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Piedade SR, Canata GL, Maffulli N. TRANSCULTURAL ADAPTATION AND VALIDATION OF THE 4-DOMAIN SPORTS PROM INTO ITALIAN. J ISAKOS 2024:100305. [PMID: 39182760 DOI: 10.1016/j.jisako.2024.100305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 08/06/2024] [Accepted: 08/07/2024] [Indexed: 08/27/2024]
Abstract
OBJECTIVES This work aims to evaluate and validate the process of cross-cultural adaptation and validation of the 4-Domain Sports PROM (4-DSP) into Italian, assessing its understandability and reproducibility in all questionnaire domains for Italian-speaking patients. METHODS Cross-sectional study, level of evidence II. The questionnaire was self-administered by 100 patients (80 males and 20 females) who had undergone anterior cruciate ligament (ACL) reconstruction and had a one-year minimum follow-up. The mean age and standard deviation (SD) was 31.20 ± 12.65 years. According to their level of sports participation, 51% were recreational, 31% were regional, 12% were national, and 6% were international athletes. All patients filled in the 4-DSP questionnaire without direct supervision of their trainer/coach or researcher. All data were collected and processed anonymously. The translation and cultural adaptation of the 4-DSP involved six phases: (1) translation, (2) synthesis, (3) back-translation, (4) pre-test, (5) expert committee review, (6) final version approval by the author of the original version for publication. RESULTS The cross-cultural validation of the questionnaire 4-DSP into Italian presented a global Cronbach's ALPHA of 0.65, Conceptual equivalence to translation and relevance were 99.09% and 99.81%, respectively, and the percentage of agreement was 99.09%. CONCLUSION The cross-culturally validated version of the 4-DSP into Italian proved to be adequately understandable and reproducible in all questionnaire domains and can be safely and reliably used in Italian-speaking patients. LEVEL OF EVIDENCE Study level II.
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Affiliation(s)
- S R Piedade
- Exercise and Sports Medicine, Department of Orthopaedic, Rheumatology, and Traumatology, University of Campinas, UNICAMP, School of Medical Sciences, Campinas, Brazil.
| | - G L Canata
- Centre of Sports Traumatology, Koelliker Hospital, Torino, TO, Italy
| | - N Maffulli
- Department of Orthopaedic and Traumatology, Faculty of Medicine and Psychology, Sapienza, University of Rome, Italy; Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, Mile End Hospital, Queen Mary University of London, London, E1 4DG UK; School of Pharmacy and Bioengineering, Keele University School of Medicine, Thornburrow Drive, Stoke On Trent, England
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2
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Hutchings HA, Lanyon KJ, Holland G, Alikhan R, Jenkins R, Laing H, Hughes A, Lobban T, Pollock K, Tod D, Lister S. Can we collect health-related quality of life information from anticoagulated atrial fibrillation participants who have recently experienced a bleed? An observational feasibility study in primary and secondary care in Wales and through a UK online forum. BMJ Open 2023; 13:e075335. [PMID: 37802619 PMCID: PMC10565208 DOI: 10.1136/bmjopen-2023-075335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 09/13/2023] [Indexed: 10/10/2023] Open
Abstract
OBJECTIVE To evaluate the feasibility of recruiting participants diagnosed with atrial fibrillation (AF) taking oral anticoagulation therapies (OATs) and recently experiencing a bleed to collect health-related quality of life (HRQoL) information. DESIGN Observational feasibility study. The study aimed to determine the feasibility of recruiting participants with minor and major bleeds, the most appropriate route for recruitment and the appropriateness of the patient-reported outcome measures (PROMs) selected for collecting HRQoL information in AF patients, and the preferred format of the surveys. SETTING Primary care, secondary care and via an online patient forum. PARTICIPANTS The study population was adult patients (≥18) with AF taking OATs who had experienced a recent major or minor bleed within the last 4 weeks. PRIMARY AND SECONDARY OUTCOME MEASURES Primary outcomes - PROMs: EuroQol 5 Dimensions-5 Levels, Perception of Anticoagulant Treatment Questionnaire, part 2 only (part 2), atrial fibrillation effect on quality of life. Secondary outcomes - Location of bleed, bleed severity, current treatment, patient perceptions of HRQoL in relation to bleeding events. RESULTS We received initial expressions of interest from 103 participants. We subsequently recruited 32 participants to the study-14 from primary care and 18 through the AF forum. No participants were recruited through secondary care. Despite 32 participants consenting, only 26 initial surveys were completed. We received follow-up surveys from 11 participants (8 primary care and 3 AF forum). COVID-19 had a major impact on the study. CONCLUSIONS Primary care was the most successful route for recruitment. Most participants recruited to the study experienced a minor bleed. Further ways to recruit in secondary care should be explored, especially to capture more serious bleeds. TRIAL REGISTRATION NUMBER The study is registered in the Clinicaltrials.gov database, NCT04921176.
