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Kuharic M, Kulbokas V, Hanson K, Nazari JL, Shah KK, Nguyen A, Hensle T, Marras C, Armstrong MJ, Jalundhwala YJ, Pickard AS. OFF episode quality of life impact scale (OFFELIA): A new measure of quality of life for off episodes in Parkinson's disease. Parkinsonism Relat Disord 2024; 123:106070. [PMID: 38503261 DOI: 10.1016/j.parkreldis.2024.106070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 01/21/2024] [Accepted: 02/25/2024] [Indexed: 03/21/2024]
Abstract
INTRODUCTION OFF Episodes occur in people with Parkinson's disease when their medication wears off, and motor and/or non-motor symptoms emerge. Existing measures used to assess OFF Episodes focus on the time spent in OFF Episodes through diaries or by identifying symptoms, but they are limited in their ability to capture the severity and functional impact of OFF episodes. The aim of this study was to develop and validate a new instrument, called "OFFELIA," that measures the impact of OFF episodes on the quality of life of individuals with Parkinson's disease. METHODS Participants completed a cross-sectional questionnaire, "Impact and Communication on OFF Periods," while enrolled in the online clinical study Fox Insights. The data collected was used to develop OFFELIA. Psychometric testing was performed on 18 candidate items using classical, exploratory factor analysis, and item response theory methods. RESULTS 569 individuals with Parkinson's disease completed the questionnaire. All items were retained for the final measure, with 17 items aggregated into two multi-item scales (functioning and psychological well-being) and one item reported separately as it did not function well with the other items (employment). Known group comparisons based on average duration, frequency and unpredictability of OFF episodes indicated that OFFELIA subscales were more sensitive than existing generic and condition-specific measures. CONCLUSION Initial evidence supports the validity of OFFELIA, a new instrument that assesses the impact of OFF periods on daily life. This instrument can be used in assessing clinical therapeutic strategies targeting OFF episodes in Parkinson's disease.
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Affiliation(s)
- Maja Kuharic
- Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, 833 South Wood Street (MC 871), Chicago, IL, USA, 60612; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N Michigan Ave, Chicago, IL, USA, 60611.
| | - Victoria Kulbokas
- Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, 833 South Wood Street (MC 871), Chicago, IL, USA, 60612.
| | - Kent Hanson
- Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, 833 South Wood Street (MC 871), Chicago, IL, USA, 60612.
| | - Jonathan L Nazari
- Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, 833 South Wood Street (MC 871), Chicago, IL, USA, 60612.
| | - Kanya K Shah
- Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, 833 South Wood Street (MC 871), Chicago, IL, USA, 60612.
| | - Ai Nguyen
- Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, 833 South Wood Street (MC 871), Chicago, IL, USA, 60612.
| | - Tara Hensle
- Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, 833 South Wood Street (MC 871), Chicago, IL, USA, 60612.
| | - Connie Marras
- The Edmond J Safra Program in Parkinson's Disease, University Health Network, University of Toronto, Toronto, Canada.
| | - Melissa J Armstrong
- Department of Neurology, University of Florida College of Medicine, Gainesville, FL, USA; Fixel Institute for Neurological Diseases, Gainesville, FL, USA.
| | - Yash J Jalundhwala
- Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, 833 South Wood Street (MC 871), Chicago, IL, USA, 60612; Moderna, Inc., Cambridge, MA, USA.
| | - A Simon Pickard
- Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, 833 South Wood Street (MC 871), Chicago, IL, USA, 60612.
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Tang X, Schalet BD, Janulis P, Keruly JC, Moore RD, Milloy MJ, DeBeck K, Hayashi K, Javanbakht M, Kim S, Siminski S, Shoptaw S, Gorbach PM. Evaluating the agreement between different substance use recall periods in multiple HIV cohorts. Drug Alcohol Depend 2024; 254:111043. [PMID: 38061201 PMCID: PMC10872532 DOI: 10.1016/j.drugalcdep.2023.111043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 11/23/2023] [Accepted: 11/25/2023] [Indexed: 01/08/2024]
Abstract
BACKGROUND This study aims to evaluate the agreement in substance use on both binary and ordinal scales between 3-month and 6-month recall periods with samples from different communities, demographic backgrounds, and HIV status. METHODS We administered the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) to 799 participants from three different North American cohorts focused on substance use and HIV. We conducted a within-person agreement analysis by calculating the agreement levels and Kappa statistic between data collected using the 3-month recall ASSIST and 6-month custom substance use surveys as well as different terminology for each substance in multiple cohorts. RESULTS For all drugs studied, the agreement on the binary use or ordinal frequency of use metrics showed a high agreement level between 80.4% and 97.9% and an adequate adjusted kappa value between 0.61 and 0.96, suggesting substantial agreement. According to the agreement criteria we proposed, substance use data collected using different recall periods and with variation in drug names can be harmonized across cohorts. CONCLUSIONS This study is the first to evaluate the feasibility of data harmonization of substance use by demonstrating high level of agreement between different recall periods in different cohorts. The results can inform data harmonization efforts in consortia where data are collected from cohorts using different questions and recall periods.
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Affiliation(s)
- Xiaodan Tang
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | - Benjamin D Schalet
- Department of Epidemiology and Data Science, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Patrick Janulis
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago IL, USA
| | - Jeanne C Keruly
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Richard D Moore
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - M-J Milloy
- Department of Medicine, University of British Columbia, Vancouver, Canada; British Columbia Centre on Substance Use, Vancouver, Canada
| | - Kora DeBeck
- British Columbia Centre on Substance Use, Vancouver, Canada; School of Public Policy, Simon Fraser University, Vancouver Canada
| | - Kanna Hayashi
- British Columbia Centre on Substance Use, Vancouver, Canada; Faculty of Health Sciences, Simon Fraser University, Vancouver Canada
| | - Marjan Javanbakht
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
| | - Soyeon Kim
- Frontier Science Foundation, Boston, MA, USA
| | | | - Steven Shoptaw
- Department of Family Medicine, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, USA
| | - Pamina M Gorbach
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
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Mendelson S, Anbukkarasu P, Cassisi JE, Zaman W. Gastrointestinal functioning and menstrual cycle phase in emerging young adult women: a cross-sectional study. BMC Gastroenterol 2023; 23:406. [PMID: 37990300 PMCID: PMC10664285 DOI: 10.1186/s12876-023-03036-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 11/07/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Women experience more severe gastrointestinal (GI) symptoms compared to men. The onset of puberty and the menstrual cycle may influence these differences. Additionally, health anxiety is an important construct that has been shown to play a role in increased symptomatology across many medical conditions. Using standardized clinical measures often employed to assess disorders of gut-brain interaction (DGBI) we aimed to identify differences of GI functioning across menstrual cycle phases and to evaluate the role of health anxiety in this relationship. METHODS Six hundred three participants completed a survey including functional GI assessment scales (PROMIS-GI®), an abdominal pain scale and map, and a health anxiety measure. They were grouped by menstrual cycle phases (Menses, Follicular, Early-Luteal, and Premenstrual) based on self-reported start date of most recent period. Multivariate analyses of covariance were conducted to identify differences between menstrual cycle phase and scores on the symptom scales. Heath anxiety was included as a covariate in all analyses. RESULTS No significant differences were found between menstrual cycle group and PROMIS-GI scores. Higher GI-symptom and pain levels were found as health anxiety increased. Pain in the hypogastric region of the abdomen was significantly higher during the Menses phase when compared to Early-Luteal and Premenstrual phases. A subset of participants with DGBI diagnoses demonstrated significantly higher GI-symptom severity on several PROMIS-GI scales when compared to matched controls who did not have those diagnoses. In addition, participants with DGBI diagnoses reported significantly greater pain across multiple abdominal regions than their non-diagnosed counterparts. CONCLUSIONS GI symptom levels as measured by the PROMIS-GI scales in otherwise healthy women were not dependent on menstrual cycle phase. Yet, the PROMIS-GI scales were sensitive to symptom differences in women with DGBI diagnoses. Overall, this study demonstrated that the PROMIS-GI measures are unlikely to be affected by gynecological functioning in healthy young women. We argue that the abdominal pain map is an essential addition to classification and diagnosis.
