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Creation and validation of a new tool for the monitoring efficacy of neurogenic bowel dysfunction treatment on response: the MENTOR tool.
Spinal Cord ( IF 2.1 ) Pub Date : 2020-01-27 , DOI: 10.1038/s41393-020-0424-8 Anton Emmanuel 1 , Klaus Krogh 2 , Steven Kirshblum 3 , Peter Christensen 4 , Michele Spinelli 5 , Dirk van Kuppevelt 6 , Rainer Abel 7 , Dietrich Leder 8 , Bruno Gallo Santacruz 9 , Kimberly Bain 10 , Valentina Passananti 1
Spinal Cord ( IF 2.1 ) Pub Date : 2020-01-27 , DOI: 10.1038/s41393-020-0424-8 Anton Emmanuel 1 , Klaus Krogh 2 , Steven Kirshblum 3 , Peter Christensen 4 , Michele Spinelli 5 , Dirk van Kuppevelt 6 , Rainer Abel 7 , Dietrich Leder 8 , Bruno Gallo Santacruz 9 , Kimberly Bain 10 , Valentina Passananti 1
Affiliation
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STUDY DESIGN
Prospective observational study.
OBJECTIVES
A tool to help decision-making tool for Neurogenic Bowel Dysfunction (NBD) in individuals with SCI is needed. We present a project to create and validate a new tool, the Monitoring Efficacy of NBD Treatment On Response (MENTOR), and to determine its level of concordance with decisions made by experienced clinicians in the field.
SETTING
UK, Denmark, USA, Italy, The Netherlands, Germany.
METHODS
The first phase was creation of the tool through a modified Delphi process. The second phase was the validation, wherein individuals with spinal cord injury with NBD were asked to complete the MENTOR tool immediately prior to clinic consultation. From the responses to the questionnaire of the tool, each participant was allocated into one of three categories reflecting the possible therapeutic recommendations ("recommend change", "further discussion" and "monitoring"). An expert clinician then assessed the participant, blinded to MENTOR results, and made an independent treatment decision.
RESULTS
A total of 248 MENTOR forms were completed. Strong agreement was found when the MENTOR tool recommended monitoring (92%) or treatment change (83%); the lowest concordance when the decision was for the "further discussion" option (59%). Patient acceptability was reported by 97% of individuals.
CONCLUSIONS
MENTOR is an easy to use tool to monitor the treatment of NBD and determinate progression through the clinical pathway. This validation study shows good correspondence between expert clinician opinion and MENTOR result. The tool has potential to be used in other patient groups, following further studies.
中文翻译：
创建和验证一种新工具，以监测神经源性肠功能障碍治疗对疗效的反应：MENTOR工具。
研究设计前瞻性观察研究。目的需要一种有助于SCI患者神经源性肠功能障碍（NBD）决策工具的工具。我们提出了一个项目，以创建和验证一种新工具，即对NBD反应治疗的监测功效（MENTOR），并确定其与该领域经验丰富的临床医生所做决定的一致性。设置英国，丹麦，美国，意大利，荷兰，德国。方法第一阶段是通过改进的Delphi流程创建工具。第二阶段是验证，其中要求NBD脊髓损伤的患者在就诊之前立即完成MENTOR工具。根据对该工具问卷的答复，每个参与者被分为三个类别之一，以反映可能的治疗建议（“建议更改”，“进一步讨论”和“监测”）。然后由专业的临床医生评估参与者，不知道MENTOR的结果，并做出独立的治疗决定。结果共完成248个MENTOR表格。当MENTOR工具建议监测（92％）或治疗改变（83％）时，发现强烈同意；决定“进一步讨论”选项时的最低一致性（59％）。97％的患者报告了患者的可接受性。结论MENTOR是一种易于使用的工具，可以监视NBD的治疗并确定临床途径的进展。该验证研究表明专家临床医生的意见与MENTOR结果之间的良好对应关系。经过进一步研究，该工具有可能被其他患者使用。
更新日期：2020-01-27
中文翻译：
创建和验证一种新工具，以监测神经源性肠功能障碍治疗对疗效的反应：MENTOR工具。
研究设计前瞻性观察研究。目的需要一种有助于SCI患者神经源性肠功能障碍（NBD）决策工具的工具。我们提出了一个项目，以创建和验证一种新工具，即对NBD反应治疗的监测功效（MENTOR），并确定其与该领域经验丰富的临床医生所做决定的一致性。设置英国，丹麦，美国，意大利，荷兰，德国。方法第一阶段是通过改进的Delphi流程创建工具。第二阶段是验证，其中要求NBD脊髓损伤的患者在就诊之前立即完成MENTOR工具。根据对该工具问卷的答复，每个参与者被分为三个类别之一，以反映可能的治疗建议（“建议更改”，“进一步讨论”和“监测”）。然后由专业的临床医生评估参与者，不知道MENTOR的结果，并做出独立的治疗决定。结果共完成248个MENTOR表格。当MENTOR工具建议监测（92％）或治疗改变（83％）时，发现强烈同意；决定“进一步讨论”选项时的最低一致性（59％）。97％的患者报告了患者的可接受性。结论MENTOR是一种易于使用的工具，可以监视NBD的治疗并确定临床途径的进展。该验证研究表明专家临床医生的意见与MENTOR结果之间的良好对应关系。经过进一步研究，该工具有可能被其他患者使用。
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