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Salvi D, Poffley E, Orchard E, Tarassenko L. The Mobile-Based 6-Minute Walk Test: Usability Study and Algorithm Development and Validation. JMIR Mhealth Uhealth 2020; 8:e13756. [PMID: 31899457 PMCID: PMC6969385 DOI: 10.2196/13756] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 06/07/2019] [Accepted: 08/31/2019] [Indexed: 12/19/2022] Open
Abstract
Background The 6-min walk test (6MWT) is a convenient method for assessing functional capacity in patients with cardiopulmonary conditions. It is usually performed in the context of a hospital clinic and thus requires the involvement of hospital staff and facilities, with their associated costs. Objective This study aimed to develop a mobile phone–based system that allows patients to perform the 6MWT in the community. Methods We developed 2 algorithms to compute the distance walked during a 6MWT using sensors embedded in a mobile phone. One algorithm makes use of the global positioning system to track the location of the phone when outdoors and hence computes the distance travelled. The other algorithm is meant to be used indoors and exploits the inertial sensors built into the phone to detect U-turns when patients walk back and forth along a corridor of fixed length. We included these algorithms in a mobile phone app, integrated with wireless pulse oximeters and a back-end server. We performed Bland-Altman analysis of the difference between the distances estimated by the phone and by a reference trundle wheel on 49 indoor tests and 30 outdoor tests, with 11 different mobile phones (both Apple iOS and Google Android operating systems). We also assessed usability aspects related to the app in a discussion group with patients and clinicians using a technology acceptance model to guide discussion. Results The mean difference between the mobile phone-estimated distances and the reference values was −2.013 m (SD 7.84 m) for the indoor algorithm and −0.80 m (SD 18.56 m) for the outdoor algorithm. The absolute maximum difference was, in both cases, below the clinically significant threshold. A total of 2 pulmonary hypertension patients, 1 cardiologist, 2 physiologists, and 1 nurse took part in the discussion group, where issues arising from the use of the 6MWT in hospital were identified. The app was demonstrated to be usable, and the 2 patients were keen to use it in the long term. Conclusions The system described in this paper allows patients to perform the 6MWT at a place of their convenience. In addition, the use of pulse oximetry allows more information to be generated about the patient’s health status and, possibly, be more relevant to the real-life impact of their condition. Preliminary assessment has shown that the developed 6MWT app is highly accurate and well accepted by its users. Further tests are needed to assess its clinical value.
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Affiliation(s)
- Dario Salvi
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, United Kingdom
| | - Emma Poffley
- Department of Cardiology, Oxford University NHS Foundation Trust, Oxford, United Kingdom
| | - Elizabeth Orchard
- Department of Cardiology, Oxford University NHS Foundation Trust, Oxford, United Kingdom
| | - Lionel Tarassenko
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, United Kingdom
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Solà I, Trujols J, Ribalta E, Alcaraz S, Robleda G, Selva Olid C, Pérez de los Cobos J. Quality of life and well-being from the perspective of patients on opioid agonist maintenance treatment: study protocol for a systematic review of qualitative research and a scoping review of measures. Syst Rev 2019; 8:299. [PMID: 31787102 PMCID: PMC6886222 DOI: 10.1186/s13643-019-1237-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 11/17/2019] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Opioid agonist maintenance treatment (OAMT) is a first-line treatment for heroin dependence, but its effectiveness has been assessed primarily through clinical outcomes with a limited attention to patient perspectives. Despite the increased use of patient reported outcome measures their patient-centeredness is highly questionable. This is the protocol of a systematic review of qualitative research on how OAMT users construct the meaning of their quality of life and well-being and a scoping review of instruments that measure these domains. METHODS We will conduct a systematic review of qualitative research exploring the views of quality of life of patients on OAMT (registration number CRD42018086490). According pre-specified eligibility criteria, we will include studies from a comprehensive search of bibliographical databases from their inception. We will extract data from included studies and assess their risk of bias with the CASP appraisal criteria, and will implement a thematic analysis to generate a set of interpretative analytical themes ascertaining their confidence using the CERQual approach. We will implement similar methods to conduct a scoping review to assess to what extent the existing measures of these domains were focused on user's views, assessing their validity using the COSMIN methodology, and summarizing their characteristics and level of patient centeredness. CONCLUSION The findings from the reviews will contribute to obtain a genuine understanding of the perspective from users on OAMT regarding their perception of well-being and quality of life and will likely lead to greater patient centeredness when assessing such variables, which in turn may contribute to a more patient-centered care.
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Affiliation(s)
- Ivan Solà
- Iberoamerican Cochrane Center, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Joan Trujols
- Addictive Behaviours Unit, Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Biomedical Research Networking Center on Mental Health (CIBERSAM), Barcelona, Spain
- Addictive Behaviors Research Group, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Elisa Ribalta
- Addictive Behaviours Unit, Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Saul Alcaraz
- Addictive Behaviours Unit, Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Gemma Robleda
- Iberoamerican Cochrane Center, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
- Escuela Superior de Enfermería Mar, Barcelona, Spain
- Departament de Ciències Experimentals i de la Salut, UPF, Barcelona, Spain
| | - Clara Selva Olid
- PETRO Research Group, Bellaterra, Spain
- Department of Social Psychology, Universitat Autònoma de Barcelona (UAB), Bellaterra, Spain
| | - José Pérez de los Cobos
- Addictive Behaviours Unit, Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Biomedical Research Networking Center on Mental Health (CIBERSAM), Barcelona, Spain
- Addictive Behaviors Research Group, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, School of Medicine, Autonomous University of Barcelona (UAB), Bellaterra, Bellaterra, Spain
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Gilmore NJ, Canin B, Whitehead M, Sedenquist M, Griggs L, Finch L, Grossman V, Targia V, Wells M, Kamen C, Flannery M, Magnuson A, Plumb S, Obrecht S, Lowenstein LM, Lopez G, Anderson J, Berenberg J, Vogel V, Bearden J, Dale W, Mohile SG. Engaging older patients with cancer and their caregivers as partners in cancer research. Cancer 2019; 125:4124-4133. [PMID: 31420878 PMCID: PMC6856383 DOI: 10.1002/cncr.32402] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 05/22/2019] [Accepted: 06/06/2019] [Indexed: 11/08/2022]
Abstract
Active patient partner engagement with SCOREboard – a diverse group of older patients with cancer, caregivers of older patients with cancer, survivors, and patient advocates – to conduct the largest randomized geriatric assessment clinical trial to date, has been shown to be feasible and resulted in tangible and invaluable benefits for both the research team and patient partners alike. Actively engaging patient partners should be an essential component in the development, conduct, and completion of all clinical research.
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Affiliation(s)
- Nikesha J Gilmore
- James P. Wilmot Cancer Institute, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Beverly Canin
- SCOREboard Stakeholder Advisory Group, James P. Wilmot Cancer Institute, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Mary Whitehead
- SCOREboard Stakeholder Advisory Group, James P. Wilmot Cancer Institute, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Margaret Sedenquist
- SCOREboard Stakeholder Advisory Group, James P. Wilmot Cancer Institute, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Lorraine Griggs
- SCOREboard Stakeholder Advisory Group, James P. Wilmot Cancer Institute, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Lynn Finch
- SCOREboard Stakeholder Advisory Group, James P. Wilmot Cancer Institute, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Valerie Grossman
- SCOREboard Stakeholder Advisory Group, James P. Wilmot Cancer Institute, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Valerie Targia
- SCOREboard Stakeholder Advisory Group, James P. Wilmot Cancer Institute, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Megan Wells
- James P. Wilmot Cancer Institute, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Charles Kamen
- James P. Wilmot Cancer Institute, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Marie Flannery
- School of Nursing, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Allison Magnuson
- James P. Wilmot Cancer Institute, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Sandy Plumb
- James P. Wilmot Cancer Institute, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Spencer Obrecht
- James P. Wilmot Cancer Institute, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Lisa M Lowenstein
- Department of Health Services Research, Division of Cancer Prevention and Population Sciences, University of Texas, MD Anderson Cancer Center, Houston, Texas
| | - Gilberto Lopez
- James P. Wilmot Cancer Institute, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Jainy Anderson
- James P. Wilmot Cancer Institute, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Jeffrey Berenberg
- Hawaii Minority Underserved National Cancer Institute Community Oncology Research Program (MU-NCORP), Honolulu, Hawaii
| | - Victor Vogel
- Hematology and Oncology, Cancer Institute, Geisinger Medical Center, Danville, Pennsylvania
| | - James Bearden
- Southeast Clinical Oncology Research Consortium (SCOR), Winston-Salem, North Carolina
| | - William Dale
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Supriya G Mohile
- James P. Wilmot Cancer Institute, University of Rochester School of Medicine and Dentistry, Rochester, New York
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Ng S, Kirkman M, Fisher J, Pusic A, Parker E, Cooter RD, Elder E, Moore C, McNeil J, Hopper I. Establishing the acceptability of a brief patient reported outcome measure and feasibility of implementing it in a breast device registry - a qualitative study. J Patient Rep Outcomes 2019; 3:63. [PMID: 31641976 PMCID: PMC6805841 DOI: 10.1186/s41687-019-0152-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 09/25/2019] [Indexed: 12/11/2022] Open
Abstract
Background To examine the acceptability of a Patient Reported Outcome Measure (PROM) that assesses perceptions and experiences of implants for breast reconstruction or augmentation, and the feasibility of implementing it in the Australian Breast Device Registry (ABDR). Methods The BREAST-Q Implant Surveillance (BREAST-Q IS) is a 5-question PROM derived from the BREAST-Q questionnaire. It assesses perceptions of breast appearance and sensation, and experiences of pain. Breast implant recipients (recruited via community networks, social media and notices in surgeons’ rooms) and surgeons contributing to the ABDR were invited to review the BREAST-Q-IS. Participation was by individual semi-structured interviews by telephone or email, or by completion of a paper questionnaire. Transcripts of audio recordings and emailed text were analysed thematically. Results Twenty one breast implant recipients (10 after reconstruction and 11 augmentation), 8 surgeons (five plastic, three breast) and 2 medical professionals performing cosmetic surgeries were interviewed. Six themes were identified: Overall impression, Emotional response to the BREAST-Q IS, Method of follow-up, Suggested improvements, Group variation, and Potential Clinical utility. Overall, breast implant recipients and surgeons found the BREAST-Q IS to be acceptable and unlikely to provoke strong emotional reactions. Email was the preferred mode of contact. Most suggested improvements were to add questions. Surgeons expressed concern that subjective responses to the PROM might not accurately reflect experiences and that the PROM would predict need for revision rather than device failure. Conclusion This study supports the acceptability and feasibility of BREAST-Q IS as a PROM for recipients of breast implants. Further validation of the Breast-Q IS is required.
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Affiliation(s)
- Sze Ng
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Maggie Kirkman
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Jane Fisher
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Andrea Pusic
- Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Emily Parker
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Rodney D Cooter
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.,Australian Society of Plastic Surgeons, Sydney, NSW, Australia
| | - Elisabeth Elder
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.,Breast Surgeons of Australia and New Zealand, Randwick, NSW, Australia
| | - Colin Moore
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.,Australasian College of Cosmetic Surgery, Parramatta, NSW, Australia
| | - John McNeil
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Ingrid Hopper
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.
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Findeklee S, Radosa JC, Schafhaupt S, Younes S, Radosa CG, Mothes A, Solomayer EF, Radosa MP. Evaluating the use of Clavien-Dindo classification and Picker Patient Experience Questionnaire as quality indicators in gynecologic endoscopy. Arch Gynecol Obstet 2019; 300:1317-1324. [PMID: 31583461 DOI: 10.1007/s00404-019-05302-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 09/10/2019] [Indexed: 11/30/2022]
Abstract
PURPOSE Over the last few decades, laparoscopy has become a standard procedure within gynecological surgery. Validated quality indicators for the determination of the objective (perioperative complications) and subjective (patient satisfaction) quality of treatment as a surrogate parameter for the success of the treatment have so far found no regular application in the clinical routine. The purpose of this study was to evaluate the use of the Clavien-Dindo (CD) classification for postoperative complications and the Picker Patient Experience Questionnaire (PPE-15) as tools in the evaluation of endoscopic therapies in clinical routine. METHODS Retrospectively, perioperative complications using the CD classification and patient satisfaction utilizing the PPE-15 were reviewed for a total of 212 consecutive patients at a gynecologic endoscopic referral center (Agaplesion Diakonie Kliniken, Kassel, Germany) in September 2018. RESULTS An overall complication rate of 13.21% (28 out of 138 patients) was observed. Five patients (2.36%) had complications grade III and above according to the CD classification system. 138 patients out of 212 chose to answer the PPE-15 (return rate 65.01%). 112 patients (81.16%) reported about problems during their treatment in our hospital in their PPE-15. "Purpose of medicines not explained" was the most mentioned item (28.99%) by patients during their hospital stay. CONCLUSION CD classification and PPE-15 may be helpful instruments to evaluate the quality of care in gynecology. The application of both instruments for the assessment of treatment quality in clinical routine should be further investigated in prospective studies.
