Application of Minimal Clinically Important Difference in Outcome Assessment Tools for Bronchiectasis Treatment

doi:10.12114/j.issn.1007-9572.2022.0290

Chinese General Practice ›› 2022, Vol. 25 ›› Issue (30): 3739-3746.DOI: 10.12114/j.issn.1007-9572.2022.0290

Special Issue: 患者报告结局最新文章合辑

• Clinical Hot Topic • Previous Articles Next Articles

Application of Minimal Clinically Important Difference in Outcome Assessment Tools for Bronchiectasis Treatment

1. Henan University of Chinese Medicine, Zhengzhou 450046, China
2. Department of Respiratory Medicine, the First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou 450000, China

Received:2022-04-10 Revised:2022-06-12 Published:2022-10-20 Online:2022-06-30
Contact: Yang XIE
About author:
GUAN J R, REN J M, XIE Y, et al. Application of minimal clinically important difference in outcome assessment tools for bronchiectasis treatment[J]. Chinese General Practice, 2022, 25 (30) : 3739-3746, 3754.

最小临床重要差值在支气管扩张症疗效测评工具中的应用与思考

1．450046　河南省郑州市，河南中医药大学
2．450000　河南省郑州市，河南中医药大学第一附属医院呼吸科

通讯作者: 谢洋
作者简介:
关佳瑞，任嘉铭，谢洋，等.最小临床重要差值在支气管扩张症疗效测评工具中的应用与思考[J].中国全科医学，2022，25（30）：3739-3746，3754.[www.chinagp.net] 作者贡献：关佳瑞进行文章的构思与设计，撰写论文并对文章负责；关佳瑞、张彭负责文章的资料收集与整理；任嘉铭负责文章的修订；谢洋负责文章的质量控制及审校，对文章整体负责、监督管理。
基金资助:
国家自然科学基金重点项目(81830116); 国家重点研发计划(2018YFC1704806); 河南省自然科学基金优秀青年科学基金项目(212300410056); 河南省科技攻关计划(172102310200); 河南省第二批中医药拔尖人才项目(豫卫中医函〔2021〕15号)

Abstract

Abstract:

Increased bronchiectasis (BE) prevalence has imposed heavy economic burden on patients and their families, greatly affecting the quality of life of patients. With increased use of patient reported outcome (PRO) in bronchiectasis treatment assessment, researchers not only focus on statistical pre-and post-treatment differences (P<0.05) , but also pay attention to minimal clinically important difference (MCID) . Currently, there is still a lack of relevant data about MCID in BE-PRO assessment tools. We reviewed the latest research on the use of MCID in BE-PRO assessment tools, aiming at providing a quantitative basis for outcome assessment in BE treatment.

Key words: Bronchiectasis, Patient reported outcome, Quality of life, Minimal clinically important difference, Measurement instrument, Scale

摘要：

支气管扩张症（BE）发病率逐年增高，给患者及家庭造成了沉重的经济负担，对患者生存质量影响较大。随着患者报告结局（PRO）在BE临床应用中的增多，研究者不再只关注其统计学差异（P<0.05），其最小临床重要差值（MCID）也逐渐成为研究热点。当前对BE-PRO测评工具的MCID研究还缺乏相关数据，本文概述了MCID在BE-PRO测评工具中的研究现状，以期为BE相关临床疗效评价提供量化标准及参考依据。

关键词: 支气管扩张症, 患者报告结局, 生活质量, 最小临床重要差值, 测评工具, 量表

Jiarui GUAN,Jiaming REN,Yang XIE, et al. Application of Minimal Clinically Important Difference in Outcome Assessment Tools for Bronchiectasis Treatment[J]. Chinese General Practice, 2022, 25(30): 3739-3746. DOI: 10.12114/j.issn.1007-9572.2022.0290.
关佳瑞,任嘉铭,谢洋等. 最小临床重要差值在支气管扩张症疗效测评工具中的应用与思考[J]. 中国全科医学, 2022, 25(30): 3739-3746. DOI: 10.12114/j.issn.1007-9572.2022.0290.

