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Sinnott JA, Torkashvand E, Meade CE, Salani R, Vetter MH, Hall B, Skolnick R, Bixel KL, Cohn DE, Cosgrove CM, Copeland LJ, Hebert C, Felix AS. Changes in prospectively collected patient-reported outcomes among women with incident endometrial cancer. J Cancer Surviv 2024:10.1007/s11764-024-01536-z. [PMID: 38265703 DOI: 10.1007/s11764-024-01536-z] [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: 09/13/2023] [Accepted: 01/12/2024] [Indexed: 01/25/2024]
Abstract
PURPOSE We examined associations between patient and treatment characteristics with longitudinally collected patient-reported outcome (PRO) measures to provide a data-informed description of the experiences of women undergoing treatment for endometrial cancer. METHODS We administered National Institutes of Health Patient Reported Outcomes Measurement Information System (PROMIS) questionnaires at the preoperative visit and at 6 and 12 months after surgery. Anxiety, depression, fatigue, sleep disturbance, pain, physical function, and ability to participate in social roles were assessed. Analysis of variance (ANOVA) and linear mixed models were used to examine associations between patient characteristics and PRO measures at baseline and through time. RESULTS Of 187 women enrolled, 174 (93%) and 103 (69%) completed the 6- and 12-month questionnaires, respectively. Anxiety was substantially elevated at baseline (half of one population-level standard deviation) and returned to general population mean levels at 6 and 12 months. Younger age, Medicaid/None/Self-pay insurance, prevalent diabetes, and current smoking were associated with higher symptom burden on multiple PRO measures across the three time points. Women with aggressive histology, higher disease stage, or those with adjuvant treatment had worse fatigue at 6 months, which normalized by 12 months. CONCLUSIONS We observed a high symptom burden at endometrial cancer diagnosis, with most PRO measures returning to general population means by 1 year. Information on risk factor-PRO associations can be used during the clinical visit to inform supportive service referral. IMPLICATIONS FOR CANCER SURVIVORS These findings can inform clinicians' discussions with endometrial cancer survivors regarding expected symptom trajectory following diagnosis and treatment.
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Affiliation(s)
- Jennifer A Sinnott
- Department of Statistics, The Ohio State University College of Arts and Sciences, Columbus, OH, USA
| | - Elaheh Torkashvand
- Division of Epidemiology, The Ohio State University College of Public Health, 1841 Neil Avenue, 304 Cunz Hall, Columbus, OH, 43210, USA
| | - Caitlin E Meade
- Division of Epidemiology, The Ohio State University College of Public Health, 1841 Neil Avenue, 304 Cunz Hall, Columbus, OH, 43210, USA
| | - Ritu Salani
- Department of Obstetrics and Gynecology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Monica Hagan Vetter
- Division of Gynecologic Oncology, Baptist Health Medicine Group, Lexington, KY, USA
| | - Bobbie Hall
- Division of Epidemiology, The Ohio State University College of Public Health, 1841 Neil Avenue, 304 Cunz Hall, Columbus, OH, 43210, USA
| | | | - Kristin L Bixel
- Division of Gynecologic Oncology, The Ohio State University College of Medicine, Columbus, OH, USA
| | - David E Cohn
- Division of Gynecologic Oncology, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Casey M Cosgrove
- Division of Gynecologic Oncology, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Larry J Copeland
- Division of Gynecologic Oncology, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Courtney Hebert
- Division of Biomedical Informatics, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Ashley S Felix
- Division of Epidemiology, The Ohio State University College of Public Health, 1841 Neil Avenue, 304 Cunz Hall, Columbus, OH, 43210, USA.
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Migchels C, Zerrouk A, Crunelle CL, Matthys F, Gremeaux L, Fernandez K, Antoine J, van den Brink W, Vanderplasschen W. Patient Reported Outcome and Experience Measures (PROMs and PREMs) in substance use disorder treatment services: A scoping review. Drug Alcohol Depend 2023; 253:111017. [PMID: 37995391 DOI: 10.1016/j.drugalcdep.2023.111017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 10/24/2023] [Accepted: 10/26/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND Substance use disorders (SUD) pose significant challenges for healthcare systems, and there is a need to monitor the provision of effective, individualized care to persons accessing treatment. Patient-Reported Outcome Measures (PROMs) and Patient-Reported Experience Measures (PREMs) are increasingly used in healthcare services to measure treatment outcomes and quality of care as perceived by patients, and to guide service improvement. OBJECTIVES This review aims to identify and characterize international developments regarding the use and systematic implementation of PROMs and PREMs in SUD treatment services. METHODS A scoping review was conducted searching multiple databases to identify studies on the use and routine implementation of PROMs and PREMs in SUD treatment services. RESULTS 23 articles were selected, all dating from 2016 onwards. There was large variation in the patient-reported measures that were used, how they were developed and how and when patient-reported data were collected. Treatment providers identified leadership support, the presence of an integrated electronic patient record, and regular feedback to be the most important facilitators of successful implementation of patient-reported measures into clinical practice, whilst treatment dropout and burden to staff and patients were the most important barriers to consider. CONCLUSIONS PROMs and PREMs are increasingly used in SUD treatment services, but guidance is needed to support researchers and clinicians in selecting and implementing valid, meaningful, and comparable measures if we want to understand the effects of PROM and PREM data collection and feedback on treatment quality and results.
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Affiliation(s)
- Charlotte Migchels
- Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Department of Psychiatry, Laarbeeklaan 101, Brussels, Belgium.
| | - Amine Zerrouk
- Department of Special Needs Education, Ghent University (UGent), Ghent, Belgium
| | - Cleo L Crunelle
- Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Department of Psychiatry, Laarbeeklaan 101, Brussels, Belgium
| | - Frieda Matthys
- Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Department of Psychiatry, Laarbeeklaan 101, Brussels, Belgium
| | - Lies Gremeaux
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Kim Fernandez
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Jérôme Antoine
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Wim van den Brink
- Amsterdam UMC, Department of Psychiatry, University of Amsterdam, Amsterdam, the Netherlands
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3
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Greene GJ, Beaumont JL, Bacalao EJ, Muftic A, Kaiser K, Eisenstein AR, Mandelin AM, Cella D, Ruderman EM. Integrating PROMIS Measures in a Treat-to-Target Approach to Standardize Patient-Centered Treatment of Rheumatoid Arthritis. J Rheumatol 2023; 50:1002-1008. [PMID: 37127317 PMCID: PMC11210325 DOI: 10.3899/jrheum.2022-1176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2023] [Indexed: 05/03/2023]
Abstract
OBJECTIVE To evaluate the effect of a patient-centered rheumatoid arthritis (RA) treat-to-target (T2T) disease management approach on patient outcomes and patient satisfaction with care. METHODS In this longitudinal, observational pilot study, rheumatologists implemented a modified T2T approach that integrated Patient Reported Outcomes Measurement Information System (PROMIS) measures for depression, fatigue, pain interference, physical function, and social function into RA care. Study participants selected 1 PROMIS domain to target treatment and completed quarterly follow-up assessments. Participants were classified as improved if their Clinical Disease Activity Index (CDAI) changed by > 5 points. Change in PROMIS t scores was examined for the group with improved CDAI, and then compared to those with unchanged or worsened CDAI. Satisfaction with care was assessed using multiple measures, including the Functional Assessment of Chronic Illness Therapy-Treatment Satisfaction-Patient Satisfaction Scale. RESULTS The analytical sample (n = 119, median age 57 years, 90.8% female) was split between those with CDAI > 10 (n = 63) and CDAI ≤ 10 (n = 53). At 1 year, there was improvement in CDAI by > 5 points in 66% and 13% of individuals with baseline CDAI > 10 and baseline CDAI ≤ 10, respectively. Across all participants, improvement in CDAI by > 5 points correlated with improvements in the 5 PROMIS domains. Satisfaction with RA treatment also increased. CONCLUSION The integration of PROMIS measures into the T2T approach for RA care was associated with improvements in disease activity, and improvement in disease activity was associated with improvements in PROMIS measures.
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Affiliation(s)
- George J Greene
- G.J. Greene, PhD, A. Muftic, BSW, K. Kaiser, PhD, A.R. Eisenstein, PhD, D. Cella, PhD, Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois;
| | - Jennifer L Beaumont
- J.L. Beaumont, MS, Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, and Clinical Outcomes Solutions, Tucson, Arizona
| | - Emily J Bacalao
- E.J. Bacalao, BS, A.M. Mandelin, MD, PhD, E.M. Ruderman, MD, Department of Medicine, Division of Rheumatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Azra Muftic
- G.J. Greene, PhD, A. Muftic, BSW, K. Kaiser, PhD, A.R. Eisenstein, PhD, D. Cella, PhD, Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Karen Kaiser
- G.J. Greene, PhD, A. Muftic, BSW, K. Kaiser, PhD, A.R. Eisenstein, PhD, D. Cella, PhD, Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Amy R Eisenstein
- G.J. Greene, PhD, A. Muftic, BSW, K. Kaiser, PhD, A.R. Eisenstein, PhD, D. Cella, PhD, Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Arthur M Mandelin
- E.J. Bacalao, BS, A.M. Mandelin, MD, PhD, E.M. Ruderman, MD, Department of Medicine, Division of Rheumatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - David Cella
- G.J. Greene, PhD, A. Muftic, BSW, K. Kaiser, PhD, A.R. Eisenstein, PhD, D. Cella, PhD, Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Eric M Ruderman
- E.J. Bacalao, BS, A.M. Mandelin, MD, PhD, E.M. Ruderman, MD, Department of Medicine, Division of Rheumatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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4
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Saeb S, Korst LM, Fridman M, McCulloch J, Greene N, Gregory KD. Capacity-Building for Collecting Patient-Reported Outcomes and Experiences (PRO) Data Across Hospitals. Matern Child Health J 2023:10.1007/s10995-023-03720-6. [PMID: 37347378 PMCID: PMC10359358 DOI: 10.1007/s10995-023-03720-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2023] [Indexed: 06/23/2023]
Abstract
PURPOSE Patient-reported outcomes and experiences (PRO) data are an integral component of health care quality measurement and PROs are now being collected by many healthcare systems. However, hospital organizational capacity-building for the collection and sharing of PROs is a complex process. We sought to identify the factors that facilitated capacity-building for PRO data collection in a nascent quality improvement learning collaborative of 16 hospitals that has the goal of improving the childbirth experience. DESCRIPTION We used standard qualitative case study methodologies based on a conceptual framework that hypothesizes that adequate organizational incentives and capacities allow successful achievement of project milestones in a collaborative setting. The 4 project milestones considered in this study were: (1) Agreements; (2) System Design; (3) System Development and Operations; and (4) Implementation. To evaluate the success of reaching each milestone, critical incidents were logged and tracked to determine the capacities and incentives needed to resolve them. ASSESSMENT The pace of the implementation of PRO data collection through the 4 milestones was uneven across hospitals and largely dependent on limited hospital capacities in the following 8 dimensions: (1) Incentives; (2) Leadership; (3) Policies; (4) Operating systems; (5) Information technology; (6) Legal aspects; (7) Cross-hospital collaboration; and (8) Patient engagement. From this case study, a trajectory for capacity-building in each dimension is discussed. CONCLUSION The implementation of PRO data collection in a quality improvement learning collaborative was dependent on multiple organizational capacities for the achievement of project milestones.
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Affiliation(s)
- Samia Saeb
- Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | | | | | | | - Naomi Greene
- Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Kimberly D Gregory
- Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
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5
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Fowe IE, Wallace NT, Kaye J. The Association of Learning Health System Practicing Hospitals and other Health Information Interested Hospitals with Patient-Generated Health Data Uptake. AMIA JOINT SUMMITS ON TRANSLATIONAL SCIENCE PROCEEDINGS. AMIA JOINT SUMMITS ON TRANSLATIONAL SCIENCE 2023; 2023:176-185. [PMID: 37350873 PMCID: PMC10283141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
Patient generated health data (PGHD) has been described as a necessary addition to provider-generated information for improving care processes in US hospitals. This study evaluated the distribution of Health Information Interested (HII) US hospitals that are more likely to capture or use PGHD. The literature suggests that HII hospitals are more likely to capture and use PGHD. Cross-sectional analysis of the 2018 American Hospital Association's (AHA) health-IT-supplement and other supporting datasets showed that HII hospitals collectively and majority of HII hospital subcategories evaluated were associated with increased PGHD capture and use. The full Learning Health System (LHS) hospital subcategory had the highest association and hospitals in the meaningful use stage three compliant (MU3) and PCORI funded subcategory also had higher rates of PGHD capture or use when in combination with LHS hospitals. Hence, being LHS appears to be the strongest practice and policy lever to increase PGHD capture and use.
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Affiliation(s)
- Ibukun E Fowe
- Post-Doctoral Researcher, Florida State University, Tallahassee, FL
| | - Neal T Wallace
- Professor of Health Systems Management & Policy, OHSU-PSU School of Public Health, Portland, OR
| | - Jeffrey Kaye
- Layton Professor of Neurology and Biomedical Engineering, and Director, ORCATECH, School of Medicine, OHSU, Portland, OR
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Graham L, Hart M, Stinson M, Moise R, Mitchell L, Winders TA, Gardner DD. "Black People Like Me": A virtual conference series to engage underserved patients with asthma in patient centered outcomes research. RESEARCH INVOLVEMENT AND ENGAGEMENT 2023; 9:13. [PMID: 36964633 PMCID: PMC10037352 DOI: 10.1186/s40900-023-00428-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 03/16/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND In response to racial inequity in asthma, asthma-related research among diverse patients is vital. However, people from historically marginalized groups are underrepresented in clinical and patient-centered outcomes research (PCOR). The "Black People Like Me" (BPLM) virtual conference series was developed to: (1) engage Black patients with asthma and their caregivers in education and discussions about asthma, and (2) encourage involvement in PCOR. Education about COVID-19 and COVID-19 vaccination was also incorporated. METHODS The Project Advisory Group consisting of Black patients, clergy, physicians, and a program evaluator met monthly to develop BPLM. The program consisted of free one-hour virtual sessions held monthly for 6 months. BPLM was promoted through the Allergy & Asthma Network website, emails, social media, and personal contacts with a recruitment goal of ≥ 100 Black patients with asthma or caregivers. Program evaluations, interactive polling questions during each session, and participant pre- and post-session tests were conducted. RESULTS Sessions averaged 658 participants including Black patients, family members, caregivers, Black clergy, health care providers, and other concerned community. Overall, 77% of participants strongly agreed with satisfaction with the sessions. Pre- and post-tests demonstrated that participants exhibited growth in knowledge regarding asthma risk, PCOR, and PCOR research opportunities for patients, exhibited preexisting and sustained knowledge regarding COVID-19 vaccination and side effects, and demonstrated an increased sense of empowerment during healthcare visits. CONCLUSIONS BPLM demonstrated that a virtual platform can successfully engage Black communities. Incorporating clergy and religious organizations was critical in developing the trust of the Black community towards BPLM.
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Affiliation(s)
- LeRoy Graham
- Allergy and Asthma Network, 10304 Eaton Place, Suite 100, Fairfax, VA, 22030, USA
| | - Mary Hart
- Allergy and Asthma Network, 10304 Eaton Place, Suite 100, Fairfax, VA, 22030, USA
| | | | - Rhoda Moise
- Rhoda Moise, LLC (dba Dr. Rho Wellness), Philadelphia, PA, USA
| | - Lynda Mitchell
- Allergy and Asthma Network, 10304 Eaton Place, Suite 100, Fairfax, VA, 22030, USA
| | - Tonya A Winders
- Allergy and Asthma Network, 10304 Eaton Place, Suite 100, Fairfax, VA, 22030, USA
| | - Donna D Gardner
- Allergy and Asthma Network, 10304 Eaton Place, Suite 100, Fairfax, VA, 22030, USA.
