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Galvão EL, Pedras MJ, Cota GF, Simões TC, Rabello A. Development and initial validation of a cutaneous leishmaniasis impact questionnaire. PLoS One 2018; 13:e0203378. [PMID: 30161222 PMCID: PMC6117079 DOI: 10.1371/journal.pone.0203378] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 08/20/2018] [Indexed: 12/26/2022] Open
Abstract
Background The impact of cutaneous leishmaniasis (CL) on the quality of life of patients has been neglected in research studies worldwide. The few reported studies have used non-specific questionnaires for the disease, which represents a limitation since generic instruments may not address specific aspects of the disease, compromising the evaluation of its real impact. The aim of this paper is to describe the development and the initial validation of an instrument for evaluating the impact of CL, named the Cutaneous Leishmaniasis Impact Questionnaire. Methodology The formulation and validation of the instrument consisted of the following steps: (1) literature review; (2) conceptual framework construction and initial item generation; (3) tool analysis by health professionals (experts); (4) tool evaluation performed by the patients; and (5) a pilot study with 100 patients with localized CL, evaluated at a reference ambulatory facility in Belo Horizonte, in the state of Minas Gerais, Brazil. The structure of the proposed instrument was analyzed using hierarchical cluster analysis (ICLUST). Results Twenty-seven items were initially proposed by the researchers to compose the questionnaire. Content validity (evaluates if the instrument fully assesses the construct of interest) was evaluated by the panel of experts, while face validity (evaluates how potential participants interpret the items) was evaluated by the target population. In this step, some items were excluded, reformulated and/or included. After evaluating a factorial structure of the items in accordance with the cluster analysis, we assembled a questionnaire with 25 items (alpha = 0.86), with high reliability and homogeneity, which address the following: 1) the general impact of the disease (alpha = 0.91, beta = 0.67) and 2) the evaluation of the perception about the treatment and health services (alpha = 0.72, beta = 0.51). Conclusions The Cutaneous Leishmaniasis Impact Questionnaire, developed with contributions from patients and experts, was confirmed, in this first validation, as a useful and reliable instrument.
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Affiliation(s)
- Endi Lanza Galvão
- Pesquisa Clínica e Políticas Públicas em Doenças Infecto-Parasitárias–Instituto René Rachou—Fundação Oswaldo Cruz, Fiocruz, Belo Horizonte, Minas Gerais, Brazil
- * E-mail:
| | - Mariana Junqueira Pedras
- Pesquisa Clínica e Políticas Públicas em Doenças Infecto-Parasitárias–Instituto René Rachou—Fundação Oswaldo Cruz, Fiocruz, Belo Horizonte, Minas Gerais, Brazil
| | - Gláucia Fernandes Cota
- Pesquisa Clínica e Políticas Públicas em Doenças Infecto-Parasitárias–Instituto René Rachou—Fundação Oswaldo Cruz, Fiocruz, Belo Horizonte, Minas Gerais, Brazil
| | - Taynãna César Simões
- Pesquisa Clínica e Políticas Públicas em Doenças Infecto-Parasitárias–Instituto René Rachou—Fundação Oswaldo Cruz, Fiocruz, Belo Horizonte, Minas Gerais, Brazil
| | - Ana Rabello
- Pesquisa Clínica e Políticas Públicas em Doenças Infecto-Parasitárias–Instituto René Rachou—Fundação Oswaldo Cruz, Fiocruz, Belo Horizonte, Minas Gerais, Brazil
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Beamer LC, Grant M. Longitudinal trends in skin-related and global quality of life among women with breast radiodermatitis: A pilot study. Eur J Oncol Nurs 2018; 33:22-27. [PMID: 29551173 DOI: 10.1016/j.ejon.2018.01.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 12/16/2017] [Accepted: 01/15/2018] [Indexed: 11/18/2022]
Abstract
PURPOSE The purpose of this pilot study was to explore the relationship between skin-related quality of life (SR-QOL) and global quality of life (G-QOL) among women experiencing breast radiodermatitis, measure change in SR-QOL and G-QOL between the start and fifth week on radiotherapy, and examine the trend in SR-QOL and severity of radiodermatitis over time on treatment. METHODS A descriptive longitudinal study using repeated measurements was implemented. Forty women undergoing whole breast 3-dimensional conformal radiotherapy at a comprehensive community cancer center completed the Dermatology Life Quality Index (DLQI) weekly and Quality of Life-Breast Cancer Patient Version at baseline before and at five weeks on radiotherapy. Skin toxicity was measured weekly using the Radiation Therapy Oncology Group (RTOG) Acute Radiation Morbidity Scoring Criteria-Skin scale. A Kendall's tau correlation explored the relationship between measures of SR-QOL and G-QOL. Paired t-tests measured the change in SR-QOL and G-QOL from baseline to fifth week on radiotherapy. The mean of the baseline and weekly total DLQI and RTOG scores was calculated and plotted on a graph. RESULTS In general, SR-QOL and G-QOL were highly correlated. SR-QOL changed profoundly (p < .001) while G-QOL did not change (p = .55) between baseline and five weeks on radiotherapy. SR-QOL and radiodermatitis steadily worsened over time. CONCLUSIONS Radiation-induced skin toxicity has a major impact on SR-QOL but not G-QOL. This study provides much-needed scientific evidence to inform a larger future study in a community setting. Recommendations for future studies include inclusion of a skin-sensitive survey of radiodermatitis; larger, more diverse community-dwelling sample.