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Affiliation(s)
| | - Kirsty J Lanyon
- Swansea University Medical School, Swansea University, Swansea, UK
| | - Gail Holland
- Swansea University Medical School, Swansea University, Swansea, UK
| | - Raza Alikhan
- Department of Haematology, University Hospital of Wales, Cardiff, UK
| | | | - Hamish Laing
- VBHC Academy, School of Management, Swansea University, Swansea, UK
| | | | | | - Kevin Pollock
- Bristol-Myers Squibb Pharmaceuticals Ltd, Uxbridge, UK
| | - Daniel Tod
- Swansea University Medical School, Swansea University, Swansea, UK
| | - Steven Lister
- Bristol-Myers Squibb Pharmaceuticals Ltd, Uxbridge, UK
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Wald T, Zebralla V, Boege M, Kunz V, Neumuth T, Dietz A, Wichmann G, Wiegand S. Web-Based Patient-Reported Outcomes for ENT Patients-Evaluation of the Status Quo, Patients' View, and Future Perspectives. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811773. [PMID: 36142048 PMCID: PMC9517261 DOI: 10.3390/ijerph191811773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 09/10/2022] [Accepted: 09/16/2022] [Indexed: 05/05/2023]
Abstract
BACKGROUND Patient-reported outcomes (PRO) assess disease burden and indicate unmet needs. Home-based electronic PRO measures (ePROMs) can support tumor aftercare (TAC). Creating an ePROM is the next step after implementing the software "OncoFunction" to assess PROs during TAC of head- and neck-cancer patients (HNC). Therefore, internet use and perception on ePROMs of ENT and TAC patients were evaluated. METHODS From May-July 2020, ENT patients at a high-volume outpatient department aged >18 without need for emergency treatment were invited to complete a questionnaire concerning internet use and access, hardware, and opinion on the chances, requirements, and designs of ePROMs. RESULTS 415 questionnaires were evaluated; 46.3% of the respondents visited the common consultation hour (CCH) and 44.3% TAC; 71.9% were internet users, being younger than non-internet users; and 36.4% of TAC patients were non-internet users and 16.3% of them were without a web-enabled device. Significant differences existed in age and assessment of future perspectives between internet-/non-internet users and TAC/CCH patients, respectively. Regarding the design of ePROMs, patients preferred quarterly and short surveys. Data safety and feedback were important. CONCLUSIONS ePROMs are not suitable for everyone because of missing internet access and experience. A tailored approach to implement ePROMs in TAC is needed.
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Affiliation(s)
- Theresa Wald
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Leipzig Medical Centre, 04103 Leipzig, Germany
- Correspondence:
| | - Veit Zebralla
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Leipzig Medical Centre, 04103 Leipzig, Germany
| | - Maren Boege
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Leipzig Medical Centre, 04103 Leipzig, Germany
| | - Viktor Kunz
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Leipzig Medical Centre, 04103 Leipzig, Germany
| | - Thomas Neumuth
- Innovation Center Computer Assisted Surgery, University of Leipzig, 04103 Leipzig, Germany
| | - Andreas Dietz
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Leipzig Medical Centre, 04103 Leipzig, Germany
| | - Gunnar Wichmann
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Leipzig Medical Centre, 04103 Leipzig, Germany
| | - Susanne Wiegand
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Leipzig Medical Centre, 04103 Leipzig, Germany
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Alrubaiy L, Hutchings HA, Hughes SE, Dobbs T. Saving time and effort: Best practice for adapting existing patient-reported outcome measures in hepatology. World J Hepatol 2022; 14:896-910. [PMID: 35721294 PMCID: PMC9157705 DOI: 10.4254/wjh.v14.i5.896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 06/29/2021] [Accepted: 04/09/2022] [Indexed: 02/06/2023] Open
Abstract
It is increasingly recognised that collecting patient reported outcome measures (PROMs) data is an important part of healthcare and should be considered alongside traditional clinical assessments. As part of a more holistic view of healthcare provision, there has been an increased drive to implement PROM collection as part of routine clinical care in hepatology. This drive has resulted in an increase in the number of PROMs currently developed to be used in various liver conditions. However, the development and validation of a new PROM is time-consuming and costly. Therefore, before deciding to develop a new PROM, researchers should consider identifying existing PROMs to assess their appropriateness and, if necessary, make adaptations to existing PROMs to ensure their rigour when used with the target population. Little is written in the literature on how to identify and adapt the existing PROMs in hepatology. This article aims to provide a summary of the current literature and guidance regarding identifying and adapting existing PROMs in clinical practice.
