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Foster E, Conquest A, Ewart C, Nicolo JP, Rayner G, Winton-Brown T, O'Brien TJ, Kwan P, Malpas C, French JA. Validation of the Seizure-Related Impact Assessment Scale (SERIAS): a study protocol. BMJ Open 2024; 14:e083929. [PMID: 38862226 PMCID: PMC11168159 DOI: 10.1136/bmjopen-2024-083929] [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: 01/03/2024] [Accepted: 05/29/2024] [Indexed: 06/13/2024] Open
Abstract
INTRODUCTION This study aims to validate the Seizure-Related Impact Assessment Scale (SERIAS). This novel patient-reported outcome measure (PROM) compares the 'trade-off' between seizures and treatment-related adverse effects, and measures epilepsy disability qualitatively and quantitively. It fills an important gap in PROMs for epilepsy clinical trials and practice. METHODS AND ANALYSIS Adults with epileptologist-confirmed epilepsy from two Australian Epilepsy Centres are being recruited. People with functional seizures, or who are unable to self-complete English-language validated instruments are excluded. Participants providing informed consent are invited to complete questionnaires at baseline, 3 and 6 months later. SERIAS includes five questions that ask about the number of days per month that seizures or treatment-related adverse effects partially or fully impact work/home/school and family/social/non-work activities, as well as a visual analogue scale regarding epilepsy-related disability. SERIAS is completed alongside seven internationally validated instruments measuring treatment-related adverse effects, mood disorders and quality of life. Target recruitment is n=100, ensuring>50 people complete all questionnaires at all timepoints. Comprehensive psychometric analysis will be performed. Convergent validity will be investigated using bivariate correlations with relevant measures. Reliability will be investigated using Cronbach's alpha, McDonald's omega and test-retest correlation coefficients. SERIAS will be a novel PROM for epilepsy clinical trials and practice. ETHICS AND DISSEMINATION Multisite ethics approval was granted by the Alfred Health Ethics Committee (HREC 17/23). Results of this study will be disseminated through publication in peer-reviewed journals and presentations at scientific conferences. TRIAL REGISTRATION NUMBER ACTRN12623000599673.
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Affiliation(s)
- Emma Foster
- Department of Neurology, Alfred Health, Prahran, Victoria, Australia
- School of Translational Medicine, Monash University, Melbourne, Victoria, Australia
| | - Alison Conquest
- Department of Neurology, Alfred Health, Prahran, Victoria, Australia
- School of Translational Medicine, Monash University, Melbourne, Victoria, Australia
| | - Chris Ewart
- Community and Research Engagement (CaRE) Program, Monash University, Clayton, Victoria, Australia
| | - John-Paul Nicolo
- Department of Neurology, Alfred Health, Prahran, Victoria, Australia
- School of Translational Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Neurology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Genevieve Rayner
- Department of Neurology, Alfred Health, Prahran, Victoria, Australia
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Toby Winton-Brown
- School of Translational Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Psychiatry, Alfred Hospital, Melbourne, Victoria, Australia
| | - Terence J O'Brien
- Department of Neurology, Alfred Health, Prahran, Victoria, Australia
- School of Translational Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Neurology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
- Department of Medicine (The Royal Melbourne Hospital), The University of Melbourne, Parkville, Victoria, Australia
| | - Patrick Kwan
- Department of Neurology, Alfred Health, Prahran, Victoria, Australia
- School of Translational Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Neurology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
- Department of Medicine (The Royal Melbourne Hospital), The University of Melbourne, Parkville, Victoria, Australia
| | - Charles Malpas
- School of Translational Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Neurology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Victoria, Australia
- Department of Medicine (The Royal Melbourne Hospital), The University of Melbourne, Parkville, Victoria, Australia
