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Ciccodicola E, Liang A, Kay RM, Wren TAL. Pediatric Outcomes Data Collection Instrument Scores Within Gross Motor Function Classification Scale Levels and Functional Mobility Scale Ratings in Individuals With Cerebral Palsy. J Pediatr Orthop 2024; 44:e542-e548. [PMID: 38595088 DOI: 10.1097/bpo.0000000000002684] [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] [Indexed: 04/11/2024]
Abstract
BACKGROUND AND OBJECTIVE The Pediatric Outcomes Data Collection Instrument (PODCI) is a patient/parent-reported outcome measure used in children with cerebral palsy (CP). PODCI score variability has not been widely examined in patients of Gross Motor Function Classification System (GMFCS) level IV or using the Functional Mobility Scale (FMS). The purpose of this study is to examine the distribution of PODCI scores within patients with CP GMFCS levels I-IV and FMS levels 1-6. METHODS Retrospectively identified patients with CP whose parent/caregiver had completed the PODCI at their visit were grouped based on GMFCS and FMS level. One-way ANOVA with pairwise Bonferroni-adjusted post hoc tests was performed to compare the effect of GMFCS and FMS levels (1, 2-4, 5, or 6) on PODCI scores. RESULTS Three hundred sixty-seven patients were included (128 female, 11.7 years, SD 3.6). Global, Sports, Transfer, and Upper Extremity scores differed among all GMFCS levels ( P ≤0.056) and were significantly lower for GMFCS IV compared with all other levels. Happiness, Expectations, and Pain scores did not differ significantly among GMFCS levels including level IV ( P >0.06). Similar trends were seen at all FMS distances (5, 50, and 500âm). At 50âm, Global, Sports, Transfer, and Upper Extremity scores differed significantly among all FMS levels ( P <0.001) except that Upper Extremity Scores were similar between levels 2-4 and level 5 ( P =1.00). Happiness and Pain scores were not different between FMS levels ( P >0.27). Expectations scores differed only between FMS 1 and FMS 6 with FMS 6 being higher at the 50-m distance only ( P =0.03). CONCLUSIONS Parent-reported outcome measures are important for providing patient-centered care. Providers can examine these measures alongside functional classification systems to create a more complete clinical picture of the patient. Providers should be aware of the score trends seen in our results when evaluating the PODCI for individuals with CP to improve shared decision-making and better monitor their need for future care. LEVEL OF EVIDENCE Level III-retrospective study.
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Affiliation(s)
- Eva Ciccodicola
- Jackie and Gene Autry Orthopedic Center, Children's Hospital Los Angeles
| | - Adriana Liang
- Jackie and Gene Autry Orthopedic Center, Children's Hospital Los Angeles
| | - Robert M Kay
- Jackie and Gene Autry Orthopedic Center, Children's Hospital Los Angeles
- Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Tishya A L Wren
- Jackie and Gene Autry Orthopedic Center, Children's Hospital Los Angeles
- Keck School of Medicine, University of Southern California, Los Angeles, CA
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Cherng HRR, Qu M, Zafari Z, Bentzen SM, Armstrong TS, Gondi V, Brown PD, Mehta M, Mishra MV. Evaluating the sensitivity of EQ-5D-5L in patients with brain metastases: a secondary analysis of NRG CC001. J Natl Cancer Inst 2024; 116:983-989. [PMID: 38281073 PMCID: PMC11160499 DOI: 10.1093/jnci/djae020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 01/16/2024] [Accepted: 01/23/2024] [Indexed: 01/29/2024] Open
Abstract
BACKGROUND EuroQoL EQ-5D-5L is a commonly used measure of health-related quality of life in clinical trials given the use of its index score as a measure of health utilities. It is unclear whether EQ-5D-5L is sensitive to changes in neurocognitive function and progression that occur following brain radiation. This study sought to evaluate the sensitivity of EQ-5D-5L in reflecting these changes. METHODS A secondary analysis of NRG Oncology CC001 was performed. Mean EQ-5D-5L index and visual analog scale (VAS) score changes from baseline between groups of patients stratified by neurocognitive function and intracranial progression status were assessed. MD Anderson Symptom Inventory for brain tumor (MDASI-BT) symptom and interference items were also analyzed between groups. RESULTS EQ-5D-5L mean index and VAS score changes between patients who had cognitive failure and those who had preserved cognition showed no statistically significant differences at any timepoint. In contrast, VAS changes at 4 months (1.61 vs -5.13, P = .05) and 6 months (8.17 vs -0.14, P = .04) were significantly improved in the patients who survived without intracranial progression. MDASI-BT cognitive factor scores were improved in the cohort of patients with preserved neurocognitive function at 2 months (1.68 vs 2.08, P = .05) and 4 months (1.35 vs 1.83, P = .04). MDASI-BT symptom interference was significantly associated with intracranial progression at 4 months, but not with neurocognitive status. CONCLUSION EQ-5D-5L index and VAS scores were not sensitive to neurocognitive changes that patients experienced, but VAS scores were sensitive to progression. This study challenges the routine use of EQ-5D as a quality of life metric in brain metastases clinical trials that are focused on preventing neurocognitive dysfunction. TRIAL REGISTRATION NCT# 02360215.