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Affiliation(s)
- Laura Curr Beamer
- School of Nursing, Northern Illinois University, DeKalb, IL, USA; College of Nursing, University of Utah, Salt Lake City, UT, USA.
| | - Marcia Grant
- Nursing Research, City of Hope National Medical Center, Duarte, CA, USA.
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Clustering based on unsupervised binary trees to define subgroups of cancer patients according to symptom severity in cancer. Qual Life Res 2017; 27:555-565. [DOI: 10.1007/s11136-017-1760-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2017] [Indexed: 10/24/2022]
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Michel P, Baumstarck K, Lancon C, Ghattas B, Loundou A, Auquier P, Boyer L. Modernizing quality of life assessment: development of a multidimensional computerized adaptive questionnaire for patients with schizophrenia. Qual Life Res 2017; 27:1041-1054. [PMID: 28343349 DOI: 10.1007/s11136-017-1553-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2017] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Quality of life (QoL) is still assessed using paper-based and fixed-length questionnaires, which is one reason why QoL measurements have not been routinely implemented in clinical practice. Providing new QoL measures that combine computer technology with modern measurement theory may enhance their clinical use. The aim of this study was to develop a QoL multidimensional computerized adaptive test (MCAT), the SQoL-MCAT, from the fixed-length SQoL questionnaire for patients with schizophrenia. METHODS In this multicentre cross-sectional study, we collected sociodemographic information, clinical characteristics (i.e., duration of illness, the PANSS, and the Calgary Depression Scale), and quality of life (i.e., SQoL). The development of the SQoL-CAT was divided into three stages: (1) multidimensional item response theory (MIRT) analysis, (2) multidimensional computerized adaptive test (MCAT) simulations with analyses of accuracy and precision, and (3) external validity. RESULTS Five hundred and seventeen patients participated in this study. The MIRT analysis found that all items displayed good fit with the multidimensional graded response model, with satisfactory reliability for each dimension. The SQoL-MCAT was 39% shorter than the fixed-length SQoL questionnaire and had satisfactory accuracy (levels of correlation >0.9) and precision (standard error of measurement <0.55 and root mean square error <0.3). External validity was confirmed via correlations between the SQoL-MCAT dimension scores and symptomatology scores. CONCLUSION The SQoL-MCAT is the first computerized adaptive QoL questionnaire for patients with schizophrenia. Tailored for patient characteristics and significantly shorter than the paper-based version, the SQoL-MCAT may improve the feasibility of assessing QoL in clinical practice.
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Affiliation(s)
- Pierre Michel
- Aix-Marseille University, EA 3279 - Public Health, Chronic Diseases and Quality of Life - Research Unit, 13005, Marseille, France.
- Aix-Marseille University - I2M UMR 7373 - Mathematics Institute of Marseille, 13009, Marseille, France.
