1
|
Malcolm L. A retrospective comparative study of patient-reported outcome measures, pre-treatment and twelve months post-treatment using tumescent liposuction for the management of lower limb lipoedema. JPRAS Open 2024; 41:285-294. [PMID: 39161914 PMCID: PMC11332691 DOI: 10.1016/j.jpra.2024.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 05/19/2024] [Indexed: 08/21/2024] Open
Abstract
Background Lipoedema is a painful adipose tissue disorder, affecting the limbs of women, that is resistant to diet and exercise. The purpose of the study was to evaluate the retrospective health-related quality-of-life (HRQoL) outcomes for patients with lower limb lipoedema (LLL) following tumescent liposuction (TL). Methods Forty-seven patients received TL over 5 years from 2015-2020 for LLL. As part of their routine treatment evaluation, each patient completed 4 validated HRQoL questionnaires at initial assessment. The questionnaires examined the patients' experiences relating to anxiety and depression, lower extremity function, appearance, and symptoms. The same questionnaires were posted to the patients after an average of 12 months post-procedure/s to establish the outcomes of the intervention. Results The study demonstrated that patients' HRQoL improved at 12 months (average) following TL. The results of all the questionnaires were statistically significant, and patients with stage 3 LLL showed the most improvement in outcomes. Conclusion The findings demonstrated that TL achieves positive HRQoL outcomes in patients with LLL; however, long-term follow-up is needed to determine if the benefits sustain. Additionally, larger prospective controlled studies are required to provide robust evidence for this procedure.
Collapse
Affiliation(s)
- Lynne Malcolm
- School of Nursing, The University of Wolverhampton, Birmingham, West Midlands, UK
| |
Collapse
|
2
|
Smith AB, Ware JE, Aluko P, Kulasekaran A. The validity of single-item measures of health-related quality of life across groups differing in acute respiratory symptom severity. Qual Life Res 2024:10.1007/s11136-024-03694-0. [PMID: 39096424 DOI: 10.1007/s11136-024-03694-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2024] [Indexed: 08/05/2024]
Abstract
PURPOSE Practical considerations precluding health-related quality of life (HRQOL) monitoring in population and clinical research have spawned development of improved items for more brief surveys of frequently measured HRQOL outcomes. The aim of this study was to validate the use of the Quality of Life General (QGEN-8), a shorter 8-item alternative to the longer 36-item short form (SF)-36 Health Survey for measuring the same eight HRQOL domains across groups of adults with varying severity of acute respiratory symptoms, such as cough and sore throat. METHODS National Opinion Research Center (NORC) representative probability (N = 1,648) and supplemental opt-in (N = 5,915) U.S. adult samples were surveyed cross-sectionally online in 2020. Parallel analyses compared QGEN-8 and SF-36 estimates of group means for each of eight matching profile domains and summary physical and mental scores across groups differing in severity of acute symptoms and chronic respiratory conditions using analysis of covariance (ANCOVAs) controlling for socio-demographics and presence of chronic respiratory conditions. RESULTS In support of discriminant validity, ANCOVA estimates of QGEN-8 means with SF-36 estimates revealed the same patterns of declining HRQOL with the presence and increasing severity of symptoms and chronic condition severity. CONCLUSION QGEN-8® shows satisfactory validity and warrants further testing in cross-sectional and longitudinal population and clinical survey research as a more practical method for estimating group differences in SF-36 profile and summary component HRQOL scores.
Collapse
Affiliation(s)
- Adam B Smith
- Leeds Institute for Cardiovascular & Metabolic Medicine, University of Leeds, Leeds, UK
| | - John E Ware
- John Ware Research Group Inc, Watertown, USA
| | - Patricia Aluko
- Reckitt, Data Analytics and Research Insights, Slough, UK.
| | | |
Collapse
|
3
|
Senanayake S, Uchil R, Sharma P, Parsonage W, Kularatna S. Mapping Kansas City cardiomyopathy, Seattle Angina, and minnesota living with heart failure to the MacNew-7D in patients with heart disease. Qual Life Res 2024; 33:2151-2163. [PMID: 38839680 PMCID: PMC11286692 DOI: 10.1007/s11136-024-03676-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2024] [Indexed: 06/07/2024]
Abstract
INTRODUCTION The Kansas City Cardiomyopathy Questionnaire (KCCQ), Seattle Angina Questionnaire (SAQ), and Minnesota Living with Heart Failure Questionnaire (MLHFQ) are widely used non-preference-based instruments that measure health-related quality of life (QOL) in people with heart disease. However, currently it is not possible to estimate quality-adjusted life-years (QALYs) for economic evaluation using these instruments as the summary scores produced are not preference-based. The MacNew-7D is a heart disease-specific preference-based instrument. This study provides different mapping algorithms for allocating utility scores to KCCQ, MLHFQ, and SAQ from MacNew-7D to calculate QALYs for economic evaluations. METHODS The study included 493 participants with heart failure or angina who completed the KCCQ, MLHFQ, SAQ, and MacNew-7D questionnaires. Regression techniques, namely, Gamma Generalized Linear Model (GLM), Bayesian GLM, Linear regression with stepwise selection and Random Forest were used to develop direct mapping algorithms. Cross-validation was employed due to the absence of an external validation dataset. The study followed the Mapping onto Preference-based measures reporting Standards checklist. RESULTS The best models to predict MacNew-7D utility scores were determined using KCCQ, MLHFQ, and SAQ item and domain scores. Random Forest performed well for item scores for all questionnaires and domain score for KCCQ, while Bayesian GLM and Linear Regression were best for MLHFQ and SAQ domain scores. However, models tended to over-predict severe health states. CONCLUSION The three cardiac-specific non-preference-based QOL instruments can be mapped onto MacNew-7D utilities with good predictive accuracy using both direct response mapping techniques. The reported mapping algorithms may facilitate estimation of health utility for economic evaluations that have used these QOL instruments.
Collapse
Affiliation(s)
- Sameera Senanayake
- Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, QLD, 4059, Australia
- National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore, Singapore
| | - Rithika Uchil
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, QLD, 4059, Australia
| | - Pakhi Sharma
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, QLD, 4059, Australia.
| | - William Parsonage
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, QLD, 4059, Australia
- Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, QLD, Australia
| | - Sanjeewa Kularatna
- Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, QLD, 4059, Australia
- National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore, Singapore
| |
Collapse
|
4
|
Gong AJ, Garg T, Khalil A, Gowda PC, Mathai SC, Rowan NR, Merlo CA, Weiss CR. Health-Related Quality of Life Outcome Measures in Individuals With Hereditary Hemorrhagic Telangiectasia: A Scoping Review. Am J Rhinol Allergy 2024; 38:60-76. [PMID: 37855028 DOI: 10.1177/19458924231207123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
BACKGROUND Studies evaluating health-related quality of life (HRQOL) in patients with hereditary hemorrhagic telangiectasia (HHT) have expanded rapidly in the past decade. These studies have evaluated QOL aspects ranging from the general QOL for patients living with HHT to intervention-specific outcomes. However, few tools have been fully validated across the spectrum of disease manifestations and interventions in HHT. OBJECTIVE In this scoping review, we aim to map the literature on HHT-QOL metrics, identify gaps, inform future QOL research, and facilitate future metric development. METHODS We analyzed articles in English that assessed at least 1 measure of general HRQOL, including physical health, mental health, social health, or intervention-specific QOL in patients with HHT. Searches across 2 bibliographic databases (PubMed and Scopus) yielded 186 articles after duplicates were removed. Sixty-three studies met eligibility criteria: 22 prospective studies (34.9%), 20 retrospective studies (31.7%), 12 cross-sectional studies (17.5%), 6 randomized controlled trials or secondary analyses of a randomized controlled trials (9.5%), 2 qualitative studies (3.2%), and 1 case-control study (1.6%). Two additional studies-1 prospective and 1 cross-sectional study-were identified at the October 2022 14th International HHT Conference and included, making a total of 65 studies. RESULTS The 65 eligible studies used 30 QOL instruments. Twenty studies characterized baseline HRQOL, and 45 studies evaluated QOL before and after treatment. Of those 45 studies, 37 evaluated HRQOL before and after therapies targeting epistaxis and nasal symptoms, 4 targeted therapies for liver arteriovenous malformations and high-output heart failure, 3 evaluated therapies for both epistaxis and gastrointestinal bleeding, and 1 evaluated treatment targeting gastrointestinal bleeding alone. CONCLUSIONS Comparison of results across studies remains challenging given the heterogeneity in outcomes measures. Further development of HHT-specific patient-reported outcomes instruments that capture the global illness experience of HHT is needed.
Collapse
Affiliation(s)
- Anna J Gong
- Division of Interventional Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Tushar Garg
- Division of Interventional Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Adham Khalil
- Division of Interventional Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Prateek C Gowda
- Division of Interventional Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Stephen C Mathai
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Nicholas R Rowan
- Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Christian A Merlo
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Clifford R Weiss
- Division of Interventional Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| |
Collapse
|
5
|
Shibagaki Y, Yamazaki H, Wakita T, Ware JE, Wang J, Onishi Y, Yajima T, Sada KE, Yamamoto Y, Fukuhara S. Impact of treatment of hyperkalaemia on quality of life: design of a prospective observational cohort study of long-term management of hyperkalaemia in patients with chronic kidney disease or chronic heart failure in Japan. BMJ Open 2023; 13:e074090. [PMID: 38101840 PMCID: PMC10728966 DOI: 10.1136/bmjopen-2023-074090] [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: 03/27/2023] [Accepted: 11/30/2023] [Indexed: 12/17/2023] Open
Abstract
INTRODUCTION Hyperkalaemia (HK) is a frequent complication in patients with chronic kidney disease (CKD) and/or chronic heart failure (CHF). HK must be managed, both to protect patients from its direct clinical adverse outcomes and to enable treatment with disease-modifying therapies including renin-angiotensin-aldosterone system inhibitors. However, the experiences of patients undergoing treatment of HK are not clearly understood. Optimising treatment decisions and improving long-term patient management requires a better understanding of patients' quality of life (QOL). Thus, the aims of this research are: (1) to describe treatment patterns and the impact of treatment on a patient's QOL, (2) to study the relationships between treatment patterns and the impact of treatment on a patient's QOL and (3) to study the relationships between the control of serum potassium (S-K) and the impact of treatment on a patient's QOL, in patients with HK. METHODS AND ANALYSIS This is a prospective cohort study with 6 months of follow-up in 30-40 outpatient nephrology and cardiology clinics in Japan. The participants will be 350 patients with CKD or CHF who received their first potassium binders (PB) prescription to treat HK within the previous 6 months. Medical records will be used to obtain information on S-K, on treatment of HK with PBs and with diet, and on the patients' characteristics. To assess the impact of treatment on a patient's QOL, questionnaires will be used to obtain generic health-related QOL, CKD-specific and CHF-specific QOL, and PB-specific QOL. Multivariable regression models will be used to quantify how treatment patterns and S-K control are related to the impact of treatment on a patient's QOL. ETHICS AND DISSEMINATION Institutional review boards at all participating facilities review the study protocol. Patient consent will be obtained. The results will be published in international journals. TRIAL REGISTRATION NUMBER NCT05297409.
Collapse
Affiliation(s)
- Yugo Shibagaki
- Division of Nephrology and Hypertension, St Marianna University School of Medicine, Kawasaki, Japan
| | - Hajime Yamazaki
- Section of Clinical Epidemiology, Department of Community Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | | | - John E Ware
- Tufts University School of Medicine, Boston, Massachusetts, USA
- John Ware Research Group Inc, Watertown, Massachusetts, USA
| | - Jui Wang
- National Taiwan University College of Public Health, Taipei, Taiwan
- Institute for Health Outcomes & Process Evaluation Research, Kyoto, Japan
| | - Yoshihiro Onishi
- Institute for Health Outcomes & Process Evaluation Research, Kyoto, Japan
| | | | - Ken-Ei Sada
- Department of Clinical Epidemiology, Kochi Medical School, Nankoku, Japan
- Patient Driven Academic League (PeDAL), Tokyo, Japan
| | - Yosuke Yamamoto
- Department of Healthcare Epidemiology, Kyoto University, Kyoto, Japan
| | - Shunichi Fukuhara
- Section of Clinical Epidemiology, Department of Community Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| |
Collapse
|
6
|
Timmermans L, Golder E, Decat P, Foulon V, Van Hecke A, Schoenmakers B. Characteristics of self-management support (SMS) interventions and their impact on Quality of Life (QoL) in adults with chronic diseases: An umbrella review of systematic reviews. Health Policy 2023; 135:104880. [PMID: 37536047 DOI: 10.1016/j.healthpol.2023.104880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 07/06/2023] [Accepted: 07/20/2023] [Indexed: 08/05/2023]
Abstract
OBJECTIVE To provide an overview of types and characteristics of self-management support (SMS) interventions in adults with chronic disease and to assess the impact on the patient reported outcome Quality of Life (QoL). METHODS An umbrella review of systematic reviews was conducted. We searched PubMed, Embase, Web of Science, CINAHL and the Cochrane Library from January 2016 to November 2020 for reviews on SMS interventions for chronic diseases, assessing the impact on the patient reported outcome QoL. Quality assessment was based on the JBI Critical Appraisal Checklist for Systematic reviews and Research Syntheses tool. RESULTS 28 reviews were included. The extensive literature review revealed a variety of SMS interventions. The most frequently cited target group for the interventions were individuals with diabetes. Interventions primarily took place in the home setting. Interventional components that were often incorporated were education, eHealth and mHealth technologies, and coaching techniques. Telephone communication was regularly reported as a type of intervention follow-up. The impact on QoL was mixed and no firm conclusions can be drawn. However, our review revealed a beneficial effect of education. CONCLUSIONS AND PRACTICAL IMPLICATIONS Interventions including educational components seem promising for supporting self-management and showed a beneficial effect on QoL. More research is needed to explore where, by whom and how interventions are ideally delivered.
Collapse
Affiliation(s)
- Lotte Timmermans
- Academic Centre of General Practice, KU Leuven, Kapucijnenvoer 7 -Box 7001, Leuven 3000 Belgium.
| | - Elena Golder
- Health and Wellbeing, Plymouth Marjon University, Plymouth, UK
| | - Peter Decat
- General Practice and Primary Health Care, Ghent University, Ghent, Belgium
| | - Veerle Foulon
- Clinical Pharmacology and Pharmacotherapy, KU Leuven, Leuven, Belgium
| | - Ann Van Hecke
- Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; Staff Member of the Department Nursing Director, Ghent University Hospital, Ghent, Belgium
| | - Birgitte Schoenmakers
- Academic Centre of General Practice, KU Leuven, Kapucijnenvoer 7 -Box 7001, Leuven 3000 Belgium
| |
Collapse
|
7
|
Mezey GA, Paulik E, Máté Z. Effect of osteoarthritis and its surgical treatment on patients' quality of life: a longitudinal study. BMC Musculoskelet Disord 2023; 24:537. [PMID: 37386476 DOI: 10.1186/s12891-023-06662-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 06/23/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Osteoarthritis (OA) is one of the primary causes of pain and disability worldwide leading to patients having some of the worst health-related quality of life (QOL). The purpose of our study was to investigate the progression of the generic and disease-specific QOL of osteoarthritic patients going through total hip or knee replacement surgery and the factors that might alter the effect of surgery on QOL. METHODS A longitudinal study was performed based on data collected from 120 OA patients who filled in the short version of the WHO's generic measure of quality of life (WHOQOL-BREF) and the disease-specific Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) before and after surgery. RESULTS Domains related to physical health status showed relatively lower scores in patients before surgery. Patients reported a significant increase of QOL after surgery in the WHOQOL-BREF physical domain, especially if they were from the younger group (< 65 years, p = 0.022) or had a manual job (p = 0.008). Disease-specific QOL outcome results indicate that overall patients gained significantly better QOL in all domains of the WOMAC score. Patients with hip OA seemed to have the most benefit of their operation as they reported better outcome in WOMAC pain (p = 0.019), stiffness (p = 0.010), physical function domains (p = 0.011) and total score (p = 0.007) compared to knee OA patients. CONCLUSION There was a statistically significant improvement in all domains concerning physical functions in the study population. Patients also reported significant improvement in the social relationship domain, which indicates that OA itself as well as its management might have a profound effect on patients' life beyond the reduction of their pain.
