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Peeters M, Ottenheijm G, Bienfait P, Eekers D, Gijtenbeek A, Hanse M, Koekkoek J, van Leeuwen L, Tijssen C, Dirven L, Taphoorn M. Glioma patient-reported outcomes: patients and clinicians. BMJ Support Palliat Care 2023; 13:e205-e212. [PMID: 33653735 DOI: 10.1136/bmjspcare-2020-002699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 12/23/2020] [Accepted: 01/06/2021] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Routine assessment of patient-reported outcomes (PROs) in oncology has shown to improve the quality of the delivered care and to prolong survival. However, for successful implementation of routine assessment of PROs, more knowledge on their usability in clinical practice is needed. OBJECTIVE This study aimed to cross-sectionally assess the perspective of patients and clinicians on the practicality of routinely measuring PROs in clinical practice for glioma patients. METHODS Semistructured interviews were conducted evaluating the role of healthcare professionals (HCP) in discussing results of PRO measures (PROMs), and the preferred topics, methods and frequency of PRO assessment. Glioma patients, their proxies and HCPs involved in the treatment of glioma patients from eight centres in the Netherlands were included. RESULTS Twenty-four patients, 16 proxies and 35 HCPs were interviewed. The majority of patients, proxies and HCPs (92%, 81% and 80%, respectively) were willing to discuss PRO results during consultations. Although HCPs prefer that results are discussed with the nurse specialist, only one-third of patients/proxies agreed. Functioning of daily life was considered important in all three groups. Most participants indicated that discussion of PROM results should take place during standard follow-up visits, and completed at home about 1 week in advance. On group level, there was no preference for administration of questionnaires on paper or digitally. Lastly, all centres had staff available to send questionnaires on paper. CONCLUSION This study shows that routine assessment of PROs is desired by patients, proxies and HCP's in neuro-oncological care in Dutch hospitals.
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Affiliation(s)
- Marthe Peeters
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - Germaine Ottenheijm
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - Paul Bienfait
- Department of Neurology, Gelre Ziekenhuizen Apeldoorn, Apeldoorn, The Netherlands
| | - Daniëlle Eekers
- Department of Radiation Oncology (Maastro), Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Anja Gijtenbeek
- Department of Neurology, Radboudumc, Nijmegen, The Netherlands
| | - Monique Hanse
- Department of Neurology, Catharina Hospital, Eindhoven, The Netherlands
| | - Johan Koekkoek
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Neurology, Medisch Centrum Haaglanden, Den Haag, The Netherlands
| | - Leonie van Leeuwen
- Department of Neurology and Neurosurgery, UMC Utrecht, Utrecht, The Netherlands
| | - Cees Tijssen
- Department of Neurology, Elisabeth-TweeSteden Ziekenhuis, Tilburg, The Netherlands
| | - Linda Dirven
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Neurology, Medisch Centrum Haaglanden, Den Haag, The Netherlands
| | - Martin Taphoorn
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Neurology, Medisch Centrum Haaglanden, Den Haag, The Netherlands
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Dhar M, Kaeley N, Mahala P, Saxena V, Pathania M. The Prevalence and Associated Risk Factors of Fear of Fall in the Elderly: A Hospital-Based, Cross-Sectional Study. Cureus 2022; 14:e23479. [PMID: 35475069 PMCID: PMC9035266 DOI: 10.7759/cureus.23479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2022] [Indexed: 11/16/2022] Open
Abstract
Background Falls are one of the most common but serious health issues faced by the elderly population. Falls-related injuries not only add to the morbidity and economic burden they also have a significant negative impact on psychological health and the quality of life of the elderly. In this study, we assess the prevalence of fear of falling among the geriatric population and the risk factors associated with fear of falling. Methodology This prospective, cross-sectional study was conducted among geriatric patients aged more than 60 years attending the medical outpatient department of a tertiary care hospital in Uttarakhand, India. This study aimed to determine the prevalence of fear of falling among the geriatric population and compare various demographic and clinical parameters in elderly patients with and without fear of falling. Fear of fall was assessed using a questionnaire by asking the elderly if they had fear of falling, how often they had fear of falling, and under which circumstances did they have fear of falling. Information regarding demographics, history of daily activities, and chronic diseases was collected and assessed from all geriatric patients with and without fear of falls. Results Almost half (334; 42%) of the geriatric population had a history of fear of falling. Demographic parameters such as age over 80 years, female gender, living alone, and rural background were significantly associated with fear of falling. Similarly, a history of chronic diseases such as stroke, hypertension, and history of visual and motility impairment was significantly related to fear of falls among geriatric patients. Around 70% (571) of geriatric patients aged over 60 years had associated health problems. Conclusions This study reinstates that fear of falls is a significant health issue in the elderly age group. It also highlights multiple risk factors related to fear of falling which if controlled can significantly improve the quality of life of the geriatric population.