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Bruins TE, van Veen MM, Werker PMN, Dijkstra PU, Broekstra DC. Associations Between Clinician-Graded Facial Function and Patient-Reported Quality of Life in Adults With Peripheral Facial Palsy: A Systematic Review and Meta-analysis. JAMA Otolaryngol Head Neck Surg 2021; 147:717-728. [PMID: 34196663 DOI: 10.1001/jamaoto.2021.1290] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Understanding how the quality of life of adults (≥18 years) with peripheral facial palsy can be estimated using clinician measures of facial function and patient-reported variables might aid in counseling patients and in conducting research. Objectives To analyze associations between clinician-graded facial function and patient-reported quality of life in adults with peripheral facial palsy, compare associations between facial function and the physical and social functions of quality of life, and examine factors that might influence the associations. Data Sources A literature search was conducted in PubMed, Embase, CINAHL, Web of Science and PsycInfo on June 4, 2020, with no restrictions on the start date. Study Selection Twenty-three studies reporting an association between clinician-graded facial function and patient-reported quality of life in adults with peripheral facial palsy were included. Facial function instruments included the House-Brackmann, Sunnybrook Facial Grading System, and electronic clinician-graded facial function assessment. Quality-of-life instruments included the Facial Disability Index and Facial Clinimetric Evaluation Scale. Data Extraction and Synthesis Data extraction and qualitative synthesis were performed according to the Meta-analysis of Observational Studies in Epidemiology guidelines. Record screening, data extraction, and quality assessments were done by 2 researchers independently. Data were pooled using random-effects models. Main Outcomes and Measures The main outcome was the association between facial function and quality of life, quantified by Pearson r, Spearman ρ, or regression analysis. Results In total, 23 studies (3746 participants) were included. In the 21 studies that reported on the sex of the cohorts, there were 2073 women (57.3%). Mean or median age ranged from 21 to 64 years and mean or median duration of palsy ranged from newly diagnosed to 12 years. Bell palsy (n = 1397), benign tumor (n = 980), and infection (n = 257) were the most common etiologic factors. Pooled correlation coefficients were 0.424 (95% CI, 0.375-0.471) to 0.533 (95% CI, 0.447-0.610) between facial function and Facial Clinimetric Evaluation Scale total, 0.324 (95% CI, 0.128-0.495) to 0.397 (95% CI, 0.242-0.532) between facial function and Facial Clinimetric Evaluation Scale social function, 0.423 (95% CI, 0.322-0.514) to 0.605 (95% CI, -0.124-0.910) between facial function and Facial Disability Index physical function, and 0.166 (95% CI, 0.044-0.283) to 0.208 (95% CI, 0.031-0.373) between facial function and Facial Disability Index social function. Conclusions and Relevance Associations noted in this systematic review and meta-analysis were overall low to moderate, suggesting that only a small part of quality of life is explained by facial function. Associations were higher between facial function and physical function than social function of quality of life.
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Affiliation(s)
- Tessa E Bruins
- University of Groningen, Department of Plastic Surgery, University Medical Center Groningen, Groningen, the Netherlands
| | - Martinus M van Veen
- University of Groningen, Department of Plastic Surgery, University Medical Center Groningen, Groningen, the Netherlands
| | - Paul M N Werker
- University of Groningen, Department of Plastic Surgery, University Medical Center Groningen, Groningen, the Netherlands
| | - Pieter U Dijkstra
- University of Groningen, Center for Rehabilitation, Groningen, University Medical Center Groningen, Groningen, the Netherlands.,University of Groningen, Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, Groningen, the Netherlands
| | - Dieuwke C Broekstra
- University of Groningen, Department of Plastic Surgery, University Medical Center Groningen, Groningen, the Netherlands
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Tavares-Brito J, Fonseca ACDO, Torres RP, van Veen MM, Greene J, Salomone R, Bahmad F, Hadlock T, Bento RF. Facial Clinimetric Evaluation Scale and Synkinesis Assessment Questionnaire Translation into Brazilian Portuguese: A Validation Study. Int Arch Otorhinolaryngol 2020; 24:e24-e30. [PMID: 31915465 PMCID: PMC6946611 DOI: 10.1055/s-0039-1697992] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 08/01/2019] [Indexed: 01/27/2023] Open
Abstract
Introduction
Facial nerve palsy results in both functional disability and psychological morbidity. There are several well-established grading scales to quantify the quality of life of these patients.
