膀胱癌患者自我报告结局评估工具的系统评价

doi:10.3761/j.issn.0254-1769.2025.22.017

摘要/Abstract

摘要：

目的系统评价膀胱癌患者自我报告结局评估工具（patient self-reported outcome measures，PROMs）的测量学属性及方法学质量，为临床实践选择高质量评估工具提供依据。方法系统检索PubMed、Medline、CINAHL、Cochrane Library、Web of Science、Embase和中国生物医学文献数据库、万方数据库、中国知网及维普数据库中与膀胱癌患者自我报告结局评估工具相关的研究，检索时限为建库至2025年1月。由2名研究者独立进行文献筛选和资料提取，采用基于共识的健康测量工具遴选标准指南偏倚风险清单及其质量标准，评定纳入研究的方法学质量及测量学属性，并形成推荐意见。结果共纳入14篇研究，涉及9种膀胱癌患者自我报告结局评估工具。膀胱效用症状量表和膀胱癌指数量表被推荐为A级；其余7种评估工具被列为B级。所有评估工具均未评估跨文化效度。结论现有膀胱癌患者自我报告结局评估工具在心理测量学属性上存在显著异质性，需进一步优化开发流程、跨文化验证及大样本研究。膀胱效用症状量表和膀胱癌指数量表是当前推荐的优选工具，可与其他评估工具联合使用。

关键词: 膀胱肿瘤, 患者自我报告, 评估工具, 测量学属性, 系统评价, 循证护理学

Abstract:

Objective To systematically evaluate the measurement properties and methodological quality of patient-reported outcome measures（PROMs） for bladder cancer patients，providing a basis for selecting high-quality assessment tools in clinical practice. Methods A systematic search of the studies related to PROMs for bladder cancer patients was conducted across such databases as PubMed，MedLine，CINAHL，Cochrane Library，Web of Science，Embase，China Biology Medicine disc（CBMdisc），Wanfang Database，CNKI，and VIP Database.The search timeframe spanned from their database inception to January 2025. Totally 2 researchers independently screened the literature and extracted data. The methodological quality and measurement properties of the included studies were evaluated using the Consensus-based Standards for the Selection of Health Measurement Instruments（COSMIN） risk of bias checklist and quality criteria，and recommendations were formulated based on these assessments. Results Totally 14 studies involving 9 PROMs were included. The Bladder Utility Symptom Scale（BUSS） and Bladder Cancer Index （BCI） were recommended as Grade A. The remaining 7 tools were categorized as Grade B. The cross-cultural validity of tools was not assessed. Conclusion Current PROMs tools for bladder cancer exhibit significant heterogeneity in psychometric properties. Further optimization of development processes，cross-cultural validation，and large-sample studies are needed. BUSS and BCI are the currently optimal tools，but their long-term dynamic monitoring capabilities require further attention.

Key words: Urinary Bladder Neoplasms, Patient Self-Report, Assessment Tools, Measurement Properties, Systematic Evaluation, Evidence-Based Nursing

钟丽怡, 贾铭芳, 罗迎霞. 膀胱癌患者自我报告结局评估工具的系统评价[J]. 中华护理杂志, 2025, 60(22): 2790-2797.

ZHONG Liyi, JIA Mingfang, LUO Yingxia. Systematic evaluation of patient-reported outcome measures for bladder cancer patients[J]. Chinese Journal of Nursing, 2025, 60(22): 2790-2797.

图/表 3

表1 纳入文献的基本特征（n=14）

Table 1 General characteristics of the included literature（n=14）

表2 纳入评估工具的方法学质量和测量学属性的质量评价（n=14）

Table 2 Methodological quality and psychometric properties evaluation of the included scales（n=14）

表3 纳入评估工具测量学属性的合成结果及推荐意见（n=9）

Table 3 The synthesis results and recommendations of the measurement properties of the included assessment tools（n=9）

