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Jones R, O'Loughlin R, Xiong X, Bahrampour M, Devlin N, Hiscock H, Chen G, Mulhern B, Dalziel K. Comparative Psychometric Performance of Common Generic Paediatric Health-Related Quality of Life Instrument Descriptive Systems: Results from the Australian Paediatric Multi-Instrument Comparison Study. PHARMACOECONOMICS 2024; 42:39-55. [PMID: 37955799 PMCID: PMC11169028 DOI: 10.1007/s40273-023-01330-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/11/2023] [Indexed: 11/14/2023]
Abstract
OBJECTIVE The aim of this study was to compare the psychometric performance of common generic paediatric health-related quality-of-life instrument descriptive systems (PedsQL generic core 4.0, EQ-5D-Y-3L, EQ-5D-Y-5L, Child Health Utility 9D [CHU9D], Assessment of Quality of Life 6D [AQoL-6D], and Health Utilities Index Mark 3 [HUI3]) by child age, report type, and health status. METHODS Data for children aged 5-18 years were from the Australian Paediatric Multi-Instrument Comparison study. Ceiling effects, test-retest reliability, known-group validity, convergent and divergent validity, and responsiveness were assessed in the total sample and by child age (5-12 years vs 13-18 years), report type (self- vs proxy report), and health status. Instruments were scored using an exploratory level sum score (LSS) approach. RESULTS Survey data were available for 5945 children, with follow-up data available for 2346 children. The EQ-5D-Y-3L demonstrated ceiling effects. The PedsQL, EQ-5D-Y-3L, EQ-5D-Y-5L, and CHU9D demonstrated acceptable test-retest reliability. All instruments demonstrated known-group, convergent, and divergent validity. The EQ-5D-Y-3L, EQ-5D-Y-5L, and CHU9D demonstrated responsiveness to improvements in health and the PedsQL, EQ-5D-Y-3L, EQ-5D-Y-5L, and CHU9D to worsening health. The AQoL-6D and HUI3 had inconclusive test-retest reliability and responsiveness evidence due to small sample size. Importantly, ceiling effects, test-retest reliability and responsiveness varied by subgroup. CONCLUSION Results reflect instrument performance using LSSs, which may differ to utility scores. In the total sample, the EQ-5D-Y-5L and CHU9D descriptive systems demonstrated evidence of good performance (i.e., meeting prespecified criteria) across all psychometric attributes tested. Performance varied by child age and report type, indicating room for considerations by population and study.
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Affiliation(s)
- Renee Jones
- Health Economics Unit, Centre for Health Policy, The University of Melbourne, Melbourne, VIC, Australia.
- Health Services and Economics, Murdoch Children's Research Institute, Melbourne, VIC, Australia.
| | - Rachel O'Loughlin
- Health Economics Unit, Centre for Health Policy, The University of Melbourne, Melbourne, VIC, Australia
- Health Services and Economics, Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Health Services Research Unit, Royal Children's Hospital, Melbourne, VIC, Australia
| | - Xiuqin Xiong
- Health Economics Unit, Centre for Health Policy, The University of Melbourne, Melbourne, VIC, Australia
| | - Mina Bahrampour
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Ultimo, NSW, Australia
| | - Nancy Devlin
- Health Economics Unit, Centre for Health Policy, The University of Melbourne, Melbourne, VIC, Australia
| | - Harriet Hiscock
- Health Services and Economics, Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Health Services Research Unit, Royal Children's Hospital, Melbourne, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia
| | - Gang Chen
- Centre for Health Economics, Monash Business School, Monash University, Melbourne, VIC, Australia
| | - Brendan Mulhern
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Ultimo, NSW, Australia
| | - Kim Dalziel
- Health Economics Unit, Centre for Health Policy, The University of Melbourne, Melbourne, VIC, Australia
- Health Services and Economics, Murdoch Children's Research Institute, Melbourne, VIC, Australia
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Engler K, Avallone F, Cadri A, Lebouché B. Patient-reported outcome measures in adult HIV care: A rapid scoping review of targeted outcomes and instruments used. HIV Med 2024; 25:633-674. [PMID: 38282323 DOI: 10.1111/hiv.13599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 11/20/2023] [Indexed: 01/30/2024]
Abstract
OBJECTIVE There is international interest in the integration of patient-reported outcome measures (PROMs) into routine HIV care, but little work has synthesized the content of published initiatives. We conducted a rapid scoping review primarily to identify their selected patient-reported outcomes and respective instruments. METHODS Four databases were searched on 4 May 2022 (Medline, Embase, CINAHL and PsychINFO) for relevant English language documents published from 2005 onwards. Dual review of at least 20% of records, full texts and data extraction was performed. Outcomes and instruments were classified with an adapted 14-domain taxonomy. Instruments with evidence of validation were described. RESULTS Of 13 062 records generated for review, we retained a final sample of 94 documents, referring to 60 distinct initiatives led mostly in the USA (n = 29; 48% of initiatives), Europe (n = 16; 27%) and Africa (n = 9; 15%). The measured patient-reported outcome domains were: mental health (n = 42; 70%), substance use (n = 23; 38%), self-management (n = 16; 27%), symptoms (n = 12; 20%), sexual/reproductive health (n = 12; 20%), physical health (n = 9; 15%), treatment (n= 8; 13%), cognition (n = 7; 12%), quality of life (n = 7; 12%), violence/abuse (n = 6; 10%), stigma (n = 6; 10%), socioeconomic issues (n = 5; 8%), social support (n = 3; 5%) and body/facial appearance (n = 1; 2%). Initiatives measured 2.6 outcome domains, on average (range = 1-11). In total, 62 distinct validated PROMs were identified, with 53 initiatives (88%) employing at least one (M = 2.2). Overwhelmingly, the most used instrument was any version of the Patient Health Questionnaire to measure symptoms of depression, employed by over a third (26; 43%) of initiatives. CONCLUSION Published PROM initiatives in HIV care have spanned 19 countries and disproportionately target mental health and substance use.