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Affiliation(s)
- Laith Alrubaiy
- Department of Gastroenterology, St Mark's Hospital, London HA1 3UJ, United Kingdom
| | - Hayley A Hutchings
- Institute of Life Sciences 2, Swansea University Medical School, Singleton Park, Swansea SA2 8PP, United Kingdom
| | - Sarah E Hughes
- Swansea University Medical School, Swansea University, Swansea SA2 8PP, United Kingdom
- Centre for Patient Reported Outcome Research, Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, United Kingdom
| | - Thomas Dobbs
- Swansea University, Swansea SA2 8PP, United Kingdom
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Chiloiro G, Romano A, D’Aviero A, Dinapoli L, Zane E, Tenore A, Boldrini L, Balducci M, Gambacorta MA, Mattiucci GC, Malavasi P, Cesario A, Valentini V. Patients' Satisfaction by SmileIn TM Totems in Radiotherapy: A Two-Year Mono-Institutional Experience. Healthcare (Basel) 2021; 9:healthcare9101268. [PMID: 34682948 PMCID: PMC8535794 DOI: 10.3390/healthcare9101268] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/14/2021] [Accepted: 09/23/2021] [Indexed: 12/25/2022] Open
Abstract
Background: Patient’s satisfaction is recognized as an indicator to monitor quality in healthcare services. Patient-reported experience measures (PREMs) may contribute to create a benchmark of hospital performance by assessing quality and safety in cancer care. Methods: The areas of interest assessed were: patient-centric welcome perception (PCWP), punctuality, professionalism and comfort using the Lean Six Sigma (LSS) methodology. The RAMSI (Radioterapia Amica Mia SmileINTM (SI) My Friend RadiotherapySI), project provided for the placement of SI totems with four push buttons using HappyOrNot technology in a high-volume radiation oncology (RO) department. The SI technology was implemented in the RO department of the Fondazione Policlinico Universitario A. Gemelli IRCCS. SI totems were installed in different areas of the department. The SI Experience Index was collected, analyzed and compared. Weekly and monthly reports were created showing hourly, daily and overall trends. Results: From October 2017 to November 2019, a total of 42,755 votes were recorded: 8687, 10,431, 18,628 and 5009 feedback items were obtained for PCWP, professionalism, punctuality, and comfort, respectively. All areas obtained a SI-approved rate ≥ 8.0. Conclusions: The implementation of the RAMSI system proved to be doable according to the large amount of feedback items collected in a high-volume clinical department. The application of the LSS methodology led to specific corrective actions such as modification of the call-in-clinic system during operations planning. In order to provide healthcare optimization, a multicentric and multispecialty network should be defined in order to set up a benchmark.
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Affiliation(s)
- Giuditta Chiloiro
- Istituto di Radiologia, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (G.C.); (L.B.); (M.A.G.); (V.V.)
- UOC Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy; (A.R.); (L.D.); (A.T.); (M.B.); (G.C.M.)
| | - Angela Romano
- UOC Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy; (A.R.); (L.D.); (A.T.); (M.B.); (G.C.M.)
| | - Andrea D’Aviero
- UOC Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy; (A.R.); (L.D.); (A.T.); (M.B.); (G.C.M.)
- Correspondence:
| | - Loredana Dinapoli
- UOC Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy; (A.R.); (L.D.); (A.T.); (M.B.); (G.C.M.)
- UOS Psicologia Clinica, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy
| | - Elisa Zane
- Alta Scuola per l’Ambiente—ASA—Università Cattolica del Sacro Cuore, 25121 Brescia, Italy; (E.Z.); (p.m.)
| | - Angela Tenore
- UOC Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy; (A.R.); (L.D.); (A.T.); (M.B.); (G.C.M.)
| | - Luca Boldrini
- Istituto di Radiologia, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (G.C.); (L.B.); (M.A.G.); (V.V.)
- UOC Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy; (A.R.); (L.D.); (A.T.); (M.B.); (G.C.M.)
| | - Mario Balducci
- UOC Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy; (A.R.); (L.D.); (A.T.); (M.B.); (G.C.M.)
| | - Maria Antonietta Gambacorta
- Istituto di Radiologia, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (G.C.); (L.B.); (M.A.G.); (V.V.)
- UOC Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy; (A.R.); (L.D.); (A.T.); (M.B.); (G.C.M.)
| | - Gian Carlo Mattiucci
- UOC Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy; (A.R.); (L.D.); (A.T.); (M.B.); (G.C.M.)
| | - Pierluigi Malavasi
- Alta Scuola per l’Ambiente—ASA—Università Cattolica del Sacro Cuore, 25121 Brescia, Italy; (E.Z.); (p.m.)
- Facoltà di Scienze della Formazione, Università Cattolica del Sacro Cuore, 25121 Brescia, Italy
| | - Alfredo Cesario
- Open Innovation, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy;
| | - Vincenzo Valentini
- Istituto di Radiologia, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (G.C.); (L.B.); (M.A.G.); (V.V.)
- UOC Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy; (A.R.); (L.D.); (A.T.); (M.B.); (G.C.M.)
