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Otten M, Djamei V, Augustin M. Development, Feasibility, and Acceptability of the Electronic Patient Benefit Index for Psoriasis in Clinical Practice: Mixed Methods Study. JMIR DERMATOLOGY 2024; 7:e54762. [PMID: 39121470 DOI: 10.2196/54762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 04/11/2024] [Accepted: 04/21/2024] [Indexed: 08/11/2024] Open
Abstract
BACKGROUND Patient-reported outcomes are relevant in clinical practice showing patient benefits, supporting clinicians' decision-making, and contributing to the delivery of high standards of care. Digital monitoring of patient-reported outcomes is still rare. The Patient Benefit Index (PBI) measures benefits and goals from patients' views and may be relevant for regular documentation and shared decision-making. OBJECTIVE This study aimed to develop electronic versions of the PBI to examine their feasibility and acceptability in clinical practice for patients with psoriasis. METHODS We developed an app and a web version of the existing, valid PBI using focus groups and cognitive debriefings with patients before conducting a quantitative survey on its feasibility and acceptability. Conduction took part in an outpatient dermatology care unit in Germany. Descriptive and subgroup analyses were conducted. RESULTS A total of 139 patients completed the electronic PBIs (ePBIs) and took part in the survey. The ePBI was understandable (n=129-137, 92.8%-98.6%) and feasible, for example, easy to read (n=135, 97.1%) and simple to handle (n=137, 98.5%). Acceptability was also high, for example, patients can imagine using and discussing the ePBI data in practice (n=91, 65.5%) and documenting it regularly (n=88, 63.3%). They believe it could support treatment decisions (n=118, 84.9%) and improve communication with their physician (n=112, 81.3%). They can imagine filling in electronic questionnaires regularly (n=118, 84.9%), even preferring electronic over paper versions (n=113, 81.2%). Older and less educated people show less feasibility, but the latter expected the relationship with their physician to improve and would be more willing to invest time or effort. CONCLUSIONS The app and web version of the PBI are usable and acceptable for patients offering comprehensive documentation and patient participation in practice. An implementation strategy should consider patients' needs, barriers, and facilitators but also physicians' attitudes and requirements from the health care system.
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Affiliation(s)
- Marina Otten
- German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Vahid Djamei
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - Matthias Augustin
- German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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Li X, Li R, Li M, Yao L, Van Spall H, Zhao K, Chen Y, Xiao F, Fu Q, Xie F. A Systematic Review and Quality Assessment of Cardiovascular Disease-Specific Health-Related Quality-of-Life Instruments Part I: Instrument Development and Content Validity. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2024; 27:1130-1148. [PMID: 38608875 DOI: 10.1016/j.jval.2024.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 02/12/2024] [Accepted: 04/03/2024] [Indexed: 04/14/2024]
Abstract
OBJECTIVES Health-related quality-of-life (HRQoL) instruments for cardiovascular diseases (CVD) have been commonly used to measure important patient-reported outcomes (PROs) in clinical trials and practices. This study aimed at systematically identifying and assessing the content validity of CVD-specific HRQoL instruments in clinical studies. METHODS The research team searched Cumulative Index to Nursing and Allied Health Literature, Embase, and PubMed from inception to January 20, 2022. The research team included studies that reported the development and content validity for CVD-specific instruments. Two reviewers independently assessed the methodological quality using the Consensus-based Standards for the Selection of Health Measurement Instruments methods on evaluating content validity of PROs. Content analysis was used to categorize the items included in the instruments. RESULTS The research team found 69 studies reporting the content validity of 40 instruments specifically developed for CVD. Fourteen (35.0%) were rated "sufficient" with very low to moderate quality of evidence. For PRO development, all instruments were rated "doubtful" or "inadequate." Twenty-eight (70.0%) instruments cover the core concepts of HRQoL. CONCLUSIONS The quality of development and content validity vary among existing CVD-specific instruments. The evidence on the content validity should be considered when choosing a HRQoL instrument in CVD clinical studies and health economic evaluations.
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Affiliation(s)
- Xue Li
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada; Department of Health Technology Assessment, China National Health Development Research Center, Beijing, China
| | - Rui Li
- Department of Health Technology Assessment, China National Health Development Research Center, Beijing, China; Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, Lanzhou, Gansu, China; Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Meixuan Li
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, Lanzhou, Gansu, China; Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Liang Yao
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Harriette Van Spall
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada; Department of Medicine, McMaster University, Hamilton, ON, Canada; Research Institute of St Joseph's and Population Health Research Institute, Hamilton, ON, Canada
| | - Kun Zhao
- Department of Health Technology Assessment, China National Health Development Research Center, Beijing, China; Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Yunxiang Chen
- Department of Library, Shengjing Hospital, China Medical University, Shenyang, Liaoning, China
| | - Feiyi Xiao
- Department of Health Technology Assessment, China National Health Development Research Center, Beijing, China
| | - Qiang Fu
- Department of Health Technology Assessment, China National Health Development Research Center, Beijing, China
| | - Feng Xie
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada; Center for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada.
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Tan YJ, Ong SC, Goh SP, Chen G, Yong VS, Khor WW, Kan YM, Choong YY, Zameram AM, Tan LY, Voo JYH, Lam KK, Yen CH, Wahab MJA, Abdulla ZB. Translation, cross-cultural adaptation, and psychometric validation of the Malay version of the Assessment of Quality of Life-6 Dimensions (Malay-AQoL-6D) instrument among Malaysians living with chronic heart failure. J Patient Rep Outcomes 2024; 8:79. [PMID: 39052204 PMCID: PMC11272755 DOI: 10.1186/s41687-024-00763-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 07/09/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND This study aimed to translate and culturally adapt the Assessment of Quality of Life (AQoL)-6D into Malay (Malay-AQoL-6D), and assesses the instrument's acceptability, reliability, and validity among Malaysians living with chronic heart failure (HF). METHODS The translation and cross-cultural adaptation process adhered to international guidelines. The Malay-AQoL-6D underwent content and face validity assessments via expert review, and pretesting among healthy individuals and patients with chronic conditions. Subsequent psychometric validation utilised clinico-sociodemographic data and paired AQoL-6D and EQ-5D-5L data from a health-related quality-of-life (HRQoL) survey involving Malay-speaking patients with HF, which encompassed assessments of Malay-AQoL-6D acceptability, internal consistency and test-retest reliability, as well as its construct, concurrent, convergent and divergent, and known-group validity. RESULTS The Malay-AQoL-6D was deemed acceptable among clinicians and local patients, achieving a 90.8% completion rate among 314 patients surveyed. The instrument demonstrated strong content validity (item-level content validity index [CVI]: 0.83-1.00, average CVI: 0.98), internal consistency (Cronbach's alpha: 0.72-0.89; MacDonald's omega: 0.82-0.90, excluding the Senses dimension), and test-retest reliability (average intraclass correlation coefficients: 0.79-0.95). Confirmatory factor analysis confirmed the instrument's two-level, six-factor structure (Satorra-Bentler [SB]-scaled χ2(df: 164): 283.67, p-value < 0.001; root mean square error of approximation [RMSEA]: 0.051; comparative fix index [CFI]: 0.945, Tucker-Lewis index [TLI]: 0.937; standardised root mean-squared error [SRMR]: 0.058). The Malay-AQoL-6D's concurrent validity was evident through its good agreement with EQ-5D-5L. Multiple hypothesis tests further affirmed its construct and known-group validity. The Malay-AQoL-6D's psychometric properties remained consistent across different missing data techniques. CONCLUSION The findings suggest that Malay-AQoL-6D could be a culturally acceptable, reliable, and valid HRQoL measure for quantifying HRQoL among the local HF population. Future studies are necessary to further validate the instrument against other measures and confirm the instrument's test-retest reliability and responsiveness, which are possible with the availability of the Malay-AQoL-6D.
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Affiliation(s)
- Yi Jing Tan
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Gelugor, Penang, 11800, Malaysia
- Seri Manjung Hospital, Ministry of Health Malaysia, Seri Manjung, Perak, 32040, Malaysia
| | - Siew Chin Ong
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Gelugor, Penang, 11800, Malaysia.
| | - Sook Pin Goh
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Gelugor, Penang, 11800, Malaysia
- Tapah Hospital, Ministry of Health Malaysia, Tapah, Perak, 35000, Malaysia
| | - Gang Chen
- Centre for Health Economics, Monash University, Caulfield East, VIC, 3145, Australia
| | - Vee Sim Yong
- Clinical Research Centre, Hospital Queen Elizabeth II, Institute for Clinical Research, National Institute of Health, Ministry of Health Malaysia, Kota Kinabalu, Sabah, 88300, Malaysia
| | - Wei Wern Khor
- Sarawak General Hospital, Ministry of Health Malaysia, Kuching, Sarawak, 93586, Malaysia
| | - Ying Min Kan
- Sungai Dua Health Clinic, Ministry of Health Malaysia, Butterworth, Penang, 13800, Malaysia
| | - Yong Ying Choong
- Seri Manjung Hospital, Ministry of Health Malaysia, Seri Manjung, Perak, 32040, Malaysia
| | | | - Lin Yuing Tan
- Teluk Intan Hospital, Ministry of Health Malaysia, Teluk Intan, Perak, 36000, Malaysia
| | - James Yau Hon Voo
- Duchess of Kent Hospital, Ministry of Health Malaysia, Sandakan, Sabah, 90000, Malaysia
| | - Kar Kei Lam
- Duchess of Kent Hospital, Ministry of Health Malaysia, Sandakan, Sabah, 90000, Malaysia
| | - Chia How Yen
- Clinical Research Centre, Hospital Queen Elizabeth II, Institute for Clinical Research, National Institute of Health, Ministry of Health Malaysia, Kota Kinabalu, Sabah, 88300, Malaysia
| | | | - Zarina Banu Abdulla
- Penang General Hospital, Ministry of Health Malaysia, Georgetown, Penang, 10990, Malaysia
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Gabe-Walters M, Thomas M, Jenkins L. Demonstrating the benefit of a cellulitis-specific patient reported outcome measure (CELLUPROM ©) as part of the National Cellulitis Improvement Programme in Wales. J Patient Rep Outcomes 2024; 8:69. [PMID: 38985230 PMCID: PMC11236826 DOI: 10.1186/s41687-024-00754-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 06/27/2024] [Indexed: 07/11/2024] Open
Abstract
PURPOSE Despite a known risk of cellulitis recurrence, the management of the wider impact and risk factors has been neglected. The innovative National Cellulitis Improvement Programme (NCIP) addresses this by providing evidence-based and individualised care to improve patient reported outcomes and reduce the risk of recurrence. The aim of this paper is to examine the longer-term impact of cellulitis and to identify a suitable and clinically relevant Patient Reported Outcome Measure (PROM). METHODS A review of existing cellulitis-specific PROMs was undertaken, alongside literature detailing the patient-focused impact of cellulitis, to identify a suitable PROM for clinical use. A group of expert therapists and patient representatives (n = 14) shared their individual and collective experiences over a series of events to discuss and debate the impact of cellulitis and review available PROMs. CELLUPROM© is introduced with anonymised PROM data and case study information reported to establish the impact of CELLUPROM© within usual NCIP care. RESULTS No cellulitis-specific PROMs were identified. Literature focused on the signs and symptoms of an acute episode of cellulitis, with outcome measures primarily used to evidence the impact of an intervention. An enduring physical, social and emotional impact of cellulitis was identified in this study, providing the basis for the new cellulitis-specific PROM (CELLUPROM©), which has been implemented with good effect in clinical care. CONCLUSION This study has highlighted the lasting impact of cellulitis. Using CELLUPROM© within the risk-reduction NCIP has helped develop Value-Based Healthcare and support programme evaluation.
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Affiliation(s)
- Marie Gabe-Walters
- Lymphoedema Wales Clinical Network, Swansea Bay University Health Board, Swansea, Wales.
| | - Melanie Thomas
- Lymphoedema Wales Clinical Network, Swansea Bay University Health Board, Swansea, Wales
| | - Linda Jenkins
- National Cellulitis Improvement Programme Lead, Lymphoedema Wales Clinical Network, Swansea Bay University Health Board, Swansea, Wales
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Maronati R, Rigot SK, Mummidisetty CK, Jayaraman C, Hoppe-Ludwig S, Jayaraman A. Evaluating the Usability and Equivalence of Electronic Patient-Reported Outcome Measures for Individuals with a Lower-Limb Amputation. JOURNAL OF PROSTHETICS AND ORTHOTICS : JPO 2024; 36:205-213. [PMID: 38966094 PMCID: PMC11221574 DOI: 10.1097/jpo.0000000000000476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/06/2024]
Abstract
ABSTRACT
Introduction
Electronic versions of patient-reported outcome measures (PROMs) seem to have a clear administrative logging advantage to traditional paper versions. However, most of them have not been formally evaluated for their suitability to replace paper outcome measures for assessment of individuals with lower-limb amputations. The aim of this study is to examine the usability and equivalence of electronic to paper versions of PROMs suitable for use in prosthetic clinical care and research for persons with lower-limb loss.
Methods
In this cross-sectional study, 10 participants remotely completed the following PROMs online and then on paper: Orthotic and Prosthetic User Survey (OPUS), Modified Falls Efficacy Scale (MFES), Prosthetic Evaluation Questionnaire (PEQ), Patient Health Questionnaire–9 (PHQ-9), and Community Participation Indicators (CPI). Participants also answered open-ended and standardized questions regarding the usability of the electronic surveys. Wilcoxon signed rank tests, comparisons to minimum detectable change, intraclass correlation coefficients, and Bland-Altman plots were used to evaluate differences between the two survey versions, meaningful changes in scores, reliability, and systematic biases, respectively.
Results
Electronic surveys had fewer missing or ambiguous responses than paper surveys; however, the PEQ Social Burdens subscale could not be evaluated due to error in the creation of the electronic survey. No significant differences were found between scores of the two versions for any of the measures, but multiple participants had meaningful changes in the Appearance and Sounds PEQ subscales. All measures demonstrated acceptable reliability between versions, except the Appearance, Perceived Response, and Sounds subscales of the PEQ. No systematic biases in scores or usability concerns were found for any measures.
Conclusions
This study analysis showed that most of the electronic PROMs studied are easily used and demonstrate equivalence to the paper versions. However, the PEQ Appearance, Perceived Response, Sounds, and Social Burden subscales require further evaluation.
Clinical Relevance
Except for the PEQ, electronic versions of the PROMs in this study can likely be used interchangeably with paper versions among individuals with lower-limb loss.
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Affiliation(s)
- Rachel Maronati
- Max Näder Center for Rehabilitation Technologies and Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL, USA
- Center for Bionic Medicine, Shirley Ryan AbilityLab, Chicago, IL, USA
| | - Stephanie K. Rigot
- Max Näder Center for Rehabilitation Technologies and Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL, USA
- Center for Bionic Medicine, Shirley Ryan AbilityLab, Chicago, IL, USA
- Northwestern University, Department of Physical Medicine & Rehabilitation, Chicago, IL, USA
| | - Chaithanya K. Mummidisetty
- Max Näder Center for Rehabilitation Technologies and Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL, USA
- Center for Bionic Medicine, Shirley Ryan AbilityLab, Chicago, IL, USA
| | - Chandrasekaran Jayaraman
- Max Näder Center for Rehabilitation Technologies and Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL, USA
- Center for Bionic Medicine, Shirley Ryan AbilityLab, Chicago, IL, USA
- Northwestern University, Department of Physical Medicine & Rehabilitation, Chicago, IL, USA
| | - Shenan Hoppe-Ludwig
- Max Näder Center for Rehabilitation Technologies and Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL, USA
- Center for Bionic Medicine, Shirley Ryan AbilityLab, Chicago, IL, USA
| | - Arun Jayaraman
- Max Näder Center for Rehabilitation Technologies and Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL, USA
- Center for Bionic Medicine, Shirley Ryan AbilityLab, Chicago, IL, USA
- Northwestern University, Department of Physical Medicine & Rehabilitation, Chicago, IL, USA
- Northwestern University, Department of Physical Therapy & Human Movement Sciences, Chicago, IL, USA
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Lai-Kwon J, Thorner E, Rutherford C, Crossnohere N, Brundage M. Integrating Patient-Reported Outcomes Into the Care of People With Advanced Cancer-A Practical Guide. Am Soc Clin Oncol Educ Book 2024; 44:e438512. [PMID: 38788184 DOI: 10.1200/edbk_438512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2024]
Abstract
Patient-reported outcomes (PROs) are being increasingly integrated into routine clinical practice to enhance individual patient care. This has been driven by recognition of the benefits of PROs in enhancing symptom management, patient satisfaction, quality of life, and overall survival, and reductions in acute health care utilization. These benefits are reflected in the emergence of value-based health care initiatives incorporating PRO symptom monitoring such as the Enhancing Oncology Model in the United States. However, implementing PROs can be challenging and it can be difficult to know where to begin to select appropriate PROs, and effectively display and appropriately interpret PRO data. This manuscript summarizes an educational session at the 2024 ASCO Annual Meeting, which provided practical guidance to clinicians seeking to incorporate PROs into the care of people with advanced cancer. We focus on why it is important to collect PROs in routine care from a patient's perspective, how to select PROs for symptom monitoring (including using static patient-reported outcome measures and newer item libraries), and highlight key pearls and pitfalls in the display and interpretation of PROs. We highlight the breadth of existing resources available to guide clinicians in PRO implementation.
