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Yılmaz Topçuoğlu M, Sommerburg O, Wielpütz MO, Wucherpfennig L, Hackenberg S, Mainz JG, Baumann I. [Chronic rhinosinusitis in people with cystic fibrosis-an up-to-date review from the perspective of otorhinolaryngology]. HNO 2024:10.1007/s00106-024-01428-9. [PMID: 38363326 DOI: 10.1007/s00106-024-01428-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2023] [Indexed: 02/17/2024]
Abstract
BACKGROUND Cystic fibrosis (CF) is a complex systemic disease involving numerous organ systems. With improved treatment options and increasing life expectancy of persons with CF (PwCF), extrapulmonary manifestations are coming increasingly into the focus. From birth, almost all PwCF have radiologically detectable pathologies in the upper airways attributable to CF-associated chronic rhinosinusitis (CF-CRS). OBJECTIVE The aim of this work is to provide an up-to-date overview of CF-CRS from the otorhinolaryngology perspective and to provide the reader with background knowledge and current developments. PATHOPHYSIOLOGY The cystic fibrosis transmembrane conductance regulator (CFTR) gene defect leads to increased viscosity of sinonasal secretions and reduced mucociliary clearance, causing chronic infection and inflammation in the upper airway segment and, consequently, to CF-CRS. CLINICAL PICTURE AND DIAGNOSTICS The clinical picture of CF-CRS comprises a wide spectrum from asymptomatic to symptomatic courses. CF-CRS is diagnosed clinically and radiologically. THERAPY Sinonasal saline irrigation is recommended as a conservative treatment measure. Topical corticosteroids are also commonly used. Surgical therapy is reserved for highly symptomatic treatment-refractory patients without a sufficient response to conservative treatment including CFTR modulator (CFTRm) therapies. Depending on the CFTR mutation, CFTRm therapies are the treatment of choice. They not only improve the pulmonary and gastrointestinal manifestations in PwCF, but also have positive effects on CF-CRS. CONCLUSION The ENT specialist is part of the interdisciplinary team caring for PwCF. Depending on symptom burden and treatment responsiveness, CF-CRS should be treated conservatively and/or surgically. Modern CFTRm have a positive effect on the clinical course of CF-CRS.
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Affiliation(s)
- M Yılmaz Topçuoğlu
- Hals-Nasen-Ohrenklinik der Universitätsklinik Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland.
| | - O Sommerburg
- Sektion für Pädiatrische Pneumologie & Allergologie und Mukoviszidosezentrum, Zentrum für Kinder- und Jugendmedizin, Klinik III, Universitätsklinik Heidelberg, Heidelberg, Deutschland
| | - M O Wielpütz
- Klinik für Diagnostische und Interventionelle Radiologie, der Universitätsklinik Heidelberg, Heidelberg, Deutschland
- Translational Lung Research Center (TLRC), Deutsches Zentrum für Lungenforschung (DZL), Heidelberg, Deutschland
| | - L Wucherpfennig
- Klinik für Diagnostische und Interventionelle Radiologie, der Universitätsklinik Heidelberg, Heidelberg, Deutschland
- Translational Lung Research Center (TLRC), Deutsches Zentrum für Lungenforschung (DZL), Heidelberg, Deutschland
| | - S Hackenberg
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - J G Mainz
- Pädiatrische Pneumologie, Allergologie, Mukoviszidosezentrum Medizinische Hochschule Brandenburg (MHB) Theodor Fontane, Klinikum Westbrandenburg, Brandenburg an der Havel, Deutschland
| | - I Baumann
- Hals-Nasen-Ohrenklinik der Universitätsklinik Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland
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Blanco-Orive P, Del Corral T, Martín-Casas P, Cebrià I Iranzo MÀ, Godoy-Nieto C, López-de-Uralde-Villanueva I. Spanish adaptation and validation of the child- and parent-report cystic fibrosis questionnaire-revised (CFQ-R). Pediatr Pulmonol 2023; 58:3447-3457. [PMID: 37701960 DOI: 10.1002/ppul.26671] [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: 03/21/2023] [Revised: 07/31/2023] [Accepted: 08/30/2023] [Indexed: 09/14/2023]
Abstract
OBJECTIVE To evaluate the psychometric properties of the Spanish versions of the child- and parent-report cystic fibrosis questionnaire-revised (CFQ-R). METHODS A Spanish adaptation of the CFQ-R was performed; 68 children with CF (6-13 years) and their parents completed the child- and parent-report CFQ-R, respectively, and the Revidierter KINDer Lebensqualitätsfragebogen (KINDL) questionnaire. The CFQ-R was completed twice, 7-10 days apart, and its psychometric properties were analyzed. RESULTS The internal consistency of both CFQ-R versions was adequate (child-report version, Cronbach's α >.60 for all domains except "Treatment Burden" [α = .42] and "Social Functioning" [α = .57]; parent-report version, α > .60 for all domains except "Social Functioning" [α = .58]). For the child-report version, the lowest measurement error was for "Emotional Functioning" (standard error of measurement [SEM]: 8.3%; minimal detectable change [MDC90 ]: 19.3%), and the highest was for "Body Image" (SEM: 15%; MDC90 : 35%). For the parent-report version, the lowest measurement error was for "Physical Functioning" (SEM: 7.1%; MDC90 : 16.5%), and the highest was for "Weight" (SEM: 17.2%; MDC90 ; 40.1%). The correlation between the versions showed higher agreement for the domains related to observable signs ("Physical Functioning") and lower agreement for "Emotional Functioning." There was a significant correlation between the CFQ-R and KINDL. CONCLUSION Both the child- and parent-report versions of the Spanish CFQ-R have adequate reliability and validity for clinical and research purposes. These versions can be administered before and after starting modulator therapy to assess its effect on daily functioning. The MDC90 can help identify, with a high probability, whether real changes have occurred in the quality-of-life subscales in children with CF.