Collapse
Affiliation(s)
- Gyöngyi Anna Mezey
- Department of Public Health, Albert Szent-Györgyi Medical School, University of Szeged, 10 Dóm Square, Szeged, Hungary, 6720.
| | - Edit Paulik
- Department of Public Health, Albert Szent-Györgyi Medical School, University of Szeged, 10 Dóm Square, Szeged, Hungary, 6720
| | - Zsuzsanna Máté
- Department of Public Health, Albert Szent-Györgyi Medical School, University of Szeged, 10 Dóm Square, Szeged, Hungary, 6720
| |
Collapse
|
8
|
Ware JE, Coutinho G, Smith AB, Tselenti E, Kulasekaran A. The effects of greater frequency of two most prevalent bothersome acute respiratory symptoms on health-related quality of life in the 2020 US general population. Qual Life Res 2023; 32:1043-1051. [PMID: 36905563 PMCID: PMC10007648 DOI: 10.1007/s11136-022-03319-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2022] [Indexed: 03/12/2023]
Abstract
PURPOSE Upper respiratory tract infections (URTI) and related symptoms are widespread and a common reason for visiting primary care with cough and sore throat being most prevalent. Despite their impact on daily activities, no studies have explored the impact on health-related quality of life (HRQOL) in representative general populations. We aimed to understand the short-term impact of the two most prevalent URTI symptoms on HRQOL. METHODS Online 2020 surveys including acute (≤ 4 weeks) respiratory symptoms (sore throat and cough) and SF-36® health survey (all with 4-week recall) were analysed using analysis of covariance (ANCOVA) in comparison with adult US population norms. Linear T-score transformation of SF-6D utility (ranging from 0 to 1) enabled direct comparisons with SF-36. RESULTS In total, 7563 US adults responded (average age: 52 years; range: 18-100 years). Sore throat and cough lasting at least several days were experienced by 14% and 22% participants, respectively. Chronic respiratory conditions were reported by 22% of the sample. A clear and consistent pattern of group HRQOL means declining significantly (p < 0.001) for acute cough and sore throat symptom presence and severity. Declines were observed on SF-36 physical (PCS) and mental component (MCS) and health utility (SF-6D) scores controlling for covariates. Those reporting respiratory symptoms 'most days' declined ≥ 0.5 standard deviation (minimal important difference [MID]) worse with averages at the 19th and 34th centiles for cough on the PCS and MCS, and 21st to 26th centile for sore throat. CONCLUSION Declines in HRQOL with acute cough and sore throat symptoms consistently exceeded MID standards and should not be ignored as self-limiting without intervention. Future studies on early self-care for symptom relief and its implications on HRQOL and health economics would be valuable to understand the benefits on healthcare burden and need for updating treatment guidelines.
Collapse
Affiliation(s)
- John E Ware
- John Ware Research Group, 10 Wheeler Court, Watertown, MA, USA
- Tufts University School of Medicine, Boston, MA, USA
| | - Graça Coutinho
- Global Medical Affairs Respiratory, Reckitt Health, Slough, UK
| | | | | | | |
Collapse
|
9
|
Digital Patient-Reported Outcome Measures Assessing Health-Related Quality of Life in Skull Base Diseases-Analysis of Feasibility and Pitfalls Two Years after Implementation. Healthcare (Basel) 2023; 11:healthcare11040472. [PMID: 36833006 PMCID: PMC9956346 DOI: 10.3390/healthcare11040472] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 01/15/2023] [Accepted: 02/03/2023] [Indexed: 02/10/2023] Open
Abstract
Health-related quality of life (HRQoL) assessment is becoming increasingly important in neurosurgery following the trend toward patient-centered care, especially in the context of skull base diseases. The current study evaluates the systematic assessment of HRQoL using digital patient-reported outcome measures (PROMs) in a tertiary care center specialized in skull base diseases. The methodology and feasibility to conduct digital PROMs using both generic and disease-specific questionnaires were investigated. Infrastructural and patient-specific factors affecting participation and response rates were analyzed. Since August 2020, 158 digital PROMs were implemented in skull base patients presenting for specialized outpatient consultations. Reduced personnel capacity led to significantly fewer PROMs being conducted during the second versus (vs.) the first year after introduction (mean: 0.77 vs. 2.47 per consultation day, p = 0.0002). The mean age of patients not completing vs. those completing long-term assessments was significantly higher (59.90 vs. 54.11 years, p = 0.0136). Follow-up response rates tended to be increased with recent surgery rather than with the wait-and-scan strategy. Our strategy of conducting digital PROMs appears suitable for assessing HRQoL in skull base diseases. The availability of medical personnel for implementation and supervision was essential. Response rates during follow-up tended to be higher both with younger age and after recent surgery.
Collapse
|
10
|
McDonald IR, Welt CK, Dwyer AA. Health-related quality of life in women with primary ovarian insufficiency: a scoping review of the literature and implications for targeted interventions. Hum Reprod 2022; 37:2817-2830. [PMID: 36102839 PMCID: PMC9989734 DOI: 10.1093/humrep/deac200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 08/23/2022] [Indexed: 12/14/2022] Open
Abstract
STUDY QUESTION What is known about health-related quality of life (HR-QoL) in women with idiopathic primary ovarian insufficiency (POI)? SUMMARY ANSWER Women with POI have a range of unmet psychosocial needs relating to three interrelated themes: 'diagnostic odyssey', 'isolation and stigma' and impaired 'ego integrity'. WHAT IS KNOWN ALREADY Prior studies have reported increased depressive symptoms, diminished sexual function and altered body image/self-concept in women with POI. STUDY DESIGN, SIZE, DURATION A systematic scoping review (11 databases) on HR-QoL in POI including published quantitative, qualitative and mixed-methods studies as well as unpublished gray literature (i.e. unpublished dissertations) through June, 2021. PARTICIPANTS/MATERIALS, SETTING, METHODS After removing duplicates, 1244 articles underwent title and abstract review by independent reviewers. The remaining 72 relevant articles underwent dual full text review to determine inclusion criteria yielding 24 articles (100% concordance) for data extraction. Findings were summarized in tables by methodology and recurrent HR-QoL themes/sub-themes were mapped to define key aspects of HR-QoL in POI. Promoters of active coping were charted at the individual, interpersonal and healthcare system levels. Targets for tailored interventions supporting active coping and improved HR-QoL were mapped to the Theory of Planned Behavior (TPB). MAIN RESULTS AND THE ROLE OF CHANCE Three interrelated themes affecting HR-QoL in POI emerged from the data synthesis. First, the theme 'diagnostic odyssey' comprised sub-themes of uncertainty, lack of control, knowledge gaps, discontinuous care and negative clinical interactions. The second theme 'isolation and stigma' included sub-themes of guilt, shame, concealment, feeling labeled as infertile, lack of social support and unsympathetic clinicians. The third theme, impaired 'ego integrity' captured sub-themes of decreased sexual function, altered body image, psychological vulnerability and catastrophizing. Targets promoting active coping at the individual (n = 2), interpersonal (n = 1) and healthcare system (n = 1) levels were mapped to the TPB to inform development of tailored interventions supporting active coping and improved HR-QoL in POI (i.e. narrative intervention, co-creating patient-facing materials, peer-to-peer support and provider resources). LIMITATIONS, REASONS FOR CAUTION No studies using a POI-specific HR-QoL instrument were identified. No interventional studies aimed at improving HR-QoL in POI were identified. Only articles published in English were included in the study. WIDER IMPLICATIONS OF THE FINDINGS Women with POI frequently have impaired HR-QoL related to the life-altering infertility diagnosis. The range of unmet psychosocial needs may be relevant for informing interventions for other populations with infertility. STUDY FUNDING/COMPETING INTEREST(S) This work was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development 'Massachusetts General Hospital-Harvard Center for Reproductive Medicine' (1 P50 HD104224-01 NICHD). The authors have no conflicts to declare. REGISTRATION NUMBER N/A.
Collapse
Affiliation(s)
- Isabella R McDonald
- William F. Connell School of Nursing, Boston College, Chestnut Hill, MA, USA
| | - Corrine K Welt
- Division of Endocrinology, Metabolism and Diabetes, University of Utah, Salt Lake City, UT, USA.,Massachusetts General Hospital-Harvard Center for Reproductive Medicine, Boston, MA, USA
| | - Andrew A Dwyer
- William F. Connell School of Nursing, Boston College, Chestnut Hill, MA, USA.,Massachusetts General Hospital-Harvard Center for Reproductive Medicine, Boston, MA, USA
| |
Collapse
|
11
|
Moore T, Nees D, Hightower B, Brock L, Kee M, Wise A, Heigle B, Ottwell R, Hartwell M, Vassar M. Underreporting of patient-reported outcomes in cystic fibrosis randomized controlled trials using CONSORT-PRO and RoB 2.0. Respir Med Res 2022; 83:100962. [PMID: 36563550 DOI: 10.1016/j.resmer.2022.100962] [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: 03/23/2022] [Revised: 07/23/2022] [Accepted: 10/03/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Patient-reported outcomes (PROs) are increasingly used in randomized controlled trials (RCTs) to foster patient-centered healthcare. The aim of this investigation was to assess the completeness of reporting of PROs in RCTs pertaining to cystic fibrosis (CF). METHODS We searched MEDLINE, Embase, and Cochrane Central Register of Controlled Trials for RCTs concerning CF that included PROs as a primary or secondary outcome. The RCTs were assessed by 2 independent investigators using an adaptation of the Consolidated Standards of Reporting Trials for Patient-Reported Outcomes (CONSORT-PRO) and the Cochrane Risk of Bias (RoB) 2.0 assessment. We calculated the mean completion percentage of adherence to the CONSORT-PRO adaptation and used bivariate regression models to evaluate for associations with particular trial characteristics. RESULTS Our systematic search returned 2302 potential studies. Fifty-nine eligible RCTs were included after full-text screening. The RCT mean completeness of reporting was 38.38% (SD = 12.74). We found the following associations between trial characteristics and completeness of PRO reporting: (1) significantly higher reporting completeness for RCTs published in journals requiring adherence to the CONSORT guideline (p-value = 0.049), (2) improved reporting completeness in studies with 'some concerns' of RoB versus 'high' RoB (p-value = 0.042), and (3) significantly better reporting completeness when the PRO is the primary outcome of a RCT (p-value = 0.006). CONCLUSION Inadequate PRO reporting exists within RCTs focused on CF. Given that CF has substantial effects on quality of life, PROs are imperative to understand patients' experiences. We believe greater adherence to CONSORT-PRO will promote the standardization of PRO reporting and will facilitate comprehension of PROs by stakeholders, patients, and clinicians.
Collapse
Affiliation(s)
- Ty Moore
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, 1111 W 17th St., Tulsa, OK 74107, United States.
| | - Danya Nees
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, 1111 W 17th St., Tulsa, OK 74107, United States
| | - Brooke Hightower
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, 1111 W 17th St., Tulsa, OK 74107, United States
| | - Lydia Brock
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, 1111 W 17th St., Tulsa, OK 74107, United States
| | - Micah Kee
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, 1111 W 17th St., Tulsa, OK 74107, United States
| | - Audrey Wise
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, 1111 W 17th St., Tulsa, OK 74107, United States
| | - Benjamin Heigle
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, 1111 W 17th St., Tulsa, OK 74107, United States
| | - Ryan Ottwell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, 1111 W 17th St., Tulsa, OK 74107, United States; Department of Internal Medicine, University of Oklahoma, School of Community Medicine, Tulsa, OK, United States
| | - Micah Hartwell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, 1111 W 17th St., Tulsa, OK 74107, United States; Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
| | - Matt Vassar
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, 1111 W 17th St., Tulsa, OK 74107, United States; Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
| |
Collapse
|
12
|
Fukuhara S, Yamazaki H, Wakita T, Ware Jr. JE, Wang J, Onishi Y, Yajima T, Sada K, Yamamoto Y, Shibagaki Y. Validation of a new instrument for measuring disease-specific quality of life: A pilot study among patients with chronic kidney disease and hyperkalemia. ANNALS OF CLINICAL EPIDEMIOLOGY 2022; 5:13-19. [PMID: 38505376 PMCID: PMC10760472 DOI: 10.37737/ace.23003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 09/04/2022] [Indexed: 03/21/2024]
Abstract
BACKGROUND To prepare for a longitudinal study of the effects of potassium-lowering treatment on quality of life (QOL), we quantified the validity of a new disease-specific instrument for measuring QOL, using data from patients who had hyperkalemia (HK) due to chronic kidney disease (CKD) or chronic heart failure, and were also being treated with potassium binders (PBs). METHODS In this cross-sectional study, the participants were 98 patients at five outpatient clinics in Japan. The outcome measures were the Medical Outcomes Study 36-item short-form (SF-36), a widely used generic measure of QOL, and the Quality of Life Disease-specific Impact Scale (QDIS-7), a recently-developed disease-specific measure of QOL. Internal-consistency reliability was quantified, and factor analysis was done to confirm hypothesized QOL dimensions. Validation tests used two external criteria: CKD stage, and PB formulation. PB formulation was used because different formulations are associated with different degrees of patients' burden. Using a previously-described method, we computed the relative validity (RV) of the two measures. RESULTS Two factor scoring of the SF-36 and one factor scoring of the QDIS-7, as standardized from previous studies, were confirmed. The RVs showed that the QDIS-7 was much more valid than the SF-36, for discriminating between groups defined clinically (by CKD stage), and also between groups defined by PB formulation. Reliability was satisfactory: 0.73-0.95 for the SF-36 and 0.86 for the QDIS-7. CONCLUSIONS The QDIS-7 with CKD or PB attributions was more valid than the SF-36 for measuring the effects of CKD and of PB formulation on QOL.