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Affiliation(s)
- Julia Lai-Kwon
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Australia
| | | | - Claudia Rutherford
- Sydney Quality of Life Office, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | | | - Michael Brundage
- Queen's Cancer Research Institute, Queen's University, Kingston, Ontario, Canada
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Xue K, Li W, Liu F, Liu X, Wong J, Zhou M, Cai C, Long J, Li J, Zhang Z, Hou W, Nie G, Wang Y. Evaluation of activities of daily living using an electronic version of the Longshi Scale in patients with stroke: reliability, consistency, and preference. BMC Med Inform Decis Mak 2024; 24:125. [PMID: 38750562 PMCID: PMC11094909 DOI: 10.1186/s12911-024-02508-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 04/15/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND The Longshi Scale is a pictorial assessment tool for evaluating activities of daily living (ADL) in patients with stroke. The paper-based version presents challenges; thus, the WeChat version was created to enhance accessibility. Herein, we aimed to validate the inter-rater and test-retest reliabilities of the WeChat version of the Longshi Scale and explore its potential clinical applications. METHODS We recruited 115 patients with stroke in the study. The ADL results of each patient were assessed using both the WeChat and paper-based version of the Longshi Scale; each evaluation was conducted by 28 health professionals and 115 caregivers separately. To explore the test-retest reliability of the WeChat version, 22 patients were randomly selected and re-evaluated by health professionals using the WeChat version. All evaluation criteria were recorded, and all evaluators were surveyed to indicate their preference between the two versions. RESULTS Consistency between WeChat and the paper-based Longshi Scale was high for ADL scores by health professionals (ICC2,1 = 0.803-0.988) and caregivers (ICC2,1 = 0.845-0.983), as well as for degrees of disability (κw = 0.870 by professionals; κw = 0.800 by caregivers). Bland-Altman analysis showed no significant discrepancies. The WeChat version exhibited good test-retest reliability (κw = 0.880). The WeChat version showed similar inter-rater reliability in terms of the ADL score evaluated using the paper-based version (ICC2,1 = 0.781-0.941). The time to complete assessments did not differ significantly, although the WeChat version had a shorter information entry time (P < 0.001, 95% confidence interval: -43.463 to -15.488). Health professionals favored the WeChat version (53.6%), whereas caregivers had no significant preference. CONCLUSIONS The WeChat version of the Longshi Scale is reliable and serves as a suitable alternative for health professionals and caregivers to assess ADL levels in patients with stroke. The WeChat version of the Longshi Scale is considered user-friendly by health professionals, although it is not preferred by caregivers. TRIAL REGISTRATION This study was approved by the Ethics Committee of the Second People's Hospital of Shenzhen (approval number: 20210812003-FS01) and registered on the Clinical Trial Register Center website: clinicaltrials.gov on January 31, 2022 (registration no.: NCT05214638).
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Affiliation(s)
- Kaiwen Xue
- Department of Rehabilitation, The Second People's Hospital of Shenzhen, The First Affiliated Hospital of Shenzhen University Health Science Centre, Shenzhen, China
| | - Weihao Li
- Department of Rehabilitation, The Second People's Hospital of Shenzhen, The First Affiliated Hospital of Shenzhen University Health Science Centre, Shenzhen, China
| | - Fang Liu
- Department of Rehabilitation, The Second People's Hospital of Shenzhen, The First Affiliated Hospital of Shenzhen University Health Science Centre, Shenzhen, China
| | - Xiangxiang Liu
- National Clinical Research Center for Infectious Disease of Shenzhen; Shenzhen Third People's Hospital, Shenzhen, China
| | - John Wong
- School of Nursing and Department of Occupational Therapy, MGH Institute of Health Professions, Boston, MA, USA
| | - Mingchao Zhou
- Department of Rehabilitation, The Second People's Hospital of Shenzhen, The First Affiliated Hospital of Shenzhen University Health Science Centre, Shenzhen, China
| | - Chunli Cai
- Operation Department, Shenzhen Yilanda Technology Co. Ltd., Shenzhen, China
| | - Jianjun Long
- Department of Rehabilitation, The Second People's Hospital of Shenzhen, The First Affiliated Hospital of Shenzhen University Health Science Centre, Shenzhen, China
| | - Jiehui Li
- Department of Rehabilitation, The Second People's Hospital of Shenzhen, The First Affiliated Hospital of Shenzhen University Health Science Centre, Shenzhen, China
- School of Rehabilitation Medicine, The Shandong University of Traditional Chinese Medicine, Shandong, China
| | - Zeyu Zhang
- Department of Rehabilitation, The Second People's Hospital of Shenzhen, The First Affiliated Hospital of Shenzhen University Health Science Centre, Shenzhen, China
| | - Weilin Hou
- Department of Rehabilitation, Changzhou Hospital of Traditional Chinese Medicine, Jiangsu, China.
| | - Guohui Nie
- Department of Rehabilitation, The Second People's Hospital of Shenzhen, The First Affiliated Hospital of Shenzhen University Health Science Centre, Shenzhen, China.
| | - Yulong Wang
- Department of Rehabilitation, The Second People's Hospital of Shenzhen, The First Affiliated Hospital of Shenzhen University Health Science Centre, Shenzhen, China.
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Gildea E, Scales-Theobald E, Thompson J, Cook A, Forde K, Skingley G, Lawrie S, Williamson N, Panter C. Development and validation of a quality of life and treatment satisfaction measure in canine osteoarthritis. Front Vet Sci 2024; 11:1377019. [PMID: 38764853 PMCID: PMC11100416 DOI: 10.3389/fvets.2024.1377019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 04/08/2024] [Indexed: 05/21/2024] Open
Abstract
Introduction Canine osteoarthritis (OA) causes pain and mobility impairment. This can reduce dog quality of life (QoL), owner QoL and owners' satisfaction with, and adherence to, treatments. No existing canine OA-specific instrument assesses all three impacts. This study aimed to develop and psychometrically evaluate an owner-completed canine OA-specific measure of dog QoL, owner QoL and owner treatment satisfaction; the "Canine OA Quality of Life and Treatment Satisfaction Questionnaire" (CaOA-QoL-TS). Methods The CaOA-QoL-TS was developed using a conceptual model derived from a meta-synthesis of published literature followed by cognitive interviews with ten owners of dogs with OA, to evaluate content validity. Results Based on interview findings, ten items were reworded, four removed, and two added; resulting in 26 items that all owners understood and considered relevant. The recall period and response options were well understood and appropriate to almost all owners. To evaluate its psychometric properties, the CaOA-QoL-TS (draft 26-item version) was administered, across six timepoints in a phase 4 field study, to owners of OA treated dogs, recruited from veterinary practices (N = 93). Inter-item correlations suggested items clustered into three distinct domains: Dog QoL, Owner QoL and Treatment Satisfaction, as hypothesized. Confirmatory factor analysis supported deletion of two items and calculation of the three domain scores, with acceptable model fit. The resulting 24-item CaOA-QoL-TS instrument demonstrated strong internal consistency and good to excellent test-retest reliability. Convergent validity was supported by moderate to strong correlations with concurrent measures. Known groups validity was supported by statistically significant differences between groups categorized by owner global impression of QoL. Ability to detect change was demonstrated through statistically significant improvements over time in Owner and Dog QoL, with larger within-group effect sizes reported for the mean of 'improved' dogs compared to the mean of 'stable' dogs. Only a small sample of dogs worsened throughout the study. Anchor-based analyses supported-0.9 and-1.0-point within-group responder definitions for dog and owner QoL domains, respectively. Discussion Findings support the content validity of the CaOA-QoL-TS in canine OA. The 24-item CaOA-QoL-TS is a reliable and valid instrument to measure owner and canine QoL and TS and is sensitive to improvements following OA treatment.
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Affiliation(s)
| | | | | | - Alasdair Cook
- School of Veterinary Medicine, University of Surrey, Surrey, United Kingdom
| | - Katie Forde
- Adelphi Values Patient-Centered Outcomes, Cheshire, United Kingdom
| | - George Skingley
- Adelphi Values Patient-Centered Outcomes, Cheshire, United Kingdom
| | - Sophie Lawrie
- Adelphi Values Patient-Centered Outcomes, Cheshire, United Kingdom
| | | | - Charlotte Panter
- Adelphi Values Patient-Centered Outcomes, Cheshire, United Kingdom
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Giovannetti AM, Rosato R, Galán I, Toscano A, Anglada E, Menendez R, Hoyer J, Confalonieri P, Giordano A, Pakenham KI, Pöttgen J, Solari A. Cross-cultural validity and reliability of the comprehensive assessment of acceptance and commitment therapy processes (CompACT) in people with multiple sclerosis. Qual Life Res 2024; 33:1359-1371. [PMID: 38401014 DOI: 10.1007/s11136-024-03609-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2024] [Indexed: 02/26/2024]
Abstract
PURPOSE The Comprehensive assessment of Acceptance and Commitment Therapy (CompACT) is a 23-item questionnaire measuring psychological flexibility, a quality of life protective factor. An 18-item version was recently produced. We assessed validity and reliability of CompACT, and equivalence of paper and electronic (eCompACT) versions in people with multiple sclerosis (PwMS) in Italy, Germany and Spain. METHODS We used confirmatory factor analysis and assessed CompACT-23 and CompACT-18 measurement invariance between the three language versions. We assessed construct validity (Spearman's correlations) and internal consistency (Cronbach's alpha). Test-retest reliability (intraclass correlation coefficient, ICC) and equivalence of paper and eCompACT (ICC and linear regression model for repeated measures) were assessed in subsamples of PwMS. RESULTS A total of 725 PwMS completed the study. The three-factor structure of the CompACT-23 showed poor fit (RMSEA 0.07; CFI 0.82; SRMR 0.08), while the fit of the CompACT-18 was good (RMSEA 0.05; CFI 0.93; SRMR 0.05). Configural and partial metric invariance were confirmed, as well as partial scalar invariance (reached when five items were allowed to vary freely). The CompACT-18 showed good internal consistency (all alpha ≥ 0.78); and test-retest reliability (all ICCs ≥ 0.86). Equivalence between paper and eCompACT was excellent (all ICCs ≥ 0.86), with no mode, order, or interaction effects. CONCLUSION Results support using the refined CompACT-18 as a three-factor measure of psychological flexibility in PwMS. Paper and eCompACT-18 versions are equivalent. CompACT-18 can be used cross-culturally, but sub-optimal scalar invariance suggests that direct comparison between the three language versions should be interpreted with caution.
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Affiliation(s)
- Ambra Mara Giovannetti
- Fondazione IRCCS Istituto Neurologico Carlo Besta, (Unit of Neuroepidemiology), Via Celoria 11, 20133, Milan, Italy.
- School of Psychology, University of Queensland, Brisbane, QLD, Australia.
- Fondazione IRCCS Istituto Neurologico Carlo Besta, (Unit of Neuroimmunology and Neuromuscular Diseases), Milan, Italy.
| | - Rosalba Rosato
- Department of Psychology, University of Turin, Turin, Italy
| | - Ingrid Galán
- Centre d'Esclerosi Múltiple de Catalunya-Cemcat, Barcelona, Spain
| | - Anna Toscano
- Department of Psychology, University of Turin, Turin, Italy
| | - Elisenda Anglada
- Centre d'Esclerosi Múltiple de Catalunya-Cemcat, Barcelona, Spain
| | - Rebeca Menendez
- Centre d'Esclerosi Múltiple de Catalunya-Cemcat, Barcelona, Spain
| | - Jürgen Hoyer
- Technische Universitaet Dresden, Dresden, Germany
| | - Paolo Confalonieri
- Fondazione IRCCS Istituto Neurologico Carlo Besta, (Unit of Neuroimmunology and Neuromuscular Diseases), Milan, Italy
| | - Andrea Giordano
- Fondazione IRCCS Istituto Neurologico Carlo Besta, (Unit of Neuroepidemiology), Via Celoria 11, 20133, Milan, Italy
- Department of Psychology, University of Turin, Turin, Italy
| | | | - Jana Pöttgen
- Institute of Neuroimmunology and Multiple Sclerosis (INIMS), Center for Molecular Neurobiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Alessandra Solari
- Fondazione IRCCS Istituto Neurologico Carlo Besta, (Unit of Neuroepidemiology), Via Celoria 11, 20133, Milan, Italy
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10
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Sikorskii A, Tam S, Given B, Given CW, Adjei Boakye E, Zatirka T, Nair M, Su WTK, Jogunoori S, Watson P, Movsas B, Chang S. Thresholds in PROMIS Scores Anchored to Subsequent Unscheduled Health Service Use Among People Diagnosed With Cancer. JCO Oncol Pract 2024:OP2300356. [PMID: 38564704 DOI: 10.1200/op.23.00356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 01/03/2024] [Accepted: 02/23/2024] [Indexed: 04/04/2024] Open
Abstract
PURPOSE To establish thresholds in the Patient-Reported Outcomes Measurement Information System (PROMIS) pain interference, physical function, fatigue, and depression scores on the basis of their association with subsequent use of the emergency department (ED) or urgent care by people diagnosed with cancer. METHODS Retrospective data from 952 people seen at Henry Ford Cancer and insured through the Health Alliance Plan were analyzed using generalized linear mixed-effects models. The log odds of ED or urgent care use during 14 or 30 days after each patient-reported outcome (PRO) assessment were related to PRO scores, while adjusting for comorbidity, sociodemographic, and tumor characteristics. RESULTS Pain interference and physical function were associated with subsequent ED or urgent care visits, but fatigue and depression were not, and the results for 14- and 30-day visits were similar. Thresholds anchored in the likelihood of these visits differed according to cancer stage. For people with advanced cancer, a pain interference score of 60 or higher (odds ratio [OR] 3.75, [95% CI, 1.53 to 7.87]) and a physical function score lower than 40 (OR 2.94, [95% CI, 1.22 to 7.06]) produced the largest ORs with narrowest CIs for 30-day visits. For people with nonadvanced cancer, the thresholds of 65 for pain interference (OR 2.64, [95% CI, 1.40 to 5.01]) and 35 for physical function (OR 1.87, [95% CI, 1.01 to 3.45]) produced largest ORs with narrowest CIs for 30-day visits. CONCLUSION These anchor-based thresholds in PROMIS scores can inform clinicians' actions with the goal of preventing ED or urgent care visits.
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Affiliation(s)
- Alla Sikorskii
- Department of Psychiatry, College of Osteopathic Medicine, Michigan State University, East Lansing, MI
| | - Samantha Tam
- Department of Otolaryngology, Head and Neck Surgery, Henry Ford Health, Henry Ford Cancer, Detroit, MI
| | - Barbara Given
- College of Nursing, Michigan State University, East Lansing, MI
| | - Charles W Given
- College of Nursing, Michigan State University, East Lansing, MI
| | - Eric Adjei Boakye
- Department of Otolaryngology, Head and Neck Surgery, Henry Ford Health, Henry Ford Cancer, Detroit, MI
| | - Theresa Zatirka
- Henry Ford Cancer Patient Reported Outcomes Committee, Transformation Consulting, Henry Ford Health, Henry Ford Cancer, Detroit, MI
| | - Mrudula Nair
- Department of Public Health Sciences, Henry Ford Health, Henry Ford Cancer, Detroit, MI
| | - Wan-Ting K Su
- Department of Public Health Sciences, Henry Ford Health, Henry Ford Cancer, Detroit, MI
| | - Smitha Jogunoori
- Department of Public Health Sciences, Henry Ford Health, Henry Ford Cancer, Detroit, MI
| | - Peter Watson
- Healthy Population, Henry Ford Health, Detroit, MI
- Health Alliance Plan, Henry Ford Health, Detroit, MI
- Division of Hospital Medicine, Henry Ford Health, Detroit, MI
| | - Benjamin Movsas
- Radiation Oncology, Henry Ford Cancer, Henry Ford Health, Detroit, MI
| | - Steven Chang
- Department of Otolaryngology, Head and Neck Surgery, Henry Ford Health, Henry Ford Cancer, Detroit, MI
- Henry Ford Cancer Patient Reported Outcomes Committee, Henry Ford Cancer Head and Neck Cancer Program, Detroit, MI
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11
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Boyd AT, Rocconi LM, Morrow JA. Construct validation and measurement invariance of the Parasocial Relationships in Social Media survey. PLoS One 2024; 19:e0300356. [PMID: 38547192 PMCID: PMC10977705 DOI: 10.1371/journal.pone.0300356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 02/23/2024] [Indexed: 04/02/2024] Open
Abstract
This paper examines the construct validity and measurement invariance of the Parasocial Relationships in Social Media (PRISM) survey which was designed to provide researchers with a valid and reliable tool for measuring parasocial relationships developed in a social media context. A confirmatory factor analysis indicated the survey provides an adequate measure of parasocial relationships with online, social media celebrities, replicating the factor structure found by Boyd and colleagues when they developed PRISM and providing evidence of the construct validity of the survey. Additionally, scalar measurement invariance was achieved which supports the survey's ability to compare parasocial relationships across different social media platforms.