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Affiliation(s)
- Sebastian Findeklee
- Department for Gynecology, Obstetrics and Reproductive Medicine, Saarland University Hospital, Homburg, Germany
| | - Julia Caroline Radosa
- Department for Gynecology, Obstetrics and Reproductive Medicine, Saarland University Hospital, Homburg, Germany
| | | | - Shadi Younes
- Department for Gynecology, Agaplesion Diakonie Kliniken, Kassel, Germany.,Department for Gynecology and Obstetrics, University Hospital Leipzig, Liebigstraße 20a, Building 6, 01403, Leipzig, Germany
| | | | - Anke Mothes
- Department for Gynecology and Obstetrics, St. Georg Hospital Eisenach, Eisenach, Germany
| | - Erich Franz Solomayer
- Department for Gynecology, Obstetrics and Reproductive Medicine, Saarland University Hospital, Homburg, Germany
| | - Marc Philipp Radosa
- Department for Gynecology, Agaplesion Diakonie Kliniken, Kassel, Germany. .,Department for Gynecology and Obstetrics, University Hospital Leipzig, Liebigstraße 20a, Building 6, 01403, Leipzig, Germany.
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Rand L, Dunn M, Slade I, Upadhyaya S, Sheehan M. Understanding and using patient experiences as evidence in healthcare priority setting. COST EFFECTIVENESS AND RESOURCE ALLOCATION 2019; 17:20. [PMID: 31572067 PMCID: PMC6757378 DOI: 10.1186/s12962-019-0188-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Accepted: 09/03/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND In many countries, committees make priority-setting decisions in order to control healthcare costs. These decisions take into account relevant criteria, including clinical effectiveness, cost-effectiveness, and need, and are supported by evidence usually drawn from clinical and economic studies. These sources of evidence do not include the specific perspective and information that patients can provide about the condition and treatment. METHODS Drawing on arguments from political philosophy and ethics that are the ethical basis for many priority-setting bodies, the authors argue that criteria like need and its effects on patients and caregivers are best supported by evidence generated from patients' experiences. Social sciences and mixed-methods research support the generation and collection of robust evidence. RESULTS Patient experience is required for a decision-making process that considers all relevant evidence. For fair priority-setting, decision-makers should consider relevant evidence and reasons, so patient experience evidence should not be ignored. Patient experience must be gathered in a way that generates high quality and methodologically rigorous evidence. Established quantitative and qualitative methods can assure that evidence is systematic, adherent to quality standards, and valid. Patient, like clinical, evidence should be subject to a transparent review process. DISCUSSION Considering all relevant evidence gives each person an equal opportunity at having their treatment funded. Patient experience gives context to the clinical evidence and also directly informs our understanding of the nature of the condition and its effects, including patients' needs, how to meet them, and the burden of illness. Such evidence also serves to contextualise reported effects of the treatment. The requirement to include patient experience as evidence has important policy implications for bodies that make priority-setting decisions since it proposes that new types of evidence reviews are commissioned and considered.
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Affiliation(s)
- Leah Rand
- Board on Health Sciences Policy, National Academies of Sciences, Engineering, and Medicine, 500 Fifth Street NW, Washington, DC 20009 USA
| | - Michael Dunn
- Ethox Centre, Nuffield Department of Population Health, Big Data Institute, La Ka Shing Centre for Health Information and Discovery, University of Oxford, Old Road Campus, Oxford, OX3 7LF UK
- Wellcome Centre for Ethics and Humanities, University of Oxford, Oxford, UK
| | - Ingrid Slade
- Ethox Centre, Nuffield Department of Population Health, Big Data Institute, La Ka Shing Centre for Health Information and Discovery, University of Oxford, Old Road Campus, Oxford, OX3 7LF UK
| | - Sheela Upadhyaya
- Highly Specialised Technology Program, Centre for Health Technology Evaluation, National Institute for Health and Care Excellence, 10 Spring Gardens, London, SW1A 2BU UK
| | - Mark Sheehan
- Ethox Centre, Nuffield Department of Population Health, Big Data Institute, La Ka Shing Centre for Health Information and Discovery, University of Oxford, Old Road Campus, Oxford, OX3 7LF UK
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Madden A, Hopwood M, Neale J, Treloar C. Acceptability of Patient-Reported Outcome and Experience Measures for Hepatitis C Treatment Among People Who Use Drugs. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2019; 12:259-265. [PMID: 30270403 DOI: 10.1007/s40271-018-0332-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Growing international interest in mechanisms to capture and measure experiences and outcomes of health interventions from the patient perspective has led to the development of patient-reported measures (PRMs) across many areas of medicine. Although PRMs are now well utilised in some settings, the rapidly expanding area of direct-acting antiviral (DAA) treatments for hepatitis C has received remarkably little attention. In addition, questions are also being raised about the extent to which patients have been involved in the development of PRMs, which are primarily designed to reflect the patient perspective. In this context, the aim of this paper was to explore the possibility of developing a new PRM for use in hepatitis C DAA therapy that would also be acceptable to the patient group, in this case people who inject drugs (PWID). METHOD The study was based on a participatory design that included a peer researcher and foundational qualitative research including semi-structured interviews with 24 PWID with hepatitis C to inform the development of the PRMs. Stage 2 included four focus groups of six PWID with hepatitis C, who were asked to complete the draft measures and provide feedback. RESULTS Participants responded positively to the draft PRMs. The results indicate that participants' concerns during DAA treatment are often not sufficiently attended to in clinical settings. In the light of this finding, participants reported that PRMs have a positive role to play in the negotiation of patients' care during DAA treatment. CONCLUSIONS The findings show that utilising a participatory approach to the development of PRMs for DAA HCV treatment with PWID not only provides a way to measure experiences and outcomes of treatment from the patient perspective, but also provides a means for highly marginalised patient groups to have a say in and negotiate their care in ways that might not otherwise be possible.
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Affiliation(s)
- Annie Madden
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, Australia
| | - Max Hopwood
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, Australia
| | - Joanne Neale
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, Australia
- National Addiction Centre, Kings College London, London, UK
| | - Carla Treloar
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, Australia.
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Condon L, Bedford H, Ireland L, Kerr S, Mytton J, Richardson Z, Jackson C. Engaging Gypsy, Roma, and Traveller Communities in Research: Maximizing Opportunities and Overcoming Challenges. QUALITATIVE HEALTH RESEARCH 2019; 29:1324-1333. [PMID: 30600758 PMCID: PMC7322935 DOI: 10.1177/1049732318813558] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Gypsy, Roma, and Traveller people are marginalized worldwide and experience severe health inequalities, even in comparison to other ethnic minority groups. While diverse and hard to categorize, these communities are highly cohesive and members have a strong sense of identity as a group apart from the majority population. Researchers commonly experience challenges in accessing, recruiting, and retaining research participants from these communities, linked to their outsider status, insular nature, and history of discrimination. In this article, the challenges and the opportunities of engaging Gypsies, Roma, and Travellers in a multicenter qualitative research project are discussed. The management of public involvement and community engagement in this U.K.-based project provides insights into conducting research effectively with ethnically and linguistically diverse communities, often considered to be "hard to reach."
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Affiliation(s)
| | - Helen Bedford
- UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Lana Ireland
- Glasgow Caledonian University, Glasgow, Scotland
| | - Susan Kerr
- Glasgow Caledonian University, Glasgow, Scotland
| | - Julie Mytton
- University of the West of England, Bristol, United Kingdom
| | - Zoe Richardson
- NHS Wakefield Clinical Commissioning Group, Wakefield, United Kingdom
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Riedel F, Wähmann M, Bran GM, Conder M, Bulut OC. [Quality of life after functional aesthetic septorhinoplasty in primary surgery vs. revision surgery-a monocentric study]. HNO 2019; 67:192-198. [PMID: 30132128 DOI: 10.1007/s00106-018-0554-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Subjective assessments of quality of life (QOL) as an important aspect of outcome research have gained in importance over the past few decades. The number of prospective studies on postoperative QOL in septorhinoplasty using disease-specific instruments is sparse. The aim was to assess and compare patient QOL after primary and revision septorhinoplasty performed by a single surgeon in an ENT center. MATERIAL AND METHODS All patients completed two disease-specific QOL instruments preoperatively and at least 1 year postoperatively: the Rhinoplasty Outcome Evaluation (ROE) and the Nasal Obstruction Symptoms Evaluation (NOSE) scores. General demographic and clinical information (age, gender, medical and surgical history) were collected from all patients. All operations were performed by a single surgeon (F. R.). RESULTS A total of 237 patients were included in the study, 208 (87.8%) female and 29 (12.2%) male. The average age was 30.3 ± 8.9 years. The average observation period was 19.3 ± 7.4 months. Using the measurement tool NOSE there was a significant improvement in obstruction in the overall collective (preoperative 49.8 ± 26.2, postoperative 19.1 ± 21.3; p < 0.001) with no significant difference in primary versus revision surgery. The ROE score showed a significant improvement and both collectives (primary and secondary surgery) showed a significant improvement after the intervention. The patients with a primary intervention had a significantly higher postoperative QOL (p < 0.001). CONCLUSION The disease-specific QOL showed a significant increase after primary septorhinoplasty as well as after revision surgery. The NOSE score increased significantly in both intervention groups postoperatively.
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Affiliation(s)
- F Riedel
- HNO-Zentrum Rhein-Neckar, Stresemannstr. 22, 68165, Mannheim, Deutschland.
| | - M Wähmann
- HNO-Zentrum Rhein-Neckar, Stresemannstr. 22, 68165, Mannheim, Deutschland
| | - G M Bran
- HNO-Zentrum Rhein-Neckar, Stresemannstr. 22, 68165, Mannheim, Deutschland
| | - M Conder
- HNO-Zentrum Rhein-Neckar, Stresemannstr. 22, 68165, Mannheim, Deutschland
| | - O C Bulut
- Abteilung für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, plastische Gesichtschirurgie, Klinikum am Gesundbrunnen, SLK-Kliniken Heilbronn, Heilbronn, Deutschland
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61
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Mes MA, Chan AHY, Wileman V, Katzer CB, Goodbourn M, Towndrow S, Taylor SJC, Horne R. Patient involvement in questionnaire design: tackling response error and burden. J Pharm Policy Pract 2019; 12:17. [PMID: 31236279 PMCID: PMC6572747 DOI: 10.1186/s40545-019-0175-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 04/04/2019] [Indexed: 12/03/2022] Open
Abstract
Questionnaires capture patient perspectives succinctly and at relatively low cost, making them a popular data collection tool for health researchers. However, questionnaire data can be affected by response error and response burden. Patient involvement during questionnaire design can help reduce the effect of response error and burden. This paper describes a novel approach for patient involvement during questionnaire design, combining methods from cognitive interviewing (Think Aloud Tasks) with an open-ended follow-up discussion to collate and act on patient feedback, while also taking account of the common challenges in questionnaire design (i.e. response error and burden). The strengths and limitations of this approach are discussed, and recommendations are made for future use.
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Affiliation(s)
- Marissa Ayano Mes
- 1Centre for Behavioural Medicine, UCL School of Pharmacy, Mezzanine Floor, BMA House, Tavistock Square, London, WC1H 9JP UK
| | - Amy Hai Yan Chan
- 1Centre for Behavioural Medicine, UCL School of Pharmacy, Mezzanine Floor, BMA House, Tavistock Square, London, WC1H 9JP UK
| | - Vari Wileman
- 1Centre for Behavioural Medicine, UCL School of Pharmacy, Mezzanine Floor, BMA House, Tavistock Square, London, WC1H 9JP UK
| | - Caroline Brigitte Katzer
- 1Centre for Behavioural Medicine, UCL School of Pharmacy, Mezzanine Floor, BMA House, Tavistock Square, London, WC1H 9JP UK
| | - Melissa Goodbourn
- 2Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Old Medical School, Teviot Place, Edinburgh, EH8 9AG UK.,3Asthma UK Centre for Applied Research, Usher Institute, University of Edinburgh, Old Medical School, Teviot Place, Edinburgh, EH8 9AG UK
| | - Steven Towndrow
- 4National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care North Thames, Barts Health NHS Trust, London, UK
| | - Stephanie Jane Caroline Taylor
- 5Centre for Primary Care and Public Health, Blizard Institute, Queen Mary University London, Yvonne Carter Building, 58 Turner Street, London, E1 2AB UK
| | - Rob Horne
- 1Centre for Behavioural Medicine, UCL School of Pharmacy, Mezzanine Floor, BMA House, Tavistock Square, London, WC1H 9JP UK
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Grundy A, Keetharuth AD, Barber R, Carlton J, Connell J, Taylor Buck E, Barkham M, Ricketts T, Robotham D, Rose D, Kay J, Hanlon R, Brazier J. Public involvement in health outcomes research: lessons learnt from the development of the recovering quality of life (ReQoL) measures. Health Qual Life Outcomes 2019; 17:60. [PMID: 30975153 PMCID: PMC6458599 DOI: 10.1186/s12955-019-1123-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 03/18/2019] [Indexed: 12/14/2022] Open
Abstract
Background To provide a model for Public involvement (PI) in instrument development and other research based on lessons learnt in the co-production of a recently developed mental health patient reported outcome measure called Recovering Quality of Life (ReQoL). While service users contributed to the project as research participants, this paper focuses on the role of expert service users as research partners, hence referred to as expert service users or PI. Methods At every stage of the development, service users influenced the design, content and face validity of the measure, collaborating with other researchers, clinicians and stakeholders who were central to this research. Expert service users were integral to the Scientific Group which was the main decision-making body, and also provided advice through the Expert Service User Group. Results During the theme and item generation phase (stage 1) expert service users affirmed the appropriateness of the seven domains of the Patient Reported Outcome Measure (activity, hope, belonging and relationships, self-perception, wellbeing, autonomy, and physical health). Expert service users added an extra 58 items to the pool of 180 items and commented on the results from the face and content validity testing (stage 2) of a refined pool of 88. In the item reduction and scale generation phase (stage 3), expert service users contributed to discussions concerning the ordering and clustering of the themes and items and finalised the measures. Expert service users were also involved in the implementation and dissemination of ReQoL (stage 4). Expert service users contributed to the interpretation of findings, provided inputs at every stage of the project and were key decision-makers. The challenges include additional work to make the technical materials accessible, extra time to the project timescales, including time to achieve consensus from different opinions, sometimes strongly held, and extra costs. Conclusion This study demonstrates a successful example of how PI can be embedded in research, namely in instrument development. The rewards of doing so cannot be emphasised enough but there are challenges, albeit surmountable ones. Researchers should anticipate and address those challenges during the planning stage of the project.