Collapse
Affiliation(s)
- Shunichi Fukuhara
- Section of Clinical Epidemiology, Department of Community Medicine, Graduate School of Medicine, Kyoto University
- Johns Hopkins Bloomberg School of Public Health, Department of Health Policy and Management
| | - Hajime Yamazaki
- Section of Clinical Epidemiology, Department of Community Medicine, Graduate School of Medicine, Kyoto University
| | | | | | - Jui Wang
- College of Public Health, National Taiwan University
- Institute for Health Outcomes & Process Evaluation Research (iHope International)
| | - Yoshihiro Onishi
- Institute for Health Outcomes & Process Evaluation Research (iHope International)
| | | | - Kenei Sada
- Department of Clinical Epidemiology, Kochi Medical School
- Patient Driven Academic League (PeDAL)
| | - Yosuke Yamamoto
- Department of Healthcare Epidemiology, School of Public Health, Graduate School of Medicine, Kyoto University
| | - Yugo Shibagaki
- Division of Nephrology and Hypertension, St. Marianna University of Medicine
| |
Collapse
|
13
|
Adegboyega G, Jordan C, Kawka M, Chisvo N, Toescu SM, Hill C. Quality of life reporting in the management of posterior fossa tumours: A systematic review. Front Surg 2022; 9:970889. [PMID: 36303860 PMCID: PMC9594859 DOI: 10.3389/fsurg.2022.970889] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 08/23/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Survival amongst posterior fossa tumour (PFT) patients is improving. Clinical endpoints such as overall survival fail to depict QoL. There is yet to be a review of current QoL instruments used for adult PFTs. Aim of this review is to outline the QoL reporting in the management of PFTs and measure participation level. Methods This systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis. A search strategy to identify adult patients with PFTs who took part in QoL metrics was conducted. Observational and experimental studies published from 1990 to date were included. Studies with a sample size less than 10 and performance measures such as Karnofsky Performance Status were not considered. Results A total of 116 studies were included in the final analysis. Vestibular schwannomas were the most common tumour pathology (n = 23,886, 92.6%) followed by pilocytic astrocytomas (n = 657, 2.5%) and meningiomas (n = 437, 1.7%) Twenty-five different QoL measures were used in the study pool. SF-36 was the most common (n = 55, 17 47.4%) QoL metric in the whole study pool, followed by the Penn Acoustic Neuroma QoL scale (n = 24, 20.7%) and Dizziness Handicap Inventory (n = 16, 13.8%). Seventy-two studies reported less-than 100% participation in QoL evaluation. The commonest reason for non-participation was a lack of response (n = 1,718, 60.8%), incomplete questionnaires (n = 268, 9.4%) and cognitive dysfunction (n = 258, 9.1%). Conclusion Informed clinical decision-making in PFT patients requires the development of specific QoL outcomes. Core outcome sets, and minimal clinically important differences (MCID) are essential for these metrics to show clinically significant improvements in patient QoL.
Collapse
Affiliation(s)
- Gideon Adegboyega
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Chloe Jordan
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Michal Kawka
- Imperial College London School of Medicine, London, United Kingdom
| | - Nathan Chisvo
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | | | - Ciaran Hill
- Department of Neurosurgery, The National Hospital for Neurology and Neurosurgery, London, United Kingdom
- University College London Cancer Institute, London, United Kingdom
| |
Collapse
|
14
|
Sakamoto H, Goda A, Tobita K, Takeuchi K, Kikuchi H, Inami T, Tamura Y, Kohno T, Yamada S, Soejima K, Satoh T. EmPHasis-10 Health-Related Quality of Life and Exercise Capacity in Chronic Thromboembolic Pulmonary Hypertension After Balloon Angioplasty. J Am Heart Assoc 2022; 11:e026400. [PMID: 36056723 PMCID: PMC9496401 DOI: 10.1161/jaha.122.026400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Background Whether pulmonary hemodynamic parameters and functional capacity are associated with quality of life in patients with chronic thromboembolic pulmonary hypertension remains unknown. This study aimed to evaluate disease‐specific quality of life using the emPHasis‐10 questionnaire and assess its determinants in patients with chronic thromboembolic pulmonary hypertension with normalized pulmonary hemodynamics. Methods and Results This cross‐sectional study included 187 health status assessments of 143 patients with chronic thromboembolic pulmonary hypertension (median age, 68 [58–75] years; men/women, 51/136; use of home oxygen therapy, 51 patients [27%]) after balloon pulmonary angioplasty with normalized mean pulmonary artery pressure <25 mm Hg at rest. Right heart catheterization was performed, followed by assessment of 6‐minute walk distance and the emPHasis‐10 questionnaire. The median pulmonary artery pressure and pulmonary vascular resistance were 18 (15–21) mm Hg and 2.2 (1.7–2.9) wood units, respectively. The median emPHasis‐10 score was 14 (8–24), whereas the median 6‐minute walk distance was 447 (385–517) m. Univariate linear regression analysis showed that the emPHasis‐10 score was associated with 6‐minute walk distance (β=−0.476 [95% CI −0.604, −0.348], P<0.001) and home oxygen therapy (β=0.214 [95% CI, 0.072, 0.356], P=0.003) but not with hemodynamic parameters. Multiple regression analysis revealed that a higher emPHasis‐10 score was associated with lower 6‐minute walk distance (β=−0.475 [95% CI, −0.631 to −0.319], P<0.001). Conclusions Health‐related quality of life was associated with exercise capacity and the use of home oxygen therapy, but not with hemodynamic parameters, in patients with chronic thromboembolic pulmonary hypertension and normalized hemodynamics after balloon pulmonary angioplasty. Improvements in exercise capacity may lead to further improvements in quality of life.
Collapse
Affiliation(s)
- Hayato Sakamoto
- Department of Rehabilitation Kyorin University Hospital Tokyo Japan
| | - Ayumi Goda
- Department of Cardiovascular Medicine Kyorin University Hospital Tokyo Japan
| | - Kazuki Tobita
- Department of Rehabilitation Kyorin University Hospital Tokyo Japan
| | - Kaori Takeuchi
- Department of Cardiovascular Medicine Kyorin University Hospital Tokyo Japan
| | - Hanako Kikuchi
- Department of Cardiovascular Medicine Kyorin University Hospital Tokyo Japan
| | - Takumi Inami
- Department of Cardiovascular Medicine Kyorin University Hospital Tokyo Japan
| | - Yuichi Tamura
- Pulmonary Hypertension Center International University of Health and Welfare Mita Hospital Tokyo Japan
| | - Takashi Kohno
- Department of Cardiovascular Medicine Kyorin University Hospital Tokyo Japan
| | - Shin Yamada
- Department of Rehabilitation Kyorin University Hospital Tokyo Japan
| | - Kyoko Soejima
- Department of Cardiovascular Medicine Kyorin University Hospital Tokyo Japan
| | - Toru Satoh
- Department of Cardiovascular Medicine Kyorin University Hospital Tokyo Japan
| |
Collapse
|
15
|
McEntee ML, Gandek B, Ware JE. Improving multimorbidity measurement using individualized disease-specific quality of life impact assessments: predictive validity of a new comorbidity index. Health Qual Life Outcomes 2022; 20:108. [PMID: 35820890 PMCID: PMC9277868 DOI: 10.1186/s12955-022-02016-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 06/25/2022] [Indexed: 11/18/2022] Open
Abstract
Background Interpretation of health-related quality of life (QOL) outcomes requires improved methods to control for the effects of multiple chronic conditions (MCC). This study systematically compared legacy and improved method effects of aggregating MCC on the accuracy of predictions of QOL outcomes.
Methods Online surveys administered generic physical (PCS) and mental (MCS) QOL outcome measures, the Charlson Comorbidity Index (CCI), an expanded chronic condition checklist (CCC), and individualized QOL Disease-specific Impact Scale (QDIS) ratings in a developmental sample (N = 5490) of US adults. Controlling for sociodemographic variables, regression models compared 12- and 35-condition checklists, mortality vs. population QOL-weighting, and population vs. individualized QOL weighting methods. Analyses were cross-validated in an independent sample (N = 1220) representing the adult general population. Models compared estimates of variance explained (adjusted R2) and model fit (AIC) for generic PCS and MCS across aggregation methods at baseline and nine-month follow-up.
Results In comparison with sociodemographic-only regression models (MCS R2 = 0.08, PCS = 0.09) and Charlson CCI models (MCS R2 = 0.12, PCS = 0.16), increased variance was accounted for using the 35-item CCC (MCS R2 = 0.22, PCS = 0.31), population MCS/PCS QOL weighting (R2 = 0.31–0.38, respectively) and individualized QDIS weighting (R2 = 0.33 & 0.42). Model R2 and fit were replicated upon cross-validation. Conclusions Physical and mental outcomes were more accurately predicted using an expanded MCC checklist, population QOL rather than mortality CCI weighting, and individualized rather than population QOL weighting for each reported condition. The 3-min combination of CCC and QDIS ratings (QDIS-MCC) warrant further testing for purposes of predicting and interpreting QOL outcomes affected by MCC. Supplementary Information The online version contains supplementary material available at 10.1186/s12955-022-02016-7.
Collapse
Affiliation(s)
- Mindy L McEntee
- College of Health Solutions, Arizona State University, 500 N. 3rd Street, Phoenix, AZ, 85004-0698, USA.
| | - Barbara Gandek
- University of Massachusetts Medical School, Worchester, MA, USA.,John Ware Research Group, Inc., Watertown, MA, USA
| | - John E Ware
- College of Health Solutions, Arizona State University, 500 N. 3rd Street, Phoenix, AZ, 85004-0698, USA.,University of Massachusetts Medical School, Worchester, MA, USA.,John Ware Research Group, Inc., Watertown, MA, USA
| |
Collapse
|
16
|
Risom SS, Nørgaard MW, Streur MM. Quality of life and symptom experience measurement tools in adults with atrial fibrillation: a scoping review protocol. JBI Evid Synth 2022; 20:1376-1384. [PMID: 34937845 DOI: 10.11124/jbies-21-00167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The objective of this scoping review is to identify and map measurement tools for evaluating disease-specific quality of life and symptoms in adults with atrial fibrillation. The review will also identify key concepts that differentiate quality of life from symptom experience. INTRODUCTION Quality of life is a broad concept influenced by physical health, psychological state, degree of independence, and social/functional status. Symptoms of a chronic disease may influence quality of life through their effect on an individual's perception of physical health. Symptom experience is distinct from quality of life; however, the distinction is ill-defined, resulting in conceptual overlap in the measurement tools used to assess these concepts in patients with atrial fibrillation. INCLUSION CRITERIA Included manuscripts will describe a scale, index, questionnaire, checklist, or other form of measurement tool designed to assess quality of life or symptom experience in adults with atrial fibrillation or supraventricular arrhythmia. Peer-reviewed research manuscripts and systematic reviews, gray literature, and conceptual/theoretical papers will be included. METHODS The review will follow the JBI methodology for scoping reviews. MEDLINE, CINAHL, PsycINFO, the Cochrane Database of Systematic Reviews, and Embase will be searched, as well as Google Scholar, MedNar, and OpenGrey. Articles will be considered if they are published in English, Danish, Swedish, or Norwegian, with no date limitation. The title and abstract of each article will be independently screened by two authors, followed by full-text review of remaining articles, according to the inclusion criteria. Data will be independently extracted by two authors using a data extraction tool.
Collapse
Affiliation(s)
- Signe S Risom
- The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen O, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen O, Denmark
- Institute of Nursing and Nutrition, University College Copenhagen, Copenhagen N, Denmark
- Cardiology Department, Gentofte and Herlev University Hospital, Hellerup, Denmark
| | - Marianne W Nørgaard
- The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen O, Denmark
- Danish Centre of Systematic Reviews: A JBI Centre of Excellence, Center for Clinical Guidelines, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Megan M Streur
- Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, WA, USA
| |
Collapse
|
17
|
Hernandez‐Nino J, Ott MA, Thomas M, Alexander AB, Kline JA. Assessing quality of life after pulmonary embolism: Comparing results from the PEmb-QoL with semistructured interviews. Res Pract Thromb Haemost 2022; 6:e12732. [PMID: 35765669 PMCID: PMC9207120 DOI: 10.1002/rth2.12732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/14/2022] [Accepted: 04/20/2022] [Indexed: 11/25/2022] Open
Abstract
Background The Pulmonary Embolism Quality of Life questionnaire (PEmb-QoL) assesses quality of life (QoL) in patients with previous pulmonary embolism (PE). Objective Our aim was to assess the agreement between the PEmb-QoL and interviews and to explore other QoL concerns in patients diagnosed with PE. Methods This mixed-method study included interviews with 21 patients about QoL after PE, followed by the PEmb-QoL questionnaire. In interviews, patients were asked about their lived experiences and impact of PE. Our analysis identified the frequency and severity of decreased QoL in qualitative interviews and compared with the PEmb-QoL score. Excerpts that described the effect of PE on QoL in interview transcripts were transcoded to match the answers corresponding to the 1 to 6 numeric values for each question from the PEmb-QoL using a predetermined matrix (eg, "constant" and "daily" = all of the time = value 1) and directly compared with responses on the PEmb-QoL in the areas of emotional complaints and activities of daily living/social limitations. Results Interviews showed more functional impairment than predicted by PEmb-QoL. For fear of recurrence, 86% of participants had disagreements between PEmb-QoL scores and transcoded interview scores. We found 42% disagreement between reported descriptions of the inability to do or enjoy hobbies in interviews and the PEmb-QoL score. Conclusion Patient interviews showed discordances compared with a validated psychometric tool. To capture a more detailed and accurate picture of the effect of PE on QoL, providers and researchers should consider the addition of qualitative methods to assess outcomes.
Collapse
Affiliation(s)
| | - Mary A. Ott
- Department of PediatricsIndiana University School of MedicineIndianapolisIndianaUSA
| | - Mary Thomas
- Indiana University School of MedicineIndianapolisIndianaUSA
| | - Andreia B. Alexander
- Department of Emergency MedicineIndiana University School of MedicineIndianapolisIndianaUSA
| | | |
Collapse
|
18
|
Bian Z, Zhang Q, Shen L, Chen S. The influence of multidisciplinary team clinic on the prognosis of patients with chronic kidney disease. Exp Biol Med (Maywood) 2022; 247:815-821. [PMID: 35196905 PMCID: PMC9160933 DOI: 10.1177/15353702221077937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 01/14/2022] [Indexed: 11/15/2022] Open
Abstract
Chronic kidney disease (CKD) seriously affects the quality of life and survival time of patients, and even affects social and national economic development. In China, how to effectively control the disease process of CKD outpatients has not been determined. A retrospective analysis was made to 100 patients with CKD. Fifty patients treated with traditional clinical treatment were in the control group, and the other fifty patients treated with multidisciplinary team (MDT) clinical treatment were in the MDT group. The prognosis of the two groups after treatment was compared, including glomerular filtration rate (GFR), number of renal replacement treatments, and mortality, to evaluate the actual effect of MDT clinic. CKD patients in the MDT group received the MDT clinic for 24 months. There was no significant difference between GFR and serum creatinine level before treatment, and the quality of life was significantly higher than before. In the control group, the GFR declined more dramatically, the serum creatinine level was higher, and the quality of life was lower than before (P < 0.05). The frequency of renal replacement therapy and mortality in the MDT group were significantly lower than those in the control group (P < 0.05). MDT clinic can effectively improve the prognosis of patients with CKD, delay kidney disease progression, and reduce mortality.