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Affiliation(s)
- Paula Blanco-Orive
- Doctorate in Health Care, Faculty of Nursing, Physiotherapy and Podiatry, Complutense University of Madrid, Madrid, Spain
| | - Tamara Del Corral
- Department of Radiology, Rehabilitation and Physiotherapy, IdISSC, Faculty of Nursing, Physiotherapy and Podiatry, Complutense University of Madrid (UCM), Madrid, Spain
| | - Patricia Martín-Casas
- Department of Radiology, Rehabilitation and Physiotherapy, IdISSC, Faculty of Nursing, Physiotherapy and Podiatry, Complutense University of Madrid (UCM), Madrid, Spain
| | | | - Cristina Godoy-Nieto
- Hospital de Sabadell, Corporació Sanitària Universitària Parc Taulí, Barcelona, Spain
| | - Ibai López-de-Uralde-Villanueva
- Department of Radiology, Rehabilitation and Physiotherapy, IdISSC, Faculty of Nursing, Physiotherapy and Podiatry, Complutense University of Madrid (UCM), Madrid, Spain
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Dykowska G, Śmigrocka E, Borawska-Kowalczyk U, Sands D, Sienkiewicz Z, Leńczuk-Gruba A, Gorczyca D, Głowacka M. Parents' Knowledge of the Impact of Cystic Fibrosis on the Quality of Life of Children and Adolescents Suffering from This Disease as an Element of Patient Safety. J Clin Med 2023; 12:5214. [PMID: 37629256 PMCID: PMC10456040 DOI: 10.3390/jcm12165214] [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: 06/12/2023] [Revised: 07/28/2023] [Accepted: 07/31/2023] [Indexed: 08/27/2023] Open
Abstract
Parental perspective on the health, safety, and quality of life in children and adolescents with cystic fibrosis (CF). AIM OF THE STUDY Assessment of the impact of a chronic disease such as cystic fibrosis (CF) on the quality of life and safety of children and adolescents as perceived by parents/caretakers. METHODS The study was conducted at the Department of Lung Diseases of the Institute of Mother and Child, a branch of the Cystic Fibrosis Centre Children of Warsaw SZPZOZ in Dziekanów Leśny, the largest pediatric CF center in Poland, and in the Rodzinamuko group on Facebook. A total of 139 parents participated in the study. The study was conducted using the diagnostic survey method with the use of the Kid- & Kiddo-KINDLR questionnaire for examining the quality of life of children and adolescents and a demographic questionnaire. RESULTS The perception of cystic fibrosis (CF) as a chronic disease varies based on parental residence and professional status. The well-being of children and adolescents with CF is tied to their parents' employment, particularly regarding schooling. Social interactions are influenced by the level of parental education. The quality of life in children and adolescents with CF is age-dependent, with younger children exhibiting higher quality of life. This age-quality of life relationship extends to physical well-being, emotional well-being, and school-related aspects. Furthermore, the emotional dimension of quality of life is affected by the child's age at the time of diagnosis. CONCLUSIONS The Kid- & Kiddo-KINDLR QoL Questionnaire for children with cystic fibrosis is a good tool to measure parental knowledge. The study shows the need for the whole family to understand and be aware of the impact of CF on family life. Parents may be tired or may misunderstand or miscommunicate the medical team's instructions, which may affect both family life and patient safety. To ensure patient safety, parents should work with healthcare professionals at hospitals or clinics but also at home. They should also account for the family as a whole, not just for the problems of the child with CF.
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Affiliation(s)
- Grażyna Dykowska
- Department of Health Economics and Medical Law, Faculty of Health Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Ewa Śmigrocka
- Cystic Fibrosis Department, Institute of Mother and Child, 01-211 Warsaw, Poland; (E.Ś.); (U.B.-K.); (D.S.)
| | - Urszula Borawska-Kowalczyk
- Cystic Fibrosis Department, Institute of Mother and Child, 01-211 Warsaw, Poland; (E.Ś.); (U.B.-K.); (D.S.)
- Cystic Fibrosis Center, Children’s Hospital in Dziekanów Leśny, 05-092 Warsaw, Poland
| | - Dorota Sands
- Cystic Fibrosis Department, Institute of Mother and Child, 01-211 Warsaw, Poland; (E.Ś.); (U.B.-K.); (D.S.)
- Cystic Fibrosis Center, Children’s Hospital in Dziekanów Leśny, 05-092 Warsaw, Poland
| | - Zofia Sienkiewicz
- Department of Nursing, Social and Medical Development, Medical University of Warsaw, 02-091 Warsaw, Poland; (Z.S.); (A.L.-G.)
| | - Anna Leńczuk-Gruba
- Department of Nursing, Social and Medical Development, Medical University of Warsaw, 02-091 Warsaw, Poland; (Z.S.); (A.L.-G.)
| | - Damian Gorczyca
- Medical Faculty, Lazarski University, 02-662 Warsaw, Poland;
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Havaei N, Modaresi MR, Rezaei M, Asghari-Jafarabadi M, Kohzadi A, Ariafar Y, Ghalibaf B, Goljaryan S. Psychometric Properties of the Persian Version of Cystic Fibrosis Questionnaire: Revised in Children with Cystic Fibrosis. Int J Prev Med 2023; 14:83. [PMID: 37855002 PMCID: PMC10580193 DOI: 10.4103/ijpvm.ijpvm_137_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 10/27/2022] [Indexed: 10/20/2023] Open
Abstract
Background Cystic fibrosis is a progressive, fatal disease affecting the quality of life. The cystic fibrosis questionnaire-revised (CFQ-R) is an efficient tool to monitor health-related quality of life in patients. The aim of this study was to explore the psychometric properties of the child and parent versions of the Persian version of the CFQ-R in the Iranian population. Methods Fifty children with cystic fibrosis (6-11 years) and their parents were allocated in this methodological study to examine convergent validity, discriminant validity, test-retest reliability (n = 30), internal consistency, ceiling and floor effects, and agreement between two versions of the CFQ-R. Results Convergent validity was confirmed for parent proxy (P < 0.05). CFQ-R discriminated patients among stages of disease severity based on lung function, age, and BMI (P < 0.05). Test-retest analysis revealed good to excellent reliability (inter-class correlation coefficient (ICC) = 0.78-0.97). In most domains, lower quality of life scores was obtained in the parent proxy compared to the child version (P < 0.05). Domain-specific correlations were found between the child version and parent proxy (P < 0.05). Internal consistency was generally confirmed (α = 0.13-0.83 in child version and α = 0.25-0.87 in parent proxy). There were no floor effects. Ceiling effects were mostly seen for physical, digestion, and body image domains in the child version and for eating, weight, and school domains in the parent proxy. Conclusions The child version and parent proxy of the Persian CFQ-R are valid and reliable measures and can be applied in clinical trials to monitor the quality of life in children with cystic fibrosis. It is recommended to use both versions in conjunction to better interpret the quality of life aspects of children with cystic fibrosis.
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Affiliation(s)
- Naser Havaei
- Occupational Therapy Department, Faculty of Rehabilitation Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Reza Modaresi
- Pediatric Respiratory and Sleep Medicine Research Center, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mandana Rezaei
- Physiotherapy Department, Faculty of Rehabilitation Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Ameneh Kohzadi
- Physiotherapy Department, Faculty of Rehabilitation, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Yalda Ariafar
- Physiotherapy Department, Faculty of Rehabilitation, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Babak Ghalibaf
- Pediatric Pulmonologist, Medical School of Tabriz Azad University, Tabriz, Iran
| | - Sakineh Goljaryan
- Physiotherapy Department, Faculty of Rehabilitation Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
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Steinke E, Sommerburg O, Graeber SY, Joachim C, Labitzke C, Nissen G, Ricklefs I, Rudolf I, Kopp MV, Dittrich AM, Mall MA, Stahl M. TRACK-CF prospective cohort study: Understanding early cystic fibrosis lung disease. Front Med (Lausanne) 2023; 9:1034290. [PMID: 36687447 PMCID: PMC9853074 DOI: 10.3389/fmed.2022.1034290] [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: 09/01/2022] [Accepted: 12/05/2022] [Indexed: 01/09/2023] Open
Abstract
Background Lung disease as major cause for morbidity in patients with cystic fibrosis (CF) starts early in life. Its large phenotypic heterogeneity is partially explained by the genotype but other contributing factors are not well delineated. The close relationship between mucus, inflammation and infection, drives morpho-functional alterations already early in pediatric CF disease, The TRACK-CF cohort has been established to gain insight to disease onset and progression, assessed by lung function testing and imaging to capture morpho-functional changes and to associate these with risk and protective factors, which contribute to the variation of the CF lung disease progression. Methods and design TRACK-CF is a prospective, longitudinal, observational cohort study following patients with CF from newborn screening or clinical diagnosis throughout childhood. The study protocol includes monthly telephone interviews, quarterly visits with microbiological sampling and multiple-breath washout and as well as a yearly chest magnetic resonance imaging. A parallel biobank has been set up to enable the translation from the deeply phenotyped cohort to the validation of relevant biomarkers. The main goal is to determine influencing factors by the combined analysis of clinical information and biomaterials. Primary endpoints are the lung clearance index by multiple breath washout and semi-quantitative magnetic resonance imaging scores. The frequency of pulmonary exacerbations, infection with pro-inflammatory pathogens and anthropometric data are defined as secondary endpoints. Discussion This extensive cohort includes children after diagnosis with comprehensive monitoring throughout childhood. The unique composition and the use of validated, sensitive methods with the attached biobank bears the potential to decisively advance the understanding of early CF lung disease. Ethics and trial registration The study protocol was approved by the Ethics Committees of the University of Heidelberg (approval S-211/2011) and each participating site and is registered at clinicaltrials.gov (NCT02270476).