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Affiliation(s)
- Andrew Grundy
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | | | - Rosemary Barber
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Jill Carlton
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Janice Connell
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | | | - Michael Barkham
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - Thomas Ricketts
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | | | - Diana Rose
- King's College London, Institute of Psychiatry, London, UK
| | - John Kay
- Sheffield Hallam University, Sheffield, UK
| | | | - John Brazier
- School of Health and Related Research, University of Sheffield, Sheffield, UK
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Turner GM, Mant J. Patient-reported outcomes for subarachnoid hemorrhage: Capturing the patients' perspective. Neurology 2019; 92:259-261. [PMID: 30626654 DOI: 10.1212/wnl.0000000000006865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Grace M Turner
- From the Institute of Applied Health Research (G.M.T.), University of Birmingham; and Primary Care Unit, Department of Public Health & Primary Care (J.M.), University of Cambridge, UK.
| | - Jonathan Mant
- From the Institute of Applied Health Research (G.M.T.), University of Birmingham; and Primary Care Unit, Department of Public Health & Primary Care (J.M.), University of Cambridge, UK
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Staniszewska S, Stephens R, Flemyng E. Developing the infrastructure for patient review in academic journals. RESEARCH INVOLVEMENT AND ENGAGEMENT 2018; 4:31. [PMID: 30214823 PMCID: PMC6130087 DOI: 10.1186/s40900-018-0114-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 08/22/2018] [Indexed: 06/08/2023]
Abstract
PLAIN ENGLISH SUMMARY Peer review is a well-established part of academic publishing. Its function is to assess the quality of a manuscript before publication in a journal. Research involvement and Engagement is the world's first co-produced journal dedicated to developing the evidence base of patient and public involvement and engagement in health and social care research. Alongside traditional academic peer review we also involve other key stakeholders, including patients, carers, the public, policy makers, funders and practitioners. Following a recent survey looking at the motivations and feedback from patient reviewers in academic journals, we consider the key findings, reflect on what we already do and based on the feedback from the survey, we outline plans for future development. These plans include improving training and guidance for reviewers, changes to systems and workflows, acknowledging and engaging reviewers, and building a sense of community. ABSTRACT Peer review is a well-established part of academic publishing. Its function is to assess the quality of a manuscript before publication in a journal. Research involvement and Engagement is the world's first co-produced journal dedicated to developing the evidence base of patient and public involvement and engagement in health and social care research. Alongside traditional academic peer review we also involve other key stakeholders, including patients, carers, the public, policy makers, funders and practitioners. Following a recent survey looking at the motivations and feedback from patient reviewers in academic journals, we consider the key findings, reflect on what we already do and based on the feedback from the survey, we outline plans for future development. These plans include including improving training and guidance for reviewers, changes to systems and workflows, acknowledging and engaging reviewers, and building a sense of community.
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Affiliation(s)
- Sophie Staniszewska
- Warwick Research in Nursing, University of Warwick Medical School, Coventry, UK
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65
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Blackburn SJ. Patient involvement vs. patient participation in qualitative research in the development of PROMs. Health Expect 2018; 20:371-372. [PMID: 28514519 DOI: 10.1111/hex.12459] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Steven J Blackburn
- Research Institute for Primary Care & Health Sciences, Keele University, Keele, Staffordshire, ST5 5BG, UK
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Dibley L, Czuber-Dochan W, Woodward S, Wade T, Bassett P, Sturt J, Norton C. Development and Psychometric Properties of the Inflammatory Bowel Disease Distress Scale (IBD-DS): A New Tool to Measure Disease-Specific Distress. Inflamm Bowel Dis 2018; 24:2068-2077. [PMID: 29788323 DOI: 10.1093/ibd/izy108] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Indexed: 12/26/2022]
Abstract
BACKGROUND Inflammatory bowel disease (IBD) imposes a heavy psychosocial burden, with many patients reporting anxiety, depression, and distress. In diseases such as diabetes, disease-specific distress is associated with concordance with treatments and disease control. IBD distress, distinct from anxiety and depression, is evident in people with IBD. We aimed to develop a questionnaire for assessing IBD-specific distress, validate this against a gold standard distress measure for diabetes, and demonstrate the difference between anxiety, depression, and distress. METHODS The 94-item IBD Distress Scale (IBD-DS) was developed through secondary analysis of 3 qualitative data sets from previous IBD studies. Items were then refined through cognitive interviews in 2 stages (n = 15, n = 3). Three supplementary unscored questions were added to enable patients to identify their overall level of distress, their perceived level of disease activity, and their 3 most distressing issues. Subsequently, the 55-item IBD Distress Scale was subjected to test-retest. Two hundred seventy-five people received the test draft IBD-DS, and 168 responded (60.4%). Of these, 136 (82%) returned the retest draft of IBD-DS 3 weeks later. After analysis, further item reduction was informed by response rates, kappa values, and correlation coefficients, and test-retest was repeated. One hundred fifty-four people received the test final 28-item IBD-DS, and 123 people responded (58.8%). Of these, 95 (77%) returned the retest final IBD-DS. RESULTS The 94 items were reduced to 28 items. Good intraclass correlation (ICC) was found between test-retest scores on 72 complete data sets with unchanged disease status (ICC, 0.92; 95% confidence interval, 0.88-0.95). Cronbach's alpha was 0.95, indicating excellent internal consistency. Factor analysis indicated scoring the items as a single domain (score range, 0-168). CONCLUSION The final IBD-DS performs well and offers a tool for assessing IBD-specific distress.
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Affiliation(s)
- Lesley Dibley
- Faculty of Education and Health, University of Greenwich, London, United Kingdom.,Bart's Health NHS Trust, London, United Kingdom
| | - Wladyslawa Czuber-Dochan
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, United Kingdom
| | - Sue Woodward
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, United Kingdom
| | - Tiffany Wade
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, United Kingdom
| | - Paul Bassett
- Independent Statistician, Amersham, United Kingdom
| | - Jackie Sturt
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, United Kingdom
| | - Christine Norton
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, United Kingdom
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Pearson NA, Packham JC, Parsons H, Haywood KL. Quality and acceptability of patient-reported outcome measures used to assess fatigue in axial spondyloarthritis (axSpA): a systematic review (protocol). Syst Rev 2018; 7:116. [PMID: 30086791 PMCID: PMC6081943 DOI: 10.1186/s13643-018-0777-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 07/17/2018] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND The prevalence of axial spondyloarthritis (axSpA) is estimated between 0.15 and 1.2%, with many of those patients experiencing severe fatigue. Current axSpA assessment guidance recommends use of a single-item visual analogue scale for fatigue severity. However, concerns have been raised about the ability of such a limited assessment to identify patients with major fatigue, to detect important change in fatigue or to reflect the multi-dimensional nature of fatigue. The proposed systematic review will identify and evaluate the quality and acceptability of single- and multi-item patient-reported outcome measures (PROMs) used to assess fatigue in axSpA, seeking to make recommendations for the 'best' measures for research and/or clinical practice. METHODS/DESIGN The review will seek to include published studies which report evidence of the development and/or measurement and/or practical properties of clearly defined and reproducible measures of fatigue following completion by patients with axSpA. Five major databases will be searched from 1980 to August 2017: MEDLINE (OVID), EMBASE (OVID), PsycINFO (OVID), World of Science and CINAHL. Study methodological quality will be assessed against the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. The measurement and/or practical properties of reviewed measures will be assessed against current international standards. A short list of the 'best'-quality PROMs will be produced. The review will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. DISCUSSION This study will provide the first robust and transparent evaluation of patient-reported measures of fatigue used in the axSpA population, synthesising evidence of quality, relevance and acceptability. The review will benefit patients, clinicians, health professionals and researchers wishing to enhance axSpA-fatigue assessment in routine practice, service evaluation and research. The findings will impact future research which seeks to better understand the nature of axSpA fatigue and evaluate the relative benefit of fatigue-management strategies. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42016042271.
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Affiliation(s)
- Nathan A. Pearson
- Royal College of Nursing Research Institute, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | | | - Helen Parsons
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - Kirstie L. Haywood
- Royal College of Nursing Research Institute, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
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Maguire R, Kotronoulas G, Donnan PT, Paterson C, McCann L, Connaghan J, Di Domenico DGG, Kearney N. Development and preliminary testing of a brief clinical tool to enable daily monitoring of chemotherapy toxicity: The Daily Chemotherapy Toxicity self-Assessment Questionnaire. Eur J Cancer Care (Engl) 2018; 27:e12890. [PMID: 29993150 DOI: 10.1111/ecc.12890] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 05/31/2018] [Accepted: 06/11/2018] [Indexed: 11/30/2022]
Abstract
Close monitoring of chemotherapy toxicity can be instrumental in ensuring prompt symptom management and quality care. Our aim was to develop a brief clinical tool to enable daily assessment of chemotherapy toxicity and investigate/establish its content validity, feasibility/applicability, internal consistency and stability. Development of the Daily Chemotherapy Toxicity self-Assessment Questionnaire (DCTAQ) was based on an initial item pool created from two scoping reviews. Expert panel review (n = 15) and cognitive debriefing with patients with cancer (n = 7) were used to establish content validity. Feasibility/acceptability, applicability (self-report vs. interview-like administration), internal consistency (KR-20) and test-retest reliability (at 1-hr intervals) of the DCTAQ were field-tested with 82 patients with breast or colorectal cancer receiving active chemotherapy at eight hospitals. Initial development/content validity stages enabled item revisions and re-wording that led to a final, 11-item DCTAQ version with 10 core symptom items plus one open-ended "any other symptom" item. Feasibility and acceptability were demonstrated through the absence of participant withdrawals, absence of missing data and no complaints about tool length. The DCTAQ was found to have modest internal consistency (KR-20 = 0.56), but very good test-retest reliability. The DCTAQ is a brief clinical tool that allows for rapid and accurate daily assessments of chemotherapy toxicity in clinical practice.
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Affiliation(s)
- Roma Maguire
- Department of Computer and Information Sciences, University of Strathclyde, Glasgow, UK
| | | | - Peter T Donnan
- Population Health Sciences, Medical Research Institute, University of Dundee, Dundee, UK
| | | | - Lisa McCann
- Department of Computer and Information Sciences, University of Strathclyde, Glasgow, UK
| | - John Connaghan
- Department of Computer and Information Sciences, University of Strathclyde, Glasgow, UK
| | - David G G Di Domenico
- School of Health, Wellbeing and Social Care, Faculty of Wellbeing, Education and Language Studies, The Open University, Edinburgh, UK
| | - Nora Kearney
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
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Haywood KL, Mars TS, Potter R, Patel S, Matharu M, Underwood M. Assessing the impact of headaches and the outcomes of treatment: A systematic review of patient-reported outcome measures (PROMs). Cephalalgia 2018; 38:1374-1386. [PMID: 28920448 PMCID: PMC6024352 DOI: 10.1177/0333102417731348] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 05/25/2017] [Accepted: 06/12/2017] [Indexed: 01/03/2023]
Abstract
Aims To critically appraise, compare and synthesise the quality and acceptability of multi-item patient reported outcome measures for adults with chronic or episodic headache. Methods Systematic literature searches of major databases (1980-2016) to identify published evidence of PROM measurement and practical properties. Data on study quality (COSMIN), measurement and practical properties per measure were extracted and assessed against accepted standards to inform an evidence synthesis. Results From 10,903 reviewed abstracts, 103 articles were assessed in full; 46 provided evidence for 23 PROMs: Eleven specific to the health-related impact of migraine (n = 5) or headache (n = 6); six assessed migraine-specific treatment response/satisfaction; six were generic measures. Evidence for measurement validity and score interpretation was strongest for two measures of impact, Migraine-Specific Quality of Life Questionnaire (MSQ v2.1) and Headache Impact Test 6-item (HIT-6), and one of treatment response, the Patient Perception of Migraine Questionnaire (PPMQ-R). Evidence of reliability was limited, but acceptable for the HIT-6. Responsiveness was rarely evaluated. Evidence for the remaining measures was limited. Patient involvement was limited and poorly reported. Conclusion While evidence is limited, three measures have acceptable evidence of reliability and validity: HIT-6, MSQ v2.1 and PPMQ-R. Only the HIT-6 has acceptable evidence supporting its completion by all "headache" populations.