Objective
Translate and validate the Facial Clinimetric Evaluation (FaCE) scale and Synkinesis Assessment Questionnaire (SAQ) to Brazilian Portuguese.
Methods
This study adopted a forward-backward translation method and performed cross-cultural adaptation. A pilot study was conducted to correct any confusing language and to evaluate content validity. A validation study was then performed. Internal consistency of the Brazilian Portuguese version of the FaCE and SAQ items was evaluated by Cronbach’s alpha coefficient. Construct validity was assessed by Spearman’s Rank Correlation Coefficient between FaCE and SAQ scores to eFACE, House-Brackmann, Short Form 12 (SF-12) and Facial Disability Index (FDI) (sub)scores.
Results
A total of 90 patients were included. Cronbach’s alpha for total domain scored 0.881 for FaCE and 0.809 for SAQ. FaCE total score correlation to eFACE total and House-Brackmann showed Spearman’s r value of 0.537 and −0.538, respectively (
p
< 0.001). SAQ correlation to eFACE synkinesis subdomain was −0.449 (
p
< 0.001). No correlation was found between SAQ and HB score. FaCE total score correlations were of 0.301 and 0.547 for SF-12 PCS and MCS, respectively (
p
< 0.001). Correlation between FaCE total and FDI Physical and Social/well-being functions were 0.498 and 0.567 (
p
< 0.001).
Conclusion
Brazilian Portuguese FaCE scale and SAQ versions achieved high validity and reliability in the present study. These translated instruments demonstrated good psychometric properties, being proper to use in clinical practice in Brazil and with Brazilian Portuguese speakers.
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Affiliation(s)
- Joana Tavares-Brito
- Department of Otolaryngology, Facial Nerve Center, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Boston, Massachusetts, United States.,Faculty of Medicine, Universidade de Brasília, Brasília, Distrito Federal, Brazil
| | | | - Rodolfo Prado Torres
- Faculty of Medicine, Universidade de Brasília, Brasília, Distrito Federal, Brazil
| | - Martinus M van Veen
- Department of Otolaryngology, Facial Nerve Center, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Boston, Massachusetts, United States.,Department of Plastic Surgery, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands
| | - Jacqueline Greene
- Department of Otolaryngology, Facial Nerve Center, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Boston, Massachusetts, United States
| | - Raquel Salomone
- Department of Otolaryngology, Universidade de São Paulo, Faculdade de Medicina, São Paulo, SP, Brazil
| | - Fayez Bahmad
- Faculty of Medicine, Universidade de Brasília, Brasília, Distrito Federal, Brazil
| | - Tessa Hadlock
- Department of Otolaryngology, Facial Nerve Center, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Boston, Massachusetts, United States
| | - Ricardo Ferreira Bento
- Department of Otolaryngology, Universidade de São Paulo, Faculdade de Medicina, São Paulo, SP, Brazil
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Tavares-Brito J, van Veen MM, Dusseldorp JR, Bahmad F, Hadlock TA. Facial Palsy-Specific Quality of Life in 920 Patients: Correlation With Clinician-Graded Severity and Predicting Factors. Laryngoscope 2018; 129:100-104. [PMID: 30208215 DOI: 10.1002/lary.27481] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 07/03/2018] [Accepted: 07/09/2018] [Indexed: 11/08/2022]
Abstract
OBJECTIVES To investigate the correlation between facial palsy severity and quality of life in a broad cohort of facial palsy patients and to elucidate factors that influence this relationship. STUDY DESIGN Retrospective study. METHODS Records of patients presenting with a clinician-graded facial function (eFACE) and facial palsy-specific quality-of-life patient-reported outcome measure (FaCE) scale from the same moment were reviewed. Multiple linear regression was performed to study the effect of various variables on FaCE total score. RESULTS A total of 920 of 1,304 patients were included, 59.9% female with a mean (standard deviation) age of 48.6 (16.7) years and a median (interquartile range palsy duration of 9.6 [2.2; 42.2] months. A multiple linear regression