Health-related quality of life outcomes and level of evidence in pediatric neurosurgery.
Health-related quality of life outcomes and level of evidence in pediatric neurosurgery.
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儿科神经外科与健康相关的生活质量结果和证据水平。
DOI：
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发表时间：
2016
期刊：
影响因子：
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通讯作者：
A. Jea
中科院分区：
文献类型：
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作者：
Daniel Hansen;A. Vedantam;V. Briceño;Sandi K. Lam;T. Luerssen;A. Jea
随着循证医学的发展，人们越来越重视健康相关的生活质量（HRQOL）结果。然而，有一个显着的缺乏有效的HRQOL工具的儿科人群。此外，没有标准化或共识，目前存在关于HRQOL的结局指标应该用于小儿神经外科。作者希望确定过去10年来儿科神经外科研究中使用的HRQOL结局、频率和使用趋势。方法：回顾了2005年至2014年10年期间三种顶级儿科神经外科期刊中报告HRQOL结局的儿科神经外科手术临床研究。同行评审杂志《儿科学》上的类似研究也被用作基准。收集每篇文章的发表年份、证据等级和HRQOL结果。结果在研究期间，共有31项HRQOL研究发表在儿科神经外科文献中。相比之下，儿科有55篇这样的文章。使用HRQOL工具的出版物数量显示，儿科（B = 0.62，p = 0.02）随时间推移呈显著正趋势，但3种神经外科期刊（B = 0.12，p = 0.5）未随时间推移显著增加。作者确定了所有期刊中使用的46种不同的HRQOL工具。在神经外科期刊中，脑积水结局问卷（HOQ）（24%）是最常用的，其次是健康效用指数（HUI）（16%）、儿科生活质量量表（PedsQL）（12%）和36项简明健康调查表（SF-36）（12%）。在儿科中识别的55篇文章中，22篇（40%）使用了PedsQL版本。在牛津循证医学中心（OCEBM）系统中，没有神经外科研究达到4级以上。然而，儿科的多项研究达到了OCEBM 3级，其中几项被归类为2级，一项达到了1级。结论：在过去10年中，儿科神经外科研究中使用HRQOL结局的研究频率并未增加。与儿科的当代研究相比，儿科神经外科缺乏高质量的研究和标准化。总体而言，尽管HOQ、HUI、PedsQL和SF-36仪器正在成为儿科神经外科的标准，但需要在整个专业范围内实现更大的标准化，沿着设计和实施更严格的研究。
OBJECTIVE The emphasis on health-related quality of life (HRQOL) outcomes is increasing, along with an emphasis on evidence-based medicine. However, there is a notable paucity of validated HRQOL instruments for the pediatric population. Furthermore, no standardization or consensus currently exists concerning which HRQOL outcome measures ought to be used in pediatric neurosurgery. The authors wished to identify HRQOL outcomes used in pediatric neurosurgery research over the past 10 years, their frequency, and usage trends. METHODS Three top pediatric neurosurgical journals were reviewed for the decade from 2005 to 2014 for clinical studies of pediatric neurosurgical procedures that report HRQOL outcomes. Similar studies in the peer-reviewed journal Pediatrics were also used as a benchmark. Publication year, level of evidence, and HRQOL outcomes were collected for each article. RESULTS A total of 31 HRQOL studies were published in the pediatric neurosurgical literature over the study period. By comparison, there were 55 such articles in Pediatrics. The number of publications using HRQOL instruments showed a significant positive trend over time for Pediatrics (B = 0.62, p = 0.02) but did not increase significantly over time for the 3 neurosurgical journals (B = 0.12, p = 0.5). The authors identified a total of 46 different HRQOL instruments used across all journals. Within the neurosurgical journals, the Hydrocephalus Outcome Questionnaire (HOQ) (24%) was the most frequently used, followed by the Health Utilities Index (HUI) (16%), the Pediatric Quality of Life Inventory (PedsQL) (12%), and the 36-Item Short Form Health Survey (SF-36) (12%). Of the 55 articles identified in Pediatrics, 22 (40%) used a version of the PedsQL. No neurosurgical study reached above Level 4 on the Oxford Centre for Evidence-Based Medicine (OCEBM) system. However, multiple studies from Pediatrics achieved OCEBM Level 3, several were categorized as Level 2, and one reached Level 1. CONCLUSIONS The frequency of studies using HRQOL outcomes in pediatric neurosurgical research has not increased over the past 10 years. Within pediatric neurosurgery, high-quality studies and standardization are lacking, as compared with contemporary studies in Pediatrics. In general, although the HOQ, HUI, PedsQL, and SF-36 instruments are emerging as standards in pediatric neurosurgery, even greater standardization across the specialty is needed, along with the design and implementation of more rigorous studies.