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Affiliation(s)
- Eva Steinke
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité–Universitätsmedizin Berlin, Berlin, Germany,German Center for Lung Research (DZL), Associated Partner Site, Berlin, Germany,Berlin Institute of Health (BIH) at Charité, Berlin, Germany,*Correspondence: Eva Steinke ✉
| | - Olaf Sommerburg
- Division of Pediatric Pulmonology and Allergy and Cystic Fibrosis Center, Department of Translational Pulmonology, University of Heidelberg, Heidelberg, Germany,Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
| | - Simon Y. Graeber
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité–Universitätsmedizin Berlin, Berlin, Germany,German Center for Lung Research (DZL), Associated Partner Site, Berlin, Germany,Berlin Institute of Health (BIH) at Charité, Berlin, Germany
| | - Cornelia Joachim
- Division of Pediatric Pulmonology and Allergy and Cystic Fibrosis Center, Department of Translational Pulmonology, University of Heidelberg, Heidelberg, Germany,Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
| | - Christiane Labitzke
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité–Universitätsmedizin Berlin, Berlin, Germany
| | - Gyde Nissen
- Division of Pediatric Pneumology and Allergology, University of Lübeck, Lübeck, Germany,Airway Research Center North (ARCN), German Center for Lung Research (DZL), Lübeck, Germany
| | - Isabell Ricklefs
- Division of Pediatric Pneumology and Allergology, University of Lübeck, Lübeck, Germany,Airway Research Center North (ARCN), German Center for Lung Research (DZL), Lübeck, Germany
| | - Isa Rudolf
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany,Biomedical Research in Endstage and Obstructive Lung Disease (BREATH), German Center for Lung Research (DZL), Hannover, Germany
| | - Matthias V. Kopp
- Division of Pediatric Pneumology and Allergology, University of Lübeck, Lübeck, Germany,Airway Research Center North (ARCN), German Center for Lung Research (DZL), Lübeck, Germany,Division of Respiratory Medicine, Department of Pediatrics, University Children's Hospital, Inselspital, University of Bern, Bern, Switzerland
| | - Anna-Maria Dittrich
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany,Biomedical Research in Endstage and Obstructive Lung Disease (BREATH), German Center for Lung Research (DZL), Hannover, Germany
| | - Marcus A. Mall
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité–Universitätsmedizin Berlin, Berlin, Germany,German Center for Lung Research (DZL), Associated Partner Site, Berlin, Germany,Berlin Institute of Health (BIH) at Charité, Berlin, Germany
| | - Mirjam Stahl
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité–Universitätsmedizin Berlin, Berlin, Germany,German Center for Lung Research (DZL), Associated Partner Site, Berlin, Germany,Berlin Institute of Health (BIH) at Charité, Berlin, Germany
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Evaluation of the quality of life and associated factors of a group of children and adolescents with cystic fibrosis in the northern region of Portugal: a cross-sectional pilot study. Porto Biomed J 2022; 7:e194. [DOI: 10.1097/j.pbj.0000000000000194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 07/08/2022] [Accepted: 07/12/2022] [Indexed: 11/22/2022] Open
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Pattie P, Ranganathan S, Harrison J, Vidmar S, Hall GL, Foong RE, Harper A, Ramsey K, Wurzel D. Quality of life is poorly correlated to lung disease severity in school-aged children with cystic fibrosis. J Cyst Fibros 2021; 21:e188-e203. [PMID: 34801433 DOI: 10.1016/j.jcf.2021.11.005] [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: 08/03/2021] [Revised: 11/07/2021] [Accepted: 11/07/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND There is no data exclusively on the relationship between health-related quality-of-life (HRQOL) and lung disease severity in early school-aged children with cystic fibrosis (CF). Using data from the Australian Respiratory Early Surveillance Team for Cystic Fibrosis (AREST CF) we assessed the relationships between HRQOL, lung function and structure. METHODS 125 children aged 6.5-10 years enrolled in the AREST CF program were included from CF clinics at Royal Children's Hospital (RCH), Melbourne (n = 66) and Perth Children's Hospital (PCH), Perth (n = 59), Australia. Demographics, HRQOL measured by Cystic Fibrosis Questionnaire-Revised (CFQ-R), spirometry, multiple-breath washout (MBW) and chest CT were collected across two years. Correlation between CFQ-R scores and lung structure/function parameters and agreement between parent-proxy and child-reported HRQOL were evaluated. RESULTS No correlation was observed between most CFQ-R domain scores and FEV1 z-scores, excepting weak-positive correlation with parent CFQ-R Physical (rho = 0.21, CI 0.02-0.37), and Weight (rho = 0.21, CI 0.03-0.38) domain and child Body domain (rho = 0.26, CI 0.00-0.48). No correlation between most CFQ-R domain scores and LCI values was noted excepting weak-negative correlation with parent Respiratory (rho = -0.23, CI -0.41--0.05), Emotional (rho = -0.24, CI -0.43--0.04), and Physical (-0.21, CI -0.39--0.02) domains. Furthermore, structural lung disease on CT data demonstrated little to no association with CFQ-R parent and child domain scores. Additionally, no agreement between child self-report and parent-proxy CFQ-R scores was observed across the majority of domains and visits. CONCLUSION HRQOL correlated poorly with lung function and structure in early school-aged children with CF, hence clinical trials should consider these outcomes independently when determining study end-points.
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Affiliation(s)
- Phillip Pattie
- Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Australia.
| | - Sarath Ranganathan
- Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Australia; Department of Respiratory and Sleep Medicine, Royal Children's Hospital, Melbourne, Australia
| | - Joanne Harrison
- Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Australia; Department of Respiratory and Sleep Medicine, Royal Children's Hospital, Melbourne, Australia
| | - Suzanna Vidmar
- Department of Paediatrics, The University of Melbourne, Australia; Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Melbourne, Australia
| | - Graham L Hall
- Wal-yan Respiratory Centre, Telethon Kids Institute, Nedlands, Western Australia, Australia; School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Rachel E Foong
- Wal-yan Respiratory Centre, Telethon Kids Institute, Nedlands, Western Australia, Australia; School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Alana Harper
- Wal-yan Respiratory Centre, Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Kathryn Ramsey
- Wal-yan Respiratory Centre, Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Danielle Wurzel
- Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Australia; Department of Respiratory and Sleep Medicine, Royal Children's Hospital, Melbourne, Australia; Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
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Blanco-Orive P, Del Corral T, Martín-Casas P, Ceniza-Bordallo G, López-de-Uralde-Villanueva I. Quality of life and exercise tolerance tools in children/adolescents with cystic fibrosis: Systematic review. Med Clin (Barc) 2021; 158:519-530. [PMID: 34507821 DOI: 10.1016/j.medcli.2021.06.025] [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: 03/10/2021] [Revised: 06/14/2021] [Accepted: 06/15/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION This systematic review aims to analyze the validity and reliability of available tools to assess health-related quality of life (HRQoL) and exercise tolerance in children and adolescents with cystic fibrosis (CF). MATERIALS AND METHODS A review of observational studies studying the validity and reliability of the tools was conducted. The COSMIN (COnsesus-based Standards for the selection of health Measurements INstruments) guide was followed to analyze the quality of these tools. RESULTS A total of 18 studies were selected. Of the eight HRQoL tools, five generic and three specific, analyzed in 14 studies, the Cystic Fibrosis Questionnaire-Revised (CFQ-R) presents the best properties. Of the four tools analyzed to assess exercise tolerance, cycle ergometry and the modified shuttle test are the most valid and reliable. CONCLUSIONS The CFQ-R, cycloergometry and the modified shuttle test have the best properties for the assessment of children with CF, but more studies are needed.