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Cohen ML, Harnish SM, Lanzi AM, Brello J, Hula WD, Victorson D, Nandakumar R, Kisala PA, Tulsky DS. Establishing severity levels for patient-reported measures of functional communication, participation, and perceived cognitive function for adults with acquired cognitive and language disorders. Qual Life Res 2022; 32:1659-1670. [PMID: 36572789 PMCID: PMC10172211 DOI: 10.1007/s11136-022-03337-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2022] [Indexed: 12/28/2022]
Abstract
PURPOSE To empirically assign severity levels (e.g., mild, moderate) to four relatively new patient-reported outcome measures (PROMs) for adults with acquired cognitive/language disorders. They include the Communicative Participation Item Bank, the Aphasia Communication Outcome Measure, and Neuro-QoL's item banks of Cognitive Function (v2.0) and Ability to Participate in Social Roles and Activities (v1.0). METHOD We conducted 17 focus groups that comprised 22 adults with an acquired cognitive/language disorder from stroke, Parkinson's disease, or traumatic brain injury; 30 care partners of an adult with an acquired cognitive/language disorder; and 42 speech-language pathologists who had experience assessing/treating individuals with those and other cognitive/language disorders. In a small, moderated focus-group format, participants completed "PROM-bookmarking" procedures: They discussed hypothetical vignettes based on PROM item responses about people with cognitive/language disorders and had to reach consensus regarding whether their symptoms/function should be categorized as within normal limits or mild, moderate, or severe challenges. RESULTS There was generally good agreement among the stakeholder groups about how to classify vignettes, particularly when they reflected very high or low functioning. People with aphasia described a larger range of functional communication challenges as "mild" compared to other stakeholder types. Based on a consensus across groups, we present severity levels for specific score ranges for each PROM. CONCLUSION Standardized, stakeholder-informed severity levels that aid interpretation of PROM scores can help clinicians and researchers derive better clinical meaning from those scores, for example, by identifying important clinical windows of opportunity and assessing when symptoms have returned to a "normal" range.
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Affiliation(s)
- Matthew L Cohen
- Department of Communication Sciences and Disorders, University of Delaware, 100 Discovery Blvd 6th Floor, Newark, DE, 19713, USA. .,Center for Health Assessment Research and Translation, University of Delaware, Newark, DE, 19713, USA.
| | - Stacy M Harnish
- Department of Speech and Hearing Science, The Ohio State University, Columbus, OH, 43210, USA
| | - Alyssa M Lanzi
- Department of Communication Sciences and Disorders, University of Delaware, 100 Discovery Blvd 6th Floor, Newark, DE, 19713, USA
| | - Jennifer Brello
- Department of Speech and Hearing Science, The Ohio State University, Columbus, OH, 43210, USA
| | - William D Hula
- Geriatric Research, Education, and Clinical Center, VA Health Care System, and Department of Communication Sciences and Disorders, University of Pittsburgh, Pittsburgh, PA, USA
| | - David Victorson
- School of Medicine Department of Medical Social Science, Northwestern University, Chicago, IL, 60611, USA
| | - Ratna Nandakumar
- University of Delaware School of Education, Newark, DE, 19713, USA
| | - Pamela A Kisala
- Center for Health Assessment Research and Translation, University of Delaware, Newark, DE, 19713, USA.,Department of Physical Therapy, University of Delaware, Newark, DE, 19713, USA
| | - David S Tulsky
- Center for Health Assessment Research and Translation, University of Delaware, Newark, DE, 19713, USA.,Department of Physical Therapy, University of Delaware, Newark, DE, 19713, USA
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Furumaya A, Nooijen LE, Haring MPD, van Oers HA, van Beneden M, van Rosmalen BV, Takkenberg RB, Kazemier G, Besselink MG, de Meijer VE, Erdmann JI. Development of a set of patient reported outcome measures for patients with benign liver tumours and cysts: patient focus groups and systematic review. J Patient Rep Outcomes 2022; 6:124. [PMID: 36484883 PMCID: PMC9733760 DOI: 10.1186/s41687-022-00531-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 11/30/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Patient reported outcome measures (PROMs) may be useful for patients with benign liver tumours and cysts (BLTC) to evaluate the impact of treatment and/or guide shared decision making. Yet, a set of PROMs relevant to patients with BLTC is currently unavailable. In this study, we selected a PROMs set for patients with BLTC. METHODS Potentially relevant patient reported outcomes (PROs) were selected by psychologist-researchers based on keywords used or suggested by participants of two virtual focus groups meetings consisting of thirteen female BLTC patients with a median age of 50 years. Subsequently, patients were asked to report their most relevant PROs. PROMs identified by systematic literature review and computerized adaptive tests (CATs) in the Patient-Reported Outcomes Measurement Information System (PROMIS) were considered in selecting the final PROMs set to assess relevant outcomes. RESULTS The most important PROs were: insecurity/anxiety (11/12 patients), pain (9/12 patients), fatigue (8/12 patients), and limitations in daily life (5/12 patients). The literature review included 23 studies, which used various generic and disease-specific PROMs, often not measuring (all) relevant PROs. The final selected PROMs set included numerical rating scales for pain, two questions on overall health and quality of life and four PROMIS CATs. CONCLUSIONS A PROMs set generically and efficiently measuring outcomes relevant for patients with BLTC was developed and may be used in future research and clinical practice.
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Affiliation(s)
- Alicia Furumaya
- Department of Surgery, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, The Netherlands
| | - Lynn E Nooijen
- Department of Surgery, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, The Netherlands
| | - Martijn P D Haring
- Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Hedy A van Oers
- Child and Adolescent Psychiatry and Psychosocial Care, Emma Children's Hospital, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development and Amsterdam Public Health, Amsterdam, The Netherlands
| | - Marlou van Beneden
- Department of Strategy and Policy and Care Support, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Belle V van Rosmalen
- Department of Surgery, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, The Netherlands
| | - R Bart Takkenberg
- Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, The Netherlands
- Department of Gastroenterology and Hepatology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
| | - Geert Kazemier
- Department of Surgery, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Marc G Besselink
- Department of Surgery, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, The Netherlands
| | - Vincent E de Meijer
- Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Joris I Erdmann
- Department of Surgery, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands.
- Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, The Netherlands.
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9
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Snyder Valier AR, Huxel Bliven KC, Lam KC, Valovich McLeod TC. Patient-reported outcome measures as an outcome variable in sports medicine research. Front Sports Act Living 2022; 4:1006905. [PMID: 36406772 PMCID: PMC9666499 DOI: 10.3389/fspor.2022.1006905] [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: 07/29/2022] [Accepted: 09/26/2022] [Indexed: 11/23/2022] Open
Abstract
Injury prevention and rehabilitation research often address variables that would be considered clinician-oriented outcomes, such as strength, range of motion, laxity, and return-to-sport. While clinician-oriented variables are helpful in describing the physiological recovery from injury, they neglect the patient perspective and aspects of patient-centered care. Variables that capture patient perspective are essential when considering the impact of injury and recovery on the lives of patients. The inclusion of patient-reported outcome measures (PROMs) as dependent variables in sports medicine research, including injury prevention and rehabilitation research, provides a unique perspective regarding the patient's perception of their health status, the effectiveness of treatments, and other information that the patient deems important to their care. Over the last 20 years, there has been a significant increase in the use of PROMs in sports medicine research. The growing body of work gives opportunity to reflect on what has been done and to provide some ideas of how to strengthen the evidence moving forward. This mini-review will discuss ideas for the inclusion of PROMs in sports medicine research, with a focus on critical factors, gaps, and future directions in this area of research. Important elements of research with PROMs, including instrument selection, administration, and interpretation, will be discussed and areas for improvement, consideration, and standardization will be provided.
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Affiliation(s)
- Alison R. Snyder Valier
- Department of Athletic Training, Arizona School of Health Sciences, A.T. Still University, Mesa, AZ, United States,School of Osteopathic Medicine in Arizona, A.T. Still University, Mesa, AZ, United States
| | - Kellie C. Huxel Bliven
- Department of Interdisciplinary Health Sciences, Arizona School of Health Sciences, A.T. Still University, Mesa, AZ, United States
| | - Kenneth C. Lam
- Department of Interdisciplinary Health Sciences, Arizona School of Health Sciences, A.T. Still University, Mesa, AZ, United States
| | - Tamara C. Valovich McLeod
- Department of Athletic Training, Arizona School of Health Sciences, A.T. Still University, Mesa, AZ, United States,School of Osteopathic Medicine in Arizona, A.T. Still University, Mesa, AZ, United States,*Correspondence: Tamara C. Valovich McLeod
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10
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Ahmad FS, Jackson KL, Yount SE, Rothrock NE, Kallen MA, Lacson L, Bilimoria KY, Kho AN, Mutharasan RK, McCullough PA, Bruckel J, Fedson S, Kimmel SE, Eton DT, Grady KL, Yancy CW, Cella D. The development and initial validation of the PROMIS®+HF-27 and PROMIS+HF-10 profiles. ESC Heart Fail 2022; 9:3380-3392. [PMID: 35841128 DOI: 10.1002/ehf2.14061] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 06/11/2022] [Accepted: 06/27/2022] [Indexed: 11/06/2022] Open
Abstract
AIMS Heart failure (HF) is a common and morbid condition impacting multiple health domains. We previously reported the development of the PROMIS®-Plus-HF (PROMIS+HF) profile measure, including universal and HF-specific items. To facilitate use, we developed shorter, PROMIS+HF profiles intended for research and clinical use. METHODS AND RESULTS Candidate items were selected based on psychometric properties and symptom range coverage. HF clinicians (n = 43) rated item importance and clinical actionability. Based on these results, we developed the PROMIS+HF-27 and PROMIS+HF-10 profiles with summary scores (0-100) for overall, physical, mental, and social health. In a cross-sectional sample (n = 600), we measured internal consistency reliability (Cronbach's alpha and Spearman-Brown), test-retest reliability (intraclass coefficient; n = 100), known-groups validity via New York Heart Association (NYHA) class, and convergent validity with Kansas City Cardiomyopathy Questionnaire (KCCQ) scores. In a longitudinal sample (n = 75), we evaluated responsiveness of baseline/follow-up scores by calculating mean differences and Cohen's d and comparing with paired t-tests. Internal consistency was good to excellent (α 0.82-0.94) for all PROMIS+HF-27 scores and acceptable to good (α/Spearman-Brown 0.60-0.85) for PROMIS+HF-10 scores. Test-retest intraclass coefficients were acceptable to excellent (0.75-0.97). Both profiles demonstrated known-groups validity for the overall and physical health summary scores based on NYHA class, and convergent validity for nearly all scores compared with KCCQ scores. In the longitudinal sample, we demonstrated responsiveness for PROMIS+HF-27 and PROMIS+HF-10 overall and physical summary scores. For the PROMIS+HF overall summary scores, a group-based increase of 7.6-8.3 points represented a small to medium change (Cohen's d = 0.40-0.42). For the PROMIS+HF physical summary scores, a group-based increase of 5.0-5.9 points represented a small to medium change (Cohen's d = 0.29-0.35). CONCLUSIONS The PROMIS+HF-27 and PROMIS+HF-10 profiles demonstrated good psychometric characteristics with evidence of responsiveness for overall and physical health. These new measures can facilitate patient-centred research and clinical care, such as improving care quality through symptom monitoring, facilitating shared decision-making, evaluating quality of care, assessing new interventions, and monitoring during the initiation and titration of guideline-directed medical therapy.
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Affiliation(s)
- Faraz S Ahmad
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, 676 North Saint Clair Street, Suite 600, Chicago, IL, 60611, USA.,The Center for Health Information Partnerships (CHIP), Institute of Public Health & Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Kathryn L Jackson
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Susan E Yount
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Nan E Rothrock
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Michael A Kallen
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Leilani Lacson
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Karl Y Bilimoria
- Surgical Outcomes and Quality Improvement Center (SOQIC), Department of Surgery and Center for Healthcare Studies, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Abel N Kho
- The Center for Health Information Partnerships (CHIP), Institute of Public Health & Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Raja Kannan Mutharasan
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, 676 North Saint Clair Street, Suite 600, Chicago, IL, 60611, USA
| | | | - Jeffrey Bruckel
- Division of Cardiology, University of Rochester Medical Center, Rochester, NY, USA
| | - Savitri Fedson
- Section of Cardiology, Michael E DeBakey Veterans Administration Medical Center, Houston, TX, USA.,Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, USA
| | - Stephen E Kimmel
- Department of Epidemiology, University of Florida College of Public Health and Health Professions and College of Medicine, Gainesville, FL, USA
| | - David T Eton
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA.,Division of Health Care Delivery Research, Mayo Clinic, Rochester, MN, USA
| | - Kathleen L Grady
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, 676 North Saint Clair Street, Suite 600, Chicago, IL, 60611, USA.,Division of Cardiac Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Clyde W Yancy
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, 676 North Saint Clair Street, Suite 600, Chicago, IL, 60611, USA
| | - David Cella
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Center for Patient Centered Outcomes, Institute of Public Health & Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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11
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Fowe IE, Wallace NT, Rissi JJ. The Evolution and Typology of Learning Health System Hospitals and other Health Information Interested Hospitals in the US. PERSPECTIVES IN HEALTH INFORMATION MANAGEMENT 2022; 19:1b. [PMID: 36035327 PMCID: PMC9335161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This study identifies the type, distribution, and interactions of US hospitals that identify as electronic-data-driven, patient-centric, and learning-focused. Such facilities, termed Health Information Interested (HII) hospitals in this study, meet the defining criteria for one or more of the following designations: learning health systems (LHS), Health Information Technology for Economic and Clinical Health (HITECH) meaningful use stage three compliant (MU3), Patient-Centered Outcomes Research Institute (PCORI) funded, or medical home/safety net (MH/SN) hospital. The American Hospital Association (AHA) IT supplemental survey and other supporting data spanning 2013 to 2018 were used to identify HII hospitals. HII hospitals increased from 19.9 percent to 62.4 percent of AHA reporting hospitals from 2013 to 2018. HII subcategories in 2018 such as the full LHS (37.2 percent) and MU3 (46.9 percent) were dominant, with 33.2 percent having both designations. This indicates increased interest in patient-centric, learning-focused care using electronic health data. This information can enable health information management (HIM) professionals to be aware of programs or approaches that can facilitate learning-focused, patient-centric care using electronic health data within health systems.
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12
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Tung TH, Luo C, Geng CZ, Tung YH, Wang BL. Coronavirus disease 2019 in dermatology practice: Perspective of three levels of prevention on public health. DERMATOL SIN 2022. [DOI: 10.4103/ds.ds_33_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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13
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Moazzami M, Katz P, Bonilla D, Engel L, Su J, Akhavan P, Anderson N, Tayer-Shifman OE, Beaton D, Touma Z. Validity and reliability of patient reported outcomes measurement information system computerized adaptive tests in systemic lupus erythematous. Lupus 2021; 30:2102-2113. [PMID: 34797991 PMCID: PMC8649426 DOI: 10.1177/09612033211051275] [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] [Indexed: 11/16/2022]
Abstract
BACKGROUND The evaluation of Patient Reported Outcomes Measurement Information System (PROMIS) computerized adaptive test (CAT) in adults with systemic lupus erythematous (SLE) is an emerging field of research. We aimed to examine the test-retest reliability and construct validity of the PROMIS CAT in a Canadian cohort of patients with SLE. METHODS Two hundred twenty-seven patients completed 14 domains of PROMIS CAT and seven legacy instruments during their clinical visits. Test-retest reliability of PROMIS was evaluated 7-10 days from baseline using intraclass correlation coefficient (ICC (2; 1)). The construct validity of the PROMIS CAT domains was evaluated against the commonly used legacy instruments, and also in comparison to disease activity and disease damage using Spearman correlations. A multitrait-multimethod matrix (MMM) approach was used to further assess construct validity comparing selected 10 domains of PROMIS and SF-36 domains. RESULTS Moderate to excellent reliability was found for all domains (ICC [2;1] ranging from lowest, 0.66 for Sleep Disturbance and highest, 0.93 for the Mobility domain). Comparing seven legacy instruments with 14 domains of PROMIS CAT, moderate to strong correlations (0.51-0.91) were identified. The average time to complete all PROMIS CAT domains was 11.7 min. The MMM further established construct validity by showing moderate to strong correlations (0.55-0.87) between select PROMIS and SF-36 domains; the average correlations from similar traits (convergent validity) were significantly greater than the average correlations from different traits. CONCLUSIONS These results provide evidence on the reliability and validity of PROMIS CAT in SLE in a Canadian cohort.