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Affiliation(s)
- Sivanne Mendelson
- Department of Psychology, University of Central Florida, Orlando, FL, 32816, USA
| | - Preethashree Anbukkarasu
- College of Medicine, University of Central Florida, 6850 Lake Nona Blvd, Orlando, FL, 32827, USA
| | - Jeffrey E Cassisi
- Department of Psychology, University of Central Florida, Orlando, FL, 32816, USA.
| | - Widaad Zaman
- Department of Psychology, University of Central Florida, Orlando, FL, 32816, USA
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Vickers AJ, Assel M, Hannon M, Desai P, Carlsson SV, McCready T, Cracchiolo J, Simon B. A comparison of brief versus explicit descriptors for verbal rating scales: interrupted time series design. Health Qual Life Outcomes 2023; 21:105. [PMID: 37705045 PMCID: PMC10498613 DOI: 10.1186/s12955-023-02184-0] [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] [Received: 06/27/2023] [Accepted: 08/21/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND Verbal rating scales (VRS) are widely used in patient-reported outcome (PRO) measures. At our institution, patients complete an online instrument using VRSs with a five-point brief response scale to assess symptoms as part of routine follow-up after ambulatory cancer surgery. We received feedback from patients that the brief VRS descriptors such as "mild" or "somewhat" were vague. We added explicit descriptors to our VRSs, for instance, "Mild: I can generally ignore my pain" for pain severity or "Somewhat: I can do some things okay, but most of my daily activities are harder because of fatigue" for fatigue interference. We then compared responses before and after this change was made. METHODS The symptoms investigated were pain, fatigue and nausea. Our hypothesis was that the explicit descriptors would reduce overall variance. We therefore compared the coefficient of variation of scores and tested the association between symptoms scores and known predictors thereof. We also compared time to completion between questionnaires with and without the additional descriptors. RESULTS A total of 17,500 patients undergoing 21,497 operations were assigned questionnaires in the period before the descriptors were added; allowing for a short transition period, 1,417 patients having 1436 operations were assigned questionnaires with the additional descriptors. Symptom scores were about 10% lower with the additional descriptors but the coefficient of variation was slightly higher. Moreover, the only statistically significant difference between groups for association with a known predictor favored the item without the additional language for nausea severity (p = 0.004). Total completion time was longer when the instrument included the additional descriptors, particularly the first and second time that the questionnaire was completed. CONCLUSIONS Adding descriptors to a VRS of post-operative symptoms did not improve scale properties in patients undergoing ambulatory cancer surgery. We have removed the additional descriptors from our tool. We recommend further comparative psychometric research using data from PROs collected as part of routine clinical care.
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Affiliation(s)
- Andrew J Vickers
- Departments of Epidemiology and Biostatistics (AV, MA, SC), Anesthesiology (PD, TM, BS) and Surgery (MH, JC, SC), Memorial Sloan Kettering Cancer Center, 485 Lexington Ave, 2Nd Floor, New York, NY, 10017, USA.
| | - Melissa Assel
- Departments of Epidemiology and Biostatistics (AV, MA, SC), Anesthesiology (PD, TM, BS) and Surgery (MH, JC, SC), Memorial Sloan Kettering Cancer Center, 485 Lexington Ave, 2Nd Floor, New York, NY, 10017, USA
| | - Michael Hannon
- Departments of Epidemiology and Biostatistics (AV, MA, SC), Anesthesiology (PD, TM, BS) and Surgery (MH, JC, SC), Memorial Sloan Kettering Cancer Center, 485 Lexington Ave, 2Nd Floor, New York, NY, 10017, USA
| | - Priyanka Desai
- Departments of Epidemiology and Biostatistics (AV, MA, SC), Anesthesiology (PD, TM, BS) and Surgery (MH, JC, SC), Memorial Sloan Kettering Cancer Center, 485 Lexington Ave, 2Nd Floor, New York, NY, 10017, USA
| | - Sigrid V Carlsson
- Departments of Epidemiology and Biostatistics (AV, MA, SC), Anesthesiology (PD, TM, BS) and Surgery (MH, JC, SC), Memorial Sloan Kettering Cancer Center, 485 Lexington Ave, 2Nd Floor, New York, NY, 10017, USA
- Department of Urology, (SC) Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
| | - Taylor McCready
- Departments of Epidemiology and Biostatistics (AV, MA, SC), Anesthesiology (PD, TM, BS) and Surgery (MH, JC, SC), Memorial Sloan Kettering Cancer Center, 485 Lexington Ave, 2Nd Floor, New York, NY, 10017, USA
| | - Jennifer Cracchiolo
- Departments of Epidemiology and Biostatistics (AV, MA, SC), Anesthesiology (PD, TM, BS) and Surgery (MH, JC, SC), Memorial Sloan Kettering Cancer Center, 485 Lexington Ave, 2Nd Floor, New York, NY, 10017, USA
| | - Brett Simon
- Departments of Epidemiology and Biostatistics (AV, MA, SC), Anesthesiology (PD, TM, BS) and Surgery (MH, JC, SC), Memorial Sloan Kettering Cancer Center, 485 Lexington Ave, 2Nd Floor, New York, NY, 10017, USA
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Systematic Review of the Effect of a One-Day Versus Seven-Day Recall Duration on Patient Reported Outcome Measures (PROMs). THE PATIENT 2023; 16:201-221. [PMID: 36786931 PMCID: PMC10121527 DOI: 10.1007/s40271-022-00611-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/09/2022] [Indexed: 02/15/2023]
Abstract
BACKGROUND There is ongoing uncertainty around the most suitable recall period for patient-reported outcome measures (PROMs). METHOD This systematic review integrates quantitative and qualitative literature across health, economics, and psychology to explore the effect of a one-day (or '24-h') versus seven-day (or 'one week') recall period. The following databases were searched from database inception to 30 November 2021: MEDLINE, EMBASE, PsycINFO, Web of Science, EconLit, CINAHL Complete, Cochrane Library, and Sociological Abstracts. Studies were included that compared a one-day (or '24-h') versus seven-day (or weekly) recall period condition on patient-reported scores for PROM and Health-Related Quality-of-Life (HRQoL) instrument scores in adult populations (aged 18 and above) or combined paediatric and adult populations with a majority of respondents aged over 18 years. Studies were excluded if they assessed health behaviours only, used ecological momentary assessment to derive an index of daily recall, or incorporated clinician reports of patient symptoms. We extracted results relevant to six domains with generic health relevance: physical functioning, pain, cognition, psychosocial