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Affiliation(s)
- Paula Blanco-Orive
- Programa de doctorado en Cuidados en Salud, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, España
| | - Tamara Del Corral
- Departamento de Radiología, Rehabilitación y Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, España
| | - Patricia Martín-Casas
- Departamento de Radiología, Rehabilitación y Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, España.
| | - Guillermo Ceniza-Bordallo
- Programa de doctorado en Cuidados en Salud, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, España
| | - Ibai López-de-Uralde-Villanueva
- Departamento de Radiología, Rehabilitación y Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, España
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Alishbayli G, Kilinc AA, Cokugras H. Evaluation of the health-related quality of life in Turkish cystic fibrosis patients. Pediatr Int 2021; 63:965-970. [PMID: 33207026 DOI: 10.1111/ped.14553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 10/30/2020] [Accepted: 11/11/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Prolongation of life expectancy in cystic fibrosis (CF) to the fourth decade makes health-related quality of life (HRQOL) an important issue in this population. This study aims to evaluate the effects of clinical and socio-demographic characteristics of patients on different aspects of HRQOL in a pediatric CF population. We also intend to assess some measures of reliability and validity of the Turkish CF Questionnaire-Revised (CFQ-R) forms. METHODS Fifty-four CF patients and 46 parents / caregivers filled the appropriate CFQ-R forms. Disease severity was evaluated via modified Shwachman-Kulczycki (SK) scores, and additional clinical information was obtained from patient records. RESULTS Forty-three percent (n = 23) of patients were female, the mean age of patients being 13.3 ± 3.96 years. Self- and proxy-reported points showed a strong correlation (Spearman's rho > 0.6) on more observable domains of HRQOL (e.g. physical functioning). No significant difference was found between sexes on any HRQOL domain. When compared between age groups, treatment burden appeared to worsen with age, while social functioning improved. All three forms of the CFQ-R Turkish version showed acceptable internal consistency reliability and convergence with disease severity measures. CONCLUSIONS The CFQ-R showed a fair correlation with the Shwachman-Kulczycki score and the FEV1% value, which makes its longitudinal use possible in clinical practice. It is important to use self-reported evaluations as well as parent / caregiver-reported HRQOL evaluations, especially in young children. More studies are needed to assess the psychometric properties of Turkish CFQ-R forms.
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Affiliation(s)
- Gulzar Alishbayli
- Department of Pediatrics, Cerrahpasa Faculty of Medicine, Istanbul University- Cerrahpasa, Istanbul, Turkey
| | - Ayse Ayzit Kilinc
- Department of Pediatric Pulmonology, Cerrahpasa Faculty of Medicine, Istanbul University- Cerrahpasa, Istanbul, Turkey
| | - Haluk Cokugras
- Department of Pediatrics, Cerrahpasa Faculty of Medicine, Istanbul University- Cerrahpasa, Istanbul, Turkey.,Department of Pediatric Pulmonology, Cerrahpasa Faculty of Medicine, Istanbul University- Cerrahpasa, Istanbul, Turkey
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Ratnayake I, Ahern S, Ruseckaite R. Acceptability of patient reported outcome measures (PROMs) in a cystic fibrosis data registry. BMJ Open Respir Res 2021; 8:8/1/e000927. [PMID: 34281916 PMCID: PMC8291302 DOI: 10.1136/bmjresp-2021-000927] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 06/27/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction Improvements in the treatment of cystic fibrosis (CF) have resulted in longer survival and an increased focus on optimising daily functioning with the condition. Patient-reported outcome measures (PROMs) are valuable tools in evaluating the health-related quality of life of persons with chronic diseases. PROMs may be incorporated into clinical registries to assess and provide feedback regarding the health-related quality of life of the affected population. This study uses qualitative methodology to describe the views of patients with CF, caregivers and clinicians on the usefulness and practicality of incorporating a PROM in the Australian Cystic Fibrosis Data Registry (ACFDR). Methods We conducted semistructured interviews with a convenience sample of patients with CF (n=5), caregivers (n=7) and clinicians (n=13) on their opinions on incorporating the Cystic Fibrosis Questionnaire-Revised or the Cystic Fibrosis Quality of Life Questionnaire into the ACFDR. We analysed data into topics and subtopics using conventional content analysis. Results Participants believed that PROMs could generate useful aggregate health-related quality of life data to support better understanding of the experiences of the modern CF population. Participants emphasised that implementation must be supported by processes to feedback data to patients and clinicians. Most participants preferred electronic PROMs administration for easy integration into existing systems and the potential to support feedback. Conclusion Patients, caregivers and clinicians in this study generally supported the usefulness and practicality of PROM implementation in the ACFDR.
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Affiliation(s)
- Irushi Ratnayake
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Susannah Ahern
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Rasa Ruseckaite
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Thee S, Stahl M, Fischer R, Sutharsan S, Ballmann M, Müller A, Lorenz D, Urbanski-Rini D, Püschner F, Amelung VE, Fuchs C, Mall MA. A multi-centre, randomized, controlled trial on coaching and telemonitoring in patients with cystic fibrosis: conneCT CF. BMC Pulm Med 2021; 21:131. [PMID: 33882893 PMCID: PMC8058751 DOI: 10.1186/s12890-021-01500-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 04/13/2021] [Indexed: 11/29/2022] Open
Abstract
Background The extend of lung disease remains the most important prognostic factor for survival in patients with cystic fibrosis (CF), and lack of adherence is the main reason for treatment failure. Early detection of deterioration in lung function and optimising adherence are therefore crucial in CF care. We implement a randomized controlled trial to evaluate efficacy of telemonitoring of adherence, lung function, and health condition in combination with behavior change interventions using innovative digital technologies. Methods This is a multi-centre, randomized, controlled, non-blinded trial aiming to include 402 patients ≥ 12 years-of-age with CF. A standard-of-care arm is compared to an arm receiving objective, continuous monitoring of adherence to inhalation therapies, weekly home spirometry using electronic devices with data transmission to patients and caring physicians combined with video-conferencing, a self-management app and professional telephone coaching. The duration of the intervention phase is 18 months. The primary endpoint is time to the first protocol-defined pulmonary exacerbation. Secondary outcome measures include number of and time between pulmonary exacerbations, adherence to inhalation therapy, changes in forced expiratory volume in 1 s from baseline, number of hospital admissions, and changes in health-related quality of life. CF-associated medical treatment and care, and health care related costs will be assessed by explorative analysis in both arms. Discussion This study offers the opportunity to evaluate the effect of adherence interventions using telemedicine capable devices on adherence and lung health, possibly paving the way for implementation of telemedicine in routine care for patients with CF. Trial registration: This study has been registered with the German Clinical Trials Register (Identifier: DRKS00024642, date of registration 01 Mar 2021, URL: https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00024642). Supplementary Information The online version contains supplementary material available at 10.1186/s12890-021-01500-y.