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Prior SJ, Heath A, Reeves NS, Campbell SJ, Maxwell H, Bramble M, Marlow A, Doherty D. Determining readiness for a reablement approach to care in Australia: Development of a pre-employment questionnaire. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:498-508. [PMID: 32877000 DOI: 10.1111/hsc.13150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 06/25/2020] [Accepted: 08/06/2020] [Indexed: 06/11/2023]
Abstract
Reablement is described as a goal directed intervention with a view to maintain or improve the independence of clients through "doing with, rather than doing for". As a relatively new concept in care, lack of specific skills in reablement is not uncommon, however, intrinsic values aligned with reablement are beneficial to organisations providing care and support to clients. The aim of this study is to develop a pre-employment questionnaire to assess readiness for a reablement approach to care as a step towards developing a reablement culture across organisations. A questionnaire based on activities of daily living (ADL), developed by the research team in consultation with a local community-based care organisation, was completed by 166 staff members at a community-based care organisation in Tasmania across several timepoints during and following reablement education sessions in 2018. The scores from these questionnaires were utilised to develop a questionnaire appropriate for determining readiness for reablement prior to employment within the organisation. Over a period of twelve months, a total of 407 Reablement Readiness Questionnaires were submitted by staff, indicating high levels of willingness to engage in reablement prior to and following the education sessions. Exploratory factor analyses were performed, and the construct validity and internal consistency of the emerging factors were assessed. An exploratory factor analysis indicated that ADL, in relation to reablement, consist of three dimensions-Lifestyle, My body and Connecting. The corresponding questions were subsequently built into an online questionnaire for pre-employment use. This questionnaire also has potential benefit in recruitment of staff to other community service organisations, to ascertain their readiness for reablement prior to beginning a variety of different roles within client care and support.
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Affiliation(s)
- Sarah J Prior
- Tasmanian School of Medicine, University of Tasmania, Burnie, Tasmania, Australia
| | - Anne Heath
- University College, University of Tasmania, Burnie, Tasmania, Australia
| | - Nicole S Reeves
- Tasmanian School of Medicine, University of Tasmania, Burnie, Tasmania, Australia
| | - Steven J Campbell
- School of Nursing, University of Tasmania, Newnham, Tasmania, Australia
| | - Hazel Maxwell
- School of Health Sciences, University of Tasmania, Sydney, New South Wales, Australia
| | - Marguerite Bramble
- School of Nursing, Midwifery and Indigenous Health, Charles Sturt University, Bathurst, New South Wales, Australia
| | - Annette Marlow
- School of Nursing, University of Tasmania, Newnham, Tasmania, Australia
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van Dam M, Sikkes SA, Rammeloo E, Reinders E, Jelgerhuis JR, Geurts JJ, Uitdehaag BM, Hulst HE. Cognitive functioning in everyday life: The development of a questionnaire on instrumental activities of daily living in multiple sclerosis. Mult Scler J Exp Transl Clin 2021; 7:20552173211038027. [PMID: 34408904 PMCID: PMC8365017 DOI: 10.1177/20552173211038027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 07/19/2021] [Indexed: 12/03/2022] Open
Abstract
Neuropsychological test scores in people with MS (PwMS) do not fully reflect cognitive functioning in daily life. Therefore, we developed a questionnaire based on instrumental activities of daily living (IADL), using the Amsterdam IADL-Q© for Alzheimer’s disease as starting point. Forty-eight items were evaluated on relevance and clarity by (inter)national experts (n = 30), PwMS (n = 61) and proxies (n = 30). Consequently, four items were omitted, two items were merged and seven items were added. Fifty items were included in the IADL questionnaire specific to cognitive functioning in MS (the MS-IADL-Q). Future studies are warranted to assess the psychometric properties of the MS-IADL-Q.