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Affiliation(s)
- Mitra Moazzami
- Department of Medicine, 43989The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Patricia Katz
- Department of Medicine and Health Policy, 8785University of California San Francisco, San Francisco, CA, USA
| | - Dennisse Bonilla
- Division of Rheumatology, Department of Medicine, Toronto Western Hospital-Lupus Clinic, 7989University Health Network, Toronto, ON, Canada
| | - Lisa Engel
- Department of Occupational Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, 8664University of Manitoba, Winnipeg, MB, Canada
| | - Jiandong Su
- Centre for Prognosis Studies in the Rheumatic Diseases, 7989University Health Network, Toronto, ON, Canada
| | - Pooneh Akhavan
- Division of Rheumatology, Department of Medicine, Mount Sinai Hospital, 12366University of Toronto Faculty of Medicine, Toronto, ON, Canada
| | - Nicole Anderson
- Division of Rheumatology, Department of Medicine, Toronto Western Hospital-Lupus Clinic, 7989University Health Network, Toronto, ON, Canada
| | | | - Dorcas Beaton
- Health Measurement, St. Michael's Hospital, University of Toronto, 7966Institute for Work and Health, Toronto, ON, Canada
| | - Zahi Touma
- Division of Rheumatology, Department of Medicine; Toronto Western Hospital-Lupus Clinic; Institute of Health Policy, Management and Evaluation, 7938University of Toronto, Toronto, ON, Canada
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14
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Cohen ML, Harnish SM, Lanzi AM, Brello J, Victorson D, Kisala PA, Nandakumar R, Tulsky DS. Adapting a Patient-Reported Outcome Bookmarking Task to be Accessible to Adults With Cognitive and Language Disorders. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:4403-4412. [PMID: 34699261 DOI: 10.1044/2021_jslhr-21-00071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Background Patient-reported outcome (PRO) measures produce scores that do not always have obvious clinical meaning. The PRO-bookmarking procedure is a new and promising way to make PRO measures more meaningful and interpretable. However, the materials and procedures of the task may benefit from adaptations to be more accessible to individuals with cognitive and language disorders. Aims This study aims to provide an overview of the iterative refinement process used to modify the materials and procedures of the PRO-bookmarking task so that they are more accessible to adults with acquired cognitive and language impairments. Method and Procedures Our team of health psychologists, neuropsychologists, and speech-language pathologists (SLPs) conducted two focus groups with SLPs and care partners of people with aphasia using the same PRO-bookmarking materials and procedures as previous reports. These PRO-bookmarking materials and procedures were then refined iteratively based on discussion with those who participated in focus groups and among the research team, and three more times in the course of 16 additional focus groups of different stakeholders: people with Parkinson's disease, aphasia, or traumatic brain injury; care partners of people with those conditions; and SLPs who have experience with those, and other adult-acquired conditions. Outcomes and Results The PRO-bookmarking materials and procedures underwent four iterations to make them clearer, simpler, and more accessible. For example, the materials included more structured text and graphic supports where appropriate and the procedures were clustered into smaller discrete tasks and displayed graphically when possible and appropriate. Conclusions PRO-bookmarking materials and procedures were made simpler and more structured to increase their accessibility to adults with cognitive and language impairments. In fact, these adaptations made the tasks simpler and clearer for all types of stakeholders.
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Affiliation(s)
- Matthew L Cohen
- Department of Communication Sciences and Disorders, University of Delaware, Newark
- Center for Health Assessment Research and Translation, University of Delaware, Newark
| | - Stacy M Harnish
- Department of Speech and Hearing Science, The Ohio State University, Columbus
| | - Alyssa M Lanzi
- Department of Communication Sciences and Disorders, University of Delaware, Newark
| | - Jennifer Brello
- Department of Speech and Hearing Science, The Ohio State University, Columbus
| | - David Victorson
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Pamela A Kisala
- Center for Health Assessment Research and Translation, University of Delaware, Newark
| | | | - David S Tulsky
- Center for Health Assessment Research and Translation, University of Delaware, Newark
- Department of Physical Therapy, University of Delaware, Newark
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15
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Bingham CO, Butanis AL, Orbai AM, Jones M, Ruffing V, Lyddiatt A, Schrandt MS, Bykerk VP, Cook KF, Bartlett SJ. Patients and clinicians define symptom levels and meaningful change for PROMIS pain interference and fatigue in RA using bookmarking. Rheumatology (Oxford) 2021; 60:4306-4314. [PMID: 33471127 PMCID: PMC8633670 DOI: 10.1093/rheumatology/keab014] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 11/30/2020] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVES Using patient-reported outcomes to inform clinical decision-making depends on knowing how to interpret scores. Patient-Reported Outcome Measurement Information System® (PROMIS®) instruments are increasingly used in rheumatology research and care, but there is little information available to guide interpretation of scores. We sought to identify thresholds and meaningful change for PROMIS Pain Interference and Fatigue scores from the perspective of RA patients and clinicians. METHODS We developed patient vignettes using the PROMIS item banks representing a continuum of Pain Interference and Fatigue levels. During a series of face-to-face 'bookmarking' sessions, patients and clinicians identified thresholds for mild, moderate and severe levels of symptoms and identified change deemed meaningful for making treatment decisions. RESULTS In general, patients selected higher cut points to demarcate thresholds than clinicians. Patients and clinicians generally identified changes of 5-10 points as representing meaningful change. The thresholds and meaningful change scores of patients were grounded in their lived experiences having RA, approach to self-management, and the impacts on function, roles and social participation. CONCLUSION Results offer new information about how both patients and clinicians view RA symptoms and functional impacts. Results suggest that patients and providers may use different strategies to define and interpret RA symptoms, and select different thresholds when describing symptoms as mild, moderate or severe. The magnitude of symptom change selected by patients and clinicians as being clinically meaningful in interpreting treatment efficacy and loss of response may be greater than levels determined by external anchor and statistical methods.
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Affiliation(s)
- Clifton O Bingham
- Division of Rheumatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Alessandra L Butanis
- Division of Rheumatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ana Maria Orbai
- Division of Rheumatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Michelle Jones
- Division of Rheumatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Victoria Ruffing
- Division of Rheumatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Anne Lyddiatt
- Patient Partners in Arthritis, Ingersoll, ON, Canada
| | | | | | - Karon F Cook
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Susan J Bartlett
- Division of Rheumatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Divisions of Clinical Epidemiology and Rheumatology, Department of Medicine, McGill University, CORE Offices
- Research Institute – McGill University Health Centre, Centre for Outcomes Research and Evaluation, Montreal, QC, Canada
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16
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Gupta A, Lai A, Mozersky J, Ma X, Walsh H, DuBois JM. Enabling qualitative research data sharing using a natural language processing pipeline for deidentification: moving beyond HIPAA Safe Harbor identifiers. JAMIA Open 2021; 4:ooab069. [PMID: 34435175 PMCID: PMC8382275 DOI: 10.1093/jamiaopen/ooab069] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/25/2021] [Accepted: 08/10/2021] [Indexed: 11/20/2022] Open
Abstract
Objective Sharing health research data is essential for accelerating the translation of research into actionable knowledge that can impact health care services and outcomes. Qualitative health research data are rarely shared due to the challenge of deidentifying text and the potential risks of participant reidentification. Here, we establish and evaluate a framework for deidentifying qualitative research data using automated computational techniques including removal of identifiers that are not considered HIPAA Safe Harbor (HSH) identifiers but are likely to be found in unstructured qualitative data. Materials and Methods We developed and validated a pipeline for deidentifying qualitative research data using automated computational techniques. An in-depth analysis and qualitative review of different types of qualitative health research data were conducted to inform and evaluate the development of a natural language processing (NLP) pipeline using named-entity recognition, pattern matching, dictionary, and regular expression methods to deidentify qualitative texts. Results We collected 2 datasets with 1.2 million words derived from over 400 qualitative research data documents. We created a gold-standard dataset with 280K words (70 files) to evaluate our deidentification pipeline. The majority of identifiers in qualitative data are non-HSH and not captured by existing systems. Our NLP deidentification pipeline had a consistent F1-score of ∼0.90 for both datasets. Conclusion The results of this study demonstrate that NLP methods can be used to identify both HSH identifiers and non-HSH identifiers. Automated tools to assist researchers with the deidentification of qualitative data will be increasingly important given the new National Institutes of Health (NIH) data-sharing mandate.
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Affiliation(s)
- Aditi Gupta
- Institute for Informatics, Washington University, St. Louis, Missouri, USA
| | - Albert Lai
- Institute for Informatics, Washington University, St. Louis, Missouri, USA
| | - Jessica Mozersky
- Bioethics Research Center, Division of General Medical Sciences, Washington University, St. Louis, Missouri, USA
| | - Xiaoteng Ma
- Institute for Informatics, Washington University, St. Louis, Missouri, USA
| | - Heidi Walsh
- Bioethics Research Center, Division of General Medical Sciences, Washington University, St. Louis, Missouri, USA
| | - James M DuBois
- Bioethics Research Center, Division of General Medical Sciences, Washington University, St. Louis, Missouri, USA
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17
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Teoh L, Chatfield MD, Acworth JP, McCallum GB, Chang AB. How Does the Canadian Acute Respiratory Illness and Flu Scale Relate to Other Scales in Pediatric Asthma Exacerbations? J Asthma 2021; 59:1590-1596. [PMID: 34156320 DOI: 10.1080/02770903.2021.1946823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objectives: In children with asthma exacerbations, we evaluated the relationship between Canadian Acute Respiratory Illness and Flu Scale (CARIFS) scores and (a) Asthma Diary Scale (ADS) scores for 14 days; (b) Pediatric Asthma Caregiver's Quality of Life (QoL) Questionnaire (PACQLQ) scores on days 1, 7 and 14; (c) viral detection. We hypothesized that in children with acute asthma, CARIFS scores correlate with ADS and PACQLQ scores over time and that viruses have little impact on CARIFS scores.Methods: In children aged 2-16 years who presented with acute asthma to the Emergency Departments of 2 hospitals, we documented the clinical history, examination, asthma severity at baseline and on presentation. Eighteen respiratory pathogens were determined by PCR on nasopharyngeal aspirate (NPA) collected on recruitment. The parent(s) recorded their child's daily CARIFS and ADS and weekly PACQLQ for 14 days. We used Spearman's correlation to relate the scores of 108 children.Results: CARIFS scores correlated well with ADS scores throughout 14 days (rs ranged 0.30-0.67). CARIFS and PACQLQ scores correlated -0.28, -0.14 and -0.44 on days 1, 7 and 14 respectively. There was no significant difference in CARIFS scores between children whose NPAs were PCR virus-positive or -negative over 14 days.Conclusions: CARIFS and ADS scores correlated well as a disease severity measure during the recovery period in children with acute asthma and this was not influenced by the virus state. The ADS may be used as an alternative in selected situations. The CARIFS reflects different aspects to acute asthma severity and QoL.
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Affiliation(s)
- Laurel Teoh
- Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Mark D Chatfield
- Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Jason P Acworth
- Emergency Medicine Department, Queensland Children's Hospital, Brisbane, Queensland, Australia
| | - Gabrielle B McCallum
- Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Anne B Chang
- Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.,Department of Respiratory and Sleep Medicine, Queensland Children's Hospital and Australian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
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18
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Cohen ML, Lanzi A, Boulton AJ. Clinical Use of PROMIS, Neuro-QoL, TBI-QoL, and Other Patient-Reported Outcome Measures for Individual Adult Clients with Cognitive and Language Disorders. Semin Speech Lang 2021; 42:192-210. [PMID: 34261163 PMCID: PMC9297691 DOI: 10.1055/s-0041-1731365] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Patient-reported outcome measures (PROMs) assess health outcomes from the patient's perspective. The National Institutes of Health has invested in the creation of numerous PROMs that comprise the PROMIS, Neuro-QoL, and TBI-QoL measurement systems. Some of these PROMs are potentially useful as primary or secondary outcome measures, or as contextual variables for the treatment of adults with cognitive/language disorders. These PROMs were primarily created for clinical research and interpretation of group means. They also have potential for use with individual clients; however, at present there is only sparse evidence and direction for this application of PROMs. Previous research by Cohen and Hula (2020) described how PROMs could support evidence-based practices in speech-language pathology. This companion article extends upon that work to present clinicians with implementation information about obtaining, administering, scoring, and interpreting PROMs for individual clients with cognitive/language disorders. This includes considerations of the type and extent of communication support that is appropriate, implications of the relatively large measurement error that accompanies individual scores and pairs of scores, and recommendations for applying minimal detectable change values depending on the clinician's desired level of measurement precision. However, more research is needed to guide the interpretation of PROM scores for an individual client.
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Affiliation(s)
- Matthew L. Cohen
- Department of Communication Sciences & Disorders; University of Delaware; Newark, DE, USA
- Center for Health Assessment Research and Translation; University of Delaware; Newark, DE, USA
| | - Alyssa Lanzi
- Department of Communication Sciences & Disorders; University of Delaware; Newark, DE, USA
| | - Aaron J. Boulton
- Center for Health Assessment Research and Translation; University of Delaware; Newark, DE, USA
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19
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Teoh L, Chatfield MD, Acworth JP, McCallum GB, Chang AB. Determinants of cough and caregivers' quality of life in pediatric asthma exacerbations. Pediatr Pulmonol 2021; 56:371-377. [PMID: 33179390 DOI: 10.1002/ppul.25168] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 10/26/2020] [Accepted: 11/03/2020] [Indexed: 01/26/2023]
Abstract
OBJECTIVES In hospitalized and nonhospitalized children with asthma exacerbations, we evaluated the determinants of (a) prolonged cough on day-14 and (b) asthma quality of life (QoL) questionnaires for parents (PACQLQ) on day-21. We hypothesized that children with more severe acute asthma are more likely to have prolonged cough and/or poorer PACQLQ during the recovery phase. DESIGN Prospective cohort study performed during 2009-2011. METHODOLOGY Two hundred and forty-four children aged 2-16 years presenting with acute asthma to the Emergency Departments of two hospitals were recruited. Clinical history, examination, baseline asthma severity, and acute asthma severity on presentation were documented. Validated daily cough diaries and weekly PACQLQ were recorded for 14 and 21 days, respectively. RESULTS 34.4% and 32.2% of children who returned the daytime and nighttime cough diaries respectively had a prolonged cough. Those on regular inhaled corticosteroids (ICS) were significantly more likely to have a daytime or nighttime cough score of ≥1 on day-14 (odds ratio [ORadjusted ] = 4.70, 95% confidence interval [CI] 1.65, 13.35, p = .004 and ORadjusted = 2.65, 95% CI 1.05, 6.69, p = .040, respectively). PACQLQ on day-21 was significantly poorer in younger children (mean difference [MD] = -0.04 per year, 95% CI -0.08, -0.01, p = .016), those on ICS (MD = -0.31, 95% CI -0.52, -0.09, p = .005), leukotriene antagonists (MD = -0.42, 95% CI -0.83, -0.02, p = .040) and in those who had an unplanned visit for asthma on day-21 (MD = -1.20, 95% CI -1.61, -0.78, p = .0001). CONCLUSIONS Post an acute asthma exacerbation, children on regular ICS were more likely to have prolonged cough and poorer QoL. While this may be reflective of asthma severity or control, its association deserves further evaluation.
