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Welch C, Greig C, Lewis D, Majid Z, Masud T, Moorey H, Pinkney T, Stanley B, Jackson T. Baseline Nutritional Status and In-Hospital Step Count are Associated with Muscle Quantity, Quality, and Function: Results of an Exploratory Study. J Nutr Gerontol Geriatr 2023; 42:110-126. [PMID: 37787986 DOI: 10.1080/21551197.2023.2259335] [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: 10/04/2023]
Abstract
This exploratory study aimed to assess associations of baseline nutritional status and in-hospital step count with muscle quantity, quality, and function. Seventy-nine participants aged ≥70 years (mean age 79.1 years, 44.3% female) were recruited (elective colorectal surgery, emergency abdominal surgery, and general medical patients with infections). Baseline nutrition (Mini Nutritional Assessment) and in-hospital step count (Fitbit Inspire devices) were assessed. Ultrasound quadriceps, bioelectrical impedance analysis, and physical function were assessed at baseline and 7 (±2) days and 13 (±1) weeks post-admission/post-operatively. Baseline nutritional status was associated with baseline rectus femoris ultrasound echogenicity (normal: 58.5, at risk: 68.5, malnourished: 81.2; p = 0.025), bilateral anterior thigh thickness (normal: 5.07 cm, at risk: 4.03 cm, malnourished: 3.05 cm; p = 0.021), and skeletal muscle mass (Sergi equation) (normal: 21.6 kg, at risk: 18.2 kg, malnourished: 12.0 kg; p = 0.007). Step count was associated with baseline patient-reported physical function (<900 37.1, ≥900 44.5; p = 0.010). There was a significant interaction between nutrition, step count, and time for skeletal muscle mass (Janssen equation) (p = 0.022).
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Affiliation(s)
- Carly Welch
- Medical Research Council (MRC) Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Birmingham and University of Nottingham, Nottingham, UK
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Department of Twins Research, King's College London, London, UK
| | - Carolyn Greig
- Medical Research Council (MRC) Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Birmingham and University of Nottingham, Nottingham, UK
- School of Sport, Exercise, and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
- Birmingham Biomedical Research Centre, University of Birmingham and University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Danielle Lewis
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Zeinab Majid
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Tahir Masud
- Medical Research Council (MRC) Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Birmingham and University of Nottingham, Nottingham, UK
- Nottingham University Hospitals NHS Trust, Nottingham, UK
- University of Nottingham, Nottingham, UK
| | - Hannah Moorey
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Thomas Pinkney
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Academic Department of Surgery, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Benjamin Stanley
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Thomas Jackson
- Medical Research Council (MRC) Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Birmingham and University of Nottingham, Nottingham, UK
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
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Welch C, Wilson D, Sayer AA, Witham MD, Jackson TA. Development of a UK core dataset for geriatric medicine research: a position statement and results from a Delphi consensus process. BMC Geriatr 2023; 23:168. [PMID: 36959622 PMCID: PMC10035483 DOI: 10.1186/s12877-023-03805-5] [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: 02/14/2022] [Accepted: 02/07/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND There is lack of standardisation in assessment tools used in geriatric medicine research, which makes pooling of data and cross-study comparisons difficult. METHODS We conducted a modified Delphi process to establish measures to be included within core and extended datasets for geriatric medicine research in the United Kingdom (UK). This included three complete questionnaire rounds, and one consensus meeting. Participants were selected from attendance at the NIHR Newcastle Biomedical Research Centre meeting, May 2019, and academic geriatric medicine e-mailing lists. Literature review was used to develop the initial questionnaire, with all responses then included in the second questionnaire. The third questionnaire used refined options from the second questionnaire with response ranking. RESULTS Ninety-eight responses were obtained across all questionnaire rounds (Initial: 19, Second: 21, Third: 58) from experienced and early career researchers in geriatric medicine. The initial questionnaire included 18 questions with short text responses, including one question for responders to suggest additional items. Twenty-six questions were included in the second questionnaire, with 108 within category options. The third questionnaire included three ranking, seven final agreement, and four binary option questions. Results were discussed at the consensus meeting. In our position statement, the final consensus dataset includes six core domains: demographics (age, gender, ethnicity, socioeconomic status), specified morbidities, functional ability (Barthel and/or Nottingham Extended Activities of Daily Living), Clinical Frailty Scale (CFS), cognition, and patient-reported outcome measures (dependent on research question). We also propose how additional variables should be measured within an extended dataset. CONCLUSIONS Our core and extended datasets represent current consensus opinion of academic geriatric medicine clinicians across the UK. We consider the development and further use of these datasets will strengthen collaboration between researchers and academic institutions.