Collapse
Affiliation(s)
- Zhixiang Bian
- Department of Nephrology, Shanghai Fourth People’s
Hospital, Shanghai 200434, China
| | - Qin Zhang
- Department of Nephrology, Shanghai Fourth People’s
Hospital, Shanghai 200434, China
| | - Li Shen
- Department of Nephrology, Shanghai Fourth People’s
Hospital, Shanghai 200434, China
| | - Shunjie Chen
- Department of Nephrology, Shanghai Fourth People’s
Hospital, Shanghai 200434, China
| |
Collapse
|
19
|
Shimizu S, Onishi Y, Kabaya K, Wang J, Fukuma S, Morinaga J, Hatakeyama S, Kobayashi S, Maeno K, Yamazaki H, Fukuhara S. Cohort profile: Alliance for Quality Assessment in Healthcare-Dialysis (AQuAH-D) prospective cohort study of patients on haemodialysis in Japan. BMJ Open 2022; 12:e054427. [PMID: 35078844 PMCID: PMC8796223 DOI: 10.1136/bmjopen-2021-054427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 12/09/2021] [Indexed: 11/18/2022] Open
Abstract
PURPOSE The global burden of kidney failure is increasing, but the treatment of kidney failure varies widely between patients, between dialysis facilities and over time. The Alliance for Quality Assessment in Healthcare-Dialysis (AQuAH-D) aims to conduct efficient and timely cohort studies on associations between those variations and clinical and patient-reported outcomes. PARTICIPANTS Included are outpatients aged 20 years old or older who are undergoing haemodialysis and have consented to participate. A total of 2895 patients were enrolled from 25 facilities in Japan between August 2018 and July 2020 and are to be followed until 31 December 2026. Chart review and annual questionnaires are used to collect data on patient characteristics and on outcomes including quality of life. Data on medications, haemodialysis prescriptions and blood tests are obtained from existing electronic records. Data are collected retrospectively from 1 January 2017 to patient enrolment, and prospectively from patient enrolment until the end of December 2026. FINDINGS TO DATE To date, the mean age is 68.3 (SD 12.2) years and 35.2% are female. The most common cause of kidney failure is diabetic nephropathy (37.4%). In January 2020, the facilities' median weekly doses of erythropoietin stimulating agent (ESA) and of intravenous vitamin D ranged from 1846 to 9692 IU (epoetin alfa equivalent) and 0.78 to 2.25 µg (calcitriol equivalent), respectively. The facilities' percentages of patients to whom calcimimetics are prescribed varied from 19% to 79%. During the retrospective period (averaging 1.85 years per participant), the incidence rates of any hospitalisation and of hospitalisation due to cardiovascular disease were 67.2 and 12.0 per 100 person-years, respectively. FUTURE PLANS AQuAH-D data will be updated every 6 months and will be available for studies addressing a wide range of research questions, using the advantages of granular data and quality-of-life measurement of ageing patients on haemodialysis.
Collapse
Affiliation(s)
- Sayaka Shimizu
- Department of Research, Institute for Health Outcomes & Process Evaluation Research, Kyoto, Japan
- Section of Clinical Epidemiology, Department of Community Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yoshihiro Onishi
- Department of Research, Institute for Health Outcomes & Process Evaluation Research, Kyoto, Japan
| | - Koji Kabaya
- Department of Research, Institute for Health Outcomes & Process Evaluation Research, Kyoto, Japan
| | - Jui Wang
- Department of Research, Institute for Health Outcomes & Process Evaluation Research, Kyoto, Japan
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Shingo Fukuma
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Jun Morinaga
- Department of Nephrology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Shingo Hatakeyama
- Department of Urology, Hirosaki University School of Medicine Graduate School of Medicine, Hirosaki, Japan
| | | | | | - Hajime Yamazaki
- Section of Clinical Epidemiology, Department of Community Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shunichi Fukuhara
- Section of Clinical Epidemiology, Department of Community Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of General Medicine, Shirakawa Satellite for Teaching and Research (STAR), Fukushima Medical University, Fukushima, Japan
| |
Collapse
|
20
|
Azaria S, Cherian AJ, Gowri M, Thomas S, Gaikwad P, Mj P, Abraham DT. Impact of thyroidectomy on quality of life in benign goitres: results from a prospective cohort study. Langenbecks Arch Surg 2022; 407:1193-1199. [PMID: 34988642 DOI: 10.1007/s00423-021-02391-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 11/28/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE Benign thyroid diseases encompass a large spectrum of conditions that are chronic and subtle in nature. A majority of patients choose non-surgical management and continue living their daily lives with subconscious impairment of optimal functioning. We studied the effect of thyroidectomy on the quality of life (QoL) in patients with benign goitres. METHODS A prospective study was conducted on 50 patients between January 2017 and August 2018 using the ThyPRO 39 questionnaire. This is a disease-specific health-related questionnaire administered the day before surgery and 6 months following surgery. Data analysis was performed using EpiData Manager and EpiData Entry Client (v 3.1). RESULTS The mean age of the cohort was 43.30 years ± 11.61, with a female preponderance (34:16). The most common indications for surgery were suspicion of malignancy and compressive symptoms in 34% and 30%, respectively. The most common histopathology reported was nodular/adenomatous hyperplasia (56%). Prior to surgery, the most common domains affected were emotional susceptibility and tiredness. Following surgery, a significant improvement in all domains of the ThyPRO 39 questionnaire were seen except for psychological well-being (p=0.126). In addition, the composite scores significantly improved (p<0.001). Younger age, female gender, and longer duration of goitre were the factors that significantly affected the outcomes in various domains. CONCLUSION Patients with benign goitres have subtle impairment of QoL which showed significant improvement following thyroidectomy.
Collapse
Affiliation(s)
- Swarna Azaria
- Department of General Surgery, Christian Medical College, Vellore, Tamil Nadu, 632004, India
| | - Anish Jacob Cherian
- Department of Endocrine Surgery, Christian Medical College, Vellore, Tamil Nadu, 632004, India
| | - Mahasampath Gowri
- Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, 632004, India
| | - Shawn Thomas
- Department of Endocrine Surgery, Christian Medical College, Vellore, Tamil Nadu, 632004, India
| | - Pranay Gaikwad
- Department of General Surgery, Christian Medical College, Vellore, Tamil Nadu, 632004, India
| | - Paul Mj
- Department of Endocrine Surgery, Christian Medical College, Vellore, Tamil Nadu, 632004, India
| | - Deepak Thomas Abraham
- Department of Endocrine Surgery, Christian Medical College, Vellore, Tamil Nadu, 632004, India.
| |
Collapse
|
21
|
Walsh L, Reilly JF, Cornwall C, Gaich GA, Gipson DS, Heerspink HJL, Johnson L, Trachtman H, Tuttle KR, Farag YMK, Padmanabhan K, Pan-Zhou XR, Woodworth JR, Czerwiec FS. Safety and Efficacy of GFB-887, a TRPC5 Channel Inhibitor, in Patients With Focal Segmental Glomerulosclerosis, Treatment-Resistant Minimal Change Disease, or Diabetic Nephropathy: TRACTION-2 Trial Design. Kidney Int Rep 2021; 6:2575-2584. [PMID: 34622097 PMCID: PMC8484122 DOI: 10.1016/j.ekir.2021.07.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 06/08/2021] [Accepted: 07/02/2021] [Indexed: 10/27/2022] Open
Abstract
Introduction A critical unmet need exists for precision therapies for chronic kidney disease. GFB-887 is a podocyte-targeting, small molecule inhibitor of transient receptor potential canonical-5 (TRPC5) designed specifically to treat patients with glomerular kidney diseases characterized by an overactivation of the TRPC5-Rac1 pathway. In a first-in-human study, GFB-887 was found to be safe and well tolerated, had a pharmacokinetic (PK) profile allowing once-daily dosing, and dose dependently decreased urinary Rac1 in healthy adults. Methods TRACTION-2 is a phase 2a, double-blind, placebo-controlled, multiple-ascending dose study of GFB-887 in patients with focal segmental glomerulosclerosis (FSGS), treatment-resistant minimal change disease (TR-MCD), or diabetic nephropathy (DN) (NCT04387448). Adult patients on stable renin-angiotensin system blockade and/or immunosuppression with persistent proteinuria will be randomized and dosed in 3 ascending dose levels to GFB-887 or placebo for 12 weeks. Cohorts may be expanded or biomarker-enriched depending upon results of an adaptive interim analysis. Results The primary objective is to evaluate the effect of increasing doses of GFB-887 on proteinuria. Safety and tolerability, quality of life, pharmacokinetic/pharmacodynamic profiles, and the potential association of urinary Rac1 with efficacy will also be evaluated. The projected sample size has 80% power to detect a treatment difference in proteinuria of 54% (FSGS/TR-MCD) or 44% (DN) compared to placebo. Conclusion TRACTION-2 will explore whether targeted blockade of the TRPC5-Rac1 pathway with GFB-887 is an efficacious and safe treatment strategy for patients with FSGS, TR-MCD, and DN and the potential value of urinary Rac1 as a predictive biomarker of treatment response.
Collapse
Affiliation(s)
- Liron Walsh
- Goldfinch Bio, Inc., Cambridge, Massachusetts, USA
| | | | | | | | | | | | | | | | - Katherine R Tuttle
- Providence Health Care, Spokane, WA.,University of Washington, Seattle, Washington, USA
| | | | | | | | | | | |
Collapse
|
22
|
Sandhu SA, Angel CA, Campbell KL, Hickman IJ, MacLaughlin HL. Standardised Outcome Reporting for the Nutrition Management of Complex Chronic Disease: A Rapid Review. Nutrients 2021; 13:3388. [PMID: 34684389 PMCID: PMC8538850 DOI: 10.3390/nu13103388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/18/2021] [Accepted: 09/21/2021] [Indexed: 11/05/2022] Open
Abstract
Individuals with coexisting chronic diseases or with complex chronic disease are among the most challenging and costly patients to treat, placing a growing demand on healthcare systems. Recommending effective treatments, including nutrition interventions, relies on standardised outcome reporting from randomised controlled trials (RCTs) to enable data synthesis. This rapid review sought to determine how the scope and consistency of the outcomes reported by RCTs investigating nutrition interventions for the management of complex chronic disease compared to what is recommended by the core outcome sets (COS) for individual disease states. Peer-reviewed RCTs published between January 2010 and July 2020 were systematically sourced from PubMed, CINAHL and Embase, and COS were sourced from the International Consortium for Health Outcomes Measurements (ICHOM) and the Core Outcome Measures in Effectiveness Trials (COMET) database. A total of 45 RCTs (43 studies) and 7 COS were identified. Outcomes were extracted from both the RCTs and COS and were organised using COMET Taxonomy Core Areas. A total of 66 outcomes and 439 outcome measures were reported by the RCTs. The RCTs demonstrated extensive outcome heterogeneity, with only five outcomes (5/66, 8%) being reported with relative consistency (cited by ≥50% of publications). Furthermore, the scope of the outcomes reported by studies was limited, with a notable paucity of patient-reported outcomes. Poor agreement (25%) was observed between the outcomes reported in the RCTs and those recommended by the COS. This review urges greater uptake of the existing COS and the development of a COS for complex chronic disease to be considered so that evidence can be better synthesised regarding effective nutrition interventions.
Collapse
Affiliation(s)
- Savita A Sandhu
- School of Exercise and Nutrition Sciences, Queensland University of Technology (QUT), Brisbane 4059, Australia;
| | - Chloe A Angel
- School of Exercise and Nutrition Sciences, Queensland University of Technology (QUT), Brisbane 4059, Australia;
| | - Katrina L Campbell
- Healthcare Excellence and Innovation, Metro North Hospital and Health Service, Brisbane 4029, Australia;
| | - Ingrid J Hickman
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane 4102, Australia;
- Faculty of Medicine, University of Queensland, Brisbane 4006, Australia
| | - Helen L MacLaughlin
- School of Exercise and Nutrition Sciences, Queensland University of Technology (QUT), Brisbane 4059, Australia;
- Royal Brisbane and Women’s Hospital, Brisbane 4029, Australia
| |
Collapse
|
23
|
Wedin M, Stålberg K, Marcickiewicz J, Ahlner E, Åkesson Å, Lindahl G, Wodlin NB, Kjølhede P. Impact of lymphadenectomy and lymphoedema on health-related quality of life 1 year after surgery for endometrial cancer. A prospective longitudinal multicentre study. BJOG 2021; 129:450-460. [PMID: 34437763 DOI: 10.1111/1471-0528.16870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess the impact of lymphadenectomy and lymphoedema of the lower limbs (LLL) on health-related quality of life (HRQoL) 1 year after surgery for endometrial cancer (EC). DESIGN Prospective longitudinal cohort multicentre study. SETTING Departments of obstetrics and gynaecology at four university hospitals, six central hospitals and four county hospitals in Sweden. POPULATION Two-hundred-and-thirty-five women with early stage EC were included; 116 with high-risk EC underwent surgery including lymphadenectomy (+LA), and 119 with low-risk EC had surgery without lymphadenectomy (-LA). METHODS The generic SF-36 and EQ-5D-3L and the lymphoedema-specific LYMQOL questionnaire were used to assess HRQoL. LLL was assessed by systematic circumferential measurements of the legs enabling volume estimation, clinical evaluation and patient-reported perception of leg swelling. All assessments were carried out on four occasions; preoperatively, and 4-6 weeks, 6 months and 1 year postoperatively. MAIN OUTCOME MEASURE HRQoL scores. RESULTS No significant differences were seen in HRQoL between the +LA and -LA groups 1 year postoperatively. Irrespective of method of determining LLL, women with LLL were significantly more affected in the LYMQOL domains Function, Appearance/body image and Physical symptoms, but not in the domain Emotion/mood, than women without LLL. No such differences were seen in the generic HRQoL or in the LYMQOL global score between the groups with and without LLL. CONCLUSIONS Lymphadenectomy did not seem to affect generic HRQoL adversely. Irrespective of the method of measuring, LLL affected the lymphoedema-specific HRQoL negatively, mainly in physical domains, but had no impact on the generic HRQoL. TWEETABLE ABSTRACT Lymphoedema has impact on lymphoedema-specific, but not on generic, HRQoL, 1 year after surgery for EC.
Collapse
Affiliation(s)
- M Wedin
- Department of Obstetrics and Gynaecology in Linköping, Department of Biomedical and Clinical Science, Linköping University, Linköping, Sweden
| | - K Stålberg
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - J Marcickiewicz
- Department of Obstetrics and Gynaecology, Varberg Hospital, Varberg, Sweden
| | - E Ahlner
- Department of Oncology, Department of Biomedical and Clinical Science, Linköping University, Linköping, Sweden
| | - Å Åkesson
- Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - G Lindahl
- Department of Oncology, Department of Biomedical and Clinical Science, Linköping University, Linköping, Sweden
| | - N B Wodlin
- Department of Obstetrics and Gynaecology in Linköping, Department of Biomedical and Clinical Science, Linköping University, Linköping, Sweden
| | - P Kjølhede
- Department of Obstetrics and Gynaecology in Linköping, Department of Biomedical and Clinical Science, Linköping University, Linköping, Sweden
| | | |
Collapse
|
24
|
Benazizi I, Bernal-Soriano MC, Pardo Y, Ribera A, Peralta-Chiriboga A, Ferrer M, Alonso-Jaquete A, Alonso J, Lumbreras B, Parker LA. Adaptation and psychometric validation of Diabetes Health Profile (DHP-18) in patients with type 2 diabetes in Quito, Ecuador: a cross-sectional study. Health Qual Life Outcomes 2021; 19:189. [PMID: 34332613 PMCID: PMC8325239 DOI: 10.1186/s12955-021-01818-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 07/06/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction The Diabetes Health Profile (DHP‐18), structured in three dimensions (psychological distress (PD), barriers to activity (BA) and disinhibited eating (DE)), assesses the psychological and behavioural burden of living with type 2 diabetes. The objectives were to adapt the DHP‐18 linguistically and culturally for use with patients with type 2 DM in Ecuador, and to evaluate its psychometric properties. Methods Participants were recruited using purposive sampling through patient clubs at primary health centres in Quito, Ecuador. The DHP-18 validation consisted in the linguistic validation made by two Ecuadorian doctors and eight patient interviews. And in the psychometric validation, where participants provided clinical and sociodemographic data and responded to the SF-12v2 health survey and the linguistically and culturally adapted version of the DHP-18. The original measurement model was evaluated with confirmatory factor analysis (CFA). Reliability was assessed through internal consistency using Cronbach’s alpha and test–retest reproducibility by administering DHP-18 in a random subgroup of the participants two weeks after (n = 75) using intraclass correlation coefficient (ICC). Convergent validity was assessed by establishing previous hypotheses of the expected correlations with the SF12v2 using Spearman’s coefficient. Results Firstly, the DHP-18 was linguistically and culturally adapted. Secondly, in the psychometric validation, we included 146 participants, 58.2% female, the mean age was 56.8 and 31% had diabetes complications. The CFA indicated a good fit to the original three factor model (χ2 (132) = 162.738, p < 0.001; CFI = 0.990; TLI = 0.989; SRMR = 0.086 and RMSEA = 0.040. The BA dimension showed the lowest standardized factorial loads (λ) (ranging from 0.21 to 0.77), while λ ranged from 0.57 to 0.89 and from 0.46 to 0.73, for the PD and DE dimensions respectively. Cronbach’s alphas were 0.81, 0.63 and 0.74 and ICCs 0.70, 0.57 and 0.62 for PD, BA and DE, respectively. Regarding convergent validity, we observed weaker correlations than expected between DHP-18 dimensions and SF-12v2 dimensions (r > −0.40 in two of three hypotheses). Conclusions The original three factor model showed good fit to the data. Although reliability parameters were adequate for PD and DE dimensions, the BA presented lower internal consistency and future analysis should verify the applicability and cultural equivalence of some of the items of this dimension to Ecuador.