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James CJ, Graham PL, Betances Reinoso FA, Breuning SN, Durko M, Huarte Irujo A, Royo López J, Müller L, Perenyi A, Jaramillo Saffon R, Salinas Garcia S, Schüssler M, Schwarz Langer MJ, Skarzynski PH, Mecklenburg DJ. The Listening Network and Cochlear Implant Benefits in Hearing-Impaired Adults. Front Aging Neurosci 2021; 13:589296. [PMID: 33716706 PMCID: PMC7947658 DOI: 10.3389/fnagi.2021.589296] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 01/28/2021] [Indexed: 01/10/2023] Open
Abstract
Older adults with mild or no hearing loss make more errors and expend more effort listening to speech. Cochlear implants (CI) restore hearing to deaf patients but with limited fidelity. We hypothesized that patient-reported hearing and health-related quality of life in CI patients may similarly vary according to age. Speech Spatial Qualities (SSQ) of hearing scale and Health Utilities Index Mark III (HUI) questionnaires were administered to 543 unilaterally implanted adults across Europe, South Africa, and South America. Data were acquired before surgery and at 1, 2, and 3 years post-surgery. Data were analyzed using linear mixed models with visit, age group (18–34, 35–44, 45–54, 55–64, and 65+), and side of implant as main factors and adjusted for other covariates. Tinnitus and dizziness prevalence did not vary with age, but older groups had more preoperative hearing. Preoperatively and postoperatively, SSQ scores were significantly higher (Δ0.75–0.82) for those aged <45 compared with those 55+. However, gains in SSQ scores were equivalent across age groups, although postoperative SSQ scores were higher in right-ear implanted subjects. All age groups benefited equally in terms of HUI gain (0.18), with no decrease in scores with age. Overall, younger adults appeared to cope better with a degraded hearing before and after CI, leading to better subjective hearing performance.
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Affiliation(s)
| | - Petra L Graham
- Department of Mathematics and Statistics, Macquarie University, North Ryde, NSW, Australia
| | | | | | - Marcin Durko
- Department of Otolaryngology, Head and Neck Oncology, Medical University of Lodz, Lodz, Poland
| | - Alicia Huarte Irujo
- Department of Otorhinolaryngology, Clínica Universidad de Navarra, Pamplona, Spain
| | - Juan Royo López
- Servicio de Otorrinolaringología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - Lida Müller
- Tygerberg Hospital-Stellenbosch University Cochlear Implant Unit, Tygerberg, South Africa
| | - Adam Perenyi
- Department of Otolaryngology and Head Neck Surgery, Albert Szent Györgyi Medical Center, University of Szeged, Szeged, Hungary
| | | | - Sandra Salinas Garcia
- Servicio de Otorrinolaringología y Patología Cérvico-Facial, Fundación Jiménez Díaz University Hospital, Madrid, Spain
| | - Mark Schüssler
- Deutsches HörZentrum Hannover der HNO-Klinik, Medizische Hochschule Hannover, Hannover, Germany
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Piedade SR, Hutchinson MR, Ferreira DM, Ferretti M, Maffulli N. Validation and Implementation of 4-domain Patient-reported Outcome Measures (PROMs) Tailored for Orthopedic Sports Medicine. Int J Sports Med 2021; 42:853-858. [PMID: 33440443 DOI: 10.1055/a-1327-2970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The validation of a 4-domain PROM tailored to orthopedic sports medicine was performed through item generation, item scaling, validity and reliability testing, statistical analysis, as well as item reduction. Conbrach's alpha was used to verify item homogeneity, i. e. their accuracy or consistency. This PROM showed acceptable statistical accuracy and clinical applicability for a variety of surgical treatments, regardless of the anatomical injury sites. Moreover, this PROM considers the athletes' primary physical demands in an non-injured baseline condition, their motivation to continue sports practice and participation, and the influence of sports practice on their quality of life. This 4-domain PROM tailored for orthopedic sports medicine appears to be a valid tool to assess athletes and high-performing practitioners with sports injuries, recording their perception of injury, expectations of treatment; evaluation of postoperative care and treatment received, and perceived outcomes compared to their pre-injury status of physical demands in sports activity. The tool is unique, allowing direct comparisons between athletes' perception of pre-injury baseline, injury, treatment, and outcome. It will be a welcome adjunct to the sports medicine professional's tool box when assessing athlete's status and outcome after injury and intervention.