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Affiliation(s)
- Carly Welch
- Medical Research Council - Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Birmingham and University of Nottingham, B15 2TT, Birmingham, UK.
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, B15 2TT, Birmingham, UK.
- University Hospitals Birmingham NHS Foundation Trust, B15 2GW, Birmingham, UK.
- Guy's and St Thomas' NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge, London, SE1 7EH, UK.
| | - Daisy Wilson
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, B15 2TT, Birmingham, UK
- University Hospitals Birmingham NHS Foundation Trust, B15 2GW, Birmingham, UK
| | - Avan A Sayer
- AGE Research Group, NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK
| | - Miles D Witham
- AGE Research Group, NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK
| | - Thomas A Jackson
- Medical Research Council - Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Birmingham and University of Nottingham, B15 2TT, Birmingham, UK
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, B15 2TT, Birmingham, UK
- University Hospitals Birmingham NHS Foundation Trust, B15 2GW, Birmingham, UK
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Welch C, Greig C, Majid Z, Masud T, Moorey H, Pinkney T, Jackson T. The feasibility of conducting acute sarcopenia research in hospitalised older patients: a prospective cohort study. Eur Geriatr Med 2022; 13:463-473. [PMID: 34608617 PMCID: PMC8490139 DOI: 10.1007/s41999-021-00565-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 09/17/2021] [Indexed: 01/03/2023]
Abstract
PURPOSE To assess feasibility of conducting acute sarcopenia research in complex populations of hospitalised older adults. METHODS Patients ≥ 70 years old were recruited to three cohorts: elective colorectal surgery, emergency (abdominal) surgery, medical patients with infections. Participants were recruited to the elective cohort in preoperative assessment clinic, and acutely admitted participants from surgical and medical wards at the Queen Elizabeth Hospital Birmingham. Serial measures of muscle quantity (ultrasound quadriceps, bioelectrical impedance analysis), muscle function (hand grip strength, physical performance), and questionnaires (mini-nutritional assessment, physical function) were performed at baseline, within 7 (± 2) days of admission/surgery, and 13 (± 1) weeks post-admission/surgery. Feasibility outcomes were assessed across timepoints including recruitment and drop-out rates, and procedure completion rates. RESULTS Eighty-one participants were recruited (mean age 79, 38.3% females). Recruitment rates were higher in elective (75%, 24/32) compared to emergency surgery (37.2%, 16/43), and medical participants (45.1%, 41/91; p = 0.003). Drop-out rates varied from 8.3 to 19.5% at 7 days, and 12.5-43.9% at 13 weeks. Age and gender did not differ between patients assessed for eligibility, approached, or recruited. Completion rates were highest for ultrasound quadriceps (98.8%, 80/81 across all groups at baseline). Gait speed completion rates were lower in medical (70.7%, 29/41) compared to elective participants (100%, 24/24) at baseline. CONCLUSION Higher participation refusal and drop-out rates should be expected for research involving recruitment of participants from the acute setting. Assessment of muscle quantity/quality through ultrasound is recommended in early-stage trials in the acute setting, where completion rates of physical performance testing are expected to be lower.
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Affiliation(s)
- Carly Welch
- Medical Research Council (MRC)-Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Birmingham and University of Nottingham, Birmingham and Nottingham, UK.
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham and Nottingham, B152TT, UK.