Collapse
Affiliation(s)
- Ikram Benazizi
- Department of Public Health, Universidad Miguel Hernández, Sant Joan d'Alacant, Alicante, Spain.
| | - Mari Carmen Bernal-Soriano
- Department of Public Health, Universidad Miguel Hernández, Sant Joan d'Alacant, Alicante, Spain.,CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Yolanda Pardo
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Aida Ribera
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Cardiovascular Epidemiology and Research Unit, University Hospital and Research Institute Vall d'Hebron (VHIR), Barcelona, Spain
| | - Andrés Peralta-Chiriboga
- Department of Public Health, Universidad Miguel Hernández, Sant Joan d'Alacant, Alicante, Spain.,Instituto de Salud Pública, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
| | - Montserrat Ferrer
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Alfonso Alonso-Jaquete
- Unidad Docente de Medicina Preventiva y Salud Pública de Cantabria, Consejería de Sanidad de Cantabria, Santander, Spain
| | - Jordi Alonso
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain
| | - Blanca Lumbreras
- Department of Public Health, Universidad Miguel Hernández, Sant Joan d'Alacant, Alicante, Spain.,CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Lucy Anne Parker
- Department of Public Health, Universidad Miguel Hernández, Sant Joan d'Alacant, Alicante, Spain.,CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| |
Collapse
|
25
|
Jandhyala R. Neutral theory: applicability and neutrality of using generic health-related quality of life tools in diseases or conditions where specific tools are available. BMC Med Res Methodol 2021; 21:86. [PMID: 33902436 PMCID: PMC8077839 DOI: 10.1186/s12874-021-01279-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 04/08/2021] [Indexed: 11/15/2022] Open
Abstract
Background Health-related quality of life (HRQoL) tools are limited by the indicators included in the construct and variation in interpretation by different researchers. Neutral Theory describes the ideal construct that includes all relevant indicators and, therefore, complete accuracy, or neutrality. Neutral Theory can thereby provide the framework to develop or test constructs. To assess the application of Neutral Theory, the neutrality of generic tools (SF-36 and EQ-5D) at measuring HRQoL was compared to disease/condition-specific tools, with the latter considered surrogates for the Neutral construct. Methods Full descriptions of all disease/condition-specific HRQoL tools published on PubMed (to 01-Jul-19) were sourced. For each tool, the number of items with and without a direct match within the SF-36 and EQ-5D was recorded and the sensitivity/specificity calculated. Results The SF-36 and EQ-5D did not achieve a sensitivity/specificity both > 50% against any of the 163 disease/condition-specific tools identified. At 20% prevalence of poor HRQoL, the false positive rate (FPR) was > 75% for all but two tools against the SF-36 and six tools against the EQ-5D. Increasing poor HRQoL to 80%, 47 tools for the SF-36 and 48 tools for the EQ-5D had a FPR < 50%. For rare disease tools (< 1/2000 population; n = 17), sensitivity/specificity ranged from 0 to 40%/5–31% for the SF-36 and 0–22%/29–100% for the EQ-5D. For non-rare (n = 75) and symptom-specific tools (n = 71) sensitivity/specificity was: 0–100%/0–100% (SF-36) and 0–50%/0–100% (EQ-5D); and 0–60%/0–19% (SF-36) and 0–25%/0–100% (EQ-5D), respectively. No concordance was recorded for 18% (2/11) of results from studies of rare disease tools versus the SF-36 (no data vs EQ-5D). For non-rare, disease-specific tools, results were discordant for 30% (25/84) and 35% (23/65) of studies against the SF-36 and EQ-5D, respectively. For symptom-specific tools, corresponding results were 36% (24/66) and 16% (5/31). Conclusions Generic HRQoL tools appear poorly correlated with disease/condition-specific tools, which indicates that adoption of Neutral Theory in the development and assessment of HRQoL tools could improve their relevance, accuracy, and utility in economic evaluations of health interventions. Supplementary Information The online version contains supplementary material available at 10.1186/s12874-021-01279-w.
Collapse
Affiliation(s)
- Ravi Jandhyala
- Medialis Limited, Banbury, UK. .,Centre for Pharmaceutical Medicine Research, Institute of Pharmaceutical Science, Faculty of Life Science & Medicine, King's College London, London, UK.
| |
Collapse
|
26
|
Jespersen LN, Andersen A, Due P, Ersbøll AK, Damsgaard MT, Michelsen SI. From questionnaire to practical application: A quality of life profile for populations with diverse disabilities. Scand J Public Health 2021; 50:362-370. [PMID: 33530853 DOI: 10.1177/1403494820981437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS Existing quality of life questionnaires are either disease specific or generic in their assessment of themes which are perceived important to the quality of life in populations with disabilities. To be able to improve quality of life in a population with diverse disabilities there was a need for a cross-disability instrument. The Electronic Quality of Life (EQOL)-questionnaire was developed to meet this need. It is crucial that such an instrument is validated, easy to use, and interpret by, for example, clinicians and policy planners. This study aims to test the content validity of the EQOL questionnaire and to construct a user-friendly, cross-disability quality of life profile. METHODS To further test the content validity of the EQOL-questionnaire, we conducted field test analyses on 318 individuals (aged 16-64) with self-reported disabilities. Comments on the questionnaire were scrutinised and sorted. A profile with six domains of quality of life was developed. Model fit was evaluated by confirmatory factor analysis and content validity was evaluated based on distributions. RESULTS The EQOL-questionnaire was found to have an acceptable content validity and respondents from the field test found that it features important themes of quality of life. The confirmatory factor analysis estimated a satisfying model fit by the root-mean-squared error of approximation (0.06), whereas the comparative fit index and goodness of fit index indicated poorer model fit. Graphical charts, with colour categories for user-friendly interpretation, were constructed. CONCLUSION By identifying themes reported as problematic, the EQOL-profile can be used to inform and target interventions aiming to improve quality of life in populations with diverse disabilities.
Collapse
Affiliation(s)
- Louise N Jespersen
- National Institute of Public Health, University of Southern Denmark, Denmark.,Steno Diabetes Center Copenhagen, Denmark
| | - Anette Andersen
- National Institute of Public Health, University of Southern Denmark, Denmark.,Steno Diabetes Center Aarhus, Denmark
| | - Pernille Due
- National Institute of Public Health, University of Southern Denmark, Denmark
| | - Annette K Ersbøll
- National Institute of Public Health, University of Southern Denmark, Denmark
| | - Mogens T Damsgaard
- National Institute of Public Health, University of Southern Denmark, Denmark
| | - Susan I Michelsen
- National Institute of Public Health, University of Southern Denmark, Denmark
| |
Collapse
|
27
|
Sleep Well, Endoscopist: January 2021 Annals of Emergency Medicine Journal Club. Ann Emerg Med 2021; 77:127-128. [PMID: 33349365 DOI: 10.1016/j.annemergmed.2020.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
28
|
Fanning E, Maher N, Cools A, Falvey EC. Outcome Measures After Shoulder Stabilization in the Athletic Population: A Systematic Review of Clinical and Patient-Reported Metrics. Orthop J Sports Med 2020; 8:2325967120950040. [PMID: 32984424 PMCID: PMC7498977 DOI: 10.1177/2325967120950040] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 04/07/2020] [Indexed: 01/02/2023] Open
Abstract
Background: Athletic endeavor can require the “athletic shoulder” to tolerate significant
load through supraphysiological range and often under considerable
repetition. Outcome measures are valuable when determining an athlete’s safe
return to sport. Few data are available to guide a clinician’s choice from
the variety of measures available. Purpose: To describe the use of quantifiable objective outcome measures and
patient-reported outcome tools after glenohumeral joint stabilization,
specifically in an athletic population. The secondary aim of our study was
to assess whether the method of measurement used was clearly described and
standardized to aid clinical interpretation. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic search of MEDLINE, Scopus, SPORTDiscus, and Web of Science
databases was performed in December 2018 based on the PRISMA (Preferred
Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. After
the application of selection criteria, a full review of identified papers,
and screening of reference lists, a total of 62 studies were included in the
review. All studies were independently appraised for quality, predefined
data fields were populated and cross-checked for accuracy, and results were
then summarized from these data fields. Results: Of the 62 included studies, 94% used a quantifiable objective clinical
outcome. A majority (85%) of the studies measured range of motion, 21%
recorded muscle strength, 5% measured electromyographic activity, 5%
examined shoulder kinematics, and 3% assessed joint proprioception after
surgery. However, only 18% of the studies clearly described a standardized
method of measuring the outcome. Nearly all (95%) of the studies used at
least 1 patient-reported outcome measure. The Rowe score was most commonly
used (35%). Conclusion: We must standardize and clearly describe the use of quantifiable objective
outcome measures to aid clinical interpretation. A concerted effort should
also be made to standardize the use of patient-reported outcome tools after
shoulder stabilization in the athletic population.
Collapse
Affiliation(s)
- Edel Fanning
- Sports Surgery Clinic, Sports Medicine, Dublin, Ireland.,University College Cork, Cork, Ireland
| | - Natasha Maher
- Calderdale and Huddersfield NHS Foundation Trust, Huddersfield, West Yorkshire, UK
| | - Ann Cools
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Gent, Belgium
| | - Eanna C Falvey
- Sports Surgery Clinic, Sports Medicine, Dublin, Ireland.,University College Cork, Cork, Ireland
| |
Collapse
|
29
|
Multimorbidity, physical frailty, and self-rated health in older patients with atrial fibrillation. BMC Geriatr 2020; 20:343. [PMID: 32917137 PMCID: PMC7488548 DOI: 10.1186/s12877-020-01755-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 09/02/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Holistic care models emphasize management of comorbid conditions to improve patient-reported outcomes in treatment of atrial fibrillation (AF). We investigated relations between multimorbidity, physical frailty, and self-rated health (SRH) among older adults with AF. METHODS Patients (n = 1235) with AF aged 65 years and older were recruited from five medical centers in Massachusetts and Georgia between 2015 and 2018. Ten previously diagnosed cardiometabolic and 8 non-cardiometabolic conditions were assessed from medical records. Physical Frailty was assessed with the Cardiovascular Health Study frailty scale. SRH was categorized as either "excellent/very good", "good", and "fair/poor". Separate multivariable ordinal logistic models were used to examine the associations between multimorbidity and SRH, physical frailty and SRH, and multimorbidity and physical frailty. RESULTS Overall, 16% of participants rated their health as fair/poor and 14% were frail. Hypertension (90%), dyslipidemia (80%), and heart failure (37%) were the most prevalent cardiometabolic conditions. Arthritis (51%), anemia (31%), and cancer (30%), the most common non-cardiometabolic diseases. After multivariable adjustment, patients with higher multimorbidity were more likely to report poorer health status (Odds Ratio (OR): 2.15 [95% CI: 1.53-3.03], ≥ 8 vs 1-4; OR: 1.37 [95% CI: 1.02-1.83], 5-7 vs 1-4), as did those with more prevalent cardiometabolic and non-cardiometabolic conditions. Patients who were pre-frail (OR: 1.73 [95% CI: 1.30-2.30]) or frail (OR: 6.81 [95% CI: 4.34-10.68]) reported poorer health status. Higher multimorbidity was associated with worse frailty status. CONCLUSIONS Multimorbidity and physical frailty were common and related to SRH. Our findings suggest that holistic management approaches may influence SRH among older patients with AF.
Collapse
|
30
|
Development and validation of a revised trauma-specific quality of life instrument. J Trauma Acute Care Surg 2020; 88:501-507. [PMID: 31626032 DOI: 10.1097/ta.0000000000002505] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND The National Academies of Science has called for routine collection of long-term outcomes after injury. One of the main barriers for this is the lack of practical trauma-specific tools to collect such outcomes. The only trauma-specific long-term outcomes measure that applies a biopsychosocial view of patient care, the Trauma Quality-of-Life (T-QoL), has not been adopted because of its length, lack of composite scores, and unknown validity. Our objective was to develop a shorter version of the T-QoL measure that is reliable, valid, specific, and generalizable to all trauma populations. METHODS We used two random samples selected from a prospective registry developed to follow long-term outcomes of adult trauma survivors (Injury Severity Score ≥9) admitted to three level I trauma centers. First, we validated the original T-QoL instrument using the 12-Item Short-Form Health Survey (SF-12) version 2.0 and Breslau post-traumatic stress disorder screening (B-PTSD) tools. Second, we conducted a confirmatory factor analysis to reduce the length of the original T-QoL instrument, and using a different sample, we scored and performed internal consistency and validity assessments of the revised T-QoL (RT-QoL) components. RESULTS All components of the original T-QoL were significantly correlated negatively with the B-PTSD and positively with the SF-12 mental and physical composite scores. After confirmatory factor analysis, a three-component structure using 18 items (six items/component) most appropriately represented the data. Each component in the revised instrument demonstrated a high level of internal consistency (Cronbach's α ≥0.8) and correlated negatively with the B-PTSD and positively with the SF-12, demonstrating concurrent validity. In addition, each of the RT-QoL components was able to distinguish between individuals based on their work status, with those who have returned to work reporting better health. CONCLUSION This more practical RT-QoL measure greatly increases the ability to evaluate long-term outcomes in trauma more efficiently and meaningfully, without sacrificing the validity and psychometric properties of the original instrument. LEVEL OF EVIDENCE Prognostic and epidemiological, level III.
Collapse
|
31
|
Abu HO, Saczynski JS, Ware J, Mehawej J, Paul T, Awad H, Bamgbade BA, Pierre-Louis IC, Tisminetzky M, Kiefe CI, Goldberg RJ, McManus DD. Impact of comorbid conditions on disease-specific quality of life in older men and women with atrial fibrillation. Qual Life Res 2020; 29:3285-3296. [PMID: 32656722 DOI: 10.1007/s11136-020-02578-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Older persons with atrial fibrillation (AF) experience significant impairment in quality of life (QoL), which may be partly attributable to their comorbid diseases. A greater understanding of the impact of comorbidities on QoL could optimize patient-centered care among older persons with AF. OBJECTIVE To assess impairment in disease-specific QoL due to comorbid conditions in older adults with AF. METHODS Patients aged ≥ 65 years diagnosed with AF were recruited from five medical centers in Massachusetts and Georgia between 2015 and 2018. At 1 year of follow-up, the Quality of Life Disease Impact Scale-for Multiple Chronic Conditions was used to provide standardized assessment of patient self-reported impairment in QoL attributable to 34 comorbid conditions grouped in 10 clusters. RESULTS The mean age of study participants (n = 1097) was 75 years and 48% were women. Overall, cardiometabolic, musculoskeletal, and pulmonary conditions were the most prevalent comorbidity clusters. A high proportion of participants (82%) reported that musculoskeletal conditions exerted the greatest impact on their QoL. Men were more likely than women to report that osteoarthritis and stroke severely impacted their QoL. Patients aged < 75 years were more likely to report that obesity, hip/knee joint problems, and fibromyalgia extremely impacted their QoL than older participants. CONCLUSIONS Among older persons with AF, while cardiometabolic diseases were highly prevalent, musculoskeletal conditions exerted the greatest impact on patients' disease-specific QoL. Understanding the extent of impairment in QoL due to underlying comorbidities provides an opportunity to develop interventions targeted at diseases that may cause significant impairment in QoL.