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Affiliation(s)
- Hua-Ren R Cherng
- Department of Radiation Oncology, University of Maryland Medical Center, Baltimore, MD, USA
| | - Melody Qu
- Department of Radiation Oncology, London Regional Cancer Centre, London, ON, Canada
| | - Zafar Zafari
- Department of Practice, Sciences, and Health Outcomes Research, University of Maryland School of Pharmacy, Baltimore, MD, USA
| | - Søren M Bentzen
- Division of Biostatistics and Bioinformatics, University of Maryland Greenebaum Cancer Center, and Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Terri S Armstrong
- Neuro-Oncology Branch, National Cancer Institute Center for Cancer Research, Bethesda, MD, USA
| | - Vinai Gondi
- Department of Radiation Oncology, Northwestern Medicine Cancer Center and Proton Center, Warrenville, IL, USA
| | - Paul D Brown
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN, USA
| | - Minesh Mehta
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL, USA
| | - Mark V Mishra
- Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD, USA
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Goss Sawhney T, Dobes A, O’Charoen S. Real-World Persistency for Inflammatory Bowel Disease Biologics Using Patient Registry Data. CROHN'S & COLITIS 360 2023; 5:otad051. [PMID: 37941597 PMCID: PMC10629214 DOI: 10.1093/crocol/otad051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Indexed: 11/10/2023] Open
Abstract
Background Although it is a truism that drugs benefit patients only when taken, surprisingly little is known about real-world drug-use persistence and discontinuation, even for expensive biologic drugs. Methods We used longitudinal self-reported drug-use data from the inflammatory bowel disease (IBD) Partners registry of people with IBD to construct Kaplan-Meier drug-use persistency graphs for biologic drug-use spans that started between 2017 and 2022. Results We examined 2034 drug-use spans for 1594 survey participants. Most of the biologic drugs had a 75%+ persistency rate around the one-year mark and 60%+ persistency at the 3-year mark. The overall persistency and the differences in persistency between drugs were aligned with published literature. Conclusions This analysis demonstrates the feasibility of collecting IBD-specific patient-reported drug persistency data via a voluntary patient registry. Patient-reported persistency provides real-world drug persistency data and the patient's perspectives as to why they discontinued use of the drug-a combination of data and perspective that is not available from any other real-world medical record, claim, and pharmacy data source that are valuable to physician, patients, payers, healthcare policymakers, and health technology assessment organizations.
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Affiliation(s)
- Tia Goss Sawhney
- Teus Health, LLC, Newark, NJ, USA
- New York University, School of Global Public Health, New York, NY, USA
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Scott KS, Barbosa GO, Pan J, Heathcock JC. Using the PODCI to Measure Motor Function and Parent Expectations in Children With Cerebral Palsy. Phys Ther 2021; 101:pzab215. [PMID: 34529078 PMCID: PMC8651067 DOI: 10.1093/ptj/pzab215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 07/12/2021] [Accepted: 07/31/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Involving parents in the evaluation of their child with cerebral palsy (CP) is associated with enhanced neurodevelopmental outcomes. The pediatric outcomes data collection instrument (PODCI) is a patient-reported outcome measure primarily used to assess motor function following orthopedic surgical intervention or for older children with more independent motor function. The PODCI expectations scale has infrequently been reported in previous studies. This study aims to determine the relationship between parent-reported motor performance using the PODCI and motor capacity assessed by pediatric therapists for young children with CP across all ability levels and to explore the use of the PODCI expectations scale for quantifying therapy-related parent expectations. METHODS This prospective cohort study included 108 participants with CP, 2 to 8 years of age, gross motor function classification systems (GMFCS) levels I to V. Measures included the PODCI, gross motor function measure (GMFM), and GMFCS. RESULTS There were moderate (r = 0.513) to large (r = 0.885) relationships between PODCI and GMFM scores. PODCI scores were significantly different across GMFCS levels. Weak, significant relationships (r = -0.28) were found between function expectations scores and measures of function. CONCLUSION The PODCI, GMFM, and GMFCS provide different, but strongly related, information about the abilities of young children. The GMFM measures motor capacity. Parents report daily function and health-related quality of life for their child using the PODCI. Parent expectations for intervention outcomes may relate to a child's motor function. IMPACT These study results are consistent with those for older children with greater independent mobility, indicating an opportunity for expanded use of the PODCI for measuring motor performance for younger children with CP across all ability levels. A strategy is provided for using the PODCI expectations scale to quantify parent therapy-related expectations in future research and clinical settings. Therapy-related expectations may relate to child outcomes.
