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Wu EY, Li SC, Torok KS, Virkud YV, Fuhlbrigge RC, Rabinovich CE. Baseline Description of the Juvenile Localized Scleroderma Subgroup From the Childhood Arthritis and Rheumatology Research Alliance Legacy Registry. ACR Open Rheumatol 2019; 1:119-124. [PMID: 31777788 PMCID: PMC6858014 DOI: 10.1002/acr2.1019] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objective Localized scleroderma (LS) is a chronic inflammatory and fibrosing skin disorder. We present baseline data on the juvenile LS (jLS) cohort from the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Legacy Registry, a multicenter observational registry of pediatric rheumatologic disorders. Methods This is a cross-sectional analysis of children with jLS enrolled in the CARRA Legacy Registry between May 2010 and April 2014. Descriptive statistics were used for demographic, clinical, and laboratory features. Data analysis included two-sample t test, χ2 test, Fisher's exact test, linear/logistic regression, and analysis of variance. Results Of 381 children with jLS, 76% were female and 80% Caucasian. Mean onset age was 8.2 years, with 17% having a 2-year or greater delay to first pediatric rheumatology (PRH) visit. Linear scleroderma was the most common subtype (54%). Antinuclear antibody (ANA) positivity was associated with joint contracture (P = 0.04), muscle atrophy (P = 0.014), and extremity shortening (P = 0.007). Elevated aldolase was associated with joint contracture (P = 0.008) and elevated creatine kinase (CK) with muscle atrophy (P = 0.028) and extremity shortening (P = 0.016). Children with functional limitation (27%) had earlier first PRH visit compared with those without (P = 0.01). Poorer function correlated with muscle atrophy, joint contracture, and extremity shortening (P < 0.001). Methotrexate (97%) and corticosteroids (68%) were the most common medications used. Conclusion Children with jLS without joint limitation are referred later, highlighting the insidious onset and need for educating referring providers. Poorer function correlated with muscle atrophy, joint contracture, and limb shortening. ANA positivity and elevated CK or aldolase were associated with muscle atrophy, joint contracture, and/or limb shortening, suggesting predictors of muscle involvement.
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Affiliation(s)
| | - Suzanne C Li
- Hackensack University Medical Center Hackensack New Jersey
| | - Kathryn S Torok
- Children's Hospital of Pittsburgh of UPMC Pittsburgh Pennsylvania
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102
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Marcus M, Maida CA, Wang Y, Xiong D, Hays RD, Coulter ID, Lee SY, Spolsky VW, Shen J, Crall JJ, Liu H. Child and Parent Demographic Characteristics and Oral Health Perceptions Associated with Clinically Measured Oral Health. JDR Clin Trans Res 2019; 3:302-313. [PMID: 30938594 DOI: 10.1177/2380084418774549] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To examine child and parent reports about the child's oral health and assess the associations of these reports with clinical assessments of oral health status by dental examiners. METHODS Surveys with 139 items for children and 133 items for parents were administered by Audio Computer-Assisted Self-Interview Software. In addition, the Children's Oral Health Status Index (COHSI) was computed from a dental examination. RESULTS A total of 334 families with children ages 8 to 17 y participated at 12 dental practices in Los Angeles County. Ordinary least squares regression models were estimated separately for child and parent surveys to identify items uniquely associated with the COHSI. Ten of 139 items the children reported regarding their oral health were associated with the COHSI. The strongest associations were found for child's age, aesthetic factors (straight teeth and pleased with teeth), and cognitive factors related to perception of dental appearance (pleased/happy with the look of the child's mouth, teeth, and jaws). Nine of 133 parent items about the child's oral health were associated with the COHSI in the parent model, notably being a single parent, parent's gender, parent born in the United States, pleased or happy with the look of their child's teeth, and accessing the Internet. CONCLUSION These child and parent survey items have potential to be used to assess oral health status for groups of children in programs and practices in lieu of dental screenings. KNOWLEDGE TRANSLATION STATEMENT The paper's results inform the development of a toolkit that can be used by schools, public health agencies, and dental programs to identify children with low oral health status based on parents' and children's responses to survey items across demographic, physical, mental, and social domains. These survey items can be used to inform parents of the desirability of proactively addressing inadequacies in their child's oral health status, enabling them to more rationally address dental needs.