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Affiliation(s)
- Kirstie L Haywood
- Warwick Research in Nursing, Department
of Health Sciences, Warwick Medical School, The
University
of Warwick, Gibbet Hill, Coventry, UK
- On behalf of the CHESS team; Warwick
Clinical Trials Unit, Warwick Medical School, The
University
of Warwick, Gibbet Hill, Coventry, UK
| | - Tom S Mars
- On behalf of the CHESS team; Warwick
Clinical Trials Unit, Warwick Medical School, The
University
of Warwick, Gibbet Hill, Coventry, UK
- Warwick Clinical Trials Unit, Warwick
Medical School, The
University
of Warwick, Gibbet Hill, Coventry, UK
| | - Rachel Potter
- On behalf of the CHESS team; Warwick
Clinical Trials Unit, Warwick Medical School, The
University
of Warwick, Gibbet Hill, Coventry, UK
- Warwick Clinical Trials Unit, Warwick
Medical School, The
University
of Warwick, Gibbet Hill, Coventry, UK
| | - Shilpa Patel
- On behalf of the CHESS team; Warwick
Clinical Trials Unit, Warwick Medical School, The
University
of Warwick, Gibbet Hill, Coventry, UK
- Warwick Clinical Trials Unit, Warwick
Medical School, The
University
of Warwick, Gibbet Hill, Coventry, UK
| | - Manjit Matharu
- On behalf of the CHESS team; Warwick
Clinical Trials Unit, Warwick Medical School, The
University
of Warwick, Gibbet Hill, Coventry, UK
- Headache Group, UCL Institute of
Neurology, Queen Square, London, UK
| | - Martin Underwood
- On behalf of the CHESS team; Warwick
Clinical Trials Unit, Warwick Medical School, The
University
of Warwick, Gibbet Hill, Coventry, UK
- Warwick Clinical Trials Unit, Warwick
Medical School, The
University
of Warwick, Gibbet Hill, Coventry, UK
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Pearson NA, Packham JC, Tutton E, Parsons H, Haywood KL. Assessing fatigue in adults with axial spondyloarthritis: a systematic review of the quality and acceptability of patient-reported outcome measures. Rheumatol Adv Pract 2018; 2:rky017. [PMID: 31431965 PMCID: PMC6649921 DOI: 10.1093/rap/rky017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 05/01/2018] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE The aim was to evaluate the quality and acceptability of patient-reported outcome measures used to assess fatigue in patients with axial spondyloarthritis. METHODS A two-stage systematic review of major electronic databases (1980-2017) was carried out to: (i) identify measures; and (ii) identify evaluative studies. Study and measurement quality were evaluated following international standards. Measurement content was appraised against a conceptual model of RA-fatigue. RESULTS From 387 reviewed abstracts, 23 articles provided evidence for nine fatigue-specific measures: 6 multi-item and 3 single-item. No axial spondyloarthritis-fatigue-specific measure was identified. Evidence of reliability was limited, but acceptable for the Multi-dimensional Fatigue Inventory (internal consistency, test-retest) and Short Form 36-item Health Survey Vitality subscale (SF-36 VT; internal consistency). Evidence of construct validity was moderate for the Functional Assessment of Chronic Illness Therapy-Fatigue and 10 cm visual analog scale, limited for the SF-36 VT and not available for the remaining measures. Responsiveness was rarely evaluated. Evidence of measurement error, content validity or structural validity was not identified. Most measures provide a limited reflection of fatigue; the most comprehensive were the Multi-dimensional Assessment of Fatigue, Multi-dimensional Fatigue Inventory-20, Functional Assessment of Chronic Illness Therapy-fatigue and Fatigue Severity Scale. CONCLUSION The limited content and often poor quality of the reviewed measures limit any clear recommendation for fatigue assessment in this population; assessments should be applied with caution until further robust evidence is established. Well-developed, patient-derived measures can provide essential evidence of the patient's perspective to inform clinical research and drive tailored health care. The collaborative engagement of key stakeholders must seek to ensure that future fatigue assessment is relevant, acceptable and of high quality.
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Affiliation(s)
- Nathan A Pearson
- Warwick Research in Nursing, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Jonathan C Packham
- Institute of Applied Clinical Science, Keele University, Staffordshire, UK
- Haywood Academic Rheumatology Centre, Staffordshire, UK
| | - Elizabeth Tutton
- Warwick Research in Nursing, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
- Trauma Research, Kadoorie Centre, John Radcliffe Hospital, Oxford University Hospitals, Oxford, UK
| | - Helen Parsons
- Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - Kirstie L Haywood
- Warwick Research in Nursing, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
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Connell J, Carlton J, Grundy A, Taylor Buck E, Keetharuth AD, Ricketts T, Barkham M, Robotham D, Rose D, Brazier J. The importance of content and face validity in instrument development: lessons learnt from service users when developing the Recovering Quality of Life measure (ReQoL). Qual Life Res 2018; 27:1893-1902. [PMID: 29675691 PMCID: PMC5997715 DOI: 10.1007/s11136-018-1847-y] [Citation(s) in RCA: 90] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2018] [Indexed: 11/25/2022]
Abstract
PURPOSE Service user involvement in instrument development is increasingly recognised as important, but is often not done and seldom reported. This has adverse implications for the content validity of a measure. The aim of this paper is to identify the types of items that service users felt were important to be included or excluded from a new Recovering Quality of Life measure for people with mental health difficulties. METHODS Potential items were presented to service users in face-to-face structured individual interviews and focus groups. The items were primarily taken or adapted from current measures and covered themes identified from earlier qualitative work as being important to quality of life. Content and thematic analysis was undertaken to identify the types of items which were either important or unacceptable to service users. RESULTS We identified five key themes of the types of items that service users found acceptable or unacceptable; the items should be relevant and meaningful, unambiguous, easy to answer particularly when distressed, do not cause further upset, and be non-judgemental. Importantly, this was from the perspective of the service user. CONCLUSIONS This research has underlined the importance of service users' views on the acceptability and validity of items for use in developing a new measure. Whether or not service users favoured an item was associated with their ability or intention to respond accurately and honestly to the item which will impact on the validity and sensitivity of the measure.
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Affiliation(s)
- Janice Connell
- School of Health and Related Research, University of Sheffield, Sheffield, UK.
| | - Jill Carlton
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Andrew Grundy
- School of Health Sciences, Medical School, University of Nottingham, Nottingham, UK
| | | | | | - Thomas Ricketts
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Michael Barkham
- Centre for Psychological Services Research, University of Sheffield, Sheffield, UK
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - Dan Robotham
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- The McPin Foundation, London, UK
| | - Diana Rose
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - John Brazier
- School of Health and Related Research, University of Sheffield, Sheffield, UK
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Using PROMs in Healthcare: Who Should Be in the Driving Seat-Policy Makers, Health Professionals, Methodologists or Patients? PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2018; 9:495-498. [PMID: 27646693 DOI: 10.1007/s40271-016-0197-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Rumsey N. Psychosocial adjustment to skin conditions resulting in visible difference (disfigurement): What do we know? Why don't we know more? How shall we move forward? Int J Womens Dermatol 2018; 4:2-7. [PMID: 29872669 PMCID: PMC5986108 DOI: 10.1016/j.ijwd.2017.09.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 09/18/2017] [Accepted: 09/21/2017] [Indexed: 11/18/2022] Open
Abstract
This article offers an overview of the current understanding of the psychological factors and processes that play a part in the continuum of distress and positive adjustment in people who are affected by dermatological conditions that affect appearance. Despite research demonstrating the significant psychosocial challenges posed by visible difference and mounting evidence of the role played by psychosocial variables in the etiology, exacerbation, and treatment of skin conditions, current healthcare provisions focus predominantly on the amelioration of physical manifestations. Impediments to progress in the understanding of psychological adjustment, blocks to the development of effective interventions, and challenges to the implementation of integrated psychological and medical care are reviewed. A route map to advance current understanding and care provision is proposed.
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Affiliation(s)
- N. Rumsey
- Centre for Appearance Research, University of the West of England, Bristol, United Kingdom
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Ellard DR, Underwood M, Achana F, Antrobus JH, Balasubramanian S, Brown S, Cairns M, Griffin J, Griffiths F, Haywood K, Hutchinson C, Lall R, Petrou S, Stallard N, Tysall C, Walsh DA, Sandhu H. Facet joint injections for people with persistent non-specific low back pain (Facet Injection Study): a feasibility study for a randomised controlled trial. Health Technol Assess 2018. [PMID: 28639551 DOI: 10.3310/hta21300] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The National Institute for Health and Care Excellence (NICE) 2009 guidelines for persistent low back pain (LBP) do not recommend the injection of therapeutic substances into the back as a treatment for LBP because of the absence of evidence for their effectiveness. This feasibility study aimed to provide a stable platform that could be used to evaluate a randomised controlled trial (RCT) on the clinical effectiveness and cost-effectiveness of intra-articular facet joint injections (FJIs) when added to normal care. OBJECTIVES To explore the feasibility of running a RCT to test the hypothesis that, for people with suspected facet joint back pain, adding the option of intra-articular FJIs (local anaesthetic and corticosteroids) to best usual non-invasive care is clinically effective and cost-effective. DESIGN The trial was a mixed design. The RCT pilot protocol development involved literature reviews and a consensus conference followed by a randomised pilot study with an embedded mixed-methods process evaluation. SETTING Five NHS acute trusts in England. PARTICIPANTS Participants were patients aged ≥ 18 years with moderately troublesome LBP present (> 6 months), who had failed previous conservative treatment and who had suspected facet joint pain. The study aimed to recruit 150 participants (approximately 30 per site). Participants were randomised sequentially by a remote service to FJIs combined with 'best usual care' (BUC) or BUC alone. INTERVENTIONS All participants were to receive six sessions of a bespoke BUC rehabilitation package. Those randomised into the intervention arm were, in addition, given FJIs with local anaesthetic and steroids (at up to six injection sites). Randomisation occurred at the end of the first BUC session. MAIN OUTCOME MEASURES Process and clinical outcomes. Clinical outcomes included a measurement of level of pain on a scale from 0 to 10, which was collected daily and then weekly via text messaging (or through a written diary). Questionnaire follow-up was at 3 months. RESULTS Fifty-two stakeholders attended the consensus meeting. Agreement informed several statistical questions and three design considerations: diagnosis, the process of FJI and the BUC package and informing the design for the randomised pilot study. Recruitment started on 26 June 2015 and was terminated by the funder (as a result of poor recruitment) on 11 December 2015. In total, 26 participants were randomised. Process data illuminate some of the reasons for recruitment problems but also show that trial processes after enrolment ran smoothly. No between-group analysis was carried out. All pain-related outcomes show the expected improvement between baseline and follow-up. The mean total cost of the overall treatment package (injection £419.22 and BUC £264.00) was estimated at £683.22 per participant. This is similar to a NHS tariff cost for a course of FJIs of £686.84. LIMITATIONS Poor recruitment was a limiting factor. CONCLUSIONS This feasibility study achieved consensus on the main challenges in a trial of FJIs for people with persistent non-specific low back pain. FUTURE WORK Further work is needed to test recruitment from alternative clinical situations. TRIAL REGISTRATION EudraCT 2014-000682-50 and Current Controlled Trials ISRCTN93184143. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 21, No. 30. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- David R Ellard
- Warwick Clinical Trials Unit, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Martin Underwood
- Warwick Clinical Trials Unit, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Felix Achana
- Warwick Clinical Trials Unit, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - James Hl Antrobus
- South Warwickshire NHS Foundation Trust, Warwick Hospital, Warwick, UK
| | - Shyam Balasubramanian
- Pain Management Service, University Hospital Coventry and Warwickshire, Coventry, UK
| | - Sally Brown
- University/User Teaching and Research Action Partnership (UNTRAP), University of Warwick, Coventry, UK
| | - Melinda Cairns
- Department of Allied Health Professions and Midwifery, School of Health and Social Work, University of Hertfordshire, Hatfield, UK
| | - James Griffin
- Warwick Clinical Trials Unit, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Frances Griffiths
- Social Science and Systems in Health, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Kirstie Haywood
- Royal College of Nursing Research Institute, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Charles Hutchinson
- Population Evidence and Technologies Room, Warwick Medical School, University of Warwick, University Hospitals of Coventry and Warwickshire, Coventry, UK
| | - Ranjit Lall
- Warwick Clinical Trials Unit, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Stavros Petrou
- Warwick Clinical Trials Unit, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Nigel Stallard
- Statistics and Epidemiology, Division of Health Sciences, University of Warwick, Coventry, UK
| | - Colin Tysall
- University/User Teaching and Research Action Partnership (UNTRAP), University of Warwick, Coventry, UK
| | - David A Walsh
- Arthritis Research UK Pain Centre, Academic Rheumatology, University of Nottingham, Nottingham, UK
| | - Harbinder Sandhu
- Warwick Clinical Trials Unit, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
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Packham TL, MacDermid JC, Michlovitz SL, Buckley N. Content validation of the Patient-Reported Hamilton Inventory for Complex Regional Pain Syndrome: Validité de contenu du Hamilton Inventory for Complex Regional Pain Syndrome, une mesure des résultats déclarés par le patient. Can J Occup Ther 2018; 85:99-105. [PMID: 29475370 DOI: 10.1177/0008417417734562] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Complex regional pain syndrome (CRPS) is a perplexing neurological condition, and persons with CRPS experience substantial loss of daily roles and activities. A condition-specific measure is being developed to evaluate CRPS. PURPOSE We describe the use of cognitive interviews to examine content validity of this patient-reported outcome measure for CRPS. METHOD Interviews with 44 persons with CRPS were analyzed to identify problems with wording and support content validation. Item-total correlations were calculated for proposed subscales, and scores were plotted to consider floor/ceiling effects. FINDINGS Interviews identified questions where respondents considered factors unrelated to the construct of interest or were underaddressed by the questionnaire, including depression and skin temperature. The symptoms, daily function, and coping/social impact scales demonstrated satisfactory correlations (Cronbach's alpha 0.76-0.86). Despite a sampling bias of severity, no frank floor/ceiling effects were noted. IMPLICATIONS This study builds a foundation for continuing development and evaluation of the measurement properties of the Patient-Reported Hamilton Inventory for CRPS. It makes explicit the iterative decisions involved in rigorous instrument development.