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Affiliation(s)
- Kimberley S Scott
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio, USA
| | - Gardenia O Barbosa
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio, USA
| | - Jeff Pan
- Center for Biostatistics, Department of Biomedical Informatics, The Ohio State University, Columbus, Ohio, USA
| | - Jill C Heathcock
- Pediatric and Rehabilitation Laboratory, School of Health and Rehabilitation Sciences, Division of Physical Therapy, The Ohio State University, Columbus, Ohio, USA
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Janssen LMM, Drost RMWA, Paulus ATG, Garfield K, Hollingworth W, Noble S, Thorn JC, Pokhilenko I, Evers SMAA. Aspects and Challenges of Resource Use Measurement in Health Economics: Towards a Comprehensive Measurement Framework. PHARMACOECONOMICS 2021; 39:983-993. [PMID: 34169466 PMCID: PMC8352823 DOI: 10.1007/s40273-021-01048-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/26/2021] [Indexed: 06/02/2023]
Abstract
BACKGROUND While the methods for conducting health economics research in general are improving, current guidelines provide limited guidance regarding resource use measurement (RUM). Consequently, a variety of methods exists, yet there is no overview of aspects to consider when deciding on the most appropriate RUM methodology. Therefore, this study aims to (1) identify and categorize existing knowledge regarding aspects of RUM, and (2) develop a framework that provides a comprehensive overview of methodological aspects regarding RUM. METHODS Relevant articles were identified by enrolling a search string in six databases and handsearching the DIRUM database. Included articles were descriptively reviewed and served as input for a comprehensive framework. Health economics experts were involved during the process to establish the framework's face validity. RESULTS Forty articles were included in the scoping review. The RUM framework consists of four methodological RUM domains: 'Whom to measure', addressing whom to ask and whom to measure; 'How to measure', addressing the different approaches of measurement; 'How often to measure', addressing recall period and measurement patterns; and 'Additional considerations', which covers additional aspects that are essential for further refining the methodologies for measurement. Evidence retrieved from the scoping review was categorized according to these domains. CONCLUSION This study clustered the aspects of RUM methodology in health economics into a comprehensive framework. The results may guide health economists in their decision making regarding the selection of appropriate RUM methods and developing instruments for RUM. Furthermore, policy makers may use these findings to review study results from an evidence-based perspective.
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Affiliation(s)
- Luca M M Janssen
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, Maastricht, The Netherlands.
| | - Ruben M W A Drost
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, Maastricht, The Netherlands
| | - Aggie T G Paulus
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, Maastricht, The Netherlands
| | - Kirsty Garfield
- Department of Population Health Sciences, University of Bristol, Bristol, UK
| | | | - Sian Noble
- Department of Population Health Sciences, University of Bristol, Bristol, UK
| | - Joanna C Thorn
- Department of Population Health Sciences, University of Bristol, Bristol, UK
| | - Irina Pokhilenko
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, Maastricht, The Netherlands
| | - Silvia M A A Evers
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, Maastricht, The Netherlands
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Centre for Economic Evaluation and Machine Learning, Utrecht, The Netherlands
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Scott K, Lewis J, Pan X, Heathcock J. Parent-Reported PEDI-CAT Mobility and Gross Motor Function in Infants With Cerebral Palsy. Pediatr Phys Ther 2021; 33:156-161. [PMID: 34086623 PMCID: PMC8217157 DOI: 10.1097/pep.0000000000000801] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study is to determine the relationship between the Pediatric Evaluation of Disability Index-Computer Adapted Test (PEDI-CAT), a parent-reported outcome measure, and therapist-administered measures of motor function for infants with cerebral palsy (CP) with moderate to severe motor impairments. METHODS A prospective, cohort study included 54 infants, ages 6 to 24 months, with CP or high risk of CP, Gross Motor Function Classification System (GMFCS) levels III to V. Measures included the Gross Motor Function Measure (GMFM) and the mobility domain of the PEDI-CAT (PEDI-mob). RESULTS A significant correlation was found between PEDI-mob and GMFM scores. Significant differences were found in PEDI-mob scores as a function of GMFCS level. CONCLUSIONS The PEDI-mob adds value to motor evaluations of infants with CP. Parents can accurately contribute information about daily motor performance for goal setting and treatment planning. The PEDI-mob offers a practical solution when longer assessments cannot be completed.