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Affiliation(s)
- M Marcus
- 1 Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA
| | - C A Maida
- 1 Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA.,2 Division of Oral Biology and Medicine, School of Dentistry, University of California, Los Angeles, CA, USA
| | - Y Wang
- 1 Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA.,3 Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - D Xiong
- 1 Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA.,3 Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - R D Hays
- 4 Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, CA, USA.,5 Department of Medicine, Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.,6 RAND Corporation, Santa Monica, CA, USA
| | - I D Coulter
- 1 Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA.,6 RAND Corporation, Santa Monica, CA, USA
| | - S Y Lee
- 7 Division of Constitutive & Regenerative Sciences, Section of Restorative Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA
| | - V W Spolsky
- 1 Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA
| | - J Shen
- 1 Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA
| | - J J Crall
- 1 Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA
| | - H Liu
- 1 Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA.,3 Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, CA, USA.,5 Department of Medicine, Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
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103
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Utilization of a Wide Array of Nonvalidated Outcome Scales in Pediatric Orthopaedic Publications: Can't We All Measure the Same Thing? J Pediatr Orthop 2019; 39:e153-e158. [PMID: 30300277 DOI: 10.1097/bpo.0000000000001263] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE Clinical changes are best evaluated with standardized, validated outcomes, including both patient-reported outcome measures and surgeon-reported outcome measures (PROMs and SROMs). The purpose of this study was to describe the spectrum of outcome measures used in pediatric orthopaedic publications over the past 10 years and to determine the proportion that are in fact age-appropriate, validated, and appropriately applied in terms of condition and population. METHODS The Journal of Bone and Joint Surgery, The Bone and Joint Journal, Journal of Pediatric Orthopaedics A and B, and Journal of Children's Orthopaedics were systematically searched for studies including children aged 18 and below, over a 10-year period from January 2005 to December 2014. Economic evaluations, letters, editorials, review articles, and clinical guidelines were excluded. SROMs and PROMs used were extracted, as were details on subject age and condition for which they were used. Each outcome scale was assessed for validity, and the proportion of scales used appropriately was calculated. Cochrane-Armitage test of trend was used to determine changes in PROM and SROM utilization over the study period. RESULTS A total of 4614 articles were identified, of which 2251 met inclusion and exclusion criteria. In total, 259 (11.5%) of studies used a PROM, whereas 326 (14.5%) used a SROM. A total of 230 different outcome scales were identified; 115 were patient reported and 115 were surgeon reported. However, only 18.7% of SROMs and 38.3% of PROMs were applied to an age and disease-appropriate demographic. Overall, there was a significant increase in the overall utilization of PROMs during the study period (P=0.004), but no corresponding increase in pediatric-validated PROMs (P=0.164). SROM utilization did not significantly change over the study period (P=0.337). CONCLUSIONS Within the field of pediatric orthopaedics, an expansive variety of outcome scales are used, many of which have not been validated in children. Improved uniformity in reporting of outcomes and use of disease and age-validated outcomes scales is essential to improve multicenter research collaboration and data quality to generate appropriate evidence-based conclusions and treatment strategies in pediatric orthopaedics. LEVEL OF EVIDENCE Level IV-systematic review.
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104
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Forrest CB, Zorc JJ, Moon J, Pratiwadi R, Becker BD, Maltenfort MG, Guevara JP. Evaluation of the PROMIS pediatric global health scale (PGH-7) in children with asthma. J Asthma 2018; 56:534-542. [PMID: 29712498 DOI: 10.1080/02770903.2018.1471701] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To evaluate the reliability and validity of the PROMIS Pediatric Global Health scale, a 7-item measure of perceived physical, mental, and social health, in children with asthma. METHODS From February 2014 to February 2015, convenience samples of 8-17 year-old children (n = 182) and parents of 5-17 year-old children (n = 328) visiting an emergency department for treatment of asthma were enrolled. The Asthma Control Test was used to characterize children as controlled versus not controlled, and the PROMIS Asthma Impact Scale was used to assess asthma symptoms' impact on functional status. We conducted longitudinal analyses among 92 children and 218 parents at 3 weeks, and 74 children and 171 parents at 8 weeks after enrollment. RESULTS The PGH-7 reliability ranged from 0.66 to 0.81 for child-report and 0.76 to 0.82 for parent-proxy. In cross-sectional analyses, children with controlled asthma had PGH-7 scores 0.40-0.95 standard deviation units higher than those who were uncontrolled. The PGH-7 was responsive to changes in overall general health between time points, with moderate effect sizes (0.5-0.6 standard deviation units). In longitudinal analyses, PGH-7 scores were no different between those who stayed uncontrolled versus became controlled at 3 weeks of follow-up; however, by 8 weeks of follow-up, the differences between these groups were 0.7-0.8 standard deviation units, indicative of large effects. CONCLUSIONS The PGH-7 is a reliable and valid patient-reported outcome for assessing general health among children with asthma. It is a useful complement to other asthma-specific outcome measures.