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Affiliation(s)
- Stephanie Thee
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Division of Cystic Fibrosis, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Mirjam Stahl
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Division of Cystic Fibrosis, Charité - Universitätsmedizin Berlin, Berlin, Germany.,German Centre for Lung Research (DZL), Associated Partner, Berlin, Germany
| | | | - Sivagurunathan Sutharsan
- Department of Pulmonary Medicine, Division of Cystic Fibrosis, University Medicine Essen -Ruhrlandklinik, University of Duisburg-Essen, Essen, Germany
| | - Manfred Ballmann
- Department of Pediatrics, University Medicine Rostock, Rostock, Germany
| | | | | | | | - Franziska Püschner
- Private Institute for Applied Health Services Research (Inav) GmbH, Berlin, Germany
| | - Volker Eric Amelung
- Private Institute for Applied Health Services Research (Inav) GmbH, Berlin, Germany
| | | | - Marcus Alexander Mall
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Division of Cystic Fibrosis, Charité - Universitätsmedizin Berlin, Berlin, Germany. .,German Centre for Lung Research (DZL), Associated Partner, Berlin, Germany. .,Berlin Institute of Health (BIH), Berlin, Germany.
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Abstract
BACKGROUND To determine patient-reported outcome measures (PROMs) which may be suitable for incorporation into the Australian Cystic Fibrosis Data Registry (ACFDR) by identifying PROMs administered in adult and paediatric cystic fibrosis (CF) populations in the last decade. METHODS We searched MEDLINE, EMBASE, Scopus, CINAHL, PsycINFO and Cochrane Library databases for studies published between January 2009 and February 2019 describing the use of PROMs to measure health-related quality of life (HRQoL) in adult and paediatric patients with CF. Validation studies, observational studies and qualitative studies were included. The search was conducted on 13 February 2019. The COnsensus-based Standards for the selection of health Measurement INstruments Risk of Bias Checklist was used to assess the methodological quality of included studies. RESULTS Twenty-seven different PROMs were identified. The most commonly used PROMs were designed specifically for CF. Equal numbers of studies were conducted on adult (32%, n=31), paediatric (35%, n=34) and both (27%, n=26) populations. No PROMs were used within a clinical registry setting previously. The two most widely used PROMs, the Cystic Fibrosis Questionnaire-Revised (CFQ-R) and the Cystic Fibrosis Quality of Life Questionnaire (CFQoL), demonstrated good psychometric properties and acceptability in English-speaking populations. DISCUSSION We found that although PROMs are widely used in CF, there is a lack of reporting on the efficacy of methods and timepoints of administration. We identified the CFQ-R and CFQoL as the most suitable for incorporation in the ACFDR as they captured significant effects of CF on HRQoL and were reliable and valid in CF populations. These PROMs will be used in a further qualitative study assessing patients' with CF and clinicians' perspectives toward the acceptability and feasibility of incorporating a PROM in the ACFDR. PROSPERO REGISTRATION NUMBER CRD42019126931.
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Affiliation(s)
- Irushi Ratnayake
- Department of Epidemiology and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Susannah Ahern
- Department of Epidemiology and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Rasa Ruseckaite
- Department of Epidemiology and Preventive Medicine, Monash University, Clayton, Victoria, Australia
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13
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Perez AA, Hays SR, Soong A, Gao Y, Greenland JR, Leard LE, Shah RJ, Golden J, Kukreja J, Venado A, Kleinhenz ME, Singer JP. Improvements in frailty contribute to substantial improvements in quality of life after lung transplantation in patients with cystic fibrosis. Pediatr Pulmonol 2020; 55:1406-1413. [PMID: 32237273 PMCID: PMC8048765 DOI: 10.1002/ppul.24747] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Accepted: 03/07/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND While lung transplantation (LTx) improves health-related quality of life (HRQL) in cystic fibrosis (CF), the determinants of this improvement are unknown. In other populations, frailty-a syndrome of vulnerability to physiologic stressors-is associated with disability and poor HRQL. We hypothesized that improvements in frailty would be associated with improved disability and HRQL in adults with CF undergoing LTx. METHODS In a single-center prospective cohort study from 2010 to 2017, assessments of frailty, disability, and HRQL were performed before and at 3- and 6-months after LTx. We assessed frailty by the short physical performance battery (SPPB). We assessed disability with the Lung Transplant Valued Life Activities scale (LT-VLA) and HRQL by the Medical Outcomes Study Short Form Physical and Mental Component Summary scales (SF12-PCS, -MCS), the Airway Questionnaire 20-Revised (AQ20R), and the Euroqol 5D (EQ5D). We tested the association of concurrent changes in frailty and lung function on disability and HRQL by linear mixed-effects models adjusted for sex and body mass index. RESULTS Among 23 participants with CF, improvements in frailty and lung function were independently associated with improved disability and some HRQL measures. For example, each 1-point improvement in SPPB or 200 mL improvement in FEV1 was associated with improved LT-VLA disability by 0.14 (95%CI: 0.08-0.20) and 0.07 (95%CI: 0.05-0.09) points and improved EQ5D by 0.05 (95%CI: 0.03 to 0.07) and 0.02 (95%CI: 0.01-0.03) points, respectively. CONCLUSION Improvement in frailty is a novel determinant of improved disability and HRQL in adults with CF undergoing LTx.
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Affiliation(s)
- Alyssa A Perez
- Department of Medicine, University of California San Francisco, San Francisco, California
| | - Steven R Hays
- Department of Medicine, University of California San Francisco, San Francisco, California
| | - Allison Soong
- Department of Medicine, University of California San Francisco, San Francisco, California
| | - Ying Gao
- Department of Medicine, University of California San Francisco, San Francisco, California
| | - John R Greenland
- Department of Medicine, University of California San Francisco, San Francisco, California
| | - Lorriana E Leard
- Department of Medicine, University of California San Francisco, San Francisco, California
| | - Rupal J Shah
- Department of Medicine, University of California San Francisco, San Francisco, California
| | - Jeffrey Golden
- Department of Medicine, University of California San Francisco, San Francisco, California
| | - Jasleen Kukreja
- Department of Surgery, University of California San Francisco, San Francisco, California
| | - Aida Venado
- Department of Medicine, University of California San Francisco, San Francisco, California
| | - Mary Ellen Kleinhenz
- Department of Medicine, University of California San Francisco, San Francisco, California
| | - Jonathan P Singer
- Department of Medicine, University of California San Francisco, San Francisco, California
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Ellemunter H, Steinkamp G. Lung clearance index to detect the efficacy of Aztreonam lysine inhalation in patients with cystic fibrosis and near normal spirometry - A single-centre feasibility study. PLoS One 2019; 14:e0221673. [PMID: 31498805 PMCID: PMC6733506 DOI: 10.1371/journal.pone.0221673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 08/10/2019] [Indexed: 12/29/2022] Open
Abstract
Comparing the efficacy of inhaled antibiotics can be difficult in small groups of patients with cystic fibrosis and mild lung disease. In a feasibility study we compared Aztreonam lysine for inhalation solution (AZLI; Cayston®) to standard inhaled antibiotic therapy in patients with cystic fibrosis and near normal spirometry. To detect treatment responses we used both lung clearance index (LCI) and forced expiratory volume in one second (FEV1). At baseline, median FEV1 was 87% pred. and median LCI was 8.6 (upper limit of normal: 7.0). After 4 weeks, LCI improved by -0.36 after AZLI and deteriorated by +0.12 after tobramycin treatment (p = 0.039). No significant differences between treatments (p = 0.195) were observed using FEV1. These results suggest that lung clearance index can be used to detect treatment induced changes in subjects with mild lung disease.