model predicting FaCE total score was established, finding 10 significant variables: eFACE; viral, malignant, and congenital etiologies; overweight status; anxiety; chronic pain; previous treatment; radiotherapy; and duration of palsy (R2 = 0.261, P < 0.001). Gender, age, laterality, surgical etiology, depression, and timing of evaluation (at initial intake or at follow up) were not found to predict FaCE total scores. CONCLUSION A correlation between facial palsy severity and quality of life was found in a large cohort of patients comprising various etiologies. Additionally, novel factors that predict quality of life in facial palsy were revealed. This information may help specialists to predict which facial palsy patients are at higher risk of a poorer quality of life, regardless of severity. LEVEL OF EVIDENCE 4 Laryngoscope, 129:100-104, 2019.
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Affiliation(s)
- Joana Tavares-Brito
- Facial Nerve Center, Department of Otolaryngology, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Boston, Massachusetts, U.S.A.,Healthy Science School, University of Brasilia, Brasilia, Brazil
| | - Martinus M van Veen
- Facial Nerve Center, Department of Otolaryngology, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Boston, Massachusetts, U.S.A.,Department of Plastic Surgery, University Medical Center Groningen and University of Groningen, Groningen, the Netherlands
| | - Joseph R Dusseldorp
- Facial Nerve Center, Department of Otolaryngology, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Boston, Massachusetts, U.S.A.,Department of Plastic and Reconstructive Surgery, Royal Australasian College of Surgeons and University of Sydney, Sydney, Australia
| | - Fayez Bahmad
- Healthy Science School, University of Brasilia, Brasilia, Brazil
| | - Tessa A Hadlock
- Facial Nerve Center, Department of Otolaryngology, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Boston, Massachusetts, U.S.A
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Serrano MD, Garrido M, Fuentes RM, Simón MJ, Díaz MJ. The impact of biological frailty syndrome on quality of life of nursing home residents. Appl Nurs Res 2017; 35:112-117. [DOI: 10.1016/j.apnr.2017.02.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 02/01/2017] [Indexed: 12/19/2022]
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Clinician and Patient-reported Outcomes Are Associated With Psychological Factors in Patients With Chronic Shoulder Pain. Clin Orthop Relat Res 2016; 474:2030-9. [PMID: 27357692 PMCID: PMC4965376 DOI: 10.1007/s11999-016-4894-0] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 05/10/2016] [Indexed: 01/31/2023]
Abstract
BACKGROUND Validated clinician outcome scores are considered less associated with psychosocial factors than patient-reported outcome measurements (PROMs). This belief may lead to misconceptions if both instruments are related to similar factors. QUESTIONS We asked: In patients with chronic shoulder pain, what biopsychosocial factors are associated (1) with PROMs, and (2) with clinician-rated outcome measurements? METHODS All new patients between the ages of 18 and 65 with chronic shoulder pain from a unilateral shoulder injury admitted to a Swiss rehabilitation teaching hospital between May 2012 and January 2015 were screened for potential contributing biopsychosocial factors. During the study period, 314 patients were screened, and after applying prespecified criteria, 158 patients were evaluated. The median symptom duration was 9 months (interquartile range, 5.5-15 months), and 72% of the patients (114 patients) had rotator cuff tears, most of which were work injuries (59%, 93 patients) and were followed for a mean of 31.6 days (SD, 7.5 days). Exclusion criteria were concomitant injuries in another location, major or minor upper limb neuropathy, and inability to understand the validated available versions of PROMs. The PROMs were the DASH, the Brief Pain Inventory, and the Patient Global Impression of Change, before and after treatment (physiotherapy, cognitive therapy and vocational training). The Constant-Murley score was used as a clinician-rated outcome