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Affiliation(s)
- Christopher B Forrest
- a Department of Pediatrics , Perelman School of Medicine, University of Pennsylvania , Philadelphia , PA , USA.,b Division of General Pediatrics , Children's Hospital of Philadelphia , Philadelphia , PA , USA
| | - Joseph J Zorc
- a Department of Pediatrics , Perelman School of Medicine, University of Pennsylvania , Philadelphia , PA , USA.,c Division of Emergency Medicine , Children's Hospital of Philadelphia , Philadelphia , PA , USA
| | - JeanHee Moon
- a Department of Pediatrics , Perelman School of Medicine, University of Pennsylvania , Philadelphia , PA , USA.,b Division of General Pediatrics , Children's Hospital of Philadelphia , Philadelphia , PA , USA
| | - Ramya Pratiwadi
- a Department of Pediatrics , Perelman School of Medicine, University of Pennsylvania , Philadelphia , PA , USA.,b Division of General Pediatrics , Children's Hospital of Philadelphia , Philadelphia , PA , USA
| | - Brandon D Becker
- a Department of Pediatrics , Perelman School of Medicine, University of Pennsylvania , Philadelphia , PA , USA.,b Division of General Pediatrics , Children's Hospital of Philadelphia , Philadelphia , PA , USA
| | - Mitchell G Maltenfort
- a Department of Pediatrics , Perelman School of Medicine, University of Pennsylvania , Philadelphia , PA , USA.,b Division of General Pediatrics , Children's Hospital of Philadelphia , Philadelphia , PA , USA
| | - James P Guevara
- a Department of Pediatrics , Perelman School of Medicine, University of Pennsylvania , Philadelphia , PA , USA.,b Division of General Pediatrics , Children's Hospital of Philadelphia , Philadelphia , PA , USA
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105
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Short form development for oral health patient-reported outcome evaluation in children and adolescents. Qual Life Res 2018; 27:1599-1611. [PMID: 29508207 DOI: 10.1007/s11136-018-1820-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2018] [Indexed: 10/17/2022]
Abstract
PURPOSE Children and adolescents are vulnerable to dental problems and oral diseases. This paper presents the development of two multi-item self-report scales for use in assessing oral health status of children and adolescents. METHODS Following the Patient-Reported Outcome Measurement Information System framework, survey questions were designed using a newly developed conceptual model. These items were administered to 334 children and adolescents (8-17 years) along with concurrent dental exams. Exploratory and confirmatory factor analyses were conducted and the item response theory graded response model was used to estimate item parameters and oral health status scores and to identify short-form items. The items were selected by high level of information and wide coverage of different domains to assess Child Oral Health Status Index (COHSI) and treatment referral recommendations (RR). RESULTS The long form consists of 28 items. The short-form includes 12 items (8 for COHSI and 7 for RR with 3 common items).The intra-class correlations between long form and short-form were 0.90 for COHSI and 0.87 for RR. CONCLUSION The short-forms provide a possible solution for the longstanding challenge of oral health evaluation for large populations of children and adolescents. The calibrated long form provides the foundation for computer adaptive test administration. These oral health assessment toolkits can be used for oral health screening, surveillance program, policy planning, and research.