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, B152GW, UK.
| | - Carolyn Greig
- Medical Research Council (MRC)-Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Birmingham and University of Nottingham, Birmingham and Nottingham, UK
- School of Sport, Exercise, and Rehabilitation Sciences, University of Birmingham, Birmingham, B152TT, UK
- Birmingham Biomedical Research Centre, University of Birmingham and University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Zeinab Majid
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham and Nottingham, B152TT, UK
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, B152GW, UK
| | - Tahir Masud
- Medical Research Council (MRC)-Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Birmingham and University of Nottingham, Birmingham and Nottingham, UK
- University of Nottingham, Nottingham, UK
- Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Hannah Moorey
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, B152GW, UK
- School of Sport, Exercise, and Rehabilitation Sciences, University of Birmingham, Birmingham, B152TT, UK
| | - Thomas Pinkney
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, B152GW, UK
- Academic Department of Surgery, University of Birmingham, Birmingham, B152TT, UK
| | - Thomas Jackson
- Medical Research Council (MRC)-Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Birmingham and University of Nottingham, Birmingham and Nottingham, UK
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham and Nottingham, B152TT, UK
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, B152GW, UK
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Welch C, Greig C, Lewis D, Majid Z, Masud T, Moorey H, Pinkney T, Stanley B, Jackson T. Trajectories of muscle quantity, quality and function measurements in hospitalized older adults. Geriatr Gerontol Int 2022; 22:311-318. [PMID: 35246911 PMCID: PMC9313889 DOI: 10.1111/ggi.14366] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 01/30/2022] [Accepted: 02/09/2022] [Indexed: 12/01/2022]
Abstract
AIM Acute sarcopenia is defined by the development of incident sarcopenia (low muscle quantity/quality and function) within 6 months of a stressor event. However, outcome measures for clinical trials have not been validated. This study aimed to characterize changes in muscle quantity, quality, strength, and physical function during and after hospitalization. METHODS Patients aged ≥70 years admitted for elective colorectal surgery, emergency abdominal surgery or acute infections were recruited from a single university hospital. Assessments were carried out at baseline, and within 7 ± 2 days and 13 ± 1 weeks postoperatively or post-admission. RESULTS A total of 79 participants (mean age 79 years, 39% female) were included. Physical function defined by the Patient-Reported Outcome Measures Information System T-score declined from baseline (42.3, 95% CI 40.2-44.3) to 7 days (36.6, 95% CI 34.5-38.8; P = 0.001), with improvement after 13 weeks (40.5, 95% CI 37.9-43.0). Changes in muscle quantity, quality and function measurements were overall heterogeneous, with few significant changes at the study population level. Change in rectus femoris echogenicity over 13 weeks correlated with changes in handgrip strength (r = 0.53; P < 0.001) and gait speed (r = 0.59; P = 0.003) over the same period. CONCLUSIONS Patient-Reported Outcome Measures Information System T-score provides a sensitive measure of change in physical function in hospitalized older patients. However, changes in muscle quantity, quality and function measurements were heterogeneous, and not significant at the study population level. Further research should assess for factors that might be predictive of changes within individuals to enable stratified interventions. Geriatr Gerontol Int 2022; 22: 311-318.