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Affiliation(s)
- Austin T. Boyd
- Educational Leadership and Policy Studies, The University of Tennessee, Knoxville, Knoxville, Tennessee, United States of America
- American Reading Company, Blue Bell, Pennsylvania, United States of America
| | - Louis M. Rocconi
- Educational Leadership and Policy Studies, The University of Tennessee, Knoxville, Knoxville, Tennessee, United States of America
| | - Jennifer Ann Morrow
- Educational Leadership and Policy Studies, The University of Tennessee, Knoxville, Knoxville, Tennessee, United States of America
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12
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Tacchino A, Di Giovanni R, Grange E, Spirito MM, Ponzio M, Battaglia MA, Brichetto G, Solaro CM. The administration of the paper and electronic versions of the Manual Ability Measure-36 (MAM-36) and Fatigue Severity Scale (FSS) is equivalent in people with multiple sclerosis. Neurol Sci 2024; 45:1155-1162. [PMID: 37828384 DOI: 10.1007/s10072-023-07103-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 09/26/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND The mobile device diffusion has increasingly highlighted the opportunity to collect patient-reported outcomes (PROs) through electronic patient-reported outcomes measurements (ePROMs) during the clinical routine. Despite the ePROMs promises and advantages, the equivalence when a PRO measure is moved from the original paper-and-pencil to the electronic version is still little investigated. This study aims at evaluating equivalence between PROMs and ePROMs self-administration in people with multiple sclerosis (PwMS); in addition, preference of self-administration type was evaluated. METHODS The Manual Ability Measure-36 (MAM-36) and Fatigue Severity Scale (FSS) were selected for the equivalence test. The app ABOUTCOME was developed through a user-centered design approach to administer the questionnaires on tablet. Both paper-and-pencil and electronic versions were randomly self-administered. Intrarater reliability between both versions was evaluated through the intraclass correlation coefficient (ICC, excellent for values ≥ 0.75). RESULTS Fifty PwMS (35 females) participated to the study (mean age: 54.7±11.0 years, disease course: 27 relapsing-remitting and 23 progressive; mean EDSS: 4.7±1.9; mean disease duration: 13.3±9.5 years). No statistically significant differences were found for the means total scores of MAM-36 (p = 0.61) and FSS (p = 0.78). The ICC value for MAM-36 and FSS was excellent (0.98 and 0.94, respectively). Most of participants preferred the tablet version (84%). CONCLUSION The results of the study provide evidence about the equivalence between the paper-and-pencil and electronic versions of PROs administration. In addition, PwMS prefer electronic methods rather than paper because the information can be provided more efficiently and accurately. The results could be easily extended to other MS PROs.
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Affiliation(s)
- Andrea Tacchino
- Italian Multiple Sclerosis Foundation (FISM), Scientific Research Area, Via Operai, 40, 16149, Genoa, Italy.
| | | | - Erica Grange
- Italian Multiple Sclerosis Foundation (FISM), Scientific Research Area, Via Operai, 40, 16149, Genoa, Italy
| | - Maria Marcella Spirito
- Italian Multiple Sclerosis Foundation (FISM), Scientific Research Area, Via Operai, 40, 16149, Genoa, Italy
| | - Michela Ponzio
- Italian Multiple Sclerosis Foundation (FISM), Scientific Research Area, Via Operai, 40, 16149, Genoa, Italy
| | | | - Giampaolo Brichetto
- Italian Multiple Sclerosis Foundation (FISM), Scientific Research Area, Via Operai, 40, 16149, Genoa, Italy
- Italian Multiple Sclerosis Society (AISM) Rehabilitation Service of Liguria, Genoa, Italy
| | - Claudio Marcello Solaro
- CRRF "Mons. L. Novarese", Moncrivello (VC), Italy
- Galliera Hospital, Neurology Unit, Genoa, Italy
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13
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Lindegaard SF, Højen AA, Rolving N. Electronic adaptation and danish cross-cultural translation of PEmb-QoL and VEINES-QoL/Sym for patients with venous thromboembolism. J Patient Rep Outcomes 2024; 8:21. [PMID: 38407682 PMCID: PMC10897079 DOI: 10.1186/s41687-024-00698-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 02/07/2024] [Indexed: 02/27/2024] Open
Abstract
PURPOSE Most patient-reported outcome (PROs) used in thrombosis research and clinical practice are delivered using technology like online questionnaires. However, only few have undergone formal electronic adaptation from paper to digital versions, threatening the validity and reliability of the PROs. The present study aimed to perform an electronic adaption and cross-cultural translation of two PROs measuring health-related quality of life in a Danish cohort of patients with venous thrombosis (VTE), specifically the VEINES-QoL/Sym questionnaire and the PEmb-QoL questionnaire. METHODS The electronic adaption and cross-cultural translation processes followed the international guidelines recommended by ISPOR. The migration of the questionnaires from paper to electronic versions was conducted in the Research Electronic Data Capture (REDCap). Following approval of the electronically adapted and translated versions, a pretest of the questionnaires was performed by cognitive interviewing patients with VTE recruited from a hospital setting. RESULTS Nine men and ten women between the age of 19 and 73 years participated in cognitive interviews. The questionnaires were successfully adapted from paper to electronic versions, and during the migration process only a few modifications to the content and format were made. Most comments were related to technicalities, e.g. touch functions and checkboxes. The cross-cultural translation of both questionnaires was satisfactory, as only minor rephrasing was required. CONCLUSIONS The original and Danish version of VEINES-QoL/Sym and PEmb-QoL were successfully adapted into electronic versions and are ready to share for REDCap users. Furthermore, the Danish versions of the two questionnaires have shown satisfactory face validity.
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Affiliation(s)
- Stine Foged Lindegaard
- Danish Center for Health Services Research, Aalborg University Hospital and Aalborg University , Aalborg, Denmark
| | - Anette Arbjerg Højen
- Danish Center for Health Services Research, Aalborg University Hospital and Aalborg University , Aalborg, Denmark
| | - Nanna Rolving
- Department of Physical and Occupational Therapy, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus N, 8200, Denmark.
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14
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Hirayama T, Ishiki H, Yanai Y, Horiguchi S, Sugisawa A, Sato J, Kojima R, Sato K, Mizuta T, Kojima R, Udagawa R, Kojima Y, Satomi E. Feasibility of an Electronic Patient-Reported Outcome Tool for Screening Distress and Supportive Care Needs of Adolescents and Young Adults with Cancer. J Adolesc Young Adult Oncol 2024; 13:138-146. [PMID: 37252764 PMCID: PMC10890963 DOI: 10.1089/jayao.2023.0014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
Purpose: Although adolescent and young adult (AYA) cancer patients are digital natives and have high digital communication needs, previous studies of screening tools for AYAs have primarily used paper when measuring patient-reported outcomes (PROs). There are no reports on using an electronic PRO (ePRO) screening tool with AYAs. This study evaluated the feasibility of such a tool in clinical settings, and assessed the prevalence of AYAs' distress and supportive care needs. Methods: An ePRO tool based on the Distress Thermometer and Problem List (DTPL)-Japanese (DTPL-J) version for AYAs was implemented in a clinical setting for 3 months. To determine the prevalence of distress and need for supportive care, descriptive statistics were calculated for participant characteristics, selected items, and Distress Thermometer (DT) scores. Response rates, referral rates to an attending physician and other experts, and time required to complete PRO tools were assessed to evaluate feasibility. Results: From February to April 2022, 244 (93.8%) of 260 AYAs completed the ePRO tool based on the DTPL-J for AYAs. Based on a DT cutoff of ≥5, 65 of 244 patients (26.6%) had high distress. Worry (n = 81, 33.2%) was the most frequently selected item. Primary nurses referred 85 (32.7%) patients to an attending physician or other experts. The referral rate resulting from ePRO screening was significantly higher than that after PRO screening (χ2(1) = 17.99, p < 0.001). The average response time did not differ significantly between ePRO and PRO screening (p = 0.252). Conclusion: This study suggests the feasibility of an ePRO tool based on the DTPL-J for AYAs.
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Affiliation(s)
- Takatoshi Hirayama
- Department of Psycho-Oncology and National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Hiroto Ishiki
- Department of Palliative Medicine, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Yuko Yanai
- Department of Psycho-Oncology and National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Saki Horiguchi
- Department of Nursing, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Akiko Sugisawa
- Department of Nursing, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Jun Sato
- Department of Nursing, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Ryugo Kojima
- Department of Nursing, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Kaori Sato
- Department of Nursing, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Tomoko Mizuta
- Department of Psycho-Oncology and National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Rebekah Kojima
- Department of Palliative Medicine, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Ryoko Udagawa
- Department of Pharmacy, and National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Yuki Kojima
- Department of Medical Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Eriko Satomi
- Department of Palliative Medicine, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
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15
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Shah R, Badawy SM. Health-related quality of life with standard and curative therapies in thalassemia: A narrative literature review. Ann N Y Acad Sci 2024; 1532:50-62. [PMID: 38270933 PMCID: PMC10923063 DOI: 10.1111/nyas.15100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
Health-related quality of life (HRQOL) is a patient-reported outcome that assesses the impact of a disease or illness on different domains of a patient's life. Different general and disease-specific measures can be used to evaluate HRQOL. This article aimed to summarize the evidence for HRQOL among patients with transfusion-dependent (TDT) and non-transfusion-dependent thalassemia (NTDT). We included HRQOL data related to standard therapy with blood transfusions, iron chelation, and/or luspatercept in TDT and NTDT, as well as curative therapies for TDT, including hematopoietic stem cell transplant (HSCT) and gene therapy. Patients with thalassemia had worse HRQOL scores compared to the general population, and chronic pain was seen to increase in frequency and severity over time with age. NTDT patients reported worse physical health and functioning, mental health, general health, and vitality than TDT patients. However, TDT patients reported worse pain, change in health, and social support than NTDT. Most therapies improved overall HRQOL among thalassemia patients. Deferasirox, an oral iron chelator, was associated with more HRQOL benefits compared to deferoxamine, an intravenous iron chelator. Luspatercept showed clinically meaningful improvement in physical functioning among TDT and NTDT. Furthermore, HSCT and gene therapy were associated with better physical, emotional, and mental domains scores.
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Affiliation(s)
- Richa Shah
- Department of Medical Education, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Sherif M. Badawy
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Division of Hematology, Oncology, and Stem Cell Transplant, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois, USA
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16
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Mowlem FD, Elash CA, Dumais KM, Haenel E, O'Donohoe P, Olt J, Kalpadakis-Smith AV, James B, Balestrieri G, Becker K, Newara MC, Kern S. Best Practices for the Electronic Implementation and Migration of Patient-Reported Outcome Measures. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2024; 27:79-94. [PMID: 37879401 DOI: 10.1016/j.jval.2023.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 10/11/2023] [Accepted: 10/17/2023] [Indexed: 10/27/2023]
Abstract
While the use of electronic methods to collect patient-reported outcome data in clinical trials continues to increase, it remains the case that many patient-reported outcome measures (PROMs) have originally been developed and validated on paper. Careful consideration during the move from paper PROMs to electronic format is required to preserve the integrity of the measure and ensure a "faithful migration." Relevant literature has long called out the importance of following migration best practices during this process; nevertheless, such best practices are distributed across multiple documents. This article consolidates and builds upon existing electronic PROM implementation best practice recommendations to provide a comprehensive, up-to-date, single point of reference. It reflects the current consensus based on the significant advances in technology capabilities and knowledge gleaned from the growing evidence base on electronic migration and implementation, to balance the need for maintaining the integrity of the measure while optimizing respondent usability. It also specifies whether the practice is rooted in evidence or expert consensus, to enable those using these best practices to make informed and considered decisions when conducting migration.
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17
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Golden AH, Gabriel MH, Russo J, Price M, Ruhmel S, Nilsson A, Delong PS, Jelsma J, Carty M. Let's talk about it: an exploration of the comparative use of three different digital platforms to gather patient-reported outcome measures. J Patient Rep Outcomes 2023; 7:130. [PMID: 38085402 PMCID: PMC10716086 DOI: 10.1186/s41687-023-00666-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 11/20/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Patient-reported outcome (PRO) measures provide valuable evidence in clinical trials; however, poor compliance with PRO measures is a notable and long-standing problem, resulting in missing data that potentially impact the interpretation of trial results. Interactive, patient-centric platforms may increase participants' motivation to complete PRO measures over the course of a clinical trial. Thus, the aim of this study was to evaluate and optimize the usability of 3 popular consumer technologies-a traditional app-based interface, a chatbot interface, and a speech-operated interface-that may be used to improve user engagement and compliance with PRO measures. METHODS Participants aged 18-75 years from the general United States population tested the usability of 3 ePRO platforms: a traditional app-based interface using Datacubed Health Platform (Datacubed), a web-based chatbot interface using the Orbita platform, and a speech-operated Alexa interface using an Alexa Skill called "My Daily Wellness." The usability of these platforms was tested with 2 PRO measures: the EQ-5D-5 L and the SF-12v2 Health Survey (SF-12v2), Daily recall. Using a crossover design, 3 cohorts of participants tested each ePRO platform daily for 1 week. After testing, interviews were conducted regarding the participants' experience with each platform. RESULTS A total of 24 adults participated in the study. The mean age of participants was 45 years (range, 21-71 years), and half were female (n = 12; 50%). Overall, participants prioritized speed, ease of use, and device portability in selecting their preferred platform. The Datacubed app met these criteria and was the preferred platform among most participants (n = 20; 83%). Participants also suggested various modifications to the platforms, such as programmable notifications, adjustable speed, and additional daily reminders. CONCLUSIONS These data demonstrate the importance of speed, ease of use, and device portability, features that are currently incorporated in the Datacubed app, in ePRO platforms used in future clinical trials. Additionally, the usability of ePRO platforms may be optimized by adding programmable notifications, adjustable speed, and increased daily reminders. The results of this study may be used to enhance the usability and patient centricity of these platforms to improve user compliance and engagement during clinical trials.
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Affiliation(s)
| | | | - Jon Russo
- RTI Health Solutions, Research Triangle Park, NC, USA
| | - Mark Price
- RTI Health Solutions, Research Triangle Park, NC, USA
| | - Stephen Ruhmel
- Janssen Research & Development, LLC, 920 Route 202, Raritan, NJ, 08869, USA.
| | - Ami Nilsson
- Janssen Research & Development, LLC, 920 Route 202, Raritan, NJ, 08869, USA
| | | | - Jennifer Jelsma
- EuroQol Research Foundation, Rotterdam, Netherlands
- Department of Health and Rehabilitation Sciences, University of Cape Town, Cape Town, South Africa
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18
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Rautenberg TA, Ng SKA, Downes M. A cross-sectional study of symptoms and health-related quality of life in menopausal-aged women in China. BMC Womens Health 2023; 23:563. [PMID: 37915020 PMCID: PMC10621238 DOI: 10.1186/s12905-023-02728-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 10/24/2023] [Indexed: 11/03/2023] Open
Abstract
OBJECTIVE To measure symptoms and health-related quality of life in a cross-sectional cohort of menopausal-aged women in China. METHOD A cross-sectional survey was conducted in a general population cohort of 2,000 Chinese females over the age of 45 years. Patients completed the Chinese version of the EuroQol-5D five level (EQ5D5L) health-related quality of life instrument via Personal Digital Assistant. Raw scores were converted to utility tariffs using value sets for China. Statistical analysis included Pearson's chi-square test, z test for multiple comparisons with adjustment by the Bonferroni method, independent-sample t-test, ANOVA, and adjustment by the Tukey method for multiple comparison. Results were considered statistically significant when p < 0.05 and the study was reported according to the STROBE recommendations. RESULTS In a cohort of 2000 women, 732 (37%) were premenopausal, 798 (40%) were perimenopausal and 470 (23%) were postmenopausal. Perimenopausal women reported significantly more symptoms (91%) compared to premenopausal (77%) and postmenopausal (81%) women. Health-related quality of life was significantly lower in symptomatic perimenopausal women compared to premenopausal (0.919, p < 0.05) and postmenopausal (0.877, p < 0.05) women. Within each group there was a statistically significant difference between the health-related quality of life of women with symptoms compared to without symptoms. CONCLUSION The perimenopausal phase of menopause is associated with significantly more symptoms and significantly lower HRQoL compared to premenopausal and postmenopausal phases.