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Affiliation(s)
- Maureen van Dam
- Department of Anatomy and Neurosciences, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Sietske Am Sikkes
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Emma Rammeloo
- Department of Anatomy and Neurosciences, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Evy Reinders
- Department of Anatomy and Neurosciences, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Julia R Jelgerhuis
- Department of Anatomy and Neurosciences, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jeroen Jg Geurts
- Department of Anatomy and Neurosciences, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Bernhard Mj Uitdehaag
- Department of Epidemiology and Biostatistics, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Hanneke E Hulst
- Department of Anatomy and Neurosciences, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Oort Q, Dirven L, Sikkes SAM, Aaronson N, Boele F, Brannan C, Egeter J, Grant R, Klein M, Lips I, Narita Y, Sato H, Sztankay M, Stockhammer G, Talacchi A, Uitdehaag BMJ, Reijneveld JC, Taphoorn MJB. Development of an EORTC questionnaire measuring instrumental activities of daily living (IADL) in patients with brain tumours: phase I-III. Qual Life Res 2021; 30:1491-1502. [PMID: 33496902 PMCID: PMC8068708 DOI: 10.1007/s11136-020-02738-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2020] [Indexed: 04/02/2024]
Abstract
PURPOSE Being able to function independently in society is an important aspect of quality of life. This ability goes beyond self-care, requires higher order cognitive functioning, and is typically measured with instrumental activities of daily living (IADL) questionnaires. Cognitive deficits are frequently observed in brain tumour patients, however, IADL is almost never assessed because no valid and reliable IADL measure is available for this patient group. Therefore, this measure is currently being developed. METHODS This international multicentre study followed European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Group module development guidelines. Three out of four phases are completed: phases (I) generation of items, (II) construction of the item list, and (III) pre-testing. This paper reports the item selection procedures and preliminary psychometric properties of the questionnaire. Brain tumour patients (gliomas and brain metastases), their informal caregivers, and health care professionals (HCPs) were included. RESULTS Phase I (n = 44 patient-proxy dyads and 26 HCPs) generated 59 relevant and important activities. In phase II, the activities were converted into items. In phase III (n = 85 dyads), the 59 items were pre-tested. Item selection procedures resulted in 32 items. Exploratory factor analysis revealed a preliminary dimensional structure consisting of five scales with acceptable to excellent internal consistency (α = 0.73-0.94) and two single items. For three scales, patients with cognitive impairments had significantly more IADL problems than patients without impairments. CONCLUSION A phase IV validation study is needed to confirm the psychometric properties of the EORTC IADL-BN32 questionnaire in a larger international sample.
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Affiliation(s)
- Quirien Oort
- Department of Neurology and Brain Tumor Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, PO BOX 7057, 1007 MB, Amsterdam, The Netherlands.