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Affiliation(s)
- Kim Engler
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Francesco Avallone
- Department of Family Medicine, McGill University, Montreal, Quebec, Canada
| | - Abdul Cadri
- Department of Family Medicine, McGill University, Montreal, Quebec, Canada
| | - Bertrand Lebouché
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Department of Family Medicine, McGill University, Montreal, Quebec, Canada
- Chronic Viral Illness Service, Royal Victoria Hospital, McGill University Health Centre, Montreal, Quebec, Canada
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Snowdon DA, Collyer TA, Marsh L, Srikanth V, Beare R, Baber S, Naude K, Andrew NE. Healthcare consumer acceptability of routine use of the EQ-5D-5L in clinical care: a cross-sectional survey. Qual Life Res 2024; 33:1307-1321. [PMID: 38321194 PMCID: PMC11045645 DOI: 10.1007/s11136-024-03598-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2024] [Indexed: 02/08/2024]
Abstract
PURPOSE Patient reported outcome measures, such as the EQ-5D-5L, provide a measure of self-perceived health status or health-related quality of life. Understanding the consumer acceptability of a patient reported outcome measure can help to decide about its implementation across a healthcare organisation and possibly increase the likelihood of its use in clinical care. This study established the acceptability of the EQ-5D-5L from the perspective of clients receiving healthcare, and determined if acceptability varied by client sub-types. METHODS A cross-sectional survey explored clients' experience of the EQ-5D-5L. Eligible clients were aged ≥ 18 years and completed the EQ-5D-5L on admission and discharge to one of two multi-disciplinary community health services. Likert scale items explored acceptability, and open-ended questions determined if the EQ-5D-5L reflects experience of illness. Associations between acceptability and client characteristics were established using χ2 test. Open-ended questions were analysed using content analysis. RESULTS Most of the 304 clients (mean age 70 years, SD 16) agreed that the EQ-5D-5L: was easy to use/understand (n = 301, 99%) and useful (n = 289, 95%); improved communication with their therapist (n = 275, 90%); and made them feel more in control of their health (n = 276, 91%). Most clients also agreed that they wished to continue using the EQ-5D-5L (n = 285, 93%). Clients aged ≥ 60 years reported lower acceptability. Clients noted that the EQ-5D-5L did not capture experience of illness related to fatigue, balance/falls, cognition, and sleep. CONCLUSION The EQ-5D-5L is acceptable for use in care but does not capture all aspects of health relevant to clients, and acceptability varies by subgroup.
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Affiliation(s)
- David A Snowdon
- National Centre for Healthy Ageing, 2 Hastings Road, Frankston, VIC, Australia.
- Academic Unit, Peninsula Health, Frankston, VIC, Australia.
- Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, VIC, Australia.