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76
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Haywood KL, Pearson N, Morrison LJ, Castrén M, Lilja G, Perkins GD. Assessing health-related quality of life (HRQoL) in survivors of out-of-hospital cardiac arrest: A systematic review of patient-reported outcome measures. Resuscitation 2018; 123:22-37. [DOI: 10.1016/j.resuscitation.2017.11.065] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 11/03/2017] [Accepted: 11/26/2017] [Indexed: 12/14/2022]
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77
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Peeters G, Barker AL, Talevski J, Ackerman I, Ayton DR, Reid C, Evans SM, Stoelwinder JU, McNeil JJ. Do patients have a say? A narrative review of the development of patient-reported outcome measures used in elective procedures for coronary revascularisation. Qual Life Res 2018; 27:1369-1380. [PMID: 29380228 DOI: 10.1007/s11136-018-1795-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2018] [Indexed: 10/18/2022]
Abstract
PURPOSE Patient-reported outcome measures (PROMs) capture health information from the patient's perspective that can be used when weighing up benefits, risks and costs of treatment. This is important for elective procedures such as those for coronary revascularisation. Patients should be involved in the development of PROMs to accurately capture outcomes that are important for the patient. The aims of this review are to identify if patients were involved in the development of cardiovascular-specific PROMs used for assessing outcomes from elective coronary revascularisation, and to explore what methods were used to capture patient perspectives. METHODS PROMs for evaluating outcomes from elective coronary revascularisation were identified from a previous review and an updated systematic search. The studies describing the development of the PROMs were reviewed for information on patient input in their conceptual and/or item development. RESULTS 24 PROMs were identified from a previous review and three additional PROMs were identified from the updated search. Full texts were obtained for 26 of the 27 PROMs. The 26 studies (11 multidimensional, 15 unidimensional) were reviewed. Only nine studies reported developing PROMs using patient input. For eight PROMs, the inclusion of patient input could not be judged due to insufficient information in the full text. CONCLUSIONS Only nine of the 26 reviewed PROMs used in elective coronary revascularisation reported involving patients in their conceptual and/or item development, while patient input was unclear for eight PROMs. These findings suggest that the patient's perspective is often overlooked or poorly described in the development of PROMs.
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Affiliation(s)
- Geeske Peeters
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia. .,Global Brain Health Institute, University of California, San Francisco
- Trinity College, Dublin, Trinity College, Lloyd Building, Dublin 2, Ireland.
| | - Anna L Barker
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Jason Talevski
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Ilana Ackerman
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Darshini R Ayton
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Christopher Reid
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.,School of Public Health, Curtin University, Perth, WA, Australia
| | - Sue M Evans
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Johannes U Stoelwinder
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - John J McNeil
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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78
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de Wit M, Kirwan JR, Tugwell P, Beaton D, Boers M, Brooks P, Collins S, Conaghan PG, D'Agostino MA, Hofstetter C, Hughes R, Leong A, Lyddiatt A, March L, May J, Montie P, Richards P, Simon LS, Singh JA, Strand V, Voshaar M, Bingham CO, Gossec L. Successful Stepwise Development of Patient Research Partnership: 14 Years' Experience of Actions and Consequences in Outcome Measures in Rheumatology (OMERACT). PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2017; 10:141-152. [PMID: 27704486 PMCID: PMC5362656 DOI: 10.1007/s40271-016-0198-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
There is increasing interest in making patient participation an integral component of medical research. However, practical guidance on optimizing this engagement in healthcare is scarce. Since 2002, patient involvement has been one of the key features of the Outcome Measures in Rheumatology (OMERACT) international consensus effort. Based on a review of cumulative data from qualitative studies and internal surveys among OMERACT participants, we explored the potential benefits and challenges of involving patient research partners in conferences and working group activities. We supplemented our review with personal experiences and reflections regarding patient participation in the OMERACT process. We found that between 2002 and 2016, 67 patients have attended OMERACT conferences, of whom 28 had sustained involvement; many other patients contributed to OMERACT working groups. Their participation provided face validity to the OMERACT process and expanded the research agenda. Essential facilitators have been the financial commitment to guarantee sustainable involvement of patients at these conferences, procedures for recruitment, selection and support, and dedicated time allocated in the program for patient issues. Current challenges include the representativeness of the patient panel, risk of pseudo-professionalization, and disparity in patients’ and researchers’ perception of involvement. In conclusion, OMERACT has embedded long-term patient involvement in the consensus-building process on the measurement of core health outcomes. This integrative process continues to evolve iteratively. We believe that the practical points raised here can improve participatory research implementation.
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Affiliation(s)
- Maarten de Wit
- OMERACT Patient Research Partner, Amsterdam, The Netherlands. .,Department of Medical Humanities, VU University Medical Centre/EMGO+ instituut, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
| | - John R Kirwan
- Academic Rheumatology Unit, Bristol Royal Infirmary, University of Bristol, Bristol, BS2 8HW, UK
| | - Peter Tugwell
- Department of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Dorcas Beaton
- Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St Michael's Hospital, University of Toronto, Toronto, ON, Canada
| | - Maarten Boers
- Department of Epidemiology and Biostatistics, Amsterdam Rheumatology and Immunology Center, VU University Medical Center, Amsterdam, The Netherlands
| | - Peter Brooks
- Centre for Health Policy School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | | | - Philip G Conaghan
- NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - Maria-Antonietta D'Agostino
- Department of Rheumatology, Hôpital Ambroise Paré, APHP, Université Versailles Saint Quentin en Yvelines, Boulogne-Billancourt, France
| | | | - Rod Hughes
- Ashford St Peter's Foundation trust Hospital, Chertsey, Surrey, UK
| | - Amye Leong
- OMERACT Patient Research Partner, Santa Barbara, CA, USA.,Healthy Motivations, Santa Barbara, CA, 93108, USA.,Bone and Joint Decade, The Global Alliance for Musculoskeletal Health, Truro, Cornwall, UK
| | - Ann Lyddiatt
- OMERACT Patient Research Partner, Vancouver, BC, Canada
| | - Lyn March
- Institute of Bone and Joint Research, Sydney Medical School and School of Public Health, University of Sydney, Sydney, NSW, Australia.,Department of Rheumatology, Royal North Shore, St. Leonards, NSW, Australia
| | - James May
- OMERACT Patient Research Partner, Seattle, WA, USA
| | - Pamela Montie
- OMERACT Patient Research Partner, Vancouver, BC, Canada.,Arthritis Patient Advisory Board, Arthritis Research Centre Canada, Richmond, BC, Canada
| | - Pamela Richards
- Academic Rheumatology Unit, Bristol Royal Infirmary, University of Bristol, Bristol, BS2 8HW, UK.,OMERACT Patient Research Partner, Bristol, UK
| | | | - Jasvinder A Singh
- Medicine Service, VA Medical Center, Birmingham, AL, USA.,Division of Epidemiology at School of Public Health, Department of Medicine at School of Medicine, University of Alabama, Birmingham, AL, 35294-0022, USA.,Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Rochester, MN, 55905, USA
| | - Vibeke Strand
- Division Immunology/Rheumatology, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Marieke Voshaar
- OMERACT Patient Research Partner, Amsterdam, The Netherlands.,Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
| | - Clifton O Bingham
- Division of Rheumatology, Johns Hopkins University, Baltimore, MD, USA
| | - Laure Gossec
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Universités, UPMC Univ Paris 06, GRC-08, Paris, France.,Rheumatology Department, Pitie-Salpétrière Hospital, AP-HP, Paris, France
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79
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van den Driest JJ, Schiphof D, Luijsterburg PAJ, Koffeman AR, Koopmanschap MA, Bindels PJE, Bierma-Zeinstra SMA. Effectiveness and cost-effectiveness of duloxetine added to usual care for patients with chronic pain due to hip or knee osteoarthritis: protocol of a pragmatic open-label cluster randomised trial (the DUO trial). BMJ Open 2017; 7:e018661. [PMID: 28893757 PMCID: PMC5595178 DOI: 10.1136/bmjopen-2017-018661] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Osteoarthritis (OA) is a highly prevalent painful condition of the musculoskeletal system. The effectiveness of current analgesic options has proven to be limited and improved analgesic treatment is needed. Several randomised placebo-controlled trials have now demonstrated the efficacy of duloxetine, an antidepressant with a centrally acting effect, in the treatment of OA pain. The aim of the current study is to investigate if duloxetine is effective and cost-effective as a third-choice analgesic added to usual care for treating chronic pain compared with usual care alone in general practice. METHODS AND ANALYSIS A pragmatic open, cluster randomised trial is conducted. Patients with pain due to hip or knee OA on most days of the past 3 months with insufficient benefit of non-steroidal anti-inflammatory drugs or contraindications or intolerable side effects are included. General practices are randomised to either (1) duloxetine and usual care or (2) usual care only. Primary outcome is pain at 3 months measured on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale. Secondary outcomes at 3 months and 1 year are pain (WOMAC, at 1 year), function (WOMAC), adverse reactions, quality of life and modification of the response to treatment by the presence of centrally sensitised pain (modified PainDETECT). At 1 year, medical and productivity costs will be assessed. Analyses will be performed following the intention-to-treat principle taking the cluster design into account. ETHICS AND DISSEMINATION The study is approved by the local Medical Ethics Committee (2015-293). Results will be published in a scientific peer-reviewed journal and will be communicated at conferences. TRIAL REGISTRATION NUMBER Dutch Trial Registry(ntr4798); Pre-results.
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Affiliation(s)
| | - Dieuwke Schiphof
- Department of General Practice, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Pim A J Luijsterburg
- Department of General Practice, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Aafke R Koffeman
- Department of Public Health and Primary Care, Leids Universitair Medisch Centrum, Leiden, Zuid-Holland, The Netherlands
| | - Marc A Koopmanschap
- Department of Health Policy and Management/iMTA, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Patrick J E Bindels
- Department of General Practice, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Sita M A Bierma-Zeinstra
- Department of General Practice, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Orthopedics, Erasmus University Medical Center, Rotterdam, The Netherlands
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80
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Wiering B, de Boer D, Delnoij D. Patient involvement in the development of patient-reported outcome measures: The developers' perspective. BMC Health Serv Res 2017; 17:635. [PMID: 28886742 PMCID: PMC5591531 DOI: 10.1186/s12913-017-2582-8] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 08/30/2017] [Indexed: 01/02/2023] Open
Abstract
Background Patient-reported outcome measures (PROMs) are increasingly used in health care. To capture the patient’s perspective, patient involvement in PROM development is needed. As earlier research showed varying degrees of patient involvement in PROM development, this study aimed to investigate why PROM developers do or do not involve patients, how patients can be successfully involved and what the negative aspects and benefits of patient involvement are. Methods PROM developers who, according to an earlier scoping review, involved patients in at least two phases of PROM development or did not involve patients at all, were contacted for a telephone interview. The interviews were recorded, transcribed and analysed using a general inductive approach. Results From the PROM developers who involved patients, 21 developers were interviewed and three answered questions via e-mail. Most developers considered patient involvement necessary to create a valid questionnaire and relied on guidelines, personal experience and practical considerations for choosing a qualitative method. Negative aspects of patient involvement were mainly time investment and budget impact. One developer who did not involve patients was interviewed. Two developers sent back answers via e-mail. These developers did not involve patients because of limited resources or because no benefits were expected. Conclusion Although PROM developers agree that patient involvement is necessary, a lack of resources can be a stumbling block. Most developers rely on guidelines, personal experience or practical considerations for choosing a qualitative method. Although this may be a good place to start, to optimize patient involvement developers should explicitly think about which methods would suit their study.