| | - Linda Dirven
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Neurology, Haaglanden Medical Center, The Hague, The Netherlands
| | - Sietske A M Sikkes
- Department of Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Alzheimer Center, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Clinical Developmental & Clinical Neuropsychology, Faculty of Behavioural and Movement Sciences (FGB), Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Neil Aaronson
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Florien Boele
- Leeds Institute of Medical Research, St James's University Hospital, Leeds, LS9 7TF, UK
- Faculty of Medicine and Health, Leeds Institute of Health Sciences, University of Leeds, Leeds, LS2 9JT, UK
| | - Christine Brannan
- East & North Hertfordshire NHS Trust Incorporating Mount Vernon Cancer Centre, Northwood, UK
| | - Jonas Egeter
- Department for Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria
| | - Robin Grant
- Department of Clinical Neurosciences, Western General Hospital, Edinburgh, UK
| | - Martin Klein
- Department of Medical Psychology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Irene Lips
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - Yoshitaka Narita
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center, Tokyo, Japan
| | - Hitomi Sato
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center, Tokyo, Japan
- Department of Nursing, Teikyo Heisei University, Tokyo, Japan
| | - Monika Sztankay
- Department for Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Andrea Talacchi
- Department of Neurosurgery, Azienda Ospedaliera San Giovanni Addolorata, Rome, Italy
| | - Bernard M J Uitdehaag
- Department of Neurology and Brain Tumor Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, PO BOX 7057, 1007 MB, Amsterdam, The Netherlands
| | - Jaap C Reijneveld
- Department of Neurology and Brain Tumor Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, PO BOX 7057, 1007 MB, Amsterdam, The Netherlands
- Department of Neurology, Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, The Netherlands
| | - Martin J B Taphoorn
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Neurology, Haaglanden Medical Center, The Hague, The Netherlands
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Correia MS, Neville IS, Almeida CCD, Hayashi CY, Ferreira LTD, Quadros DG, Gomes Dos Santos A, Solla DJF, Marta GN, Teixeira MJ, Paiva WS. Clinical outcome assessments of motor status in patients undergoing brain tumor surgery. Clin Neurol Neurosurg 2020; 201:106420. [PMID: 33388662 DOI: 10.1016/j.clineuro.2020.106420] [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: 09/17/2020] [Revised: 11/21/2020] [Accepted: 12/04/2020] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Clinical outcome assessment (COA) is an important instrument for testing the effectiveness of treatments and for supporting healthcare professionals on decision-making. This review aims to assess the use of COAs, and the evaluation time points of motor status in patients with brain tumor (BT) undergoing surgery. METHODS We performed a scoping review through MEDLINE, EMBASE, and LILACS databases, looking for original studies in primary or secondary BT, having motor function status as the primary outcome. EXCLUSION CRITERIA mixed sample, BT recurrence, and an unspecific description of motor deficits evaluation. RESULTS Nine studies met the eligibility criteria. There were 449 patients assessed. A total of 18 scales evaluated these BT patients, 12 performance outcomes measures (PerfO) tested motor function. Four scales were the clinician-reported outcome measures (ClinRO) found in this review, two assessed performance status, and two rated ambulation. Two patient-reported outcome measures (PRO) appraised functionality. CONCLUSIONS A variety of instruments were used to assess BT patients. Rehabilitation studies are more likely to associate the use of PerfO and PRO concerning motor and functional status. The use of specific validated scales to the BT population was rare. The lack of a standardized approach hampers the quality of BT patient's assessment.
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Affiliation(s)
- Mayla Santana Correia
- Instituto do Cancer do Estado de São Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, 01246-000, Brazil.
| | - Iuri Santana Neville
- Instituto do Cancer do Estado de São Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, 01246-000, Brazil; Division of Neurosurgery, LIM-62, Department of Neurology, University of Sao Paulo Medical School, Sao Paulo, 01246-903, Brazil
| | - Cesar Cimonari de Almeida
- Division of Neurosurgery, LIM-62, Department of Neurology, University of Sao Paulo Medical School, Sao Paulo, 01246-903, Brazil
| | - Cintya Yukie Hayashi
- Division of Neurosurgery, LIM-62, Department of Neurology, University of Sao Paulo Medical School, Sao Paulo, 01246-903, Brazil
| | - Luana Talita Diniz Ferreira
- Hospital Samaritano Paulista, Sao Paulo, 01333-030, Brazil; School of Public Health, University of Sao Paulo, Sao Paulo, 01246-904, Brazil
| | - Danilo Gomes Quadros
- Division of Neurosurgery, LIM-62, Department of Neurology, University of Sao Paulo Medical School, Sao Paulo, 01246-903, Brazil
| | | | - Davi Jorge Fontoura Solla
- Division of Neurosurgery, LIM-62, Department of Neurology, University of Sao Paulo Medical School, Sao Paulo, 01246-903, Brazil
| | - Gustavo Nader Marta
