PDF(Pubmed)
Abstract：
OBJECTIVE: Breast cancer follow-up (surveillance and aftercare) varies from one-size-fits-all to more personalised approaches. A systematic review was performed to get insight in existing evidence on (cost-)effectiveness of personalised follow-up.
METHODS: PubMed, Scopus and Cochrane were searched between 01-01-2010 and 10-10-2022 (review registered in PROSPERO:CRD42022375770). The inclusion population comprised nonmetastatic breast cancer patients ≥ 18 years, after completing curative treatment. All intervention-control studies studying personalised surveillance and/or aftercare designed for use during the entire follow-up period were included. All review processes including risk of bias assessment were performed by two reviewers. Characteristics of included studies were described.
RESULTS: Overall, 3708 publications were identified, 64 full-text publications were read and 16 were included for data extraction. One study evaluated personalised surveillance. Various personalised aftercare interventions and outcomes were studied. Most common elements included in personalised aftercare plans were treatment summaries (75%), follow-up guidelines (56%), lists of available supportive care resources (38%) and PROs (25%). Control conditions mostly comprised usual care. Four out of seven (57%) studies reported improvements in quality of life following personalisation. Six studies (38%) found no personalisation effect, for multiple outcomes assessed (e.g. distress, satisfaction). One (6.3%) study was judged as low, four (25%) as high risk of bias and 11 (68.8%) as with concerns.
CONCLUSIONS: The included studies varied in interventions, measurement instruments and outcomes, making it impossible to draw conclusions on the effectiveness of personalised follow-up. There is a need for a definition of both personalised surveillance and aftercare, whereafter outcomes can be measured according to uniform standards.
METHODS: PubMed, Scopus and Cochrane were searched between 01-01-2010 and 10-10-2022 (review registered in PROSPERO:CRD42022375770). The inclusion population comprised nonmetastatic breast cancer patients ≥ 18 years, after completing curative treatment. All intervention-control studies studying personalised surveillance and/or aftercare designed for use during the entire follow-up period were included. All review processes including risk of bias assessment were performed by two reviewers. Characteristics of included studies were described.
RESULTS: Overall, 3708 publications were identified, 64 full-text publications were read and 16 were included for data extraction. One study evaluated personalised surveillance. Various personalised aftercare interventions and outcomes were studied. Most common elements included in personalised aftercare plans were treatment summaries (75%), follow-up guidelines (56%), lists of available supportive care resources (38%) and PROs (25%). Control conditions mostly comprised usual care. Four out of seven (57%) studies reported improvements in quality of life following personalisation. Six studies (38%) found no personalisation effect, for multiple outcomes assessed (e.g. distress, satisfaction). One (6.3%) study was judged as low, four (25%) as high risk of bias and 11 (68.8%) as with concerns.
CONCLUSIONS: The included studies varied in interventions, measurement instruments and outcomes, making it impossible to draw conclusions on the effectiveness of personalised follow-up. There is a need for a definition of both personalised surveillance and aftercare, whereafter outcomes can be measured according to uniform standards.
摘要：
目的：乳腺癌随访（监测和善后护理）从一刀切到更个性化的方法各不相同。进行了系统评价，以深入了解个性化随访（成本）有效性的现有证据。
方法：PubMed，Scopus和Cochrane在2010年1月1日至2022年10月10日之间进行了搜索（在PROSPERO中注册的评论：CRD42022375770）。纳入人群包括≥18岁的非转移性乳腺癌患者，完成治愈治疗后。包括所有干预控制研究，研究在整个随访期间使用的个性化监视和/或护理。包括偏见风险评估在内的所有审查过程均由两名审查者进行。描述了纳入研究的特点。
结果：总体而言，确定了3708种出版物，阅读了64篇全文出版物，其中16篇用于数据提取。一项研究评估了个性化监测。研究了各种个性化的护理干预措施和结果。个性化护理计划中包含的最常见元素是治疗总结（75％），后续指南(56%)，可用的支持性护理资源列表(38%)和专业人员(25%)。控制条件主要包括常规护理。七项研究中有四项(57%)报告个性化后生活质量有所改善。六项研究（38%）没有发现个性化效果，对于评估的多个结果(例如，痛苦，满意度)。一项（6.3%）研究被判定为低，4例(25%)为高偏倚风险，11例(68.8%)为担忧风险。
结论：纳入的研究在干预措施方面有所不同，测量工具和结果，使得无法就个性化随访的有效性得出结论。需要定义个性化监控和善后护理，之后可以根据统一标准来衡量结果。
方法：PubMed，Scopus和Cochrane在2010年1月1日至2022年10月10日之间进行了搜索（在PROSPERO中注册的评论：CRD42022375770）。纳入人群包括≥18岁的非转移性乳腺癌患者，完成治愈治疗后。包括所有干预控制研究，研究在整个随访期间使用的个性化监视和/或护理。包括偏见风险评估在内的所有审查过程均由两名审查者进行。描述了纳入研究的特点。
结果：总体而言，确定了3708种出版物，阅读了64篇全文出版物，其中16篇用于数据提取。一项研究评估了个性化监测。研究了各种个性化的护理干预措施和结果。个性化护理计划中包含的最常见元素是治疗总结（75％），后续指南(56%)，可用的支持性护理资源列表(38%)和专业人员(25%)。控制条件主要包括常规护理。七项研究中有四项(57%)报告个性化后生活质量有所改善。六项研究（38%）没有发现个性化效果，对于评估的多个结果(例如，痛苦，满意度)。一项（6.3%）研究被判定为低，4例(25%)为高偏倚风险，11例(68.8%)为担忧风险。
结论：纳入的研究在干预措施方面有所不同，测量工具和结果，使得无法就个性化随访的有效性得出结论。需要定义个性化监控和善后护理，之后可以根据统一标准来衡量结果。