measurement. Statistical models were used to estimate associations between biopsychosocial factors and outcomes. RESULTS Greater disability on the DASH was associated with psychological factors (Hospital Anxiety and Depression Scale, Pain Catastrophizing Scale combined coefficient, 0.64; 95% CI, 0.25-1.03; p = 0.002) and social factors (language, professional qualification combined coefficient, -6.15; 95% CI, -11.09 to -1.22; p = 0.015). Greater pain on the Brief Pain Inventory was associated with psychological factors (Hospital Anxiety and Depression Scale, Pain Catastrophizing Scale combined coefficient, 0.076; 95% CI, 0.021-0.13; p = 0.006). Poorer impression of change was associated with psychological factors (Hospital Anxiety and Depression Scale, Pain Catastrophizing Scale, Tampa Scale of Kinesiophobia coefficient, 0.93; 95% CI, 0.87-0.99; p = 0.026) and social factors (education, language, and professional qualification coefficient, 6.67; 95% CI, 2.77-16.10; p < 0.001). Worse clinician-rated outcome was associated only with psychological factors (Hospital Anxiety and Depression Scale (depression only), Pain Catastrophizing Scale, Tampa Scale of Kinesiophobia combined coefficient, -0.35; 95% CI, -0.58 to -0.12; p = 0.003). CONCLUSIONS Depressive symptoms and catastrophizing appear to be key factors influencing PROMs and clinician-rated outcomes. This study suggests revisiting the Constant-Murley score. LEVEL OF EVIDENCE Level III, prognostic study.
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Ethnic differences in the number of miscarriages, number of children, perceived family support and the impact of the disease on daily living in patients with systemic lupus erythematosus. Clin Rheumatol 2013; 32:1223-8. [PMID: 23515603 DOI: 10.1007/s10067-013-2234-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2012] [Revised: 02/04/2013] [Accepted: 03/04/2013] [Indexed: 10/27/2022]
Abstract
Our aim was to test for ethnic differences in the number of children, number of miscarriages, family support and the impact of the disease on daily living among patients with systemic lupus erythematosus (SLE). Patients with SLE (n = 54) who attended two hospitals in Essex, UK, were asked to complete a semi-structured, validated questionnaire. The number of children and the number of miscarriages were reported numerically. The level of family support and the impact of the disease on daily living were reported using 10 cm visual analogue scales (VAS) in which 10 cm represented the maximum support and worst effect on daily living, respectively. There were 20 Caucasian, 22 Asian and 12 African/Afro-Caribbean patients. There were 50 females and four males. The mean ± standard deviation (SD) age was 45.9 ± 12.2 years, and the mean ± SD age at disease onset was 35.6 ± 11.1 years. Overall, 34/50 female patients (68 %) reported having children of their own, while 17/50 female patients (34 %) reported one or more miscarriages. The miscarriages were mostly reported by Caucasian patients (45 % versus 18.1 % for Asian and 33.3 % for African/Afro-Caribbean patients; P < 0.05). All of the groups received support from their families (90.7 % overall), but the level of support was greater for Caucasian (mean ± SD VAS, 6.6 ± 3.4 cm) than for Asian (5.4 ± 3.9 cm) and African/Afro-Caribbean (5.4 ± 4.9 cm) patients (P = 0.06). More than half of the patients (53.7 %) reported a severe impact of SLE on daily living, while 13 % reported a moderate impact, 22.2 % reported a mild impact and 11.1 % reported no impact. The impact of SLE on daily living was significantly worse for African/Afro-Caribbean patients compared with Asian patients (P < 0.05). Overall, one in two patients with SLE reported having children of their own, while one in three patients reported having at least one miscarriage. Ninety percent of the patients received family support for their disease. Miscarriages and family support were more frequently reported by Caucasian patients. Asian patients had more children and experienced fewer miscarriages, while African/Afro-Caribbean patients reported a worse impact of the disease on daily living compared with the other ethnic groups.