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106
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Iturralde E, Adams RN, Barley RC, Bensen R, Christofferson M, Hanes SJ, Maahs DM, Milla C, Naranjo D, Shah AC, Tanenbaum ML, Veeravalli S, Park KT, Hood KK. Implementation of Depression Screening and Global Health Assessment in Pediatric Subspecialty Clinics. J Adolesc Health 2017; 61:591-598. [PMID: 28830798 PMCID: PMC7162556 DOI: 10.1016/j.jadohealth.2017.05.030] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Revised: 05/10/2017] [Accepted: 05/24/2017] [Indexed: 12/21/2022]
Abstract
PURPOSE Adolescents with chronic illness face greater risk of psychosocial difficulties, complicating disease management. Despite increased calls to screen for patient-reported outcomes, clinical implementation has lagged. Using quality improvement methods, this study aimed to investigate the feasibility of standardized screening for depression and assessment of global health and to determine recommended behavioral health follow-up, across three pediatric subspecialty clinics. METHODS A total of 109 patients aged 12-22 years (median = 16.6) who were attending outpatient visits for treatment of diabetes (80% type 1), inflammatory bowel disease, or cystic fibrosis completed the 9-item Patient Health Questionnaire (PHQ-9) depression and Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric Global Health measures on electronic tablets. Patients screening positive on the PHQ-9 received same-day behavioral health assessment and regular phone check-ins to facilitate necessary follow-up care. RESULTS Overall, 89% of 122 identified patients completed screening during a 6-month window. Patients completed measures in a timely manner (within 3 minutes) without disruption to clinic flow, and they rated the process as easy, comfortable, and valuable. Depression scores varied across disease type. Patients rated lower global health relative to a previously assessed validation cohort. Depression and global health related significantly to certain medical outcomes. Fifteen percent of patients screened positive on the PHQ-9, of whom 50% confirmed attending behavioral health appointments within 6 months of screening. CONCLUSIONS A standardized depression and global health assessment protocol implemented across pediatric subspecialties was feasible and effective. Universal behavioral health screening for adolescents and young adults living with chronic disease is necessary to meet programmatic needs in pediatric subspecialty clinics.
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Affiliation(s)
- Esti Iturralde
- Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University School of Medicine, Stanford, California
| | - Rebecca N Adams
- Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University School of Medicine, Stanford, California
| | - Regan C Barley
- Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University School of Medicine, Stanford, California
| | - Rachel Bensen
- Division of Gastroenterology, Department of Pediatrics, Stanford Children's Inflammatory Bowel Disease Center, Stanford University School of Medicine, Stanford, California
| | - Megan Christofferson
- Division of Gastroenterology, Department of Pediatrics, Stanford Children's Inflammatory Bowel Disease Center, Stanford University School of Medicine, Stanford, California
| | - Sarah J Hanes
- Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University School of Medicine, Stanford, California
| | - David M Maahs
- Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University School of Medicine, Stanford, California
| | - Carlos Milla
- Division of Pulmonary Medicine, Stanford Children's CysticFibrosis Center, Department of Pediatrics, Stanford University School of Medicine, Stanford, California
| | - Diana Naranjo
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
| | - Avni C Shah
- Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University School of Medicine, Stanford, California
| | - Molly L Tanenbaum
- Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University School of Medicine, Stanford, California
| | - Sruthi Veeravalli
- Division of Pulmonary Medicine, Stanford Children's CysticFibrosis Center, Department of Pediatrics, Stanford University School of Medicine, Stanford, California
| | - K T Park
- Division of Gastroenterology, Department of Pediatrics, Stanford Children's Inflammatory Bowel Disease Center, Stanford University School of Medicine, Stanford, California
| | - Korey K Hood
- Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University School of Medicine, Stanford, California; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California.
