 288 patients enrolled, 249 (86.5%) provided clinical data, including 208 who underwent septoplasty or FESS. Granular VAS scores, submitted by 195 patients, demonstrated 80% of these patients achieved minimal pain by postoperative day 8. A nonsignificant trend of increased days to pain relief by procedure emerged: septoplasty (mean ± standard deviation [SD], 3.60 ± 2.44), FESS (3.96 ± 3.25), FESS with septoplasty (4.40 ± 3.04), and FESS with drilling (4.86 ± 3.68). Across procedures, PROMIS pain interference increased at 2 weeks (9.17 ± 4.15) and decreased at 3 months (5.32 ± 2.61) compared with baseline (7.09 ± 4.63), with greater improvement noted in the FESS subgroup at 3 months. Patients returned to work at mean 7.1 days regardless of procedure.ConclusionsWith its high response rate, mobile digital patient engagement platforms may effectively track postoperative outcomes with the potential for reduced sample bias.