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Affiliation(s)
- Tamlyn A Rautenberg
- Centre for Applied Health Economics, Griffith University, Brisbane, Australia.
- Menzies Health Institute Queensland, Brisbane, Australia.
- Metro North Hospital and Health Service, Brisbane, Australia.
| | - Shu Kay Angus Ng
- Centre for Applied Health Economics, Griffith University, Brisbane, Australia
| | - Martin Downes
- Centre for Applied Health Economics, Griffith University, Brisbane, Australia
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McMullan C, Retzer A, Hughes SE, Aiyegbusi OL, Bathurst C, Boyd A, Coleman J, Davies EH, Denniston AK, Dunster H, Frost C, Harding R, Hunn A, Kyte D, Malpass R, McNamara G, Mitchell S, Mittal S, Newsome PN, Price G, Rowe A, van Reil W, Walker A, Wilson R, Calvert M. Development and usability testing of an electronic patient-reported outcome (ePRO) solution for patients with inflammatory diseases in an Advanced Therapy Medicinal Product (ATMP) basket trial. J Patient Rep Outcomes 2023; 7:98. [PMID: 37812323 PMCID: PMC10562321 DOI: 10.1186/s41687-023-00634-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 09/10/2023] [Indexed: 10/10/2023] Open
Abstract
BACKGROUND Electronic patient-reported outcome (ePRO) systems are increasingly used in clinical trials to provide evidence of efficacy and tolerability of treatment from the patient perspective. The aim of this study is twofold: (1) to describe how we developed an electronic platform for patients to report their symptoms, and (2) to develop and undertake usability testing of an ePRO solution for use in a study of cell therapy seeking to provide early evidence of efficacy and tolerability of treatment and test the feasibility of the system for use in later phase studies. METHODS An ePRO system was designed to be used in a single arm, multi-centre, phase II basket trial investigating the safety and activity of the use of ORBCEL-C™ in the treatment of patients with inflammatory conditions. ORBCEL-C™ is an enriched Mesenchymal Stromal Cells product isolated from human umbilical cord tissue using CD362+ cell selection. Usability testing sessions were conducted using cognitive interviews and the 'Think Aloud' method with patient advisory group members and Research Nurses to assess the usability of the system. RESULTS Nine patient partners and seven research nurses took part in one usability testing session. Measures of fatigue and health-related quality of life, the PRO-CTCAE™ and FACT-GP5 global tolerability question were included in the ePRO system. Alert notifications to the clinical team were triggered by PRO-CTCAE™ and FACT-GP5 scores. Patient participants liked the simplicity and responsiveness of the patient-facing app. Two patients were unable to complete the testing session, due to technical issues. Research Nurses suggested minor modifications to improve functionality and the layout of the clinician dashboard and the training materials. CONCLUSION By testing the effectiveness, efficiency, and satisfaction of our novel ePRO system (PROmicsR), we learnt that most people with an inflammatory condition found it easy to report their symptoms using an app on their own device. Their experiences using the PROmicsR ePRO system within a trial environment will be further explored in our upcoming feasibility testing. Research nurses were also positive and found the clinical dashboard easy-to-use. Using ePROs in early phase trials is important in order to provide evidence of therapeutic responses and tolerability, increase the evidence based, and inform methodology development. TRIAL REGISTRATION ISRCTN, ISRCTN80103507. Registered 01 April 2022, https://www.isrctn.com/ISRCTN80103507.
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Affiliation(s)
- Christel McMullan
- Centre for Patient Reported Outcome Research (CPROR), Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
- NIHR Surgical Reconstruction and Microbiology Research Centre, University of Birmingham, Birmingham, UK.
- Centre for Trauma Science Research, University of Birmingham, Birmingham, UK.
| | - Ameeta Retzer
- Centre for Patient Reported Outcome Research (CPROR), Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
- NIHR Surgical Reconstruction and Microbiology Research Centre, University of Birmingham, Birmingham, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
| | - Sarah E Hughes
- Centre for Patient Reported Outcome Research (CPROR), Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
- National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) West Midlands, Birmingham, UK
| | - Olalekan Lee Aiyegbusi
- Centre for Patient Reported Outcome Research (CPROR), Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
- National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) West Midlands, Birmingham, UK
- National Institute for Health Research (NIHR) Biomedical Research Centre at University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham, Birmingham, UK
| | - Camilla Bathurst
- National Institute for Health Research (NIHR) Biomedical Research Centre at University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham, Birmingham, UK
- Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, UK
| | | | - Jamie Coleman
- Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | | | - Alastair K Denniston
- Centre for Patient Reported Outcome Research (CPROR), Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
- DEMAND Hub, University of Birmingham, Birmingham, UK
- Health Data Research UK, London, UK
- Academic Unit of Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- National Institute of Health Research Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and University College London, Institute of Ophthalmology, London, UK
| | | | | | - Rosie Harding
- Birmingham Law School, University of Birmingham, Birmingham, UK
| | | | - Derek Kyte
- School of Allied Health & Community, University of Worcester, Worcester, UK
| | - Rebecca Malpass
- National Institute for Health Research (NIHR) Biomedical Research Centre at University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham, Birmingham, UK
- Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, UK
| | | | | | | | - Philip N Newsome
- Centre for Patient Reported Outcome Research (CPROR), Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
- National Institute for Health Research (NIHR) Biomedical Research Centre at University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham, Birmingham, UK
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - Gary Price
- Centre for Patient Reported Outcome Research (CPROR), Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Anna Rowe
- National Institute for Health Research (NIHR) Biomedical Research Centre at University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham, Birmingham, UK
- Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, UK
| | - Wilma van Reil
- Research Governance, University Hospital Birmingham, Birmingham, UK
| | - Anita Walker
- Centre for Patient Reported Outcome Research (CPROR), Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
- NIHR Surgical Reconstruction and Microbiology Research Centre, University of Birmingham, Birmingham, UK
| | - Roger Wilson
- Centre for Patient Reported Outcome Research (CPROR), Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
- National Cancer Research Institute (NCRI) Consumer Forum, London, UK
| | - Melanie Calvert
- Centre for Patient Reported Outcome Research (CPROR), Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
- NIHR Surgical Reconstruction and Microbiology Research Centre, University of Birmingham, Birmingham, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
- National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) West Midlands, Birmingham, UK
- National Institute for Health Research (NIHR) Biomedical Research Centre at University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham, Birmingham, UK
- DEMAND Hub, University of Birmingham, Birmingham, UK
- Health Data Research UK, London, UK
- Midlands Health Data Research UK, Birmingham, UK
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Narra LR, Verdini N, Lapen K, Nipp R, Gillespie EF. Patient-Reported Outcomes in Clinical Trials: From an Endpoint to an Intervention in Cancer Care. Semin Radiat Oncol 2023; 33:358-366. [PMID: 37684065 DOI: 10.1016/j.semradonc.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2023]
Abstract
Underreporting of patient symptoms by clinicians is a common and well-documented phenomenon that has led to integrating patient-reported outcomes (PROs) as endpoints into clinical trials. While PROs are often used to measure disease symptoms, cancer therapy toxicities, and quality of life, they can also assess patients' general experiences and preferences. With the increasing use of electronic medical records and the digital health revolution in oncology, conversion from paper to electronic PROs (ePROs) has also facilitated the integration of PROs into routine care. Evidence from clinical trials is rapidly emerging to support ePROs as a care delivery innovation, given the potential for ePROs to improve patient outcomes through timely evaluation and response to patient needs. Meanwhile, work is ongoing to understand and address ePRO use and challenges to equitable integration, including technical and language barriers for patients, clinicians, and health systems. Nonetheless, the health system and regulatory bodies continue to develop stipulations to promote the use of ePROs. Herein, we review the evolution of PROs from an endpoint to an intervention in prospective clinical trials in oncology.
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Affiliation(s)
| | - Nicholas Verdini
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Kaitlyn Lapen
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Ryan Nipp
- Division of Hematology-Oncology, University of Oklahoma, Oklahoma City, OK
| | - Erin F Gillespie
- Department of Radiation Oncology, University of Washington, Seattle, WA; Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY.
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21
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Philipps L, Foster S, Gardiner D, Gath J, Gillman A, Haviland J, Hill E, King D, Manning G, Stiles M, Hall E, Lewis R. Study within a trial of electronic versus paper-based Patient-Reported oUtcomes CollEction (SPRUCE): study protocol for a partially randomised patient preference study. BMJ Open 2023; 13:e073817. [PMID: 37734892 PMCID: PMC10514621 DOI: 10.1136/bmjopen-2023-073817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 08/30/2023] [Indexed: 09/23/2023] Open
Abstract
INTRODUCTION Patient-reported outcomes (PRO) are currently collected from trial participants using paper questionnaires by the Clinical Trials and Statistics Unit at The Institute of Cancer Research (ICR-CTSU). Streamlining PRO collection using electronic questionnaires (ePRO) may improve data collection and patient experience. Here, we outline our protocol for a Study within a trial of electronic versus paper-based Patient-Reported oUtcomes CollEction (SPRUCE), which investigates the acceptability of ePRO in oncology clinical trials. METHODS AND ANALYSIS SPRUCE was developed alongside patient and public contributors. SPRUCE runs in multiple host trials with a partially randomised patient preference design, allowing participants to be randomised or choose their preference of electronic or paper questionnaires. Questionnaires are scheduled in accordance with host trial follow-up. The primary objective will assess differences in return rates (compliance) between ePRO and paper PROs at the first timepoint post-host trial intervention in the randomised group. Paper PRO compliance is expected to be 90%. 244 randomised participants are required to exclude ≤80% compliance rates with ePRO (10% non-inferiority margin, with 80% power and one-sided alpha=0.05). SPRUCE aims to assess acceptability of ePRO in oncology clinical trials, establish whether ePRO is acceptable to ICR-CTSU trial participants and can capture complete PRO data, consistent with paper PROs. ETHICS AND DISSEMINATION The SPRUCE protocol (ICR-CTSU/2021/10074) was approved by the Coventry and Warwick Central Research Ethics Committee (21/WM/0223) on 21 October 2021. Results will be disseminated via presentations, publications and lay summaries. No participant identifiable data will be included. TRIAL REGISTRATION SWAT169.
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Affiliation(s)
- Lara Philipps
- Clinical Trials and Statistics Unit (ICR-CTSU), The Institute of Cancer Research, London, UK
| | - Stephanie Foster
- Clinical Trials and Statistics Unit (ICR-CTSU), The Institute of Cancer Research, London, UK
| | - Deborah Gardiner
- Clinical Trials and Statistics Unit (ICR-CTSU), The Institute of Cancer Research, London, UK
| | - Jacqui Gath
- Independent Patient Representative, London, UK
| | - Alexa Gillman
- Clinical Trials and Statistics Unit (ICR-CTSU), The Institute of Cancer Research, London, UK
| | - Joanne Haviland
- Pragmatic Clinical Trials Unit, Queen Mary University of London, London, UK
| | - Elizabeth Hill
- Clinical Trials and Statistics Unit (ICR-CTSU), The Institute of Cancer Research, London, UK
| | - Diana King
- Independent Patient Representative, London, UK
| | - Georgina Manning
- Clinical Trials and Statistics Unit (ICR-CTSU), The Institute of Cancer Research, London, UK
| | - Morgaine Stiles
- Clinical Trials and Statistics Unit (ICR-CTSU), The Institute of Cancer Research, London, UK
| | - Emma Hall
- Clinical Trials and Statistics Unit (ICR-CTSU), The Institute of Cancer Research, London, UK
| | - Rebecca Lewis
- Clinical Trials and Statistics Unit (ICR-CTSU), The Institute of Cancer Research, London, UK
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Salm H, Hentschel L, Eichler M, Pink D, Fuhrmann S, Kramer M, Reichardt P, Schuler MK. Evaluation of electronic patient-reported outcome assessment in inpatient cancer care: a feasibility study. Support Care Cancer 2023; 31:575. [PMID: 37707633 PMCID: PMC10501936 DOI: 10.1007/s00520-023-08014-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 08/23/2023] [Indexed: 09/15/2023]
Abstract
PURPOSE Patient-reported outcome (PRO) measures are increasingly important in evaluating medical care. The increased integration of technology within the healthcare systems allows for collection of PROs electronically. The objectives of this study were to Ashley et al. J Med Internet Res (2013) implement an electronic assessment of PROs in inpatient cancer care and test its feasibility for patients and Dawson et al. BMJ (2010) determine the equivalence of the paper and electronic assessment. METHODS We analyzed two arms from a study that was originally designed to be an interventional, three-arm, and multicenter inpatient trial. A self-administered questionnaire based on validated PRO-measures was applied and completed at admission, 1 week after, and at discharge. For this analysis - focusing on feasibility of the electronic assessment - the following groups will be considered: Group A (intervention arm) received a tablet version, while group B (control arm) completed the questionnaire on paper. A feasibility questionnaire, that was adapted from Ashley et al. J Med Internet Res (2013), was administered to group A. RESULTS We analyzed 103 patients that were recruited in oncology wards. ePRO was feasible to most patients, with 84% preferring the electronic over paper-based assessment. The feasibility questionnaire contained questions that were answered on a scale ranging from "1" (illustrating non achievement) to "5" (illustrating achieving goal). The majority (mean 4.24, SD .99) reported no difficulties handling the electronic tool and found it relatively easy finding time for filling out the questionnaire (mean 4.15, SD 1.05). There were no significant differences between the paper and the electronic assessment regarding the PROs. CONCLUSION Results indicate that electronic PRO assessment in inpatient cancer care is feasible.
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Affiliation(s)
- Hanna Salm
- Department of Internal Medicine C, University Hospital Greifswald, Greifswald, Germany.
- Sarcoma Center Berlin-Brandenburg, Helios Hospital Bad Saarow, Bad Saarow, Germany.
| | | | - Martin Eichler
- National Center for Tumor Diseases (NCT/UCC), Dresden, Germany
| | - Daniel Pink
- Department of Internal Medicine C, University Hospital Greifswald, Greifswald, Germany
- Sarcoma Center Berlin-Brandenburg, Helios Hospital Bad Saarow, Bad Saarow, Germany
| | - Stephan Fuhrmann
- Clinic for Hematology and Oncology, Helios Hospital Emil von Behring Berlin, Berlin, Germany
| | | | - Peter Reichardt
- Clinic for Oncology and Palliative Medicine, Helios Hospital Berlin Buch, Berlin, Germany
| | - Markus K Schuler
- Division of Hematology, Oncology and Stem Cell Transplantation, Medical Clinic I, Department of Medicine I, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
- Onkologischer Schwerpunkt am Oskar-Helene-Heim, Berlin, Germany
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23
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Kortbeek S, Hossain A, John T, Ng VL. Equivalence of the adapted electronic Pediatric Liver Transplant Quality of Life (PeLTQL) questionnaire: A patient-reported outcome measure for children and teens. Liver Transpl 2023; 29:1012-1015. [PMID: 36940170 DOI: 10.1097/lvt.0000000000000129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 02/28/2023] [Indexed: 03/21/2023]
Affiliation(s)
- Simone Kortbeek
- Section of Pediatric Gastroenterology, Hepatology, and Nutrition, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada
| | - Alomgir Hossain
- Clinical Research Services, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Tomisin John
- Division of Gastroenterology, Hepatology, and Nutrition, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
- Transplant and Regenerative Medicine Centre, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Vicky L Ng
- Division of Gastroenterology, Hepatology, and Nutrition, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
- Transplant and Regenerative Medicine Centre, The Hospital for Sick Children, Toronto, Ontario, Canada
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24
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Nagino K, Okumura Y, Akasaki Y, Fujio K, Huang T, Sung J, Midorikawa-Inomata A, Fujimoto K, Eguchi A, Hurramhon S, Yee A, Miura M, Ohno M, Hirosawa K, Morooka Y, Murakami A, Kobayashi H, Inomata T. Smartphone App-Based and Paper-Based Patient-Reported Outcomes Using a Disease-Specific Questionnaire for Dry Eye Disease: Randomized Crossover Equivalence Study. J Med Internet Res 2023; 25:e42638. [PMID: 37535409 PMCID: PMC10436120 DOI: 10.2196/42638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 03/22/2023] [Accepted: 07/12/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND Using traditional patient-reported outcomes (PROs), such as paper-based questionnaires, is cumbersome in the era of web-based medical consultation and telemedicine. Electronic PROs may reduce the burden on patients if implemented widely. Considering promising reports of DryEyeRhythm, our in-house mHealth smartphone app for investigating dry eye disease (DED) and the electronic and paper-based Ocular Surface Disease Index (OSDI) should be evaluated and compared to determine their equivalency. OBJECTIVE The purpose of this study is to assess the equivalence between smartphone app-based and paper-based questionnaires for DED. METHODS This prospective, nonblinded, randomized crossover study enrolled 34 participants between April 2022 and June 2022 at a university hospital in Japan. The participants were allocated randomly into 2 groups in a 1:1 ratio. The paper-app group initially responded to the paper-based Japanese version of the OSDI (J-OSDI), followed by the app-based J-OSDI. The app-paper group responded to similar questionnaires but in reverse order. We performed an equivalence test based on minimal clinically important differences to assess the equivalence of the J-OSDI total scores between the 2 platforms (paper-based vs app-based). A 95% CI of the mean difference between the J-OSDI total scores within the ±7.0 range between the 2 platforms indicated equivalence. The internal consistency and agreement of the app-based J-OSDI were assessed with Cronbach α coefficients and intraclass correlation coefficient values. RESULTS A total of 33 participants were included in this study. The total scores for the app- and paper-based J-OSDI indicated satisfactory equivalence per our study definition (mean difference 1.8, 95% CI -1.4 to 5.0). Moreover, the app-based J-OSDI total score demonstrated good internal consistency and agreement (Cronbach α=.958; intraclass correlation=0.919; 95% CI 0.842 to 0.959) and was significantly correlated with its paper-based counterpart (Pearson correlation=0.932, P<.001). CONCLUSIONS This study demonstrated the equivalence of PROs between the app- and paper-based J-OSDI. Implementing the app-based J-OSDI in various scenarios, including telehealth, may have implications for the early diagnosis of DED and longitudinal monitoring of PROs.