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Affiliation(s)
- Sérgio Rocha Piedade
- Exercise and Sports Medicine, Department of Orthopedics and Traumatology, School of Medical Sciences, University of Campinas, UNICAMP, Campinas, SP, Brazil
| | - Mark R Hutchinson
- Department of Orthopedics, University of Illinois at Chicago, Chicago, United States
| | - Daniel Miranda Ferreira
- Department of Radiology, School of Medical Sciences, University of Campinas, UNICAMP, Campinas, SP, Brazil
| | - Mario Ferretti
- Department of Orthopedics, Hospital Israelita Albert Einstein, Sao Paulo, Brazil
| | - Nicola Maffulli
- Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, London, United Kingdom of Great Britain and Northern Ireland
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Zebralla V, Müller J, Wald T, Boehm A, Wichmann G, Berger T, Birnbaum K, Heuermann K, Oeltze-Jafra S, Neumuth T, Singer S, Büttner M, Dietz A, Wiegand S. Obtaining Patient-Reported Outcomes Electronically With "OncoFunction" in Head and Neck Cancer Patients During Aftercare. Front Oncol 2020; 10:549915. [PMID: 33324544 PMCID: PMC7724103 DOI: 10.3389/fonc.2020.549915] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 10/19/2020] [Indexed: 11/14/2022] Open
Abstract
The disease and treatment of patients with head and neck cancer can lead to multiple late and long-term sequelae. Especially pain, psychosocial problems, and voice issues can have a high impact on patients' health-related quality of life. The aim was to show the feasibility of implementing an electronic Patient-Reported Outcome Measure (PROM) in patients with head and neck cancer (HNC). Driven by our department's intention to assess Patient-Reported Outcomes (PRO) based on the International Classification of Functioning during tumor aftercare, the program "OncoFunction" has been implemented and continuously refined in everyday practice. The new version of "OncoFunction" was evaluated by 20 head and neck surgeons and radiation oncologists in an interview. From 7/2013 until 7/2017, 846 patients completed the PROM during 2,833 of 3,610 total visits (78.5%). The latest software version implemented newly developed add-ins and increased the already high approval ratings in the evaluation as the number of errors and the time required decreased (6 vs. 0 errors, 1.35 vs. 0.95 min; p<0.01). Notably, patients had different requests using PRO in homecare use. An additional examination shows that only 59% of HNC patients use the world wide web. Using OncoFunction for online-recording and interpretation of PROM improved data acquisition in daily HNC patients' follow-up. An accessory timeline grants access to former consultations and their visualization supported and simplified structured examinations. This provides an easy-to-use representation of the patient's functional outcome supporting comprehensive aftercare, considering all aspects of the patient's life.
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Affiliation(s)
- Veit Zebralla
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Centre, Leipzig, Germany
| | - Juliane Müller
- Innovation Center Computer Assisted Surgery, University of Leipzig, Leipzig, Germany
| | - Theresa Wald
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Centre, Leipzig, Germany
| | - Andreas Boehm
- Department of Otorhinolaryngology, Clinic St. Georg Leipzig, Leipzig, Germany
| | - Gunnar Wichmann
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Centre, Leipzig, Germany
| | - Thomas Berger
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Centre, Leipzig, Germany
| | - Klemens Birnbaum
- Fraunhofer-Institute for Photonic Microsystems, Dresden, Germany
| | - Katharina Heuermann
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Centre, Leipzig, Germany
| | - Steffen Oeltze-Jafra
- Innovation Center Computer Assisted Surgery, University of Leipzig, Leipzig, Germany
| | - Thomas Neumuth
- Innovation Center Computer Assisted Surgery, University of Leipzig, Leipzig, Germany
| | - Susanne Singer
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center Mainz, Mainz, Germany
| | - Matthias Büttner
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center Mainz, Mainz, Germany
| | - Andreas Dietz
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Centre, Leipzig, Germany
| | - Susanne Wiegand
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Centre, Leipzig, Germany
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Watson L, Qi S, DeIure A, Photitai E, Chmielewski L, Smith L. Validating a Patient-Reported Outcomes-Derived Algorithm for Classifying Symptom Complexity Levels Among Patients With Cancer. J Natl Compr Canc Netw 2020; 18:1518-1525. [PMID: 33152696 DOI: 10.6004/jnccn.2020.7586] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 05/07/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND The patient-reported outcomes (PROs) symptom complexity algorithm, derived from self-reported symptom scores using the Edmonton Symptom Assessment System and concerns indicated on the Canadian Problem Checklist, has not been validated extensively. METHODS This is a retrospective chart review study using data from the Alberta Cancer Registry and electronic medical records from Alberta Health Services. The sample includes patients with cancer who visited a cancer facility in Alberta, Canada, from February 2016 through November 2017 (n=1,466). RESULTS The effect size (d=1.2) indicates that the magnitude of difference in health status between the severe- and low-complexity groups is large. The symptom complexity algorithm effectively classified subgroups of patients with cancer with distinct health status. Using Karnofsky performance status, the algorithm shows a sensitivity of 70.3%, specificity of 84.1%, positive predictive value of 79.1%, negative predictive value of 76.7%, and accuracy of 77.7%. An area under the receiver operating characteristic of 0.824 was found for the complexity algorithm, which is generally regarded as good, This same finding was also regarded as superior to the alternative algorithm generated by 2-step cluster analysis (area under the curve, 0.721). CONCLUSIONS The validity of the PRO-derived symptom complexity algorithm is established in this study. The algorithm demonstrated satisfactory accuracy against a clinician-driven complexity assessment and a strong correlation with the known group analysis. Furthermore, the algorithm showed a higher screening capacity compared with the algorithm generated from 2-step cluster analysis, reinforcing the importance of contextualization when classifying patients' symptoms, rather than purely relying on statistical outcomes. The algorithm carries importance in clinical settings, acting as a symptom complexity flag, helping healthcare teams identify which patients may need more timely, targeted, and individualized patient symptom management.