| | - Taya A Collyer
- National Centre for Healthy Ageing, 2 Hastings Road, Frankston, VIC, Australia
- Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Lucy Marsh
- National Centre for Healthy Ageing, 2 Hastings Road, Frankston, VIC, Australia
- Academic Unit, Peninsula Health, Frankston, VIC, Australia
| | - Velandai Srikanth
- National Centre for Healthy Ageing, 2 Hastings Road, Frankston, VIC, Australia
- Academic Unit, Peninsula Health, Frankston, VIC, Australia
- Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Richard Beare
- National Centre for Healthy Ageing, 2 Hastings Road, Frankston, VIC, Australia
- Academic Unit, Peninsula Health, Frankston, VIC, Australia
- Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, VIC, Australia
- Developmental Imaging, Murdoch Children's Research Institute, Melbourne, Australia
| | - Stephanie Baber
- Physiotherapy Department, Golf Links Road Rehabilitation Centre, Peninsula Health, Frankston, VIC, Australia
| | - Kim Naude
- National Centre for Healthy Ageing, 2 Hastings Road, Frankston, VIC, Australia
- Academic Unit, Peninsula Health, Frankston, VIC, Australia
| | - Nadine E Andrew
- National Centre for Healthy Ageing, 2 Hastings Road, Frankston, VIC, Australia
- Academic Unit, Peninsula Health, Frankston, VIC, Australia
- Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, VIC, Australia
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Kennedy GEM, Tharmaseelan A, Phillips JRA, Evans JT, Kunutsor SK. Does arthroscopic or open washout in native knee septic arthritis result in superior post-operative function? A systematic review and meta-analysis of randomised controlled trials and observational studies. Syst Rev 2024; 13:106. [PMID: 38610047 PMCID: PMC11010436 DOI: 10.1186/s13643-024-02508-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 03/05/2024] [Indexed: 04/14/2024] Open
Abstract
AIMS Septic arthritis (SA) of the native knee joint is associated with significant morbidity. This review compared post-operative functional outcomes (patient-reported outcome measures (PROMs) and range of movement (ROM)) following arthroscopic washout (AW) and open washout (OW) amongst adult patients with SA of the native knee. The need for further operative intervention was also considered. METHODS Electronic databases of PubMed, MEDLINE, Embase, Cochrane, Web of Science and Scopus were searched between 16 February 2023 and 18 March 2023. Randomised controlled trials (RCTs) and comparative observational analytic studies comparing function (reflected in PROMs or ROM) at latest follow-up following AW and OW were included. A narrative summary was provided concerning post-operative PROMs. Pooled estimates for mean ROM and re-operation rates were conducted using the random-effects model. The risk of bias was assessed using the Cochrane risk-of-bias assessment tool-2 for RCTs and the Risk of Bias in Non-Randomized Studies of Interventions tool for observational analytic studies. RESULTS Of 2580 retrieved citations, 7 articles (1 RCT and 6 cohort studies) met the inclusion criteria. Of these, five had some concerns/moderate risk of bias, and two had serious risk. There was a slight tendency for superior mean PROMs following AW compared with OW, but due to small effect sizes, this was unlikely clinically relevant. Additionally, the use of four different PROMs scales made direct comparisons impossible. AW was associated with superior ROM (mean difference 20.18° (95% CI 14.35, 26.02; p < 0.00001)), whilst there was a tendency for lower re-operation requirements following AW (OR 0.64, 95% CI 0.26, 1.57, p = 0.44). CONCLUSIONS AW was associated with equivalent to superior post-operative function and lower requirement for further intervention compared with OW. Results need to be interpreted cautiously, taking into consideration the methodological and clinical heterogeneity of the included studies. SYSTEMATIC REVIEW REGISTRATION PROSPERO 2022, CRD42022364062.
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Affiliation(s)
| | | | | | - Jon T Evans
- Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK
- University of Exeter, Exeter, UK
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Kamran R, Jackman L, Laws A, Stepney M, Harrison C, Jain A, Rodrigues J. Patient and healthcare professional perspectives on the Practical Guide to Implementing PROMs in Gender-Affirming Care (PG-PROM-GAC): analysis of open-ended responses from patients and healthcare professionals. BMJ Open Qual 2024; 13:e002721. [PMID: 38569665 PMCID: PMC11002366 DOI: 10.1136/bmjoq-2023-002721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 03/12/2024] [Indexed: 04/05/2024] Open
Abstract
IMPORTANCE Several international calls have been made for evidence-based patient-reported outcome measure (PROM) implementation for gender-affirming care. The Practical Guide to Implementing PROMs in Gender-Affirming Care (PG-PROM-GAC) is a resource which can help guide PROM implementation efforts, developed using a three-phase participatory research approach with transgender and gender-diverse (TGD) patients and gender-affirming healthcare professionals. However, thoughts and perspectives from TGD patients and gender-affirming healthcare professionals on the PG-PROM-GAC need to be investigated. OBJECTIVE Investigate patient and healthcare professional perspectives on the PG-PROM-GAC through analysis of open-ended survey results. DESIGN Qualitative study analysing open-ended responses from TGD patients and gender-affirming healthcare professionals. SETTING Participants were recruited from a UK National Health System (NHS) gender clinic. PARTICIPANTS Patients receiving care at an NHS gender clinic and healthcare professionals working at an NHS gender clinic were eligible for participation. Eligible participants were invited to participate in this study via email. INTERVENTION Participants were sent an open-ended survey to collect responses on the PG-PROM-GAC. MAIN OUTCOMES AND MEASURES Data were thematically analysed by two independent researchers and interpreted following guidance from established methods in implementation science. RESULTS A total of 64 TGD patients and 9 gender-affirming healthcare professionals responded to the open-ended survey (mean (SD) age: 35 (16) and 48 (8), respectively). Four main themes emerged from the data: overall opinions and support for the PG-PROM-GAC, presentation of the PG-PROM-GAC, impact of gender clinic resources on PROM implementation and impact of PROM selection on implementation. Data were used to iterate the PG-PROM-GAC in response to participant feedback. CONCLUSIONS AND RELEVANCE The PG-PROM-GAC is an acceptable and feasible resource that can be used by clinicians, researchers and policymakers to guide PROM implementation for gender-affirming care settings, helping to align gender-affirming care with patient needs.