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Affiliation(s)
- Ken Nagino
- Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yuichi Okumura
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yasutsugu Akasaki
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
- AI Incubation Farm, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kenta Fujio
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Tianxiang Huang
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Jaemyoung Sung
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Akie Midorikawa-Inomata
- Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Keiichi Fujimoto
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Atsuko Eguchi
- Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Shokirova Hurramhon
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Alan Yee
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Maria Miura
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Mizu Ohno
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kunihiko Hirosawa
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yuki Morooka
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Akira Murakami
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hiroyuki Kobayashi
- Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Takenori Inomata
- Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
- AI Incubation Farm, Juntendo University Graduate School of Medicine, Tokyo, Japan
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Zolnowski-Kolp V, Um Din N, Havreng-Théry C, Pariel S, Veyron JH, Lafuente-Lafuente C, Belmin J. Assessment of Frailty by the French Version of the Vulnerable Elders Survey-13 on Digital Tablet: Validation Study. J Med Internet Res 2023; 25:e42017. [PMID: 37531175 PMCID: PMC10433029 DOI: 10.2196/42017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 04/30/2023] [Accepted: 04/30/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND Frailty assessment is a major issue in geriatric medicine. The Vulnerable Elders Survey-13 (VES-13) is a simple and practical tool that identifies frailty through a 13-item questionnaire completed by older adults or their family caregivers by self-administration (pencil and paper) or by telephone interview. The VES-13 provides a 10-point score that is also a recognized mortality predictor. OBJECTIVE This study aims to design an electronic version of the Echelle de Vulnérabilité des Ainés-13, the French version of the VES-13 (eEVA-13) for use on a digital tablet and validate it. METHODS The scale was implemented as a web App in 3 different screens and used on an Android tablet (14.0× 25.6 cm). Participants were patients attending the outpatient clinic of a French geriatric hospital or hospitalized in a rehabilitation ward and family caregivers of geriatric patients. They completed the scale twice, once by a reference method (self-administered questionnaire or telephone interview) and once by eEVA-13 using the digital tablet. Agreement for diagnosis of frailty was assessed with the κ coefficient, and scores were compared by Bland and Altman plots and interclass correlation coefficients. User experience was assessed by a self-administered questionnaire. RESULTS In total, 86 participants, including 40 patients and 46 family caregivers, participated in the study. All family caregivers had previously used digital devices, while 13 (32.5%) and 10 (25%) patients had no or infrequent use of them previously. We observed no failure to complete the eEVA-13, and 70% of patients (28/40) and no family caregivers needed support to complete the eEVA-13. The agreement between the eEVA-13 and the reference method for the diagnosis of frailty was excellent (κ=0.92) with agreement in 83 cases and disagreement in 3 cases. The mean difference between the scores provided by the 2 scales was 0.081 (95% CI-1.263 to 1.426). Bland and Altman plots showed a high level of agreement between the eEVA-13 and the reference methods and interclass correlation coefficient value was 0.997 (95% CI 0.994-0.998) for the paper and tablet group and 0.977 (95% CI 0.957-0.988) for the phone and tablet groups. The tablet assessment was found to be easy to use by 77.5% (31/40) of patients and by 96% (44/46) of caregivers. Finally, 85% (39/46) of family caregivers and 50% (20/40) of patients preferred the eEVA-13 to the original version. CONCLUSIONS The eEVA-13 is an appropriate digital tool for diagnosing frailty and can be used by older adults and their family caregivers. The scores obtained with eEVA-13 are highly correlated with those obtained with the original version. The use of health questionnaires on digital tablets is feasible in frail and very old patients, although some patients may need help to use them.
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Affiliation(s)
- Victoria Zolnowski-Kolp
- LivingLab Pratiques en santé dans le grand âge, Hôpital Charles Foix, Ivry-sur-Seine, France
| | - Nathavy Um Din
- LivingLab Pratiques en santé dans le grand âge, Hôpital Charles Foix, Ivry-sur-Seine, France
- Sorbonne Université and Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire d'Informatique Médicale et d'Ingénierie des Connaissances pour la e-Santé (LIMICS), Paris, France
| | - Charlotte Havreng-Théry
- Sorbonne Université and Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire d'Informatique Médicale et d'Ingénierie des Connaissances pour la e-Santé (LIMICS), Paris, France
- Presage Care, Paris, France
| | - Sylvie Pariel
- Service de gériatrie ambulatoire, Hôpital Charles Foix, Ivry-sur-Seine, France
| | | | - Carmelo Lafuente-Lafuente
- Service de gériatrie à orientation cardiovasculaire et neuropsychogériatrique, Hôpital Charles Foix, Ivry-sur-Seine, France
- Clinical Epidemiology and Ageing (CEpiA), Unit Institut National de la Santé et de la Recherche Médicale (INSERM), Créteil, France
| | - Joel Belmin
- LivingLab Pratiques en santé dans le grand âge, Hôpital Charles Foix, Ivry-sur-Seine, France
- Sorbonne Université and Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire d'Informatique Médicale et d'Ingénierie des Connaissances pour la e-Santé (LIMICS), Paris, France
- Service de gériatrie à orientation cardiovasculaire et neuropsychogériatrique, Hôpital Charles Foix, Ivry-sur-Seine, France
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Pan J, Yap N, Prasse T, Hofstetter CP. Validation of smartphone app-based digital patient reported outcomes in full-endoscopic spine surgery. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2023; 32:2903-2909. [PMID: 37405531 DOI: 10.1007/s00586-023-07819-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 06/05/2023] [Accepted: 06/05/2023] [Indexed: 07/06/2023]
Abstract
PURPOSE Patient reported outcome measures (PROMs) are important tools to assess patient function, pain, disability, and quality of life. We aim to study the efficiency and validity of digital PROMs collection using a smartphone app compared to traditional paper PROMs. METHODS Patients undergoing evaluation for full-endoscopic spine surgery were recruited from the outpatient clinic at Harborview Medical Center. Visual analogue scale (VAS), Oswestry disability index (ODI), and EQ5-5D PROMs were administered on paper and through a smartphone app called SpineHealthie. Compliance rates were collected, and PROM results were assessed for correlation between paper and digital methods. RESULTS 123 patients were enrolled. 57.7% of patients completed paper PROMs, 82.9% completed digital PROMs, and 48.8% completed both. Of the patients that completed both, Spearman's correlation was greatest for VAS leg, ODI, and EQ5 index scores. Correlation was weaker for VAS back pain, neck pain, and upper extremity pain. Patients tended to report lower disability and higher quality of life on the digital PROM compared to the paper PROM. CONCLUSION The SpineHealthie app effectively and accurately collects PROMs digitally, showing strong concordance with traditional paper PROMs. We conclude that digital PROMs constitute a promising strategy for monitoring patients after spine surgery over time.
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Affiliation(s)
- James Pan
- Department of Neurological Surgery, University of Washington, 325 Ninth Ave, Box 359924, Seattle, WA, 98104, USA
| | - Natalie Yap
- Department of Neurological Surgery, University of Washington, 325 Ninth Ave, Box 359924, Seattle, WA, 98104, USA
| | - Tobias Prasse
- Department of Neurological Surgery, University of Washington, 325 Ninth Ave, Box 359924, Seattle, WA, 98104, USA
- Department of Orthopedics and Trauma Surgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Christoph P Hofstetter
- Department of Neurological Surgery, University of Washington, 325 Ninth Ave, Box 359924, Seattle, WA, 98104, USA.
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Nakshbandi G, Moor CC, Wijsenbeek MS. Role of the internet of medical things in care for patients with interstitial lung disease. Curr Opin Pulm Med 2023; 29:285-292. [PMID: 37212372 PMCID: PMC10241441 DOI: 10.1097/mcp.0000000000000971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
PURPOSE OF REVIEW Online technologies play an increasing role in facilitating care for patients with interstitial lung disease (ILD). In this review, we will give an overview of different applications of the internet of medical things (IoMT) for patients with ILD. RECENT FINDINGS Various applications of the IoMT, including teleconsultations, virtual MDTs, digital information, and online peer support, are now used in daily care of patients with ILD. Several studies showed that other IoMT applications, such as online home monitoring and telerehabilitation, seem feasible and reliable, but widespread implementation in clinical practice is lacking. The use of artificial intelligence algorithms and online data clouds in ILD is still in its infancy, but has the potential to improve remote, outpatient clinic, and in-hospital care processes. Further studies in large real-world cohorts to confirm and clinically validate results from previous studies are needed. SUMMARY We believe that in the near future innovative technologies, facilitated by the IoMT, will further enhance individually targeted treatment for patients with ILD by interlinking and combining data from various sources.
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Affiliation(s)
- Gizal Nakshbandi
- Department of Respiratory Medicine, Erasmus University Medical Centre, Rotterdam, The Netherlands
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Morga A, Dibenedetto S, Adiutori R, Su J. Patient-reported outcomes validated in phase 3 clinical trials: a targeted literature review. Curr Med Res Opin 2023; 39:955-962. [PMID: 37337959 DOI: 10.1080/03007995.2023.2224164] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 06/06/2023] [Accepted: 06/08/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUND Regulatory guidance advises validation of patient-reported outcome (PRO) instruments prior to use in pivotal clinical studies, which may then be used to generate critical patient-centered evidence and support labelling claims. This targeted literature review aimed to determine if PRO instruments psychometrically validated in a phase 3 trial setting could support label claims from the same phase 3 study (i.e. PRO data were generated as an endpoint). METHODS A targeted search of published studies (1 January 2006-3 June 2021) using the MEDLINE database identified PRO instruments validated during phase 3 trials. The search included instrument terms (e.g. patient-reported outcome measures, questionnaire, survey) and validation terms (e.g. reproducibility, minimal important difference), without filtering for therapeutic indications. Results were limited to phase 3 clinical trials or validation studies. The PROLABELS database was used to identify PROs validated in phase 3 trials and accepted in labelling claims. RESULTS Of 355 references identified, 68 studies with PRO psychometric validation in phase 3 studies were selected, covering 78 instruments. Of these, 20 were novel PRO instruments and 58 were existing instruments being validated for a new therapeutic indication/population. The psychometric properties most frequently validated were internal consistency reliability, known-group validity, responsiveness, minimal important difference, and concurrent validity. Five novel instruments obtained ten labelling claims for seven drugs/products. CONCLUSIONS These results suggest that quantitative validation of novel PRO instruments, and existing PROs for new indications, can occur within the context of phase 3 trials, and these PROs can also support label claims.
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Affiliation(s)
| | | | | | - Jun Su
- Astellas Pharma Inc, Westborough, MA, USA
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Degenhardt T, Fasching PA, Lüftner D, Müller V, Thomssen C, Schem C, Witzel I, Decker T, Tesch H, Kümmel S, Uleer C, Wuerstlein R, Hoffmann O, Warm M, Marschner N, Schinköthe T, Kates RE, Schumacher J, Otremba B, Zaiss M, Harbeck N, Schmidt M. PRECYCLE: multicenter, randomized phase IV intergroup trial to evaluate the impact of eHealth-based patient-reported outcome (PRO) assessment on quality of life in patients with hormone receptor positive, HER2 negative locally advanced or metastatic breast cancer treated with palbociclib and an aromatase inhibitor or palbociclib and fulvestrant. Trials 2023; 24:338. [PMID: 37198674 DOI: 10.1186/s13063-023-07306-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 04/11/2023] [Indexed: 05/19/2023] Open
Abstract
BACKGROUND Efficacy and quality of life (QoL) are key criteria for therapy selection in metastatic breast cancer (MBC). In hormone receptor positive (HR +) human epidermal growth factor receptor 2 negative (HER2 -) MBC, addition of targeted oral agents such as everolimus or a cycline-dependent kinase 4/6 (CDK 4/6) inhibitor (e.g., palbociclib, ribociclib, abemaciclib) to endocrine therapy substantially prolongs progression-free survival and in the case of a CDK 4/6i also overall survival. However, the prerequisite is adherence to therapy over the entire course of treatment. However, particularly with new oral drugs, adherence presents a challenge to disease management. In this context, factors influencing adherence include maintaining patients' satisfaction and early detection/management of side effects. New strategies for continuous support of oncological patients are needed. An eHealth-based platform can help to support therapy management and physician-patient interaction. METHODS PreCycle is a multicenter, randomized, phase IV trial in HR + HER2 - MBC. All patients (n = 960) receive the CDK 4/6 inhibitor palbociclib either in first (62.5%) or later line (37.5%) together with endocrine therapy (AI, fulvestrant) according to national guidelines. PreCycle evaluates and compares the time to deterioration (TTD) of QoL in patients supported by eHealth systems with substantially different functionality: CANKADO active vs. inform. CANKADO active is the fully functional CANKADO-based eHealth treatment support system. CANKADO inform is a CANKADO-based eHealth service with a personal login, documentation of daily drug intake, but no further functions. To evaluate QoL, the FACT-B questionnaire is completed at every visit. As little is known about relationships between behavior (e.g., adherence), genetic background, and drug efficacy, the trial includes both patient-reported outcome and biomarker screening for discovery of forecast models for adherence, symptoms, QoL, progression free survival (PFS), and overall survival (OS). DISCUSSION The primary objective of PreCycle is to test the hypothesis of superiority for time to deterioration (TTD) in terms of DQoL = "Deterioration of quality of life" (FACT-G scale) in patients supported by an eHealth therapy management system (CANKADO active) versus in patients merely receiving eHealth-based information (CANKADO inform). EudraCT Number: 2016-004191-22.
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Affiliation(s)
- Tom Degenhardt
- Breast Center, Department of Obstetrics and Gynecology and CCC Munich, LMU University Hospital, Munich, Germany
- Hausarztpraxis Wolfratshausen, Wolfratshausen, Germany
| | - Peter A Fasching
- Obstetrics and Gynecology, University Hospital Erlangen, Erlangen, Germany
| | - Diana Lüftner
- Immanuel Hospital Märkische Schweiz, Buckow, Germany
- Immanuel Hospital Rüdersdorf and Medical University of Brandenburg Theodor Fontane, Brandenburg, Germany
| | - Volkmar Müller
- Clinic and Polyclinic for Gynecology, Hamburg-Eppendorf University Medical Center, Hamburg, Germany
| | - Christoph Thomssen
- Gynecology, Martin-Luther-University Halle-Wittenberg, Halle-Saale, Germany
| | | | - Isabell Witzel
- Clinic and Polyclinic for Gynecology, Hamburg-Eppendorf University Medical Center, Hamburg, Germany
| | - Thomas Decker
- Hematology/Oncology, Onkologie Ravensburg, Ravensburg, Germany
| | - Hans Tesch
- Hämatologisch-Onkologische Gemeinschaftspraxis, Frankfurt, Germany
| | | | | | - Rachel Wuerstlein
- Breast Center, Department of Obstetrics and Gynecology and CCC Munich, LMU University Hospital, Munich, Germany
- West German Study Group, Moenchengladbach, Germany
| | | | - Mathias Warm
- Breast Center, Academic Hospital Cologne-Holweide, Cologne, Germany
| | | | - Timo Schinköthe
- CANKADO Service GmbH, Kirchheim, Germany
- Research Center Smart Digital Health, University of the Bundeswehr, Neubiberg, Germany
| | | | | | | | - Matthias Zaiss
- Praxis Interdisziplinäre Onkologie U. Hämatologie, Freiburg, Germany
| | - Nadia Harbeck
- Breast Center, Department of Obstetrics and Gynecology and CCC Munich, LMU University Hospital, Munich, Germany.
