【罂粟摘要】应用15项康复质量量表评价术后康复质量：一项系统回顾和meta分析

关注罂粟花，共同学习麻醉最新文献！     应用15项康复质量量表评价术后康复质量：一项系统回顾和meta分析  

贵州医科大学  麻醉与心脏电生理课题组

翻译：佟睿   编辑：潘志军   审校：曹莹

背景：                 

在术后几天或几周内，以病人为中心的全球康复结果测量方法非常少。这项meta分析评估了15项康复质量（QoR-15）量表的心理测量特性和临床可接受性。                   

方法   ：           

我们在书目数据库中搜索对QoR-15进行心理测量评估或使用QoR-15作为术后结果衡量标准的研究。记录筛选、数据提取和质量评估由两名研究人员独立完成。使用随机效应meta分析计算估计所有研究的总体汇总统计数据的加权平均值。使用Fisher z变换对汇集的相关系数进行变换，然后进行反向变换以计算汇集的结果。四个共同的主要终点是QoR-15量表的有效性、可靠性、反应性和临床实用性。      

结果：

  共有26项独特的研究符合资格标准，纳入了来自使用15种语言的16个国家和地区的多达22847名患者。在另外18个国家和6种语言的172项研究中，使用QoR-15作为结果衡量标准。QoR-15量表具有良好的判别效度，有并发症和无并发症患者的QoR-15评分的平均差异(9.6；95%可信区间[CI]，5.9-13.3；P<0.001)，以及良好的收敛效度(对于全球视觉模拟恢复量表，pooled γ=0.63；95%CI，0.54-0.71)。信度很高：内部一致性(pooled α=0.85；95%可信区间，0.83-0.87)，分半信度=0.80(95%可信区间，0.75-0.84)，测试信度=0.97(95%可信区间，0.95-0.98)。还有很高的响应性(合并标准化反应平均值=0.87；95%可信区间，0.65-1.08)，患者招募进入评估研究性(96%；95%可信区间，93-99)，以及出色的完成率和返回率(91%；95%可信区间，84-96)。完成QoR-15的平均时间为2.7分钟(95%可信区间，2.2-3.1)。    

结论: QoR-15是一种有效的、可靠的、反应灵敏的、以患者为中心的外科患者预后指标。患者和临床医生都高度接受。    

原始文献来源：

Paul S. Myles, Mark A. Shulman, Jennifer Reilly, et al. Measurement of quality of recovery after surgery using the 15-item quality of recovery scale: a systematic review and meta-analysis.[J]Br J Anae, 128 (6): 1029e1039 (2022)

罂粟花  

Measurement of quality of recovery after surgery using the 15-item quality of recovery scale: a systematic review and meta-analysis

Abstract

Background: There are very few patient-centred global outcome measures of recovery in the days or weeks after surgery.This meta-analysis evaluated the psychometric properties and clinical acceptability of the 15-item quality of recovery (QoR-15) scale.

Method: We searched bibliographic databases for studies undertaking psychometric evaluation of the QoR-15 or using the QoR-15 as an outcome measure after surgery. Record screening, data extraction, and quality assessments were independently done by two researchers. Weighted averages estimating overall summary statistics across all the studies were calculated using random-effects meta-analysis. Pooled correlation coefficients were transformed using a Fisher z-transformation and then back-transformed to calculate pooled results. The four co-primary endpoints were validity, reliability, responsiveness, and clinical utility of the QoR-15 scale.

Results: A total of 26 unique studies met the eligibility criteria, yielding up to 22 847 patients across 16 countries, in 15 languages. A further 172 studies in a further 18 countries and six languages used the QoR-15 as an outcome measure. The QoR-15 had excellent discriminant validity, with the mean difference in QoR-15 scores in patients with and without postoperative complications (9.6; 95% confidence interval [CI], 5.9-13.3; P<0.001), and good convergent validity (for a global visual analogue recovery scale, pooled γ=0.63; 95% CI, 0.54-0.71). There was excellent reliability: internal consistency (pooled α=0.85; 95% CI, 0.83-0.87), split-half reliability=0.80 (95% CI, 0.75-0.84), and testeretest reliability=0.97 (95% CI, 0.95-0.98). There was also high responsiveness (pooled standardised response mean=0.87; 95% CI, 0.65-1.08), patient recruitment into evaluation studies (96%; 95% CI, 93-99), and excellent completion and return rates (91%; 95% CI, 84-96). The mean time to complete the QoR-15 was 2.7 (95% CI, 2.2-3.1) min.

Conclusion: The QoR-15 is a valid, reliable, and responsive patient-centred outcome metric in surgical patients. It is highly acceptable to both patients and clinicians.

 圣人之道，吾性自足，向之求理于事物者误也。  

——王阳明

END