背景:子宫内膜异位症患者的性功能应通过患者报告的结果指标(PROMs)进行评估,该指标具有较高的信度和效度。目的是研究用于评估子宫内膜异位症患者性功能的PROM,以改善他们对研究和临床实践的选择。
方法:我们从2000年1月至2023年9月进行了系统的文献综述。检索所有研究,包括确诊子宫内膜异位症的女性,并评估性生活质量或性功能或性困扰。根据基于Consensus的健康测量仪器选择标准(COSMIN)建议,评估了用于性功能障碍的PROM的不同特性。评估的特性是:结构有效性,内部一致性,跨文化有效性,可靠性,测量误差,标准有效性,构造效度,和响应性。该文献综述在Prospero上注册为2018CRD42018102278。
结果:纳入74篇评估性功能的文章。在25个评估性功能的PROM中,女性性功能指数(FSFI)是最常用的(34/74[45.9%]项),其次是女性性困扰量表(9/74[12.2%]项)和性活动问卷(SAQ)(8/74[10.8%]项)。最常用的测量属性是“假设检验”和“响应性”。具有这两种测量特性的高水平证据的PROM是FSFI,SAQ,短性功能量表,女性性满意度量表,性生活质量-女性,女性性功能简介,和女性问卷中的性健康结果。FSFI问卷似乎更适合评估药物治疗,和用于评估手术治疗的SAQ。只有一种仪器是子宫内膜异位症特有的(视力障碍量表[SIDI]的主观影响)。
结论:在这篇关于子宫内膜异位症性功能评估问卷的系统文献综述中,根据COSMIN标准,FSFI和SAQ问卷具有最佳的测量特性。FSFI问卷似乎适合评估医疗,和SAQ进行手术治疗。SIDI是唯一的具体问卷,但其响应性仍有待定义。
BACKGROUND: Sexual function of patients with endometriosis should be assessed by patient-reported outcome measures (PROMs) that present high reliability and validity. The objective was to study the PROMs used to assess sexual function for patients with endometriosis to improve their selection for research and clinical practice.
METHODS: We performed a systematic literature review from January 2000 to September 2023. All studies including women with confirmed endometriosis and assessing sexual quality of life or sexual function or sexual distress were retrieved. Different properties of PROMs used for sexual dysfunction were assessed according to the
COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) recommendations. Properties evaluated were: structural validity, internal consistency, cross-cultural validity, reliability, measurement error, criterion validity, construct validity, and responsiveness. This literature review was registered on Prospero as 2018 CRD42018102278.
RESULTS: Seventy-four articles with evaluation of sexual function were included. Of the 25 PROMs assessing sexual function, the Female Sexual Function Index (FSFI) was the most frequently used (34/74 [45.9%] items), followed by the Female Sexual Distress Scale (9/74 [12.2%] items) and the Sexual Activity Questionnaire (SAQ) (8/74 [10.8%] items). The most commonly used measurement properties were \"hypothesis testing\" and \"responsiveness\". The PROMs with a high level of evidence for these two measurement properties were the FSFI, the SAQ, the Short Sexual Functioning Scale, the Sexual Satisfaction Scale for Women, Sexual Quality of Life-Female, the Brief Profile of Female Sexual Function, and the Sexual Health Outcomes in Women Questionnaire. The FSFI questionnaire appeared to be more relevant for evaluating medical treatment, and the SAQ for evaluating surgical treatment. Only one instrument was specific to endometriosis (the Subjective Impact of Dyspareunia Inventory [SIDI]).
CONCLUSIONS: In this systematic literature review of sexual function assessment questionnaires in endometriosis, the FSFI and the SAQ questionnaires emerged as having the best measurement properties according to the COSMIN criteria. The FSFI questionnaire appears to be suited for evaluating medical treatment, and the SAQ for surgical treatment. The SIDI is the only specific questionnaire, but its responsiveness remains to be defined.