- West German Study Group, Moenchengladbach, Germany.
| | - Marcus Schmidt
- Department of Obstetrics and Gynecology, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
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Lostelius PV, Mattebo M, Adolfsson ET, Söderlund A, Andersén M, Vadlin S, Revenäs Å. Development and usability evaluation of an electronic health report form to assess health in young people: a mixed-methods approach. BMC Med Inform Decis Mak 2023; 23:91. [PMID: 37165371 PMCID: PMC10170452 DOI: 10.1186/s12911-023-02191-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 05/04/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND Electronic Patient-Reported Outcomes (ePROs) have potential to improve health outcomes and healthcare. The development of health-technology applications, such as ePROs, should include the potential users and be theoretically grounded. Swedish Youth Health Clinics (YHCs) offer primarily sexual and psychological healthcare for young people aged 12 to 25 years old. Young people in healthcare settings are considered a vulnerable group. The development of a collection of Patient-Reported Outcomes (PROs) in an Electronic Health Report Form (eHRF) for identifying health and health-related problems in young people, was preceded by a qualitative interview study, exploring young people's views on using an eHRF at YHCs and which questions about health an eHRF should contain. The aim of the current study was to develop and evaluate the usability of an eHRF prototype for identifying health and health-related problems in young people visiting YHCs. METHODS This study used a participatory design. During the development, an expert panel consisting of eight researchers and one Information Technology worker, participated. A wide literature search was performed to find PROs to construct an eHRF prototype to cover health areas. A mixed methods usability evaluation included 14 participants (young people, healthcare professionals, and an expert panel). RESULTS The development resulted in an eHRF prototype, containing ten reliable and valid health questionnaires addressing mental-, physical-, and sexual health and social support, a self-efficacy question, and background questions, in total 74 items. The interviews in the usability evaluation resulted in three categories describing the usability of the eHRF: 'Captures the overall health of young people but needs clarification', 'Fun, easy, and optional and will keep young people's interest', and 'Potential contribution to improve the health consultation'. The quantitative results support the usability of the eHRF for YHCs. CONCLUSIONS The participatory approach contributed to development of the eHRF prototype to cover health areas adapted for the target population. The usability evaluation showed that the eHRF was usable and had the potential for self-reflection and contributions to cooperation between young people and healthcare professionals during the health consultation.
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Affiliation(s)
- Petra V Lostelius
- Clinic for Pain Rehabilitation Västmanland, Region Västmanland, Västerås, Sweden.
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.
- Centre for Innovation, Research and Education, Region Västmanland, Vastmanland Hospital, Vasteras, Sweden.
| | - Magdalena Mattebo
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | - Eva Thors Adolfsson
- Centre for Clinical Research, Region Västmanland - Uppsala University, Region Vastmanland, Vasteras, Sweden
| | - Anne Söderlund
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | - Mikael Andersén
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Sofia Vadlin
- Centre for Clinical Research, Region Västmanland - Uppsala University, Region Vastmanland, Vasteras, Sweden
| | - Åsa Revenäs
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
- Centre for Clinical Research, Region Västmanland - Uppsala University, Region Vastmanland, Vasteras, Sweden
- Orthopedic Clinic, Västerås hospital Region Västmanland, Västerås, Sweden
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Harji DP, Koh C, McKigney N, Solomon MJ, Griffiths B, Evans M, Heriot A, Sagar PM, Velikova G, Brown JM. Development and validation of a patient reported outcome measure for health-related quality of life for locally recurrent rectal cancer: a multicentre, three-phase, mixed-methods, cohort study. EClinicalMedicine 2023; 59:101945. [PMID: 37256101 PMCID: PMC10225622 DOI: 10.1016/j.eclinm.2023.101945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 03/18/2023] [Accepted: 03/20/2023] [Indexed: 06/01/2023] Open
Abstract
Background Locally recurrent rectal cancer (LRRC) occurs in 5-10% of patients following previous treatment of rectal cancer. It has a significant impact on patients' overall health-related quality of life (HrQoL). Major advances in surgical treatments have led to improved survival outcomes. However, due to the lack of disease-specific, validated patient-reported outcome measure (PROM), HrQoL, is variably assessed. The aim of this study is to develop a disease-specific, psychometrically robust, and validated PROM for use in LRRC. Methods A multicentre, three phase, mixed-methods, observational study was performed across five centres in the UK and Australia. Adult patients (>18 years old) with an existing or previously treated LRRC within the last 2 years were eligible to participate. Patients completed the proposed LRRC-QoL, EORTC QLQ-CR29, and FACT-C questionnaires. Scale structure was analysed using multi-trait scaling analysis and exploratory factor analysis, reliability was assessed using Cronbach's and the intra-class coefficient, convergent validity was assessed using Pearson's correlation, and known-groups comparison was assessed using the student t-test or ANOVA. Findings Between 01/03/2015 and 31/12/2019, 117 patients with a diagnosis of LRRC were recruited. The final scale structure of the LRRC-QoL consisted of nine multi-item scales (healthcare services, psychological impact, pain, urostomy-related symptoms, lower limb symptoms, stoma, sexual function, sexual interest, and urinary symptoms) and three single items. Cronbach's Alpha and Intraclass correlation values of >0.7 across the majority of scales supported overall reliability. Convergent validity was demonstrated between LRRC-QoL Pain Scale and FACT-C Physical Well Being scale (r = 0.528, p < 0.001), LRRC-QoL Psychological Impact scale with EORTC QLQ CR29 Body Image (r = 0.680, p < 0.001) and the FACT-C Emotional Well Being scale (r = 0.326, p < 0.001), and LRRC-QoL Urinary Symptoms scale with EORTC QLQ-CR29 Urinary Frequency scale (r = 0.310, p < 0.001). Known-groups validity was demonstrated for gender, disease location, treatment intent, and re-recurrent disease. Interpretation The LRRC-QoL has demonstrated robust psychometric properties and can be used in clinical and academic practice. Funding None.
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Affiliation(s)
- Deena P. Harji
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
- Manchester University NHS Foundation Trust, Manchester, UK
| | - Cherry Koh
- Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Sydney, NSW, Australia
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, NSW, Australia
- RPA Institute of Academic Surgery, Royal Prince Alfred Hospital, Sydney, NSW, Australia
- Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Niamh McKigney
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - Michael J. Solomon
- Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Sydney, NSW, Australia
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, NSW, Australia
- RPA Institute of Academic Surgery, Royal Prince Alfred Hospital, Sydney, NSW, Australia
- Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Ben Griffiths
- Manchester University NHS Foundation Trust, Manchester, UK
| | - Martyn Evans
- Department of Surgery, Morriston HospitalHeol Maes Eglwys, Morriston, Swansea, Wales, UK
| | - Alexander Heriot
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia
| | - Peter M. Sagar
- The John Goligher Department of Colorectal Surgery, St. James's University Hospital, Leeds, UK
| | - Galina Velikova
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
- St James's Institute of Oncology, St James's University Hospital, Leeds, UK
| | - Julia M. Brown
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
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McLeod LD, Rockwood NJ. Comparability Among Modes of Data Collection for Patient-Reported Outcome Measures: Opening the Gates for Faithful Migration. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2023; 26:620-622. [PMID: 36990208 DOI: 10.1016/j.jval.2023.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 03/21/2023] [Accepted: 03/22/2023] [Indexed: 05/03/2023]
Affiliation(s)
- Lori D McLeod
- Patient-Centered Outcomes Assessment, RTI Health Solutions, Research Triangle Park, NC, USA.
| | - Nicholas J Rockwood
- Patient-Centered Outcomes Assessment, RTI Health Solutions, Research Triangle Park, NC, USA
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O'Donohoe P, Reasner DS, Kovacs SM, Byrom B, Eremenco S, Barsdorf AI, Arnera V, Coons SJ. Updated Recommendations on Evidence Needed to Support Measurement Comparability Among Modes of Data Collection for Patient-Reported Outcome Measures: A Good Practices Report of an ISPOR Task Force. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2023; 26:623-633. [PMID: 37121630 DOI: 10.1016/j.jval.2023.01.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 01/04/2023] [Indexed: 05/03/2023]
Abstract
The ISPOR Task Force on measurement comparability between modes of data collection for patient-reported outcome measures (PROMs) has updated the good practice recommendations from the 2009 ISPOR electronic patient-reported outcome and 2014 patient-reported outcome mixed modes Good Research Practices Task Force reports in light of accumulated evidence of measurement comparability among different modes of PROM data collection. Furthermore, with the increasing use of electronic formats of clinical outcome assessments in clinical trials and the US Food and Drug Administration's encouragement of electronic data collection, this new task force report provides stakeholders with best practice recommendations reflecting the current body of evidence and enables them to respond to future developments in research and technology. This task force recommends an evidence-based approach to determine whether new research is needed to evaluate measurement comparability for a given questionnaire or technology. The suitability of existing evidence depends upon whether it satisfactorily demonstrates that the change in data collection mode has not affected the PROM's measurement properties. In cases where sufficient evidence of measurement comparability exists and best practices for faithful migration are followed, this task force concludes that further testing of measurement comparability among the data collection modes is unnecessary, including cases of "mixing modes" within clinical trials such as bring your own device designs.
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Affiliation(s)
| | - David S Reasner
- Division of Clinical Outcome Assessment, Office of Drug Evaluation Sciences, Office of New Drugs, Center for Drug Evaluation and Research, FDA, Silver Spring, MD, USA
| | - Sarrit M Kovacs
- Division of Gastroenterology, Office of Immunology and Inflammation, Office of New Drugs, Center for Drug Evaluation and Research, FDA, Silver Spring, MD, USA
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Zhao X, Tong Z, Sun L, Zhang Q, Du X, Xu S, Shen C, Wei Y, Liu W, Miao L, Zeng Y. Clinical Characteristics, Treatment Patterns, and Effectiveness in Chinese Patients with Angina Pectoris Using Electronic Patient-Reported Outcomes: Protocol for a Multicenter, Prospective, Cohort Study (GREAT). Adv Ther 2023; 40:1899-1912. [PMID: 36737594 DOI: 10.1007/s12325-023-02425-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 01/03/2023] [Indexed: 02/05/2023]
Abstract
BACKGROUND Angina pectoris (AP) is the initial and the most common manifestation of coronary artery disease (CAD). Therefore, management and control of AP can help prevent further complications associated with CAD. However, there is under-reporting of angina symptoms in clinical practice, resulting in under-treatment and reduced quality of life (QoL). Prospective and standardized monitoring is needed to support timely and appropriate treatment. OBJECTIVES To establish a large cohort of Chinese patients with AP and compare the effectiveness of different anti-angina regimens with the help of electronic patient-reported outcomes (e-PROs), using the Seattle Angina Questionnaire (SAQ) to assess health status. METHODS The registry study (GREAT) is a multicenter, prospective, observational, cohort study. Patients diagnosed with AP will be enrolled from 10 hospitals and assessed based on the different anti-anginal regimens. Patients will be followed up every 3 months from baseline to 12 months to observe the difference in the therapeutic effectiveness of the drugs. Data will be collected in the form of e-PROs combined with on-site visit records. PLANNED OUTCOMES The change in SAQ summary score (SAQ SS) at Month 12 from baseline will be the primary outcome. The secondary measures will include changes in SAQ SS at Months 3, 6, and 9 from baseline, changes in retest results of vascular stenosis imaging at Month 12 from baseline, and medication adherence based on the proportion of days covered. Safety data will be evaluated based on the incidence of adverse events (AEs). CONCLUSION This study will evaluate the effectiveness of anti-anginal regimens using ePROs in real-world settings in China. The results from this study may provide a new perspective on treatment patterns and the effectiveness of different anti-anginal regimens for patients with AP. STUDY REGISTRATION NUMBER NCT05050773.
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Affiliation(s)
- Xiliang Zhao
- Center for Cardiology, Beijing Anzhen Hospital, Beijing, 100029, China
| | - Zichuan Tong
- Department of Cardiology, Beijing Daxing District People's Hospital, Beijing, China
| | - Liling Sun
- Department of Cardiology, Beijing Changping District Hospital, Beijing, China
| | - Qihua Zhang
- Department of Cardiology, Beijing Miyun District Hospital, Beijing, China
| | - Xin Du
- Center for Cardiology, Beijing Anzhen Hospital, Beijing, 100029, China
| | - Su'e Xu
- Department of Cardiology, Huai'an Hospital of Traditional Chinese Medicine, Beijing, China
| | - Chengning Shen
- Department of Cardiology, Ruyang People's Hospital, Ruyang, China
| | - Ying Wei
- Department of Cardiology, Dezhou People's Hospital, Dezhou, China
| | - Wei Liu
- Department of Cardiology, Beijing Jishuitan Hospital, Beijing, China
| | - Lifu Miao
- Department of Cardiology, Beijing Huaxin Hospital, Beijing, China
| | - Yong Zeng
- Center for Cardiology, Beijing Anzhen Hospital, Beijing, 100029, China.
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Vanderhout S, Potter BK, Smith M, Butcher NJ, Vaters J, Chakraborty P, Adams J, Inbar-Feigenberg M, Offringa M, Speechley K, Trakadis Y, Binik A. Ethical and practical considerations related to data sharing when collecting patient-reported outcomes in care-based child health research. Qual Life Res 2023:10.1007/s11136-023-03393-2. [PMID: 37002464 PMCID: PMC10329050 DOI: 10.1007/s11136-023-03393-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2023] [Indexed: 04/03/2023]
Abstract
Abstract
Purpose
The collection and use of patient reported outcomes (PROs) in care-based child health research raises challenging ethical and logistical questions. This paper offers an analysis of two questions related to PROs in child health research: (1) Is it ethically obligatory, desirable or preferable to share PRO data collected for research with children, families, and health care providers? And if so, (2) What are the characteristics of a model best suited to guide the collection, monitoring, and sharing of these data?
Methods
A multidisciplinary team of researchers, providers, patient and family partners, and ethicists examined the literature and identified a need for focus on PRO sharing in pediatric care-based research. We constructed and analyzed three models for managing pediatric PRO data in care-based research, drawing on ethical principles, logistics, and opportunities to engage with children and families.
Results
We argue that it is preferable to share pediatric PRO data with providers, but to manage expectations and balance the risks and benefits of research, this requires a justifiable data sharing model. We argue that a successful PRO data sharing model will allow children and families to have access to and control over their own PRO data and be engaged in decision-making around how PROs collected for research may be integrated into care, but require support from providers.
Conclusion
We propose a PRO data sharing model that can be used across diverse research settings and contributes to improved transparency, communication, and patient-centered care and research.
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Thomsen LH, Vexø LE, Schnack TH, Hansen KE, Forman A, Hartwell D, Nielsen HS, Hummelshoj L, Nyegaard M, Madsen ME. Danish translation, cross-cultural adaptation, and electronic migration of the World Endometriosis Research Foundation Endometriosis Phenome and Biobanking Harmonisation Project Endometriosis Patient Questionnaire. Front Glob Womens Health 2023; 4:1102006. [PMID: 36994241 PMCID: PMC10042231 DOI: 10.3389/fgwh.2023.1102006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 02/01/2023] [Indexed: 03/16/2023] Open
Abstract
ObjectivesThis study aims to translate and cross-culturally adapt the standard version of the World Endometriosis Research Foundation (WERF) EPHect Endometriosis Patient Questionnaire (EPQ) into Danish and to ensure equivalence of a Danish electronic version.MethodsThe translation, cultural adaption, and electronic migration followed recommendations from the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) and the Critical Path Institute. Ten women with endometriosis were enrolled for cognitive debriefing of the paper version (pEPQ) after translation and back translation. The questionnaire was then migrated into an electronic version (eEPQ) and subsequently tested for usability and measurement equivalence by five women with endometriosis.ResultsCross-cultural alterations were needed for medical terms, response options for ethnicity, the educational system, and measurement units. Thirteen questions were altered after back translation, while 21 underwent minor changes after cognitive debriefing. After testing the eEPQ, 13 questions were altered. Questions tested for measurement equivalence across the two modes of administration were found comparable. The median time-to-complete the pEPQ and eEPQ was 62 min (range: 29–110) and 63 min (range: 31–88), respectively. General comments included the questionnaire being relevant but long and repetitive.ConclusionsWe find the the Danish pEPQ and eEPQ similar and comparable to the original English instrument. However, attention must be drawn to questions regarding measurement units, ethnicity, and educational systems before cross-country comparison. The Danish pEPQ and eEPQ are suitable for obtaining subjective data on women with endometriosis.
