全球肿瘤相关性血栓栓塞症风险评估工具的循证研究
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篇名: | 全球肿瘤相关性血栓栓塞症风险评估工具的循证研究 |
TITLE: | Evidence-based evaluation of the global cancer-associated thromboembolism risk assessment tools |
摘要: | 目的 基于循证方法对全球肿瘤相关性血栓栓塞症风险评估工具进行评价,以期为构建我国特异性评估工具提供方法学参考与循证依据。方法全面检索中国知网、万方数据库、维普网、中国生物医学文献数据库、PubMed及Embase6个数据库和NCCN、ASCO及ESMO等学会网站,检索截止时间为2022年6月30日,并于2023年1月补充检索。对纳入的风险评估工具,定性描述分析其基本特性与方法学质量,重点对比各评估工具评价维度、工具性能、风险分层能力等关键要素。结果研究共纳入14个风险评估工具,其研究样本量为208~18956例,受试者平均年龄分布在53.1~74.0岁;适用人群涵盖门诊肿瘤患者、淋巴瘤患者及多发性骨髓瘤患者等。工具中身体质量指数、静脉血栓栓塞症既往史和肿瘤部位是常见的预测因子。所有工具均进行了方法学验证,其中9个以权重评分的方式呈现。同时进行了特异性、敏感性、阴性预测值、阳性预测值和曲线下面积或C统计量分析的工具仅7个。结论现有工具构建偏倚风险较高,工具验证结果异质性较大,整体方法学质量有待提高,风险分层能力也有待考究,在我国临床实践中仍存在一定局限性。 |
ABSTRACT: | OBJECTIVE To evaluate the global cancer-associated thromboembolism risk assessment tools based on evidence- based methods, and to provide methodological reference and evidence-based basis for constructing a specific tool in China. METHODS A comprehensive search was conducted on 6 databases, including CNKI, Wanfang data, VIP, CBM, PubMed, and Embase, as well as on the websites of NCCN, ASCO, ESMO and so on with a deadline of June 30, 2022. Furthermore, a supplementary search was conducted in January 2023. The essential characteristics and methodological quality of included risk assessment tools were described and analyzed qualitatively, focusing on comparing each assessment stratification ability. RESULTS Totally 14 risk assessment tools were included in the study, with a sample size of 208-18 956 cases and an average age distribution of 53.1-74.0 years. The applicable population included outpatient cancer student@sina.com patients, lymphoma patients, and multiple myeloma patients,etc. The common predictive factors were body mass index, venous thromboembolism history, and tumor site. All tools had undergone methodological validation, with 9 presented in a weighted scoring format. Only seven tools were used simultaneously for specificity, sensitivity, negative predictive value (NPV), positive predictive value (PPV) and area under the curve (AUC) or C statistical analysis. CONCLUSIONS The risk of bias in constructing existing tools is high, and the heterogeneity of tool validation results is significant. The overall methodological quality must be improved, and its risk stratification ability must also be investigated. There are still certain limitations in clinical practice in China. |
期刊: | 2024年第35卷第03期 |
作者: | 秦小莉;高秀容;何琴;藕顺龙;罗静;魏华;蒋倩 |
AUTHORS: | QIN Xiaoli,GAO Xiurong,HE Qin,OU Shunlong,LUO Jing,WEI Hua,JIANG Qian |
关键字: | 肿瘤相关性血栓栓塞症;风险评估工具;循证研究 |
KEYWORDS: | cancer-associated thromboembolism; risk assessment tools; evidence-based research |
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