Collapse
Affiliation(s)
- Hawa O Abu
- Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA.
| | - Jane S Saczynski
- Department of Pharmacy and Health Systems Sciences, School of Pharmacy, Northeastern University, Boston, MA, USA
| | - John Ware
- John Ware Research Group, Watertown, MA, USA
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Jordy Mehawej
- Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA
| | - Tenes Paul
- Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA
| | - Hamza Awad
- Departments of Community Medicine and Internal Medicine, Mercer University School of Medicine, Macon, GA, USA
| | - Benita A Bamgbade
- Department of Pharmacy and Health Systems Sciences, School of Pharmacy, Northeastern University, Boston, MA, USA
| | - Isabelle C Pierre-Louis
- Department of Pharmacy and Health Systems Sciences, School of Pharmacy, Northeastern University, Boston, MA, USA
| | - Mayra Tisminetzky
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
- Division of Geriatrics, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Catarina I Kiefe
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Robert J Goldberg
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - David D McManus
- Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA
| |
Collapse
|
32
|
Boudewijns EA, Claessens D, van Schayck OCP, Keijsers LCEM, Salomé PL, In 't Veen JCCM, Bilo HJG, Gidding-Slok AHM. ABC-tool reinvented: development of a disease-specific 'Assessment of Burden of Chronic Conditions (ABCC)-tool' for multiple chronic conditions. BMC FAMILY PRACTICE 2020; 21:11. [PMID: 31931729 PMCID: PMC6958572 DOI: 10.1186/s12875-019-1075-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 12/24/2019] [Indexed: 02/03/2023]
Abstract
Background Numerous instruments have been developed to assess patient reported outcomes; most approaches however focus on a single condition. With the increasing prevalence of multimorbidity, this might no longer be appropriate. Moreover, a more comprehensive approach that facilitates shared decision making and stimulates self-management is most likely more valuable for clinical practice than a questionnaire alone. This study aims to transform the Assessment of Burden of Chronic Obstructive Pulmonary Disease (COPD) (ABC)-tool into the Assessment of Burden of Chronic Conditions (ABCC)-tool for COPD, asthma, and diabetes mellitus type 2 (DM2). The tool consists of a scale, a visualisation of the outcomes, and treatment advice. Methods Requirements for the tool were formulated. Questionnaires were developed based on a literature study of existing questionnaires, clinical guidelines, interviews with patients and healthcare providers, and input from an expert group. Cut-off points and treatment advice were determined to display the results and to provide practical recommendations. Results The ABCC-scale consists of a generic questionnaire and disease-specific questionnaires, which can be combined into a single individualized questionnaire for each patient. Results are displayed in one balloon chart, and each domain includes practical recommendations. Conclusions The ABCC-tool is expected to facilitate conversations between a patient and a healthcare provider, and to help formulate treatment plans and care plans with personalised goals. By facilitating an integrated approach, this instrument can be applied in a variety of circumstances and disease combinations.
Collapse
Affiliation(s)
- Esther A Boudewijns
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200, MD, Maastricht, the Netherlands.
| | - Danny Claessens
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200, MD, Maastricht, the Netherlands
| | - Onno C P van Schayck
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200, MD, Maastricht, the Netherlands
| | - Lotte C E M Keijsers
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200, MD, Maastricht, the Netherlands
| | | | - Johannes C C M In 't Veen
- Department of Pulmonology, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands.,Department of Pulmonology, Erasmus MC, Rotterdam, The Netherlands
| | - Henk J G Bilo
- Department of Internal Medicine, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Annerika H M Gidding-Slok
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200, MD, Maastricht, the Netherlands
| |
Collapse
|
33
|
Yamazaki H, Matsuoka K, Fernandez J, Hibi T, Watanabe M, Hisamatsu T, Fukuhara S. Ulcerative colitis outcomes research in Japan: protocol for an observational prospective cohort study of YOURS (YOu and Ulcerative colitis: Registry and Social network). BMJ Open 2019; 9:e030134. [PMID: 31501121 PMCID: PMC6738732 DOI: 10.1136/bmjopen-2019-030134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Ulcerative colitis (UC) is a chronic inflammatory disease that mainly affects the colon in young patients. Typical symptoms of UC are bloody diarrhoea and faecal urgency, which disturb the quality of life (QOL) of patients, and intractable UC leads to hospitalisation and colectomy. To improve relevant outcomes such as symptoms, QOL and colectomy, many clinical questions need to be resolved regarding what the ideal lifestyle, psychosocial burden and optimal practice patterns are. In this YOu and Ulcerative colitis: Registry and Social network (YOURS) study, we will investigate the effect of lifestyle, psychosocial factors and practice patterns on patient-reported outcomes (PRO), hospitalisation rate and colectomy rate in Japanese patients with UC. METHODS AND ANALYSIS For this prospective cohort study, we recruited 2006 patients from five hospitals (Tokyo and Chiba; May 2018-January 2019). Patients will be able to access their own data and compare them with summarised data from all patients on the website beyond the YOURS study. At baseline, patients will answer a questionnaire regarding lifestyle (diet, exercise, sleep and work), psychosocial factors (stress, depression and social support) and PRO (symptoms and QOL). Information on practice patterns (eg, medications, endoscopy frequency) will be collected from electronic medical records. Gaps between patients' needs and healthcare professionals' practice will be identified. Follow-up surveys will be conducted periodically for approximately 3 years. Research questions suggested by patients and healthcare professionals may be used in subsequent surveys. Results from the YOURS study will demonstrate optimal UC management strategies to improve relevant outcomes.The study was approved by the ethics committees of five investigational sites before starting the study. The results will be submitted to journals.UMIN000031995.
Collapse
Affiliation(s)
- Hajime Yamazaki
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Katsuyoshi Matsuoka
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Sakura Medical Center, Chiba, Japan
| | - Jovelle Fernandez
- Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan
| | - Toshifumi Hibi
- Center for Advanced IBD Research and Treatment, Kitasato University Kitasato Institute Hospital, Tokyo, Japan
| | - Mamoru Watanabe
- Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Tokyo, Japan
- TMDU Advanced Research Institute, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tadakazu Hisamatsu
- Department of Gastroenterology and Hepatology, Kyorin University School of Medicine, Tokyo, Japan
| | - Shunichi Fukuhara
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
| |
Collapse
|
34
|
Skovlund SE, Lichtenberg TH, Hessler D, Ejskjaer N. Can the Routine Use of Patient-Reported Outcome Measures Improve the Delivery of Person-Centered Diabetes Care? A Review of Recent Developments and a Case Study. Curr Diab Rep 2019; 19:84. [PMID: 31420754 DOI: 10.1007/s11892-019-1190-x] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
PURPOSE OF REVIEW In recent years, the recommendation for and use of patient-reported outcome measures (PROMs) in routine diabetes care has significantly increased. We review recent evidence and highlight key opportunities and challenges related to the active clinical use of PROMs to support person-centered diabetes care and focus areas for future research in the area. RECENT FINDINGS Recent pragmatic studies support that integration of multi-dimensional PROMs for diabetes in clinical care as part of a care improvement strategy can be acceptable for and valued by people with diabetes (PWD) and healthcare professionals (HCPs) and may improve multiple aspects of quality of care, including screening, medical care monitoring and decision support, individualization of self-management support and goal-setting, and broader benefits related to active patient participation and person-centred diabetes care. We identify multiple intervention, individual, and care setting characteristics, which influence acceptability, feasibility, implementation, and effectiveness of PROMs in routine care. Recent clinical PROM studies highlight the value of mixed methods research and systematic involvement of PWD, clinicians, and other stakeholders in the design and implementation of questionnaires for patient input in routine diabetes care. We identified a new significant trend towards participatory development of multi-dimensional PROMs with the aim of IT-enabled integration into routine diabetes care to facilitate multiple components of person-centered diabetes care and better clinical, quality of life, and cost outcomes. While results from large-scale randomized controlled studies are still limited, a growing number of pragmatic implementation studies support that user-centric PROM interventions have the potential to facilitate significant improvements in care for PWD.
Collapse
Affiliation(s)
- Soren E Skovlund
- Steno Diabetes Center North Denmark, Aalborg University Hospital, Aalborg, Denmark.
- Department of Clinical Medicine, Aalborg University, Søndre Skovvej 15, DK-9000, Aalborg, Denmark.
| | | | - D Hessler
- Family & Community Medicine, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - N Ejskjaer
- Steno Diabetes Center North Denmark, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Søndre Skovvej 15, DK-9000, Aalborg, Denmark
| |
Collapse
|
35
|
Senanayake S, Mahesh PKB, Gunawardena N, Graves N, Kularatna S. Validity and internal consistency of EQ-5D-3L quality of life tool among pre-dialysis patients with chronic kidney disease in Sri Lanka, a lower middle-income country. PLoS One 2019; 14:e0211604. [PMID: 31242189 PMCID: PMC6594575 DOI: 10.1371/journal.pone.0211604] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 06/12/2019] [Indexed: 11/18/2022] Open
Abstract
Objective EQ-5D-3L is a generic QOL tool used mainly in economic evaluations. Burden of Chronic Kidney Disease (CKD) is rising in Sri Lanka. Assessing the validity of generic QOL tools creates new opportunities of their utilization among patients with CKD. Methods A cross-sectional study was conducted among 1036 CKD patients, selected using the simple random sampling technique. The validity was tested with six a-priori hypotheses. These included construct validity assessments, evaluating convergent validity and performing known group comparisons. EQ-5D-3L, Short Form-36 (SF-36) were used to assess QOL. Center for Epidemiological Studies Depression Scale (CES-D-20) and General Health Questionnaire-12 (GHQ-12) were used to assess the presence of depression and psychological distress respectively. Internal consistency of the whole tool and when each item is removed was assessed by Cronbach alpha. Results The response rate was 99.2%. Majority of participants were males (n = 646,62.4%) in the age category of 41–60 (n = 530; 51.2%). Most were in either stage 4 or 5 of CKD (n = 646,75.1%). The summary measures of SF-36, positively and significantly correlated with the EQ-5D-3L index and VAS scores (p<0.001). EQ-5D-3L QOL scores were significantly different between the group with depression and without as measured by CES-D-20 (p<0.001). Assessed using GHQ-12, similar significance was detected between the group with psychological distress and without (p<0.001). The Cronbach alpha was 0.834 and when each item was removed, ranged from 0.782 to 0.832. Conclusion EQ-5D-3L is a valid generic QOL tool with satisfactory internal consistency to be used among CKD patients in the pre-dialysis stage.
Collapse
Affiliation(s)
- Sameera Senanayake
- Australian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, Australia
- Ministry of Health, Colombo, Sri Lanka
- * E-mail:
| | - P. K. B. Mahesh
- Ministry of Health, Colombo, Sri Lanka
- School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | | | - Nicholas Graves
- Australian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, Australia
| | - Sanjeewa Kularatna
- Australian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, Australia
| |
Collapse
|
36
|
Nogueira D, Reis E, Ferreira P, Schindler A. Measuring Quality of Life in the Speaker with Dysarthria: Reliability and Validity of the European Portuguese Version of the QoL-DyS. Folia Phoniatr Logop 2019; 71:176-190. [PMID: 30995654 DOI: 10.1159/000495564] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 11/18/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The impact of acquired dysarthria on the person's life and social participation is well recognized and is the key to the process of rehabilitation. Evaluation of the effectiveness of an intervention that addresses this impact is a challenge for clinicians and researchers. OBJECTIVES The purpose of this study was to evaluate the validity and reliability of the European Portuguese version of the Quality of Life in the Speaker with Dysarthria (QoL-DyS). METHODS This research was conducted in three phases: (i) cultural and linguistic adaptation; (ii) feasibility and reliability; and (iii) validity. The sample was composed of 105 subjects with dysarthria and 103 healthy subjects. The QAD (Quick Assessment for Dysarthria), PEAT10 (Portuguese Eating Assessment Tool), and EQ-5D (EuroQol five-dimension scale) were used for validity and reliability. RESULTS AND CONCLUSION The QoL-DyS correlated positively with the QAD, PEAT-10, and EQ5D. Cronbach's α was 0.973, and it remained excellent when any item was deleted. The QoL-DyS score mean difference between the non-dysarthric cohort and the dysarthric cohort was also significant. Confirmatory factor analysis did not validate the original 40-item scale but a 33-item scale maintaining the four domains of the original version. A significantly higher perception of QoL was found in the non-dysarthric group. The results indicate that the European Portuguese version of the QoL-DyS is a reliable and valid tool to assess QoL in patients with dysarthria and may be used for screening in clinical practice and in research.
Collapse
Affiliation(s)
- Dalia Nogueira
- Business Research Unit, Instituto Universitário de Lisboa (ISCTE-IUL), Lisbon, Portugal, .,Santa Casa da Misericórdia de Lisboa, Lisbon, Portugal,
| | - Elizabeth Reis
- Business Research Unit, Instituto Universitário de Lisboa (ISCTE-IUL), Lisbon, Portugal
| | - Pedro Ferreira
- Faculdade de Economia, Universidade de Coimbra, Coimbra, Portugal
| | - Antonio Schindler
- Dipartimento di Scienze Biomediche e Cliniche "L. Sacco," Università degli Studi di Milano, Milan, Italy
| |
Collapse
|
37
|
Velema MS, de Nooijer A, Hermus ARMM, Timmers HJLM, Lenders JWM, Husson O, Deinum J. A disease-specific Quality of Life questionnaire for primary aldosteronism. Endocr Connect 2019; 8:389-397. [PMID: 30865926 PMCID: PMC6454297 DOI: 10.1530/ec-19-0026] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Accepted: 03/13/2019] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To develop a primary aldosteronism (PA) disease-specific Health-Related Quality of Life (HRQoL) questionnaire. METHODS We included newly diagnosed patients with PA (n = 26), and patients with PA after adrenalectomy (n = 25) or treated with mineralocorticoid receptor antagonists (n = 25). According to the guidelines for developing HRQoL questionnaires from the European Organization for Research and Treatment of Cancer (EORTC): Phase I: systematic literature review followed by focus group meetings with patients (n = 13) resulting in a list of 94 HRQoL issues. Relevance of issues was rated by 18 other patients and by health care professionals (n = 15), resulting in 30 remaining issues. Phase II: selected issues were converted into questions. Phase III: the provisional questionnaire was pre-tested by a third group of patients (n = 45) who also completed the EORTC core Quality of Life questionnaire (QLQ-C30). Psychometric testing resulted in a final selection of questions with their scale structure. RESULTS After the collection and selection of HRQoL issues a provisional questionnaire consisting of 30 items was formed. Of these items, 26 could be assigned to one of the four scales 'physical and mental fatigue', 'anxiety and stress', 'fluid balance' and 'other complaints' cumulatively accounting for 68% of variation in all items. All scales had good reliability and validity. There was a significant correlation of all four scales with the QLQ-C30 in most cases. CONCLUSIONS We developed the first PA-specific HRQoL questionnaire (PA-QoL) using standard, methodologically proven guidelines. After completion of the final validation (phase IV, international field testing), the questionnaire can be implemented into clinical practice.