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Affiliation(s)
- Line Holdgaard Thomsen
- Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Correspondence: Line Holdgaard Thomsen
| | - Laura Emilie Vexø
- Department of Gynecology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Obstetrics and Gynecology, Copenhagen University Hospital, Hvidovre, Denmark
| | | | | | - Axel Forman
- Department of Gynecology and Obstetrics, Aarhus University Hospital, Aarhus, Denmark
| | - Dorthe Hartwell
- Department of Gynecology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Henriette Svarre Nielsen
- Department of Obstetrics and Gynecology, Copenhagen University Hospital, Hvidovre, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Lone Hummelshoj
- World Endometriosis Research Foundation (WERF), London, United Kingdom
- Endometriosis.org, London, United Kingdom
| | - Mette Nyegaard
- Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Mette Elkjær Madsen
- Department of Gynecology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Obstetrics and Gynecology, Copenhagen University Hospital, Hvidovre, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Hirao K, Takahashi H, Kuroda N, Uchida H, Tsuchiya K, Kikuchi S. Differences in Center for Epidemiologic Studies Depression Scale, Generalized Anxiety Disorder-7 and Kessler Screening Scale for Psychological Distress Scores between Smartphone Version versus Paper Version Administration: Evidence of Equivalence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4773. [PMID: 36981682 PMCID: PMC10049019 DOI: 10.3390/ijerph20064773] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 03/02/2023] [Accepted: 03/06/2023] [Indexed: 06/18/2023]
Abstract
The use of electronic patient-reported outcomes has increased recently, and smartphones offer distinct advantages over other devices. However, previous systematic reviews have not investigated the reliability of the Center for Epidemiologic Studies Depression Scale (CES-D), Generalized Anxiety Disorder-7 (GAD-7), and Kessler Screening Scale for Psychological Distress (K6) when used with smartphones, and this has not been fully explored. This study aimed to evaluate the equivalence of the paper and smartphone versions of the CES-D, GAD-7, and K6, which were compared following a randomized crossover design method in 100 adults in Gunma, Japan. Participants responded to the paper and smartphone versions at 1-week intervals. The equivalence of paper and smartphone versions was evaluated using the intraclass correlation coefficient (ICCagreement). The mean participant age was 19.86 years (SD = 1.08, 23% male). The ICCagreements for the paper and smartphone versions of the CES-D, GAD-7, and K6 were 0.76 (95% confidence interval [CI] 0.66-0.83), 0.68 (95% CI 0.59-0.77), and 0.83 (95% CI 0.75-0.88), respectively. Thus, the CES-D and K6 scales are appropriate for use in a smartphone version, which could be applied to clinical and research settings in which the paper or smartphone versions could be used as needed.
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Affiliation(s)
- Kazuki Hirao
- Graduate School of Health Sciences, Gunma University, Maebashi 371-8514, Japan
- Department of Occupational Therapy, Faculty of Medicine, Gunma University, Maebashi 371-8514, Japan
| | - Hyono Takahashi
- Department of Occupational Therapy, Faculty of Medicine, Gunma University, Maebashi 371-8514, Japan
| | - Natsuki Kuroda
- Department of Occupational Therapy, Faculty of Medicine, Gunma University, Maebashi 371-8514, Japan
| | - Hiroyuki Uchida
- Department of Rehabilitation, Kurashiki Heisei Hospital, Kurashiki 710-0826, Japan
| | - Kenji Tsuchiya
- Department of Rehabilitation, Faculty of Health Sciences, Nagano University of Health and Medicine, Nagano 381-2227, Japan
| | - Senichiro Kikuchi
- Graduate School of Health Sciences, Gunma University, Maebashi 371-8514, Japan
- Department of Occupational Therapy, Faculty of Medicine, Gunma University, Maebashi 371-8514, Japan
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Kheradmand E, Rahimi SM, Nakhaei Amroodi M, Nejati P, Griffin S. Cross-cultural adaptation, validity and reliability of the Persian translation of the Western Ontario Shoulder Instability Index (WOSI). J Orthop Surg Res 2023; 18:174. [PMID: 36882849 PMCID: PMC9990569 DOI: 10.1186/s13018-023-03593-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 02/08/2023] [Indexed: 03/09/2023] Open
Abstract
PURPOSE The Western Ontario Shoulder Instability Index (WOSI) is the most commonly used patient-reported outcome measure to record the quality of life in patients with shoulder instability. The current study aimed to translate the WOSI into the Persian language and evaluate its psychometric properties. METHODS The translation procedure of the WOSI was performed according to a standard guideline. A total of 52 patients were included in the study and responded to the Persian WOSI, Oxford shoulder score (OSS), Oxford shoulder instability score (OSIS), and disabilities of arm, shoulder and hand (DASH). A sub-group of 41 patients responded for the second time to the Persian WOSI after an interval of 1-2 weeks. The internal consistency, test-retest reliability using intraclass correlation coefficient (ICC), measurement error, minimal detectable change (MDC), and floor and ceiling effect were analyzed. The hypothesis testing method was used to assess construct validity by calculating Pearson correlation coefficient between WOSI and DASH, OSS, and OSIS. RESULTS Cronbach's alpha value was 0.93, showing strong internal consistency. Test-retest reliability was good to excellent (ICC = 0.90). There was no floor and ceiling effect. The standard error of measurement and MDC were 8.30% and 23.03%, respectively. Regarding construct validity, 83.3% of the results agreed with hypotheses. High correlations were observed between WOSI and DASH, OSS and OSIS (0.746, 0.759 and 0.643, respectively) indicating excellent validity for the Persian WOSI. CONCLUSION The current study results demonstrated that the Persian WOSI is a valid and reliable instrument and can be used in the clinic and research for Persian-speaking patients with shoulder instability.
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Affiliation(s)
- Ehsan Kheradmand
- Department of Sports and Exercise Medicine, Hazrat-e Rasool General Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Mohsen Rahimi
- Department of Sports and Exercise Medicine, Hazrat-e Rasool General Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
| | - Morteza Nakhaei Amroodi
- Department of Orthopedic Surgery, Bone and Joint Reconstruction Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Parisa Nejati
- Department of Sports and Exercise Medicine, Hazrat-e Rasool General Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Sharon Griffin
- Fowler Kennedy Sports Medicine Clinic, University of Western Ontario, London, ON, Canada
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Jiang T, Li A, Zhang M, Zhou Z, Wang L, Zhang X, Zhang Y, Zhang Q. Measuring Self-management Among People with Diabetes Mellitus: A Systematic Review of Patient-Reported Diabetes-Specific Instruments in English and Chinese. Adv Ther 2023; 40:769-813. [PMID: 36607543 DOI: 10.1007/s12325-022-02361-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 10/13/2022] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Effective behavioral management is critical for people with diabetes to achieve glycemic control. Many instruments have been developed to measure diabetes-specific self-management. This review aimed to retrieve existing self-management-related instruments and identify well-validated instruments suitable for clinical research and practice. METHODS First, PubMed, Psych INFO, ERIC, and two Chinese databases (CNKI and Wanfang Data) were searched to identify existing instruments for self-management in diabetes systematically. Second, instruments were screened based on the pre-specified inclusion and exclusion criteria. Third, the psychometric property data of each included instrument were retrieved, and instruments with poor psychometric properties were excluded. Fourth, selected instruments were categorized into four categories: knowledge and health literacy, belief and self-efficacy, self-management behaviors, and composite scales. Finally, recommendations were made according to the application status and quality of the instruments. Instruments in English and Chinese were screened and summarized separately. RESULTS A total of 406 instruments (339 English instruments and 67 Chinese instruments) were identified. Forty-three English instruments were included. Five focused on knowledge and literacy, 12 on belief and self-management perception-related constructs, 21 on self-management and behaviors, and 5 on composite measures. We further recommended 19 English scales with relatively good quality and are frequently applied. Twenty-five Chinese instruments were included, but none were recommended because of a lack of sufficient psychometric property data. CONCLUSION Many English instruments measuring diabetes self-management have been developed and validated. Further research is warranted to validate instruments adapted or developed in the Chinese population.
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Affiliation(s)
- Tian Jiang
- Department of endocrinology, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Shushan District, Hefei, Anhui, China
| | - Aihua Li
- Sanofi China, 19F, Tower III, Kerry Center 1228 Middle Yan'an Road, Shanghai, China
| | - Minlu Zhang
- Sanofi China, 19F, Tower III, Kerry Center 1228 Middle Yan'an Road, Shanghai, China
| | - Zhou Zhou
- Sanofi China, 19F, Tower III, Kerry Center 1228 Middle Yan'an Road, Shanghai, China
| | - Lu Wang
- Sanofi China, 19F, Tower III, Kerry Center 1228 Middle Yan'an Road, Shanghai, China
| | - Xiaoqian Zhang
- Department of endocrinology, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Shushan District, Hefei, Anhui, China
| | - Yi Zhang
- Department of endocrinology, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Shushan District, Hefei, Anhui, China
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Qiu Zhang
- Department of endocrinology, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Shushan District, Hefei, Anhui, China.
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Bolzani A, Kupf S, Hodiamont F, Burner-Fritsch I, Bausewein C, Ramsenthaler C. Measurement equivalence of the paper-based and electronic version of the Integrated Palliative care Outcome Scale (IPOS): A randomised crossover trial. Palliat Med 2023; 37:760-770. [PMID: 36856258 DOI: 10.1177/02692163231157871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
BACKGROUND The Integrated Palliative Care Outcome Scale (IPOS) validly and reliably measures symptoms and concerns of those receiving palliative care. AIM To determine the equivalence of the paper version with an electronic version of the IPOS (eIPOS). DESIGN Multicentre randomised crossover trial (NCT03879668) with a within-subject comparison of the two modes (washout period 30 min). SETTING/PARTICIPANTS Convenience sample of specialist inpatient and palliative home care patients aged over 18 years with cancer and non-cancer conditions was recruited. Scores were compared using intraclass correlation coefficients (ICC), Bland-Altman plots and via a mixed-effects analysis of variance. RESULTS Fifty patients were randomised to complete paper-electronic (n = 24) and electronic-paper (n = 26) IPOS with median age 69 years (range 24-95), 56% male, 16% non-cancer. The ICCs showed very high concordance for the total score (ICC 0.99, 95% CI 0.98-1.00), lowest ICCs being observed for symptoms 'Appetite loss' and 'Drowsiness' (ICC 0.95, 95% CI 0.92-0.97). Nine of seventeen items had ICCs above 0.98, as did all subscales. No statistically significant mode, order, age, and interaction effects were observed for IPOS total score and subscales, except for 'Communication' (Fmode = 5.9, p = 0.019). Fifty-eight percent preferred the electronic version. In the group 75+ years, 53% preferred the paper version. Only three entries in the free-text main problems differed between the versions. CONCLUSION The very high equivalence in scores and free text between the IPOS and the eIPOS demonstrates that eIPOS is feasible and reliable in an older palliative population.
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Affiliation(s)
- Anna Bolzani
- Department of Palliative Medicine, University Hospital Munich, Ludwig-Maximilians-University Munich, Germany
| | - Sophie Kupf
- Department of Palliative Medicine, University Hospital Munich, Ludwig-Maximilians-University Munich, Germany
| | - Farina Hodiamont
- Department of Palliative Medicine, University Hospital Munich, Ludwig-Maximilians-University Munich, Germany
| | - Isabel Burner-Fritsch
- Department of Palliative Medicine, University Hospital Munich, Ludwig-Maximilians-University Munich, Germany
| | - Claudia Bausewein
- Department of Palliative Medicine, University Hospital Munich, Ludwig-Maximilians-University Munich, Germany
| | - Christina Ramsenthaler
- School of Health Professions, Zurich University of Applied Sciences ZHAW, Switzerland.,Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK.,Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK
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Equivalence of Paper and Electronic-Based Patient Reported Outcome Measures for Children: A Systematic Review. J Pediatr Gastroenterol Nutr 2023; 76:128-136. [PMID: 36240491 DOI: 10.1097/mpg.0000000000003636] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
Patient-reported outcome measures (PROMs) exist for a variety of chronic gastrointestinal disorders in children. The availability of electronic (e-)formats of PROMs enhance the accessibility of these tools. The International Society for Pharmacoeconomic and Outcomes Research (ISPOR) defines measurement equivalence (ME) as "comparability of the psychometric properties of data" obtained from the administration of original and adapted versions of PROMs. Consideration of proxy PROM versions is unique to pediatrics and must be included in ME evaluations. We conducted a systematic review (SR) of the literature evaluating ME of e-versions adapted from pediatric paper-based PROMs. A literature search was conducted through Medline, Embase, APA PsychInfo, and the Cochrane Library. Titles, abstracts, and manuscripts were reviewed by 2 independent reviewers. The search yielded 19 studies meeting pre-defined criteria. Just over half (52.6%) of 19 PROMs were disease-specific ones. ME between paper- and e-PROM versions was reported as present in all 19 studies evaluating 5653 participants under the age of 18 years. However, only 6 (31.6%) studies evaluated ME in proxy reported e-versions. Despite the use of PROMs for children with a variety of chronic gastrointestinal disorders, only 1 study evaluated a PROM in this population (IMPACT III for inflammatory bowel disease). Findings from this SR highlight strategic opportunities for the pediatric gastroenterologist to broaden the clinical and research armamentarium to include e-PROMs.
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Astradsson A, Sørensen NT, Graversen AS, Nemeiko I, Bilgin-Freiert A, Stephansen LV, Einarsson HB, Schougaard LMV, Juhler M, Hansen TS. Hydroflex: Use of Patient Reported Outcomes in a Clinical Setting Among Patients with Hydrocephalus. World Neurosurg 2023; 169:e67-e72. [PMID: 36270591 DOI: 10.1016/j.wneu.2022.10.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 10/09/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE/BACKGROUND A patient-reported outcome (PRO) measure is defined as "any report of the status of a patient's health condition that comes directly from the patient without interpretation of the patient's response by a clinician or anyone else". PRO data are increasingly being used in health care to facilitate monitoring of symptoms, facilitate communication between patients and clinicians, facilitate early identification of problems, and reduce unnecessary outpatient appointments for stable patients. METHODS We have designed a PRO system specifically for hydrocephalus, a program named Hydroflex. The aim of Hydroflex is to use PRO measures to decide the need for clinical attention and let the patients report their need regarding a physical consultation. Patients receive questionnaires at home instead of having prescheduled appointments at the outpatient clinic. Based on an automated algorithm, the patients' PRO measures are ranked to help clinical decision-making. RESULTS In this paper, we describe the implementation and early experience of Hydroflex at our institution. CONCLUSIONS It is our belief that Hydroflex provides more continuity in the treatment of patients with hydrocephalus. Also, it provides for a more standardized follow-up scheme, and we postulate this will lead to improved patient satisfaction and involvement and fewer outpatient appointments. Also, Hydroflex is useful for quality control and prospective research.
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Affiliation(s)
- Arnar Astradsson
- Department of neurosurgery, Aarhus University Hospital, Aarhus, Denmark.
| | - Nanna Toxvig Sørensen
- AmbuFlex - Center for Patient-reported Outcomes, Central Denmark Region, Gødstrup Hospital, Herning, Denmark
| | | | - Ivona Nemeiko
- Department of neurosurgery, Aarhus University Hospital, Aarhus, Denmark
| | | | | | | | - Liv Marit Valen Schougaard
- AmbuFlex - Center for Patient-reported Outcomes, Central Denmark Region, Gødstrup Hospital, Herning, Denmark
| | - Marianne Juhler
- Department of neurosurgery, Aarhus University Hospital, Aarhus, Denmark
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Wijsenbeek MS, Moor CC, Johannson KA, Jackson PD, Khor YH, Kondoh Y, Rajan SK, Tabaj GC, Varela BE, van der Wal P, van Zyl-Smit RN, Kreuter M, Maher TM. Home monitoring in interstitial lung diseases. THE LANCET. RESPIRATORY MEDICINE 2023; 11:97-110. [PMID: 36206780 DOI: 10.1016/s2213-2600(22)00228-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 06/08/2022] [Accepted: 06/08/2022] [Indexed: 11/05/2022]
Abstract
The widespread use of smartphones and the internet has enabled self-monitoring and more hybrid-care models. The COVID-19 pandemic has further accelerated remote monitoring, including in the heterogenous and often vulnerable group of patients with interstitial lung diseases (ILDs). Home monitoring in ILD has the potential to improve access to specialist care, reduce the burden on health-care systems, improve quality of life for patients, identify acute and chronic disease worsening, guide treatment decisions, and simplify clinical trials. Home spirometry has been used in ILD for several years and studies with other devices (such as pulse oximeters, activity trackers, and cough monitors) have emerged. At the same time, challenges have surfaced, including technical, analytical, and implementational issues. In this Series paper, we provide an overview of experiences with home monitoring in ILD, address the challenges and limitations for both care and research, and provide future perspectives. VIDEO ABSTRACT.