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Tan D, Danoudis M, McGinley J, Morris ME. Relationships between motor aspects of gait impairments and activity limitations in people with Parkinson's disease: A systematic review. Parkinsonism Relat Disord 2012; 18:117-24. [DOI: 10.1016/j.parkreldis.2011.07.014] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2011] [Revised: 07/28/2011] [Accepted: 07/30/2011] [Indexed: 11/25/2022]
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Factores asociados con calidad de vida relacionada con la salud en mayores institucionalizados: diferencias entre hombres y mujeres. ENFERMERIA CLINICA 2012; 22:27-34. [DOI: 10.1016/j.enfcli.2011.09.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2011] [Revised: 08/26/2011] [Accepted: 09/25/2011] [Indexed: 11/19/2022]
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Lindenhovius ALC, Doornberg JN, Ring D, Jupiter JB. Health status after open elbow contracture release. J Bone Joint Surg Am 2010; 92:2187-95. [PMID: 20844161 DOI: 10.2106/jbjs.h.01594] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Operative contracture release may improve motion of a posttraumatic stiff elbow. In this study, we tested the hypothesis that improvement in ulnohumeral motion after elbow contracture release leads to improvement in general health status and decreases upper-extremity-specific disability. METHODS Twenty-three patients with posttraumatic loss of ≥30° of elbow flexion or extension who elected to have an open elbow capsulectomy completed the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH) and the Short Form-36 (SF-36) preoperatively and at least one year postoperatively. Pain was measured with use of the American Shoulder and Elbow Surgeons (ASES) Elbow Evaluation instrument. Four patients underwent additional, subsequent procedures to address residual elbow stiffness. RESULTS One patient who needed several additional procedures, including a total elbow arthroplasty, was considered to have had a failure of the operative contracture release and was excluded from the analysis; this left twenty-two patients in the study. On the average, the arc of flexion and extension improved from 51° preoperatively to 106° postoperatively; the DASH score, from 38 points to 18 points; the SF-36 Physical Component Summary (PCS) score, from 39 points to 49 points (all p < 0.05); and the SF-36 Mental Component Summary (MCS) score, from 49 points to 54 points (p < 0.05). There was no significant correlation between the improvement in the arc of flexion and extension and the improvement in the DASH (p = 0.53), PCS (p = 0.73), or MCS (p = 0.41) score. There also was no correlation between the final arc of flexion and extension and the final DASH score (p = 0.39 for the total score, p = 0.52 for the PCS score, and p = 0.42 for the MCS score). CONCLUSIONS Health status and disability scores improve after open elbow contracture release, but the improvements do not correlate with the improvement in elbow motion. Among multiple objective and subjective factors, pain was a strong predictor of the final general health status and arm-specific disability.
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Affiliation(s)
- Anneluuk L C Lindenhovius
- Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
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Mar J, Larrañaga I, Arrospide A, Begiristain JM. Impact of disability on different domains of health-related quality of life in the noninstitutionalized general population. CLINICOECONOMICS AND OUTCOMES RESEARCH 2010; 2:97-103. [PMID: 21935318 PMCID: PMC3169959 DOI: 10.2147/ceor.s10709] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2010] [Indexed: 11/23/2022] Open
Abstract
The relationship between disability and health related quality of life (HRQL) is complex because of the role that function plays in the measurement, and certain points need to be dealt with in greater detail when the analysis is applied to the different dimensions of HRQL. The purpose of this study was to assess the impact of disability on different domains of quality of life. Variables were drawn from the 2002 Basque Country Health Survey. Logistic regression models were constructed to measure the adjusted effect of disability on quality of life as determined by the SF-36 questionnaire. The models were adjusted for sociodemographic variables and the presence of comorbidity. The greatest difference between disabled and nondisabled subjects was found in the physical components of the questionnaire. Odds Ratios (ORs) for a suboptimal level of quality of life as determined by functional status were much higher for the physical than for the mental dimensions. Adjustment for different variables showed a decrease in ORs in the physical, mental, and social dimensions. This study establishes a significant relationship between disability and the loss of quality of life in both physical and mental dimensions of SF-36, irrespective of the associated disease.