- Instituto do Cancer do Estado de São Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, 01246-000, Brazil; Department of Radiation Oncology, Hospital Sírio-Libanês, Sao Paulo, 01308-050, Brazil
| | - Manoel Jacobsen Teixeira
- Division of Neurosurgery, LIM-62, Department of Neurology, University of Sao Paulo Medical School, Sao Paulo, 01246-903, Brazil; Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, 01246-903, Brazil
| | - Wellingson Silva Paiva
- Division of Neurosurgery, LIM-62, Department of Neurology, University of Sao Paulo Medical School, Sao Paulo, 01246-903, Brazil; Hospital Samaritano Paulista, Sao Paulo, 01333-030, Brazil
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Schiff D, Van den Bent M, Vogelbaum MA, Wick W, Miller CR, Taphoorn M, Pope W, Brown PD, Platten M, Jalali R, Armstrong T, Wen PY. Recent developments and future directions in adult lower-grade gliomas: Society for Neuro-Oncology (SNO) and European Association of Neuro-Oncology (EANO) consensus. Neuro Oncol 2020; 21:837-853. [PMID: 30753579 DOI: 10.1093/neuonc/noz033] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
The finding that most grades II and III gliomas harbor isocitrate dehydrogenase (IDH) mutations conveying a relatively favorable and fairly similar prognosis in both tumor grades highlights that these tumors represent a fundamentally different entity from IDH wild-type gliomas exemplified in most glioblastoma. Herein we review the most recent developments in molecular neuropathology leading to reclassification of these tumors based upon IDH and 1p/19q status, as well as the potential roles of methylation profiling and deletional analysis of cyclin-dependent kinase inhibitor 2A and 2B. We discuss the epidemiology, clinical manifestations, benefit of surgical resection, and neuroimaging features of lower-grade gliomas as they relate to molecular subtype, including advanced imaging techniques such as 2-hydroxyglutarate magnetic resonance spectroscopy and amino acid PET scanning. Recent, ongoing, and planned studies of radiation therapy and both cytotoxic and targeted chemotherapies are summarized, including both small molecule and immunotherapy approaches specifically targeting the mutant IDH protein.
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Affiliation(s)
- David Schiff
- Department of Neurology, University of Virginia, Charlottesville, Virginia
| | - Martin Van den Bent
- Department of Neurology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | | | - Wolfgang Wick
- Divison of Neuro-Oncology, German Cancer Research Center, Heidelberg, Germany
| | - C Ryan Miller
- Pathology and Lab Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Martin Taphoorn
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - Whitney Pope
- Section of Neuroradiology, UCLA, Los Angeles, California
| | - Paul D Brown
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota
| | - Michael Platten
- Department of Neurology, Mannheim University Hospital, Mannheim, Germany
| | | | - Terri Armstrong
- Neuro-Oncology Branch, National Institute of Health, Bethesda, Maryland
| | - Patrick Y Wen
- Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
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Zarino B, Di Cristofori A, Fornara GA, Bertani GA, Locatelli M, Caroli M, Rampini P, Cogiamanian F, Crepaldi D, Carrabba G. Long-term follow-up of neuropsychological functions in patients with high grade gliomas: can cognitive status predict patient's outcome after surgery? Acta Neurochir (Wien) 2020; 162:803-812. [PMID: 31993749 DOI: 10.1007/s00701-020-04230-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 01/13/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Patients affected by a high-grade glioma (HGG) have a poor prognosis with a median survival of 12-16 months. Such poor prognosis affects the perception of the remaining life by patients and the neuropsychological status can strongly affect every-day functioning of these patients. Monitoring changes of neuropsychological functioning (NPF) overtime may provide better clinical information and optimize the neuro-oncological management. The aims of our work were (1) to investigate the feasibility of a complex neuropsychological battery in HGG patients before and during follow-up after surgery; (2) to study the neuropsychological profile of patients affected by HGGs and their relation with the disease status (relapse/death) across time after surgery. METHODS One hundred two patients who received surgery for HGG between 2011 and 2017 were studied. All clinical data were prospectively recorded. NPF was assessed during the neuro-oncological follow-up through the Milano-Bicocca Battery (MIBIB). Statistical analysis was performed on the neuropsychological results of the tests administered. RESULTS First, MIBIB proved to be suitable for patients with HGG tumors before and after surgery, and during long-term follow-up; it also showed a cluster structure representative of the principal cognitive domains. Second, we found a steep decline in the neuropsychological profile before death and/or tumor relapse for the 52% of the neuropsychological tests administered. CONCLUSION Complex neuropsychological batteries can be administered to HGG patients before and during follow-up after surgery. There is a correlation between neuropsychological deterioration and tumor relapse and/or death, which may reflect a progressive damage to cognitive functions due to tumor infiltration and progression.