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Affiliation(s)
- Carly Welch
- Medical Research Council (MRC) – Versus Arthritis Center for Musculoskeletal Aging ResearchUniversity of Birmingham and University of NottinghamBirminghamUK
- Institute of Inflammation and Aging, College of Medical and Dental SciencesUniversity of BirminghamBirminghamUK
- University Hospitals Birmingham NHS Foundation TrustBirminghamUK
| | - Carolyn Greig
- Medical Research Council (MRC) – Versus Arthritis Center for Musculoskeletal Aging ResearchUniversity of Birmingham and University of NottinghamBirminghamUK
- School of Sport, Exercise, and Rehabilitation SciencesUniversity of BirminghamBirminghamUK
- Birmingham Biomedical Research CenterUniversity of Birmingham and University Hospitals Birmingham NHS Foundation TrustBirminghamUK
| | - Danielle Lewis
- Institute of Inflammation and Aging, College of Medical and Dental SciencesUniversity of BirminghamBirminghamUK
| | - Zeinab Majid
- Institute of Inflammation and Aging, College of Medical and Dental SciencesUniversity of BirminghamBirminghamUK
- University Hospitals Birmingham NHS Foundation TrustBirminghamUK
| | - Tahir Masud
- Medical Research Council (MRC) – Versus Arthritis Center for Musculoskeletal Aging ResearchUniversity of Birmingham and University of NottinghamBirminghamUK
- Nottingham University Hospitals NHS TrustNottinghamUK
- University of NottinghamNottinghamUK
| | - Hannah Moorey
- Institute of Inflammation and Aging, College of Medical and Dental SciencesUniversity of BirminghamBirminghamUK
- University Hospitals Birmingham NHS Foundation TrustBirminghamUK
| | - Thomas Pinkney
- University Hospitals Birmingham NHS Foundation TrustBirminghamUK
- Academic Department of SurgeryUniversity of BirminghamBirminghamUK
| | - Benjamin Stanley
- Institute of Inflammation and Aging, College of Medical and Dental SciencesUniversity of BirminghamBirminghamUK
| | - Thomas Jackson
- Medical Research Council (MRC) – Versus Arthritis Center for Musculoskeletal Aging ResearchUniversity of Birmingham and University of NottinghamBirminghamUK
- Institute of Inflammation and Aging, College of Medical and Dental SciencesUniversity of BirminghamBirminghamUK
- University Hospitals Birmingham NHS Foundation TrustBirminghamUK
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Kaye J, Aisen P, Amariglio R, Au R, Ballard C, Carrillo M, Fillit H, Iwatsubo T, Jimenez-Maggiora G, Lovestone S, Natanegara F, Papp K, Soto ME, Weiner M, Vellas B. Using Digital Tools to Advance Alzheimer's Drug Trials During a Pandemic: The EU/US CTAD Task Force. JPAD-JOURNAL OF PREVENTION OF ALZHEIMERS DISEASE 2021; 8:513-519. [PMID: 34585227 PMCID: PMC8244451 DOI: 10.14283/jpad.2021.36] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The 2020 COVID-19 pandemic has disrupted Alzheimer’s disease (AD) clinical studies worldwide. Digital technologies may help minimize disruptions by enabling remote assessment of subtle cognitive and functional changes over the course of the disease. The EU/US Clinical Trials in Alzheimer’s Disease (CTAD) Task Force met virtually in November 2020 to explore the opportunities and challenges associated with the use of digital technologies in AD clinical research. While recognizing the potential of digital tools to accelerate clinical trials, improve the engagement of diverse populations, capture clinically meaningful data, and lower costs, questions remain regarding the stability, validity, generalizability, and reproducibility of digital data. Substantial concerns also exist regarding regulatory acceptance and privacy. Nonetheless, the Task Force supported further exploration of digital technologies through collaboration and data sharing, noting the need for standardization of digital readouts. They also concluded that while it may be premature to employ remote assessments for trials of novel experimental medications, remote studies of non-invasive, multi-domain approaches may be feasible at this time.