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Affiliation(s)
- Kimberley Scott
- The Ohio State University (Drs Scott, Pan, and Heathcock), Columbus, Ohio; Nationwide Children's Hospital (Dr Lewis), Columbus, Ohio
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Sen A. Six years after manual small incision cataract surgery-Perspective from a secondary level eye hospital in Rural India. Indian J Ophthalmol 2021; 69:590-593. [PMID: 33595481 PMCID: PMC7942105 DOI: 10.4103/ijo.ijo_1355_20] [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] [Indexed: 11/23/2022] Open
Abstract
Purpose: We assessed the long-term impact of manual small incision cataract surgery (MSICS) in rural Central India using patient reported outcomes (PRO). Methods: 841 patients undergoing MSICS by a single surgeon from January 2012 to July 2013 were included. The same patients were contacted telephonically in November 2019 and were asked to report their perceived outcome of the cataract surgery. Data on the fellow eye status were also collected. These data were compared with objective data recorded at the time of surgery. Results: The mean age was 61.53 ± 10.9 with 59% women. 96% had presenting visual acuity (VA) ≤5/60. 86% had visually significant cataract in the fellow eye; 2.5% were cataract blind. 85% had unaided VA ≥ 6/18 at 6 weeks. 223 patients were contactable by telephone after 6 years. 55 had expired and their relatives gave the information. Of these, 90% reported “good” outcome. PRO at 6 years and unaided VA at 6 weeks after surgery correlated significantly (P = 0.05). 40% had undergone cataract surgery of the fellow eye in the interim. Of those who reported “not good” outcome, 70% had undergone fellow eye surgery, compared with 38% in those who reported “good” outcome (P = 0.005). Conclusion: Telephonic PRO correlates with unaided VA 6 years after cataract surgery and could replace a follow-up visit. A PRO of poor vision in the already operated eye was the only factor correlating with fellow eye surgery.
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Affiliation(s)
- Alo Sen
- Department of Ophthalmology, Christian Medical College, CMC Schell Campus, Vellore, Tamil Nadu, India
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Garfield K, Husbands S, Thorn JC, Noble S, Hollingworth W. Development of a brief, generic, modular resource-use measure (ModRUM): cognitive interviews with patients. BMC Health Serv Res 2021; 21:371. [PMID: 33882905 PMCID: PMC8058988 DOI: 10.1186/s12913-021-06364-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 04/08/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Self-report resource-use measures (RUMs) are often used to collect healthcare use data from participants in healthcare studies. However, RUMs are typically adapted from existing measures on a study-by-study basis, resulting in a lack of standardisation which limits comparability across studies. Psychometric testing of RUMs is rarely conducted. This paper reports on cognitive interviews with patients to test the content validity and acceptability of a new RUM (ModRUM). ModRUM is a brief, generic RUM with a core module on healthcare use and questions/modules to increase depth and breadth. METHODS A purposeful sampling strategy with maximum variation was used to recruit patients from primary care to participate in "think-aloud" interviews with retrospective probing. Participants verbalised their thought processes as they completed ModRUM, which allowed errors (issues with completion) to be identified. The interviewer asked follow-up and probing questions to investigate errors, clarity and acceptability. Interviews were audio-recorded and transcribed verbatim. Research team members independently scored transcripts to identify errors in comprehension, recall, judgement and response. Members met to agree on final scores. Interview transcripts were analysed qualitatively using techniques of constant comparison, to identify common themes and ideas for improvement. Data collection and analysis were performed concurrently and in rounds. RESULTS Twenty participants were interviewed between December 2019 and March 2020. Interviews were conducted in three rounds, with revisions made iteratively and in response to interview findings. Seven participants completed the core module and 13 completed the core module plus depth questions. Of 71 issues, 28 were in comprehension, 14 in retrieval, 10 in judgement, 18 in response and 1 uncategorised. Most issues (21 issues by 2 participants) were due to participants including family healthcare use. Other issues included using incorrect recall periods (5 issues) and overlooking questions leading to missing responses (9 issues). Common participant suggestions included highlighting important details and providing additional definition or examples for some terms. The length, content and layout were acceptable to most participants. CONCLUSIONS A generic RUM is needed to increase study comparability. RUM development requires thorough testing to demonstrate and enhance validity. Cognitive interviewing has demonstrated the acceptability and content validity of ModRUM.
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Affiliation(s)
- Kirsty Garfield
- Health Economics at Bristol, Population Health Sciences, Bristol Medical School, University of Bristol, 1-5 Whiteladies Road, Bristol, BS8 1NU, UK.
- MRC ConDuCT-II Hub for Trials Methodology Research, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 1NU, UK.