参考文献 32

[1]	Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022:GLOBOCAN estimates of incidence and mortality world-wide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2024, 74(3):229-263.
[2]	Lopez-Beltran A, Cookson MS, Guercio BJ, et al. Advances in diagnosis and treatment of bladder cancer[J]. BMJ, 2024, 384:e076743.
[3]	刘玉芹, 杨明莹, 李丹娜, 等. 膀胱癌特异性患者报告结局测量工具的研究进展[J]. 解放军护理杂志, 2021, 38(6):62-65.
	Liu YQ, Yang MY, Li DN, et al. Research progress of patient-reported outcome measures for bladder cancer specific patients[J]. Nurs J Chin PLA, 2021, 38(6):62-65.
[4]	Di Maio M, Basch E, Denis F, et al. The role of patient-repor-ted outcome measures in the continuum of cancer clinical care:ESMO clinical practice guideline[J]. Ann Oncol, 2022, 33(9):878-892. DOI PMID
[5]	Prinsen CC, Mokkink LB, Bouter LM, et al. COSMIN guideline for systematic reviews of patient-reported outcome measures[J]. Qual Life Res, 2018, 27(5):1147-1157. DOI PMID
[6]	Mokkink LB, Prinsen CAC, Bouter LM, et al. The COnsensus-based Standards for the selection of health Measurement INs-truments(COSMIN) and how to select an outcome measurement instrument[J]. Braz J Phys Ther, 2016, 20(2):105-113. DOI URL
[7]	Mokkink LB, de Vet HW, Prinsen CC, et al. COSMIN risk of bias checklist for systematic reviews of patient-reported out-come measures[J]. Qual Life Res, 2018, 27(5):1171-1179. DOI PMID
[8]	Terwee CB, Prinsen CC, Chiarotto A, et al. COSMIN methodo-logy for evaluating the content validity of patient-reported out-come measures:a Delphi study[J]. Qual Life Res, 2018, 27(5):1159-1170. DOI PMID
[9]	Alhazzani W, Guyatt G. An overview of the GRADE approach and a peek at the future[J]. Med J Aust, 2018, 209(7):291-292. PMID
[10]	刘玉芹. 膀胱癌患者报告结局量表的研制与评价[D]. 昆明: 昆明医科大学, 2022.
	Liu YQ. Development and evaluation of Bladder Cancer Patients’ Reported Outcome Scale[D]. Kunming: Kunming Me-dical University, 2022.
[11]	Perlis N, Krahn MD, Boehme KE, et al. The Bladder Utility Symptom Scale:a novel patient reported outcome instrument for bladder cancer[J]. J Urol, 2018, 200(2):283-291. DOI URL
[12]	王雪. 膀胱效用症状量表测量学研究[D]. 天津: 天津医科大学, 2021.
	Wang X. Measurement of Bladder Utility Symptom Scale[D]. Tianjin: Tianjin Medical University, 2021.
[13]	Degboe A, Ivanescu C, Rohay JM, et al. Validity and perfor-mance of the Functional Assessment of Cancer Therapy-Bladder(FACT-Bl) among advanced urothelial cancer patients[J]. Support Care Cancer, 2019, 27(11):4189-4198.
[14]	Gilbert SM, Dunn RL, Hollenbeck BK, et al. Development and validation of the Bladder Cancer Index:a comprehensive,disease specific measure of health related quality of life in patients with localized bladder cancer[J]. J Urol, 2010, 183(5):1764-1769. DOI PMID
[15]	孟庭瑞. 膀胱癌指数(BCI)量表的汉化和信效度研究[D]. 昆明: 昆明医科大学, 2023.
	Meng TR. Study on the sinicization,reliability and validity of Bladder Cancer Index(BCI) Scale[D]. Kunming: Kunming Me-dical University, 2023.
[16]	Cookson MS, Dutta SC, Chang SS, et al. Health related quality of life in patients treated with radical cystectomy and urinary diversion for urothelial carcinoma of the bladder:development and validation of a new disease specific questionnaire[J]. J Urol, 2003, 170(5):1926-1930. DOI URL
[17]	Anderson CB, Feurer ID, Large MC, et al. Psychometric chara-cteristics of a condition-specific,health-related quality-of-life survey:the FACT-Vanderbilt Cystectomy Index[J]. Urology, 2012, 80(1):77-83. DOI URL