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Affiliation(s)
- Marlies S Wijsenbeek
- Centre of Excellence for Interstitial Lung Diseases and Sarcoidosis, Department of Respiratory Medicine, Erasmus MC, University Medical Center, Rotterdam, Netherlands.
| | - Catharina C Moor
- Centre of Excellence for Interstitial Lung Diseases and Sarcoidosis, Department of Respiratory Medicine, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - Kerri A Johannson
- Department of Medicine and Snyder Institute for Chronic Diseases, University of Calgary, Calgary, AB, Canada
| | - Peter D Jackson
- Department of Pulmonary and Critical Care Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Yet H Khor
- Central Clinical School, Monash University, Melbourne, VIC, Australia; Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, VIC, Australia
| | - Yasuhiro Kondoh
- Department of Respiratory Medicine and Allergy, Tosei General Hospital, Seto, Japan
| | - Sujeet K Rajan
- Department of Chest Medicine, Bombay Hospital Institute of Medical Sciences, Bhatia Hospital, Mumbai, India
| | - Gabriela C Tabaj
- Department of Respiratory Medicine, Cetrángolo Hospital, Buenos Aires, Argentina
| | - Brenda E Varela
- Department of Respiratory Medicine, Hospital Alemán, Buenos Aires, Argentina
| | - Pieter van der Wal
- Patient expert, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
| | - Richard N van Zyl-Smit
- Division of Pulmonology and University of Cape Town Lung Institute, Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
| | - Michael Kreuter
- Center for Interstitial and Rare Lung Diseases and Interdisciplinary Center for Sarcoidosis, Thoraxklinik, University Hospital Heidelberg, Germany; German Center for Lung Research, Heidelberg, Germany; Department of Pneumology, RKH Clinics Ludwigsburg, Ludwigsburg, Germany
| | - Toby M Maher
- Division of Pulmonary, Critical Care and Sleep Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; National Heart and Lung Institute, Imperial College London, London, UK
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de Vlieger JCN, Luiting WH, Lockyer J, Meyer P, Fleer J, Sanderman R, Wietasch JKG. Validation of the Dutch translation of the quality of recovery-15 scale. BMC Anesthesiol 2022; 22:243. [PMID: 35915438 PMCID: PMC9341122 DOI: 10.1186/s12871-022-01784-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 07/20/2022] [Indexed: 11/18/2022] Open
Abstract
Background The 15-item Quality of Recovery-15 (QoR-15) scale is strongly recommended as a standard patient-reported outcome measure assessing the quality of recovery after surgery and anesthesia in the postoperative period. This study aimed to validate the Dutch translation of the questionnaire (QoR-15NL). Materials and methods An observational, prospective, single-centre cohort study was conducted. Patients who underwent surgery under general anesthesia completed the QoR-15NL (preoperatively (t1) and twice postoperatively (t2 and t3)) and a visual analogue scale (VAS) for general recovery at t2. A psychometric evaluation was performed to assess the QoR-15NL’s validity, reliability, responsiveness, reproducibility and feasibility. Results Two hundred and eleven patients agreed to participate (recruitment rate 94%), and 165 patients were included (completion rate 78%). The QoR-15NL score correlated with the VAS for general recovery (rs = 0.59). Construct validity was further demonstrated by confirmation of expected negative associations between the QoR-15NL and duration of surgery (rs = -0.25), duration of Post Anesthesia Care Unit stay (rs = -0.31), and duration of hospital stay (rs = -0.27). The QoR-15NL score decreased significantly according to the extent of surgery. Cronbach’s alpha was 0.87, split-half reliability was 0.8, and the test–retest intra-class coefficient was 0.93. No significant floor- or ceiling effect was observed. Conclusion The QoR-15NL scale is a valid, easy-to-use, and reliable outcome assessment tool with high responsiveness for patient-reported quality of recovery after surgery and general anesthesia in the Dutch-speaking population. The QoR-15NL’s measurement properties are comparable to the original questionnaire and other translated versions. Trial registration not applicable. Supplementary Information The online version contains supplementary material available at 10.1186/s12871-022-01784-5.
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Newton L, Knight-West O, Eremenco S, Hudgens S, Crescioni M, Symonds T, Reasner DS, Byrom B, O’Donohoe P, Vallow S. Comparability of a provisioned device versus bring your own device for completion of patient-reported outcome measures by participants with chronic obstructive pulmonary disease: qualitative interview findings. J Patient Rep Outcomes 2022; 6:86. [PMID: 35925498 PMCID: PMC9352826 DOI: 10.1186/s41687-022-00492-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 07/24/2022] [Indexed: 11/10/2022] Open
Abstract
Background There is interest in participants using their own smartphones or tablets (“bring your own device”; BYOD) to complete patient-reported outcome (PRO) measures in clinical studies. Our study aimed to qualitatively evaluate participants’ experience using a provisioned device (PD) versus their own smartphone (BYOD) for this purpose. Methods Participants with chronic obstructive pulmonary disease (COPD) were recruited for this observational, cross-over study and completed PRO measures daily on one device type for 15 days, then switched to the other device type to complete the same measures for another 15 days. After each 15-day period, semi-structured interviews were conducted about their experience with the device. Results Of 64 participants enrolled, the final qualitative analysis populations comprised those who participated in an interview without protocol violations. Thus, the qualitative longitudinal population (LP) included n = 57 (89%), while the qualitative cross-sectional population (CSP) included n = 60 (94%). CSP participants found both device types easy to use. Twenty CSP participants (33%) reported missing data entry on at least one day when using PD, and 24 (40%) reported missing at least one day when using BYOD. In the LP, preference for one of the device types was somewhat evenly split; 45.6% (n = 26) preferred PD and 50.9% (n = 29) preferred BYOD. The most common reason for preferring PD was that it was “dedicated” to the study; the “convenience” of carrying a single device was the main reason for preferring BYOD. Conclusion The findings from the interviews demonstrated few differences in participants’ experience completing PRO measures on a PD versus BYOD. Our study supports the use of BYOD as a potential addition to PD for collecting PRO data and contributes evidence that BYOD may be employed to collect PRO data in demographically diverse patient populations.
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Houts CR, Bush EN, Edwards MC, Wirth RJ. Using validity theory and psychometrics to evaluate and support expanded uses of existing scales. Qual Life Res 2022; 31:2969-2975. [PMID: 35657470 DOI: 10.1007/s11136-022-03162-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2022] [Indexed: 01/28/2023]
Abstract
BACKGROUND Scale development is a complex activity requiring significant investments of time and money to produce evidence of a scale's ability to produce reliable scores and valid inferences. With increasing use of clinical outcome assessments (COAs) in medical product development, evidentiary expectations of regulatory bodies to support inferences are a key consideration. The goal of this paper is to demonstrate how existing methods in measurement science can be used to identify and fill evidence gaps when considering re-purposing an existing scale for a new use case (e.g., new patient population, altering the recall period), rather than creating a new COA tool. METHODS We briefly review select validity theory and psychometric concepts, linking them to the nomenclature in the COA/regulated space. Four examples (two in-text and two in online supplemental materials) of modifications are presented to demonstrate these ideas in practice for quality of life (QOL)-related measures. RESULTS Each example highlights the initial process of evaluating the desired validity claims, identifying gaps in evidence to support these claims, and determining how such gaps could be filled, often without having to develop a new measure. CONCLUSIONS If an existing scale, with minimal modification or additional evidence, can be shown to be fit for a new purpose, considerable effort can be saved and research waste avoided. In many cases, a new instrument is simply unnecessary. Far better to recycle an "old" scale for a new use-with sufficient evidence that it is fit for that purpose-than to "buy" a new one.
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Affiliation(s)
| | | | | | - R J Wirth
- Vector Psychometric Group, LLC, Chapel Hill, USA
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Comparative study of the pencil-and-paper and digital formats of the Spanish DARS scale. Acta Neuropsychiatr 2022; 34:253-259. [PMID: 34939915 DOI: 10.1017/neu.2021.45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The Dimensional Anhedonia Rating Scale (DARS) is a novel questionnaire to assess anhedonia of recent validation. In this work, we aim to study the equivalence between the traditional paper-and-pencil and the digital format of DARS. Sixty-nine patients filled the DARS in a paper-based and digital versions. We assessed differences between formats (Wilcoxon test), validity of the scales [Kappa and intraclass correlation coefficients (ICCs)], and reliability (Cronbach's alpha and Guttman's coefficient). We calculated the comparative fit index and the root mean squared error (RMSE) associated with the proposed one-factor structure. Total scores were higher for paper-based format. Significant differences between both formats were found for three items. The weighted Kappa coefficient was approximately 0.40 for most of the items. Internal consistency was greater than 0.94, and the ICC for the digital version was 0.95 and 0.94 for the paper-and-pencil version (F = 16.7, p < 0.001). Comparative Adjustment Index was 0.97 for the digital DARS and 0.97 for the paper-and-pencil DARS, and RMSE was 0.11 for the digital DARS and 0.10 for the paper-and-pencil DARS. We concluded that the digital DARS is consistent in many respects with the paper-and-pencil questionnaire, but equivalence with this format cannot be assumed without caution.
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Tawfik B, Burgess E, Kosich M, Jaffe SA, Guest DD, Brown-Glaberman U, Pankratz VS, Sussman A. Patient, provider, and nurse preferences of patient reported outcomes (PRO) and side effect management during cancer treatment of underrepresented racial and ethnic minority groups, rural and economically disadvantaged patients: a mixed methods study. Cancer Causes Control 2022; 33:1193-1205. [PMID: 35829828 PMCID: PMC10185305 DOI: 10.1007/s10552-022-01605-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 06/23/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE The purpose of this study was to evaluate patient, oncologist and nurse perspectives on side effects and patient reported outcomes (PROs) with the question of how to optimize side effect management and PRO tools in this unique population. METHODS This pilot study utilized a mixed method explanatory design. Patients receiving intravenous (IV) chemotherapy from June to August 2020 were surveyed about side effect burden and PRO system preferences. Providers and nurses (PN) completed complementary surveys. Semi-structured phone interviews were conducted among a subset of each group. RESULTS Of 90 patient surveys collected; 51.1% minority, 35.6% rural, and 40.0% income < $30,000, 48% felt side effect management was a significant issue. All patients reported access to a communication device but 12.2% did not own a cell phone; 68% smart phone, 20% cell phone, 22% landline, 53% computer, and 39% tablet. Patients preferred a response to reported side effects within 0-3 h (73%) while only 29% of the 55 PN surveyed did (p < 0.0001). Interviews reinforced that side effect burden was a significant issue, the varied communication devices, and a PRO system could improve side effect management. CONCLUSION In a non-White, rural and low-income patient population, 87.8% of patients reported owning a cell phone. Although all agreed side effect management was a prominent issue, expectations between patients and PN differed substantially. Qualitative data echoed the above and providing concrete suggestions to inform development of a PRO program and side effect mitigation strategies among a diverse patient population.
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Affiliation(s)
- Bernard Tawfik
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA.
- Division of Hematology and Oncology, University of New Mexico Department of Internal Medicine, Albuquerque, NM, USA.
- Division of Hematology/Oncology, UNM Comprehensive Cancer Center, MSC 07-4025, 1 University of New Mexico, Albuquerque, NM, 87131-0001, USA.
| | - Ellen Burgess
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
| | - Mikaela Kosich
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
| | | | - Dolores D Guest
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
- Division of Epidemiology, Biostatistics and Preventive Medicine, University of New Mexico Department of Internal Medicine, Albuquerque, NM, USA
| | - Ursa Brown-Glaberman
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
- Division of Hematology and Oncology, University of New Mexico Department of Internal Medicine, Albuquerque, NM, USA
| | - V Shane Pankratz
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
- Division of Epidemiology, Biostatistics and Preventive Medicine, University of New Mexico Department of Internal Medicine, Albuquerque, NM, USA
| | - Andrew Sussman
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
- University of New Mexico Department of Family and Community Medicine, Albuquerque, NM, USA
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Kamstra RJM, Boorsma A, Krone T, van Stokkum RM, Eggink HM, Peters T, Pasman WJ. Validation of the Mobile App Version of the EQ-5D-5L Quality of Life Questionnaire Against the Gold Standard Paper-Based Version: Randomized Crossover Study. JMIR Form Res 2022; 6:e37303. [PMID: 35969437 PMCID: PMC9412727 DOI: 10.2196/37303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 06/03/2022] [Accepted: 06/20/2022] [Indexed: 11/13/2022] Open
Abstract
Background Study participants and patients often perceive (long) questionnaires as burdensome. In addition, paper-based questionnaires are prone to errors such as (unintentionally) skipping questions or filling in a wrong type of answer. Such errors can be prevented with the emergence of mobile questionnaire apps. Objective This study aimed to validate an innovative way to measure the quality of life using a mobile app based on the EQ-5D-5L questionnaire. This validation study compared the EQ-5D-5L questionnaire requested by a mobile app with the gold standard paper-based version of the EQ-5D-5L. Methods This was a randomized, crossover, and open study. The main criteria for participation were participants should be aged ≥18 years, healthy at their own discretion, in possession of a smartphone with at least Android version 4.1 or higher or iOS version 9 or higher, digitally skilled in downloading the mobile app, and able to read and answer questionnaires in Dutch. Participants were recruited by a market research company that divided them into 2 groups balanced for age, gender, and education. Each participant received a digital version of the EQ-5D-5L questionnaire via a mobile app and the EQ-5D-5L paper-based questionnaire by postal mail. In the mobile app, participants received, for 5 consecutive days, 1 question in the morning and 1 question in the afternoon; as such, all questions were asked twice (at time point 1 [App T1] and time point 2 [App T2]). The primary outcomes were the correlations between the answers (scores) of each EQ-5D-5L question answered via the mobile app compared with the paper-based questionnaire to assess convergent validity. Results A total of 255 participants (healthy at their own discretion), 117 (45.9%) men and 138 (54.1%) women in the age range of 18 to 64 years, completed the study. To ensure randomization, the measured demographics were checked and compared between groups. To compare the results of the electronic and paper-based questionnaires, polychoric correlation analysis was performed. All questions showed a high correlation (0.64-0.92; P<.001) between the paper-based and the mobile app–based questions at App T1 and App T2. The scores and their variance remained similar over the questionnaires, indicating no clear difference in the answer tendency. In addition, the correlation between the 2 app-based questionnaires was high (>0.73; P<.001), illustrating a high test-retest reliability, indicating it to be a reliable replacement for the paper-based questionnaire. Conclusions This study indicates that the mobile app is a valid tool for measuring the quality of life and is as reliable as the paper-based version of the EQ-5D-5L, while reducing the response burden.
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Affiliation(s)
- Regina J M Kamstra
- Netherlands Organization for Applied Scientific Research (TNO), Zeist, Netherlands
| | - André Boorsma
- Netherlands Organization for Applied Scientific Research (TNO), Zeist, Netherlands
| | - Tanja Krone
- Netherlands Organization for Applied Scientific Research (TNO), Utrecht, Netherlands
| | - Robin M van Stokkum
- Netherlands Organization for Applied Scientific Research (TNO), Utrecht, Netherlands
| | - Hannah M Eggink
- Netherlands Organization for Applied Scientific Research (TNO), Zeist, Netherlands
| | | | - Wilrike J Pasman
- Netherlands Organization for Applied Scientific Research (TNO), Zeist, Netherlands
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50
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Wingood M, Jones S, Gell NM, Brach JS, Peters DM. Evaluation of Electronic and Pen-and-Paper Formats of the Inventory of Physical Activity Barriers: A Randomized Crossover Study. J Phys Act Health 2022; 19:540-547. [PMID: 35894970 PMCID: PMC10080583 DOI: 10.1123/jpah.2021-0821] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 06/01/2022] [Accepted: 06/21/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND The Inventory of Physical Activity Barriers (IPAB) assesses physical activity participation barriers. Development, refinement, and psychometric evaluation of the IPAB occurred via an electronic format. However, various circumstances may require using a pen-and-paper format. As instrument formats are not always interchangeable, the authors aimed to establish whether 2 different formats (electronic and pen and paper) can be used interchangeably for the IPAB. METHODS This randomized crossover study included 66 community-dwelling adults aged 50 years and older (mean age = 73 [SD = 7.6]). Half the sample completed the electronic format of the IPAB first and the pen-and-paper format second, and the other half completed them in reverse order. Tests of equivalence and a Bland-Altman plot were performed. RESULTS The intraclass correlation coefficient between formats was .94, and kappa was .68. The mean difference between the 2 administration forms of the IPAB was 0.002 (P = .96). Both administration formats had high internal consistency (Cronbach alpha = .92 and .93) and illustrated construct validity (P ≤ .001 for both administration formats). CONCLUSION Pen-and-paper and electronic formats of the IPAB are equivalent and, thus, can be used interchangeably among non-Hispanic whites who are highly educated. The format should be used consistently if completing preintervention and postintervention evaluations or comparing scores.
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Affiliation(s)
- Mariana Wingood
- Department of Rehabilitation and Movement Science, University of Vermont, Burlington, VT,USA
| | - Salene Jones
- Public Health Science Division, Fred Hutchinson Cancer Research Center, Seattle, WA,USA
| | - Nancy M Gell
- Department of Rehabilitation and Movement Science, University of Vermont, Burlington, VT,USA
| | - Jennifer S Brach
- Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA,USA
| | - Denise M Peters
- Department of Rehabilitation and Movement Science, University of Vermont, Burlington, VT,USA
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