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Affiliation(s)
- Barbara Zarino
- Unit of Neurosurgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35 (Padiglione Monteggia), 20122, Milan, Italy.
| | - Andrea Di Cristofori
- Unit of Neurosurgery, Azienda Socio SanitariaTerritoriale - Monza, Ospedale San Gerardo, Via Pergolesi 33, 20900, Monza, MB, Italy.
| | - Giorgia Abete Fornara
- Unit of Neurosurgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35 (Padiglione Monteggia), 20122, Milan, Italy
| | - Giulio Andrea Bertani
- Unit of Neurosurgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35 (Padiglione Monteggia), 20122, Milan, Italy
| | - Marco Locatelli
- Unit of Neurosurgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35 (Padiglione Monteggia), 20122, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Manuela Caroli
- Unit of Neurosurgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35 (Padiglione Monteggia), 20122, Milan, Italy
| | - Paolo Rampini
- Unit of Neurosurgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35 (Padiglione Monteggia), 20122, Milan, Italy
| | - Filippo Cogiamanian
- Unit of Neurophysiopathology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Davide Crepaldi
- Neuroscience Area, Scuola Internazionale Superiore di Studi Avanzati (SISSA), Trieste, Italy
| | - Giorgio Carrabba
- Unit of Neurosurgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35 (Padiglione Monteggia), 20122, Milan, Italy
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Penas-Prado M, Wu J, Cahill DP, Brat DJ, Costello JF, Kluetz PG, Cairncross JG, van den Bent M, Verhaak RGW, Aboud O, Burger P, Chang SM, Cordova C, Huang RY, Rowe LS, Taphoorn MJB, Gilbert MR, Armstrong TS. Proceedings of the Comprehensive Oncology Network Evaluating Rare CNS Tumors (NCI-CONNECT) Oligodendroglioma Workshop. Neurooncol Adv 2019; 2:vdz048. [PMID: 33289010 DOI: 10.1093/noajnl/vdz048] [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: 01/08/2023] Open
Abstract
Background Oligodendroglioma is a rare primary central nervous system (CNS) tumor with highly variable outcome and for which therapy is usually not curative. At present, little is known regarding the pathways involved with progression of oligodendrogliomas or optimal biomarkers for stratifying risk. Developing new therapies for this rare cancer is especially challenging. To overcome these challenges, the neuro-oncology community must be particularly innovative, seeking multi-institutional and international collaborations, and establishing partnerships with patients and advocacy groups thereby ensuring that each patient enrolled in a study is as informative as possible. Methods The mission of the National Cancer Institute's NCI-CONNECT program is to address the challenges and unmet needs in rare CNS cancer research and treatment by connecting patients, health care providers, researchers, and advocacy organizations to work in partnership. On November 19, 2018, the program convened a workshop on oligodendroglioma, one of the 12 rare CNS cancers included in its initial portfolio. The purpose of this workshop was to discuss scientific progress and regulatory challenges in oligodendroglioma research and develop a call to action to advance research and treatment for this cancer. Results The recommendations of the workshop include a multifaceted and interrelated approach covering: biology and preclinical models, data sharing and advanced molecular diagnosis and imaging; clinical trial design; and patient outreach and engagement. Conclusions The NCI-CONNECT program is well positioned to address challenges in oligodendroglioma care and research in collaboration with other stakeholders and is developing a list of action items for future initiatives.
