Digital DiagnosticsDigital DiagnosticsDigital DiagnosticsDigital Diagnostics2712-84902712-8962Eco-Vector54599710.17816/DD545997Original Study ArticlesОригинальные исследования原创性科研成果Research ArticleDelphi method to determine a list of questionnaire-assessed parameters in the follow-up of patients with inflammatory bowel diseaseОпределение методом дельфийского консенсуса списка оцениваемых с помощью опросников параметров при наблюдении пациентов с воспалительными заболеваниями кишечника在对炎症性肠病患者进行随访时采用德尔菲法确定一份通过问卷评估的参数清单https://orcid.org/0000-0002-8521-40453164-5518ShumskayaYuliya F.ШумскаяЮлия ФедоровнаShumskayaYuliya F.
Russian Federation
shumskayayf@zdrav.mos.ruhttps://orcid.org/0000-0001-7705-97546983-5991AkhmedzyanovaDina A.АхмедзяноваДина АльфредовнаAkhmedzyanovaDina A.
Russian Federation
AkhmedzyanovaDA@zdrav.mos.ruhttps://orcid.org/0000-0001-9337-74532015-1822MnatsakanyanMarina G.МнацаканянМарина ГенриковнаMnatsakanyanMarina G.
Russian Federation

MD, Dr. Sci. (Med.), Professor

д-р мед. наук, профессор

MD, Dr. Sci. (Med.), Professor

mnatsakanyan_m_g@staff.sechenov.ruhttps://orcid.org/0000-0001-7641-2755KolosovaKsenia Y.КолосоваКсения ЮрьевнаKolosovaKsenia Y.
Russian Federation

MD, Cand. Sci. (Med.)

канд. мед. наук

MD, Cand. Sci. (Med.)

kolosova_k_yu@staff.sechenov.ruhttps://orcid.org/0000-0001-6759-6820TashchyаnOlga V.ТащянОльга ВалерьевнаTashchyаnOlga V.
Russian Federation

MD, Cand. Sci. (Med.)

канд. мед. наук

MD, Cand. Sci. (Med.)

olgatash1@rambler.ruhttps://orcid.org/0000-0002-4459-74814872-7130YurazhMarta V.ЮражМарта ВалериевнаYurazhMarta V.
Russian Federation
yurazh_m_v@staff.sechenov.ruhttps://orcid.org/0000-0002-9661-02548592-0558ReshetnikovRoman V.РешетниковРоман ВладимировичReshetnikovRoman V.
Russian Federation

Cand. Sci. (Phys.-Math.)

канд. физ.-мат. наук

Cand. Sci. (Phys.-Math.)

reshetnikov@fbb.msu.ruResearch and Practical Clinical Center for Diagnostics and Telemedicine TechnologiesНаучно-практический клинический центр диагностики и телемедицинских технологийResearch and Practical Clinical Center for Diagnostics and Telemedicine TechnologiesThe First Sechenov Moscow State Medical UniversityПервый Московский государственный медицинский университет имени И.М. СеченоваThe First Sechenov Moscow State Medical University1409202315122023444814911107202331082023Copyright ©; 2023, Eco-VectorCopyright ©; 2023, Эко-векторCopyright ©; 2023, Eco-Vector2023Eco-VectorЭко-векторEco-Vectorhttps://creativecommons.org/licenses/by-nc-nd/4.0https://jdigitaldiagnostics.com/DD/article/view/545997

BACKGROUND: Patients with inflammatory bowel disease often require lifelong follow-up by a clinician. Telemedicine monitoring is a promising area of such healthcare services, often based on the evaluation of patients’ remote questionnaire results by a medical practitioner.

AIM: To define, using the Delphi method, a list of questionnaire-assessed parameters for monitoring and treating patients with IBD.

MATERIALS AND METHODS: The study was conducted in three stages. An electronic survey form was created to collect information, ensuring that the respondent’s experience was included when completing the survey. In the first stage, respondents answered an open-ended question about what parameters assessed by questionnaires should be monitored in patients with IBD. In the second stage, participants answered the same question but selected any number of items from a list. In the third stage, the responses were analyzed. The primary endpoint was a consensus on each parameter, defined as >75% respondent agreement.

RESULTS: The study had 15 participants, 13.3% of whom were male. Of all respondents, 46% worked in an outpatient setting, whereas 54% worked in an inpatient setting. Their ages ranged from 25 to 53 years, with 53% of the participants having 1–4 years of experience and 47% having 17–29 years of experience. None of the parameters reached a 75% agreement level based on the results of the first stage. In the second stage, respondents reached a consensus on 72% of the parameters. No relationship was found between respondents’ age, sex, years of experience, or job settings and responses in the first and second stages.