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Affiliation(s)
- Helmut Ellemunter
- Cystic Fibrosis (CF) Centre at the Medical University of Innsbruck, Innsbruck, Austria
| | - Gratiana Steinkamp
- Cystic Fibrosis (CF) Centre at the Medical University of Innsbruck, Innsbruck, Austria
- Clinical Research and Medical Scientific Writing, Schwerin, Germany
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Tabori H, Arnold C, Jaudszus A, Mentzel HJ, Renz DM, Reinsch S, Lorenz M, Michl R, Gerber A, Lehmann T, Mainz JG. Abdominal symptoms in cystic fibrosis and their relation to genotype, history, clinical and laboratory findings. PLoS One 2017; 12:e0174463. [PMID: 28472055 PMCID: PMC5417419 DOI: 10.1371/journal.pone.0174463] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 03/09/2017] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND & AIMS Abdominal symptoms (AS) are a hallmark of the multiorgan-disease cystic fibrosis (CF). However, the abdominal involvement in CF is insufficiently understood and, compared to the pulmonary manifestation, still receives little scientific attention. Aims were to assess and quantify AS and to relate them to laboratory parameters, clinical findings, and medical history. METHODS A total of 131 patients with CF of all ages were assessed with a new CF-specific questionnaire (JenAbdomen-CF score 1.0) on abdominal pain and non-pain symptoms, disorders of appetite, eating, and bowel movements as well as symptom-related quality of life. Results were metrically dimensioned and related to abdominal manifestations, history of surgery, P. aeruginosa and S. aureus colonization, genotype, liver enzymes, antibiotic therapy, lung function, and nutritional status. RESULTS AS during the preceding 3 months were reported by all of our patients. Most common were lack of appetite (130/131) and loss of taste (119/131) followed by abdominal pain (104/131), flatulence (102/131), and distention (83/131). Significantly increased AS were found in patients with history of rectal prolapse (p = 0.013), distal intestinal obstruction syndrome (p = 0.013), laparotomy (p = 0.022), meconium ileus (p = 0.037), pancreas insufficiency (p = 0.042), or small bowel resection (p = 0.048) as well as in patients who have been intermittently colonized with P. aeruginosa (p = 0.006) compared to patients without history of these events. In contrast, no statistically significant associations were found to CF-associated liver disease, chronic pathogen colonization, lung function, CF-related diabetes, and nutritional status. CONCLUSION As the complex abdominal involvement in CF is still not fully understood, the assessment of the common AS is of major interest. In this regard, symptom questionnaires like the herein presented are meaningful and practical tools facilitating a wider understanding of the abdominal symptoms in CF. Furthermore, they render to evaluate possible abdominal effects of novel modulators of the underlying cystic fibrosis transmembrane (conductance) regulator (CFTR) defect.
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Affiliation(s)
- Harold Tabori
- Jena University Hospital, Cystic Fibrosis Center, Jena, Germany
| | - Christin Arnold
- Jena University Hospital, Cystic Fibrosis Center, Jena, Germany
| | - Anke Jaudszus
- Jena University Hospital, Cystic Fibrosis Center, Jena, Germany
| | | | - Diane M. Renz
- Jena University Hospital, Pediatric Radiology, Jena, Germany
| | - Steffen Reinsch
- Jena University Hospital, Pediatric Gastroenterology, Jena, Germany
| | - Michael Lorenz
- Jena University Hospital, Cystic Fibrosis Center, Jena, Germany
| | - Ruth Michl
- Jena University Hospital, Cystic Fibrosis Center, Jena, Germany
| | - Andrea Gerber
- Jena University Hospital, Cystic Fibrosis Center, Jena, Germany
| | - Thomas Lehmann
- Jena University Hospital, Institute of Medical Statistics, Jena, Germany
| | - Jochen G. Mainz
- Jena University Hospital, Cystic Fibrosis Center, Jena, Germany
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16
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Vahedi L, Jabarpoor-Bonyadi M, Ghojazadeh M, Vahedi A, Rafeey M. Gender Differences in Clinical Presentations of Cystic Fibrosis Patients in Azeri Turkish Population. Tuberc Respir Dis (Seoul) 2016; 79:267-273. [PMID: 27790278 PMCID: PMC5077730 DOI: 10.4046/trd.2016.79.4.267] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 12/22/2015] [Accepted: 06/05/2016] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Cystic fibrosis (CF) is an autosomal recessive disorder with several clinical presentations. This study was undertaken in the Azeri Turkish population in Iran, to investigate gender differences in the age at onset and diagnosis, age of death, and duration of illness of CF. METHODS The data of 331 CF patients from 2001 to 2015 was surveyed. Parameters including age, sex, ΔF508 mutation, age at onset, age at diagnosis, age of death and clinical presentations were evaluated for both sexes, using descriptive analysis. The association of gender with these variables was studied using logistic regression, chi-square test and Mann-Whitney U test by SPSS version 18. Odds ratio with a confidence interval of 95% and p≤0.05 was considered statistically significant. RESULTS The study included 191 males (57.7%) and 140 females (42.3%), all showing statistically significant difference (p<0.001). Age duration differed between genders. Male and female patients were further under 9 and 4 years, respectively. The occurrence of ΔF508 mutation was 0.51 times more in females than in males. Age, diagnosis and sex were closely associated: males were diagnosed at a significantly later age than females (p=0.05). While this compression performed based on clinical presentations, males with respiratory disease had a later median age at diagnosis than females at lifespan (p=0.001). The risk of infertility in males was approximately two times greater than in females (p=0.02). CONCLUSION These findings indicate gender differences in CF patients. Future studies are needed to establish other differences and evaluate the causes for the gender variations.