| | - Karine Baumstarck
- Aix-Marseille University, EA 3279 - Public Health, Chronic Diseases and Quality of Life - Research Unit, 13005, Marseille, France
| | - Christophe Lancon
- Aix-Marseille University, EA 3279 - Public Health, Chronic Diseases and Quality of Life - Research Unit, 13005, Marseille, France
| | - Badih Ghattas
- Aix-Marseille University, EA 3279 - Public Health, Chronic Diseases and Quality of Life - Research Unit, 13005, Marseille, France
- Aix-Marseille University - I2M UMR 7373 - Mathematics Institute of Marseille, 13009, Marseille, France
| | - Anderson Loundou
- Aix-Marseille University, EA 3279 - Public Health, Chronic Diseases and Quality of Life - Research Unit, 13005, Marseille, France
| | - Pascal Auquier
- Aix-Marseille University, EA 3279 - Public Health, Chronic Diseases and Quality of Life - Research Unit, 13005, Marseille, France
| | - Laurent Boyer
- Aix-Marseille University, EA 3279 - Public Health, Chronic Diseases and Quality of Life - Research Unit, 13005, Marseille, France
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Defining Quality of Life Levels to Enhance Clinical Interpretation in Multiple Sclerosis. Med Care 2017; 55:e1-e8. [DOI: 10.1097/mlr.0000000000000117] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Atherton PJ, Burger KN, Pederson LD, Kaggal S, Sloan JA. Patient-reported outcomes questionnaire compliance in Cancer Cooperative Group Trials (Alliance N0992). Clin Trials 2016; 13:612-620. [PMID: 27365012 PMCID: PMC5133154 DOI: 10.1177/1740774516655101] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND/AIMS The use of patient-reported outcomes in clinical trials is a focal point for research and policy. Non-compliance with planned questionnaires and missing data can threaten both internal validity and generalizability. This retrospective analysis was conducted to determine the extent of, and characteristics associated with, missing patient-reported outcomes. METHODS Study characteristics, patient characteristics and adverse events, and reasons for non-compliance were compiled from 14 closed Alliance for Clinical Trials in Oncology, Mayo Clinic Cancer Center, or Mayo Clinic Cancer Research Consortium clinical trials. Compliance rates were calculated for each patient using the number of booklets completed while the patient was on trial divided by the number of booklets the patient was expected to complete. Frequency counts and summary statistics were compiled. Logistic regression techniques were employed. RESULTS The 1640 included patients had a median age of 58 years and were mostly White (90.8%) and female (73.8%). Compliance rates per study ranged from 84.7% to 97.2%. The primary endpoint of overall compliance rate was 93.1%. A total of 1267 patients were compliant. Those non-compliant were slightly older (mean = 58.6 vs 57.5, p = 0.03) and had different types of cancers (p < 0.01). There were no differences in compliance according to tumor status (p = 0.66), clinical stage (p = 0.81), baseline quality of life (p = 0.42 for ≥8 vs <8 and p = 0.12 for ≥6 vs <6), or maximum adverse event grade incidence (p = 0.33 for grade 2+ incidence and p = 0.36 for grade 3+ incidence). Reasons for non-compliance included patient refusal (N = 136), booklet not administered to patient (N = 199), no clinic visit at the scheduled time for booklet completion (N = 40), and at-home-completed booklet not returned (N = 224). Logistic regression indicates gender (p < 0.01), race (p < 0.01), performance score (p = 0.02), dose delay status (p = 0.01), and incidence of grade 3 or higher adverse event (p = 0.03) were correlates of compliance. CONCLUSION Patient-reported outcomes have successfully been implemented into Alliance and Mayo Clinic trials with high rates of patient compliance. Further improvement in compliance can be made with staff commitment and education. Patients are typically non-compliant only when the task at hand is burdensome, unclear, or logistically challenging. Existing tracking systems used for the other trial outcomes should be utilized to ensure successful capture of patient-reported outcomes.
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Affiliation(s)
- Pamela J Atherton
- Alliance Statistics and Data Center, Mayo Clinic, Rochester, MN, USA
| | - Kelli N Burger
- Alliance Statistics and Data Center, Mayo Clinic, Rochester, MN, USA
| | - Levi D Pederson
- Alliance Statistics and Data Center, Mayo Clinic, Rochester, MN, USA
| | - Suneetha Kaggal
- Alliance Statistics and Data Center, Mayo Clinic, Rochester, MN, USA
| | - Jeff A Sloan
- Alliance Statistics and Data Center, Mayo Clinic, Rochester, MN, USA
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Kim CH, Chung CK, Choi Y, Shin H, Woo JW, Kim SM, Lee HJ. The usefulness of a mobile device-based system for patient-reported outcomes in a spine outpatient clinic. Spine J 2016; 16:843-50. [PMID: 26961200 DOI: 10.1016/j.spinee.2016.02.048] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2015] [Revised: 01/28/2016] [Accepted: 02/23/2016] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Patient-reported outcomes (PROs) are typically collected using a paper form, but this format is cumbersome to incorporate into outpatient clinic visits as well as in research. Therefore, we developed a mobile device-based system (mobile system) for spinal PRO. We hypothesized that this system may improve the quality of care in an outpatient clinic. PURPOSE This study aimed to analyze the patient-reported efficacy of a mobile system through a survey of patients' responses compared with a paper system. STUDY DESIGN/SETTING A prospective observational study was carried out. PATIENT SAMPLE Surveys were conducted for 103 patients who had experience using both the paper and electronic systems in the outpatient clinic. OUTCOME MEASURES Patient-reported positive response score (PRS) was the outcome measure. METHODS The survey included the characteristics of the patients (sex, age, use of smartphone, familiarity with smartphone applications, proficiency of typing with mobile device, site of pain, and education level) and eight questions in four domains: (1) efficacy in the waiting room, (2) efficacy during the clinic visit, (3) overall satisfaction, and (4) opinion about the use of this system. The response to each question was scored from 1 to 5 (1, negative; 5, positive response). The patient-reported PRS was calculated by adding the scores of the 8 questions and converting the total range to 0-100 (60, neutral). RESULTS The mean PRS of the 8 questions was 79.8 (95% CI, 76.7-83.9). The mean PRS was 78.9 (75.6-82.2) at the waiting room and was 80.5 (77.1-83.9) during the clinic. The PRS for overall satisfaction and use of this system were 83.3 (79.6-87.0) and 77.1 (71.9-82.3), respectively. The use of smartphones and the proficiency of typing were independently significant predictors of PRS with an R(2) value of 0.325. CONCLUSIONS The mobile device-based system improved the patient-reported efficacy in spine outpatient clinics. However, various factors such as the use of smartphones need to be considered when developing and applying mobile systems.