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Affiliation(s)
- J Kaye
- Jeffrey Kaye, Layton Aging and Alzheimer's Disease Center, School of Medicine, Oregon Health and Science University, Portland, OR, USA,
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Welch C, Greig CA, Masud T, Pinkney T, Jackson TA. Protocol for understanding acute sarcopenia: a cohort study to characterise changes in muscle quantity and physical function in older adults following hospitalisation. BMC Geriatr 2020; 20:239. [PMID: 32650734 PMCID: PMC7350619 DOI: 10.1186/s12877-020-01626-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Accepted: 06/22/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Older adults are vulnerable to the effects of acute sarcopenia (acute muscle insufficiency) following hospitalisation. However, this condition remains poorly characterised to date. It is hypothesised that acute sarcopenia arises due to a combination of bed rest and inflammatory surge. This study aims to characterise changes in muscle quantity and function, determining which factors (clinical and biological) are most predictive, and how these relate to change in physical function at 13 weeks. METHODS This study will include three groups of patients aged 70 years and older; patients undergoing elective colorectal surgery, patients admitted for emergency abdominal surgery, and patients admitted under general medicine with acute bacterial infections. Changes in muscle quantity (Bilateral Anterior Thigh Thickness with ultrasound and bioelectrical impedance analysis) and muscle function (muscle strength, physical performance) within 1 week of hospitalisation or surgery will be characterised, with follow-up of patients at 13 weeks. Physical function will be measured using the Patient Reported Outcome Measures Information System, and the Short Physical Performance Battery (or gait speed alone within 1 week of surgery). DISCUSSION This study will fully characterise changes in muscle quantity and function in hospitalised older adults and enable risk stratification towards targeted interventions in clinical practice. The results of this study will inform further research involving interventions to ameliorate changes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03858192 ; Prospectively registered 28th February 2019.
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Affiliation(s)
- Carly Welch
- Medical Research Council and Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Birmingham and University of Nottingham, Birmingham and Nottingham, UK
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- University of Birmingham Research Laboratories, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B152GW UK
| | - Carolyn A. Greig
- Medical Research Council and Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Birmingham and University of Nottingham, Birmingham and Nottingham, UK
- Birmingham Biomedical Research Centre, University of Birmingham and University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- School of Sport and Exercise Sciences, University of Birmingham, Birmingham, UK
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT UK
| | - Tahir Masud
- Medical Research Council and Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Birmingham and University of Nottingham, Birmingham and Nottingham, UK
- University of Nottingham, Nottingham, UK
- Nottingham University Hospitals NHS Trust, Nottingham, UK
- Clinical Gerontology Research Unit (CGRU), First Floor, South Corridor, City Hospital, Nottingham, NG5 1PB UK
| | - Thomas Pinkney
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Academic Department of Surgery, University of Birmingham, Room 29, 4th Floor, Heritage Building, Edgbaston, Birmingham, B15 2TH UK
| | - Thomas A. Jackson
- Medical Research Council and Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Birmingham and University of Nottingham, Birmingham and Nottingham, UK
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- University of Birmingham Research Laboratories, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B152GW UK
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Smit EB, Bouwstra H, van der Wouden JC, Hertogh CMPM, Wattel EM, Roorda LD, Terwee CB. Development of a Patient-Reported Outcomes Measurement Information System (PROMIS®) short form for measuring physical function in geriatric rehabilitation patients. Qual Life Res 2020; 29:2563-2572. [PMID: 32318940 PMCID: PMC7434792 DOI: 10.1007/s11136-020-02506-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2020] [Indexed: 12/05/2022]
Abstract
Purpose To develop and test the validity of a Patient-Reported Outcomes Measurement Information System (PROMIS®) short form for measuring physical function of geriatric rehabilitation patients. Methods Experts selected items from the Dutch-Flemish PROMIS v1.2 Physical Function (PROMIS-PF) item bank and proposed new items to develop the PROMIS-PF short form for geriatric rehabilitation (PROMIS-PF-GR). Patients evaluated its content validity. Structural validity was assessed by evaluating unidimensionality (confirmatory, exploratory, and bi-factor analyses [criterion: Omega H > 0.80 and ECV > 0.60]), local independence (criterion: residual correlation < 0.20) ,and monotonicity (criterion: Hi-coefficient ≥ 0.30). Measurement invariance was assessed by evaluating Differential Item Functioning (DIF) between geriatric rehabilitation patients and people from the general population using ordinal logistic regression. Internal consistency was assessed by calculating Cronbach’s alpha (criterion: alpha ≥ 0.70). Results Experts selected 24 items from the PROMIS-PF item bank and proposed one new item which was not included in the short form. Patients considered the 24 items relevant and containing essential information. The PROMIS-PF-GR’s psychometric properties were evaluated in 207 patients (mean age ± SD, 80.0 ± 8.3 year; 58% female). The 24 items were found to be sufficiently unidimensional (Omega H = 0.82, ECV = 0.70), locally independent (98.7% item pairs), and monotone (all ≥ 0.32). Five items were flagged for DIF, but their impact on the total score was negligible. Cronbach’s alpha was 0.94. Conclusion The PROMIS-PF-GR was developed from the PROMIS-PF and has good content validity, structural validity, measurement invariance, and internal consistency in Dutch geriatric rehabilitation patients. We recommend to confirm the content validity of the PROMIS-PF-GR in other countries.