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107
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Schifferdecker KE, Yount SE, Kaiser K, Adachi-Mejia A, Cella D, Carluzzo KL, Eisenstein A, Kallen MA, Greene GJ, Eton DT, Fisher ES. A method to create a standardized generic and condition-specific patient-reported outcome measure for patient care and healthcare improvement. Qual Life Res 2017; 27:367-378. [PMID: 28795261 DOI: 10.1007/s11136-017-1675-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2017] [Indexed: 12/22/2022]
Abstract
PURPOSE Patient-reported outcome measures (PROMs), which are generic or condition-specific, are used for a number of reasons, including clinical care, clinical trials, and in national-level efforts to monitor the quality of health care delivery. Creating PROMs that meet different purposes without overburdening patients, healthcare systems, providers, and data systems is paramount. The objective of this study was to test a generalizable method to incorporate condition-specific issues into generic PROM measures as a first step to producing PROMs that efficiently provide a standardized score. This paper outlines the method and preliminary findings focused on a PROM for osteoarthritis of the knee (OA-K). METHODS We used a mixed-methods approach and PROMIS® measures to test development of a combined generic and OA-K-specific PROM. Qualitative methods included patient focus groups and provider interviews to identify impacts of OA-K important to patients. We then conducted a thematic analysis and an item gap analysis: identified areas covered by existing generic PROMIS measures, identified "gap" areas not covered, compared gap areas to legacy instruments to verify relevance, and developed new items to address gaps. We then performed cognitive testing on new items and drafted an OA-K-specific instrument based on findings. RESULTS We identified 52 existing PROMIS items and developed 24 new items across 14 domains. CONCLUSIONS We developed a process for creating condition-specific instruments that bridge gaps in existing generic measures. If successful, the methodology will create instruments that efficiently gather the patient's perspective while allowing health systems, researchers, and other interested parties to monitor and compare outcomes over time, conditions, and populations.
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Affiliation(s)
- Karen E Schifferdecker
- Community and Family Medicine, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA. .,Center for Program Design and Evaluation at Dartmouth, Geisel School of Medicine at Dartmouth, 21 Lafayette Street, #373, Lebanon, NH, 03766, USA.
| | - Susan E Yount
- Department of Medical Social Sciences, Northwestern University's Feinberg School of Medicine, Chicago, IL, USA
| | - Karen Kaiser
- Department of Medical Social Sciences, Northwestern University's Feinberg School of Medicine, Chicago, IL, USA
| | - Anna Adachi-Mejia
- Community and Family Medicine, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA.,Center for Program Design and Evaluation at Dartmouth, Geisel School of Medicine at Dartmouth, 21 Lafayette Street, #373, Lebanon, NH, 03766, USA.,The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - David Cella
- Department of Medical Social Sciences, Northwestern University's Feinberg School of Medicine, Chicago, IL, USA
| | - Kathleen L Carluzzo
- Center for Program Design and Evaluation at Dartmouth, Geisel School of Medicine at Dartmouth, 21 Lafayette Street, #373, Lebanon, NH, 03766, USA
| | - Amy Eisenstein
- Department of Medical Social Sciences, Northwestern University's Feinberg School of Medicine, Chicago, IL, USA.,Leonard Schanfield Research Institute at CJE SeniorLife, Chicago, IL, USA
| | - Michael A Kallen
- Department of Medical Social Sciences, Northwestern University's Feinberg School of Medicine, Chicago, IL, USA
| | - George J Greene
- Department of Medical Social Sciences, Northwestern University's Feinberg School of Medicine, Chicago, IL, USA
| | - David T Eton
- Department of Health Sciences Research, Division of Health Care Policy and Research, Mayo Clinic, Rochester, MN, USA
| | - Elliott S Fisher
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
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108
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Corathers SD, Mara CA, Chundi PK, Kichler JC. Psychosocial Patient-Reported Outcomes in Pediatric and Adolescent Diabetes: a Review and Case Example. Curr Diab Rep 2017; 17:45. [PMID: 28508255 DOI: 10.1007/s11892-017-0872-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
PURPOSE OF REVIEW The purpose of this review is to define psychosocial patient-reported outcomes (PROs) relevant to pediatric and adolescent diabetes populations. Potential domains for PROs include a spectrum of emotional, behavioral, social, physical, overall health, and/or care management areas. A literature review of potential PRO measures, selection criteria, and implementation strategies including a case example will be presented. RECENT FINDINGS Among the pediatric, adolescent, and emerging adult populations, research indicates a relative higher risk for distress, depression, anxiety, and eating disorders as compared to peers without diabetes. Use of PRO measures can expand providers' focus beyond glycemic control, or simply hemoglobin A1c, to better appreciate the impact of diabetes on the whole child/adolescent, and provide services that address patients' individually identified needs, which are most salient to them. Successful selection and implementation of psychosocial PRO measures should be designed to include pathways for real-time provider interaction with the patient and respective PRO data to guide clinical care.