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Affiliation(s)
- Linda Watson
- 1Alberta Health Services, and.,2University of Calgary, Calgary, Alberta, Canada
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Alqudimat MR, Toupin April K, Hundert A, Jibb L, Victor C, Nathan PC, Stinson J. Questionnaires assessing the use of complementary health approaches in pediatrics and their measurement properties: A systematic review. Complement Ther Med 2020; 53:102520. [PMID: 33066855 DOI: 10.1016/j.ctim.2020.102520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 06/16/2020] [Accepted: 07/17/2020] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES To identify questionnaires assessing the use of complementary health approaches (CHA) in pediatrics, describe their content, and appraise the methodological quality of the studies and the measurement properties of the questionnaires. METHOD Major electronic databases were searched from 2011 to 2020. Studies which aimed to assess the use of CHA and studies which reported developing and validating CHA questionnaires in pediatrics were included. Two reviewers independently screened the studies, extracted the data, and rated the methodological quality of the studies and measurement properties of the questionnaires using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. When consensus was not reached, a third reviewer was consulted. RESULTS Thirty-eight studies were included. From these studies, 35 CHA questionnaires with a variety of different items were identified. Only two studies aimed to evaluate the measurement properties of two questionnaires. One questionnaire, available as a self- and proxy-report, was initially validated in children with juvenile idiopathic arthritis, and the other, available as an interviewer-administered questionnaire, was validated in children with cancer. According to the COSMIN, the methodological quality of both studies was inadequate or doubtful, and both questionnaires was not thoroughly validated. CONCLUSION This systematic review showed a lack of a thoroughly validated CHA questionnaire in pediatrics. However, two questionnaires were found to hold promise. To address this gap, one of the existing questionnaires should be adapted and further validated.
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Affiliation(s)
- Mohammad R Alqudimat
- University of Toronto, Lawrence S. Bloomberg Faculty of Nursing, 155 College Street, Suite 130, Toronto, ON M5T 1P8, Canada; The Hospital for Sick Children, Child Health Evaluation Sciences, 555 University Avenue, Toronto, ON M5G 1X8, Canada.
| | - Karine Toupin April
- Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road Ottawa, ON K1H 8L1, Canada; University of Ottawa, Department of Pediatrics and School of Rehabilitation Sciences, 451 Smyth Road, Ottawa, ON K1H 8M5, Canada
| | - Amos Hundert
- The Hospital for Sick Children, Child Health Evaluation Sciences, 555 University Avenue, Toronto, ON M5G 1X8, Canada
| | - Lindsay Jibb
- University of Toronto, Lawrence S. Bloomberg Faculty of Nursing, 155 College Street, Suite 130, Toronto, ON M5T 1P8, Canada; The Hospital for Sick Children, Child Health Evaluation Sciences, 555 University Avenue, Toronto, ON M5G 1X8, Canada
| | - Charles Victor
- University of Toronto, Institute of Health Policy, Management and Evaluation, 2075 Bayview Ave, Toronto, ON M4N 3M5, Canada
| | - Paul C Nathan
- The Hospital for Sick Children, Division of Haematology/Oncology, 555 University Avenue, Toronto, ON M5G 1X8, Canada
| | - Jennifer Stinson
- University of Toronto, Lawrence S. Bloomberg Faculty of Nursing, 155 College Street, Suite 130, Toronto, ON M5T 1P8, Canada; The Hospital for Sick Children, Child Health Evaluation Sciences, 555 University Avenue, Toronto, ON M5G 1X8, Canada
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11
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Paterson C, Primeau C, Howard N, Xiberras P, Pillay B, Crowe H. Experiences of Unmet Need and Access to Supportive Care for Men Receiving Androgen Deprivation Therapy for Prostate Cancer: A Bi-national Study. Semin Oncol Nurs 2020; 36:151049. [PMID: 32703715 DOI: 10.1016/j.soncn.2020.151049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The number of men affected by incurable prostate cancer is expected to increase worldwide. Research is needed to enable men to share their experiences of unmet supportive care needs in current care delivery. We aimed to identify the most frequently reported domains of unmet supportive care needs, levels of anxiety, depression, distress, health-related quality of life, and to identify any perceived barriers to receiving supportive care. DATA SOURCES Men diagnosed with prostate cancer who had received a minimum of 6 months of ADT were recruited into a cross-sectional study. Participants completed standardised questionnaires; clinical and demographic data was also collected. CONCLUSION Two hundred seventy-two patients were invited, and 102 participated. No statistically significant differences were found between participant scores from Australia and UK in relation to anxiety and depression, exercise, health-related quality of life, or distress scores. Perceived barriers include service delivery related to information provision and difficulties in the navigation of complex care systems. IMPLICATIONS FOR NURSING PRACTICE Men affected by prostate cancer receiving ADT reported unmet supportive care needs, specifically related to sexual, informational, and psychological aspects of care. Mapping future trajectories of needs and identifying men at high risk can significantly improve timely and tailored interventions.