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Affiliation(s)
- Laurel Teoh
- Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Mark D Chatfield
- Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Jason P Acworth
- Department of Emergency Medicine, Queensland Children's Hospital, Brisbane, Queensland, Australia
| | - Gabrielle B McCallum
- Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Anne B Chang
- Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.,Department of Respiratory and Sleep Medicine, Queensland Children's Hospital and Centre for Children's Health Research, Queensland University of Technology, Brisbane, Queensland, Australia
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20
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Hamilton DF, Giesinger JM, Giesinger K. Technological developments enable measuring and using patient-reported outcomes data in orthopaedic clinical practice. World J Orthop 2020; 11:584-594. [PMID: 33362994 PMCID: PMC7745490 DOI: 10.5312/wjo.v11.i12.584] [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: 04/28/2020] [Revised: 10/30/2020] [Accepted: 11/11/2020] [Indexed: 02/06/2023] Open
Abstract
Patient-reported outcomes measures form the backbone of outcomes evaluation in orthopaedics, with most of the literature now relying on these scoring tools to measure change in patient health status. This patient-reported information is increasingly collected routinely by orthopaedic providers but use of the data is typically restricted to academic research. Developments in electronic data capture and the outcome tools themselves now allow use of this data as part of the clinical consultation. This review evaluates the role of patient reported outcomes data as a tool to enhance daily orthopaedic clinical practice, and documents how develop-ments in electronic outcome measures, computer-adaptive questionnaire design and instant graphical display of questionnaire can facilitate enhanced patient-clinician shared decision making.
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Affiliation(s)
- David F Hamilton
- School of Health and Social Care, Edinburgh Napier University, Edinburgh EH114BN, United Kingdom
| | - Johannes M Giesinger
- University Hospital of Psychiatry II, Medical University of Innsbruck, Innsbruck 6020, Austria
| | - Karlmeinrad Giesinger
- Department of Orthopaedics and Traumatology, Kantonsspital St Gallen, St Gallen 9000, Switzerland
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Crins MHP, Terwee CB, Westhovens R, van Schaardenburg D, Smits N, Joly J, Verschueren P, Van der Elst K, Dekker J, Boers M, Roorda LD. First Validation of the Full PROMIS Pain Interference and Pain Behavior Item Banks in Patients With Rheumatoid Arthritis. Arthritis Care Res (Hoboken) 2020; 72:1550-1559. [PMID: 31562795 DOI: 10.1002/acr.24077] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 09/24/2019] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Pain interference and pain behavior are highly relevant outcomes in patients with rheumatoid arthritis (RA). The Patient-Reported Outcomes Measurement Information System (PROMIS) is a universally applicable set of item banks measuring patient-reported health, and if applied as computerized adaptive tests (CATs), more efficiently and precisely than current instruments. The objective was to study the psychometric properties of the Dutch-Flemish PROMIS pain interference (PROMIS-PI) and the PROMIS pain behavior (PROMIS-PB) item banks in patients with RA. METHODS A total of 2,029 patients with RA completed the full PROMIS-PI (version 1.1, 40 items), and 1,554 patients completed the full PROMIS-PB (version 1.1, 39 items). The following psychometric properties were studied: unidimensionality, local dependence, monotonicity and graded response model (GRM) fit, cross-cultural validity (differential item functioning [DIF] for language [Dutch versus Flemish]), other forms of measurement invariance, construct validity, reliability, and floor and ceiling effects. RESULTS The PROMIS-PI and PROMIS-PB banks were sufficiently unidimensional (Omega-hierarchical [Omega-H] 0.99, 0.95, and explained common variance 0.95, 0.78, respectively), had negligible local dependence (0.3-1.4% of item pairs), good monotonicity (H 0.75, 0.46), and a good GRM model fit (no misfitting items). Furthermore, both item banks showed good cross-cultural validity (no DIF for language), measurement invariance (no DIF for age, sex, administration mode, and disease activity), good construct validity (all hypotheses met), high reliability (>0.90 in the range of patients with RA), and an absence of floor and ceiling effects (0% minimum or maximum score, respectively). CONCLUSION Both PROMIS-PI and PROMIS-PB banks showed good psychometric properties in patients with RA and can be used as CATs in research and clinical practice.
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Affiliation(s)
- Martine H P Crins
- Amsterdam Rehabilitation Research Center, Reade, Amsterdam, The Netherlands
| | - Caroline B Terwee
- Amsterdam UMC, Vrije Universiteit Amsterdam, and Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | | | - Dirkjan van Schaardenburg
- Amsterdam Rheumatology and Immunology Center, Reade, and Academic Medical Center, Amsterdam, The Netherlands
| | - Niels Smits
- University of Amsterdam, Amsterdam, The Netherlands
| | - Johan Joly
- KU Leuven and University Hospitals Leuven, Leuven, Belgium
| | | | | | - Joost Dekker
- Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Maarten Boers
- Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam Rheumatology and Immunology Center, Reade, and VU University Medical Center, Amsterdam, The Netherlands
| | - Leo D Roorda
- Amsterdam Rehabilitation Research Center, Reade, Amsterdam, The Netherlands
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Bartlett SJ, Gutierrez AK, Andersen KM, Bykerk VP, Curtis JR, Haque UJ, Orbai AM, Jones MR, Bingham CO. Identifying Minimal and Meaningful Change in PROMIS ® for Rheumatoid Arthritis: Use of Multiple Methods and Perspectives. Arthritis Care Res (Hoboken) 2020; 74:588-597. [PMID: 33166066 PMCID: PMC10360361 DOI: 10.1002/acr.24501] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 10/22/2020] [Accepted: 11/03/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND Rheumatoid arthritis (RA) is chronic, painful, disabling condition resulting in significant impairments in physical, emotional, and social health. We used different methods and perspectives to evaluate the responsiveness of PROMIS® short forms (SFs) and identify minimal and meaningful score changes. METHODS Adults with RA enrolled in a multi-site prospective observational cohort completed PROMIS Physical Function, Pain Interference, Fatigue, Participation in Social Roles/Activities SFs, PROMIS-29, and pain, patient global, and rated change in specific symptoms and RA (a little vs. lot better or worse) at the second visit. Physicians recorded joint counts, MD Global Assessment, and change in RA at visit 2. We compared mean score differences for minimal and meaningful improvement/worsening using patient and MD change ratings and distribution-based methods, and visually inspected empirical cumulative distribution function curves by change categories. RESULTS The 348 adults were mostly (81%) female with longstanding RA. Using patient ratings, generally 1-3 point differences were observed for minimal change and 3-7 points for meaningful change. Larger differences were observed with patient vs. physician ratings and for symptom-specific vs. RA change. Mean differences were similar among SF versions. Prespecified hypotheses about change in PROMIS Physical Function, Pain Interference, Fatigue and Participation and legacy scales were supported. CONCLUSIONS PROMIS SFs and the PROMIS-29 Profile are responsive to change and generally distinguish between minimal and meaningful improvement and worsening in key RA domains. These data add to a growing body of evidence demonstrating robust psychometric properties of PROMIS and supporting use in RA care, research, and decision-making.
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Affiliation(s)
- Susan J Bartlett
- Divisions of Clinical Epidemiology and Rheumatology, McGill University, CORE Centre, 5252 de Maisonneuve #3D.57, Montreal, QC, Canada, H4A 3S5.,RI-MUHC, Centre for Outcomes Research and Evaluation and MUHC Center for Outcomes Research, 5252 de Maisonneuve #3D.57, Montreal, QC, Canada, H4A 3S5.,Division of Rheumatology, Johns Hopkins University, MFL Center Tower, 5200 Eastern Avenue, Suite 4100, Baltimore, MD, 21224, USA
| | - Anna Kristina Gutierrez
- Division of Rheumatology, Johns Hopkins University, MFL Center Tower, 5200 Eastern Avenue, Suite 4100, Baltimore, MD, 21224, USA
| | - Kathleen M Andersen
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street #W6021, Baltimore, MD, 21205, USA.,Center for Drug Safety and Effectiveness, Johns Hopkins University, 615 North Wolfe Street #W6035, Baltimore, MD, 21205, United States
| | - Vivian P Bykerk
- Rheumatology, Hospital for Special Surgery, Weill Cornell Medical College, 525 East 71st St, 7th floor, New York, NY, USA, 10021
| | - Jeffrey R Curtis
- University of Alabama at Birmingham, Division of Clinical Immunology and Rheumatology, Birmingham, AL, United States
| | - Uzma J Haque
- Division of Rheumatology, Johns Hopkins University, MFL Center Tower, 5200 Eastern Avenue, Suite 4100, Baltimore, MD, 21224, USA
| | - Ana-Maria Orbai
- Division of Rheumatology, Johns Hopkins University, MFL Center Tower, 5200 Eastern Avenue, Suite 4100, Baltimore, MD, 21224, USA
| | - Michelle R Jones
- Division of Rheumatology, Johns Hopkins University, MFL Center Tower, 5200 Eastern Avenue, Suite 4100, Baltimore, MD, 21224, USA
| | - Clifton O Bingham
- Division of Rheumatology, Johns Hopkins University, MFL Center Tower, 5200 Eastern Avenue, Suite 4100, Baltimore, MD, 21224, USA
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Lane CY, Givens DL, Thoma LM. General Functional Status: Common Outcome Measures for Adults With Rheumatic Disease. Arthritis Care Res (Hoboken) 2020; 72 Suppl 10:431-451. [PMID: 33091251 DOI: 10.1002/acr.24196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 03/24/2020] [Indexed: 12/30/2022]
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Packer T, Kephart G, Audulv Å, Keddy A, Warner G, Peacock K, Sampalli T. Protocol for development, calibration and validation of the Patient-Reported Inventory of Self-Management of Chronic Conditions (PRISM-CC). BMJ Open 2020; 10:e036776. [PMID: 32998919 PMCID: PMC7528366 DOI: 10.1136/bmjopen-2020-036776] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
INTRODUCTION Assessing and measuring patients' chronic condition self-management needs are critical to quality health care and to related research. One in three adults around the world live with multiple chronic conditions. While many patient-reported measures of self-management have been developed, none has emerged as the gold standard, and all have one or more of the following limitations: (1) they fail to measure the different domains of self-management important to patients, (2) they lack sufficient specificity to support patient-centred care or identify the specific components of self-management interventions that work and/or (3) they lack suitability for patients with multiple chronic conditions. METHODS AND ANALYSIS The Patient-Reported Inventory of Self-Management of Chronic Conditions (PRISM-CC) is being developed to overcome these shortcomings. It will measure respondents' perceived success (or difficulty) in self-managing seven domains important to patients. The protocol has three phases. Phase 1 is conceptual model development and item generation. Phase 2 is assessment of the relevance and understanding of items by people with chronic conditions. Phase 3 is item analysis, dimensionality assessment, scaling and preliminary validation of the PRISM-CC using an online survey of people with chronic conditions (n~750). The expected completion date is early 2021. ETHICS AND DISSEMINATION This study will adhere to the Canadian Tri-Council Policy Statement on Ethical Conduct for Research Involving Humans. Ethics approval for all phases has been obtained from the Nova Scotia Health Authority Research Ethics Board. Once completed, the PRISM-CC will be made available for research and healthcare at minimal to no cost.
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Affiliation(s)
- Tanya Packer
- Schools of Occupational Therapy and Health Administration, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
- Rehabilitation Department, Radboud Unversity Medical Centre, Nijmegen, Gelderland, The Netherlands
| | - George Kephart
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Åsa Audulv
- Department of Nursing, Umeå Universitet Medicinska fakulteten, Umea, Sweden
| | - America Keddy
- School of Occupational Therapy, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Grace Warner
- School of Occupational Therapy, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Kylie Peacock
- School of Occupational Therapy, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Tara Sampalli
- Research, Innovation and Discovery, Nova Scotia Health, Halifax, Nova Scotia, Canada
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Bartlett SJ, De Leon E, Orbai AM, Haque UJ, Manno RL, Ruffing V, Butanis A, Duncan T, Jones MR, Leong A, Perin J, Smith KC, Bingham CO. Patient-reported outcomes in RA care improve patient communication, decision-making, satisfaction and confidence: qualitative results. Rheumatology (Oxford) 2020; 59:1662-1670. [PMID: 31665477 DOI: 10.1093/rheumatology/kez506] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 09/24/2019] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE To evaluate the impact of integrating patient-reported outcomes (PROs) into routine clinics, from the perspective of patients with RA, clinicians and other staff. METHODS We conducted a prospective cohort study using a mixed methods sequential explanatory design at an academic arthritis clinic. RA patients completed selected Patient-Reported Outcomes Measurement Information System measures on tablets in the waiting room. Results were immediately available to discuss during the visit. Post-visit surveys with patients and physicians evaluated topics discussed and their impact on decision making; patients rated confidence in treatment. Focus groups or interviews with patients, treating rheumatologists and clinic staff were conducted to understand perspectives and experiences. RESULTS Some 196 patients and 20 rheumatologists completed post-visit surveys at 816 and 806 visits, respectively. Focus groups were conducted with 24 patients, 10 rheumatologists and 4 research/clinic staff. PROs influenced medical decision-making and RA treatment changes (38 and 18% of visits, respectively). Patients reported very high satisfaction and treatment confidence. Impact on clinical workflow was minimal after a period of initial adjustment. PROs were valued by patients and physicians, and provided new insight into how patients felt and functioned over time. Reviewing results together improved communication, and facilitated patient-centred care, shared decision making, and the identification of new symptoms and contributing psychosocial/behavioural factors. CONCLUSION PRO use at RA visits was feasible, increased understanding of how disease affects how patients feel and function, facilitated shared decision-making, and was associated with high patient satisfaction and treatment confidence.
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Affiliation(s)
- Susan J Bartlett
- Divisions of Clinical Epidemiology, Rheumatology and Respiratory Epidemiology and Clinical Trials Unit, McGill University, Center for Outcomes Research, Montreal, QC, Canada.,Division of Rheumatology, Department of Medicine, Johns Hopkins University
| | - Elaine De Leon
- Division of Rheumatology, Department of Medicine, Johns Hopkins University.,Center for Qualitative Studies in Health and Medicine, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Ana-Maria Orbai
- Division of Rheumatology, Department of Medicine, Johns Hopkins University
| | - Uzma J Haque
- Division of Rheumatology, Department of Medicine, Johns Hopkins University
| | - Rebecca L Manno
- Division of Rheumatology, Department of Medicine, Johns Hopkins University
| | - Victoria Ruffing
- Division of Rheumatology, Department of Medicine, Johns Hopkins University
| | - Alessandra Butanis
- Division of Rheumatology, Department of Medicine, Johns Hopkins University
| | - Trisha Duncan
- Division of Rheumatology, Department of Medicine, Johns Hopkins University
| | - Michelle R Jones
- Division of Rheumatology, Department of Medicine, Johns Hopkins University
| | | | - Jamie Perin
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Katherine Clegg Smith
- Center for Qualitative Studies in Health and Medicine, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Clifton O Bingham
- Division of Rheumatology, Department of Medicine, Johns Hopkins University
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Schichtel M, Wee B, Perera R, Onakpoya I. The Effect of Advance Care Planning on Heart Failure: a Systematic Review and Meta-analysis. J Gen Intern Med 2020; 35:874-884. [PMID: 31720968 PMCID: PMC7080664 DOI: 10.1007/s11606-019-05482-w] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 09/16/2019] [Accepted: 10/11/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND Advance care planning is widely advocated to improve outcomes in end-of-life care for patients suffering from heart failure. But until now, there has been no systematic evaluation of the impact of advance care planning (ACP) on clinical outcomes. Our aim was to determine the effect of ACP in heart failure through a meta-analysis of randomized controlled trials (RCTs). METHODS We searched CINAHL, Cochrane Central Register of Controlled Trials, Database of Systematic Reviews, Embase, ERIC, Ovid MEDLINE, Science Citation Index and PsycINFO (inception to July 2018). We selected RCTs including adult patients with heart failure treated in a hospital, hospice or community setting. Three reviewers independently screened studies, extracted data, assessed the risk of bias (Cochrane risk of bias tool) and evaluated the quality of evidence (GRADE tool) and analysed interventions according to the Template for Intervention Description and Replication (TIDieR). We calculated standardized mean differences (SMD) in random effects models for pooled effects using the generic inverse variance method. RESULTS Fourteen RCTs including 2924 participants met all of the inclusion criteria. There was a moderate effect in favour of ACP for quality of life (SMD, 0.38; 95% CI [0.09 to 0.68]), patients' satisfaction with end-of-life care (SMD, 0.39; 95% CI [0.14 to 0.64]) and the quality of end-of-life communication (SMD, 0.29; 95% CI [0.17 to 0.42]) for patients suffering from heart failure. ACP seemed most effective if it was introduced at significant milestones in a patient's disease trajectory, included family members, involved follow-up appointments and considered ethnic preferences. Several sensitivity analyses confirmed the statistically significant direction of effect. Heterogeneity was mainly due to different study settings, length of follow-up periods and compositions of ACP. CONCLUSIONS ACP improved quality of life, patient satisfaction with end-of-life care and the quality of end-of-life communication for patients suffering from heart failure and could be most effective when the right timing, follow-up and involvement of important others was considered.