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Affiliation(s)
- E B Smit
- Department of General Practice & Elderly Care Medicine, Amsterdam Public Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7 (room B-357), 1081 BT, Amsterdam, The Netherlands.
| | - H Bouwstra
- Department of General Practice & Elderly Care Medicine, Amsterdam Public Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7 (room B-357), 1081 BT, Amsterdam, The Netherlands
| | - J C van der Wouden
- Department of General Practice & Elderly Care Medicine, Amsterdam Public Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7 (room B-357), 1081 BT, Amsterdam, The Netherlands
| | - C M P M Hertogh
- Department of General Practice & Elderly Care Medicine, Amsterdam Public Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7 (room B-357), 1081 BT, Amsterdam, The Netherlands
| | - E M Wattel
- Department of General Practice & Elderly Care Medicine, Amsterdam Public Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7 (room B-357), 1081 BT, Amsterdam, The Netherlands
| | - L D Roorda
- Amsterdam Rehabilitation Research Center | Reade, Amsterdam, The Netherlands
| | - C B Terwee
- Department of Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Lenio S, Lissemore FM, Sajatovic M, Smyth KA, Tatsuoka C, Woyczynski WA, Lerner AJ. Detrending Changes the Temporal Dynamics of a Semantic Fluency Task. Front Aging Neurosci 2016; 8:252. [PMID: 27833550 PMCID: PMC5081546 DOI: 10.3389/fnagi.2016.00252] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 10/13/2016] [Indexed: 11/13/2022] Open
Abstract
Objective: To study the dynamics of clustering semantic fluency responses and switching between clusters. Methods: We conducted a cross-sectional study of participants (N = 60) in a study of patient reported outcomes who were given the Saint Louis University Mental Status test. Sixty-second animal naming tests were scored for the timing of responses as well as the clustering of responses into semantic categories. Time scores were detrended to correct for exponential exhaustion and normalize the time scale across individuals. Results: Grouped by number of responses given, low performers (LP; Carter et al., 2012) switched between clusters fewer times than medium performers (MP) and high performers (HP). Prior to detrending, LP showed increased intracluster response times when compared to the other groups, but no differences were shown in intercluster response times. After detrending, however, the difference in intracluster response times disappeared and LP showed significantly faster detrended intercluster response times compared to both MP and HP. Conclusion: Prior to detrending, slower intracluster response times appear to be driving poorer performance. When time scores are detrended, our findings suggest that LP participants have quicker intercluster response times but exhaust more quickly as well. Detrending can help describe the interplay between the structure-loss and retrieval-slowing models of declining semantic fluency by isolating the component mechanisms involved in each.
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Affiliation(s)
- Steven Lenio
- School of Medicine, Case Western Reserve University Cleveland, OH, USA
| | | | - Martha Sajatovic
- School of Medicine, Case Western Reserve UniversityCleveland, OH, USA; Departments of Psychiatry and Neurology, University Hospitals Cleveland Medical CenterCleveland, OH, USA
| | - Kathleen A Smyth
- School of Medicine, Case Western Reserve University Cleveland, OH, USA
| | - Curtis Tatsuoka
- School of Medicine, Case Western Reserve University Cleveland, OH, USA
| | - Wojbor A Woyczynski
- Department of Mathematics, Applied Mathematics and Statistics, and Center for Stochastic and Chaotic Processes in Science and Technology, Case Western Reserve University Cleveland, OH, USA
| | - Alan J Lerner
- School of Medicine, Case Western Reserve University Cleveland, OH, USA
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