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Affiliation(s)
- Chi Heon Kim
- Department of Neurosurgery, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, 03080 Seoul, South Korea; Department of Neurosurgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, 03080 Seoul, South Korea; Clinical Research Institute, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, 03080 Seoul, South Korea
| | - Chun Kee Chung
- Department of Neurosurgery, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, 03080 Seoul, South Korea; Department of Neurosurgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, 03080 Seoul, South Korea; Clinical Research Institute, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, 03080 Seoul, South Korea; Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, 1 Gwanak-ro, Gwanak-gu, 08826 Seoul, South Korea.
| | - Yunhee Choi
- Medical Research Collaborating Center, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, 03080 Seoul, South Korea
| | - HyunJeong Shin
- Medical Research Collaborating Center, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, 03080 Seoul, South Korea
| | - Ji Won Woo
- Department of Neurosurgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, 03080 Seoul, South Korea
| | - Sung-Mi Kim
- Department of Neurosurgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, 03080 Seoul, South Korea
| | - Hyuk-Joon Lee
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, 03080 Seoul, South Korea
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Sloan JA, Halyard M, El Naqa I, Mayo C. Lessons From Large-Scale Collection of Patient-Reported Outcomes: Implications for Big Data Aggregation and Analytics. Int J Radiat Oncol Biol Phys 2016; 95:922-929. [PMID: 27302508 PMCID: PMC6544440 DOI: 10.1016/j.ijrobp.2016.04.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 03/05/2016] [Accepted: 04/05/2016] [Indexed: 11/22/2022]
Affiliation(s)
- Jeff A Sloan
- Division of Biomedical Statistics and Bioinformatics, Mayo Clinic, Rochester, Minnesota.
| | - Michele Halyard
- Department of Radiation Oncology, Mayo Clinic, Phoenix, Arizona
| | - Issam El Naqa
- Department of Radiation Oncology, University of Michigan Medical School, Ann Arbor, Michigan
| | - Charles Mayo
- Department of Radiation Oncology, University of Michigan Medical School, Ann Arbor, Michigan
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Kalfon P, Mimoz O, Loundou A, Geantot MA, Revel N, Villard I, Amour J, Azoulay E, Garrouste-Orgeas M, Martin C, Sharshar T, Baumstarck K, Auquier P. Reduction of self-perceived discomforts in critically ill patients in French intensive care units: study protocol for a cluster-randomized controlled trial. Trials 2016; 17:87. [PMID: 26880373 PMCID: PMC4754872 DOI: 10.1186/s13063-016-1211-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 02/04/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND It is now well documented that critically ill patients are exposed to stressful conditions and experience discomforts from multiple sources. Improved identification of the discomforts of patients in intensive care units (ICUs) may have implications for managing their care, including consideration of ethical issues, and may assist clinicians in choosing the most appropriate interventions. The primary objective of this study was to assess the effectiveness of a multicomponent program of discomfort reduction in critically ill patients. The secondary objectives were to assess the sustainability of the impact of the program and the potential seasonality effect. METHODS/DESIGN We conducted a multicenter, cluster-randomized, controlled, single (patient)-blind study involving 34 French adult ICUs. The experimental intervention was a 6-month period during which the multicomponent program was implemented in the ICU and included the following steps: identification of discomforts, immediate feedback to the healthcare team, and implementation of targeted interventions. The control intervention was a 6-month period during which any program was implemented. The primary endpoint was the monthly overall score of self-reported discomfort from the French questionnaire on discomforts in ICU patients (IPREA). The secondary endpoints were the scores of the discomfort items of IPREA. The sample size was 660 individuals to obtain 80% power to detect a 25% difference in the overall discomfort score of IPREA between the two groups (design effect: 2.9). DISCUSSION The results of this cluster-randomized controlled study are expected to confirm that a multicomponent program of discomfort reduction may be a new strategy in the management of care for critically ill patients. TRIAL REGISTRATION ClinicalTrials.gov NCT02442934, registered 11 May 2015.