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Affiliation(s)
- Markus Schichtel
- Department of Public Health and Primary Care, Primary Care Unit, University of Cambridge, Cambridge, UK.
| | - Bee Wee
- Oxford Centre for Education and Research in Palliative Care, Churchill Hospital, Oxford, UK
| | - Rafael Perera
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Igho Onakpoya
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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27
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Southerland LT, Stephens JA, Carpenter CR, Mion LC, Moffatt-Bruce SD, Zachman A, Hill M, Caterino JM. Study protocol for IMAGE: implementing multidisciplinary assessments for geriatric patients in an emergency department observation unit, a hybrid effectiveness/implementation study using the Consolidated Framework for Implementation Research. Implement Sci Commun 2020; 1:28. [PMID: 32885187 PMCID: PMC7427917 DOI: 10.1186/s43058-020-00015-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 01/27/2020] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Older adults in the emergency department (ED) are at high risk for functional decline, unrecognized delirium, falls, and medication interactions. Holistic assessment by a multidisciplinary team in the ED decreases these adverse outcomes and decreases admissions, but there are many barriers to incorporating this type of care during the ED visit. METHODS This is a hybrid type II effectiveness-implementation study using a pre-/post-cohort design (n = 380) at a tertiary care academic ED with an ED observation unit (Obs Unit). The intervention is a two-step protocol of (step 1) ED nurses screening adult patients ≥ 65 years old for geriatric needs using the Delirium Triage Screen, 4-Stage Balance Test, and the Identifying Seniors at Risk score. Patients who have geriatric needs identified by this screening but who do not meet hospital admission criteria will (step 2) be placed in the Obs Unit for multidisciplinary geriatric assessment by the hospital's geriatric consultation team, physical therapists, occupational therapists, pharmacists, and/or case managers. Not all patients may require all elements of the multidisciplinary geriatric assessment. The Consolidated Framework for Implementation Research: Care Transitions Framework was used to identify barriers to implementation. Lean Six Sigma processes will be used to overcome these identified barriers with the goal of achieving geriatric screening rates of > 80%. Implementation success and associated factors will be reported. For the effectiveness aim, pre-/post-cohorts of adults ≥ 65 years old cared for in the Obs Unit will be followed for 90 days post-ED visit (n = 150 pre and 230 post). The primary outcome is the prevention of functional decline. Secondary outcomes include health-related quality of life, new geriatric syndromes identified, new services provided, and Obs Unit metrics such as length of stay and admission rates. DISCUSSION A protocol for implementing integrated multidisciplinary geriatric assessment into the ED setting has the potential to improve patient functional status by identifying and addressing geriatric issues and needs prior to discharge from the ED. Using validated frameworks and implementation strategies will increase our understanding of how to improve the quality of ED care for older adults in the acute care setting. TRIAL REGISTRATION ClinicalTrials.gov Identifier, NCT04068311, registered 28 August 2019.
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Affiliation(s)
- Lauren T. Southerland
- Department of Emergency Medicine, The Ohio State Wexner Medical Center, 750 Prior Hall, 376 W 10th Ave, Columbus, OH 43210 USA
| | - Julie A. Stephens
- Center for Biostatistics, Department of Biomedical Informatics, The Ohio State College of Medicine, Columbus, OH USA
| | | | - Lorraine C. Mion
- College of Nursing, The Ohio State Wexner Medical Center, Columbus, OH USA
| | | | - Angela Zachman
- Department of Emergency Medicine, The Ohio State Wexner Medical Center, 750 Prior Hall, 376 W 10th Ave, Columbus, OH 43210 USA
| | - Michael Hill
- Department of Emergency Medicine, The Ohio State Wexner Medical Center, 750 Prior Hall, 376 W 10th Ave, Columbus, OH 43210 USA
| | - Jeffrey M. Caterino
- Department of Emergency Medicine, The Ohio State Wexner Medical Center, 750 Prior Hall, 376 W 10th Ave, Columbus, OH 43210 USA
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28
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Cohen ML, Hula WD. Patient-Reported Outcomes and Evidence-Based Practice in Speech-Language Pathology. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2020; 29:357-370. [PMID: 32011905 DOI: 10.1044/2019_ajslp-19-00076] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose The patient's perspective of their health is a core component of evidence-based practice (EBP) and person-centered care. Patient-reported outcomes (PROs), captured with PRO measures (PROMs), are the main way of formally soliciting and measuring the patient's perspective. Currently, however, PROs play a relatively small role in mainstream speech-language pathology practice. The purpose of this article is to raise important questions about how PROs could be applied to EBP in speech-language pathology for individuals with communication disorders and to propose preliminary approaches to address some of these questions. Method Based on a narrative review of the literature, this article introduces relevant terminology and broadly describes PRO applications in other health care fields. The article also raises questions related to PRO-informed clinical practice in speech-language pathology. To address some of these questions, the article explores previous research to provide suggestions for clinical administration, interpretation, and future research. Conclusion More routine measurement of subjective health constructs via PROMs-for example, constructs such as effort, participation, self-efficacy, and psychosocial functioning-may improve EBP. More routine use of PROMs could significantly expand the information that is available to clinicians about individual clients and add to the evidence base for the profession of speech-language pathology. However, careful consideration and more research are needed on how to capture and interpret PROs from individuals with cognitive and language disorders.
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Affiliation(s)
- Matthew L Cohen
- Department of Communication Sciences and Disorders and Center for Health Assessment Research and Translation, University of Delaware, Newark
| | - William D Hula
- Geriatric Research, Education, and Clinical Center, VA Health Care System, and Department of Communication Sciences and Disorders, University of Pittsburgh, PA
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Wohlfahrt A, Bingham CO, Marder W, Phillips K, Bolster MB, Moreland LW, Zhang Z, Neogi T, Lee YC. Responsiveness of Patient-Reported Outcomes Measurement Information System Measures in Rheumatoid Arthritis Patients Starting or Switching a Disease-Modifying Antirheumatic Drug. Arthritis Care Res (Hoboken) 2020; 71:521-529. [PMID: 29885039 DOI: 10.1002/acr.23617] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 06/05/2018] [Indexed: 01/18/2023]
Abstract
OBJECTIVE The Patient-Reported Outcomes Measurement Information System (PROMIS) is a calibrated item bank used to assess patient-reported outcomes across multiple domains. The purpose of this study was to describe the performance of selected PROMIS measures in patients with rheumatoid arthritis (RA) with active disease who were initiating a disease-modifying antirheumatic drug (DMARD). METHODS Participants in an ongoing prospective observational study completed 8 PROMIS measures before and after DMARD initiation. Linear regression models were performed to identify cross-sectional associations between baseline PROMIS measures and disease activity, measured using the Clinical Disease Activity Index (CDAI). Paired t-tests were performed to evaluate responsiveness after 12 weeks of DMARD treatment. Associations between changes in PROMIS measures and changes in the CDAI score were assessed using linear regression. RESULTS Among the 156 participants who completed the first study visit, the mean ± SD baseline CDAI score was 25.5 ± 14.0. Baseline scores for PROMIS measures of physical health, pain, and sleep were associated with the baseline CDAI score (P ≤ 0.05). Among the 106 participants with 12-week data, all PROMIS scores improved after DMARD initiation (P ≤ 0.05). With the exception of depression, changes in all assessed PROMIS measures were correlated with changes in the CDAI score (standardized βs from |0.23| to |0.38|). CONCLUSION These data provide support for the utility of PROMIS measures for the assessment of physical and mental health in individuals with active RA. All PROMIS measures improved significantly after DMARD initiation, with the magnitudes of association between changes in PROMIS measures and changes in the CDAI score in the low-to-moderate range.
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Affiliation(s)
| | | | - Wendy Marder
- University of Michigan Medical School, Ann Arbor
| | | | | | | | - Zhi Zhang
- Brigham and Women's Hospital, Boston, Massachusetts
| | - Tuhina Neogi
- Boston University School of Medicine, Boston, Massachusetts
| | - Yvonne C Lee
- Brigham and Women's Hospital, Boston, Massachusetts
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Patient-centered Outcomes Research in Pulmonary, Critical Care, and Sleep Medicine. An Official American Thoracic Society Workshop Report. Ann Am Thorac Soc 2019; 15:1005-1015. [PMID: 30168741 DOI: 10.1513/annalsats.201806-406ws] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Patient-centered outcomes research (PCOR) represents a paradigm shift in research methods aimed to create the body of evidence that supports clinical practice and informs health care decisions. PCOR integrates patients and other key stakeholders including family members, policy makers, clinicians, and patient advocates and advocacy groups as research partners throughout all stages of the research process. The importance of PCOR has received increased recognition, yet there is little evidence available to help guide researchers interested in the design and conduct of PCOR. In May 2014, we convened a workshop to identify key issues related to designing, conducting, and disseminating findings from PCOR studies. Workshop participants included a diverse group of patients, patient advocates, clinicians (physicians, nurses, psychologists, and advanced practice providers), researchers, administrators, and funders within and beyond the pulmonary, critical care, and sleep medicine communities. Participants identified important issues and considerations to address when undertaking PCOR. In this report, we summarize the results of this workshop to inform members of the pulmonary, sleep, and critical care community interested in participating in PCOR. Key findings include the following: 1) requirements for research to be considered PCOR; 2) the potential significant impact of PCOR on patients, clinicians, and researchers; 3) guiding principles and practical strategies to form successful patient-centered research partnerships, conduct PCOR, and disseminate study results to a broad audience of stakeholders; 4) benefits and challenges of PCOR for researchers; and 5) resources available within the American Thoracic Society to help with the conduct of PCOR.
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PROMIS 4-item measures and numeric rating scales efficiently assess SPADE symptoms compared with legacy measures. J Clin Epidemiol 2019; 115:116-124. [DOI: 10.1016/j.jclinepi.2019.06.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 06/17/2019] [Accepted: 06/30/2019] [Indexed: 11/24/2022]
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Craig ET, Orbai AM, Mackie S, Bartlett SJ, Bingham CO, Goodman S, Hill C, Holt R, Leong A, Karyekar C, Leung YY, Richards P, Halls S. Advancing Stiffness Measurement in Rheumatic Disease: Report from the Stiffness Special Interest Group at OMERACT 2018. J Rheumatol 2019; 46:1374-1378. [PMID: 30770511 PMCID: PMC6697231 DOI: 10.3899/jrheum.181074] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2019] [Indexed: 01/14/2023]
Abstract
OBJECTIVE To improve measurement of stiffness in rheumatic disease. METHODS Data presented included (1) 2 qualitative projects, (2) the rheumatoid arthritis (RA) stiffness patient-reported outcome measure (RAST), and (3) 3 items assessing stiffness severity, duration, and interference. RESULTS Stiffness is multidimensional and includes aspects of stiffness experience such as duration, severity, and effect. Stiffness items showed construct validity in RA. Further efforts are required to develop an instrument that will be taken through the Outcome Measures in Rheumatology (OMERACT) Filter 2.1 for instrument selection. CONCLUSION The research agenda for the group includes domain content voting for individual diseases, and development of stiffness item banks and disease-specific short forms.
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Affiliation(s)
- Ethan T Craig
- From the Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Rheumatology, Hospital for Special Surgery, Weill Cornell Medical College, New York, New York; Horizon Pharma Inc., Lake Forest; College of Pharmacy, University of Illinois, Chicago, Illinois; Healthy Motivation, Bone and Joint Decade Global Alliance for Musculoskeletal Health, Santa Barbara, California; Janssen Scientific Affairs LLC, Horsham, Pennsylvania, USA; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; and Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds; University of Bristol; University of the West of England, Bristol, Bristol, UK; McGill University, Montreal, Quebec, Canada; Division of Medicine, The University of Adelaide, Adelaide; Rheumatology Unit, The Queen Elizabeth Hospital, Woodville, Australia; Singapore General Hospital, Duke-National University of Singapore (NUS) Medical School, Singapore.
- E.T. Craig, MD, MHS, Johns Hopkins University School of Medicine; A.M. Orbai, MD, MHS, Johns Hopkins University School of Medicine; S. Mackie, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; S.J. Bartlett, PhD, McGill University, and Johns Hopkins University School of Medicine; C.O. Bingham III, MD, Johns Hopkins University School of Medicine; S. Goodman, MD, Department of Rheumatology, Hospital for Special Surgery, Weill Cornell Medical College; C. Hill, MBBS, MD, MSc, FRACP, Division of Medicine, The University of Adelaide, and Rheumatology Unit, The Queen Elizabeth Hospital; R. Holt, PharmD, MBA, Horizon Pharma Inc., and Adjunct Professor, College of Pharmacy, University of Illinois; A. Leong, MBA, Healthy Motivation, Bone and Joint Decade Global Alliance for Musculoskeletal Health; C. Karyekar, MD, PhD, Janssen Scientific Affairs LLC; Y.Y. Leung, MD, MB ChB, MRCP, FHKAM, FAMS, Singapore General Hospital, Duke-NUS Medical School; P. Richards, Patient Research Partner, University of Bristol; S. Halls, PhD, University of the West of England. Dr. Craig and Dr. Orbai are co-first authors.