wellbeing, sleep-related symptoms and aggregated disease-specific signs and symptoms. Quantitative studies compared weekly recall scores with the mean or maximum score over the last seven days or with the same-day recall score. RESULTS Overall, across the 24 quantitative studies identified, 158 unique results were identified. Symptoms tended to be reported as more severe and HRQoL lower when assessed with a weekly recall than a one-day recall. A narrative synthesis of 33 qualitative studies integrated patient perspectives on the suitability of a one-day versus seven-day recall period for assessing health state or quality of life. Participants had mixed preferences, some noted the accuracy of recall for the one-day period but others preferred the seven-day recall for conditions characterised by high symptom variability, or where PROMs concepts required integration of infrequent experiences or functioning over time. CONCLUSION This review identified a clear trend toward higher symptom scores and worse quality of life being reported for a seven-day compared to a one-day recall. The review also identified anomalies in this pattern for some wellbeing items and a need for further research on positively framed items. A better understanding of the impact of using different recall periods within PROMs and HRQoL instruments will help contextualise future comparisons between instruments. Questionnaires ask patients about their health over different time periods (e.g., "what were your symptoms like over the last week?" versus "what were your symptoms like today?"). Studies find that people may report their symptoms as more severe when they are asked to think about their symptoms over the last week compared to the last day. Understanding how different time periods influence patient responses will allow researchers to compare and develop new questionnaires and may help clinicians to choose the best questionnaire to understand their patient's condition. We conducted a systematic literature review on studies which had looked at the impact of using different recall periods on patient responses. We found 24 studies that compared patient scores from questionnaires asking their health "over the last day" compared to "over the last week". Overall, symptoms tended to be reported as more severe and health as poorer when they were reported over the last week compared to the last day on average. We also found 33 studies that asked patients to describe which recall period they preferred. Patients had mixed preferences with more preferring a seven-day recall where symptoms and health impacts varied a lot.
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Recommendations on the use of item libraries for patient-reported outcome measurement in oncology trials: findings from an international, multidisciplinary working group. Lancet Oncol 2023; 24:e86-e95. [PMID: 36725153 DOI: 10.1016/s1470-2045(22)00654-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/14/2022] [Accepted: 10/18/2022] [Indexed: 02/01/2023]
Abstract
The use of item libraries for patient-reported outcome (PRO) measurement in oncology allows for the customisation of PRO assessment to measure key health-related quality of life concepts of relevance to the target population and intervention. However, no high-level recommendations exist to guide users on the design and implementation of these customised PRO measures (item lists) across different PRO measurement systems. To address this issue, a working group was set up, including international stakeholders (academic, independent, industry, health technology assessment, regulatory, and patient advocacy), with the goal of creating recommendations for the use of item libraries in oncology trials. A scoping review was carried out to identify relevant publications and highlight any gaps. Stakeholders commented on the available guidance for each research question, proposed recommendations on how to address gaps in the literature, and came to an agreement using discussion-based methods. Nine primary research questions were identified that formed the scope and structure of the recommendations on how to select items and implement item lists created from item libraries. These recommendations address methods to drive item selection, plan the structure and analysis of item lists, and facilitate their use in conjunction with other measures. The findings resulted in high-level, instrument-agnostic recommendations on the use of item-library-derived item lists in oncology trials.
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Cocks K, Wells JR, Johnson C, Schmidt H, Koller M, Oerlemans S, Velikova G, Pinto M, Tomaszewski KA, Aaronson NK, Exall E, Finbow C, Fitzsimmons D, Grant L, Groenvold M, Tolley C, Wheelwright S, Bottomley A. Content validity of the EORTC quality of life questionnaire QLQ-C30 for use in cancer. Eur J Cancer 2023; 178:128-138. [PMID: 36436330 DOI: 10.1016/j.ejca.2022.10.026] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 10/24/2022] [Accepted: 10/25/2022] [Indexed: 11/17/2022]
Abstract
AIM The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (QLQ-C30) is among the most widely used patient-reported outcome measures in cancer research and practice. It was developed prior to guidance that content should be established directly from patients to confirm it measures concepts of interest and is appropriate and comprehensive for the intended population. This study evaluated the content validity of the QLQ-C30 for use with cancer patients. METHODS Adults undergoing cancer treatment in Europe and the USA participated in open-ended concept elicitation interviews regarding their functional health, symptoms, side-effects and impacts on health-related quality of life. Thematic analysis was conducted, and similarities across cancer types, disease stages and countries or languages were explored. RESULTS Interviews with 113 patients with cancer (85 European, 28 USA) including breast, lung, prostate, colorectal and other cancers were conducted between 2016 and 2020. Conceptual saturation was achieved. The most frequently reported concepts were included in the QLQ-C30 conceptual framework. QLQ-C30 items were widely understood across language versions and were relevant to patients across cancer types and disease stages. While several new concepts were elicited such as difficulty climbing steps or stairs, weight loss, skin problems and numbness, many were not widely experienced and/or could be considered sub-concepts of existing concepts. CONCLUSIONS The QLQ-C30 demonstrates good evidence of content validity for the assessment of functional health, symptom burden and health-related quality of life in patients with localised-to-advanced cancer.