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Affiliation(s)
- Pierre Kalfon
- Service de réanimation, Centre Hospitalier Louis Pasteur, Chartres, France.
| | - Olivier Mimoz
- Centre Hospitalier Universitaire (CHU) La Miletrie, Poitiers, France.
| | - Anderson Loundou
- EA3279 Self-perceived Health Assessment Research Unit Aix-Marseille University, Marseille, France.
| | | | | | - Isabelle Villard
- CHU Beaujon, Assistance Publique - Hôpitaux de Paris (APHP), Clichy, France.
| | | | | | | | - Claude Martin
- CHU Hôpital Nord, Assistance Publique - Hôpitaux de Marseille, Marseille, France.
| | | | - Karine Baumstarck
- EA3279 Self-perceived Health Assessment Research Unit Aix-Marseille University, Marseille, France.
| | - Pascal Auquier
- EA3279 Self-perceived Health Assessment Research Unit Aix-Marseille University, Marseille, France.
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Faget-Agius C, Catherine FA, Boyer L, Wirsich J, Jonathan W, Ranjeva JP, Jean-Philippe R, Richieri R, Raphaelle R, Soulier E, Elisabeth S, Confort-Gouny S, Sylviane CG, Auquier P, Pascal A, Guye M, Maxime G, Lançon C, Christophe L. Neural substrate of quality of life in patients with schizophrenia: a magnetisation transfer imaging study. Sci Rep 2015; 5:17650. [PMID: 26632639 PMCID: PMC4668560 DOI: 10.1038/srep17650] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 11/02/2015] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to investigate the neural substrate underlying quality of life (QoL) and to demonstrate the microstructural abnormalities associated with impaired QoL in a large sample of patients with schizophrenia, using magnetisation transfer imaging. A total of 81 right-handed men with a diagnosis of schizophrenia and 25 age- and sex-similar healthy controls were included and underwent a 3T MRI with magnetization transfer ratio (MTR) to detect microstructural abnormalities. Compared with healthy controls, patients with schizophrenia had grey matter (GM) decreased MTR values in the temporal lobe (BA21, BA37 and BA38), the bilateral insula, the occipital lobe (BA17, BA18 and BA19) and the cerebellum. Patients with impaired QoL had lower GM MTR values relative to patients with preserved QoL in the bilateral temporal pole (BA38), the bilateral insula, the secondary visual cortex (BA18), the vermis and the cerebellum. Significant correlations between MTR values and QoL scores (p < 0.005) were observed in the GM of patients in the right temporal pole (BA38), the bilateral insula, the vermis and the right cerebellum. Our study shows that QoL impairment in patients with schizophrenia is related to the microstructural changes in an extensive network, suggesting that QoL is a bio-psychosocial marker.
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Affiliation(s)
| | - Faget-Agius Catherine
- Aix-Marseille University, EA 3279, Public Health: Chronic Diseases and Quality of Life, School of Medicine, 13005 Marseille, France
- Department of Psychiatry, Conception University Hospital, 13009 Marseille, France
- Department of Public Health, Timone University Hospital, Assistance Publique - Hôpitaux de Marseille, 13005 Marseille, France
- Aix Marseille University, Centre de Résonance Magnétique Biologique et Médicale (CRMBM) UMR CNRS 7339, Medical School of Marseille, France
- Centre d'Exploration Métabolique par Résonance Magnétique (CEMEREM), Medical Imaging Department, Timone University Hospital, AP-HM, Marseille, France
| | - Laurent Boyer
- Aix-Marseille University, EA 3279, Public Health: Chronic Diseases and Quality of Life, School of Medicine, 13005 Marseille, France
- Department of Public Health, Timone University Hospital, Assistance Publique - Hôpitaux de Marseille, 13005 Marseille, France
| | | | - Wirsich Jonathan
- Aix Marseille University, Centre de Résonance Magnétique Biologique et Médicale (CRMBM) UMR CNRS 7339, Medical School of Marseille, France
- Centre d'Exploration Métabolique par Résonance Magnétique (CEMEREM), Medical Imaging Department, Timone University Hospital, AP-HM, Marseille, France
| | | | - Ranjeva Jean-Philippe
- Aix Marseille University, Centre de Résonance Magnétique Biologique et Médicale (CRMBM) UMR CNRS 7339, Medical School of Marseille, France
- Centre d'Exploration Métabolique par Résonance Magnétique (CEMEREM), Medical Imaging Department, Timone University Hospital, AP-HM, Marseille, France
| | | | - Richieri Raphaelle
- Aix-Marseille University, EA 3279, Public Health: Chronic Diseases and Quality of Life, School of Medicine, 13005 Marseille, France
- Department of Psychiatry, Conception University Hospital, 13009 Marseille, France
- Department of Public Health, Timone University Hospital, Assistance Publique - Hôpitaux de Marseille, 13005 Marseille, France
| | | | - Soulier Elisabeth