[18]	Kim M, Oh SJ, Kwak C, et al. Psychometric validation study of the Korean version of the Functional Assessment of Can-cer Therapy-Vanderbilt Cystectomy Index[J]. PLoS One, 2018, 13(1): e0190570.
[19]	Stenzelius K, Lind AK, Wanegård J, et al. Patient-reported out-come after radical cystectomy:translation and psychometric validation of the Swedish version of the Functional Asses-sment of Cancer Therapy Scale Vanderbilt Cystectomy Index[J]. Scand J Urol, 2016, 50(5):374-379. DOI PMID
[20]	Siracusano S, Niero M, Lonardi C, et al. Development of a questionnaire specifically for patients with Ileal Orthotopic Neobladder(IONB)[J]. Health Qual Life Outcomes, 2014, 12:135. DOI URL
[21]	洪慧. 膀胱癌腹壁造口患者自我报告结局量表的研制与初步考评[D]. 南昌: 南昌大学, 2021.
	Hong H. Development and preliminary evaluation of Self-reported Outcome Scale for Patients with Bladder Cancer Un-dergoing Abdominal Ostomy[D]. Nanchang: Nanchang Univer-sity, 2021.
[22]	郭灿. 膀胱癌泌尿造口患者支持性照顾需求量表的编制与初步应用[D]. 南昌: 南昌大学, 2023.
	Guo C. Development and preliminary application of Suppor-tive Care Demand Scale for Patients with Bladder Cancer Under-going Urostomy[D]. Nanchang: Nanchang University, 2023.
[23]	张晗. 输尿管皮肤造口人自我管理量表的编制及应用[D]. 南昌: 南昌大学, 2020.
	Zhang H. Development and application of Self-management Scale for Ureterostomy Patients[D]. Nanchang: Nanchang Uni-versity, 2020.
[24]	彭健, 沈蓝君, 陈祎婷, 等. COSMIN-RoB清单简介及测量工具内部结构研究的偏倚风险清单解读[J]. 中国循证医学杂志, 2020, 20(10):1234-1240.
	Peng J, Shen LJ, Chen YT, et al. An overview of the COS-MIN-RoB checklist and the interpretation of it in evaluating the risk of bias of studies on internal structure[J]. Chin J Evid Based Med, 2020, 20(10):1234-1240.
[25]	Olshansky E, Lakes KD, Vaughan J, et al. Enhancing the con-struct and content validity of rating scales for clinical research:using qualitative methods to develop a rating scale to assess parental perceptions of their role in promoting infant exercise[J]. Int J Educ Psychol Assess, 2012, 10(1):36-50.
[26]	陆诗燕, 刘羡, 江笑笑, 等. 肝癌患者特异性自我报告结局评估工具测量学属性的系统评价[J]. 中华护理杂志, 2024, 59(22):2734-2741. DOI
	Lu SY, Liu X, Jiang XX, et al. Systematic review of measure-ment properties of liver cancer patient specific self-reported outcome assessment tools[J]. Chin J Nurs, 2024, 59(22):2734-2741.
[27]	Ondé D, Alvarado JM. Reconsidering the conditions for condu-cting confirmatory factor analysis[J]. Span J Psychol, 2020, 23:e55. DOI URL
[28]	陈丽霞, 施慧, 朱德政, 等. 成人低血糖恐惧评估工具的质量评价[J]. 中华护理杂志, 2024, 59(9):1072-1079.
	Chen LX, Shi H, Zhu DZ, et al. Quality appraisal of hypogly-cemia fear assessment tools for adults[J]. Chin J Nurs, 2024, 59(9):1072-1079.
[29]	刘宁, 李婧菱, 左顺利, 等. 烧伤患者身体意象特异性评估工具的系统评价[J]. 中华护理杂志, 2025, 60(4):478-486. DOI
	Liu N, Li JL, Zuo SL, et al. Systematic review of a body image assessment tool for burn patients[J]. Chin J Nurs, 2025, 60(4):478-486. DOI
[30]	Lee EH, Kim CJ, Lee J, et al. Self-administered health literacy instruments for people with diabetes:systematic review of mea-surement properties[J]. J Adv Nurs, 2017, 73(9):2035-2048. DOI URL
[31]	王旋, 温贤秀, 苟莉, 等. 心脏康复依从性评估工具测量学属性的系统评价[J]. 中华护理杂志, 2024, 59(6):736-743. DOI
	Wang X, Wen XX, Gou L, et al. The cardiac rehabilitation adherence assessment tools:a systematic review of psychome-tric properties[J]. Chin J Nurs, 2024, 59(6):736-743.
[32]	刘素香, 边莉, 张叶群, 等. 基于COSMIN指南对糖尿病患者健康素养评估工具的系统评价[J]. 中华护理杂志, 2023, 58(21):2670-2676. DOI
	Liu SX, Bian L, Zhang YQ, et al. A systematic review of health literacy assessment tools for diabetic patients based on COSMIN guidelines[J]. Chin J Nurs, 2023, 58(21):2670-2676. DOI