| | - Ana-Maria Orbai
- From the Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Rheumatology, Hospital for Special Surgery, Weill Cornell Medical College, New York, New York; Horizon Pharma Inc., Lake Forest; College of Pharmacy, University of Illinois, Chicago, Illinois; Healthy Motivation, Bone and Joint Decade Global Alliance for Musculoskeletal Health, Santa Barbara, California; Janssen Scientific Affairs LLC, Horsham, Pennsylvania, USA; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; and Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds; University of Bristol; University of the West of England, Bristol, Bristol, UK; McGill University, Montreal, Quebec, Canada; Division of Medicine, The University of Adelaide, Adelaide; Rheumatology Unit, The Queen Elizabeth Hospital, Woodville, Australia; Singapore General Hospital, Duke-National University of Singapore (NUS) Medical School, Singapore
- E.T. Craig, MD, MHS, Johns Hopkins University School of Medicine; A.M. Orbai, MD, MHS, Johns Hopkins University School of Medicine; S. Mackie, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; S.J. Bartlett, PhD, McGill University, and Johns Hopkins University School of Medicine; C.O. Bingham III, MD, Johns Hopkins University School of Medicine; S. Goodman, MD, Department of Rheumatology, Hospital for Special Surgery, Weill Cornell Medical College; C. Hill, MBBS, MD, MSc, FRACP, Division of Medicine, The University of Adelaide, and Rheumatology Unit, The Queen Elizabeth Hospital; R. Holt, PharmD, MBA, Horizon Pharma Inc., and Adjunct Professor, College of Pharmacy, University of Illinois; A. Leong, MBA, Healthy Motivation, Bone and Joint Decade Global Alliance for Musculoskeletal Health; C. Karyekar, MD, PhD, Janssen Scientific Affairs LLC; Y.Y. Leung, MD, MB ChB, MRCP, FHKAM, FAMS, Singapore General Hospital, Duke-NUS Medical School; P. Richards, Patient Research Partner, University of Bristol; S. Halls, PhD, University of the West of England. Dr. Craig and Dr. Orbai are co-first authors
| | - Sarah Mackie
- From the Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Rheumatology, Hospital for Special Surgery, Weill Cornell Medical College, New York, New York; Horizon Pharma Inc., Lake Forest; College of Pharmacy, University of Illinois, Chicago, Illinois; Healthy Motivation, Bone and Joint Decade Global Alliance for Musculoskeletal Health, Santa Barbara, California; Janssen Scientific Affairs LLC, Horsham, Pennsylvania, USA; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; and Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds; University of Bristol; University of the West of England, Bristol, Bristol, UK; McGill University, Montreal, Quebec, Canada; Division of Medicine, The University of Adelaide, Adelaide; Rheumatology Unit, The Queen Elizabeth Hospital, Woodville, Australia; Singapore General Hospital, Duke-National University of Singapore (NUS) Medical School, Singapore
- E.T. Craig, MD, MHS, Johns Hopkins University School of Medicine; A.M. Orbai, MD, MHS, Johns Hopkins University School of Medicine; S. Mackie, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; S.J. Bartlett, PhD, McGill University, and Johns Hopkins University School of Medicine; C.O. Bingham III, MD, Johns Hopkins University School of Medicine; S. Goodman, MD, Department of Rheumatology, Hospital for Special Surgery, Weill Cornell Medical College; C. Hill, MBBS, MD, MSc, FRACP, Division of Medicine, The University of Adelaide, and Rheumatology Unit, The Queen Elizabeth Hospital; R. Holt, PharmD, MBA, Horizon Pharma Inc., and Adjunct Professor, College of Pharmacy, University of Illinois; A. Leong, MBA, Healthy Motivation, Bone and Joint Decade Global Alliance for Musculoskeletal Health; C. Karyekar, MD, PhD, Janssen Scientific Affairs LLC; Y.Y. Leung, MD, MB ChB, MRCP, FHKAM, FAMS, Singapore General Hospital, Duke-NUS Medical School; P. Richards, Patient Research Partner, University of Bristol; S. Halls, PhD, University of the West of England. Dr. Craig and Dr. Orbai are co-first authors
| | - Susan J Bartlett
- From the Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Rheumatology, Hospital for Special Surgery, Weill Cornell Medical College, New York, New York; Horizon Pharma Inc., Lake Forest; College of Pharmacy, University of Illinois, Chicago, Illinois; Healthy Motivation, Bone and Joint Decade Global Alliance for Musculoskeletal Health, Santa Barbara, California; Janssen Scientific Affairs LLC, Horsham, Pennsylvania, USA; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; and Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds; University of Bristol; University of the West of England, Bristol, Bristol, UK; McGill University, Montreal, Quebec, Canada; Division of Medicine, The University of Adelaide, Adelaide; Rheumatology Unit, The Queen Elizabeth Hospital, Woodville, Australia; Singapore General Hospital, Duke-National University of Singapore (NUS) Medical School, Singapore
- E.T. Craig, MD, MHS, Johns Hopkins University School of Medicine; A.M. Orbai, MD, MHS, Johns Hopkins University School of Medicine; S. Mackie, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; S.J. Bartlett, PhD, McGill University, and Johns Hopkins University School of Medicine; C.O. Bingham III, MD, Johns Hopkins University School of Medicine; S. Goodman, MD, Department of Rheumatology, Hospital for Special Surgery, Weill Cornell Medical College; C. Hill, MBBS, MD, MSc, FRACP, Division of Medicine, The University of Adelaide, and Rheumatology Unit, The Queen Elizabeth Hospital; R. Holt, PharmD, MBA, Horizon Pharma Inc., and Adjunct Professor, College of Pharmacy, University of Illinois; A. Leong, MBA, Healthy Motivation, Bone and Joint Decade Global Alliance for Musculoskeletal Health; C. Karyekar, MD, PhD, Janssen Scientific Affairs LLC; Y.Y. Leung, MD, MB ChB, MRCP, FHKAM, FAMS, Singapore General Hospital, Duke-NUS Medical School; P. Richards, Patient Research Partner, University of Bristol; S. Halls, PhD, University of the West of England. Dr. Craig and Dr. Orbai are co-first authors
| | - Clifton O Bingham
- From the Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Rheumatology, Hospital for Special Surgery, Weill Cornell Medical College, New York, New York; Horizon Pharma Inc., Lake Forest; College of Pharmacy, University of Illinois, Chicago, Illinois; Healthy Motivation, Bone and Joint Decade Global Alliance for Musculoskeletal Health, Santa Barbara, California; Janssen Scientific Affairs LLC, Horsham, Pennsylvania, USA; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; and Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds; University of Bristol; University of the West of England, Bristol, Bristol, UK; McGill University, Montreal, Quebec, Canada; Division of Medicine, The University of Adelaide, Adelaide; Rheumatology Unit, The Queen Elizabeth Hospital, Woodville, Australia; Singapore General Hospital, Duke-National University of Singapore (NUS) Medical School, Singapore
- E.T. Craig, MD, MHS, Johns Hopkins University School of Medicine; A.M. Orbai, MD, MHS, Johns Hopkins University School of Medicine; S. Mackie, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; S.J. Bartlett, PhD, McGill University, and Johns Hopkins University School of Medicine; C.O. Bingham III, MD, Johns Hopkins University School of Medicine; S. Goodman, MD, Department of Rheumatology, Hospital for Special Surgery, Weill Cornell Medical College; C. Hill, MBBS, MD, MSc, FRACP, Division of Medicine, The University of Adelaide, and Rheumatology Unit, The Queen Elizabeth Hospital; R. Holt, PharmD, MBA, Horizon Pharma Inc., and Adjunct Professor, College of Pharmacy, University of Illinois; A. Leong, MBA, Healthy Motivation, Bone and Joint Decade Global Alliance for Musculoskeletal Health; C. Karyekar, MD, PhD, Janssen Scientific Affairs LLC; Y.Y. Leung, MD, MB ChB, MRCP, FHKAM, FAMS, Singapore General Hospital, Duke-NUS Medical School; P. Richards, Patient Research Partner, University of Bristol; S. Halls, PhD, University of the West of England. Dr. Craig and Dr. Orbai are co-first authors
| | - Susan Goodman
- From the Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Rheumatology, Hospital for Special Surgery, Weill Cornell Medical College, New York, New York; Horizon Pharma Inc., Lake Forest; College of Pharmacy, University of Illinois, Chicago, Illinois; Healthy Motivation, Bone and Joint Decade Global Alliance for Musculoskeletal Health, Santa Barbara, California; Janssen Scientific Affairs LLC, Horsham, Pennsylvania, USA; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; and Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds; University of Bristol; University of the West of England, Bristol, Bristol, UK; McGill University, Montreal, Quebec, Canada; Division of Medicine, The University of Adelaide, Adelaide; Rheumatology Unit, The Queen Elizabeth Hospital, Woodville, Australia; Singapore General Hospital, Duke-National University of Singapore (NUS) Medical School, Singapore
- E.T. Craig, MD, MHS, Johns Hopkins University School of Medicine; A.M. Orbai, MD, MHS, Johns Hopkins University School of Medicine; S. Mackie, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; S.J. Bartlett, PhD, McGill University, and Johns Hopkins University School of Medicine; C.O. Bingham III, MD, Johns Hopkins University School of Medicine; S. Goodman, MD, Department of Rheumatology, Hospital for Special Surgery, Weill Cornell Medical College; C. Hill, MBBS, MD, MSc, FRACP, Division of Medicine, The University of Adelaide, and Rheumatology Unit, The Queen Elizabeth Hospital; R. Holt, PharmD, MBA, Horizon Pharma Inc., and Adjunct Professor, College of Pharmacy, University of Illinois; A. Leong, MBA, Healthy Motivation, Bone and Joint Decade Global Alliance for Musculoskeletal Health; C. Karyekar, MD, PhD, Janssen Scientific Affairs LLC; Y.Y. Leung, MD, MB ChB, MRCP, FHKAM, FAMS, Singapore General Hospital, Duke-NUS Medical School; P. Richards, Patient Research Partner, University of Bristol; S. Halls, PhD, University of the West of England. Dr. Craig and Dr. Orbai are co-first authors
| | - Catherine Hill
- From the Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Rheumatology, Hospital for Special Surgery, Weill Cornell Medical College, New York, New York; Horizon Pharma Inc., Lake Forest; College of Pharmacy, University of Illinois, Chicago, Illinois; Healthy Motivation, Bone and Joint Decade Global Alliance for Musculoskeletal Health, Santa Barbara, California; Janssen Scientific Affairs LLC, Horsham, Pennsylvania, USA; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; and Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds; University of Bristol; University of the West of England, Bristol, Bristol, UK; McGill University, Montreal, Quebec, Canada; Division of Medicine, The University of Adelaide, Adelaide; Rheumatology Unit, The Queen Elizabeth Hospital, Woodville, Australia; Singapore General Hospital, Duke-National University of Singapore (NUS) Medical School, Singapore
- E.T. Craig, MD, MHS, Johns Hopkins University School of Medicine; A.M. Orbai, MD, MHS, Johns Hopkins University School of Medicine; S. Mackie, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; S.J. Bartlett, PhD, McGill University, and Johns Hopkins University School of Medicine; C.O. Bingham III, MD, Johns Hopkins University School of Medicine; S. Goodman, MD, Department of Rheumatology, Hospital for Special Surgery, Weill Cornell Medical College; C. Hill, MBBS, MD, MSc, FRACP, Division of Medicine, The University of Adelaide, and Rheumatology Unit, The Queen Elizabeth Hospital; R. Holt, PharmD, MBA, Horizon Pharma Inc., and Adjunct Professor, College of Pharmacy, University of Illinois; A. Leong, MBA, Healthy Motivation, Bone and Joint Decade Global Alliance for Musculoskeletal Health; C. Karyekar, MD, PhD, Janssen Scientific Affairs LLC; Y.Y. Leung, MD, MB ChB, MRCP, FHKAM, FAMS, Singapore General Hospital, Duke-NUS Medical School; P. Richards, Patient Research Partner, University of Bristol; S. Halls, PhD, University of the West of England. Dr. Craig and Dr. Orbai are co-first authors
| | - Robert Holt
- From the Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Rheumatology, Hospital for Special Surgery, Weill Cornell Medical College, New York, New York; Horizon Pharma Inc., Lake Forest; College of Pharmacy, University of Illinois, Chicago, Illinois; Healthy Motivation, Bone and Joint Decade Global Alliance for Musculoskeletal Health, Santa Barbara, California; Janssen Scientific Affairs LLC, Horsham, Pennsylvania, USA; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; and Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds; University of Bristol; University of the West of England, Bristol, Bristol, UK; McGill University, Montreal, Quebec, Canada; Division of Medicine, The University of Adelaide, Adelaide; Rheumatology Unit, The Queen Elizabeth Hospital, Woodville, Australia; Singapore General Hospital, Duke-National University of Singapore (NUS) Medical School, Singapore
- E.T. Craig, MD, MHS, Johns Hopkins University School of Medicine; A.M. Orbai, MD, MHS, Johns Hopkins University School of Medicine; S. Mackie, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; S.J. Bartlett, PhD, McGill University, and Johns Hopkins University School of Medicine; C.O. Bingham III, MD, Johns Hopkins University School of Medicine; S. Goodman, MD, Department of Rheumatology, Hospital for Special Surgery, Weill Cornell Medical College; C. Hill, MBBS, MD, MSc, FRACP, Division of Medicine, The University of Adelaide, and Rheumatology Unit, The Queen Elizabeth Hospital; R. Holt, PharmD, MBA, Horizon Pharma Inc., and Adjunct Professor, College of Pharmacy, University of Illinois; A. Leong, MBA, Healthy Motivation, Bone and Joint Decade Global Alliance for Musculoskeletal Health; C. Karyekar, MD, PhD, Janssen Scientific Affairs LLC; Y.Y. Leung, MD, MB ChB, MRCP, FHKAM, FAMS, Singapore General Hospital, Duke-NUS Medical School; P. Richards, Patient Research Partner, University of Bristol; S. Halls, PhD, University of the West of England. Dr. Craig and Dr. Orbai are co-first authors
| | - Amye Leong
- From the Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Rheumatology, Hospital for Special Surgery, Weill Cornell Medical College, New York, New York; Horizon Pharma Inc., Lake Forest; College of Pharmacy, University of Illinois, Chicago, Illinois; Healthy Motivation, Bone and Joint Decade Global Alliance for Musculoskeletal Health, Santa Barbara, California; Janssen Scientific Affairs LLC, Horsham, Pennsylvania, USA; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; and Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds; University of Bristol; University of the West of England, Bristol, Bristol, UK; McGill University, Montreal, Quebec, Canada; Division of Medicine, The University of Adelaide, Adelaide; Rheumatology Unit, The Queen Elizabeth Hospital, Woodville, Australia; Singapore General Hospital, Duke-National University of Singapore (NUS) Medical School, Singapore
- E.T. Craig, MD, MHS, Johns Hopkins University School of Medicine; A.M. Orbai, MD, MHS, Johns Hopkins University School of Medicine; S. Mackie, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; S.J. Bartlett, PhD, McGill University, and Johns Hopkins University School of Medicine; C.O. Bingham III, MD, Johns Hopkins University School of Medicine; S. Goodman, MD, Department of Rheumatology, Hospital for Special Surgery, Weill Cornell Medical College; C. Hill, MBBS, MD, MSc, FRACP, Division of Medicine, The University of Adelaide, and Rheumatology Unit, The Queen Elizabeth Hospital; R. Holt, PharmD, MBA, Horizon Pharma Inc., and Adjunct Professor, College of Pharmacy, University of Illinois; A. Leong, MBA, Healthy Motivation, Bone and Joint Decade Global Alliance for Musculoskeletal Health; C. Karyekar, MD, PhD, Janssen Scientific Affairs LLC; Y.Y. Leung, MD, MB ChB, MRCP, FHKAM, FAMS, Singapore General Hospital, Duke-NUS Medical School; P. Richards, Patient Research Partner, University of Bristol; S. Halls, PhD, University of the West of England. Dr. Craig and Dr. Orbai are co-first authors
| | - Chetan Karyekar
- From the Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Rheumatology, Hospital for Special Surgery, Weill Cornell Medical College, New York, New York; Horizon Pharma Inc., Lake Forest; College of Pharmacy, University of Illinois, Chicago, Illinois; Healthy Motivation, Bone and Joint Decade Global Alliance for Musculoskeletal Health, Santa Barbara, California; Janssen Scientific Affairs LLC, Horsham, Pennsylvania, USA; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; and Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds; University of Bristol; University of the West of England, Bristol, Bristol, UK; McGill University, Montreal, Quebec, Canada; Division of Medicine, The University of Adelaide, Adelaide; Rheumatology Unit, The Queen Elizabeth Hospital, Woodville, Australia; Singapore General Hospital, Duke-National University of Singapore (NUS) Medical School, Singapore
- E.T. Craig, MD, MHS, Johns Hopkins University School of Medicine; A.M. Orbai, MD, MHS, Johns Hopkins University School of Medicine; S. Mackie, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; S.J. Bartlett, PhD, McGill University, and Johns Hopkins University School of Medicine; C.O. Bingham III, MD, Johns Hopkins University School of Medicine; S. Goodman, MD, Department of Rheumatology, Hospital for Special Surgery, Weill Cornell Medical College; C. Hill, MBBS, MD, MSc, FRACP, Division of Medicine, The University of Adelaide, and Rheumatology Unit, The Queen Elizabeth Hospital; R. Holt, PharmD, MBA, Horizon Pharma Inc., and Adjunct Professor, College of Pharmacy, University of Illinois; A. Leong, MBA, Healthy Motivation, Bone and Joint Decade Global Alliance for Musculoskeletal Health; C. Karyekar, MD, PhD, Janssen Scientific Affairs LLC; Y.Y. Leung, MD, MB ChB, MRCP, FHKAM, FAMS, Singapore General Hospital, Duke-NUS Medical School; P. Richards, Patient Research Partner, University of Bristol; S. Halls, PhD, University of the West of England. Dr. Craig and Dr. Orbai are co-first authors
