Measurement of patient-reported outcomes after laparoscopic cholecystectomy: a systematic review

Alexander, Harry C.; Nguyen, Cindy; Moore, Matthew R.; Bartlett, Adam; Hannam, Jacqueline A.; Poole, Garth; Merry, Alan

doi:10.1007/s00464-019-06745-7

Cited by 9 publications

(10 citation statements)

References 64 publications

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“…This systematic review identified more than 20 relevant publications in 19 countries dealing with LC outcomes. The focus was on comprehensive PROMs and this study is different from previous reviews 39 , 40 , 10 as information is given on each of the PROM tools identified and the parameters they measure.…”

Section: Discussionmentioning

confidence: 99%

“…As with previous reviews, the present review identified significant heterogeneity in the PROM tools utilized in the studies. Alexander and colleagues identified that PRO questionnaires evaluated a wide array of concepts other than HRQoL, such as cosmesis, pain, and satisfaction 10 . The present study also found that there was significant variation in both the comprehensive HRQoL PROM used and other selective PROMs evaluated in conjunction with HRQoL.…”

Section: Discussionmentioning

confidence: 99%

“…It is increasingly recognized internationally that there has been a lack of evaluation of PROMs and their experiences 10 , 11 . Outcome evaluation needs ideally to be a validated process, incorporating both the patient’s functional and QoL metrics as well as medical or process outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Patient-reported outcome measures (PROMs) after laparoscopic cholecystectomy: systematic review

et al. 2022

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Background Healthcare requires patient feedback to improve outcomes and experience. This study undertook a systematic review of the depth, variability, and digital suitability of current patient-reported outcome measures (PROMs) in patients undergoing laparoscopic cholecystectomy. Methods A PROSPERO-registered (registration number CRD42021261707) systematic review was undertaken for all relevant English language articles using PubMed version of MEDLINE, Scopus, and Web of Science electronic databases in June 2021. The search used Boolean operators and wildcards and included the keywords: laparoscopic cholecystectomy AND patient outcome OR patient-reported outcome OR patient-reported outcome measure OR PRO OR PROM. Medical Subjects Heading terms were used to search PubMed and Scopus. Articles published from 1 January 2011 to 2 June 2021 were included. Results A total of 4960 individual articles were reviewed in this study, of which 44 were found to evaluate PROMs in patients undergoing laparoscopic cholecystectomy and underwent methodological index for non-randomized studies (MINORS) grading. Twenty-one articles spanning 19 countries and four continents met all inclusion criteria and were included in the qualitative data synthesis. There was significant heterogeneity in PROMs identified with eight different comprehensive PROM tools used in the 21 studies. There was wide variation in the time points at which PROMs were recorded. Fourteen of 21 studies recorded PROMs before and after surgery, and 7 of 21 recorded PROMs only after surgery. Follow-up intervals ranged from 3 days to 2 years after surgery. Conclusions This study identified that while post-laparoscopic cholecystectomy PROMs are infrequently measured currently, tools are widely available to achieve this in clinical practice. PROMs may not capture all the outcomes but should be incorporated into future cholecystectomy outcome research. The EQ-5D™ (EuroQoL Group, Rotterdam, the Netherlands) provides a simple platform for the modern digital era.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Patient-reported outcome measures (PROMs) after laparoscopic cholecystectomy: systematic review

et al. 2022

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“…Patient reported outcome (PRO) measures (PROMs) measure the impact of surgery on patients' quality of life and are increasingly used as end‐points in clinical trials 5 . For LC, current measurement of PROs is focused on short‐term outcomes, such as pain and nausea, which capture only part of the peri‐operative experience, and are only of short‐term significance 6 . Measurement of PROs also requires administration of questionnaires which may be time consuming and expensive 7 …”

Section: Introductionmentioning

confidence: 99%

“…5 For LC, current measurement of PROs is focused on short-term outcomes, such as pain and nausea, which capture only part of the peri-operative experience, and are only of short-term significance. 6 Measurement of PROs also requires administration of questionnaires which may be time consuming and expensive. 7 Recent systematic reviews have identified significant heterogeneity in the measures used to evaluate the outcomes of LC, 3,6 which limits the ability to draw meaningful conclusions from studies.…”

