Evaluating maternity care: A core set of outcome measures
Evaluating maternity care: A core set of outcome measures
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DOI：
10.1111/j.1523-536x.2006.00145.x
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发表时间：
2007-06-01
影响因子：
2.5
通讯作者：
OBoyle, Colm
中科院分区：
文献类型：
--
作者：
Devane, Declan;Begley, Cecily M.;OBoyle, Colm
背景资料：由于研究人员使用的结局指标的选择和定义存在差异，因此比较不同试验中干预措施对特定结局的相对有效性可能存在问题。我们试图确定一套最低限度的成果措施，从关键利益攸关方的角度评估产妇护理模式。方法：采用3轮电子德尔菲调查设计。环境是多国性的，包括一系列关键利益攸关方。参与者包括一个单一的异质面板的产妇服务用户，助产士，产科医生，儿科医生/妇科医生，家庭医生/全科医生，政策制定者，服务从业者，和产妇保健研究人员。小组成员自我评估了他们在评估产妇护理模式方面的专业知识。结果：共有来自28个国家的320人表示愿意参加本次调查。218名（68.1%）参与者完成了第一轮，其中173名（79.4%）完成了第二轮，152名（87.9%）完成了第三轮。确定了50个结果，所有结果的平均值均大于总体组平均值（x = 4.18），并且至少70%的受访者在5分Likert类型量表中对纳入结果测量最小数据集的重要性进行了4分或4分以上的评分。三个结果被分解为一个结果，因此最终的最小集合包括48个结果。结论：由于在选择的结果措施，定期收集和随机评价产妇护理报告的不一致，希望使用的数据集将增加产妇护理模式的国家和国际比较的潜力。虽然这一套核心数据集无意成为规范性的或阻碍收集其他成果，但我们希望它将使评估妇女及其婴儿在怀孕和分娩期间的护理情况变得更加容易。
Background: Comparing the relative effectiveness of interventions on specific outcomes across trials can be problematic due to differences in the choice and definitions of outcome measures used by researchers. We sought to identify a minimum set of outcome measures for evaluating models of maternity care from the perspective of key stakeholders. Methods: A 3-round, electronic Delphi survey design was used. Setting was multinational, comprising a range of key stakeholders. Participants consisted of a single heterogeneous panel of maternity service users, midwives, obstetricians, pediatricians/neonatologists, family physicians/general practitioners, policymakers, service practitioners, and researchers of maternity care. Members of the panel self-assessed their expertise in evaluating models of maternity care. Results: A total of 320 people from 28 countries expressed willingness to take part in this survey. Round 1 was completed by 218 (68.1%) participants, of whom 173 (79.4%) completed round 2 and 152 (87.9%) of these completed round 3. Fifty outcomes were identified, with both a mean value greater than the overall group mean for all outcomes combined (x = 4.18) and rated 4 or more on a 5-point Likert-type scale for importance of inclusion in a minimum data set of outcome measures by at least 70 percent of respondents. Three outcomes were collapsed into a single outcome so that the final minimum set includes 48 outcomes. Conclusions: Given the inconsistencies in the choice of outcome measures routinely collected and reported in randomized evaluations of maternity care, it is hoped that use of the data set will increase the potential for national and international comparisons of models for maternity care. Although not intended to be prescriptive or to inhibit the collection of other outcomes, we hope that the core set will make it easier to assess the care of women and their babies during pregnancy and childbirth.