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Affiliation(s)
- Kim Cocks
- Adelphi Values, Patient-Centered Outcomes, Bollington, Cheshire, UK.
| | - Jane R Wells
- Formerly of Adelphi Values, Patient-Centered Outcomes, Bollington, Cheshire, UK
| | - Colin Johnson
- Surgical Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Heike Schmidt
- Institute of Health and Nursing Science and University Clinic and Outpatient Clinic for Radiotherapy, Medical Faculty, Martin Luther University Halle Wittenberg, Germany
| | - Michael Koller
- Center for Clinical Studies, University Hospital Regensburg, Regensburg, Germany
| | - Simone Oerlemans
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands
| | - Galina Velikova
- Leeds Institute of Medical Research at St James's, University of Leeds, St James's University Hospital, Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, St James's University Hospital, Leeds, UK
| | - Monica Pinto
- Strategic Health Services Department, Istituto Nazionale Tumori - IRCCS- Fondazione G Pascale, Napoli, Italy
| | - Krzysztof A Tomaszewski
- Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, Krakow, Poland
| | - Neil K Aaronson
- Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Elizabeth Exall
- Formerly of Adelphi Values, Patient-Centered Outcomes, Bollington, Cheshire, UK
| | - Chelsea Finbow
- Formerly of Adelphi Values, Patient-Centered Outcomes, Bollington, Cheshire, UK
| | | | - Laura Grant
- Adelphi Values, Patient-Centered Outcomes, Bollington, Cheshire, UK
| | - Mogens Groenvold
- The Palliative Care Research Unit, Department of Geriatrics and Palliative Medicine, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark; Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Chloe Tolley
- Adelphi Values, Patient-Centered Outcomes, Bollington, Cheshire, UK
| | - Sally Wheelwright
- Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | - Andrew Bottomley
- Quality of Life Department, European Organisation for Research and Treatment of Cancer, Brussels, Belgium
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Leach CR, Gapstur SM, Cella D, Deubler E, Teras LR. Age-related health deficits and five-year mortality among older, long-term cancer survivors. J Geriatr Oncol 2022; 13:1023-1030. [PMID: 35660092 DOI: 10.1016/j.jgo.2022.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 05/05/2022] [Accepted: 05/20/2022] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Geriatric assessment evaluates multiple domains of health that, together, are superior to using chronologic age for predicting outcomes, such as hospitalization and mortality among patients with cancer. Most studies have not included comparison groups of individuals without cancer and assessed domains around the time of initial cancer diagnosis. Further, the potential for brief, self-reported measures to capture deficits that similarly predict mortality has not been well examined. This study compared age-related health deficit prevalence between older, long-term cancer survivors and individuals without a cancer history, and estimated associations between deficits and mortality risk among survivors. MATERIALS AND METHODS Analyses included participants in the Cancer Prevention Study (CPS)-II Nutrition Cohort who were cancer-free at enrollment in 1992/1993 and completed the Patient Reported Outcome Measurement Information System® (PROMIS®) global health questionnaire in 2011. Age-related deficits in five domains (comorbidities, functional status, mental health, malnutrition/weight loss, and social support) were self-reported. Cancer information was self-reported and confirmed via medical records or state cancer registries. Vital status through 2016 and cause of death was ascertained by linkage with the National Death Index. RESULTS Analyses included 9979 participants (median age = 80) diagnosed with invasive cancer 5-20 years prior to completing the 2011 survey and 63,578 participants without a cancer history (median age = 79). Overall deficits in the five domains were similar among long-term cancer survivors and controls. However, survivors of specific cancer types - non-Hodgkin lymphoma (NHL), lung, and kidney cancer - were more likely to report deficits in mental health and functional status than the control group. Among all survivors, each domain was independently associated with all-cause mortality, particularly functional status (hazard ratio [HR] = 2.02; 95% confidence interval [CI]: 1.80-2.27) and mental health (HR = 1.84; 95% CI: 1.65-2.04). Mortality risk increased with the number of deficits. DISCUSSION These results suggest that, several years after treatment, NHL, lung, and kidney cancer survivors are still more likely to experience age-related deficits compared to other similarly-aged individuals. Furthermore, results show that shorter, self-reported physical and mental health assessments, such as the PROMIS® global health questions, are predictive of mortality among older, long-term cancer survivors and, therefore, may be useful in clinical and research settings.
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Affiliation(s)
| | | | - David Cella
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Peipert JD, Chapman R, Shaunfield S, Kallen MA, Schalet BD, Cella D. Do You Recall?: Results From a Within-Person Recall Study of the Patient-Reported Outcomes Measurement Information System (PROMIS) Short Form v2.0 - Physical Function 8c. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2022; 25:161-166. [PMID: 35094787 DOI: 10.1016/j.jval.2021.08.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 06/29/2021] [Accepted: 08/23/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVES This study aimed to determine whether responses to Patient-Reported Outcomes Measurement Information System Short Form v2.0 - Physical Function 8c (PROMIS PF8c) items differed when the use of a 7-day recall period was compared with no specified recall period. METHODS Using a within-subject design, we surveyed 1810 individuals from the US general population, administering PROMIS PF8c at survey beginning and end. The order of measure presentation was randomly assigned. We calculated recall difference scores (RDSs) as no recall score minus 7-day recall score using both item response theory-based T scores and raw summed scores. We examined the distribution and created Bland-Altman plots for both RDSTscore and RDSRaw. We also calculated correlations between no recall versus 7-day recall T score and raw scores. Finally, we determined whether differences in no recall versus 7-day recall scores were associated with patient-reported PF. RESULTS RDSTscore and RDSRaw had means (root mean square differences) of 0.00 (5.43) and -0.04 (3.79), respectively. The vast majority (%) of RDSTscore and RDSRaw values fell between the Bland-Altman limits of agreement (-10.65 to 10.66 and -7.46 to 7.38, respectively). Pearson's correlations between no recall and 7-day recall for T scores and raw scores were 0.88 and 0.87, respectively. Effect sizes for mean RDSTscore and RDSRaw compared across level of Eastern Oncology Cooperative Group performance status, patient global impression of PF severity, and single PF items were near 0. CONCLUSIONS We did not find any significant recall period effect on PF8c responses. Therefore, we recommend the use of the PROMIS physical function standard, with no specified recall time period.
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Affiliation(s)
- John Devin Peipert
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | - Robert Chapman
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Sara Shaunfield
- 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
| | - Benjamin D Schalet
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - David Cella
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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10
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Carlozzi NE, Freedman J, Troost JP, Carson T, Molton IR, Ehde DM, Najarian K, Miner JA, Boileau NR, Kratz AL. Daily Variation in Sleep Quality is Associated With Health-Related Quality of Life in People With Spinal Cord Injury. Arch Phys Med Rehabil 2022; 103:263-273.e4. [PMID: 34416248 PMCID: PMC8810726 DOI: 10.1016/j.apmr.2021.07.803] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 07/02/2021] [Accepted: 07/10/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Although sleep difficulties are common after spinal cord injury (SCI), little is known about how day-to-day fluctuations in sleep quality affects health-related quality of life (HRQOL) among these individuals. We examined the effect of sleep quality on same-day HRQOL using ecological momentary assessment methods over a 7-day period. DESIGN Repeated-measures study involving 7 days of home monitoring; participants completed HRQOL measures each night and ecological momentary assessment ratings 3 times throughout the day; multilevel models were used to analyze data. SETTING Two academic medical centers. PARTICIPANTS A total of 170 individuals with SCI (N=170). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Daily sleep quality was rated on a scale of 0 (worst) to 10 (best) each morning. Participants completed end-of-day diaries each night that included several HRQOL measures (Sleep Disturbance, Sleep-related Impairment, Fatigue, Cognitive Abilities, Pain Intensity, Pain Interference, Ability to Participate in Social Roles and Activities, Depression, Anxiety) and ecological momentary assessment ratings of HRQOL (pain, fatigue, subjective thinking) 3 times throughout each day. RESULTS Multilevel models indicated that fluctuations in sleep quality (as determined by end-of-day ratings) were significantly related to next-day ratings of HRQOL; sleep quality was related to other reports of sleep (Sleep Disturbance; Sleep-related Impairment; Fatigue) but not to other aspects of HRQOL. For ecological momentary assessment ratings, nights of poor sleep were related to worse pain, fatigue, and thinking. Generally, sleep quality showed consistent associations with fatigue and thinking across the day, but the association between sleep quality and these ecological momentary assessment ratings weakened over the course of the day. CONCLUSIONS Findings highlight the important association between sleep and HRQOL for people with SCI. Future work targeting sleep quality improvement may have positive downstream effects for improving HRQOL in people with SCI.