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Affiliation(s)
- Rakhshan Kamran
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Liam Jackman
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Anna Laws
- Northern Region Gender Dysphoria Service, Cumbria Northumberland Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | | | - Conrad Harrison
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Abhilash Jain
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Jeremy Rodrigues
- Department of Plastic Surgery, Buckinghamshire Healthcare NHS Trust, Amersham, UK
- Warwick Clinical Trials Unit, University of Warwick, Coventry, UK
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Sakugawa LS, Portela FSO, Louzada ACS, Portugal MFC, Teivelis MP, Mendes CDA, Pinheiro LL, Silva MFAD, Fioranelli A, Wolosker N. Polidocanol-foam treatment of varicose veins: Quality-of-life impact compared to conventional surgery. Clinics (Sao Paulo) 2024; 79:100346. [PMID: 38574572 PMCID: PMC11004700 DOI: 10.1016/j.clinsp.2024.100346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 01/02/2024] [Accepted: 03/11/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND AND OBJECTIVE Lower limb varicose veins are a prevalent disease associated with several available treatment options, including conventional surgery and polidocanol foam sclerotherapy. However, few studies have analyzed therapeutic modality outcomes based on Patient-Reported Outcome Measures (PROMs). This large sample-size study was designed to evaluate the outcomes of polidocanol foam sclerotherapy compared to conventional surgery based on an analysis of PROMs. METHODS This was a prospective, observational, and qualitative study of 205 patients who underwent varicose vein treatment with either polidocanol foam sclerotherapy (57 patients, 90 legs) or conventional surgery (148 patients, 236 legs). Patients were preoperatively assessed and re-evaluated 30 days after the procedure using the Venous Disease Severity Score (VCSS) and specific venous disease quality-of-life questionnaires (VEINES-QoL/Sym). RESULTS Both treatments significantly improved VCSS and VEINES results 30 days after the procedure (p < 0.05). However, surgery promoted greater improvements in VCSS (on average 4.02-points improvement, p < 0.001), VEINES-QoL (average 8-points improvement, p < 0.001), and VEINES-Sym (average 11.66 points improvement, p < 0.001) than did sclerotherapy. Postoperative pain and aesthetic concerns about the legs were the domains of the questionnaires in which the results varied the most between the treatment modalities, with worse results for sclerotherapy. CONCLUSION Both polidocanol foam sclerotherapy and conventional surgery positively impact patients' quality of life after 30 days, but the improvement is more significant for patients who undergo conventional surgery.
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Affiliation(s)
| | | | | | | | - Marcelo Passos Teivelis
- Hospital Israelita Albert Einstein, São Paulo, SP, Brazil; Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, SP, Brazil
| | | | - Lucas Lembrança Pinheiro
- Hospital Israelita Albert Einstein, São Paulo, SP, Brazil; Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, SP, Brazil
| | | | | | - Nelson Wolosker
- Hospital Israelita Albert Einstein, São Paulo, SP, Brazil; Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, SP, Brazil
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Tang E, Yantsis A, Ho M, Hussain J, Dano S, Aiyegbusi OL, Peipert JD, Mucsi I. Patient-Reported Outcome Measures for Patients With CKD: The Case for Patient-Reported Outcomes Measurement Information System (PROMIS) Tools. Am J Kidney Dis 2024; 83:508-518. [PMID: 37924931 DOI: 10.1053/j.ajkd.2023.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 08/30/2023] [Accepted: 09/04/2023] [Indexed: 11/06/2023]
Abstract
Chronic kidney disease (CKD), kidney failure, and kidney replacement therapies are associated with high symptom burden and impaired health-related quality of life (HRQOL). Symptoms change with disease progression or transition between treatment modalities and frequently go unreported and unmanaged. Tools that reliably monitor symptoms may improve the management of patients with CKD. Patient-reported outcome measures (PROMs) assess symptom severity; physical, psychological, social, and cognitive functioning; treatment-related side effects; and HRQOL. Systematic use of PROMs can improve patient-provider communication, patient satisfaction, clinical outcomes, and HRQOL. Potential barriers to their use include a lack of engagement, response burden, and limited guidance about PROM collection, score interpretation, and workflow integration. Well-defined, acceptable, and effective clinical response pathways are essential for implementing PROMs. PROMs developed by the Patient-Reported Outcomes Measurement Information System (PROMIS) address some challenges and may be suitable for clinical use among patients with CKD. PROMIS tools assess multiple patient-valued, clinically actionable symptoms and functions. They can be administered as fixed-length, customized short forms or computer adaptive tests, offering precise measurement across a range of symptom severities or function levels, tailored questions to individuals, and reduced question burden. Here we provide an overview of the potential use of PROMs in CKD care, with a focus on PROMIS.
