Harmonising knee pain patient-reported outcomes: a systematic literature review and meta-analysis of Patient Acceptable Symptom State (PASS) and individual participant data (IPD)
Harmonising knee pain patient-reported outcomes: a systematic literature review and meta-analysis of Patient Acceptable Symptom State (PASS) and individual participant data (IPD)
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协调膝盖疼痛患者报告的结果：系统文献综述和患者可接受症状状态 (PASS) 和个体参与者数据 (IPD) 的荟萃分析
DOI：
10.1016/j.joca.2022.08.011
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发表时间：
2023
影响因子：
7
通讯作者：
Georgopoulos V
中科院分区：
文献类型：
--
作者：
Georgopoulos V
目的为了促进研究之间的数据汇集，我们以患者可接受的症状状态评分 (PASS) 作为标准，探讨了骨关节炎或膝关节创伤引起的膝痛患者报告的结果测量 (PROM) 的协调性。方法我们对 PASS 评分进行了系统文献综述 (SLR)，并对同时完成的 PROM 对的评分分布进行了个体参与者数据 (IPD) 分析。将数字评定量表 (NRS)、视觉模拟量表、KOOS 和 WOMAC 疼痛问卷标准化为 0 至 100（最差）等级。元回归探讨了 PASS 的关联。 Bland Altman 图比较了使用 WebEx、KICK、MenTOR 和 NEKO 研究中的 IPD 的个体的 PROM 评分。结果SLR 确定了 18 项报告膝关节疼痛患者的 PASS 的研究。汇总标准化 PASS 为 27（95% CI：21 至 35；n= 6,339）。每个标准化 PROM 的 PASS 在统计上相似。较低的 PASS 与较低的基线疼痛 (β= 0.49，P= 0.01) 和治疗开始时间较长 (Q= 6.35，P= 0.04) 相关。韧带断裂的 PASS 评分最低（12，95% CI：11 至 13），但膝骨关节炎（31，95% CI：26 至 36）和半月板撕裂（27，95% CI：20 至 35）之间的 PASS 评分相似。在 IPD 中，每个标准化 PROM 都显示相似的组平均分数，但 PROM 之间个体内的分数存在差异（LoA 在 -7 至 -38 和 +25 至 52 之间）。结论不同的标准化 PROM 在组数据中给出相似的 PASS 阈值。与 PROM 之间相比，PASS 阈值可能更多地受到患者和治疗特征的影响。然而，不同的 PROM 在个体中给出不同的分数，可能反映了不同的疼痛经历。
ObjectiveIn order to facilitate data pooling between studies, we explored harmonisation of patient-reported outcome measures (PROMs) in people with knee pain due to osteoarthritis or knee trauma, using the Patient Acceptable Symptom State scores (PASS) as a criterion.MethodsWe undertook a systematic literature review (SLR) of PASS scores, and performed individual participant data (IPD) analysis of score distributions from concurrently completed PROM pairs. Numerical rating scales (NRS), visual analogue scales, KOOS and WOMAC pain questionnaires were standardised to 0 to 100 (worst) scales. Meta-regression explored associations of PASS. Bland Altman plots compared PROM scores within individuals using IPD from WebEx, KICK, MenTOR and NEKO studies.ResultsSLR identified 18 studies reporting PASS in people with knee pain. Pooled standardised PASS was 27 (95% CI: 21 to 35;n= 6,339). PASS was statistically similar for each standardised PROM. Lower PASS was associated with lower baseline pain (β= 0.49,P= 0.01) and longer time from treatment initiation (Q= 6.35,P= 0.04). PASS scores were lowest in ligament rupture (12, 95% CI: 11 to 13), but similar between knee osteoarthritis (31, 95% CI: 26 to 36) and meniscal tear (27, 95% CI: 20 to 35). In IPD, standardised PROMs each revealed similar group mean scores, but scores within individuals diverged between PROMs (LoA between −7 to −38 and +25 to 52).ConclusionDifferent standardised PROMs give similar PASS thresholds in group data. PASS thresholds may be affected more by patient and treatment characteristics than between PROMs. However, different PROMs give divergent scores within individuals, possibly reflecting different experiences of pain.