| | - Samantha Husbands
- Health Economics at Bristol, Population Health Sciences, Bristol Medical School, University of Bristol, 1-5 Whiteladies Road, Bristol, BS8 1NU, UK
- MRC ConDuCT-II Hub for Trials Methodology Research, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 1NU, UK
| | - Joanna C Thorn
- Health Economics at Bristol, Population Health Sciences, Bristol Medical School, University of Bristol, 1-5 Whiteladies Road, Bristol, BS8 1NU, UK
- MRC ConDuCT-II Hub for Trials Methodology Research, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 1NU, UK
| | - Sian Noble
- Health Economics at Bristol, Population Health Sciences, Bristol Medical School, University of Bristol, 1-5 Whiteladies Road, Bristol, BS8 1NU, UK
- MRC ConDuCT-II Hub for Trials Methodology Research, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 1NU, UK
| | - Will Hollingworth
- Health Economics at Bristol, Population Health Sciences, Bristol Medical School, University of Bristol, 1-5 Whiteladies Road, Bristol, BS8 1NU, UK
- MRC ConDuCT-II Hub for Trials Methodology Research, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 1NU, UK
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Frech TM, VanBuren JM, Startup E, Assassi S, Bernstein EJ, Castelino FV, Chung L, Correia C, Gordon JK, Hant FN, Hummers L, Khanna D, Sandorfi N, Shah AA, Shanmugam VK, Steen V, Evnin L. Does hand involvement in systemic sclerosis limit completion of patient-reported outcome measures? Clin Rheumatol 2021; 40:965-971. [PMID: 33094395 PMCID: PMC7897231 DOI: 10.1007/s10067-020-05467-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 10/09/2020] [Accepted: 10/13/2020] [Indexed: 01/08/2023]
Abstract
The objective of this analysis is to examine whether the severity of systemic sclerosis (SSc)-hand involvement influences patient-reported outcome measure (PROM) completion rate in a US cohort of early disease. Participants included SSc patients with less than 5 years disease duration consented and enrolled in the Collaborative, National, Quality, and Efficacy Registry (CONQUER) between June 2018 and December 2019. Participants' socio-demographics, hand clinical features (severe modified Rodnan skin score, presence of small joint contractures, acro-osteolysis, calcinosis, and digital ulcers), and completion rates of seven PROMs including a Resource Use Questionnaire were analyzed. Cohort characteristics and baseline PROM completion were evaluated. Multivariable logistic regression assessed the relationship between hand limitations and PROM incompletion at several time points using generalized estimating equations. At the time of data lock, 339 CONQUER subjects had a total of 600 visits available for analysis. Calcinosis (odds ratio [OR] 6.35, confidence interval [CI] 2.41-16.73 and acro-osteolysis OR 3.88 (1.57-9.55) were significantly associated with incomplete PROM. The Resource Use Questionnaire was the PROM most commonly not completed. Increasing age was correlated with resource use questionnaire incompletion rate. Acro-osteolysis and calcinosis were associated with lower PROM completion rates in a US SSc cohort, independent of the length of the questionnaires or the modality of administration (electronic or paper). Resource Use Questionnaires are important for understanding the economic impact and burden of chronic disease; however, in this study, it had lower completion rates than PROMs devoted to clinical variables. Key points •Multiple strategies are needed to ensure optimal completion of PROM in longitudinal cohort studies. Even if patients request electronic surveys, we have found it is important to follow up incomplete surveys with paper forms provided at the time of a clinical visit. •The Resource Utilization Questionnaire was lengthy and prone to non-completion in the younger population. •Acro-osteolysis and calcinosis were associated with reduced PROM completion rates.
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Affiliation(s)
- Tracy M Frech
- Department of Internal Medicine, Division of Rheumatology, University of Utah and Salt Lake Veterans Affair Medical Center, 1900 E 30 N, SOM 4b200, Salt Lake City, UT, 84132, USA.
| | - John M VanBuren
- Department of Pediatrics, University of Utah, Salt Lake City, UT, USA
| | - Emily Startup
- Department of Pediatrics, University of Utah, Salt Lake City, UT, USA
| | - Shervin Assassi
- The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Elana J Bernstein
- Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, USA
| | - Flavia V Castelino
- Harvard Medical School and Massachusetts General Hospital, Boston, MA, USA
| | - Lorinda Chung
- Department of Medicine and Dermatology, Division of Rheumatology, Stanford University and Palo Alto Veterans Affairs Health Care System, Stanford, CA, USA
| | - Chase Correia
- Department of Medicine, Division of Rheumatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Faye N Hant
- Division of Rheumatology and Immunology, Medical University of South Carolina, Charleston, SC, USA
| | - Laura Hummers
- Department of Medicine, Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Dinesh Khanna
- University of Michigan Scleroderma Program, Ann Arbor, MI, USA
| | - Nora Sandorfi
- Division of Rheumatology, University of Pennsylvania, Philadelphia, PA, USA