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Affiliation(s)
- Evan Tang
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Ajmera Transplant Centre, University Health Network, Toronto, Ontario, Canada
| | - Alyssa Yantsis
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Ajmera Transplant Centre, University Health Network, Toronto, Ontario, Canada
| | - Matthew Ho
- Ajmera Transplant Centre, University Health Network, Toronto, Ontario, Canada
| | - Junayd Hussain
- Ajmera Transplant Centre, University Health Network, Toronto, Ontario, Canada
| | - Sumaya Dano
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Ajmera Transplant Centre, University Health Network, Toronto, Ontario, Canada
| | - Olalekan L Aiyegbusi
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham (OLA), Birmingham, United Kingdom; National Institute for Health Research Applied Research Centre West Midlands, Birmingham, United Kingdom
| | - John D Peipert
- Department of Medical Social Sciences, Northwestern University, Chicago, Illinois
| | - Istvan Mucsi
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Ajmera Transplant Centre, University Health Network, Toronto, Ontario, Canada.
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Merenda M, Earnest A, Ruseckaite R, Tse WC, Elder E, Hopper I, Ahern S. Patient-Reported Outcome Measures in High-Risk Medical Device Registries: A Scoping Review. Aesthet Surg J Open Forum 2024; 6:ojae015. [PMID: 38650972 PMCID: PMC11033681 DOI: 10.1093/asjof/ojae015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024] Open
Abstract
Little is known about the methods and outcomes of patient-reported outcome measure (PROM) use among high-risk medical device registries. The objective of this scoping review was to assess the utility and predictive ability of PROMs in high-risk medical device registries. We searched Ovid Medline, Embase, APA PsychINFO, Cochrane Library, and Scopus databases for published literature. After searching, 4323 titles and abstracts were screened, and 262 full texts were assessed for their eligibility. Seventy-six papers from across orthopedic (n = 64), cardiac (n = 10), penile (n = 1), and hernia mesh (n = 1) device registries were identified. Studies predominantly used PROMs as an outcome measure when comparing cohorts or surgical approaches (n = 45) or to compare time points (n = 13) including pre- and postintervention. Fifteen papers considered the predictive ability of PROMs. Of these, 8 treated PROMs as an outcome, 5 treated PROMs as a risk factor through regression analysis, and 2 papers treated PROMs as both a risk factor and as an outcome. One paper described PROMs to study implant survival. To advance methods of PROM integration into clinical decision-making for medical devices, an understanding of their use in high-risk device registries is needed. This scoping review found that there is a paucity of studies using PROMs to predict long-term patient and clinical outcomes in high-risk medical device registries. Determination as to why PROMs are rarely used for predictive purposes in long-term data collection is needed if PROM data are to be considered suitable as real-world evidence for high-risk device regulatory purposes, as well as to support clinical decision-making. Level of Evidence 4
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Affiliation(s)
- Michelle Merenda
- Corresponding Author: Mrs Michelle Merenda, Level 3, 553 St Kilda Rd, Melbourne, Victoria 3004, Australia. E-mail:
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Naude K, Andrew NE, Srikanth V, Parker E, Marsh L, Beare R, McNaney R, Snowdon DA. Using a multi-stakeholder co-design process to develop a health service organisation-wide patient reported outcome measure collection system. Qual Life Res 2024; 33:619-636. [PMID: 38041742 DOI: 10.1007/s11136-023-03552-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2023] [Indexed: 12/03/2023]
Abstract
PURPOSE Limited examples exist of successful Patient Reported Outcome Measure (PROM) implementation across an entire healthcare organisation. The aim of this study was to use a multi-stakeholder co-design process to develop a PROM collection system, which will inform implementation of routine collection of PROMs across an entire healthcare organisation. METHODS Co-design comprised semi-structured interviews with clinicians (n = 11) and workshops/surveys with consumers (n = 320). The interview guide with clinicians focused on their experience using PROMs, preferences for using PROMs, and facilitators/barriers to using PROMs. Co-design activities specific to consumers focused on: (1) how PROMs will be administered (mode), (2) when PROMs will be administered (timing), (3) who will assist with PROMs collection, and (4) how long a PROM will take to complete. Data were analysed using a manifest qualitative content analysis approach. RESULTS Core elements identified during the co-design process included: PROMs collection should be consumer-led and administered by someone other than a clinician; collection at discharge from the healthcare organisation and at 3-6 months post discharge would be most suitable for supporting comprehensive assessment; PROMs should be administered using a variety of modes to accommodate the diversity of consumer preferences, with electronic as the default; and the time taken to complete PROMs should be no longer than 5-10 min. CONCLUSION This study provides new information on the co-design of a healthcare organisation-wide PROM collection system. Implementing a clinician and patient informed strategy for PROMs collection, that meets their preferences across multiple domains, should address known barriers to routine collection.