| | - Ying Ying Leung
- From the Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Rheumatology, Hospital for Special Surgery, Weill Cornell Medical College, New York, New York; Horizon Pharma Inc., Lake Forest; College of Pharmacy, University of Illinois, Chicago, Illinois; Healthy Motivation, Bone and Joint Decade Global Alliance for Musculoskeletal Health, Santa Barbara, California; Janssen Scientific Affairs LLC, Horsham, Pennsylvania, USA; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; and Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds; University of Bristol; University of the West of England, Bristol, Bristol, UK; McGill University, Montreal, Quebec, Canada; Division of Medicine, The University of Adelaide, Adelaide; Rheumatology Unit, The Queen Elizabeth Hospital, Woodville, Australia; Singapore General Hospital, Duke-National University of Singapore (NUS) Medical School, Singapore
- E.T. Craig, MD, MHS, Johns Hopkins University School of Medicine; A.M. Orbai, MD, MHS, Johns Hopkins University School of Medicine; S. Mackie, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; S.J. Bartlett, PhD, McGill University, and Johns Hopkins University School of Medicine; C.O. Bingham III, MD, Johns Hopkins University School of Medicine; S. Goodman, MD, Department of Rheumatology, Hospital for Special Surgery, Weill Cornell Medical College; C. Hill, MBBS, MD, MSc, FRACP, Division of Medicine, The University of Adelaide, and Rheumatology Unit, The Queen Elizabeth Hospital; R. Holt, PharmD, MBA, Horizon Pharma Inc., and Adjunct Professor, College of Pharmacy, University of Illinois; A. Leong, MBA, Healthy Motivation, Bone and Joint Decade Global Alliance for Musculoskeletal Health; C. Karyekar, MD, PhD, Janssen Scientific Affairs LLC; Y.Y. Leung, MD, MB ChB, MRCP, FHKAM, FAMS, Singapore General Hospital, Duke-NUS Medical School; P. Richards, Patient Research Partner, University of Bristol; S. Halls, PhD, University of the West of England. Dr. Craig and Dr. Orbai are co-first authors
| | - Pamela Richards
- From the Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Rheumatology, Hospital for Special Surgery, Weill Cornell Medical College, New York, New York; Horizon Pharma Inc., Lake Forest; College of Pharmacy, University of Illinois, Chicago, Illinois; Healthy Motivation, Bone and Joint Decade Global Alliance for Musculoskeletal Health, Santa Barbara, California; Janssen Scientific Affairs LLC, Horsham, Pennsylvania, USA; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; and Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds; University of Bristol; University of the West of England, Bristol, Bristol, UK; McGill University, Montreal, Quebec, Canada; Division of Medicine, The University of Adelaide, Adelaide; Rheumatology Unit, The Queen Elizabeth Hospital, Woodville, Australia; Singapore General Hospital, Duke-National University of Singapore (NUS) Medical School, Singapore
- E.T. Craig, MD, MHS, Johns Hopkins University School of Medicine; A.M. Orbai, MD, MHS, Johns Hopkins University School of Medicine; S. Mackie, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; S.J. Bartlett, PhD, McGill University, and Johns Hopkins University School of Medicine; C.O. Bingham III, MD, Johns Hopkins University School of Medicine; S. Goodman, MD, Department of Rheumatology, Hospital for Special Surgery, Weill Cornell Medical College; C. Hill, MBBS, MD, MSc, FRACP, Division of Medicine, The University of Adelaide, and Rheumatology Unit, The Queen Elizabeth Hospital; R. Holt, PharmD, MBA, Horizon Pharma Inc., and Adjunct Professor, College of Pharmacy, University of Illinois; A. Leong, MBA, Healthy Motivation, Bone and Joint Decade Global Alliance for Musculoskeletal Health; C. Karyekar, MD, PhD, Janssen Scientific Affairs LLC; Y.Y. Leung, MD, MB ChB, MRCP, FHKAM, FAMS, Singapore General Hospital, Duke-NUS Medical School; P. Richards, Patient Research Partner, University of Bristol; S. Halls, PhD, University of the West of England. Dr. Craig and Dr. Orbai are co-first authors
| | - Serena Halls
- From the Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Rheumatology, Hospital for Special Surgery, Weill Cornell Medical College, New York, New York; Horizon Pharma Inc., Lake Forest; College of Pharmacy, University of Illinois, Chicago, Illinois; Healthy Motivation, Bone and Joint Decade Global Alliance for Musculoskeletal Health, Santa Barbara, California; Janssen Scientific Affairs LLC, Horsham, Pennsylvania, USA; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; and Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds; University of Bristol; University of the West of England, Bristol, Bristol, UK; McGill University, Montreal, Quebec, Canada; Division of Medicine, The University of Adelaide, Adelaide; Rheumatology Unit, The Queen Elizabeth Hospital, Woodville, Australia; Singapore General Hospital, Duke-National University of Singapore (NUS) Medical School, Singapore
- E.T. Craig, MD, MHS, Johns Hopkins University School of Medicine; A.M. Orbai, MD, MHS, Johns Hopkins University School of Medicine; S. Mackie, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; S.J. Bartlett, PhD, McGill University, and Johns Hopkins University School of Medicine; C.O. Bingham III, MD, Johns Hopkins University School of Medicine; S. Goodman, MD, Department of Rheumatology, Hospital for Special Surgery, Weill Cornell Medical College; C. Hill, MBBS, MD, MSc, FRACP, Division of Medicine, The University of Adelaide, and Rheumatology Unit, The Queen Elizabeth Hospital; R. Holt, PharmD, MBA, Horizon Pharma Inc., and Adjunct Professor, College of Pharmacy, University of Illinois; A. Leong, MBA, Healthy Motivation, Bone and Joint Decade Global Alliance for Musculoskeletal Health; C. Karyekar, MD, PhD, Janssen Scientific Affairs LLC; Y.Y. Leung, MD, MB ChB, MRCP, FHKAM, FAMS, Singapore General Hospital, Duke-NUS Medical School; P. Richards, Patient Research Partner, University of Bristol; S. Halls, PhD, University of the West of England. Dr. Craig and Dr. Orbai are co-first authors
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Cross cultural adaptation and validation of an Arabic version of selected PROMIS measures for use in rheumatoid arthritis patients. THE EGYPTIAN RHEUMATOLOGIST 2019. [DOI: 10.1016/j.ejr.2018.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Fox GWC, Rodriguez S, Rivera-Reyes L, Loo G, Hazan A, Hwang U. PROMIS Physical Function 10-Item Short Form for Older Adults in an Emergency Setting. J Gerontol A Biol Sci Med Sci 2019; 75:1418-1423. [DOI: 10.1093/gerona/glz163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Functional status in older adults predicts hospital use and mortality, and offers insight into independence and quality of life. The Patient-Reported Outcome Measurement Information System (PROMIS) was developed to improve and standardize patient-reported outcomes measurements. The PROMIS Physical Function (PROMIS PF) 10-Item Short Form was not created specifically for older adults. By comparing PROMIS with the Katz Index of Activities of Daily Living (Katz), we evaluated PROMIS for measurement of physical function versus general function in an older adult population seen in the ED.
Methods
A prospective, convenience sample of ED patients 65 years and older (from January 1, 2015 to June 30, 2015) completed Katz and PROMIS PF. Both were compared for scoring distributions and conventional scoring thresholds for severity of impairment (eg, minimal, moderate, severe). We assessed convergence through Spearman correlations, equivalents of conventional thresholds and ranges of physical function, and item-response frequencies.
Results
A total of 357 completed both function surveys. PROMIS PF and Katz have a modest positive correlation (r = .50, p < .01). Mean PROMIS PF scores within Katz scoring ranges for minimal (43, SD = 10), moderate (32, SD = 7), and severe (24, SD = 7) impairment fell within respective PROMIS PF scoring ranges (severe = 14–29, moderate = 30–39, mild = 40–45), indicating convergence. PROMIS identified impairment in 3× as many patients as did Katz, as PROMIS assesses vigorous physical function (eg, running, heavy lifting) not queried by Katz. However, PROMIS does not assess select activities of daily living (ADLs; eg, feeding, continence) important for assessment of function in older adults.
Conclusions
There is a modest correlation between PROMIS and Katz. PROMIS may better assess physical function than Katz, but is not an adequate replacement for assessment of general functional status in older adults.
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Affiliation(s)
- G W Conner Fox
- Department of Emergency Medicine and Brookdale, Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai (ISMMS), New York
| | - Sandra Rodriguez
- Department of Emergency Medicine and Brookdale, Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai (ISMMS), New York
| | - Laura Rivera-Reyes
- Department of Emergency Medicine and Brookdale, Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai (ISMMS), New York
| | - George Loo
- Department of Emergency Medicine and Brookdale, Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai (ISMMS), New York
| | - Ariela Hazan
- Department of Emergency Medicine and Brookdale, Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai (ISMMS), New York
| | - Ula Hwang
- Department of Emergency Medicine and Brookdale, Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai (ISMMS), New York
- Geriatric Research, Education and Clinical Center, James J. Peters Veterans Affairs Medical Center, Bronx, New York
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Kisala PA, Boulton AJ, Cohen ML, Slavin MD, Jette AM, Charlifue S, Hanks R, Mulcahey MJ, Cella D, Tulsky DS. Interviewer- versus self-administration of PROMIS® measures for adults with traumatic injury. Health Psychol 2019; 38:435-444. [PMID: 31045427 DOI: 10.1037/hea0000685] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To assess differential item functioning and observed mean differences across two modes of administration for PROMIS® measure scores in a sample of adults with traumatic injury. METHOD Items from 7 PROMIS® adult measures (v1.0 Physical Function, Fatigue, Pain Interference, Anger, Anxiety, and Depression and v2.0 Social Health-Emotional Support) were administered as fixed-length short forms in random order to a cross-sectional sample. Participants were randomly assigned to interviewer-administered (phone or in-person) or self-administered (via the Assessment Center website) conditions. The research was conducted at 5 medical rehabilitation institutions across the U.S. Participants included 277 adults with spinal cord injury (n = 148) or traumatic brain injury (n = 129). RESULTS DIF analyses indicated that all items were invariant to mode of administration. There was no significant effect of mode of administration for the majority of PROMIS® measures tested. Regarding observed scores, there were small but significant effects of mode of administration on the Emotional Support and Depression measures, with participants in the interview condition reporting better support/fewer symptoms. CONCLUSIONS PROMIS® instruments demonstrated measurement equivalence across interviewer-administered and self-administered conditions. These findings are particularly important for research or clinical applications where administration of PROMIS® measures by independent web- or tablet-based administration is not ideal, for example with individuals with physical or cognitive disabilities or with individuals who lack computer and/or Internet access. PROMIS® v1.0 Depression and PROMIS® v2.0 Emotional Support scores displayed a tendency toward social desirability that should be considered when these measures are interviewer-administered. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Pamela A Kisala
- Center for Health Assessment Research and Translation, College of Health Sciences, University of Delaware
| | - Aaron J Boulton
- Center for Health Assessment Research and Translation, College of Health Sciences, University of Delaware
| | - Matthew L Cohen
- Department of Communication Sciences & Disorders, College of Health Sciences, University of Delaware
| | - Mary D Slavin
- Department of Health Law, Policy and Management, Boston University School of Public Health
| | - Alan M Jette
- Massachusetts General Hospital Institute of Health Professions
| | | | - Robin Hanks
- Department of Physical Medicine and Rehabilitation, Wayne State University School of Medicine
| | - M J Mulcahey
- Department of Occupational Therapy, College of Health Professions, Thomas Jefferson University
| | - David Cella
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine
| | - David S Tulsky
- Center for Health Assessment Research and Translation, Department of Physical Therapy, College of Health Sciences, University of Delaware
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Prinsen CAC, Terwee CB. Measuring positive health: for now, a bridge too far. Public Health 2019; 170:70-77. [PMID: 30974374 DOI: 10.1016/j.puhe.2019.02.024] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 02/19/2019] [Accepted: 02/26/2019] [Indexed: 01/05/2023]
Abstract
OBJECTIVES Huber et al. introduced a new concept 'positive health', defined as 'the ability to adapt and self-manage in the face of social, physical and emotional challenges' and suggested a conceptual model comprising six domains covering 32 aspects. Our aim was to generate items and pilot test an outcome measurement instrument for measuring 'positive health' in Dutch adult citizens. STUDY DESIGN A mixed-method study: a literature search, a qualitative study with interviews and a quantitative ranking study for the development phase, to be followed by a content validity study for the validation phase. METHODS We developed items based on the concept elicitation study of Huber et al. A ranking study with end users, Dutch citizens and members of an Expert Group was performed for item reduction. Content validity of the prefinal questionnaire was evaluated. RESULTS A prefinal 46-item questionnaire was developed. The results of the content validity study, however, showed major concerns with regard to relevance, comprehensiveness and comprehensibility of the questionnaire. CONCLUSIONS Because of major concerns regarding the conceptual model of 'positive health', it was not possible to develop a valid questionnaire to measure 'positive health'. Future research should focus on the refinement of the conceptualization of 'positive health' before an adequate measurement instrument could be developed that can be used for outcome measurement purposes.
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Affiliation(s)
- Cecilia A C Prinsen
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Boelelaan 1117, Amsterdam, The Netherlands.
| | - Caroline B Terwee
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Boelelaan 1117, Amsterdam, The Netherlands
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Bykerk VP. Patient-Reported Outcomes Measurement Information System Versus Legacy Instruments: Are They Ready for Prime Time? Rheum Dis Clin North Am 2019; 45:211-229. [PMID: 30952394 DOI: 10.1016/j.rdc.2019.01.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
"Legacy" patient-reported outcome measures (PROs) have been used for decades; however, they have many limitations. The National Institutes of Health-funded PRO Measurement Information System (PROMIS) was developed to be a generic, flexible, precise, and reliable tool to measure core and additional domains of physical and emotional health and social well-being. Unlike Legacy PROs, PROMIS measures can be implemented across diseases, and use a common T-score metric-based scoring system derived using item response theory. PROMIS measure scores have potential to predict scores of Legacy PROs and could be the only set of measures needed to assess PROs.
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Affiliation(s)
- Vivian P Bykerk
- The Hospital for Special Surgery, Inflammatory Arthritis Center, Weill Cornell Medical College, 535 East 70th Street, New York, NY 10022, USA.
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38
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de Wit M, Adebajo A. Unique role of rheumatology in establishing collaborative relationships in research. Past, present and future of patient engagement. Ann Rheum Dis 2018; 78:293-296. [DOI: 10.1136/annrheumdis-2018-214387] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 11/30/2018] [Accepted: 12/02/2018] [Indexed: 11/03/2022]
Abstract
The specialty of rheumatology takes care of people with disabling and long-term musculoskeletal conditions. For these patients, good healthcare requires the establishment of a sustainable partnership with healthcare professionals. For over two decades, rheumatology has been a frontrunner in piloting and implementing new kinds of partnerships in scientific research. In this viewpoint paper, we provide evidence for the leading role of rheumatology in developing strategies for engaging patients in research agenda setting, outcome research, developing treatment recommendations, assessing grant applications, conducting patient-centred research and transferring knowledge from research into practice. Experiences and lessons learnt in rheumatology are regularly published and are currently widely adapted and implemented in other specialties and research contexts. Challenges still exist and it is expected that rheumatology, as a leading discipline in this field, may further enhance our knowledge, expertise and understanding of the conditions for relational empowerment and meaningful patient involvement.