| | - Ami A Shah
- Department of Medicine, Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Victoria K Shanmugam
- Division of Rheumatology, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Virginia Steen
- Georgetown University School of Medicine, Washington, DC, USA
| | - Luke Evnin
- Scleroderma Research Foundation, San Francisco, CA, USA
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Tosi LL, Floor MK, Dollar CM, Gillies AP, Hart TS, Cuthbertson DD, Sutton VR, Krischer JP. Assessing disease experience across the life span for individuals with osteogenesis imperfecta: challenges and opportunities for patient-reported outcomes (PROs) measurement: a pilot study. Orphanet J Rare Dis 2019; 14:23. [PMID: 30696467 PMCID: PMC6350324 DOI: 10.1186/s13023-019-1004-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 01/21/2019] [Indexed: 01/07/2023] Open
Abstract
Background Patient reported outcome (PRO) information is crucial for establishing better patient-provider communication, improving shared decision-making between clinicians and patients, assessing patient responses to therapeutic interventions, and increasing satisfaction with care. We used the Brittle Bones Disease Consortium (BBDC) Contact Registry for People with OI, managed by the Rare Disease Clinical Research Network (RDCRN) to (1) to evaluate the construct validity of the Patient-Reported Outcome Measurement Information System® (PROMIS®) to record important components of the disease experience among individuals with OI; and (2) explore the feasibility of using a registry to recruit individuals with OI to report on health status. Our long-term goal is to enhance communication of health and disease management findings back to the OI community, especially those who do not have access to major OI clinical centers. Results We demonstrated the construct validity of PROMIS instruments in OI. Our results confirm that the scores from most domains differ significantly from the general US population: individuals with OI have worse symptom burden and functioning. We found no excessive floor or ceiling effects. Our study demonstrates that the BBDC Contact Registry can be used to recruit participants for online health status surveys. However, there are numerous challenges that must be addressed: lack of self-knowledge of OI type, under-representation of men, limited ethnic diversity, and imperfect questionnaire completion rates. Conclusion Our pilot study demonstrated the feasibility of using a contact registry to recruit respondents from the OI community and to obtain analyzable PROMIS data regarding disease experience. Because the results differ from the general population and avoid excessive floor and ceiling effects, PROMIS instruments can be used to assess response to therapeutic interventions in individuals with OI. Future directions will include (1) development and validation of an OI-specific patient-based classification system that aggregates persons with similar clinical characteristics and risks for complications to identify treatment needs; and (2) integrating these PRO tools into routine patient care and research studies. Electronic supplementary material The online version of this article (10.1186/s13023-019-1004-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Laura L Tosi
- Bone Health Program, Children's National Health System, 111 Michigan Avenue, NW, Washington, DC, 20010, USA.
| | - Marianne K Floor
- Bone Health Program, Children's National Health System, 111 Michigan Avenue, NW, Washington, DC, 20010, USA
| | - Christina M Dollar
- Bone Health Program, Children's National Health System, 111 Michigan Avenue, NW, Washington, DC, 20010, USA
| | - Austin P Gillies
- Bone Health Program, Children's National Health System, 111 Michigan Avenue, NW, Washington, DC, 20010, USA
| | | | - Tracy S Hart
- Osteogenesis Imperfecta Foundation, Gaithersburg, MD, USA
| | | | - V Reid Sutton
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA.,Texas Children's Hospital, Houston, TX, USA
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11
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Pascoal C, Brasil S, Francisco R, Marques-da-Silva D, Rafalko A, Jaeken J, Videira PA, Barros L, Dos Reis Ferreira V. Patient and observer reported outcome measures to evaluate health-related quality of life in inherited metabolic diseases: a scoping review. Orphanet J Rare Dis 2018; 13:215. [PMID: 30486833 PMCID: PMC6263554 DOI: 10.1186/s13023-018-0953-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 11/14/2018] [Indexed: 12/25/2022] Open
Abstract