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Affiliation(s)
- Bianca Wiering
- Tranzo (Scientific Centre for Transformation in Care and Welfare), Tilburg University, PO Box 90153, 5000 LE, Tilburg, The Netherlands.
| | - Dolf de Boer
- NIVEL (Netherlands institute for health services research), Utrecht, the Netherlands
| | - Diana Delnoij
- Tranzo (Scientific Centre for Transformation in Care and Welfare), Tilburg University, PO Box 90153, 5000 LE, Tilburg, The Netherlands
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81
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Validity of the IQCODE-CA: An informant questionnaire on cognitive decline modified for a cardiac arrest population. Resuscitation 2017; 118:8-14. [DOI: 10.1016/j.resuscitation.2017.06.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 05/17/2017] [Accepted: 06/14/2017] [Indexed: 12/22/2022]
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82
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Bossaert L, Perkins G, Askitopoulou H, Raffay V, Greif R, Haywood K, Mentzelopoulos S, Nolan J, Van de Voorde P, Xanthos T. Ethik der Reanimation und Entscheidungen am Lebensende. Notf Rett Med 2017. [DOI: 10.1007/s10049-017-0329-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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83
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Grieve S, Perez RSGM, Birklein F, Brunner F, Bruehl S, Harden R N, Packham T, Gobeil F, Haigh R, Holly J, Terkelsen A, Davies L, Lewis J, Thomassen I, Connett R, Worth T, Vatine JJ, McCabe CS. Recommendations for a first Core Outcome Measurement set for complex regional PAin syndrome Clinical sTudies (COMPACT). Pain 2017; 158:1083-1090. [PMID: 28178071 PMCID: PMC5438049 DOI: 10.1097/j.pain.0000000000000866] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Complex regional pain syndrome (CRPS) is a persistent pain condition that remains incompletely understood and challenging to treat. Historically, a wide range of different outcome measures have been used to capture the multidimensional nature of CRPS. This has been a significant limiting factor in the advancement of our understanding of the mechanisms and management of CRPS. In 2013, an international consortium of patients, clinicians, researchers, and industry representatives was established, to develop and agree on a minimum core set of standardised outcome measures for use in future CRPS clinical research, including but not limited to clinical trials within adult populations. The development of a core measurement set was informed through workshops and supplementary work, using an iterative consensus process. "What is the clinical presentation and course of CRPS, and what factors influence it?" was agreed as the most pertinent research question that our standardised set of patient-reported outcome measures should be selected to answer. The domains encompassing the key concepts necessary to answer the research question were agreed as follows: pain, disease severity, participation and physical function, emotional and psychological function, self-efficacy, catastrophizing, and patient's global impression of change. The final core measurement set included the optimum generic or condition-specific patient-reported questionnaire outcome measures, which captured the essence of each domain, and 1 clinician-reported outcome measure to capture the degree of severity of CRPS. The next step is to test the feasibility and acceptability of collecting outcome measure data using the core measurement set in the CRPS population internationally.
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Affiliation(s)
- Sharon Grieve
- Royal United Hospitals NHS Foundation Trust, Bath, UK
- University of the West of England, Bristol, UK
| | | | | | | | - Stephen Bruehl
- Vanderbilt University School of Medicine, Nashville, USA
| | | | | | | | | | - Janet Holly
- The Ottawa Hospital Rehabilitation Centre, Ottawa, Canada
| | | | | | - Jennifer Lewis
- Royal United Hospitals NHS Foundation Trust, Bath, UK
- University of the West of England, Bristol, UK
| | | | | | | | - Jean-Jacques Vatine
- Sackler Faculty of Medicine, Tel Aviv University, Israel
- Reuth Rehabilitation Hospital, Tel Aviv, Israel
| | - Candida S McCabe
- Royal United Hospitals NHS Foundation Trust, Bath, UK
- University of the West of England, Bristol, UK
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84
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Haywood K, Lyddiatt A, Brace-McDonnell SJ, Staniszewska S, Salek S. Establishing the values for patient engagement (PE) in health-related quality of life (HRQoL) research: an international, multiple-stakeholder perspective. Qual Life Res 2017; 26:1393-1404. [PMID: 27933429 PMCID: PMC5420368 DOI: 10.1007/s11136-016-1465-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2016] [Indexed: 01/10/2023]
Abstract
PURPOSE Active patient engagement is increasingly viewed as essential to ensuring that patient-driven perspectives are considered throughout the research process. However, guidance for patient engagement (PE) in HRQoL research does not exist, the evidence-base for practice is limited, and we know relatively little about underpinning values that can impact on PE practice. This is the first study to explore the values that should underpin PE in contemporary HRQoL research to help inform future good practice guidance. METHODS A modified 'World Café' was hosted as a collaborative activity between patient partners, clinicians and researchers: self-nominated conference delegates participated in group discussions to explore values associated with the conduct and consequences of PE. Values were captured via post-it notes and by nominated note-takers. Data were thematically analysed: emergent themes were coded and agreement checked. Association between emergent themes, values and the Public Involvement Impact Assessment Framework were explored. RESULTS Eighty participants, including 12 patient partners, participated in the 90-min event. Three core values were defined: (1) building relationships; (2) improving research quality and impact; and (3) developing best practice. Participants valued the importance of building genuine, collaborative and deliberative relationships-underpinned by honesty, respect, co-learning and equity-and the impact of effective PE on research quality and relevance. CONCLUSIONS An explicit statement of values seeks to align all stakeholders on the purpose, practice and credibility of PE activities. An innovative, flexible and transparent research environment was valued as essential to developing a trustworthy evidence-base with which to underpin future guidance for good PE practice.
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Affiliation(s)
- Kirstie Haywood
- Royal College of Nursing Research Institute, Department of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | | | - Samantha J. Brace-McDonnell
- Warwick Clinical Trials Unit, University of Warwick, Coventry, UK
- Independent Cancer Patient Voice (Reg Charity no. 1138456), London, UK
| | - Sophie Staniszewska
- Royal College of Nursing Research Institute, Department of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Sam Salek
- The School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
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85
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Alreni ASE, Harrop D, Lowe A, Tanzila Potia, Kilner K, McLean SM. Measures of upper limb function for people with neck pain. A systematic review of measurement and practical properties. Musculoskelet Sci Pract 2017; 29:155-163. [PMID: 28262528 DOI: 10.1016/j.msksp.2017.02.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 01/12/2017] [Accepted: 02/17/2017] [Indexed: 12/21/2022]
Abstract
There is a strong relationship between neck pain (NP) and upper limb disability (ULD). Optimal management of NP should incorporate upper limb rehabilitation and therefore include the use of an ULD measure in the assessment and management process. Clear guidance regarding the suitability of available measures does not exist. The aim of this study was to identify all available measures of ULD for populations with NP, critically evaluate their measurement properties and finally recommend a list of suitable measures. This two-phase systematic review is reported in accordance with the PRISMA statement. Phase one identified clearly reproducible measures of ULD for patients with NP. Phase two identified evidence of their measurement properties. In total, 11 papers evaluating the measurement properties of five instruments were included in this review. The instruments identified were the DASH questionnaire, the QuickDASH questionnaire, the NULI questionnaire, the SFA and the SAMP test. There was limited positive evidence of validity of the DASH, QuickDASH, NULI, SFA and SAMP. There was limited positive evidence of reliability of the NULI, SFA and SAMP. There was unknown evidence of responsiveness of the DASH and QuickDASH. Although all measures are supported by a limited amount of low quality evidence, the DASH, QuickDASH, NULI questionnaires, and the SAMP test are promising measures, but they require further robust evaluation.
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Affiliation(s)
- Ahmad Salah Eldin Alreni
- Sheffield Hallam University, Montgomery House, 32 Collegiate Crescent, Collegiate Campus, Sheffield, S10 2BP, UK.
| | - Deborah Harrop
- Sheffield Hallam University, Montgomery House, 32 Collegiate Crescent, Collegiate Campus, Sheffield, S10 2BP, UK.
| | - Anna Lowe
- Sheffield Hallam University, Montgomery House, 32 Collegiate Crescent, Collegiate Campus, Sheffield, S10 2BP, UK.
| | - Tanzila Potia
- Sheffield Hallam University, Montgomery House, 32 Collegiate Crescent, Collegiate Campus, Sheffield, S10 2BP, UK.
| | - Karen Kilner
- Sheffield Hallam University, Montgomery House, 32 Collegiate Crescent, Collegiate Campus, Sheffield, S10 2BP, UK.
| | - Sionnadh Mairi McLean
- Sheffield Hallam University, Mercury House, 36 Collegiate Crescent, Collegiate Campus, Sheffield, S10 2BP, UK.
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Abstract
In the service economy, scholars and practitioners are even more focused on the development and appliance of innovative services. The importance of service innovation is rising in many sectors and among different organizations. Several disciplines (e.g., marketing, management, operations research, etc.) deal with this innovation, a concept widely used, but with different definitions. In this paper, service innovation has been analyzed according to the Service Dominant Logic (S-D Logic) and a service ecosystem perspective. The literature still calls for a greater understanding of how a new or renewed combination of resources affects the shaping of service ecosystems. To contribute to filling this gap, this study explores the practices that different actors, enact to co-create value in novel ways; i.e., service innovation. The paper is structured as follows. In the first section, the main academic contributions on service research have been reviewed, focusing on healthcare service innovation. This is followed by the research method and discussion of the research findings. Finally, the theoretical and managerial implications have been detailed and an agenda for future research suggested. The paper offers interesting insights to develop new or renewed practices that foster the reshaping and maintaining of a healthcare service ecosystem. Some recommendations are included to support managers in the development of service innovation strategies.
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87
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Bartlett SJ, Witter J, Cella D, Ahmed S. Montreal Accord on Patient-Reported Outcomes (PROs) use series - Paper 6: creating national initiatives to support development and use-the PROMIS example. J Clin Epidemiol 2017; 89:148-153. [PMID: 28433674 DOI: 10.1016/j.jclinepi.2017.04.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 03/16/2017] [Accepted: 04/09/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Patient-reported outcome (PRO) data are beneficial to a range of stakeholders including patients, clinicians, researchers, national funding and regulatory agencies, health system administrators, and policymakers. OBJECTIVE Because stakeholders represent diverse groups and needs, it is challenging to reach consensus on how to advance PRO development and harmonize data across settings to enable use for multiple secondary purposes. Collaborative national networks can facilitate the sharing of expertise, resources, and necessary infrastructure; create development, use, and reporting standards; optimize formats to efficiently store and transfer data; and disseminate tools and information for widespread uptake. DISCUSSION In the United States, the National Institutes of Health's Patient-Reported Outcomes Measurement Information System offers an example of how collaborators can work across distances to form essential partnerships, create a common vision, and leverage technology to accelerate the development and testing of universal PROs that are broadly applicable across health conditions and settings.
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Affiliation(s)
- Susan J Bartlett
- Department of Medicine, McGill University/McGill University Health Center, 687 Pine Avenue W R4.29, Montreal, QC, Canada H3A 1A1; Division of Rheumatology, Johns Hopkins School of Medicine, 5200 Eastern Avenue #4100, Baltimore, MD 21224, USA.
| | - James Witter
- Division of Skin and Rheumatic Diseases, NIAMS, One Democracy Plaza, 6701 Democracy Boulevard, Suite 800, Bethesda, MD 20892-4872, USA
| | - David Cella
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 N. Street Clair Suite 1900, Chicago, IL 60611, USA
| | - Sara Ahmed
- Department of Medicine, McGill University/McGill University Health Center, 687 Pine Avenue W R4.29, Montreal, QC, Canada H3A 1A1; School of Physical and Occupational Therapy, McGill University, 3654 Prom Sir-William-Osler, Montreal, QC, Canada H3G 1Y5; Centre de recherche interdisciplinaire en réadaptation (CRIR), 2275 Laurier Ave E, Montreal, Quebec, Canada H2H 2N8
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88
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Holm KE, Casaburi R, Cerreta S, Gussin HA, Husbands J, Porszasz J, Prieto-Centurion V, Sandhaus RA, Sullivan JL, Walsh LJ, Krishnan JA. Patient Involvement in the Design of a Patient-Centered Clinical Trial to Promote Adherence to Supplemental Oxygen Therapy in COPD. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2017; 9:271-9. [PMID: 26521057 DOI: 10.1007/s40271-015-0150-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Patients are increasingly viewed as key stakeholders who can contribute in meaningful ways to clinical research and are emphasized in research funded by the Patient-Centered Outcomes Research Institute (PCORI). We are not aware of other peer-reviewed publications that report methods and outcomes of patient engagement to refine study design for a PCORI-sponsored clinical effectiveness trial. OBJECTIVE The aim of this report was to describe the process and outcomes of involving patients in the design of a clinical trial to promote adherence to supplemental oxygen therapy among patients with chronic obstructive pulmonary disease. METHODS In-person focus groups and individual discussions via telephone and email were used to elicit feedback to refine the intervention and clarify outcomes of highest importance to patients. RESULTS A total of 25 patients and five caregivers provided feedback. Their feedback has informed decisions regarding the length of intervention sessions (20 min and in some cases longer was acceptable), the importance of including caregivers, and discussion topics (e.g., social discomfort about using oxygen in public, identifying personally relevant reasons to use oxygen, pulmonary rehabilitation). Multiple outcomes were rated as highly important to patients (physical function, fatigue, sleep, anxiety, depression, and ability to participate in social roles and activities), and the outcome that was ranked as most important varied by individual. Therefore, multiple patient-reported outcomes will be used as endpoints for the clinical trial. CONCLUSIONS Patient involvement led to refinements of the intervention and clinical trial endpoints to better address the expressed needs and concerns of patients and caregivers.