Section: Introductionmentioning

confidence: 99%

Days alive and out of hospital after laparoscopic cholecystectomy

Alexander

Moore

Hannam

et al. 2022

ANZ Journal of Surgery

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Background: Days alive and out of hospital (DAOH) is a metric that incorporates several outcomes into a single, standardized measure. This study aimed to explore the utility of DAOH in assessing the outcomes of a retrospective cohort of patients undergoing laparoscopic cholecystectomy (LC). Methods: Patients undergoing LC at Auckland City Hospital between 1 January 2010 and 31 August 2015 were included. DAOH values were calculated for the 90 days from the date of surgery (DAOH 90 ) and described using median and interquartile ranges (IQR). DAOH 90 distributions were compared using a two-tailed (non-parametric) Wilcoxon-Mann-Whitney test. Results: 1652 patients undergoing LC were studied. Patients experiencing complications (n = 70, 4.2%) had fewer DAOH 90 (median 83, IQR 79, 86) than patients who underwent uncomplicated LC (median 88, IQR 86, 88), P < 0.001. Patients who were converted to open cholecystectomy (n = 70, 4.2%) also had fewer DAOH 90 (median 82.5, IQR 79, 84) than patients who underwent uncomplicated LC, P < 0.001. Post-operative complications and conversion had a statistically significant effect on DAOH 90 at each of the tested quantiles, except for conversion at the 0.1 quantile. Conclusion: DAOH 90 is readily calculable from existing New Zealand administrative data sources and is sensitive to the occurrence of complications after LC.

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Usefulness of preoperative drip infusion cholangiography with computed tomography for predicting surgical difficulty during laparoscopic cholecystectomy

Nakazawa

Akamatsu

Miyata

et al. 2020

J Hepato Biliary Pancreat

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BackgroundDrip infusion cholangiography with computed tomography (DIC‐CT) is a major preoperative modality used for patients undergoing laparoscopic cholecystectomy (LC).MethodsThis study included 218 patients for whom preoperative DIC‐CT images were obtained prior to undergoing LC. The association between gallbladder (GB) opacification in DIC‐CT and the operative time was assessed.ResultsThe GB opacification on the DIC‐CT images was classified as follows: Grade 0, homogeneous opacification; Grade 1, heterogeneous opacification; Grade 2, only cystic duct can be identified; and Grade 3, no opacification. Images obtained for the 218 patients showed 41 (18.8%) with Grade 0, 91 (41.7%) with Grade 1, 54 (24.8%) with Grade 2, and 32 (14.7%) with Grade 3. The operative time and intraoperative blood loss were significantly longer and larger, respectively, in cases classified as Grade 2 or 3 (GB negative) compared with cases classified as Grade 0 or 1 (GB positive). We created an LC difficulty score based on the following variables that were significant independent predictors of increased operative time: GB negativity in DIC‐CT (P = .002, 2 points), GB wall thickness (P = .002, 2 points), body mass index (P = .015, 1 point), preoperative alkaline phosphatase value (P = .018, 1 point), and preoperative C‐reactive protein value (P = .04, 1 point). The LC difficulty score (Grade A, score 0‐2; Grade B, score 3‐5; and Grade C, score 6‐7) was significantly associated with a prolonged operative time.ConclusionDrip infusion cholangiography with computed tomography is useful for predicting the surgical difficulty of LC.

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Measurement of patient-reported outcomes after laparoscopic cholecystectomy: a systematic review

Cited by 9 publications

References 64 publications

Patient-reported outcome measures (PROMs) after laparoscopic cholecystectomy: systematic review

Patient-reported outcome measures (PROMs) after laparoscopic cholecystectomy: systematic review

Days alive and out of hospital after laparoscopic cholecystectomy

Usefulness of preoperative drip infusion cholangiography with computed tomography for predicting surgical difficulty during laparoscopic cholecystectomy

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