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Affiliation(s)
- Catherine Paterson
- Faculty of Health, University of Canberra, Canberra ACT, Australia; Robert Gordon University, Aberdeen, Garthdee, Scotland; Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research group, University of Canberra, Canberra ACT, Australia; ACT Synergy Nursing and Midwifery Research Centre, Canberra Hospital and ACT Health, ACT, Australia.
| | | | | | | | - Brindha Pillay
- Epworth HealthCare, Victoria, Australia; Peter MacCallum Cancer Centre, Victoria, Australia; Royal Melbourne Hospital, Victoria, Australia
| | - Helen Crowe
- Epworth HealthCare, Victoria, Australia; Australian Prostate Centre, Victoria, Australia; Royal Melbourne Hospital, Victoria, Australia
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Ali A, Song YP, Mehta S, Mistry H, Conroy R, Coyle C, Logue J, Tran A, Wylie J, Janjua T, Joseph L, Joseph J, Choudhury A. Palliative Radiation Therapy in Bladder Cancer—Importance of Patient Selection: A Retrospective Multicenter Study. Int J Radiat Oncol Biol Phys 2019; 105:389-393. [DOI: 10.1016/j.ijrobp.2019.06.2541] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 06/10/2019] [Accepted: 06/13/2019] [Indexed: 11/17/2022]
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Hughes SE, Rapport F, Watkins A, Boisvert I, McMahon CM, Hutchings HA. Study protocol for the validation of a new patient-reported outcome measure (PROM) of listening effort in cochlear implantation: the Listening Effort Questionnaire-Cochlear Implant (LEQ-CI). BMJ Open 2019; 9:e028881. [PMID: 31289085 PMCID: PMC6629460 DOI: 10.1136/bmjopen-2018-028881] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 05/14/2019] [Accepted: 05/17/2019] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION Listening effort may be defined as the cognitive resources needed to understand an auditory message. A sustained requirement for listening effort is known to have a negative impact on individuals' sense of social connectedness, well-being and quality of life. A number of hearing-specific patient-reported outcome measures (PROMs) exist currently; however, none adequately assess listening effort as it is experienced in the listening situations of everyday life. The Listening Effort Questionnaire-Cochlear Implant (LEQ-CI) is a new, hearing-specific PROM designed to assess perceived listening effort as experienced by adult CI patients. It is the aim of this study to conduct the first psychometric evaluation of the LEQ-CI's measurement properties. METHODS AND ANALYSIS This study is a phased, prospective, multi-site validation study in a UK population of adults with severe-profound sensorineural hearing loss who meet local candidacy criteria for CI. In phase 1, 250 CI patients from four National Health Service CI centres will self-complete a paper version of the LEQ-CI. Factor analysis will establish unidimensionality and Rasch analysis will evaluate item fit, differential item functioning, response scale ordering, targeting of persons and items, and reliability. Classical test theory methods will assess acceptability/data completeness, scaling assumptions, targeting and internal consistency reliability. Phase 1 results will inform refinements to the LEQ-CI. In phase 2, a new sample of adult CI patients (n=100) will self-complete the refined LEQ-CI, the Speech, Spatial and Qualities of Hearing Scale, the Nijmegen Cochlear Implant Questionnaire and the Fatigue Assessment Scale to assess construct validity. ETHICS AND DISSEMINATION This study was approved by the Abertawe Bro Morgannwg University Health Board/Swansea University Joint Study Review Committee and the Newcastle and North Tyneside 2 Research Ethics Committee, Ref: 18/NE/0320. Dissemination will be in high-quality journals, conference presentations and SEH's doctoral dissertation.
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Affiliation(s)
- Sarah E Hughes
- Swansea University Medical School, Swansea University, Swansea, UK
- South Wales Cochlear Implant Programme, Bridgend, UK
| | - Frances Rapport
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Alan Watkins
- Swansea University Medical School, Swansea University, Swansea, UK
| | - Isabelle Boisvert
- Department of Linguistics (Audiology Section), Macquarie University, Sydney, New South Wales, Australia
- The HEARing CRC, Melbourne, Australia
| | - Catherine M McMahon
- Department of Linguistics (Audiology Section), Macquarie University, Sydney, New South Wales, Australia
- The HEARing CRC, Melbourne, Australia
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Dobbs TD, Rodrigues J, Hart AM, Whitaker IS. Improving measurement 1: Harnessing the PROMise of outcome measures. J Plast Reconstr Aesthet Surg 2019; 72:363-365. [PMID: 30655241 DOI: 10.1016/j.bjps.2018.12.040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 11/18/2018] [Accepted: 12/21/2018] [Indexed: 12/12/2022]
Affiliation(s)
- Thomas D Dobbs
- Reconstructive Surgery & Regenerative Medicine Research Group, Institute of Life Sciences, Swansea University Medical School, Swansea, UK
| | - Jeremy Rodrigues
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre, Nuffield Orthopaedic Centre, Windmill Road, Oxford, UK.