- Aix Marseille University, Centre de Résonance Magnétique Biologique et Médicale (CRMBM) UMR CNRS 7339, Medical School of Marseille, France
- Centre d'Exploration Métabolique par Résonance Magnétique (CEMEREM), Medical Imaging Department, Timone University Hospital, AP-HM, Marseille, France
| | | | - Confort-Gouny Sylviane
- Aix Marseille University, Centre de Résonance Magnétique Biologique et Médicale (CRMBM) UMR CNRS 7339, Medical School of Marseille, France
- Centre d'Exploration Métabolique par Résonance Magnétique (CEMEREM), Medical Imaging Department, Timone University Hospital, AP-HM, Marseille, France
| | | | - Auquier Pascal
- Aix-Marseille University, EA 3279, Public Health: Chronic Diseases and Quality of Life, School of Medicine, 13005 Marseille, France
- Department of Public Health, Timone University Hospital, Assistance Publique - Hôpitaux de Marseille, 13005 Marseille, France
| | | | - Guye Maxime
- Aix Marseille University, Centre de Résonance Magnétique Biologique et Médicale (CRMBM) UMR CNRS 7339, Medical School of Marseille, France
- Centre d'Exploration Métabolique par Résonance Magnétique (CEMEREM), Medical Imaging Department, Timone University Hospital, AP-HM, Marseille, France
| | - Christophe Lançon
- Aix-Marseille University, EA 3279, Public Health: Chronic Diseases and Quality of Life, School of Medicine, 13005 Marseille, France
- Department of Psychiatry, Conception University Hospital, 13009 Marseille, France
- Department of Public Health, Timone University Hospital, Assistance Publique - Hôpitaux de Marseille, 13005 Marseille, France
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Michel P, Auquier P, Baumstarck K, Loundou A, Ghattas B, Lançon C, Boyer L. How to interpret multidimensional quality of life questionnaires for patients with schizophrenia? Qual Life Res 2015; 24:2483-92. [PMID: 25854680 DOI: 10.1007/s11136-015-0982-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2015] [Indexed: 11/28/2022]
Abstract
PURPOSE The classification of patients into distinct categories of quality of life (QoL) levels may be useful for clinicians to interpret QoL scores from multidimensional questionnaires. The aim of this study had been to define clusters of QoL levels from a specific multidimensional questionnaire (SQoL18) for patients with schizophrenia by using a new method of interpretable clustering and to test its validity regarding socio-demographic, clinical, and QoL information. METHODS In this multicentre cross-sectional study, patients with schizophrenia have been classified using a hierarchical top-down method called clustering using unsupervised binary trees (CUBT). A three-group structure has been employed to define QoL levels as "high", "moderate", or "low". Socio-demographic, clinical, and QoL data have been compared between the three clusters to ensure their clinical relevance. RESULTS A total of 514 patients have been analysed: 78 are classified as "low", 265 as "moderate", and 171 as "high". The clustering shows satisfactory statistical properties, including reproducibility (using bootstrap analysis) and discriminancy (using factor analysis). The three clusters consistently differentiate patients. As expected, individuals in the "high" QoL level cluster report the lowest scores on the Positive and Negative Syndrome Scale (p = 0.01) and the Calgary Depression Scale (p < 0.01), and the highest scores on the Global Assessment of Functioning (p < 0.03), the SF36 (p < 0.01), the EuroQol (p < 0.01), and the Quality of Life Inventory (p < 0.01). CONCLUSION Given the ease with which this method can be applied, classification using CUBT may be useful for facilitating the interpretation of QoL scores in clinical practice.
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Affiliation(s)
- Pierre Michel
- EA 3279 - Public Health, Chronic Diseases and Quality of Life - Research Unit, Aix-Marseille Univ, 13005, Marseille, France.,Department of Mathematics, Faculté des Sciences de Luminy, Aix-Marseille Univ, 13009, Marseille, France
| | - Pascal Auquier
- EA 3279 - Public Health, Chronic Diseases and Quality of Life - Research Unit, Aix-Marseille Univ, 13005, Marseille, France
| | - Karine Baumstarck
- EA 3279 - Public Health, Chronic Diseases and Quality of Life - Research Unit, Aix-Marseille Univ, 13005, Marseille, France
| | - Anderson Loundou
- EA 3279 - Public Health, Chronic Diseases and Quality of Life - Research Unit, Aix-Marseille Univ, 13005, Marseille, France
| | - Badih Ghattas
- Department of Mathematics, Faculté des Sciences de Luminy, Aix-Marseille Univ, 13009, Marseille, France
| | - Christophe Lançon
- EA 3279 - Public Health, Chronic Diseases and Quality of Life - Research Unit, Aix-Marseille Univ, 13005, Marseille, France
| | - Laurent Boyer
- EA 3279 - Public Health, Chronic Diseases and Quality of Life - Research Unit, Aix-Marseille Univ, 13005, Marseille, France.