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Affiliation(s)
| | - Jing Wu
- Neuro-Oncology Branch/National Cancer Institute, Bethesda, Maryland
| | - Daniel P Cahill
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Daniel J Brat
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Joseph F Costello
- Department of Neurological Surgery, University of California, San Francisco
| | - Paul G Kluetz
- Oncology Center of Excellence, U.S. Food and Drug Administration, Washington DC
| | | | | | - Roel G W Verhaak
- Jackson Laboratory for Genomic Medicine, Farmington, Connecticut
| | - Orwa Aboud
- Neuro-Oncology Branch/National Cancer Institute, Bethesda, Maryland.,Brain Tumor Program, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland
| | - Peter Burger
- Neuropathology Division, Johns Hopkins, Baltimore, Maryland
| | - Susan M Chang
- Department of Neurological Surgery, University of California, San Francisco
| | - Christine Cordova
- Neuro-Oncology Branch/National Cancer Institute, Bethesda, Maryland.,NYU School of Medicine, Laura and Isaac Perlmutter Cancer Center, New York, NY
| | - Raymond Y Huang
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Lindsay S Rowe
- Radiation Oncology Branch/National Cancer Institute, Bethesda, Maryland
| | - Martin J B Taphoorn
- Leiden University Medical Center and Haaglanden Medical Center, The Hague, The Netherlands
| | - Mark R Gilbert
- Neuro-Oncology Branch/National Cancer Institute, Bethesda, Maryland
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10
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Rosenlund L, Degsell E, Jakola AS. Moving from clinician-defined to patient-reported outcome measures for survivors of high-grade glioma. Patient Relat Outcome Meas 2019; 10:267-276. [PMID: 31692481 PMCID: PMC6711557 DOI: 10.2147/prom.s179313] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 07/23/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Persons with high-grade glioma face both neurological and cancer-related symptoms from the tumor itself and its treatment affecting their daily lives. Survival alone is not an adequate outcome, the quality of the survivorship experience needs to be regarded with equal importance. Patient-reported outcome (PRO) measures can be used to evaluate treatment effects and symptom management interventions. PURPOSE The aim of this review was to identify the use, challenges, and potential of PRO measures in survivors of high-grade glioma. METHODS A narrative expert opinion review was performed on the subject. In addition to our own experiences we searched PubMed, Cumulative Index to Nursing and Allied Health Literature, the Cochrane Library, and PsycINFO for brain tumor-specific PRO measures used in the population of adult patients with high-grade glioma, both original articles and reviews were included. RESULTS There are several PRO measures that have been validated for patients with primary brain tumors including high-grade glioma. PRO measures are used both in clinical trials to evaluate the effect of treatment on health-related quality of life, and in daily clinical practice for holistic needs assessment and symptom management. Common PRO measures used for patients with high-grade glioma are European Organization for Research and Treatment of Cancer general instrument for patients with cancer together with brain tumor module, Functional Assessment of Cancer Therapy-Brain, and MD Anderson Symptom Inventory for Brain Tumor. Neurologic and cognitive disorders often occur in patients with high-grade glioma, which affects patients' ability to self-report over time, making it more challenging in this population. PRO as a primary outcome seems underutilized. CONCLUSION For clinical research, PRO measures need to be used together with other clinical outcome measures rather than replacing traditional outcome measures. Moving to more use of PRO measures in survivorship care has potential to improve patient-caregiver-healthcare team communication, symptom management, and quality of care. Implementing PROs in survivorship care should also involve caregivers and a response based on the results.
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Affiliation(s)
- Lena Rosenlund
- Regional Cancer Centre Stockholm, Stockholm, Sweden
- Institute of Health and Care Sciences, Sahlgrenska Academy, Gothenburg, Sweden
| | - Eskil Degsell
- Regional Cancer Centre Stockholm, Stockholm, Sweden
- Malignant Brain Tumor Pathway, Quality and Patient Safety Department, Karolinska University Hospital, Stockholm, Sweden
- The Swedish Brain Tumor Association, Stockholm, Sweden
| | - Asgeir Store Jakola
- Department of Clinical Neurosciences, Institute of Physiology and Neuroscience, Sahlgrenska Academy, Gothenburg, Sweden
- Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Neurosurgery, St. Olavs Hospital, Trondheim, Norway
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11
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Oort Q, Taphoorn MJB, Sikkes SAM, Uitdehaag BMJ, Reijneveld JC, Dirven L. Evaluation of the content coverage of questionnaires containing basic and instrumental activities of daily living (ADL) used in adult patients with brain tumors. J Neurooncol 2019; 143:1-13. [PMID: 30887244 PMCID: PMC6482128 DOI: 10.1007/s11060-019-03136-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Accepted: 02/26/2019] [Indexed: 11/15/2022]