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Affiliation(s)
- Noelle E. Carlozzi
- Department of Physical Medicine & Rehabilitation, University of Michigan, Ann Arbor, MI, USA,Corresponding Author. Noelle E. Carlozzi, Ph.D., University of Michigan, Department of Physical Medicine & Rehabilitation, North Campus Research Complex, 2800 Plymouth Road Building NCRC B14, Room G216, Ann Arbor, MI,
| | - Jenna Freedman
- Department of Physical Medicine & Rehabilitation, University of Michigan, Ann Arbor, MI, USA
| | - Jonathan P. Troost
- Michigan Institute for Clinical and Health Research, University of Michigan, Ann Arbor, MI, USA
| | - Traci Carson
- Department of Physical Medicine & Rehabilitation, University of Michigan, Ann Arbor, MI, USA
| | - Ivan R. Molton
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Dawn M. Ehde
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Kayvan Najarian
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA,Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Jennifer A. Miner
- Department of Physical Medicine & Rehabilitation, University of Michigan, Ann Arbor, MI, USA
| | - Nicholas R. Boileau
- Department of Physical Medicine & Rehabilitation, University of Michigan, Ann Arbor, MI, USA
| | - Anna L. Kratz
- Department of Physical Medicine & Rehabilitation, University of Michigan, Ann Arbor, MI, USA
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Joeris A, Zhu TY, Lambert S, Wood A, Jayakumar P. Real-world patient data: Can they support decision making and patient engagement? Injury 2021:S0020-1383(21)01002-0. [PMID: 34949460 DOI: 10.1016/j.injury.2021.12.012] [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: 11/11/2021] [Accepted: 12/04/2021] [Indexed: 02/02/2023]
Abstract
Patient-reported outcomes (PROs) capture data related to patients' perception of their health status and aspects of health care delivery. In parallel, digital innovations have advanced the administration, storage, processing, and accessibility of PROs, allowing these data to become actively incorporated in day-to-day clinical practice along the entire patient care pathway. Further, the emergence of shared decision making, where patients are engaged in informed treatment selection aligned with their preferences, values, and needs, can be realized by PROs and technology. This technology-enabled, data-driven approach provides insights which, when actioned, can enhance musculoskeletal care of patients and populations, while enriching the clinician-patient experience of decision making. In this review, we provide an overview of the opportunities enabled by PROs and technology for the cycle of orthopedic care.
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Affiliation(s)
- Alexander Joeris
- AO Innovation Translation Center, Clinical Science, AO Foundation, Davos, Switzerland.
| | - Tracy Y Zhu
- AO Innovation Translation Center, Clinical Science, AO Foundation, Davos, Switzerland
| | - Simon Lambert
- University College London Hospital, London, United Kingdom
| | - Andrea Wood
- Universal Research Solutions LLC, Columbia, MO, United States
| | - Prakash Jayakumar
- Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, TX, United States
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Ikeda T, Cooray U, Murakami M, Osaka K. Maintaining Moderate or Vigorous Exercise Reduces the Risk of Low Back Pain at 4 Years of Follow-Up: Evidence From the English Longitudinal Study of Ageing. THE JOURNAL OF PAIN 2021; 23:390-397. [PMID: 34583021 DOI: 10.1016/j.jpain.2021.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 08/04/2021] [Accepted: 08/27/2021] [Indexed: 11/25/2022]
Abstract
Few studies have examined whether maintaining moderate or vigorous physical activity (PA) reduces the risk of low back pain in older people. This study aimed to examine the magnitude of the associations of changes in PA on the risk of low back pain at 4 years of follow-up. We analyzed 4,882 participants in the English Longitudinal Study of Ageing who were initially free from low back pain (mean age, 65.6 ± 8.9 years at baseline). Self-reported PA, which was assessed at wave 6 (2012-2013) and wave 7 (2014-2015), was used as the exposure. The PA of the respondents was categorized into "no PA at all," "up to moderate PA," and "up to vigorous PA" groups. Self-reported moderate/severe low back pain assessed at 4 years of follow-up (2016-2017) was used as the outcome. Maintaining moderate (relative risk [RR], 0.59; 95% confidence interval [CI], 0.36-0.99) or vigorous (RR, 0.46; 95% CI, 0.27-0.77) PA at least 1-3 times a month was negatively associated with prevalence of low back pain compared with no PA at all. Interventions for maintaining either moderate or vigorous PA might be beneficial in preventing the incidence of low back pain in the older population. PERSPECTIVE: Perspective: This study examined the magnitude of the association between changes in physical activity over time and the risk of low back pain. The findings suggest that encouraging people to maintain at least moderate physical activity over 2 years is useful for reducing the risk of low back pain at 4 years of follow-up.