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Affiliation(s)
- Javier Mar
- Research Unit, Hospital Alto Deba, Navarra 16, Mondragón, Spain
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Met R, Reekers JA, Koelemay MJW, Legemate DA, de Haan RJ. The AMC linear disability score (ALDS): a cross-sectional study with a new generic instrument to measure disability applied to patients with peripheral arterial disease. Health Qual Life Outcomes 2009; 7:88. [PMID: 19822016 PMCID: PMC2766362 DOI: 10.1186/1477-7525-7-88] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2009] [Accepted: 10/12/2009] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The AMC Linear Disability Score (ALDS) is a calibrated generic itembank to measure the level of physical disability in patients with chronic diseases. The ALDS has already been validated in different patient populations suffering from chronic diseases. The aim of this study was to assess the clinimetric properties of the ALDS in patients with peripheral arterial disease. METHODS Patients with intermittent claudication (IC) and critical limb ischemia (CLI) presenting from January 2007 through November 2007 were included. Risk factors for atherosclerosis, ankle/brachial index and toe pressure, the Vascular Quality of Life Questionnaire (VascuQol), and the ALDS were recorded. To compare ALDS and VascuQol scores between the two patient groups, an unpaired t-test was used. Correlations were determined between VascuQol, ALDS and pressure measurements. RESULTS Sixty-two patients were included (44 male, mean +/- sd age was 68 +/- 11 years) with IC (n = 26) and CLI (n = 36). The average ALDS was significantly higher in patients with IC (80, +/- 10) compared to patients with CLI (64, +/- 18). Internal reliability consistency of the ALDS expressed as Cronbach's alpha coefficient was excellent (alpha > 0.90). There was a strong convergent correlation between the ALDS and the disability related Activity domain of the VascuQol (r = 0.64). CONCLUSION The ALDS is a promising clinimetric instrument to measure disability in patients with various stages of peripheral arterial disease.
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Affiliation(s)
- Rosemarie Met
- Department of Radiology, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands
| | - Jim A Reekers
- Department of Radiology, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands
| | - Mark JW Koelemay
- Department of Vascular Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands
| | - Dink A Legemate
- Department of Vascular Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands
| | - Rob J de Haan
- Department of Clinical Epidemiology and Biostatistics, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands
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Lindenhovius ALC, Buijze GA, Kloen P, Ring DC. Correspondence between perceived disability and objective physical impairment after elbow trauma. J Bone Joint Surg Am 2008; 90:2090-7. [PMID: 18829905 DOI: 10.2106/jbjs.g.00793] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Substantial differences between disability and impairment are commonplace and puzzling. Subjective (psychosocial) factors may be paramount given that pain is a more important determinant of perceived overall arm-specific disability than is objective elbow impairment. To further evaluate the relationship between impairment and disability, we tested the hypothesis that objective loss of elbow motion predicts perceived elbow-related task-specific disability better than does pain after elbow trauma. METHODS One hundred and fifty-eight patients were evaluated at a median of twenty-six months after a traumatic elbow injury and completed the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. Predictors of the total DASH score and of the scores for individual DASH items that were expected to be related to elbow function were evaluated with univariate and multivariate analyses. RESULTS Motion accounted for 35% of the variability in the total DASH score, for 11% to 12% of the variability in the responses to questions specific to hand-based activities, and for 24% to 33% of the variability in the scores for tasks depending on elbow motion. Pain accounted for 41% of the variability in the total DASH score and was a better predictor than motion of disability associated with three tasks: opening a tight jar (with pain and motion accounting for 24% and 11% of the variability, respectively), pushing open a door (25% and 12%, respectively), and placing an object overhead (28% and 25%, respectively). None of the multivariate models explained more than 53% of the variability in the DASH scores. CONCLUSIONS Objective physical elbow impairment correlated with self-reported disability with respect to specific tasks, but a large proportion of disability remains unexplained. Further research is needed to better understand the differences between objective impairment and perceived disability.
