Outcome measurement in functional neurological disorder: a systematic review and recommendations.
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Pick Susannah, Anderson David G, Asadi-Pooya Ali A, Aybek Selma, Baslet Gaston, Bloem Bastiaan R, Bradley-Westguard Abigail, Brown Richard J, Carson Alan J, Chalder Trudie, Damianova Maria, David Anthony S, Edwards Mark J, Epstein Steven A, Espay Alberto J, Garcin Béatrice, Goldstein Laura H, Hallett Mark, Jankovic Joseph, Joyce Eileen M, Kanaan Richard A, Keynejad Roxanne C, Kozlowska Kasia, LaFaver Kathrin, LaFrance W Curt, Lang Anthony E, Lehn Alex, Lidstone Sarah, Maurer Carine W, Mildon Bridget, Morgante Francesca, Myers Lorna, Nicholson Clare, Nielsen Glenn, Perez David L, Popkirov Stoyan, Reuber Markus, Rommelfanger Karen S, Schwingenshuh Petra, Serranova Tereza, Shotbolt Paul, Stebbins Glenn T, Stone Jon, Tijssen Marina Aj, Tinazzi Michele, Nicholson Timothy R
Аннотация
METHODS: A systematic review was conducted to identify existing FND-specific outcome measures and the most common measurement domains and measures in previous treatment studies. Searches of Embase, MEDLINE and PsycINFO were conducted between January 1965 and June 2019. The findings were discussed during two international meetings of the FND-Core Outcome Measures group.
RESULTS: Five FND-specific measures were identified-three clinician-rated and two patient-rated-but their measurement properties have not been rigorously evaluated. No single measure was identified for use across the range of FND symptoms in adults. Across randomised controlled trials (k=40) and observational treatment studies (k=40), outcome measures most often assessed core FND symptom change. Other domains measured commonly were additional physical and psychological symptoms, life impact (ie, quality of life, disability and general functioning) and health economics/cost-utility (eg, healthcare resource use and quality-adjusted life years).
CONCLUSIONS: There are few well-validated FND-specific outcome measures. Thus, at present, we recommend that existing outcome measures, known to be reliable, valid and responsive in FND or closely related populations, are used to capture key outcome domains. Increased consistency in outcome measurement will facilitate comparison of treatment effects across FND symptom types and treatment modalities. Future work needs to more rigorously validate outcome measures used in this population.