CONCLUSIONS: The final list of parameters recommended for evaluation during the monitoring and treatment of patients with IBD included abdominal pain, frequency of defecation and stool quality, presence of pathological stool impurities, body temperature, joint/muscle pain, sleep quality, anxiety, depression, work capacity for employed/ability to attend lessons for students, energy and quantity of vigor, fixation on the disease, patients’ general evaluation of their quality of life, and treatment adherence.

Обоснование. Пациенты с воспалительными заболеваниями кишечника часто нуждаются в пожизненном наблюдении врача. Перспективным направлением таких услуг здравоохранения является телемедицинское наблюдение, часто основывающееся на оценке медицинским работником результатов удалённого анкетирования пациентов.

Цель. Используя дельфийский метод, определить список оцениваемых с помощью анкетирования параметров для последующего применения в наблюдении и лечении пациентов с воспалительными заболеваниями кишечника.

Материалы и методы. Экспертную группу участников исследования составили врачи-гастроэнтерологи с различным опытом работы. Для сбора информации была создана электронная форма опроса, при заполнении которой обязательно указывался стаж участника. Исследование состояло из трёх этапов. На первом этапе респонденты отвечали на открытый вопрос о том, какие параметры, оцениваемые с помощью опросников, необходимо мониторировать у пациентов с воспалительными заболеваниями кишечника. На втором этапе участники отвечали на тот же вопрос, выбирая пункты из предложенных, без ограничений по количеству. Третьим этапом исследования выполнен анализ полученных ответов. Первичной конечной точкой считалось достижение по каждому параметру консенсуса более чем 75% респондентов.

Результаты. В исследовании приняли участие 15 человек, из них 13,3% — мужчины. Из всех респондентов, 46% работают в амбулаторно-поликлинических организациях, 54% — в стационаре. Возрастной диапазон составил от 25 до 53 лет, при этом 53% участников имели стаж от 1 до 4 лет, 47% — от 17 до 29 лет. По результатам первого этапа ни один из параметров не достиг уровня согласия 75%. После второго этапа респонденты достигли согласия по 72% параметров. Связи между возрастом, полом, стажем респондентов, а также местом их работы и ответами как на первом, так и на втором этапах обнаружено не было.

Заключение. В итоговый список параметров, рекомендуемых для оценки во время лечения и наблюдения пациентов с ВЗК, вошли: боль в животе; частота дефекации и качество стула; наличие патологических примесей в кале; температура тела; боли в суставах/мышцах; качество сна; эмоциональное состояние: тревожность, настроение; трудоспособность для работающих/возможность посещать занятия для обучающихся; энергичность, количество сил; фиксированность на заболевании; общая оценка пациентом качества своей жизни; приверженность лечению.

论证。炎症性肠病患者通常需要医生的终生随访。远程随访是提供此类医疗服务的一个很有前途的途径。远程随访通常基于医疗服务提供者对远程患者问卷调查结果的评估。

该研究的目的是采用德尔菲法，确定一份通过问卷评估的参数清单，以便日后应用于炎症性肠病患者的随访和治疗。

材料和方法。参与研究的专家组由具有不同工作经验的消化内科医生组成。我们制作了一份电子调查表来收集信息。在填写问卷时，必须注明参与者的工作年限。研究分为三个阶段。在第一阶段，受访者回答了一个开放式问题，即应该对炎症性肠病患者的哪些参数进行评估。在第二阶段，受访者回答了同样的问题。但在这一阶段，他们从建议的项目中选择项目，项目数量不限。研究的第三阶段是对回答进行分析。每个参数的主要终点是75%以上的受访者达成共识。

结果。15人参与了研究，其中13.3%为男性。在所有受访者中，46%在门诊机构工作，54%在医院工作。年龄范围为25岁至53岁之间。同时，53%的参与者拥有1至4年的工作经验，47%的参与者拥有17至29年的工作经验。在第一阶段结束时，没有一个参数达到75%的同意程度。第二阶段结束后，受访者对72%的参数达成了一致意见。在第一阶段和第二阶段，受访者的年龄、性别、工作年限和工作地点与答复之间都未发现相关性。

结论。炎症性肠病患者治疗和随访期间的最终评估参数清单包括：腹痛；排便次数和粪便质量；粪便中是否有病理性杂质；体温；关节/肌肉疼痛；睡眠质量；情绪状态：焦虑、情绪；工作的人的工作能力/学习的人的上课能力；精力、体力；对疾病的固执；患者对其生活质量的总体评价；坚持治疗的情况。

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