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Affiliation(s)
- Anneluuk L C Lindenhovius
- Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Yawkey Center, Boston, MA 02114, USA
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Frihagen F, Grotle M, Madsen JE, Wyller TB, Mowinckel P, Nordsletten L. Outcome after femoral neck fractures: a comparison of Harris Hip Score, Eq-5d and Barthel Index. Injury 2008; 39:1147-56. [PMID: 18656868 DOI: 10.1016/j.injury.2008.03.027] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2008] [Revised: 03/15/2008] [Accepted: 03/19/2008] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The objective of this study was to evaluate the discriminatory ability and responsiveness of the Harris Hips Score, the Barthel Index and the Eq-5d (Euroqol) in an unselected population of patients with displaced femoral neck fracture. METHODS Data were collected at 4 and 12 months after surgery from a population of 222 patients. Patients with complete data sets who suffered a serious complication (n=23) were compared with patients with no complication (n=56). The assessment scales' ability to discriminate between the groups was calculated, as was the change score and the standardised response mean. RESULTS All scales were able to discriminate between the complications group and the non-complications group at 4 months, but only Harris Hip Score had independent explanatory ability in a logistic regression analysis. All scales showed a positive change score for the complications group from 4 to 12 months. The standardised response mean was 0.75 for Harris Hip Score, 0.40 for Barthel Index, 0.46 for the Eq-5d index score, and 0.57 for the Eq-5d visual analogue scale. Barthel Index had a marked ceiling effect with 51/79 (65%) scoring 19 or 20 at 4 months. The response rate was 71-87% for Eq-5d and 96-98% for Harris Hip Score and Barthel Index. CONCLUSION All the scales may be used for this patient group, but Harris Hip Score performed better than the other scales.
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Affiliation(s)
- Frede Frihagen
- Orthopaedic Centre, Ullevaal University Hospital, Oslo, Norway.
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Alshubaili AF, Ohaeri JU, Awadalla AW, Mabrouk AA. Quality of life in multiple sclerosis: a Kuwaiti MSQOL-54 experience. Acta Neurol Scand 2008; 117:384-92. [PMID: 18028242 DOI: 10.1111/j.1600-0404.2007.00960.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES We compared the quality of life (QOL) self-ratings of relapsing-remitting multiple sclerosis (RRMS) and progressive multiple sclerosis (PMS) patients with those of the general population; and assessed the association of demographic, clinical, and caregiver variables with patients' QOL. METHODS Consecutive clinic attendees were assessed with MSQOL-54, Beck's Depression Inventory, and Expanded Disability Status Scale. Caregivers rated their impression of patients' QOL and attitudes to patients' illness. RESULTS Of 170 patients (35.5% M, 64.5% F), 85.3% had RRMS and 14.7% PMS. RRMS had higher QOL domain scores (P < 0.001). Patients had lower QOL than controls (P < 0.001). Depression was the commonest significant covariate of QOL domains. After controlling for depression and disability, differences between the MS groups were less significant. Predictors of overall QOL were caregiver impression of patient's QOL, depression, and treatment side effects. CONCLUSION Programs that address depression, disability, the impact of treatment side effects, caregiver attitudes and education should enhance QOL outcomes.
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Affiliation(s)
- A F Alshubaili
- Department of Neurology, Ibn Sina Hospital, Safat, Kuwait
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