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Affiliation(s)
- Kim Naude
- National Centre for Healthy Ageing, 2 Hastings Road, Frankston, VIC, Australia.
- Academic Unit, Peninsula Health, Frankston, VIC, Australia.
| | - Nadine E Andrew
- National Centre for Healthy Ageing, 2 Hastings Road, Frankston, VIC, Australia
- Academic Unit, Peninsula Health, Frankston, VIC, Australia
- Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Velandai Srikanth
- National Centre for Healthy Ageing, 2 Hastings Road, Frankston, VIC, Australia
- Academic Unit, Peninsula Health, Frankston, VIC, Australia
- Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Emily Parker
- National Centre for Healthy Ageing, 2 Hastings Road, Frankston, VIC, Australia
- Academic Unit, Peninsula Health, Frankston, VIC, Australia
| | - Lucy Marsh
- National Centre for Healthy Ageing, 2 Hastings Road, Frankston, VIC, Australia
- Academic Unit, Peninsula Health, Frankston, VIC, Australia
| | - Richard Beare
- National Centre for Healthy Ageing, 2 Hastings Road, Frankston, VIC, Australia
- Academic Unit, Peninsula Health, Frankston, VIC, Australia
- Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, VIC, Australia
- Developmental Imaging, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Roisin McNaney
- Action Lab, Department of Human Centered Computing, Monash University, Melbourne, VIC, Australia
| | - David A Snowdon
- National Centre for Healthy Ageing, 2 Hastings Road, Frankston, VIC, Australia
- Academic Unit, Peninsula Health, Frankston, VIC, Australia
- Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, VIC, Australia
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Law K, Harris E, McCabe MG, Yorke J, van der Veer SN. Measurement Properties of Patient-Reported Outcome Measures for Adolescent and Young Adult Survivors of a Central Nervous System Tumor: A Systematic Review. J Adolesc Young Adult Oncol 2024; 13:40-54. [PMID: 37307017 PMCID: PMC10877386 DOI: 10.1089/jayao.2023.0048] [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: 06/13/2023] Open
Abstract
Purpose: To identify and evaluate patient-reported outcome measures (PROMs) for assessing survivorship-related concepts for adolescent and young adult (AYA) survivors of central nervous system (CNS) tumors. Methods: We searched five electronic databases. Two researchers independently screened all titles for inclusion and used consensus-based standards for the selection of health measurement instruments (COSMIN) guidance to grade the quality of evidence for each measurement property. Results: Four studies met eligibility criteria: single-item pain thermometer; single-item fatigue thermometer; 37-item pediatric functional assessment of cancer therapy-brain tumor survivors, measuring quality of life; and 12-item Perceived Barriers Scale to assess barriers to employment. The Perceived Barrier Scale showed high-quality evidence for internal consistency and moderate quality evidence for construct and structural validity. Evidence for the measurement properties of the other PROMs was low-to-moderate quality. Conclusion: We found one PROM with sufficient evidence for good measurement properties to support its use. This warrants development and evaluation of further PROMs to inform ongoing supportive care for this population. Implications for Cancer Survivors: The Perceived Barriers Scale is sufficiently validated and could be considered to guide support for AYA survivors of CNS tumors to achieve their employment goals.