Collapse
Affiliation(s)
- Marieke Stientje Velema
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
- Correspondence should be addressed to M S Velema:
| | - Aline de Nooijer
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Ad R M M Hermus
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Henri J L M Timmers
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Jacques W M Lenders
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
- Department of Internal Medicine III, University Hospital Carl Gustav Carus at the Technical University Dresden, Dresden, Germany
| | - Olga Husson
- Division of Clinical Studies, Institute of Cancer Research, London, UK
| | - Jaap Deinum
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
- Department of Internal Medicine III, University Hospital Carl Gustav Carus at the Technical University Dresden, Dresden, Germany
| |
Collapse
|
38
|
The effect of transitional care on the prevention of diabetic foot ulcers in patients at high risk for diabetic foot. Int J Diabetes Dev Ctries 2019. [DOI: 10.1007/s13410-019-00736-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
|
39
|
Ware JE, Richardson MM, Meyer KB, Gandek B. Improving CKD-Specific Patient-Reported Measures of Health-Related Quality of Life. J Am Soc Nephrol 2019; 30:664-677. [PMID: 30898870 DOI: 10.1681/asn.2018080814] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 01/30/2019] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Patient-reported outcome measures that are more practical and clinically useful are needed for patients with CKD. We compared a new CKD-specific quality-of-life impact scale (CKD-QOL) with currently used measures. METHODS Patients (n=485) in different treatment groups (nondialysis stages 3-5, on dialysis, or post-transplant) completed the kidney-specific CKD-QOL and Kidney Disease Quality of Life-36 (KDQOL-36) forms and the generic SF-12 Health Survey at baseline and 3 months. New items summarizing quality of life (QOL) impact attributed to CKD across six QOL domains yielded single impact scores from a six-item static (fixed-length) form and from computerized adaptive tests (CATs) with three to six items. Validity tests compared the CKD-QOL, KDQOL-36 (Burden, Effects, and Symptoms/Problems subscales), and generic SF-12 measures across groups in four tests of clinical status and clinician assessment of change (CKD-specific tests), and number of comorbidities. ANOVA was used to test for group mean differences, variances in each measure explained by groups, and relative validity (RV) in comparison with the referent KDQOL-36 Burden subscale. RESULTS KDQOL-36 and CKD-QOL measures generally discriminated better than generic SF-12v2 measures. The pattern of variances across CKD-specific tests comparing validity favored CKD-QOL two-fold over KDQOL-36. Two RV test results confirmed CKD-QOL improvements over the referent KDQOL scale. Results for static and CAT CKD-QOL forms were similar. SF-12 Physical and KDQOL-36 Symptoms scores worsened with increasing comorbid condition counts. CONCLUSIONS Overall, compared with the KDQOL-36, the new approach to summarizing CKD-specific QOL impact performed better across multiple tests of validity. CAT surveys were more efficient than static surveys.
Collapse
Affiliation(s)
- John E Ware
- John Ware Research Group, Outcomes Measurement Department, Watertown, Massachusetts; .,Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Michelle M Richardson
- William B. Schwartz Division of Nephrology, Department of Medicine, Tufts Medical Center, Boston, Massachusetts; and.,Dialysis Clinic, Inc., Outcomes Monitoring Program, Boston, Massachusetts
| | - Klemens B Meyer
- William B. Schwartz Division of Nephrology, Department of Medicine, Tufts Medical Center, Boston, Massachusetts; and.,Dialysis Clinic, Inc., Outcomes Monitoring Program, Boston, Massachusetts
| | - Barbara Gandek
- John Ware Research Group, Outcomes Measurement Department, Watertown, Massachusetts.,Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts
| |
Collapse
|
40
|
Peshko D, Kulbachinskaya E, Korsunskiy I, Kondrikova E, Pulvirenti F, Quinti I, Blyuss O, Dunn Galvin A, Munblit D. Health-Related Quality of Life in Children and Adults with Primary Immunodeficiencies: A Systematic Review and Meta-Analysis. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2019; 7:1929-1957.e5. [PMID: 30797077 DOI: 10.1016/j.jaip.2019.02.013] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 01/30/2019] [Accepted: 02/05/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Primary immunodeficiency diseases (PIDs) are a group of diseases that have been found to have an adverse impact on quality of life and health-related quality of life (HRQOL). OBJECTIVE To systematically assess available evidence on the HRQOL of patients with PID. METHODS We performed a literature search of all studies reporting HRQOL assessments in patients with PID published in English from inception to April 11, 2017, using MEDLINE and EMBASE. RESULTS Of 1699 articles, 37 met the inclusion criteria. HRQOL was assessed by using various generic instruments. Child Health Questionnaire - Parent Form 50 and short-form 36 were the most frequently used (for children and adults, respectively). No PID-specific HRQOL instruments were used for children. HRQOL is significantly lower in adults with PID (mean score difference, -24.46; 95% CI, -34.57 to -14.34) and children (-10.06; 95% CI, -12.95 to -7.17) compared with the reference population and lower than in patients with other chronic conditions. There is a general agreement between child- and parent-reported data, although parents report child school-related HRQOL as more impaired than do children (6.19; 95% CI, 0.38 to 11.99). Most studies were of low to moderate quality and had methodological limitations. CONCLUSIONS Available evidence suggests that patients with PID have a lower HRQOL than do healthy individuals and patients with other chronic conditions, including diabetes mellitus and juvenile idiopathic arthritis. No disease-specific instruments are available for children, and few options are available for adults. This finding highlights the need for developing PID-specific instruments that would allow for a more sensitive evaluation of PID impact on patient health and psychological well-being, school/work, and social activities.
Collapse
Affiliation(s)
- Dmitrii Peshko
- Department of Paediatrics, Sechenov University, Moscow, Russia
| | - Ekaterina Kulbachinskaya
- Department of Paediatrics, Sechenov University, Moscow, Russia; The Research and Clinical Institute for Pediatrics named after Academician Yuri Veltischev of the Pirogov Russian National Research Medical University, Moscow, Russia
| | - Ilya Korsunskiy
- Department of Paediatrics, Sechenov University, Moscow, Russia; Moscow City Paediatric Hospital #9 named after Speransky, Moscow, Russia
| | | | | | - Isabella Quinti
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Oleg Blyuss
- Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, United Kingdom; Department of Applied Mathematics, Lobachevsky State University of Nizhny Novgorod, Nizhny Novgorod, Russia
| | | | - Daniel Munblit
- Department of Paediatrics, Sechenov University, Moscow, Russia; Department of Paediatrics, Imperial College London, London, United Kingdom; The In-VIVO Global Network, an Affiliate of the World Universities Network (WUN), New York, NY; Healthcare Department of Moscow, Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russia.
| |
Collapse
|
41
|
Endo M, Odaira K, Ono R, Kurauchi G, Koseki A, Goto M, Sato Y, Kon S, Watanabe N, Sugawara N, Takada H, Kimura E. Health-related quality of life and its correlates in Japanese patients with myotonic dystrophy type 1. Neuropsychiatr Dis Treat 2019; 15:219-226. [PMID: 30679907 PMCID: PMC6338121 DOI: 10.2147/ndt.s187607] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
PURPOSE Myotonic dystrophy type 1 (DM1) is a common form of muscular dystrophy that presents with a variety of symptoms that can affect patients' quality of life (QoL). Despite the importance of clarifying patients' subjective experience in both physical and psychosocial aspects for improved symptom management, there is lack of evidence concerning QoL of patients with DM1 in Japan. PATIENTS AND METHODS A cross-sectional study was performed with 51 DM1 patients who completed questionnaires that measured health-related QoL (HRQoL), depression, and daytime sleepiness. Activities of daily living, body mass index (BMI), and genetic information were also collected, together with general demographic information. Correlation analyses using these variables were performed. Furthermore, regression analysis was utilized to assess the relationship that HRQoL, depression, and daytime sleepiness scores have with other variables. RESULTS Physical component summary (PCS) score was affected by the disease more than the mental component summary (MCS) score among study participants. Moderate correlation was observed between PCS and depression, PCS and Barthel index, and depression and daytime sleepiness. Regression analysis revealed that age, sex, cytosine-thymine-guanine repeats, and BMI did not predict the aforementioned dependent variables. CONCLUSION DM1 symptoms influenced physical component scores more than mental component scores, although the state of physical wellness seemed to affect patients' mood. Explaining the QoL of these patients only using biologic and genetic characteristics was not sufficient. We conclude that social and psychological aspects of these patients' lives and the nature of adjustments made by patients due to DM1 to require further examination in order to improve the standard of care.
Collapse
Affiliation(s)
- Makiko Endo
- Clinical Research Unit, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo 187-8551, Japan,
| | - Kaori Odaira
- Regional Medical Liaison Office, National Hospital Organization, Aomori Hospital, Namioka, Aomori 038-1331, Japan
| | - Ryohei Ono
- Section for Development and Disability Training, National Hospital Organization, Aomori Hospital, Namioka, Aomori 038-1331, Japan
| | - Go Kurauchi
- Department of Rehabilitation, National Hospital Organization, Aomori Hospital, Namioka, Aomori 038-1331, Japan
| | - Atsushi Koseki
- Section for Development and Disability Training, National Hospital Organization, Hanamaki Hospital, Hanamaki, Iwate 025-0033, Japan
| | - Momoko Goto
- Section for Development and Disability Training, National Hospital Organization, Aomori Hospital, Namioka, Aomori 038-1331, Japan
| | - Yumi Sato
- Department of Rehabilitation, National Hospital Organization, Aomori Hospital, Namioka, Aomori 038-1331, Japan
| | - Seiko Kon
- Department of Neurology, National Hospital Organization, Aomori Hospital, Namioka, Aomori 038-1331, Japan
| | - Norio Watanabe
- School of Public Health, Graduate School of Medicine, Kyoto University, Sakyo-ku, Kyoto 606-8501, Japan
| | - Norio Sugawara
- Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, Kodaira, Tokyo 187-8551, Japan
| | - Hiroto Takada
- Department of Neurology, National Hospital Organization, Aomori Hospital, Namioka, Aomori 038-1331, Japan
| | - En Kimura
- Department of Clinical Research Support, Translational Medical Center, National Center of Neurology and Psychiatry, Kodaira, Tokyo 187-8551, Japan
| |
Collapse
|
42
|
Jelsness-Jørgensen LP, Jensen Ø, Gibbs C, Bekkhus Moe R, Hofsø D, Bernklev T. Psychometric testing of the Norwegian Diabetes Health Profile (DHP-18) in patients with type 1 diabetes. BMJ Open Diabetes Res Care 2018; 6:e000541. [PMID: 30613400 PMCID: PMC6304096 DOI: 10.1136/bmjdrc-2018-000541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 09/14/2018] [Accepted: 11/08/2018] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE The Diabetes Health Profile-18 (DHP-18) was developed to measure disease-specific health-related quality of life. It has been translated into Norwegian but remains invalidated. The purpose of this paper was to examine the psychometric properties of the Norwegian DHP-18. RESEARCH DESIGN AND METHODS Participants with type 1 diabetes were recruited from three outpatient clinics in Norway. Clinical and sociodemographic data were collected, and participants completed the DHP-18 and the Short-Form 36 (SF-36). Descriptive analysis, frequencies, t-tests and the chi-squared tests were used. Principal axis factoring (PAF) and confirmatory factor analysis (CFA) were used. Convergent validity was tested using Spearman's correlation between the DHP-18 and SF-36. Reliability was tested using Cronbach's alpha and intraclass correlation coefficient. RESULTS In total, 288 patients were included. No floor and ceiling effects were found. A forced PAF analysis revealed that three questions had an eigenvalue below 0.40. In the unforced PAF analysis, one question loaded below 0.40, while three questions loaded into a fourth factor. The correlation between the DHP-18 and SF-36 dimensions was low to moderate. Problematic internal consistency was observed for the disinhibited eating dimension in the forced PAF and in the suggested fourth dimension in the unforced PAF. CFA revealed poor fit. The test-retest reliability displayed good to excellent values, but responsiveness was limited. CONCLUSIONS Problematic issues were identified regarding factor structure, item loadings, internal consistency and responsiveness. Further evaluation of responsiveness is particularly recommended, and using a revised 14-item DHP version is suggested.
Collapse
Affiliation(s)
- Lars-Petter Jelsness-Jørgensen
- Department of Health and Welfare, Østfold University College, Halden, Norway
- Department of Internal Medicine, Østfold Hospital Trust, Grålum, Norway
| | - Øystein Jensen
- Department of Health and Welfare, Østfold University College, Halden, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Charlotte Gibbs
- Department of Endocrinology, Telemark Hospital Trust, Skien, Norway
| | | | - Dag Hofsø
- Morbid Obesity Centre and Section of Endocrinology, Vestfold Hospital Trust, Tønsberg, Norway
| | - Tomm Bernklev
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Research and Development, Vestfold Hospital Trust, Tønsberg, Norway
| |
Collapse
|
43
|
Jespersen LN, Michelsen SI, Holstein BE, Tjørnhøj-Thomsen T, Due P. Conceptualization, operationalization, and content validity of the EQOL-questionnaire measuring quality of life and participation for persons with disabilities. Health Qual Life Outcomes 2018; 16:199. [PMID: 30305098 PMCID: PMC6180454 DOI: 10.1186/s12955-018-1024-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 09/21/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Measurement of quality of life demands thoroughly developed and validated instruments. The development steps from theory to concepts and from empirical data to items are sparsely described in the literature of questionnaire development. Furthermore, there seems to be a need for an instrument measuring quality of life and participation in a population with diverse disabilities. The aim of this paper was to present and discuss the initial steps in the development of the Electronic Quality of Life questionnaire (EQOL). METHODS The development of EQOL included six steps: 1) Establishing conceptual understanding; 2) Development of interview guides which build on the conceptual understanding; 3) Qualitative interviews of 55 participants (10-40 years old) with different types and severities of disabilities; 4) Conceptualization of domains identified in the qualitative data through thematic analysis; 5) Operationalization of the identified domains into items and; 6) Evaluation of content validity of the first version of the EQOL-measure. Content validity was examined by cognitive interviews with participants in the target group as well as by continuous feedback from an advisory board. RESULTS We identified six domains (function and health, environment (physical and social), social network, wellbeing, occupation, and managing strategies) based on themes derived from the qualitative interviews and on conceptual discussions within the author group. These domains were incorporated in a conceptual model and items were generated to measure the content of each domain. Participants expressed satisfaction with EQOL but most participants felt that there were too many items. CONCLUSIONS In total, 191 items were included in the questionnaire. Participants felt that the EQOL-questionnaire was relevant to their quality of life and participation. We have shown that it is possible to include quality of life and participation for people with various disabilities in one instrument. Although capturing less detail than a condition specific instrument, EQOL includes aspects perceived important for people with disabilities who are not included in general surveys. This is relevant when for example evaluating environmental adaptations and when comparing populations with various disabilities.