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Affiliation(s)
- Sarah D Corathers
- Division of Endocrinology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 7012, Cincinnati, OH, 45229, USA.
- James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
| | - Constance A Mara
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Pavan K Chundi
- James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Jessica C Kichler
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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An Analysis of (Dis)Ordered Categories, Thresholds, and Crossings in Difference and Divide-by-Total IRT Models for Ordered Responses. SPANISH JOURNAL OF PSYCHOLOGY 2017; 20:E10. [PMID: 28190418 DOI: 10.1017/sjp.2017.11] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Threshold parameters have distinct referents across models for ordered responses. In difference models, thresholds are trait levels at which responding beyond category k is as likely as responding at or below it; in divide-by-total models, thresholds are trait levels at which responding in category k is as likely as responding in category k - 1. Thus, thresholds in divide-by-total models (but not in difference models) are the crossings of the option response functions for consecutive categories. Thresholds in difference models are always ordered but they may inconsequentially yield ordered or disordered crossings. In contrast, assimilation of thresholds and crossings in divide-by-total models questions category order when crossings are disordered. We analyze these aspects of difference and divide-by-total models, their relation to the order of response categories, and the consequences of collapsing categories to instate ordered crossings under divide-by-total models. We also show that item parameters in models for ordered responses can never contradict the pre-assumed order of categories and that the empirical order can only be established using a polytomous model that does not assume ordered categories, although this often gives rise to spurious outcomes. Practical implications for scale development are discussed.
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110
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Victorson DE, Schuette S, Schalet BD, Kundu SD, Helfand BT, Novakovic K, Sufrin N, McGuire M, Brendler C. Factors Affecting Quality of Life at Different Intervals After Treatment of Localized Prostate Cancer: Unique Influence of Treatment Decision Making Satisfaction, Personality and Sexual Functioning. J Urol 2016; 196:1422-1428. [DOI: 10.1016/j.juro.2016.05.099] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2016] [Indexed: 01/16/2023]
Affiliation(s)
- David E. Victorson
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Stephanie Schuette
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Benjamin D. Schalet
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Shilajit D. Kundu
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Brian T. Helfand
- Division of Urology, NorthShore University Health System, Evanston, Illinois
| | - Kristian Novakovic
- Division of Urology, NorthShore University Health System, Evanston, Illinois
| | - Nathaniel Sufrin
- Division of Urology, NorthShore University Health System, Evanston, Illinois
| | - Michael McGuire
- Division of Urology, NorthShore University Health System, Evanston, Illinois
| | - Charles Brendler
- Division of Urology, NorthShore University Health System, Evanston, Illinois
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111
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Concurrent validity of the PROMIS® pediatric global health measure. Qual Life Res 2015; 25:739-51. [DOI: 10.1007/s11136-015-1111-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2015] [Indexed: 10/23/2022]
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112
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Beverung LM, Strouse JJ, Hulbert ML, Neville K, Liem RI, Inusa B, Fuh B, King A, Meier ER, Casella J, DeBaun MR, Panepinto JA. Health-related quality of life in children with sickle cell anemia: impact of blood transfusion therapy. Am J Hematol 2015; 90:139-43. [PMID: 25345798 DOI: 10.1002/ajh.23877] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Revised: 10/14/2014] [Accepted: 10/23/2014] [Indexed: 11/05/2022]
Abstract
The completion of the Multicenter Silent Infarct Transfusion Trial demonstrated that children with pre-existing silent cerebral infarct and sickle cell anemia (SCA) who received regular blood transfusion therapy had a 58% relative risk reduction of infarct recurrence when compared to observation. However, the total benefit of blood transfusion therapy, as assessed by the parents, was not measured against the burden of monthly blood transfusion therapy. In this planned ancillary study, we tested the hypothesis that a patient centered outcome, health-related quality of life (HRQL), would be greater in participants randomly assigned to the blood transfusion therapy group than the observation group. A total of 89% (175 of 196) of the randomly allocated participants had evaluable entry and exit HRQL evaluations. The increase in Change in Health, measured as the child's health being better, was significantly greater for the transfusion group than the observation group (difference estimate = -0.54, P ≤ 0.001). This study provides the first evidence that children with SCA who received regular blood transfusion therapy felt better and had better overall HRQL than those who did not receive transfusion therapy.