Figures/Tables 1

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量表名称		维度	条目数	积分解读	MCID估值
普适性量表
	SF-36	生理功能、生理职能、躯体疼痛、总体健康、生命活力、社交功能、情感职能、心理健康	36	分值越高，生存质量越差	SWIGRIS^[15]：3分（分布法）；2~4分（锚定法）
	HADS	焦虑、抑郁	14	分值越高，焦虑抑郁情绪越严重	SMID^[17]：1.3~1.8分（HADS-A：锚定法+分布法）；1.5~1.7分（HADS-D：锚定法+分布法） WYNNE^[18]：2分（锚定法+分布法）
疾病特异性量表
	SGRQ	症状、活动、日常生活影响	50	0~100分，分值越高，生存质量越差	JONES^[26]：4分（锚定法） SWIGRIS^[27]：7分REHMAN^[28]：5.07分（锚定法） 6.05分（分布法）
	CRQ	呼吸困难、疲劳、心理功能、对疾病的控制	41	41~287分，分值越高，生存质量越好	JAESCHKE^[4]：呼吸领域为3分（锚定法） WYRWICH^[32]：0.5分/条目（专家意见法+分布法）
	SOLDQ	身体功能、情绪功能、应对技巧、治疗满意度	29	0~400分，分值越高，生存质量越好	—
	QOL-B	生理功能、角色功能、活力、情绪功能、社会功能、治疗负担、健康感觉、呼吸症状	37	0~100分，分值越高，生活质量越好	QUITTNER^[39]：7~10分（锚定法+分布法） OLVEIRA^[40]：呼吸领域为6.8分（分布法） QUELLHORST^[41]：8.5~14.1（分布法）
	BHQ	呼吸道症状、身体功能、心理健康、药物和治疗、社会功能	10	分值越高，生存质量越好	—
	CAT	咳嗽、咳痰、胸闷、睡眠、精力、情绪、运动耐力、日常运动影响	8	0~40分，分值越高，生存质量越差	SMID^[17]：2~3分（锚定法+分布法） FINCH^[49]：4分（锚定法+分布法） TSILIGIANNI^[50]：3.76分（分布法）
	CCQ	症状、功能、精神状态	10	0~6分，分值越高，生存质量越差	TSILIGIANNI^[50]：0.41分（分布法）
症状特异性量表
	LCQ	生理、心理、社交	19	3~21分，分值越高，咳嗽对生存质量影响越小	BROKKAAR^[57]：3分BIRRING^[59]：1.5~2.0分
	mMRC	呼吸困难	4	0~4分，分值越高，呼吸困难越严重	—
	CQLQ	身体不适、社会心理问题、职业技能、情感健康、极端身体不适、人身安全恐惧	28	28~112分，分值越高，生活质量越差	LECHTZIN^[66]：5.0~5.7（分布法）
	CASA-Q	咳嗽症状，咳嗽影响，咳痰症状、痰液影响	20	分值越高，生存质量越差	—
	LRTI-VAS	呼吸困难、疲劳、咳嗽、疼痛程度、痰色	5	5~50分，分值越高，症状越严重	—

量表名称		维度	条目数	积分解读	MCID估值
普适性量表
	SF-36	生理功能、生理职能、躯体疼痛、总体健康、生命活力、社交功能、情感职能、心理健康	36	分值越高，生存质量越差	SWIGRIS^[15]：3分（分布法）；2~4分（锚定法）
	HADS	焦虑、抑郁	14	分值越高，焦虑抑郁情绪越严重	SMID^[17]：1.3~1.8分（HADS-A：锚定法+分布法）；1.5~1.7分（HADS-D：锚定法+分布法） WYNNE^[18]：2分（锚定法+分布法）
疾病特异性量表
	SGRQ	症状、活动、日常生活影响	50	0~100分，分值越高，生存质量越差	JONES^[26]：4分（锚定法） SWIGRIS^[27]：7分REHMAN^[28]：5.07分（锚定法） 6.05分（分布法）
	CRQ	呼吸困难、疲劳、心理功能、对疾病的控制	41	41~287分，分值越高，生存质量越好	JAESCHKE^[4]：呼吸领域为3分（锚定法） WYRWICH^[32]：0.5分/条目（专家意见法+分布法）
	SOLDQ	身体功能、情绪功能、应对技巧、治疗满意度	29	0~400分，分值越高，生存质量越好	—
	QOL-B	生理功能、角色功能、活力、情绪功能、社会功能、治疗负担、健康感觉、呼吸症状	37	0~100分，分值越高，生活质量越好	QUITTNER^[39]：7~10分（锚定法+分布法） OLVEIRA^[40]：呼吸领域为6.8分（分布法） QUELLHORST^[41]：8.5~14.1（分布法）
	BHQ	呼吸道症状、身体功能、心理健康、药物和治疗、社会功能	10	分值越高，生存质量越好	—
	CAT	咳嗽、咳痰、胸闷、睡眠、精力、情绪、运动耐力、日常运动影响	8	0~40分，分值越高，生存质量越差	SMID^[17]：2~3分（锚定法+分布法） FINCH^[49]：4分（锚定法+分布法） TSILIGIANNI^[50]：3.76分（分布法）
	CCQ	症状、功能、精神状态	10	0~6分，分值越高，生存质量越差	TSILIGIANNI^[50]：0.41分（分布法）
症状特异性量表
	LCQ	生理、心理、社交	19	3~21分，分值越高，咳嗽对生存质量影响越小	BROKKAAR^[57]：3分BIRRING^[59]：1.5~2.0分
	mMRC	呼吸困难	4	0~4分，分值越高，呼吸困难越严重	—
	CQLQ	身体不适、社会心理问题、职业技能、情感健康、极端身体不适、人身安全恐惧	28	28~112分，分值越高，生活质量越差	LECHTZIN^[66]：5.0~5.7（分布法）
	CASA-Q	咳嗽症状，咳嗽影响，咳痰症状、痰液影响	20	分值越高，生存质量越差	—
	LRTI-VAS	呼吸困难、疲劳、咳嗽、疼痛程度、痰色	5	5~50分，分值越高，症状越严重	—

Application of Minimal Clinically Important Difference in Outcome Assessment Tools for Bronchiectasis Treatment

最小临床重要差值在支气管扩张症疗效测评工具中的应用与思考

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