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Affiliation(s)
- Kristen E Holm
- Department of Medicine, National Jewish Health, Denver, CO, USA. .,Department of Community and Behavioral Health, Colorado School of Public Health, Aurora, CO, USA.
| | - Richard Casaburi
- Rehabilitation Clinical Trials Center, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | | | - Hélène A Gussin
- Population Health Sciences Program, University of Illinois Hospital and Health Sciences System, Chicago, IL, USA
| | | | - Janos Porszasz
- Rehabilitation Clinical Trials Center, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | | | - Robert A Sandhaus
- Department of Medicine, National Jewish Health, Denver, CO, USA.,AlphaNet, Miami, FL, USA.,Alpha-1 Foundation, Miami, FL, USA
| | | | | | - Jerry A Krishnan
- Population Health Sciences Program, University of Illinois Hospital and Health Sciences System, Chicago, IL, USA.,Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA
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Engler K, Lessard D, Toupin I, Lènàrt A, Lebouché B. Engaging stakeholders into an electronic patient-reported outcome development study: On making an HIV-specific e-PRO patient-centered. HEALTH POLICY AND TECHNOLOGY 2017. [DOI: 10.1016/j.hlpt.2016.11.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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90
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McLean S, Holden MA, Potia T, Gee M, Mallett R, Bhanbhro S, Parsons H, Haywood K. Quality and acceptability of measures of exercise adherence in musculoskeletal settings: a systematic review. Rheumatology (Oxford) 2017; 56:426-438. [PMID: 28013200 PMCID: PMC5410983 DOI: 10.1093/rheumatology/kew422] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 10/18/2016] [Indexed: 01/16/2023] Open
Abstract
Objective To recommend robust and relevant measures of exercise adherence for application in the musculoskeletal field. Method A systematic review of measures was conducted in two phases. Phase 1 sought to identify all reproducible measures used to assess exercise adherence in a musculoskeletal setting. Phase 2 identified published evidence of measurement and practical properties of identified measures. Eight databases were searched (from inception to February 2016). Study quality was assessed against the Consensus-based Standards for the Selection of Health Measurement Instruments guidelines. Measurement quality was assessed against accepted standards. Results Phase 1: from 8511 records, 326 full-text articles were reviewed; 45 reproducible measures were identified. Phase 2: from 2977 records, 110 full-text articles were assessed for eligibility; 10 articles provided evidence of measurement/practical properties for just seven measures. Six were exercise adherence-specific measures; one was specific to physical activity but applied as a measure of exercise adherence. Evidence of essential measurement and practical properties was mostly limited or not available. Assessment of relevance and comprehensiveness was largely absent and there was no evidence of patient involvement during the development or evaluation of any measure. Conclusion The significant methodological and quality issues encountered prevent the clear recommendation of any measure; future applications should be undertaken cautiously until greater clarity of the conceptual underpinning of each measure is provided and acceptable evidence of essential measurement properties is established. Future research should seek to engage collaboratively with relevant stakeholders to ensure that exercise adherence assessment is high quality, relevant and acceptable.
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Affiliation(s)
- Sionnadh McLean
- Faculty of Health and Wellbeing, Collegiate Campus, Sheffield Hallam University, Sheffield
| | | | - Tanzila Potia
- Faculty of Health and Wellbeing, Collegiate Campus, Sheffield Hallam University, Sheffield
| | - Melanie Gee
- Centre for Health and Social Care Research, Collegiate Campus, Sheffield Hallam University, Sheffield
| | - Ross Mallett
- Faculty of Health and Wellbeing, Collegiate Campus, Sheffield Hallam University, Sheffield
| | - Sadiq Bhanbhro
- Centre for Health and Social Care Research, Collegiate Campus, Sheffield Hallam University, Sheffield
| | | | - Kirstie Haywood
- Royal College of Nursing Research Institute, Warwick Medical School, Warwick University, Coventry, UK
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91
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Kirwan JR, de Wit M, Frank L, Haywood KL, Salek S, Brace-McDonnell S, Lyddiatt A, Barbic SP, Alonso J, Guillemin F, Bartlett SJ. Emerging Guidelines for Patient Engagement in Research. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2017; 20:481-486. [PMID: 28292494 DOI: 10.1016/j.jval.2016.10.003] [Citation(s) in RCA: 133] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 09/06/2016] [Accepted: 10/03/2016] [Indexed: 05/16/2023]
Abstract
There is growing recognition that involving patients in the development of new patient-reported outcome measures helps ensure that the outcomes that matter most to people living with health conditions are captured. Here, we describe and discuss different experiences of integrating patients as full patient research partners (PRPs) in outcomes research from multiple perspectives (e.g., researcher, patient, and funder), drawing from three real-world examples. These diverse experiences highlight the strengths, challenges, and impact of partnering with patients to conceptualize, design, and conduct research and disseminate findings. On the basis of our experiences, we suggest basic guidelines for outcomes researchers on establishing research partnerships with patients, including: 1) establishing supportive organizational/institutional policies; 2) cultivating supportive attitudes of researchers and PRPs with recognition that partnerships evolve over time, are grounded in strong communication, and have shared goals; 3) adhering to principles of respect, trust, reciprocity, and co-learning; 4) addressing training needs of all team members to ensure communications and that PRPs are conversant in and familiar with the language and process of research; 5) identifying the resources and advanced planning required for successful patient engagement; and 6) recognizing the value of partnerships across all stages of research. The three experiences presented explore different approaches to partnering; demonstrate how this can fundamentally change the way research work is conceptualized, conducted, and disseminated; and can serve as exemplars for other forms of patient-centered outcomes research. Further work is needed to identify the skills, qualities, and approaches that best support effective patient-researcher partnerships.
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Affiliation(s)
- John R Kirwan
- University of Bristol Academic Rheumatology Unit, Bristol Royal Infirmary, Bristol, UK
| | - Maarten de Wit
- Department of Medical Humanities, VU University, Amsterdam, The Netherlands
| | - Lori Frank
- Patient-Centered Outcomes Research Institute, Washington DC USA
| | - Kirstie L Haywood
- Royal College of Nursing Research Institute, Warwick Medical School, Warwick University, Coventry, UK
| | - Sam Salek
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | | | | | - Skye P Barbic
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada
| | - Jordi Alonso
- IMIM-Institut Hospital del Mar d'Investicacions Médiques, CIBER en Epdiemiología y Salud Pública (CIBERESP). Barcelona, Spain
| | - Francis Guillemin
- Faculté de Médecine, Université de Lorraine, Vandoeuvre-les-Nancy, France
| | - Susan J Bartlett
- Divisions of Clinical Epidemiology, Rheumatology and Respirology. McGill University, Montreal, QC.
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92
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Carroll SL, Embuldeniya G, Abelson J, McGillion M, Berkesse A, Healey JS. Questioning patient engagement: research scientists' perceptions of the challenges of patient engagement in a cardiovascular research network. Patient Prefer Adherence 2017; 11:1573-1583. [PMID: 28979105 PMCID: PMC5602467 DOI: 10.2147/ppa.s135457] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Patient engagement in research is a dominant discourse in clinical research settings as it is seen as a move toward sustainable and equitable health care systems. In Canada, a key driver is the Strategy for Patient-Oriented Research of the Canadian Institutes of Health Research, which asserts that meaningful patient engagement can only be fostered when stakeholders understand its value. This study assessed researchers' perceptions of the meaning and value of patient engagement in research within a Canadian cardiovascular research network. In doing so, the secondary aim was to inform the development of a structured patient engagement initiative by identifying potential challenges and related mitigation strategies. METHODS We employed a multi-method strategy involving electronic surveys and semi-structured telephone interviews with network research scientists across Canada. Interview data were analyzed using thematic and content analysis. Survey data were analyzed using descriptive statistics. RESULTS Thirty-eight electronic surveys (response rate =33%) and 16 interviews were completed with network members. Some participants were uncertain about the meaning and value of patient engagement. While voicing guarded support, four challenges relating to patient engagement were identified from the interviews: 1) identification of representative and appropriate patients, 2) uncertainty about the scope of patients' roles given concerns about knowledge discrepancies, 3) a perceived lack of evidence of the impact of patient engagement, and 4) the need for education and culture change as a prerequisite for patient engagement. Research scientists were largely concerned that patients untrained in science and tasked with conveying an authentic patient experience and being a conduit for the voices of others might unsettle a traditional model of conducting research. CONCLUSION Concerns about patient involvement in research were related to a lack of clarity about the meaning, process, and impact of involvement. This study highlights the need for education on the meaning of patient engagement, evidence of its impact, and guidance on practical aspects of implementation within this research community.