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Affiliation(s)
- Takaaki Ikeda
- Department of Health Policy Science, Graduate School of Medical Science, Yamagata University, Yamagata, Japan; Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan.
| | - Upul Cooray
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Masayasu Murakami
- Department of Health Policy Science, Graduate School of Medical Science, Yamagata University, Yamagata, Japan
| | - Ken Osaka
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
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13
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Lee MK, Beebe TJ, Yost KJ, Eton DT, Novotny PJ, Dueck AC, Frost M, Sloan JA. Score equivalence of paper-, tablet-, and interactive voice response system-based versions of PROMIS, PRO-CTCAE, and numerical rating scales among cancer patients. J Patient Rep Outcomes 2021; 5:95. [PMID: 34533663 PMCID: PMC8448797 DOI: 10.1186/s41687-021-00368-0] [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: 02/06/2021] [Accepted: 09/04/2021] [Indexed: 11/21/2022] Open
Abstract
Background The study tests the effects of data collection modes on patient responses associated with the multi-item measures such as Patient-Reported Outcomes Measurement System (PROMIS®), and single-item measures such as Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE), and Numerical Rating Scale (NRS) measures. Methods Adult cancer patients were recruited from five cancer centers and administered measures of anxiety, depression, fatigue, sleep disturbance, pain intensity, pain interference, ability to participate in social roles and activities, global mental and physical health, and physical function. Patients were randomized to complete the measures on paper (595), interactive voice response (IVR, 596) system, or tablet computer (589). We evaluated differential item functioning (DIF) by method of data collection using the R software package, lordif. For constructs that showed no DIF, we concluded equivalence across modes if the equivalence margin, defined as ± 0.20 × pooled SD, completely surrounds 95% confidence intervals (CI's) for difference in mean score. If the 95% CI fell totally outside the equivalence margin, we concluded systematic score difference by modes. If the 95% CI partly overlaps the equivalence margin, we concluded neither equivalence nor difference. Results For all constructs, no DIF of any kind was found for the three modes. The scores on paper and tablet were more comparable than between IVR and other modes but none of the 95% CI’s were completely outside the equivalence margins, in which we established neither equivalence nor difference. Percentages of missing values were comparable for paper and tablet modes. Percentages of missing values were higher for IVR (2.3% to 6.5% depending on measures) compared to paper and tablet modes (0.7% to 3.3% depending on measures and modes), which was attributed to random technical difficulties experienced in some centers. Conclusion Across all mode comparisons, there were some measures with CI’s not completely contained within the margin of small effect. Two visual modes agreed more than visual-auditory pairs. IVR may induce differences in scores unrelated to constructs being measured in comparison with paper and tablet. The users of the surveys should consider using IVR only when paper and computer administration is not feasible.
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Affiliation(s)
- Minji K Lee
- Department of Quantitative Health Sciences, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.
| | - Timothy J Beebe
- Division of Health Policy and Management, University of Minnesota School of Public Health, 625 Michigan Ave, 27th Floor, Chicago, IL, 60611, USA
| | - Kathleen J Yost
- Department of Quantitative Health Sciences, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - David T Eton
- Department of Quantitative Health Sciences, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Paul J Novotny
- Department of Quantitative Health Sciences, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Amylou C Dueck
- Department of Quantitative Health Sciences, Mayo Clinic, 13400 E. Shea Blvd., Scottsdale, AZ, 85259, USA
| | - Marlene Frost
- Department of Quantitative Health Sciences, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Jeff A Sloan
- Department of Quantitative Health Sciences, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
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van den Berg L, Brouwer P, Panda N, Hoogbergen MM, Solsky I, Onnela JP, Haynes AB, Sidey-Gibbons CJ. Feasibility and performance of smartphone-based daily micro-surveys among patients recovering from cancer surgery. Qual Life Res 2021; 31:579-587. [PMID: 34283380 DOI: 10.1007/s11136-021-02934-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2021] [Indexed: 11/24/2022]
Abstract
AIMS Daily micro-surveys, or the high-frequency administration of patient-reported outcome measures (PROMs), may provide real-time, unbiased assessments of health-related quality of life (HRQoL). We evaluated the feasibility and accuracy of daily micro-surveys using a smartphone platform among patients recovering from cancer surgery. METHODS In a prospective study (2017-2019), patients undergoing cancer surgery downloaded a smartphone application that administered daily micro-surveys comprising five randomly selected items from the Short Form-36 (SF-36). Micro-surveys were administered without replacement until the entire SF-36 was administered weekly. The full-length SF-36 was also administered preoperatively and 4, 12, and 24 weeks postoperatively. We assessed response and completion rates between the micro-surveys and full-length SF-36, as well as agreement of responses using Bland-Altman (B&A) analyses. RESULTS Ninety-five patients downloaded the application and were followed for a mean of 131 days [SD ± 85]. Response rates for the full-length SF-36 and micro-surveys was 76% [95%CI 69, 83], and 34% [95%CI 26, 39]. Despite lower response rates, more SF-36 surveys were collected using the daily micro-surveys compared to the intermittent full-length SF-36 (9.9 [95%CI 8.4, 12.6] vs. 3.0 [95%CI 2.8, 3.3], respectively). B&A analyses demonstrated lack of agreement between micro-surveys and SF-36. However, agreement improved with higher micro-survey completion rate. Eighty-five percent of participants reported that daily micro-surveys were not burdensome. CONCLUSION This study suggests that collection of daily micro-surveys among patients recovering from cancer surgery is feasible using smartphones in the early postoperative period. Future implementation of daily micro-surveys may more granularly describe momentary HRQoL changes through a greater volume of self-reported survey data.
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Affiliation(s)
- Lisa van den Berg
- Patient-Reported Outcomes, Value & Experience (PROVE) Center, Brigham and Women's Hospital, Boston, USA
- Department of Plastic Surgery, Catharina Hospital Eindhoven, Eindhoven, The Netherlands
| | - Philip Brouwer
- Patient-Reported Outcomes, Value & Experience (PROVE) Center, Brigham and Women's Hospital, Boston, USA.
- Department of Plastic Surgery, Catharina Hospital Eindhoven, Eindhoven, The Netherlands.
| | - Nikhil Panda
- Ariadne Labs, Brigham and Women's Hospital, Harvard. T.H. School of Public Health, Boston, USA
- Department of Surgery, Massachusetts General Hospital, Boston, USA
| | - Maarten M Hoogbergen
- Department of Plastic Surgery, Catharina Hospital Eindhoven, Eindhoven, The Netherlands
| | - Ian Solsky
- Department of Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, USA
| | - Jukka-Pekka Onnela
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Alex B Haynes
- Department of Surgery, Massachusetts General Hospital, Boston, USA
- Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas At Austin, Austin, USA
| | - Christopher J Sidey-Gibbons
- Patient-Reported Outcomes, Value & Experience (PROVE) Center, Brigham and Women's Hospital, Boston, USA
- Department of Symptom Research, Center for Integrative Systems for Patient-Reported Data (INSPiRED) in Cancer Care, Houston, USA
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15
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Anttila H, Tallqvist S, Muñoz M, Leppäjoki-Tiistola S, Mäkitie O, Hiekkala S. Towards an ICF-based self-report questionnaire for people with skeletal dysplasia to study health, functioning, disability and accessibility. Orphanet J Rare Dis 2021; 16:236. [PMID: 34022932 PMCID: PMC8141148 DOI: 10.1186/s13023-021-01857-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 05/06/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Little is known about the spectrum of everyday challenges that people with skeletal dysplasia face because of their health and functioning. We aimed to identify factors related to health, functioning and disability in people with skeletal dysplasia, and their challenges with accessibility in order to form a self-reported questionnaire for national data collection. The comprehensive musculoskeletal post-acute core set of the International Classification of Functioning, Disability and Health (ICF) was used as a framework. METHODS An iterative, participatory and qualitative process was used to formulate a questionnaire. Items were searched from Patient-Reported Outcomes Measurement Information System and from other self-report instruments, additional items were formulated using ICF linking rules. Expert panels from the target population assessed the face and content validity in thematic interviews. RESULTS The questionnaire demonstrated its relevance, comprehensiveness and feasibility for people with skeletal dysplasia. The ICF linkages showed the contents' correspondence to the construct. Expert panels added 15 categories and one on chapter level to the core set and confirmed content validity. The final survey covers 86 ICF categories and 173 ICF-linked items that were grouped to 33 questions. CONCLUSIONS The content of the questionnaire proved to be sufficiently valid for people with skeletal dysplasia. It can be used to explore their health, functioning, disability and accessibility to develop care and rehabilitation policies, to plan services and to provide information to various parties involved.