Background Health-related Quality of Life (HrQoL) is a multidimensional measure, which has gained clinical and social relevance. Implementation of a patient-centred approach to both clinical research and care settings, has increased the recognition of patient and/or observer reported outcome measures (PROMs or ObsROMs) as informative and reliable tools for HrQoL assessment. Inherited Metabolic Diseases (IMDs) are a group of heterogeneous conditions with phenotypes ranging from mild to severe and mostly lacking effective therapies. Consequently, HrQoL evaluation is particularly relevant. Objectives We aimed to: (1) identify patient and/or caregiver-reported HrQoL instruments used among IMDs; (2) identify the main results of the application of each HrQoL tool and (3) evaluate the main limitations of HrQoL instruments and study design/methodology in IMDs. Methods A scoping review was conducted using methods outlined by Arksey and O’Malley. Additionally, we critically analysed each article to identify the HrQoL study drawbacks. Results Of the 1954 studies identified, 131 addressed HrQoL of IMDs patients using PROMs and/or ObsROMs, both in observational or interventional studies. In total, we identified 32 HrQoL instruments destined to self- or proxy-completion; only 2% were disease-specific. Multiple tools (both generic and disease-specific) proved to be responsive to changes in HrQoL; the SF-36 and PedsQL questionnaires were the most frequently used in the adult and pediatric populations, respectively. Furthermore, proxy data often demonstrated to be a reliable approach complementing self-reported HrQoL scores. Nevertheless, numerous limitations were identified especially due to the rarity of these conditions. Conclusions HrQoL is still not frequently assessed in IMDs. However, our results show successful examples of the use of patient-reported HrQoL instruments in this field. The importance of HrQoL measurement for clinical research and therapy development, incites to further research in HrQoL PROMs’ and ObsROMs’ creation and validation in IMDs. Electronic supplementary material The online version of this article (10.1186/s13023-018-0953-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Carlota Pascoal
- Portuguese Association for Congenital Disorders of Glycosylation (CDG), Departamento Ciências da Vida, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, 2829-516, Caparica, Portugal.,CDG & Allies - Professionals and Patient Associations International Network (PPAIN), Departamento Ciências da Vida, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, 2829-516, Caparica, Portugal.,Research Unit on Applied Molecular Biosciences (UCIBIO), Departamento Ciências da Vida, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, 2829-516, Lisbon, Portugal
| | - Sandra Brasil
- Portuguese Association for Congenital Disorders of Glycosylation (CDG), Departamento Ciências da Vida, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, 2829-516, Caparica, Portugal.,CDG & Allies - Professionals and Patient Associations International Network (PPAIN), Departamento Ciências da Vida, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, 2829-516, Caparica, Portugal.,Research Unit on Applied Molecular Biosciences (UCIBIO), Departamento Ciências da Vida, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, 2829-516, Lisbon, Portugal
| | - Rita Francisco
- Portuguese Association for Congenital Disorders of Glycosylation (CDG), Departamento Ciências da Vida, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, 2829-516, Caparica, Portugal.,CDG & Allies - Professionals and Patient Associations International Network (PPAIN), Departamento Ciências da Vida, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, 2829-516, Caparica, Portugal.,Research Unit on Applied Molecular Biosciences (UCIBIO), Departamento Ciências da Vida, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, 2829-516, Lisbon, Portugal
| | - Dorinda Marques-da-Silva
- Portuguese Association for Congenital Disorders of Glycosylation (CDG), Departamento Ciências da Vida, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, 2829-516, Caparica, Portugal.,CDG & Allies - Professionals and Patient Associations International Network (PPAIN), Departamento Ciências da Vida, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, 2829-516, Caparica, Portugal.,Research Unit on Applied Molecular Biosciences (UCIBIO), Departamento Ciências da Vida, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, 2829-516, Lisbon, Portugal
| | - Agnes Rafalko
- Glycomine, Inc, 953 Indiana St, San Francisco, CA, 94107, USA
| | - Jaak Jaeken
- Center for Metabolic Diseases, UZ and KU Leuven, Leuven, Belgium
| | - Paula A Videira
- Portuguese Association for Congenital Disorders of Glycosylation (CDG), Departamento Ciências da Vida, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, 2829-516, Caparica, Portugal.,CDG & Allies - Professionals and Patient Associations International Network (PPAIN), Departamento Ciências da Vida, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, 2829-516, Caparica, Portugal.,Research Unit on Applied Molecular Biosciences (UCIBIO), Departamento Ciências da Vida, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, 2829-516, Lisbon, Portugal
| | - Luísa Barros
- CDG & Allies - Professionals and Patient Associations International Network (PPAIN), Departamento Ciências da Vida, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, 2829-516, Caparica, Portugal.,Faculdade de Psicologia, Universidade de Lisboa, 1649-013, Lisbon, Portugal
| | - Vanessa Dos Reis Ferreira
- Portuguese Association for Congenital Disorders of Glycosylation (CDG), Departamento Ciências da Vida, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, 2829-516, Caparica, Portugal. .,CDG & Allies - Professionals and Patient Associations International Network (PPAIN), Departamento Ciências da Vida, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, 2829-516, Caparica, Portugal.