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Affiliation(s)
- Leila Vahedi
- Liver and Gastrointestinal Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Morteza Jabarpoor-Bonyadi
- Liver and Gastrointestinal Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.; Department of Medical Genetic, Faculty of Natural Sciences, Center of Excellence for Biodiversity, University of Tabriz, Tabriz, Iran
| | - Morteza Ghojazadeh
- Department of Physiology, Liver and Gastrointestinal Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amir Vahedi
- Department of Pathology, Liver and Gastrointestinal Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mandana Rafeey
- Department of Pediatrics, Tabriz Children's Hospital, Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Kilcoyne A, Lavelle LP, McCarthy CJ, McEvoy SH, Fleming H, Gallagher A, Loeve M, Tiddens H, McKone E, Gallagher CC, Dodd JD. Chest CT abnormalities and quality of life: relationship in adult cystic fibrosis. ANNALS OF TRANSLATIONAL MEDICINE 2016; 4:87. [PMID: 27047946 DOI: 10.21037/atm.2016.03.08] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND To evaluate the relationship between lung parenchymal abnormalities on chest CT and health-related quality of life in adult cystic fibrosis (CF). METHODS The chest CT scans of 101 consecutive CF adults (mean age 27.8±7.9, 64 males) were prospectively scored by two blinded radiologists in consensus using a modified Bhalla score. Health-related quality of life was assessed using the revised Quittner Cystic Fibrosis Questionnaire (CFQ-R). Multiple regressions were performed with each of the CFQ-R domains and all clinical and imaging findings to assess independent correlations. RESULTS There were 18 inpatients and 83 outpatients. For the cohort of inpatients, CT abnormalities were significantly (P<0.005 for all) associated with Respiratory Symptoms (Air Trapping), and also with Social Functioning (Consolidation) and Role Functioning (Consolidation). For outpatients, CT abnormalities were significantly (P<0.005 for all) associated with Respiratory Symptoms (Consolidation) and also with Physical Functioning (Consolidation), Vitality (Consolidation, Severity of Bronchiectasis), Eating Problems (airway wall thickening), Treatment Burden (Total CT Score), Body Image (Severity of Bronchiectasis) and Role Functioning (Tree-in-bud nodules). Consolidation was the commonest independent CT predictor for both inpatients (predictor for 2 domains) and outpatients (predictor in 3 domains). Several chest CT abnormalities excluded traditional measures such as FEV1 and BMI from the majority of CFQ-R domains. CONCLUSIONS Chest CT abnormalities are significantly associated with quality of life measures in adult CF, independent of clinical or spirometric measurements.
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Affiliation(s)
- Aoife Kilcoyne
- 1 Department of Radiology, 2 National Referral Centre for Adult Cystic Fibrosis, St. Vincent's University Hospital, Elm Park, Dublin, Ireland ; 3 Department of Pediatric Pulmonology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands ; 4 Department of Radiology, Erasmus MC, Rotterdam, The Netherlands
| | - Lisa P Lavelle
- 1 Department of Radiology, 2 National Referral Centre for Adult Cystic Fibrosis, St. Vincent's University Hospital, Elm Park, Dublin, Ireland ; 3 Department of Pediatric Pulmonology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands ; 4 Department of Radiology, Erasmus MC, Rotterdam, The Netherlands
| | - Colin J McCarthy
- 1 Department of Radiology, 2 National Referral Centre for Adult Cystic Fibrosis, St. Vincent's University Hospital, Elm Park, Dublin, Ireland ; 3 Department of Pediatric Pulmonology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands ; 4 Department of Radiology, Erasmus MC, Rotterdam, The Netherlands
| | - Sinead H McEvoy
- 1 Department of Radiology, 2 National Referral Centre for Adult Cystic Fibrosis, St. Vincent's University Hospital, Elm Park, Dublin, Ireland ; 3 Department of Pediatric Pulmonology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands ; 4 Department of Radiology, Erasmus MC, Rotterdam, The Netherlands
| | - Hannah Fleming
- 1 Department of Radiology, 2 National Referral Centre for Adult Cystic Fibrosis, St. Vincent's University Hospital, Elm Park, Dublin, Ireland ; 3 Department of Pediatric Pulmonology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands ; 4 Department of Radiology, Erasmus MC, Rotterdam, The Netherlands
| | - Annika Gallagher
- 1 Department of Radiology, 2 National Referral Centre for Adult Cystic Fibrosis, St. Vincent's University Hospital, Elm Park, Dublin, Ireland ; 3 Department of Pediatric Pulmonology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands ; 4 Department of Radiology, Erasmus MC, Rotterdam, The Netherlands
| | - Martine Loeve
- 1 Department of Radiology, 2 National Referral Centre for Adult Cystic Fibrosis, St. Vincent's University Hospital, Elm Park, Dublin, Ireland ; 3 Department of Pediatric Pulmonology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands ; 4 Department of Radiology, Erasmus MC, Rotterdam, The Netherlands
| | - Harm Tiddens
- 1 Department of Radiology, 2 National Referral Centre for Adult Cystic Fibrosis, St. Vincent's University Hospital, Elm Park, Dublin, Ireland ; 3 Department of Pediatric Pulmonology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands ; 4 Department of Radiology, Erasmus MC, Rotterdam, The Netherlands
| | - Edward McKone
- 1 Department of Radiology, 2 National Referral Centre for Adult Cystic Fibrosis, St. Vincent's University Hospital, Elm Park, Dublin, Ireland ; 3 Department of Pediatric Pulmonology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands ; 4 Department of Radiology, Erasmus MC, Rotterdam, The Netherlands
| | - Charles C Gallagher
- 1 Department of Radiology, 2 National Referral Centre for Adult Cystic Fibrosis, St. Vincent's University Hospital, Elm Park, Dublin, Ireland ; 3 Department of Pediatric Pulmonology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands ; 4 Department of Radiology, Erasmus MC, Rotterdam, The Netherlands
| | - Jonathan D Dodd
- 1 Department of Radiology, 2 National Referral Centre for Adult Cystic Fibrosis, St. Vincent's University Hospital, Elm Park, Dublin, Ireland ; 3 Department of Pediatric Pulmonology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands ; 4 Department of Radiology, Erasmus MC, Rotterdam, The Netherlands
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Abstract
OBJECTIVE This study was devised to translate Cystic Fibrosis Questionnaire-Revised to Hindi and administer it to Indian children and adolescents diagnosed with cystic fibrosis. DESIGN Cross-sectional study. SETTING This study was carried out in cystic fibrosis patients attending Pediatric Chest Clinic of a tertiary-care hospital in Northern India from July 2012 to December 2012. PARTICIPANTS 45 children (6-13 years) and their parents, and 14 adolescents. Patients with unstable health in the past two weeks were excluded. INTERVENTION Cystic Fibrosis Questionnaire- Revised translated in Hindi was administered. Clinical evaluation and scoring, throat swab cultures and spirometry were also done during the same visit. MAIN OUTCOME MEASURES Health Related Quality of Life scores were the primary measures, and clinical scores, swab cultures and spirometry were secondary measures. RESULTS Cronbachs alpha ranged from 0.020-0.863.The Factor analysis indicated that most test-items correlated more with competing scales than the intended scales. Convergence between self and proxy-rating was found to be dependent on the domain. The Cystic Fibrosis Questionnaire- Revised scores correlated well with clinical scores (r=0.65,P=0.011), Pseudomonas spp culture data and pulmonary function tests. There was an inverse relation between Health Related Quality of Life scores and age at diagnosis (r=-0.339, P=0.02). CONCLUSIONS Hindi versions of Cystic Fibrosis Questionnaire- Revised: Child, Adolescent and Parents instruments will act as an important step towards data on Health Related Quality of Life of Indian patients with cystic fibrosis.