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Affiliation(s)
- Heidi Anttila
- Public Health and Welfare Department, Knowledge Management and Co-Creation Unit, Finnish Institute for Health and Welfare, Mannerheimintie 166, 01270, Helsinki, Finland.
| | | | - Minna Muñoz
- Validia Ltd, Validia Rehabilitation, Nordenskiöldinkatu 18 B, 00250, Helsinki, Finland
| | - Sanna Leppäjoki-Tiistola
- Lyhytkasvuiset - Kortväxta ry (Finnish Association for People with Restricted Growth and for Their Families), PO Box 14, 02601, Espoo, Finland
- Finnish Association of People With Physical Disabilities, Mannerheimintie 107, 00280, Helsinki, Finland
| | - Outi Mäkitie
- Children's Hospital, University of Helsinki and Helsinki University Hospital, P.O. Box 63, 00014, Helsinki, Finland
- Folkhälsan Institute of Genetics, Helsinki, Finland
| | - Sinikka Hiekkala
- Validia Ltd, Validia Rehabilitation, Nordenskiöldinkatu 18 B, 00250, Helsinki, Finland
- Finnish Association of People With Physical Disabilities, Mannerheimintie 107, 00280, Helsinki, Finland
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Benson T, Seers H, Webb N, McMahon P. Development of social contact and loneliness measures with validation in social prescribing. BMJ Open Qual 2021; 10:bmjoq-2020-001306. [PMID: 33990393 PMCID: PMC8127978 DOI: 10.1136/bmjoq-2020-001306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 04/26/2021] [Accepted: 05/05/2021] [Indexed: 12/03/2022] Open
Abstract
Aims This paper describes two patient-reported measures of social contact and loneliness, which are closely related concepts. The first measure (R-Outcomes Social Contact measure) was developed from scratch, based on customer needs and literature review. It covers emotional and social aspects using positive terms. The second measure (R-Outcomes Loneliness measure) is adapted from the GSS Loneliness Harmonised Standard. Both measures are patient-reported outcome measures, based on patients’ own perception of how they feel. Method This development started in 2016 in response to customers’ requests to measure social contact/loneliness for patients in social prescribing projects. Both measures are compared with three other loneliness measures (the GSS Loneliness Harmonised Standard, De Jong Gierveld and Campaign to End Loneliness). Both measures are short (36 and 21 words, respectively). Mean improvement is reported as a positive number on a 0–100 scale (where high is good). We tested the psychometric performance and construct validity of the R-Outcomes Social Contact measure using secondary analysis of anonymised data collected before and after social prescribing interventions in one part of Southern England. Results In the validation study, 728 responses, collected during 2019–2020, were analysed. 90% were over 70 years old and 62% women. Cronbach’s α=0.76, which suggests that it is appropriate to use a single summary score. Mean Social Contact scores before and after social prescribing intervention were 59.9 (before) and 66.7 (after, p<0.001). Exploratory factor analysis shows that measures for social contact, health status, health confidence, patient experience, personal well-being, medication adherence and social determinants of health are correlated but distinct factors. Construct validation shows that the results are consistent with nine hypotheses, based on the loneliness literature. Conclusion The R-Outcomes Social Contact measure has good psychometric and construct validation results in a population referred to social prescribing. It is complementary to other R-Outcomes measures.
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Affiliation(s)
- Tim Benson
- R-Outcomes Ltd, Newbury, UK .,Institute of Health Informatics, University College London, London, UK
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17
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Lee MK, St Sauver JL, Anderson RT, Linzer M, Eton DT. Confirmatory Factor Analyses and Differential Item Functioning of the Patient Experience with Treatment and Self-Management (PETS vs. 2.0): A Measure of Treatment Burden. PATIENT-RELATED OUTCOME MEASURES 2021; 11:249-263. [PMID: 33447118 PMCID: PMC7801917 DOI: 10.2147/prom.s282728] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 11/19/2020] [Indexed: 11/23/2022]
Abstract
Purpose To examine the factor structure and differential item functioning (DIF) of the Patient Experience with Treatment and Self-management (PETS version 2.0), a measure of treatment burden. Patients and Methods Version 2.0 of the PETS has 60 items, extending the previously-validated 48-item version 1.0 by three domains (nine items) and three additional items in an existing domain. We conducted confirmatory factor analyses (CFA) on survey responses of 439 community-dwelling adults living with multiple chronic conditions who completed PETS version 2.0, using R packages, "lavaan" and "semTools." We tested fit of second-order factors to explore simplifying the reporting of PETS scores. We examined DIF for the two second-order factors with "lordif" R package, testing groups by gender, education, and health literacy, using the McFadden pseudo R 2 change criterion of ≥0.02 to flag items with DIF. Cronbach's alpha and the intraclass correlation coefficient (ICC) were used to determine the reliability of PETS domains. Results The first-order CFA model featuring 12 multi-item domains had an excellent fit (Comparative Fit Index [CFI]=0.989), as did the second-order CFA model (CFI=0.987), specifying two superordinate factors of treatment burden (workload and impact). Items in the workload and impact second-order factors did not show any DIF across gender, education, and health literacy groups as shown by McFadden pseudo R 2 changes <0.02. Cronbach's alphas for all multi-item domain scales were ≥0.80, and ICCs of ten scales were ≥0.70, meeting the threshold for adequate test-retest reliability. Conclusion Findings support the construct validity and reliability of PETS version 2.0. The fit of a factor model featuring superordinate (ie, second-order) factors of workload and impact supports index scoring that will simplify reporting of PETS scores. DIF analyses indicate that items from these indices can be interpreted in the same way, regardless of gender, education, or health literacy.