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Boyer L, Baumstarck K, Boucekine M, Blanc J, Lançon C, Auquier P. Measuring quality of life in patients with schizophrenia:an overview. Expert Rev Pharmacoecon Outcomes Res 2014; 13:343-9. [PMID: 23763531 DOI: 10.1586/erp.13.15] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Quality of life (QoL) is of great importance to patients with schizophrenia and their families. Although the use of QoL measures may contribute to better adherence to therapeutic interventions, more satisfaction with care, improved health outcomes and reduction of health costs, QoL assessment remains underutilized in clinical practice. In this review, the authors propose a reflection on the limitations and lack of impact of QoL measures in clinical care. Our argument is based on three challenges regarding conceptual aspects and metrics, use and limits and the usefulness of measuring QoL. For each challenge, the authors have suggested pragmatic proposals and new research directions to promote the use of QoL measures in the future. These avenues of research involve a shared responsibility between QoL researchers, the medical community and decision makers. Close collaboration between all parties is necessary to promote the use of QoL measures in schizophrenia.
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Affiliation(s)
- Laurent Boyer
- Self-Perceived Health Assessment Research Unit, School of Medicine, La Timone University, 13005 Marseille, France.
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Boyer L, Lançon C, Baumstarck K, Parola N, Berbis J, Auquier P. Evaluating the impact of a quality of life assessment with feedback to clinicians in patients with schizophrenia: randomised controlled trial. Br J Psychiatry 2013; 202:447-53. [PMID: 23661768 DOI: 10.1192/bjp.bp.112.123463] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Quality of life (QoL) measurements are increasingly considered to be an important evaluation of the treatment and care provided to patients with schizophrenia. However, there is little evidence that assessing QoL improves patient outcomes in clinical practice. AIMS To investigate the impact of a QoL assessment with feedback for clinicians regarding satisfaction and other health outcomes in patients with schizophrenia. METHOD We conducted a 6-month, prospective, randomised and controlled open-label study. Patients with schizophrenia were assigned to one of three groups: standard psychiatric assessment; QoL assessment with standard psychiatric assessment; and QoL feedback with standard psychiatric assessment. The primary outcome was patient satisfaction at 6 months. The local ethics committee (Comité de Protection des Personnes Sud-Méditerranéee V, France, trial number 07 067) and the French drug and device regulation agency (Agence Française de Sécurité Sanitaire des Produits de Santé, France, trial number A01033-50) approved this study. RESULTS We randomly assigned 124 patients into groups. Quality of life feedback significantly affected patient satisfaction. Global satisfaction was significantly higher in the QoL feedback group (72.5% of patients had a high level of satisfaction) compared with the standard psychiatric assessment (67.5%) and QoL assessment groups (45.2%). Despite trends towards decreased severity for all clinical outcomes and increased changes to medication in the QoL feedback group at 6-month follow-up, these effects were not significant. CONCLUSIONS Quality of life feedback positively influences patient satisfaction, which confirms the relevance of measuring QoL in clinical practice. The absence of a significant effect of QoL feedback on clinical outcomes also suggests that clinicians did not use these data optimally. Our findings suggest a nocebo effect of QoL assessment without feedback that should be considered by researchers and clinicians.
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Affiliation(s)
- Laurent Boyer
- MD, PhD, EA 3279 - Self-Perceived Health Assessment Research Unit, School of Medicine, La Timone University, 13005 Marseille, France.
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Measuring the quality of life in patients with multiple sclerosis in clinical practice: a necessary challenge. Mult Scler Int 2013; 2013:524894. [PMID: 23533758 PMCID: PMC3603557 DOI: 10.1155/2013/524894] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Revised: 01/07/2013] [Accepted: 02/05/2013] [Indexed: 11/18/2022] Open
Abstract
While the physical disability aspect of multiple sclerosis (MS) is of great importance, quality of life (QoL) measurements are being considered increasingly important with regard to evaluating disease progression, treatment, and the management of care provided to MS patients. Despite the acknowledged need to consider QoL issues, QoL assessment remains underutilized in clinical practice. These issues should be explored and understood to promote the use of measuring QoL in MS clinical practice. We explore the difficulties for clinicians: choosing and determining the most appropriate QoL measure and how to best integrate QoL measurements into clinical practice. This paper discusses several avenues to provide to clinicians arguments of the clinical relevance and accuracy of QoL instruments and ultimately to enhance the use of QoL measures in clinical practice for MS patients.
