核心结果集和并发症基准:确定肝移植标准化结果报告的最佳实践。

IF 4.7 2区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
Chase J Wehrle, Femke H C de Goeij, Mingyi Zhang, Fariba Abbassi, Sangeeta Satish, Chunbao Jiao, Keyue Sun, Antonio D Pinna, Koji Hashimoto, Charles Miller, Wojciech G Polak, Pierre-Alain Clavien, Jeroen De Jonge, Andrea Schlegel
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引用次数: 0

摘要

由于使用与临床无关的替代终点,以及所报告的相关移植后结果存在相当大的差异,因此肝移植(LT)结果的比较受到了阻碍。这种差异源于不同研究中的非标准结果测量、对同一并发症的不同定义以及报告时间的不同。Clavien-Dindo 分类法的建立是为了提高结果报告的严谨性,但它并不针对特定的干预措施,而且与肝移植相关的难题也尚未解决。核心结果集(COS)已用于其他专科,以实现结果研究的标准化,但尚未用于LT。因此,我们利用迄今为止发表的五项主要基准研究,采用以前验证过的指标,为 LT 定义了 10 项措施的 COS。我们还为这 10 项指标中的每项指标提供了标准定义,可供国际相关研究使用。这些定义还包括记录的标准时间点,以便于进行研究间比较和未来的荟萃分析。这 10 项结果与 3 项经过验证、与手术无关的指标配对,包括克拉维恩-丁度分类和综合并发症指数 (CCI®)。我们特别回顾了克拉维恩量表和CCI®,以提高它们在LT中的实用性,并探讨了它们与COS的配合使用。我们鼓励未来的研究将COS与Clavien-Dindo分级系统和CCI®一起使用,以提高肝移植研究的可重复性和可推广性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Core outcome sets and benchmarking complications: Defining best practices for standardized outcome reporting in liver transplantation.

The comparison of outcomes in liver transplantation (LT) is hampered by using clinically non-relevant surrogate endpoints and considerable variability in reported relevant post-transplant outcomes. Such variability stems from non-standard outcome measures across studies, variable definitions of the same complication, and different timing of reporting. The Clavien-Dindo classification was established to improve the rigor of outcome reporting but is non-specific to an intervention and there are unsolved dilemmas specifically related to liver transplantation. Core Outcome Sets (COS) have been used in other specialties to standardize outcomes research, but have not been defined for LT. Thus, we use the five major benchmarking studies published to date to define a 10-measure COS for LT using previously validated metrics. We further provide standard definitions for each of the 10 measures that may be used in international research on the topic. These definitions also include standard time-points for recording to facilitate between-study comparisons and future meta-analysis. These 10 outcomes are paired with 3 validated, procedure-independent metrics, including the Clavien-Dindo Classification and the Comprehensive Complications Index (CCI®). The Clavien scale and CCI® are specifically reviewed to enhance their utility in LT, and their use along with the COS is explored. We encourage future studies to employ this COS along with the Clavien-Dindo grading system & CCI® to improve reproducibility and generalizability of research concerning liver transplantation.

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来源期刊
Liver Transplantation
Liver Transplantation 医学-外科
CiteScore
7.40
自引率
6.50%
发文量
254
审稿时长
3-8 weeks
期刊介绍: Since the first application of liver transplantation in a clinical situation was reported more than twenty years ago, there has been a great deal of growth in this field and more is anticipated. As an official publication of the AASLD, Liver Transplantation delivers current, peer-reviewed articles on liver transplantation, liver surgery, and chronic liver disease — the information necessary to keep abreast of this evolving specialty.
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