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Affiliation(s)
- Kate Law
- Division of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
- The Christie Hospital NHS Foundation Trust, Manchester, United Kingdom
| | - Emily Harris
- The Christie Hospital NHS Foundation Trust, Manchester, United Kingdom
| | - Martin G. McCabe
- The Christie Hospital NHS Foundation Trust, Manchester, United Kingdom
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Janelle Yorke
- Division of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
- The Christie Hospital NHS Foundation Trust, Manchester, United Kingdom
| | - Sabine N. van der Veer
- Centre for Health Informatics, Division of Informatics, Imaging and Data Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
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Jones R, O’Loughlin R, Xiong X, Bahrampour M, McGregor K, Yip S, Devlin N, Hiscock H, Mulhern B, Dalziel K. Collecting Paediatric Health-Related Quality of Life Data: Assessing the Feasibility and Acceptability of the Australian Paediatric Multi-Instrument Comparison (P-MIC) Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1604. [PMID: 37892267 PMCID: PMC10605580 DOI: 10.3390/children10101604] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 09/19/2023] [Accepted: 09/23/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Collecting data using paediatric health-related quality of life (HRQoL) instruments is complex, and there is a paucity of evidence regarding the comparative performance of paediatric HRQoL instruments. The Australian Paediatric Multi-Instrument Comparison (P-MIC) study was conducted to address this paucity of evidence. This study aims to understand the (1) feasibility of collecting data using paediatric HRQoL instruments in a research setting and (2) acceptability and feasibility for children and their caregivers to complete common paediatric HRQoL instruments using data from the Australian P-MIC study. METHODS Data were from children aged 5-18 years from the Australian P-MIC study. Demographics, cost and time for data collection, dropout rates, and inconsistent responses were used to assess Aim 1. Participant-reported difficulty and completion time were used to assess Aim 2. Subgroup analyses included child age, report type (self/proxy), sample recruitment pathway (hospital/online), and online panel sample type (general population/condition groups). RESULTS Overall, 5945 P-MIC participants aged 5-18 years completed an initial survey, of these, 2346 also completed the follow-up survey (39.5% response rate). Compared with online panel recruitment, hospital recruitment was more costly and time-consuming and had higher follow-up completion (33.5% versus 80.4%) (Aim 1). Data were of similar good quality (based on inconsistent responses) for both recruitment pathways (Aim 1). Participants completed each instrument in <3 min, on average, and >70% reported each instrument as easy to complete (Aim 2). CONCLUSIONS The Australian P-MIC study was able to collect good-quality data using both online panel and hospital recruitment pathways. All instruments were acceptable and feasible to children and their caregivers.
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Affiliation(s)
- Renee Jones
- Health Economics Unit, Centre for Health Policy, The University of Melbourne, Melbourne, VIC 3010, Australia; (R.J.); (R.O.); (X.X.); (N.D.)
- Health Services and Economics, Murdoch Children’s Research Institute, Melbourne, VIC 3052, Australia (H.H.)
| | - Rachel O’Loughlin
- Health Economics Unit, Centre for Health Policy, The University of Melbourne, Melbourne, VIC 3010, Australia; (R.J.); (R.O.); (X.X.); (N.D.)
- Health Services and Economics, Murdoch Children’s Research Institute, Melbourne, VIC 3052, Australia (H.H.)
- Health Services Research Unit, Royal Children’s Hospital, Melbourne, VIC 3052, Australia
| | - Xiuqin Xiong
- Health Economics Unit, Centre for Health Policy, The University of Melbourne, Melbourne, VIC 3010, Australia; (R.J.); (R.O.); (X.X.); (N.D.)
| | - Mina Bahrampour
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Ultimo, NSW 2007, Australia; (M.B.); (B.M.)
| | - Kristy McGregor
- Health Services and Economics, Murdoch Children’s Research Institute, Melbourne, VIC 3052, Australia (H.H.)
| | - Shilana Yip
- Health Services and Economics, Murdoch Children’s Research Institute, Melbourne, VIC 3052, Australia (H.H.)
| | - Nancy Devlin
- Health Economics Unit, Centre for Health Policy, The University of Melbourne, Melbourne, VIC 3010, Australia; (R.J.); (R.O.); (X.X.); (N.D.)
| | - Harriet Hiscock
- Health Services and Economics, Murdoch Children’s Research Institute, Melbourne, VIC 3052, Australia (H.H.)
- Health Services Research Unit, Royal Children’s Hospital, Melbourne, VIC 3052, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, VIC 3010, Australia
| | - Brendan Mulhern
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Ultimo, NSW 2007, Australia; (M.B.); (B.M.)
| | - Kim Dalziel
- Health Economics Unit, Centre for Health Policy, The University of Melbourne, Melbourne, VIC 3010, Australia; (R.J.); (R.O.); (X.X.); (N.D.)
- Health Services and Economics, Murdoch Children’s Research Institute, Melbourne, VIC 3052, Australia (H.H.)