Collapse
Affiliation(s)
- Louise Norman Jespersen
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen K, Denmark
| | - Susan Ishøy Michelsen
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen K, Denmark
| | - Bjørn Evald Holstein
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen K, Denmark
| | - Tine Tjørnhøj-Thomsen
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen K, Denmark
| | - Pernille Due
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen K, Denmark
| |
Collapse
|
44
|
Lee SH, Lee KH, Chang SJ. Do health literacy and self-care behaviours affect quality of life in older persons with lung cancer receiving chemotherapy? Int J Nurs Pract 2018; 24:e12691. [PMID: 30101486 DOI: 10.1111/ijn.12691] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 07/04/2018] [Accepted: 07/09/2018] [Indexed: 11/26/2022]
Abstract
AIM This study aimed at identifying the factors associated with health literacy, self-care behaviours, and quality of life among older persons with lung cancer receiving chemotherapy. METHODS This was a descriptive study. A total of 80 older persons with lung cancer receiving chemotherapy participated in this study. Data were collected from July 21 to November 3, 2016 in Korea. The Short Form of the Korean Functional Health Literacy Test, the Self-Care Behaviours Scale, and the Functional Assessment of Cancer Therapy Scale-Lung were used to measure functional health literacy, self-care behaviours, and quality of life, respectively. Stepwise multiple regression analyses were conducted to analyse the data. RESULTS In the each regression model for the general and disease-related quality of life, performance status, self-care behaviours, and prior lines of treatment were identified as a predictor. However, functional health literacy was found to be a predictor only of disease-related quality of life. Among these predictors, self-care behaviours had the greatest impact. CONCLUSION Health care providers should be aware of the effects of health literacy and self-care behaviours on health-related quality of life and consider the factors associated with quality of life when they take care of older persons with lung cancer receiving chemotherapy.
Collapse
Affiliation(s)
- Seung Hee Lee
- Division of Hematology-Oncology, Chungbuk National University Hospital, Cheongju, South Korea
| | - Ki Hyeong Lee
- Division of Medical Oncology, Chungbuk National University Hospital, Cheongju, South Korea
| | - Sun Ju Chang
- College of Nursing and Research Institute of Nursing Science, Seoul National University, Seoul, South Korea
| |
Collapse
|
45
|
Jin X, Liu GG, Gerstein HC, Levine MAH, Steeves K, Guan H, Li H, Xie F. Item reduction and validation of the Chinese version of diabetes quality-of-life measure (DQOL). Health Qual Life Outcomes 2018; 16:78. [PMID: 29703205 PMCID: PMC5921810 DOI: 10.1186/s12955-018-0905-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 04/18/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Diabetes Quality-of-Life (DQOL) Measure is a 46-item diabetes-specific quality of life instrument. The original English version of the DQOL has been translated into Chinese after cultural adaption, and the Chinese DQOL has been validated in the Chinese diabetic patient population and used in diabetes-related studies. There are two recognized problems with the Chinese DQOL: 1) the instrument is too long, and 2) the non-response rate of certain items is relatively high. This study aimed to develop and validate a short version for the Chinese DQOL. METHODS Item reduction was conducted based on the classical test theory (CTT) and item response theory (IRT), each combined with exploratory factor analysis (EFA). The confirmatory factor analysis (CFA) and Spearman correlation coefficient were employed in validating the short versions. RESULTS Both the study sample (n = 2,886) and the validation sample (n = 2,286) were from a longitudinal observation study of Chinese type 2 diabetic patients. The CTT kept 32 items, and the IRT kept 24 items from the original 46-item version. The two short versions were comparable in psychometric properties. CONCLUSION The 24-item IRT-based short version of the Chinese DQOL was selected as the preferred short version because it imposes a lower burden on patients without compromising the psychometric properties of the instrument.
Collapse
Affiliation(s)
- Xuejing Jin
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4K1, Canada.,China Center for Health Economic Research, Peking University, Beijing, 100800, China
| | - Gordon G Liu
- China Center for Health Economic Research, Peking University, Beijing, 100800, China.,National School of Development, Peking University, Beijing, 100800, China
| | - Hertzel C Gerstein
- Department of Medicine, McMaster University, Hamilton, ON, L8S 4K1, Canada
| | - Mitchell A H Levine
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4K1, Canada.,Centre for Evaluation of Medicines, Father Sean O'Sullivan Research Centre, St. Joseph's Healthcare Hamilton, Hamilton, L8N 4A6, Canada
| | - Kathleen Steeves
- Department of Sociology, McMaster University, Hamilton, ON, L8S 4K1, Canada
| | - Haijing Guan
- China Center for Health Economic Research, Peking University, Beijing, 100800, China.,School of Pharmaceutical Science, Peking University, Beijing, 100800, China
| | - Hongchao Li
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, 211198, Jiangsu, China
| | - Feng Xie
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4K1, Canada.
| |
Collapse
|
46
|
Stel VS, Brück K, Fraser S, Zoccali C, Massy ZA, Jager KJ. International differences in chronic kidney disease prevalence: a key public health and epidemiologic research issue. Nephrol Dial Transplant 2017; 32:ii129-ii135. [PMID: 28206610 DOI: 10.1093/ndt/gfw420] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 11/08/2016] [Indexed: 01/09/2023] Open
Abstract
In this narrative review, we studied the association of risk factors for chronic kidney disease (CKD) and CKD prevalence at an ecological level and describe potential reasons for international differences in estimated CKD prevalence across European countries. We found substantial variation in risk factors for CKD such as in the prevalence of diabetes mellitus, obesity, raised blood pressure, physical inactivity, current smoking and salt intake per day. In general, the countries with a higher CKD prevalence also had a higher average score on CKD risk factors, and vice versa. There was no association between cardiovascular mortality rates and CKD prevalence. In countries with a high CKD prevalence, the prevention of noncommunicable diseases may be considered important, and, therefore, all five national response systems (e.g. an operational national policy, strategy or action plan to reduce physical inactivity and/or promote physical activity) have been implemented. Furthermore, both the heterogeneity in study methods to assess CKD prevalence as well as the international differences in the implementation of lifestyle measures will contribute to the observed variation in CKD prevalence. A robust public health approach to reduce risk factors in order to prevent CKD and reduce CKD progression risk is needed and will have co-benefits for other noncommunicable diseases.
Collapse
Affiliation(s)
- Vianda S Stel
- ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, Amsterdam, The Netherlands
| | - Katharina Brück
- ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, Amsterdam, The Netherlands
| | - Simon Fraser
- Academic Unit of Primary Care and Population Sciences, University of Southampton, Southampton, UK
| | - Carmine Zoccali
- CNR-IFC, Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension of Reggio Calabria, Reggio Calabria, Italy
| | - Ziad A Massy
- Division of Nephrology, Ambroise Paré University Hospital, APHP, University of Paris Ouest-Versailles-St-Quentin-en-Yvelines (UVSQ), Boulogne-Billancourt/Paris, France.,Institut National de la Santé et de la Recherche Médicale (INSERM) U1018, CESP, Team 5, Villejuif, France
| | - Kitty J Jager
- ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, Amsterdam, The Netherlands
| |
Collapse
|
47
|
Moloney J, Walshe M. “I had no idea what a complicated business eating is…”: a qualitative study of the impact of dysphagia during stroke recovery. Disabil Rehabil 2017; 40:1524-1531. [DOI: 10.1080/09638288.2017.1300948] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Jennifer Moloney
- Department of Clinical Speech and Language Studies, Trinity College, Dublin, Republic of Ireland
| | - Margaret Walshe
- Department of Clinical Speech and Language Studies, Trinity College, Dublin, Republic of Ireland
| |
Collapse
|
48
|
Huygens MWJ, Swinkels ICS, de Jong JD, Heijmans MJWM, Friele RD, van Schayck OCP, de Witte LP. Self-monitoring of health data by patients with a chronic disease: does disease controllability matter? BMC FAMILY PRACTICE 2017; 18:40. [PMID: 28320330 PMCID: PMC5360032 DOI: 10.1186/s12875-017-0615-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 03/07/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND There is a growing emphasis on self-monitoring applications that allow patients to measure their own physical health parameters. A prerequisite for achieving positive effects is patients' willingness to self-monitor. The controllability of disease types, patients' perceived self-efficacy and health problems could play an essential role in this. The purpose of this study is to investigate the relationship between patients' willingness to self-monitor and a range of disease and patient specific variables including controllability of disease type, patients' perceived self-efficacy and health problems. METHODS Data regarding 627 participants with 17 chronic somatic disease types from a Dutch panel of people with chronic diseases have been used for this cross-sectional study. Perceived self-efficacy was assessed using the general self-efficacy scale, perceived health problems using the Physical Health Composite Score (PCS). Participants indicated their willingness to self-monitor. An expert panel assessed for 17 chronic disease types the extent to which patients can independently keep their disease in control. Logistic regression analyses were conducted. RESULTS Patients' willingness to self-monitor differs greatly among disease types: patients with diabetes (71.0%), asthma (59.6%) and hypertension (59.1%) were most willing to self-monitor. In contrast, patients with rheumatism (40.0%), migraine (41.2%) and other neurological disorders (42.9%) were less willing to self-monitor. It seems that there might be a relationship between disease controllability scores and patients' willingness to self-monitor. No evidence is found of a relationship between general self-efficacy and PCS scores, and patients' willingness to self-monitor. CONCLUSIONS This study provides the first evidence that patients' willingness to self-monitor might be associated with disease controllability. Further research should investigate this association more deeply and should focus on how disease controllability influences willingness to self-monitor. In addition, since willingness to self-monitor differed greatly among patient groups, it should be taken into account that not all patient groups are willing to self-monitor.
Collapse
Affiliation(s)
- Martine W J Huygens
- Department of Health Services Research, School for Public Health and Primary Care (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands. .,Centre for Care Technology Research, Maastricht, The Netherlands.
| | - Ilse C S Swinkels
- NIVEL, Netherlands Institute for Health Services Research, P.O. Box 1568, 3500 BN, Utrecht, The Netherlands.,Centre for Care Technology Research, Maastricht, The Netherlands
| | - Judith D de Jong
- NIVEL, Netherlands Institute for Health Services Research, P.O. Box 1568, 3500 BN, Utrecht, The Netherlands
| | - Monique J W M Heijmans
- NIVEL, Netherlands Institute for Health Services Research, P.O. Box 1568, 3500 BN, Utrecht, The Netherlands
| | - Roland D Friele
- NIVEL, Netherlands Institute for Health Services Research, P.O. Box 1568, 3500 BN, Utrecht, The Netherlands.,Tilburg School of Social and Behavioral Sciences, Tilburg University, Tranzo, P.O. Box 90153, 5000 LE, Tilburg, The Netherlands.,Centre for Care Technology Research, Maastricht, The Netherlands
| | - Onno C P van Schayck
- Department of Family Medicine, School for Public Health and Primary Care (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.,Centre for Care Technology Research, Maastricht, The Netherlands
| | - Luc P de Witte
- Department of Health Services Research, School for Public Health and Primary Care (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.,Research Center Technology in Care, Zuyd University of Applied Sciences, P.O. Box 550, 6400 AN, Heerlen, The Netherlands.,Centre for Assistive Technology and Connected Healthcare (CATCH), University of Sheffield, 217 Portobello, Sheffield, S1 4DP, UK.,Centre for Care Technology Research, Maastricht, The Netherlands
| |
Collapse
|
49
|
Ware JE, Gandek B, Allison J. The Validity of Disease-specific Quality of Life Attributions Among Adults with Multiple Chronic Conditions. INTERNATIONAL JOURNAL OF STATISTICS IN MEDICAL RESEARCH 2016; 5:17-40. [PMID: 27087882 PMCID: PMC4831653 DOI: 10.6000/1929-6029.2016.05.01.3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND A crucial assumption underlying all disease-specific quality of life (QOL) measures, that patients can validly differentiate a specific disease in the presence of multiple chronic conditions, has not been tested using multiple methods. Our objective was to evaluate the convergent and discriminant validity of QOL attributions to specific diseases among adults with multiple chronic conditions (MCC). METHODS Adults age 18 and older (N=4,480) sampled from eight pre-identified condition groups (asthma, COPD, angina/MI with angina, congestive heart failure, diabetes, chronic kidney disease, osteoarthritis, rheumatoid arthritis) completed an Internet survey. Comorbid conditions were determined using a 35-condition checklist. Product-moment correlations were analyzed separately by pre-identified condition group using the multitrait-multimethod of construct validation, where traits were defined by 9-26 conditions and each condition was measured by two methods: disease severity rating and Disease-specific Quality of Life Impact Scale (QDIS) global rating. A third method (symptom or clinical marker) was available for the eight pre-identified conditions. Convergent validity was supported when correlations among different methods of measuring the same condition (trait) were substantial (r≥0.40). Discriminant validity was supported when correlations between the same and different methods of measuring different conditions were significantly lower than corresponding convergent correlations. RESULTS In support of convergent validity, 22 of 24 convergent correlations were substantial (r=0.38-0.84, median=0.53). In support of discriminant validity, 833 of 924 tests (90.2%) yielded significantly higher convergent than discriminant correlations across the eight pre-identified conditions. Exceptions to this pattern of results were most often observed for comorbid conditions within the same clinical area. CONCLUSIONS Collectively, convergent and discriminant test results support the construct validity of disease-specific QOL impact attributions across MCC within the eight pre-identified conditions. Noteworthy exceptions should be considered when interpreting some specific QOL impact attributions and warrant further study. Pursuit of a summary disease-specific QOL impact score standardized across MCC is recommended.
Collapse
Affiliation(s)
- John E. Ware
- University of Massachusetts Medical School, Worcester, MA
- John Ware Research Group, Watertown, MA
| | - Barbara Gandek
- University of Massachusetts Medical School, Worcester, MA
- John Ware Research Group, Watertown, MA
| | - Jeroan Allison
- University of Massachusetts Medical School, Worcester, MA
| |
Collapse
|
50
|
Testing item response theory invariance of the standardized Quality-of-life Disease Impact Scale (QDIS(®)) in acute coronary syndrome patients: differential functioning of items and test. Qual Life Res 2015; 24:1809-22. [PMID: 25601166 DOI: 10.1007/s11136-015-0916-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2015] [Indexed: 10/24/2022]
Abstract
PURPOSE The Quality-of-life (QOL) Disease Impact Scale (QDIS(®)) standardizes the content and scoring of QOL impact attributed to different diseases using item response theory (IRT). This study examined the IRT invariance of the QDIS-standardized IRT parameters in an independent sample. METHOD The differential functioning of items and test (DFIT) of a static short-form (QDIS-7) was examined across two independent sources: patients hospitalized for acute coronary syndrome (ACS) in the TRACE-CORE study (N = 1,544) and chronically ill US adults in the QDIS standardization sample. "ACS-specific" IRT item parameters were calibrated and linearly transformed to compare to "standardized" IRT item parameters. Differences in IRT model-expected item, scale and theta scores were examined. The DFIT results were also compared in a standard logistic regression differential item functioning analysis. RESULTS Item parameters estimated in the ACS sample showed lower discrimination parameters than the standardized discrimination parameters, but only small differences were found for thresholds parameters. In DFIT, results on the non-compensatory differential item functioning index (range 0.005-0.074) were all below the threshold of 0.096. Item differences were further canceled out at the scale level. IRT-based theta scores for ACS patients using standardized and ACS-specific item parameters were highly correlated (r = 0.995, root-mean-square difference = 0.09). Using standardized item parameters, ACS patients scored one-half standard deviation higher (indicating greater QOL impact) compared to chronically ill adults in the standardization sample. CONCLUSION The study showed sufficient IRT invariance to warrant the use of standardized IRT scoring of QDIS-7 for studies comparing the QOL impact attributed to acute coronary disease and other chronic conditions.
Collapse
|