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Affiliation(s)
- Sandra L Carroll
- Faculty of Health Sciences, School of Nursing, McMaster University, Hamilton, ON
- Correspondence: Sandra L Carroll, Faculty of Health Sciences, School of Nursing, McMaster University, 1280 Main Street West–HSC 2J24K, Hamilton, ON L8S 4K1, Canada, Tel +1 905 525 9140 ext 21752, Email
| | - Gayathri Embuldeniya
- Faculty of Health Sciences, School of Nursing, McMaster University, Hamilton, ON
| | - Julia Abelson
- Faculty of Health Sciences, Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON
| | - Michael McGillion
- Faculty of Health Sciences, School of Nursing, McMaster University, Hamilton, ON
| | | | - Jeff S Healey
- Faculty of Health Sciences, Department of Medicine, McMaster University, Hamilton, ON, Canada
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Greenhalgh J, Dalkin S, Gooding K, Gibbons E, Wright J, Meads D, Black N, Valderas JM, Pawson R. Functionality and feedback: a realist synthesis of the collation, interpretation and utilisation of patient-reported outcome measures data to improve patient care. HEALTH SERVICES AND DELIVERY RESEARCH 2017. [DOI: 10.3310/hsdr05020] [Citation(s) in RCA: 109] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BackgroundThe feedback of patient-reported outcome measures (PROMs) data is intended to support the care of individual patients and to act as a quality improvement (QI) strategy.ObjectivesTo (1) identify the ideas and assumptions underlying how individual and aggregated PROMs data are intended to improve patient care, and (2) review the evidence to examine the circumstances in which and processes through which PROMs feedback improves patient care.DesignTwo separate but related realist syntheses: (1) feedback of aggregate PROMs and performance data to improve patient care, and (2) feedback of individual PROMs data to improve patient care.InterventionsAggregate – feedback and public reporting of PROMs, patient experience data and performance data to hospital providers and primary care organisations. Individual – feedback of PROMs in oncology, palliative care and the care of people with mental health problems in primary and secondary care settings.Main outcome measuresAggregate – providers’ responses, attitudes and experiences of using PROMs and performance data to improve patient care. Individual – providers’ and patients’ experiences of using PROMs data to raise issues with clinicians, change clinicians’ communication practices, change patient management and improve patient well-being.Data sourcesSearches of electronic databases and forwards and backwards citation tracking.Review methodsRealist synthesis to identify, test and refine programme theories about when, how and why PROMs feedback leads to improvements in patient care.ResultsProviders were more likely to take steps to improve patient care in response to the feedback and public reporting of aggregate PROMs and performance data if they perceived that these data were credible, were aimed at improving patient care, and were timely and provided a clear indication of the source of the problem. However, implementing substantial and sustainable improvement to patient care required system-wide approaches. In the care of individual patients, PROMs function more as a tool to support patients in raising issues with clinicians than they do in substantially changing clinicians’ communication practices with patients. Patients valued both standardised and individualised PROMs as a tool to raise issues, but thought is required as to which patients may benefit and which may not. In settings such as palliative care and psychotherapy, clinicians viewed individualised PROMs as useful to build rapport and support the therapeutic process. PROMs feedback did not substantially shift clinicians’ communication practices or focus discussion on psychosocial issues; this required a shift in clinicians’ perceptions of their remit.Strengths and limitationsThere was a paucity of research examining the feedback of aggregate PROMs data to providers, and we drew on evidence from interventions with similar programme theories (other forms of performance data) to test our theories.ConclusionsPROMs data act as ‘tin openers’ rather than ‘dials’. Providers need more support and guidance on how to collect their own internal data, how to rule out alternative explanations for their outlier status and how to explore the possible causes of their outlier status. There is also tension between PROMs as a QI strategy versus their use in the care of individual patients; PROMs that clinicians find useful in assessing patients, such as individualised measures, are not useful as indicators of service quality.Future workFuture research should (1) explore how differently performing providers have responded to aggregate PROMs feedback, and how organisations have collected PROMs data both for individual patient care and to improve service quality; and (2) explore whether or not and how incorporating PROMs into patients’ electronic records allows multiple different clinicians to receive PROMs feedback, discuss it with patients and act on the data to improve patient care.Study registrationThis study is registered as PROSPERO CRD42013005938.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
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Affiliation(s)
- Joanne Greenhalgh
- School of Sociology and Social Policy, University of Leeds, Leeds, UK
| | - Sonia Dalkin
- Department of Public Health, Northumbria University, Newcastle upon Tyne, UK
| | - Kate Gooding
- School of Sociology and Social Policy, University of Leeds, Leeds, UK
| | - Elizabeth Gibbons
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Judy Wright
- School of Sociology and Social Policy, University of Leeds, Leeds, UK
| | - David Meads
- School of Sociology and Social Policy, University of Leeds, Leeds, UK
| | - Nick Black
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Ray Pawson
- School of Sociology and Social Policy, University of Leeds, Leeds, UK
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Gerardi C, Roberto A, Colombo C, Banzi R. Patient-reported outcomes: nothing without engagement. Acta Oncol 2016; 55:1494-1495. [PMID: 27553172 DOI: 10.1080/0284186x.2016.1210227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Chiara Gerardi
- Laboratory of Drug Regulatory Policies, IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - Anna Roberto
- Laboratory of Medical Research and Consumer Involvement, IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - Cinzia Colombo
- Laboratory of Medical Research and Consumer Involvement, IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - Rita Banzi
- Laboratory of Drug Regulatory Policies, IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
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Coulman KD, Howes N, Hopkins J, Whale K, Chalmers K, Brookes S, Nicholson A, Savovic J, Ferguson Y, Owen-Smith A, Blazeby J, Blazeby J, Welbourn R, Byrne J, Donovan J, Reeves BC, Wordsworth S, Andrews R, Thompson JL, Mazza G, Rogers CA. A Comparison of Health Professionals' and Patients' Views of the Importance of Outcomes of Bariatric Surgery. Obes Surg 2016; 26:2738-2746. [PMID: 27138600 PMCID: PMC5069338 DOI: 10.1007/s11695-016-2186-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND A comprehensive evaluation of bariatric surgery is required to inform decision-making. This will include measures of benefit and risk. It is possible that stakeholders involved with surgery value these outcomes differently, although this has not previously been explored. This study aimed to investigate and compare how professionals and patients prioritise outcomes of bariatric surgery. METHODS Systematic reviews and qualitative interviews created an exhaustive list of outcomes. This informed the development of a 130-item questionnaire, structured in four sections (complications of surgery; clinical effectiveness; signs, symptoms, and other measures; quality of life). Health professionals and patients rated the importance of each item on a 1-9 scale. Items rated 8-9 by at least 70 % of the participants were considered prioritised. Items prioritised in each section were compared between professionals and patients and interrater agreement assessed using kappa statistics (ĸ). RESULTS One hundred sixty-eight out of four hundred fifty-nine professionals (36.6 %) and 90/465 patients (19.4 %) completed the questionnaire. Professionals and patients prioritised 18 and 25 items, respectively, with 10 overlapping items and 23 discordant items (ĸ 0.363). Examples of items prioritised by both included 'diabetes' and 'leakage from bowel joins'. Examples of discordant items included 're-admission rates' (professionals only) and 'excess skin' (patients only). Poor agreement was seen in the 'quality of life' section (0 overlapping items, 8 discordant, ĸ -0.036). CONCLUSIONS Although there was some overlap of outcomes prioritised by professionals and patients, there were important differences. We recommend that the views of all relevant health professionals and patients are considered when deciding on outcomes to evaluate bariatric surgery.
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Affiliation(s)
- Karen D Coulman
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
| | - Noah Howes
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
- Department of Upper GI and Bariatric Surgery, Taunton and Somerset NHS Foundation Trust, Taunton, Somerset, TA1 5DA, UK
| | - James Hopkins
- Department of Upper GI and Bariatric Surgery, Taunton and Somerset NHS Foundation Trust, Taunton, Somerset, TA1 5DA, UK
| | - Katie Whale
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Katy Chalmers
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Sara Brookes
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Alex Nicholson
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Jelena Savovic
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
- The National Institute For Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West), University Hospitals Bristol NHS Foundation Trust, Whitefriars, Lewins Mead, Bristol, BS1 2NT, UK
| | - Yasmin Ferguson
- Department of Upper GI and Bariatric Surgery, Taunton and Somerset NHS Foundation Trust, Taunton, Somerset, TA1 5DA, UK
| | - Amanda Owen-Smith
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Jane Blazeby
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
- Division of Surgery, Head & Neck, University Hospitals Bristol NHS Foundation Trust, Upper Maudlin Street, Bristol, BS2 8HW, UK
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Haywood KL, Brett J, Tutton E, Staniszewska S. Patient-reported outcome measures in older people with hip fracture: a systematic review of quality and acceptability. Qual Life Res 2016; 26:799-812. [DOI: 10.1007/s11136-016-1424-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2016] [Indexed: 01/24/2023]
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97
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Patient-Centered Care and Patient-Reported Measures: Let's Look Before We Leap. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2016; 8:293-9. [PMID: 25354873 PMCID: PMC4529474 DOI: 10.1007/s40271-014-0095-7] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/30/2022]
Abstract
This commentary focuses on patient-reported measures as tools to support patient-centered care for patients with multiple chronic conditions (MCCs). We argue that those using patient-reported measures in care management or evaluation of services for MCC patients should do so in recognition of the challenges involved in treating them. MCC patient care is challenging because (1) it is difficult to specify the causes of particular symptoms; (2) assessment of many important symptoms relies on subjective report; and (3) patients require care from a variety of providers. Due to the multiple domains of health affected in single individuals, and the large variation in needs, care that is holistic and individualized (i.e. patient-centered) is appropriate for MCC patients. However, due to the afore-mentioned challenges, it is important to carefully consider what this care entails and how practical contexts shape it. Patient-centered care for MCC patients implies continuous, dialogic patient-provider relationships, and the formulation of coherent and adaptive multi-disciplinary care protocols. We identify two broadly defined contextual influences on the nature and quality of these processes and their outputs: (1) busy practice settings and (2) fragmented information technology. We then identify several consequences that may result from inattention to these contextual influences upon introduction of patient-reported measure applications. To maximize the benefits, and minimize the harms of patient-reported measure use, we encourage policy makers and providers to attend carefully to these and other important contextual factors before, during and after the introduction of patient-reported measure initiatives.
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de Wit M, Bloemkolk D, Teunissen T, van Rensen A. Voorwaarden voor succesvolle betrokkenheid van patiënten/cliënten bij medisch wetenschappelijk onderzoek. ACTA ACUST UNITED AC 2016. [DOI: 10.1007/s12508-016-0039-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Drahota A, Meza RD, Brikho B, Naaf M, Estabillo JA, Gomez ED, Vejnoska SF, Dufek S, Stahmer AC, Aarons GA. Community-Academic Partnerships: A Systematic Review of the State of the Literature and Recommendations for Future Research. Milbank Q 2016; 94:163-214. [PMID: 26994713 PMCID: PMC4941973 DOI: 10.1111/1468-0009.12184] [Citation(s) in RCA: 194] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
POLICY POINTS Communities, funding agencies, and institutions are increasingly involving community stakeholders as partners in research, to provide firsthand knowledge and insight. Based on our systematic review of major literature databases, we recommend using a single term, community-academic partnership (CAP), and a conceptual definition to unite multiple research disciplines and strengthen the field. Interpersonal and operational factors that facilitate or hinder the collaborative process have been consistently identified, including "trust among partners" and "respect among partners" (facilitating interpersonal factors) and "excessive time commitment" (hindering operational factor). Once CAP processes and characteristics are better understood, the effectiveness of collaborative partner involvement can be tested. CONTEXT Communities, funding agencies, and institutions are increasingly involving community stakeholders as partners in research. Community stakeholders can provide firsthand knowledge and insight, thereby increasing research relevance and feasibility. Despite the greater emphasis and use of community-academic partnerships (CAP) across multiple disciplines, definitions of partnerships and methodologies vary greatly, and no systematic reviews consolidating this literature have been published. The purpose of this article, then, is to facilitate the continued growth of this field by examining the characteristics of CAPs and the current state of the science, identifying the facilitating and hindering influences on the collaborative process, and developing a common term and conceptual definition for use across disciplines. METHODS Our systematic search of 6 major literature databases generated 1,332 unique articles, 50 of which met our criteria for inclusion and provided data on 54 unique CAPs. We then analyzed studies to describe CAP characteristics and to identify the terms and methods used, as well as the common influences on the CAP process and distal outcomes. FINDINGS CAP research spans disciplines, involves a variety of community stakeholders, and focuses on a large range of study topics. CAP research articles, however, rarely report characteristics such as membership numbers or duration. Most studies involved case studies using qualitative methods to collect data on the collaborative process. Although various terms were used to describe collaborative partnerships, few studies provided conceptual definitions. Twenty-three facilitating and hindering factors influencing the CAP collaboration process emerged from the literature. Outcomes from the CAPs most often included developing or refining tangible products. CONCLUSIONS Based on our systematic review, we recommend using a single term, community-academic partnership, as well as a conceptual definition to unite multiple research disciplines. In addition, CAP characteristics and methods should be reported more systematically to advance the field (eg, to develop CAP evaluation tools). We have identified the most common influences that facilitate and hinder CAPs, which in turn should guide their development and sustainment.
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Affiliation(s)
- Amy Drahota
- San Diego State University
- Child and Adolescent Services Research Center
| | - Rosemary D Meza
- Child and Adolescent Services Research Center
- University of Washington, Seattle
| | - Brigitte Brikho
- San Diego State University
- Child and Adolescent Services Research Center
| | | | | | - Emily D Gomez
- San Diego State University
- Child and Adolescent Services Research Center
| | - Sarah F Vejnoska
- Child and Adolescent Services Research Center
- University of California, San Diego
| | | | - Aubyn C Stahmer
- Child and Adolescent Services Research Center
- University of California, Davis, MIND Institute
| | - Gregory A Aarons
- Child and Adolescent Services Research Center
- University of California, San Diego
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Wiering B, de Boer D, Delnoij D. Patient involvement in the development of patient-reported outcome measures: a scoping review. Health Expect 2016; 20:11-23. [PMID: 26889874 PMCID: PMC5217930 DOI: 10.1111/hex.12442] [Citation(s) in RCA: 175] [Impact Index Per Article: 21.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2015] [Indexed: 02/06/2023] Open
Abstract
Background Patient‐reported outcome measures (PROMs) measure patients’ perspectives on health outcomes and are increasingly used in health care. To capture the patient's perspective, it is essential that patients are involved in PROM development Objective This article reviews in what ways and to what extent patients are involved in PROM development and whether patient involvement has increased over time. Search strategy Literature was searched in PubMed, EMBASE, MEDLINE and the Cochrane Methodology Register. Inclusion criteria Studies were included if they described a new PROM development. Data extraction Basic information and information regarding patient involvement in development phases was recorded. Main results A total of 189 studies, describing the development of 193 PROMs, were included. Most PROMs were meant for chronic disease patients (n = 59) and measured quality of life (n = 28). In 25.9% of the PROM development studies, no patients were involved. Patients were mostly involved during item development (58.5%), closely followed by testing for comprehensibility (50.8%), while patient involvement in determining which outcome to measure was minimal (10.9%). Some patient involvement took place in the development of most PROMs, but in only 6.7% patients were involved in all aspects of the development. Patient involvement did not increase with time. Conclusions Although patient involvement in PROM development is essential to develop valid patient‐centred PROMs, patients are not always involved. When patients are involved, their level of involvement varies considerably. These variations suggest that further attention to building and/or disseminating consensus on requirements for patient involvement in PROM development is necessary.
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Affiliation(s)
- Bianca Wiering
- Tranzo (Scientific Centre for Transformation in Care and Welfare), Tilburg University, Tilburg, The Netherlands
| | - Dolf de Boer
- NIVEL (Netherlands Institute for Health Services Research), Utrecht, The Netherlands
| | - Diana Delnoij
- Tranzo (Scientific Centre for Transformation in Care and Welfare), Tilburg University, Tilburg, The Netherlands
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