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Affiliation(s)
- Lauren M. Beverung
- Medical College of Wisconsin/Children's Research Institute of the Children's Hospital of Wisconsin; Milwaukee Wisconsin
| | - John J. Strouse
- Johns Hopkins University School of Medicine; Baltimore Maryland
| | | | - Kathleen Neville
- University of Missouri-Kansas City/Children's Mercy Hospital; Kansas City Missouri
| | - Robert I. Liem
- Northwestern University-Children's Memorial Hospital; Chicago Illinois
| | - Baba Inusa
- Guy's and St. Thomas’ Foundation Trust; London United Kingdom
| | - Beng Fuh
- East Carolina University Brody School of Medicine; Greenville North Carolina
| | - Allison King
- Washington University School of Medicine; St. Louis Missouri
| | - Emily Riehm Meier
- Children's National Medical Center/The George Washington University School of Medicine and Health Sciences; Washington District Columbia
| | - James Casella
- Johns Hopkins University School of Medicine; Baltimore Maryland
| | - Michael R. DeBaun
- Division of Hematology/Oncology, Department of Pediatrics; Vanderbilt-Meharry Center of Excellence in Sickle Cell Disease, Children's Hospital at Vanderbilt; Nashville Tennessee
| | - Julie A. Panepinto
- Medical College of Wisconsin/Children's Research Institute of the Children's Hospital of Wisconsin; Milwaukee Wisconsin
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Bevans KB, Moon J, Carle AC, Mara CA, Lai JS, DiMarco L, Muller N, Woods D. Patient reported outcomes as indicators of pediatric health care quality. Acad Pediatr 2014; 14:S90-6. [PMID: 25169465 DOI: 10.1016/j.acap.2014.06.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Revised: 06/02/2014] [Accepted: 06/05/2014] [Indexed: 01/01/2023]
Abstract
Health care reform has increased demand for pediatric health care quality evaluations, particularly those that assess the impact of care on patient and population health outcomes. Many of today's most common childhood conditions are characterized by symptoms, behaviors, and functional limitations that are best assessed as patient reported outcomes (PROs). Although they remain greatly underutilized, PROs have the potential to improve pediatric health care quality assessment at the point of care and through system-level performance evaluations. The functions, benefits, and challenges of these PRO applications are described and illustrated in case examples. Although challenges remain, numerous methodological and technical innovations facilitate the use of PROs as health care quality metrics. These include advances in PRO measure development methodologies, the integration of PRO measures into electronic health records, and developing consensus among providers that PROs provide valuable information that can be used to enhance patient care. Although additional work is needed to address remaining methodological challenges, pediatric PROs are increasingly recognized as valuable indicators of health care quality in the clinical environment and as measures of organization- and provider-level performance.
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Affiliation(s)
- Katherine B Bevans
- Department of Pediatrics, Children's Hospital of Philadelphia and the University of Pennsylvania School of Medicine, Philadelphia, Pa.
| | - JeanHee Moon
- Department of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pa
| | - Adam C Carle
- Department of Pediatrics, James M. Anderson Center for Health Systems Excellence, University of Cincinnati College of Medicine, and Department of Psychology, University of Cincinnati College of Arts and Sciences, Cincinnati, Ohio
| | - Constance A Mara
- James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Jin-Shei Lai
- Medical Social Sciences and Pediatrics, Northwestern University, Chicago, Ill
| | - Lindsay DiMarco
- Center for Healthcare Studies, Northwestern Feinberg School of Medicine, Northwestern University, Chicago, Ill
| | - Nicole Muller
- Center for Healthcare Studies, Northwestern Feinberg School of Medicine, Northwestern University, Chicago, Ill
| | - Donna Woods
- Graduate Programs in Healthcare Quality and Patient Safety and the Northwestern Program for Quality and Safety Innovation, Center for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, Ill
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