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De Faoite D. The advantages of electronic patient-reported measures and an example digital platform to collect ePROs after total knee arthroplasty. MEDICINE ACCESS @ POINT OF CARE 2018. [DOI: 10.1177/2399202618813463] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Affiliation(s)
- Diarmuid De Faoite
- Clinical, Scientific & Medical Affairs, Smith & Nephew Orthopaedics AG, Baar, Switzerland
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40
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Bartlett SJ, Gutierrez AK, Butanis A, Bykerk VP, Curtis JR, Ginsberg S, Leong AL, Lyddiatt A, Nowell WB, Orbai AM, Smith KC, Bingham CO. Combining online and in-person methods to evaluate the content validity of PROMIS fatigue short forms in rheumatoid arthritis. Qual Life Res 2018; 27:2443-2451. [PMID: 29797175 PMCID: PMC6113070 DOI: 10.1007/s11136-018-1880-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2018] [Indexed: 12/14/2022]
Abstract
PURPOSE Fatigue is frequent and often severe and disabling in RA, and there is no consensus on how to measure it. We used online surveys and in-person interviews to evaluate PROMIS Fatigue 7a and 8a short forms (SFs) in people with RA. METHODS We recruited people with RA from an online patient community (n = 200) and three academic medical centers (n = 84) in the US. Participants completed both SFs then rated the comprehensiveness and comprehensibility of the items to their fatigue experience. Cognitive debriefing of items was conducted in a subset of 32 clinic patients. Descriptive statistics were calculated, and associations were evaluated using Pearson and Spearman correlation coefficients. RESULTS Mean SF scores were similar (p ≥ .61) among clinic patients reflecting mild fatigue (i.e., 54.5-55.9), but were significantly higher (p < .001) in online participants. SF Fatigue scores correlated highly (r ≥ 0.82; p < .000) and moderately with patient assessments of disease activity (r ≥ 0.62; p = .000). Most (70-92%) reported that the items "completely" or "mostly" reflected their experience. Almost all (≥ 94%) could distinguish general fatigue from RA fatigue. Most (≥ 85%) rated individual items questions as "somewhat" or "very relevant" to their fatigue experience, averaged their fatigue over the past 7 days (58%), and rated fatigue impact versus severity (72 vs. 19%). 99% rated fatigue as an important symptom they considered when deciding how well their current treatment was controlling their RA. CONCLUSIONS Results suggest that items in the single-score PROMIS Fatigue SFs demonstrate content validity and can adequately capture the wide range of fatigue experiences of people with RA.
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Affiliation(s)
- S J Bartlett
- Center for Health Outcomes Research, McGill University, 5252 de Maisonneuve West, #3D-57, Montreal, QC, H4A 3S5, Canada.
- Division of Rheumatology, Johns Hopkins School of Medicine, Mason F Lord Tower, 5200 Eastern Avenue, Rm 404, Baltimore, MD, 21224, USA.
| | - A K Gutierrez
- Division of Rheumatology, Johns Hopkins School of Medicine, Mason F Lord Tower, 5200 Eastern Avenue, Rm 404, Baltimore, MD, 21224, USA
- Ateneo School of Medicine and Public Health, Pasig City, Philippines
| | - A Butanis
- Division of Rheumatology, Johns Hopkins School of Medicine, Mason F Lord Tower, 5200 Eastern Avenue, Rm 404, Baltimore, MD, 21224, USA
| | - V P Bykerk
- Hospital for Special Surgery, Weill Cornell Medical College, 525 East 71st St, 7th floor, New York, NY, 10021, USA
| | - J R Curtis
- Division of Rheumatology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - S Ginsberg
- Global Healthy Living Foundation, Upper Nyack, NY, USA
| | - A L Leong
- Healthy Motivation, Santa Barbara, CA, USA
| | | | - W B Nowell
- Global Healthy Living Foundation, Upper Nyack, NY, USA
| | - A M Orbai
- Division of Rheumatology, Johns Hopkins School of Medicine, Mason F Lord Tower, 5200 Eastern Avenue, Rm 404, Baltimore, MD, 21224, USA
| | - K C Smith
- Johns Hopkins Bloomberg School of Public Health Center for Qualitative Studies in Health and Medicine, Baltimore, MD, USA
| | - C O Bingham
- Division of Rheumatology, Johns Hopkins School of Medicine, Mason F Lord Tower, 5200 Eastern Avenue, Rm 404, Baltimore, MD, 21224, USA
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Abuabara K, Asgari MM, Chen SC, Dellavalle RP, Kalia S, Secrest AM, Silverberg JI, Solomon JA, Weinstock MA, Wu JJ, Chren MM. How data can deliver for dermatology. J Am Acad Dermatol 2018; 79:400-402. [PMID: 29574090 DOI: 10.1016/j.jaad.2018.03.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 03/01/2018] [Accepted: 03/13/2018] [Indexed: 02/02/2023]
Affiliation(s)
- Katrina Abuabara
- Program for Clinical Research, Department of Dermatology, University of California, San Francisco, California.
| | - Maryam M Asgari
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Suephy C Chen
- Department of Dermatology, Emory University, Atlanta, Georgia; Atlanta Veterans Affairs Medical Center, Aurora, Colorado
| | - Robert P Dellavalle
- Department of Dermatology, University of Colorado School of Medicine, Aurora, Colorado
| | - Sunil Kalia
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada
| | - Aaron M Secrest
- Department of Dermatology, University of Utah, Salt Lake City, Utah; Department of Population Health Sciences, University of Utah, Salt Lake City, Utah
| | - Jonathan I Silverberg
- Department of Dermatology, Northwestern Feinberg School of Medicine, Chicago, Illinois
| | - James A Solomon
- Dermatology Department, University of Central Florida, College of Medicine, Orlando, Florida; Ameriderm Research, Ormond Beach, Florida; Department of Medicine, University of Illinois, College of Medicine, Urbana, Illinois
| | - Martin A Weinstock
- Center for DermatoEpidemiology, Veterans Affairs Medical Center, Providence, Rhode Island; Departments of Dermatology and Epidemiology, Brown University, Providence, Rhode Island
| | - Jashin J Wu
- Department of Dermatology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California
| | - Mary-Margaret Chren
- Program for Clinical Research, Department of Dermatology, University of California, San Francisco, California; Department of Dermatology, Vanderbilt University Medical Center, Nashville, TN
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Bouayad L, Ialynytchev A, Padmanabhan B. Patient Health Record Systems Scope and Functionalities: Literature Review and Future Directions. J Med Internet Res 2017; 19:e388. [PMID: 29141839 PMCID: PMC5707430 DOI: 10.2196/jmir.8073] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 09/01/2017] [Accepted: 10/03/2017] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND A new generation of user-centric information systems is emerging in health care as patient health record (PHR) systems. These systems create a platform supporting the new vision of health services that empowers patients and enables patient-provider communication, with the goal of improving health outcomes and reducing costs. This evolution has generated new sets of data and capabilities, providing opportunities and challenges at the user, system, and industry levels. OBJECTIVE The objective of our study was to assess PHR data types and functionalities through a review of the literature to inform the health care informatics community, and to provide recommendations for PHR design, research, and practice. METHODS We conducted a review of the literature to assess PHR data types and functionalities. We searched PubMed, Embase, and MEDLINE databases from 1966 to 2015 for studies of PHRs, resulting in 1822 articles, from which we selected a total of 106 articles for a detailed review of PHR data content. RESULTS We present several key findings related to the scope and functionalities in PHR systems. We also present a functional taxonomy and chronological analysis of PHR data types and functionalities, to improve understanding and provide insights for future directions. Functional taxonomy analysis of the extracted data revealed the presence of new PHR data sources such as tracking devices and data types such as time-series data. Chronological data analysis showed an evolution of PHR system functionalities over time, from simple data access to data modification and, more recently, automated assessment, prediction, and recommendation. CONCLUSIONS Efforts are needed to improve (1) PHR data quality through patient-centered user interface design and standardized patient-generated data guidelines, (2) data integrity through consolidation of various types and sources, (3) PHR functionality through application of new data analytics methods, and (4) metrics to evaluate clinical outcomes associated with automated PHR system use, and costs associated with PHR data storage and analytics.
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Affiliation(s)
- Lina Bouayad
- Department of Information Systems and Business Analytics, Florida International University, Miami, FL, United States.,Health Services Research and Development Service, Center of Innovation on Disability and Rehabilitation Research, Tampa, FL, United States
| | - Anna Ialynytchev
- Health Services Research and Development Service, Center of Innovation on Disability and Rehabilitation Research, Tampa, FL, United States
| | - Balaji Padmanabhan
- Department of Information Systems and Decision Sciences, University of South Florida, Tampa, FL, United States
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Patient-Reported Outcomes Measurement Information System (PROMIS) Use in Surgical Care: A Scoping Study. J Am Coll Surg 2017; 224:245-254.e1. [DOI: 10.1016/j.jamcollsurg.2016.11.015] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 11/22/2016] [Accepted: 11/23/2016] [Indexed: 11/20/2022]
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44
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Hashem MD, Nallagangula A, Nalamalapu S, Nunna K, Nausran U, Robinson KA, Dinglas VD, Needham DM, Eakin MN. Patient outcomes after critical illness: a systematic review of qualitative studies following hospital discharge. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2016; 20:345. [PMID: 27782830 PMCID: PMC5080744 DOI: 10.1186/s13054-016-1516-x] [Citation(s) in RCA: 106] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 09/28/2016] [Indexed: 12/16/2022]
Abstract
BACKGROUND There is growing interest in patient outcomes following critical illness, with an increasing number and different types of studies conducted, and a need for synthesis of existing findings to help inform the field. For this purpose we conducted a systematic review of qualitative studies evaluating patient outcomes after hospital discharge for survivors of critical illness. METHODS We searched the PubMed, EMBASE, CINAHL, PsycINFO, and CENTRAL databases from inception to June 2015. Studies were eligible for inclusion if the study population was >50 % adults discharged from the ICU, with qualitative evaluation of patient outcomes. Studies were excluded if they focused on specific ICU patient populations or specialty ICUs. Citations were screened in duplicate, and two reviewers extracted data sequentially for each eligible article. Themes related to patient outcome domains were coded and categorized based on the main domains of the Patient Reported Outcomes Measurement Information System (PROMIS) framework. RESULTS A total of 2735 citations were screened, and 22 full-text articles were eligible, with year of publication ranging from 1995 to 2015. All of the qualitative themes were extracted from eligible studies and then categorized using PROMIS descriptors: satisfaction with life (16 studies), including positive outlook, acceptance, gratitude, independence, boredom, loneliness, and wishing they had not lived; mental health (15 articles), including symptoms of post-traumatic stress disorder, anxiety, depression, and irritability/anger; physical health (14 articles), including mobility, activities of daily living, fatigue, appetite, sensory changes, muscle weakness, and sleep disturbances; social health (seven articles), including changes in friends/family relationships; and ability to participate in social roles and activities (six articles), including hobbies and disability. CONCLUSION ICU survivors may experience positive emotions and life satisfaction; however, a wide range of mental, physical, social, and functional sequelae occur after hospital discharge. These findings are important for understanding patient-centered outcomes in critical care and providing focus for future interventional studies aimed at improving outcomes of importance to ICU survivors.
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Affiliation(s)
- Mohamed D Hashem
- Outcomes After Critical Illness and Surgery Group, Johns Hopkins University, Baltimore, MD, USA.,Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Aparna Nallagangula
- Outcomes After Critical Illness and Surgery Group, Johns Hopkins University, Baltimore, MD, USA.,Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Swaroopa Nalamalapu
- Outcomes After Critical Illness and Surgery Group, Johns Hopkins University, Baltimore, MD, USA.,Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Krishidhar Nunna
- Outcomes After Critical Illness and Surgery Group, Johns Hopkins University, Baltimore, MD, USA.,Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Utkarsh Nausran
- Outcomes After Critical Illness and Surgery Group, Johns Hopkins University, Baltimore, MD, USA
| | - Karen A Robinson
- Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Victor D Dinglas
- Outcomes After Critical Illness and Surgery Group, Johns Hopkins University, Baltimore, MD, USA.,Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Dale M Needham
- Outcomes After Critical Illness and Surgery Group, Johns Hopkins University, Baltimore, MD, USA.,Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.,Department of Physical Medicine and Rehabilitation, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Michelle N Eakin
- Outcomes After Critical Illness and Surgery Group, Johns Hopkins University, Baltimore, MD, USA. .,Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
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45
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Buetow SA, Martínez-Martín P, Hirsch MA, Okun MS. Beyond patient-centered care: person-centered care for Parkinson's disease. NPJ Parkinsons Dis 2016; 2:16019. [PMID: 28725700 PMCID: PMC5516574 DOI: 10.1038/npjparkd.2016.19] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 07/20/2016] [Accepted: 08/23/2016] [Indexed: 11/11/2022] Open
Abstract
Interest has grown in centering Parkinson's disease (PD) care provision on the welfare of the patient with PD. By putting the welfare of patients first, this patient-centric focus tends to subordinate the welfare of others including clinicians and carers. A possible solution is person-centered care. Rather than remove the spotlight from the patients, it widens that light to illuminate moral interests of all healthcare participants as persons whose welfare is interdependent. It assumes that unwellness among clinicians, for example, can impact the quality of the PD care they provide, such that caring for clinicians may also optimize the welfare of persons with PD. For PD, we suggest how the two models differ and why these differences are important to understand and act on to optimize benefit for participating stakeholders.
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Affiliation(s)
- Stephen A Buetow
- Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand
| | - Pablo Martínez-Martín
- National Center of Epidemiology and Center for Networked Biomedical Research on Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Mark A Hirsch
- Department of Physical Medicine and Rehabilitation, Carolinas Medical Center, Carolinas Rehabilitation, Charlotte, NC, USA
| | - Michael S Okun
- Department of Neurology, University of Florida Center for Movement Disorders and Neurorestoration, Gainesville, FL, USA
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Hogan WR, Ceusters W. Diagnosis, misdiagnosis, lucky guess, hearsay, and more: an ontological analysis. J Biomed Semantics 2016; 7:54. [PMID: 27633888 PMCID: PMC5025551 DOI: 10.1186/s13326-016-0098-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 09/06/2016] [Indexed: 11/10/2022] Open
Abstract
Background Disease and diagnosis have been the subject of much ontological inquiry. However, the insights gained therein have not yet been well enough applied to the study, management, and improvement of data quality in electronic health records (EHR) and administrative systems. Data in these systems suffer from workarounds clinicians are forced to apply due to limitations in the current state-of-the art in system design which ignore the various types of entities that diagnoses as information content entities can be and are about. This leads to difficulties in distinguishing amongst diagnostic assertions misdiagnosis from correct diagnosis, and the former from coincidentally correct statements about disease. Methods We applied recent advances in the ontological understanding of the aboutness relation to the problem of diagnosis and disease as defined by the Ontology for General Medical Science. We created six scenarios that we analyzed using the method of Referent Tracking to identify all the entities and their relationships which must be present for each scenario to hold true. We discovered deficiencies in existing ontological definitions and proposed revisions of them to account for the improved understanding that resulted from our analysis. Results Our key result is that a diagnosis is an information content entity (ICE) whose concretization(s) are typically about a configuration in which there exists a disease that inheres in an organism and instantiates a certain type (e.g., hypertension). Misdiagnoses are ICEs whose concretizations succeed in aboutness on the level of reference for individual entities and types (the organism and the disease), but fail in aboutness on the level of compound expression (i.e., there is no configuration that corresponds in total with what is asserted). Provenance of diagnoses as concretizations is critical to distinguishing them from lucky guesses, hearsay, and justified layperson belief. Conclusions Recent improvements in our understanding of aboutness significantly improved our understanding of the ontology of diagnosis and related information content entities, which in turn opens new perspectives for the implementation of data capture methods in EHR and other systems to allow diagnostic assertions to be captured with less ambiguity. Electronic supplementary material The online version of this article (doi:10.1186/s13326-016-0098-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- William R Hogan
- University of Florida, 2004 Mowry Rd, P.O. Box 100219, Gainesville, FL, 32610-0219, USA.
| | - Werner Ceusters
- Department of Biomedical Informatics, University at Buffalo, 77 Goodell street, 5th floor, Buffalo, NY, 14203, USA
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