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Cox NS, Alison JA, Holland AE. Interventions for promoting physical activity in people with cystic fibrosis. Cochrane Database Syst Rev 2013; 2013:CD009448. [PMID: 24338214 PMCID: PMC9062985 DOI: 10.1002/14651858.cd009448.pub2] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND In individuals with cystic fibrosis there are no established targets for participation in physical activity, nor have any ideal strategies to promote participation in physical activity been identified OBJECTIVES To evaluate the effect of treatment to increase participation in physical activity in people with cystic fibrosis. SEARCH METHODS We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register using the terms 'physiotherapy and exercise'.Date of the most recent search: 05 December 2013.Additionally, we conducted searches of the electronic databases MEDLINE, CINAHL (Ebscohost), PsycINFO (OvidSP) and the Physiotherapy Evidence Database (PEDro). We also searched for potentially relevant, completed but unpublished studies, on several clinical trials registers.Date of the most recent searches: 10 September 2012. SELECTION CRITERIA All randomised and quasi-randomised controlled studies which investigated strategies designed to promote increased participation in daily physical activity for individuals with cystic fibrosis. DATA COLLECTION AND ANALYSIS Two authors independently selected studies for inclusion, assessed the risk of bias and extracted data. Any disagreements were resolved by discussion and consensus, or in arbitration with a third author. MAIN RESULTS Four studies (199 participants) met the inclusion criteria and were predominantly conducted in children with cystic fibrosis. Only one study had a combined cohort of adult and paediatric participants. The description of study methods was inadequate to assess the risk of bias, particularly with regard to blinding of assessors and selective reporting. One study was conducted in an inpatient setting with follow up in the outpatient setting; while the remaining three studies were conducted in individuals with stable respiratory disease in the outpatient setting. All included studies used exercise training to promote participation in physical activity, with the duration of the intervention period ranging from 18 days to three years. No improvement in physical activity participation was reported with any intervention period less than or equal to six months. Improvements in physical activity participation were only seen where follow up occurred beyond 12 months. There was no significant impact on quality of life from any of the intervention strategies. AUTHORS' CONCLUSIONS Although participation in physical activity is generally regarded as beneficial for people with cystic fibrosis, there is a lack of evidence regarding strategies to promote the uptake and the continued participation in physical activity for this population. This review provides very limited evidence that activity counselling and exercise advice, undertaken over at least six months, to engage in a home exercise programme may result in improved physical activity participation in people with cystic fibrosis. Further research is needed to determine the effect of strategies such as health coaching or telemedicine applications, in promoting the uptake and adherence to regular participation in physical activity. In addition, establishing the ideal duration of any interventions that promote physical activity, including exercise training programmes, will be important in addressing issues relating to participation in physical activity for people with cystic fibrosis.
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Affiliation(s)
- Narelle S Cox
- School of Physiotherapy, La Trobe University, Level 4 The Alfred Centre 99 Commercial Road, Melbourne, Victoria, Australia, 3004
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Validation of a Quality of Life Questionnaire for Bronchiectasis: psychometric analyses of the Spanish QOL-B-V3.0. Qual Life Res 2013; 23:1279-92. [DOI: 10.1007/s11136-013-0560-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2013] [Indexed: 12/14/2022]
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21
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Wray J, Franklin R, Brown K, Cassedy A, Marino BS. Testing the pediatric cardiac quality of life inventory in the United kingdom. Acta Paediatr 2013; 102:e68-73. [PMID: 23121073 DOI: 10.1111/apa.12074] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Accepted: 10/29/2012] [Indexed: 01/19/2023]
Abstract
AIM To establish the validity and reliability of the Pediatric Cardiac Quality of Life Inventory (PCQLI) for children with heart disease in the United Kingdom. METHODS Three paediatric cardiac centres recruited patients aged 8-18 years with heart disease. Patient-parent pairs completed a disease-specific paediatric cardiac quality of life measure (PCQLI), a generic quality of life measure (PedsQL4.0) and behaviour and self-perception questionnaires. Validity was assessed by correlation of PCQLI scores with heart disease severity, medical care utilization, and PedsQL, behaviour and self-perception scores, and by correlation of patient and parent PCQLI scores. Reliability was evaluated by administering the PCQLI at two time points. RESULTS The study was completed by 771 patient-parent pairs. Validity was confirmed by the association of lower total PCQLI scores with more complex heart disease and a greater number of hospitalizations and cardiac surgeries (all p < 0.001); moderate to good correlations between patient and parent scores (0.50-0.68); and fair to good correlations between scores for the PCQLI and PedsQL4.0 (0.67-0.77), self-perception (0.42-0.49) and behaviour measures (0.18-0.62). Test-retest reliability correlations were high (0.72-0.90). CONCLUSION The PCQLI is a reliable and valid disease-specific quality-of-life measure for children with heart disease in the United Kingdom.
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Affiliation(s)
| | - Rodney Franklin
- Department of Paediatric Cardiology; Royal Brompton and Harefield NHS Foundation Trust; London; UK
| | - Kate Brown
- Cardiorespiratory Department; Great Ormond Street Hospital for Children NHS Foundation Trust; London; UK
| | - Amy Cassedy
- Department of Pediatrics; Cincinnati Children's Hospital Medical Center; Cincinnati; OH; USA
| | - Bradley S Marino
- Department of Pediatrics; Cincinnati Children's Hospital Medical Center; Cincinnati; OH; USA
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Yuksel H, Yilmaz O, Dogru D, Karadag B, Unal F, Quittner AL. Reliability and validity of the Cystic Fibrosis Questionnaire-Revised for children and parents in Turkey: cross-sectional study. Qual Life Res 2012; 22:409-14. [PMID: 22492294 DOI: 10.1007/s11136-012-0152-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2012] [Indexed: 11/29/2022]
Abstract
PURPOSE The purpose of study was to translate Cystic Fibrosis Questionnaire-Revised (CFQ-R) into Turkish for children with cystic fibrosis (CF) and evaluate its reliability and validity. This is the first CF-specific health-related quality of life (HRQOL) measure validated in a Muslim country. METHODS Fifty-one children aged 6-13 years treated at four centers in Turkey and 30 parents participated in this cross-sectional study. Demographic characteristics and disease severity parameters were recorded for all participants. All participants completed the parent or child versions of CFQ-R and KINDL questionnaires at enrollment. Reliability and construct validity analysis were carried out. RESULTS Both children and parents endorsed a range of responses, with no evidence of floor or ceiling effects. Item-to-total correlations indicated that most items were more highly correlated with their intended scale than competing scales. Good internal consistency was found for majority of child and parent scales. CFQ-R scales correlated significantly with clinical indices of disease severity. Good evidence of convergent validity with a generic HRQOL scale was found. CONCLUSION Turkish versions of CFQ-R Child and Parent instruments have demonstrated adequate reliability and validity and can be utilized in clinical trials or integrated into clinical evaluation and follow-up of Turkish children with CF.
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Affiliation(s)
- Hasan Yuksel
- Department of Pediatric Allergy and Pulmonology, Medical Faculty, Celal Bayar University, Manisa, Turkey.
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Erratum to: Psychometric evaluation of the Cystic Fibrosis Questionnaire-Revised in a national, US sample. Qual Life Res 2012; 21:1279-90. [DOI: 10.1007/s11136-011-0091-5] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2011] [Indexed: 10/14/2022]
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Sabbah I, Sabbah H, Sabbah S, Akoum H, Droubi N, Mercier M. Measurement Properties of the Arabic Lebanon Version of the Pediatric Quality of Life Inventory 4.0 Generic Core Scales for Young Child (5 - 7 years), and Child Aged 8 - 12 Years: Quality of Life of in Urban and Rural Children in Lebanon. ACTA ACUST UNITED AC 2012. [DOI: 10.4236/ce.2012.326146] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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25
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Psychometric evaluation of the Cystic Fibrosis Questionnaire-Revised in a national sample. Qual Life Res 2011; 21:1267-78. [DOI: 10.1007/s11136-011-0036-z] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2011] [Indexed: 11/25/2022]
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Stern M, Niemann N, Wiedemann B, Wenzlaff P. Benchmarking improves quality in cystic fibrosis care: a pilot project involving 12 centres. Int J Qual Health Care 2011; 23:349-56. [DOI: 10.1093/intqhc/mzr017] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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