Abstract
Background Everyday functioning can be assessed using measures of basic activities of daily living (BADL) or instrumental activities of daily living (IADL). The aim of this review was to provide an overview of the scope and specific content of BADL and/or IADL covered by currently used questionnaires in adult brain tumor patient studies. Methods Electronic databases were searched up to April 2017 to identify all eligible questionnaires with items regarding BADL/IADL in studies with adult brain tumor patients. Articles were selected using predetermined in- and exclusion criteria. Items with similar content were clustered into domains based on type of activity. Results Thirty-one unique questionnaires containing at least one BADL and/or IADL item were identified; 21 and 29 questionnaires containing ≥ 1 BADL or IADL item, respectively. The percentage of ADL items in these questionnaires ranged from 4 to 100%. Only two questionnaires were specifically developed to measure BADL (Barthel Index and Katz-ADL) and two specifically for IADL (Lawton-Brody IADL and preliminary IADL-BN). Content clustering revealed that IADL had a larger variation in content (31 domains, e.g. work or leisure time activities) compared to BADL (15 domains, e.g. mobility or bathing/washing). Conclusion Thirty-one questionnaires previously used in brain tumor studies contained items on BADL and/or IADL and covered a wide range of content, in particular for IADL. It is currently unclear which BADL/IADL are most relevant for brain tumor patients, and this should therefore be evaluated. Next, existing questionnaires could be adapted or validated, or new measures can be developed to meet these needs. Electronic supplementary material The online version of this article (10.1007/s11060-019-03136-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Quirien Oort
- Department of Neurology and Brain Tumor Center Amsterdam, Amsterdam University Medical Centers (Location VUmc), PO BOX 7057, 1007 MB, Amsterdam, The Netherlands.
| | - Martin J B Taphoorn
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.,Department of Neurology, Haaglanden Medical Center, The Hague, The Netherlands
| | - Sietske A M Sikkes
- Department of Epidemiology and Biostatistics, Amsterdam University Medical Centers (Location VUmc), Amsterdam, The Netherlands.,Alzheimer Center, Amsterdam University Medical Centers (Location VUmc), Amsterdam, The Netherlands
| | - Bernard M J Uitdehaag
- Department of Neurology and Brain Tumor Center Amsterdam, Amsterdam University Medical Centers (Location VUmc), PO BOX 7057, 1007 MB, Amsterdam, The Netherlands
| | - Jaap C Reijneveld
- Department of Neurology and Brain Tumor Center Amsterdam, Amsterdam University Medical Centers (Location VUmc), PO BOX 7057, 1007 MB, Amsterdam, The Netherlands.,Department of Neurology, Amsterdam University Medical Centers (Location AMC), Amsterdam, The Netherlands
| | - Linda Dirven
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.,Department of Neurology, Haaglanden Medical Center, The Hague, The Netherlands
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12
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Ambient Intelligence Environment for Home Cognitive Telerehabilitation. SENSORS 2018; 18:s18113671. [PMID: 30380634 PMCID: PMC6263953 DOI: 10.3390/s18113671] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 10/19/2018] [Accepted: 10/25/2018] [Indexed: 01/07/2023]
Abstract
Higher life expectancy is increasing the number of age-related cognitive impairment cases. It is also relevant, as some authors claim, that physical exercise may be considered as an adjunctive therapy to improve cognition and memory after strokes. Thus, the integration of physical and cognitive therapies could offer potential benefits. In addition, in general these therapies are usually considered boring, so it is important to include some features that improve the motivation of patients. As a result, computer-assisted cognitive rehabilitation systems and serious games for health are more and more present. In order to achieve a continuous, efficient and sustainable rehabilitation of patients, they will have to be carried out as part of the rehabilitation in their own home. However, current home systems lack the therapist’s presence, and this leads to two major challenges for such systems. First, they need sensors and actuators that compensate for the absence of the therapist’s eyes and hands. Second, the system needs to capture and apply the therapist’s expertise. With this aim, and based on our previous proposals, we propose an ambient intelligence environment for cognitive rehabilitation at home, combining physical and cognitive activities, by implementing a Fuzzy Inference System (FIS) that gathers, as far as possible, the knowledge of a rehabilitation expert. Moreover, smart sensors and actuators will attempt to make up for the absence of the therapist. Furthermore, the proposed system will feature a remote monitoring tool, so that the therapist can supervise the patients’ exercises. Finally, an evaluation will be presented where experts in the rehabilitation field showed their satisfaction with the proposed system.
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