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Rogausch A, Sigle J, Seibert A, Thüring S, Kochen MM, Himmel W. Feasibility and acceptance of electronic quality of life assessment in general practice: an implementation study. Health Qual Life Outcomes 2009; 7:51. [PMID: 19493355 PMCID: PMC2698929 DOI: 10.1186/1477-7525-7-51] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2008] [Accepted: 06/03/2009] [Indexed: 01/24/2023] Open
Abstract
Background Patients' health related quality of life (HRQoL) has rarely been systematically monitored in general practice. Electronic tools and practice training might facilitate the routine application of HRQoL questionnaires. Thorough piloting of innovative procedures is strongly recommended before the conduction of large-scale studies. Therefore, we aimed to assess i) the feasibility and acceptance of HRQoL assessment using tablet computers in general practice, ii) the perceived practical utility of HRQoL results and iii) to identify possible barriers hindering wider application of this approach. Methods Two HRQoL questionnaires (St. George's Respiratory Questionnaire SGRQ and EORTC QLQ-C30) were electronically presented on portable tablet computers. Wireless network (WLAN) integration into practice computer systems of 14 German general practices with varying infrastructure allowed automatic data exchange and the generation of a printout or a PDF file. General practitioners (GPs) and practice assistants were trained in a 1-hour course, after which they could invite patients with chronic diseases to fill in the electronic questionnaire during their waiting time. We surveyed patients, practice assistants and GPs regarding their acceptance of this tool in semi-structured telephone interviews. The number of assessments, HRQoL results and interview responses were analysed using quantitative and qualitative methods. Results Over the course of 1 year, 523 patients filled in the electronic questionnaires (1–5 times; 664 total assessments). On average, results showed specific HRQoL impairments, e.g. with respect to fatigue, pain and sleep disturbances. The number of electronic assessments varied substantially between practices. A total of 280 patients, 27 practice assistants and 17 GPs participated in the telephone interviews. Almost all GPs (16/17 = 94%; 95% CI = 73–99%), most practice assistants (19/27 = 70%; 95% CI = 50–86%) and the majority of patients (240/280 = 86%; 95% CI = 82–91%) indicated that they would welcome the use of electronic HRQoL questionnaires in the future. GPs mentioned availability of local health services (e.g. supportive, physiotherapy) (mean: 9.4 ± 1.0 SD; scale: 1 – 10), sufficient extra time (8.9 ± 1.5) and easy interpretation of HRQoL results (8.6 ± 1.6) as the most important prerequisites for their use. They believed HRQoL assessment facilitated both communication and follow up of patients' conditions. Practice assistants emphasised that this process demonstrated an extra commitment to patient centred care; patients viewed it as a tool, which contributed to the physicians' understanding of their personal condition and circumstances. Conclusion This pilot study indicates that electronic HRQoL assessment is technically feasible in general practices. It can provide clinically significant information, which can either be used in the consultation for routine care, or for research purposes. While GPs, practice assistants and patients were generally positive about the electronic procedure, several barriers (e.g. practices' lack of time and routine in HRQoL assessment) need to be overcome to enable broader application of electronic questionnaires in every day medical practice.
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Affiliation(s)
- Anja Rogausch
- Department of Family Medicine, University Medical Center Göttingen, Göttingen, Germany.
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Grothey A, Adjei AA, Alberts SR, Perez EA, Jaeckle KA, Loprinzi CL, Sargent DJ, Sloan JA, Buckner JC. North Central Cancer Treatment Group--achievements and perspectives. Semin Oncol 2008; 35:530-44. [PMID: 18929151 PMCID: PMC6158781 DOI: 10.1053/j.seminoncol.2008.07.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The North Central Cancer Treatment Group (NCCTG) was founded in 1977 as a regional cooperative group to allow cancer patients in the upper Midwest of the United States to gain access to clinical trials in oncology by establishing a network of community oncology practices with one academic research base, the Mayo Clinic. Since then, the NCCTG has grown into an international cooperative group with 43 members in 33 US states and Canada. This article details 30 years of achievements of the NCCTG, including important scientific contributions from disease-specific and treatment modality committees, the cancer control program, patient-reported outcomes and quality-of-life research, and biostatisticians that support the NCCTG's specific aims: to improve the duration and quality of life of cancer patients, to enhance our understanding of the biological consequences of cancer and its treatment, and to improve methods for clinical trial conduct.
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Decision making and quality of life in the treatment of cancer: a review. Support Care Cancer 2008; 17:117-27. [DOI: 10.1007/s00520-008-0505-2] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2008] [Accepted: 09/04/2008] [Indexed: 10/21/2022]
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