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Kimball AB, Sundaram M, Banderas B, Foley C, Shields AL. Development and initial psychometric evaluation of patient-reported outcome questionnaires to evaluate the symptoms and impact of hidradenitis suppurativa. J DERMATOL TREAT 2017; 29:152-164. [DOI: 10.1080/09546634.2017.1341614] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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13
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Patient- and Family-Centered Care: A Primer. J Am Coll Radiol 2016; 13:1544-1549. [DOI: 10.1016/j.jacr.2016.09.003] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 09/13/2016] [Accepted: 09/15/2016] [Indexed: 11/23/2022]
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14
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Asher AL, Chotai S, Devin CJ, Speroff T, Harrell FE, Nian H, Dittus RS, Mummaneni PV, Knightly JJ, Glassman SD, Bydon M, Archer KR, Foley KT, McGirt MJ. Inadequacy of 3-month Oswestry Disability Index outcome for assessing individual longer-term patient experience after lumbar spine surgery. J Neurosurg Spine 2016; 25:170-80. [PMID: 26989974 DOI: 10.3171/2015.11.spine15872] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Prospective longitudinal outcomes registries are at the center of evidence-driven health care reform. Obtaining real-world outcomes data at 12 months can be costly and challenging. In the present study, the authors analyzed whether 3-month outcome measurements sufficiently represent 12-month outcomes for patients with degenerative lumbar disease undergoing surgery. METHODS Data from 3073 patients undergoing elective spine surgery for degenerative lumbar disease were entered into a prospective multicenter registry (N(2)QOD). Baseline, 3-month, and 12-month follow-up Oswestry Disability Index (ODI) scores were recorded. The absolute differences between actual 12- and 3-month ODI scores was evaluated. Additionally, the authors analyzed the absolute difference between actual 12-month ODI scores and a model-predicted 12-month ODI score (the model used patients' baseline characteristics and actual 3-month scores). The minimal clinically important difference (MCID) for ODI of 12.8 points and the substantial clinical benefit (SCB) for ODI of 18.8 points were used based on the previously published values. The concordance rate of achieving MCID and SCB for ODI at 3-and 12-months was computed. RESULTS The 3-month ODI scores differed from 12-month scores by an absolute difference of 11.9 ± 10.8, and predictive modeling estimations of 12-month ODI scores differed from actual 12-month scores by a mean (± SD) of 10.7 ± 9.0 points (p = 0.001). Sixty-four percent of patients (n = 1982) achieved an MCID for ODI at 3 months in comparison with 67% of patients (n = 2088) by 12 months; 51% (n = 1731) and 61% (n = 1860) of patients achieved SCB for ODI at 3 months and 12 months, respectively. Almost 20% of patients had ODI scores that varied at least 20 points (the point span of an ODI functional category) between actual 3- and 12-month values. In the aggregate analysis of achieving MCID, 77% of patients were concordant and 23% were discordant in achieving or not achieving MCID at 3 and 12 months. The discordance rates of achieving or not achieving MCID for ODI were in the range of 19% to 27% for all diagnoses and treatments (decompression with and without fusion). The positive and negative predictive value of 3-months ODI to predict 12-month ODI was 86% and 60% for MCID and 82% and 67% for SCB. CONCLUSIONS Based on their findings, the authors conclude the following: 1) Predictive methods for functional outcome based on early patient experience (i.e., baseline and/or 3-month data) should be used to help evaluate the effectiveness of procedures in patient populations, rather than serving as a proxy for long-term individual patient experience. 2) Prospective longitudinal registries need to span at least 12 months to determine the effectiveness of spine care at the individual patient and practitioner level.
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Affiliation(s)
- Anthony L Asher
- Department of Neurological Surgery, Carolina Neurosurgery and Spine Associates and Neurological Institute, Carolinas Healthcare System, Charlotte, North Carolina
| | - Silky Chotai
- Department of Orthopaedic Surgery, Vanderbilt Spine Center, Vanderbilt University Medical Center
| | - Clinton J Devin
- Department of Orthopaedic Surgery, Vanderbilt Spine Center, Vanderbilt University Medical Center
| | - Theodore Speroff
- Geriatric Research Education Clinical Center, Tennessee Valley Health System, Veterans Health Administration
| | - Frank E Harrell
- Department of Biostatistics, Vanderbilt University School of Medicine
| | - Hui Nian
- Department of Biostatistics, Vanderbilt University School of Medicine
| | - Robert S Dittus
- Geriatric Research Education Clinical Center, Tennessee Valley Health System, Veterans Health Administration;,Departments of Medicine and Biostatistics, Division of General Internal Medicine and Public Health, Center for Health Services Research, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Praveen V Mummaneni
- Department of Neurological Surgery, University of California, San Francisco, California
| | - John J Knightly
- Department of Neurosurgery, Atlantic Neurosurgical Specialists, Morristown, New Jersey
| | - Steven D Glassman
- Department of Orthopedic Surgery, University of Louisville and the Norton Leatherman Spine Center, Louisville, Kentucky
| | - Mohamad Bydon
- Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota
| | - Kristin R Archer
- Department of Orthopaedic Surgery, Vanderbilt Spine Center, Vanderbilt University Medical Center;,Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville; and
| | - Kevin T Foley
- Department of Neurosurgery, University of Tennessee Health Sciences Center, Semmes-Murphey Neurologic & Spine Institute, Memphis, Tennessee
| | - Matthew J McGirt
- Department of Neurological Surgery, Carolina Neurosurgery and Spine Associates and Neurological Institute, Carolinas Healthcare System, Charlotte, North Carolina
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Rawson JV, Cronin P. Decision support: the super highway between health services research and change in clinical practice. Acad Radiol 2014; 21:1081-2. [PMID: 25107861 DOI: 10.1016/j.acra.2014.05.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Revised: 05/22/2014] [Accepted: 05/26/2014] [Indexed: 01/05/2023]
Affiliation(s)
- James V Rawson
- Department of Diagnostic, Therapeutic and Interventional Radiology, Medical College of Georgia, Georgia Regents University, 1120 15th St, Augusta, GA 30912.
| | - Paul Cronin
- Department of Radiology, Division of Cardiothoracic Radiology, University of Michigan Medical Center, Ann Arbor, MI
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