| | - Andrew M Hart
- Canniesburn Plastic Surgery Unit, Glasgow Royal Infirmary, North Glasgow University Hospitals NHS Trust, Glasgow, UK
| | - Iain S Whitaker
- Reconstructive Surgery & Regenerative Medicine Research Group, Institute of Life Sciences, Swansea University Medical School, Swansea, UK
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Dobbs TD, Hughes S, Mowbray N, Hutchings HA, Whitaker IS. How to decide which patient-reported outcome measure to use? A practical guide for plastic surgeons. J Plast Reconstr Aesthet Surg 2018; 71:957-966. [PMID: 29656898 DOI: 10.1016/j.bjps.2018.03.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 02/27/2018] [Accepted: 03/10/2018] [Indexed: 01/23/2023]
Abstract
The use of patient-reported outcome measures (PROMs) is increasing across all medical specialties, as their importance to patient care is validated. They are likely to play a particularly important role in plastic and reconstructive surgery where outcomes are often subjective, and the recent guidance from the Royal College of Surgeons of England advising their use in cosmetic surgery highlights this. To drive their routine use across our specialty, it is important that clinicians are capable of understanding the often complex and confusing language that surrounds their design and validation. In this article, we describe the process of PROM design and validation, and we attempt to 'demystify' the language used in the health outcome literature. We present the important steps that a well-designed PROM must go through and suggest a straightforward guide for selecting the most appropriate PROMs for use in clinical practice. We hope that this will encourage greater use of PROM data across plastic and reconstructive surgery and ultimately help improve outcomes for our patients.
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Affiliation(s)
- Thomas D Dobbs
- Reconstructive Surgery & Regenerative Medicine Research Group, Institute of Life Sciences, Swansea University Medical School, Singleton Campus, Swansea, SA2 8PP, UK; Welsh Centre for Burns and Plastics, Morriston Hospital, Heol Maes Eglwys, Morriston, Swansea, SA6 6NL, UK.
| | - Sarah Hughes
- Health Services Research, Institute of Life Sciences, Swansea University Medical School, Singleton Campus, Swansea, SA2 8PP, UK; Princess of Wales Hospital, Abertawe Bro Morgannwg University Health Board, Coity Road, Bridgend, CF31 1RQ, UK
| | - Nicholas Mowbray
- Health Services Research, Institute of Life Sciences, Swansea University Medical School, Singleton Campus, Swansea, SA2 8PP, UK
| | - Hayley A Hutchings
- Health Services Research, Institute of Life Sciences, Swansea University Medical School, Singleton Campus, Swansea, SA2 8PP, UK
| | - Iain S Whitaker
- Reconstructive Surgery & Regenerative Medicine Research Group, Institute of Life Sciences, Swansea University Medical School, Singleton Campus, Swansea, SA2 8PP, UK; Welsh Centre for Burns and Plastics, Morriston Hospital, Heol Maes Eglwys, Morriston, Swansea, SA6 6NL, UK
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Saberifiroozi M. Improving Quality of Care in Patients with Liver Cirrhosis. Middle East J Dig Dis 2017; 9:189-200. [PMID: 29255576 PMCID: PMC5726331 DOI: 10.15171/mejdd.2017.73] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 09/19/2017] [Indexed: 12/12/2022] Open
Abstract
Liver cirrhosis is a major chronic disease in the field of digestive diseases. It causes more than one million deaths per year. Despite established evidence based guidelines, the adherence to standard of care or quality indicators are variable. Complete adherence to the recommendations of guidelines is less than 50%. To improve the quality of care in patients with cirrhosis, we need a more holistic view. Because of high rate of death due to cardiovascular disease and neoplasms, the care of comorbid conditions and risk factors such as smoking, hypertension, high blood sugar or cholesterol, would be important in addition to the management of primary liver disease. Despite a holistic multidisciplinary approach for this goal, the management of such patients should be patient centered and individualized. The diagnosis of underlying etiology and its appropriate treatment is the most important step. Definition and customizing the quality indicators for quality measure in patients are needed. Because most suggested quality indicators are designed for measuring the quality of care in decompensated liver cirrhosis, we need special quality indicators for compensated and milder forms of chronic liver disease as well. Training the patients for participation in their own management, design of special clinics with dedicated health professionals in a form of chronic disease model, is suggested for improvement of quality of care in this group of patients. Special day care centers by a dedicated gastroenterologist and a trained nurse may be a practical model for better management of such patients.
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Affiliation(s)
- Mehdi Saberifiroozi
- Professor of Internal Medicine and Gastroenterology, Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences
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