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Affiliation(s)
- Minji K Lee
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
| | - Jennifer L St Sauver
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA.,Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Roger T Anderson
- Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Mark Linzer
- Hennepin Healthcare, Minneapolis, Minnesota, USA, University of Minnesota Medical School, Minneapolis, MN, USA
| | - David T Eton
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA.,Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
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Varni JW, Panepinto JA. Cognitive functioning, patient health communication, and worry mediate pain predictive effects on health-related quality of life in youth with sickle cell disease. Pediatr Blood Cancer 2020; 67:e28680. [PMID: 32860648 DOI: 10.1002/pbc.28680] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 07/25/2020] [Accepted: 08/19/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The objective was to investigate the serial mediating effects of perceived cognitive functioning, patient health communication, and disease-specific worry in the relationship between pain and overall generic health-related quality of life (HRQOL) in youth with sickle cell disease (SCD) from the patient perspective. METHODS The pain, cognitive functioning, communication and worry scales from the Pediatric Quality of Life Inventory (PedsQL) Sickle Cell Disease Module and the PedsQL Multidimensional Fatigue Scale, and the PedsQL 4.0 Generic Core Scales were completed in a multisite national study by 233 youth with SCD of ages 5-18. Hierarchical multiple regression and serial multiple mediator model analyses were conducted to test the mediating effects of perceived cognitive functioning, health communication, and disease-specific worry as intervening variables in the association between the pain predictor variable and overall generic HRQOL. RESULTS Pain predictive effects on overall generic HRQOL were serially mediated by cognitive functioning, health communication, and disease-specific worry. In predictive analytics models utilizing hierarchical multiple regression analyses with age and gender demographic covariates, pain, cognitive functioning, health communication, and worry accounted for 65% of the variance in patient-reported overall generic HRQOL (P < .001), representing a large effect size. CONCLUSIONS Perceived cognitive functioning, patient health communication, and disease-specific worry explain in part the mechanism of pain predictive effects on overall generic HRQOL in youth with SCD. Identifying SCD-specific pain, perceived cognitive functioning, health communication, and disease-specific worry as predictor variables of overall generic HRQOL from the patient perspective may inform clinical interventions and future patient-centered clinical research.
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Affiliation(s)
- James W Varni
- Department of Pediatrics, College of Medicine, Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University, College Station, Texas
| | - Julie A Panepinto
- Department of Pediatrics, Hematology/Oncology/Bone Marrow Transplantation, Children's Hospital of Wisconsin of the Children's Research Institute/Medical College of Wisconsin, Milwaukee, Wisconsin
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Selecting, Administering, and Interpreting Outcome Measures among Adults with Lower-Limb Loss: An Update for Clinicians. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2020; 8:92-109. [PMID: 33767921 DOI: 10.1007/s40141-020-00274-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Purpose of review To summarize outcome measurement research among adults with lower-limb loss (LLL) for clinicians. Recent findings Houghton Scale, Prosthetic Evaluation Questionnaire-mobility subscale (PEQ-m), Prosthetic Limb Users Survey of Mobility (PLUS-M™), Activities-Specific Balance Confidence Scale (ABC), Amputee Mobility Predictor (AMP), Comprehensive High-Level Activity Mobility Predictor, Four Square Step Test (FSST), Narrowing Beam Walking Test (NBWT), L Test, 10 Meter Walk Test (10MWT), and 6 Minute Walk Test (6MWT) are appropriate for evaluating individual patient changes post-LLL. Post-LLL, Socket Comfort Score, Patient-Specific Functional Scale, Patient-Reported Outcomes Measurement Information System 29-Item Profile, Timed Up and Go, and 2 Minute Walk Test may be more appropriate for evaluating groups. Minimal detectable change is available for 15/20 reviewed measures. Many measures differ between mobility levels. Summary Quick, reliable measures for evaluating patient functional change include ABC, PEQ-m, PLUS-M™, FSST, and L Test; when resources allow, NBWT, 10MWT, 6WMT and AMP may be considered.
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Rees-Punia E, Patel AV, Nocera JR, Chantaprasopsuk S, Demark-Wahnefried W, Leach CR, Smith TG, Cella D, Gapstur SM. Self-reported physical activity, sitting time, and mental and physical health among older cancer survivors compared with adults without a history of cancer. Cancer 2020; 127:115-123. [PMID: 33079415 PMCID: PMC9105766 DOI: 10.1002/cncr.33257] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/28/2020] [Accepted: 09/20/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND To the authors' knowledge, few studies to date have examined associations between moderate to vigorous physical activity (MVPA) and sitting time with quality of life in cancer survivors compared with a cancer-free group. The current study examined differences in global mental health (GMH) and global physical health (GPH) across levels of MVPA and sitting among cancer survivors and cancer-free participants. METHODS Cancer Prevention Study II participants (59.9% of whom were female with an age of 77.8 ± 5.8 years) were grouped as: 1) survivors who were 1 to 5 years after diagnosis (3718 participants); 2) survivors who were 6 to 10 years after diagnosis (4248 participants); and 3) cancer-free participants (ie, no history of cancer; 69,860 participants). In 2009, participants completed MVPA, sitting, and Patient-Reported Outcomes Measurement Information System GMH/GPH surveys. Mean differences in GMH and GPH T scores across MVPA (none, 0 to <7.5, 7.5 to <15, 15 to <22.5, and ≥22.5 metabolic equivalent [MET]-hours/week) and sitting (0 to <3, 3 to <6, and ≥6 hours/day) were assessed using multivariate generalized linear models. RESULTS The mean GMH and GPH scores were statistically significantly higher in cancer-free participants compared with cancer survivor groups, although the differences were not clinically meaningful (mean difference of 0.52 for GMH and 0.88 for GPH). More MVPA was associated with higher GMH and GPH scores for all 3 groups (P for trend <.001), and differences between the least and most active participants were found to be clinically meaningful (mean differences of ≥4.34 for GMH and ≥6.39 for GPH). Similarly, a lower duration of sitting was associated with higher GMH and GPH scores for all groups (P for trend <.001), with clinically meaningful differences observed between the least and most sedentary participants (mean differences of ≥2.74 for GMH and ≥3.75 for GPH). CONCLUSIONS The findings of the current study provide evidence of the importance of increased MVPA and decreased sitting for improved health in older adults with or without a prior cancer diagnosis.
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Affiliation(s)
- Erika Rees-Punia
- Department of Population Science, American Cancer Society, Atlanta, Georgia
| | - Alpa V. Patel
- Department of Population Science, American Cancer Society, Atlanta, Georgia
| | - Joseph R. Nocera
- Department of Neurology, Emory University, Atlanta, Georgia,Department of Rehabilitation Medicine, Emory University, Atlanta, Georgia,Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Medical Center, Atlanta, Georgia,Cancer Prevention and Control Program, Winship Cancer Institute, Atlanta, Georgia
| | | | - Wendy Demark-Wahnefried
- O’Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama
| | - Corinne R. Leach
- Department of Population Science, American Cancer Society, Atlanta, Georgia
| | - Tenbroeck G. Smith
- Department of Population Science, American Cancer Society, Atlanta, Georgia
| | - David Cella
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Susan M. Gapstur
- Department of Population Science, American Cancer Society, Atlanta, Georgia
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