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Taylor S, Chaudhary P, McCartin F, Higham C. Understanding the impact of radiotherapy related insufficiency fractures and exploring satisfaction with two existing patient reported outcome measures: A qualitative interview study. Tech Innov Patient Support Radiat Oncol 2023; 27:100210. [PMID: 37250199 PMCID: PMC10209447 DOI: 10.1016/j.tipsro.2023.100210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 04/27/2023] [Accepted: 05/09/2023] [Indexed: 05/31/2023] Open
Abstract
Introduction Radiotherapy related insufficiency fractures (RRIFs) occur in approximately 10-15% of cancer survivors who underwent pelvic radiotherapy. Little research has been conducted to explore the impact of RRIFs on quality of life (QOL). Patient reported outcome measures (PROMs) are often used in oncology to measure side effects and QOL. The study aims to understand the influence of RRIF on QOL and to discover whether available PROMs address their needs. Materials and methods Twenty-five patients randomly selected from a Tertiary Oncology Centre bone health clinic database of patients referred with RRIFs were approached. Interested patients were sent two existing PROMs and a patient information sheet. Eleven patients agreed to take part in a semi-structured interview to explore their experiences and their opinion on the existing PROMs. Telephone interviews were conducted. Interviews were audio recorded, transcribed, and analysed using thematic analysis. Results Four themes were identified: 1) Route to diagnosis, 2) management of RRIFs and 3) resilience all had an impact on 4) QOL. Additionally, participants discussed PROMs and how they might be integrated into clinical practice. The data highlights the wide ranging QOL impacts experienced and highlights potential areas for improvement in terms of diagnosis and management pathways. Discussion The impact of RRIFs on QOL is considerable. Participants highlighted key areas for improvement including the provision of more information, more access to support and improved management pathways. Participants also highlighted the potential benefits of PROMs but suggested existing measures could be improved.
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Affiliation(s)
- Sally Taylor
- Christie Patient Centred Research, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK
- School of Nursing and Midwifery, The University of Manchester, Oxford Road, Manchester M13 9PL, UK
| | - Prabhav Chaudhary
- Department of Endocrinology, The Christie Hospital NHS Foundation Trust, Manchester, UK
- Division of Cancer Sciences, The University of Manchester, Manchester, UK
| | - Fiona McCartin
- Department of Endocrinology, The Christie Hospital NHS Foundation Trust, Manchester, UK
| | - Claire Higham
- Department of Endocrinology, The Christie Hospital NHS Foundation Trust, Manchester, UK
- Division of Cancer Sciences, The University of Manchester, Manchester, UK
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Greene ME, Goldman RE, Hutter MM. Selection of patient-reported outcomes measures for implementation in the Metabolic and Bariatric Surgery Accreditation Quality Improvement Program. Surg Obes Relat Dis 2023; 19:897-906. [PMID: 37037688 DOI: 10.1016/j.soard.2023.01.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 11/15/2022] [Accepted: 01/29/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND The Metabolic and Bariatric Surgery Accreditation Quality Improvement Program (MBSAQIP) assesses safety after metabolic and bariatric surgery and the impact on weight and obesity-related diseases. However, changes in quality of life are likely what matters most to patients, and these are not currently assessed. The best way to measure health-related quality of life (HRQoL) is to use validated patient-reported outcomes measures (PROMs), which capture patients' perspectives of their quality of life both before and after surgery. OBJECTIVES Identify the outcomes most important to bariatric surgery patients and identify the most appropriate validated PROMs to implement in a national program for the MBSAQIP. SETTING Five hospitals from a single healthcare system in New England. METHODS A series of 18 focus groups and/or interviews conducted with patients, patients' family members, and bariatric health providers determined the outcomes most important to bariatric patients and which validated PROMs would accurately measure those outcomes. Immersion crystallization was used to analyze focus group data and identify appropriate PROMs. RESULTS Focus group participants ranked health as the most important outcome for metabolic and bariatric surgery. Self-confidence, mobility, and everyday activities were the next highest ranked HRQoL domains. The Patient-Reported Outcomes Measurement Information System 10-Item Global Health Survey was selected as the general health measure. The Obesity-Related Problems scale and the Obesity and Weight-Loss Quality of Life Instrument were the disease-specific measures selected for inclusion in the MBSAQIP PROMs program. CONCLUSION The addition of PROMs to the MBSAQIP provides a unique opportunity to monitor HRQoL at the national level, which can foster improved shared decision-making before surgery.
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Affiliation(s)
- Meridith E Greene
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | | | - Matthew M Hutter
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts.
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Snowdon DA, Srikanth V, Beare R, Noeske KE, Le E, O'Bree B, Andrew NE. Acceptability of the routine use and collection of a generic patient reported outcome measure from the perspective of healthcare staff: a qualitative study. J Patient Rep Outcomes 2023; 7:81. [PMID: 37522943 PMCID: PMC10390450 DOI: 10.1186/s41687-023-00617-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 07/11/2023] [Indexed: 08/01/2023] Open
Abstract
BACKGROUND Patient-reported outcome measures (PROMs) provide a measure of self-perceived health status or health-related quality of life. They have been used to support provider-patient decisions, healthcare delivery, and value-based healthcare models. A barrier to routine collection of PROMs is the perception that PROMs lack clinical utility. As such, it is important to establish clinicians' acceptability of the PROM prior to large-scale implementation. This study explored the acceptability of the routine use and collection of a generic PROM in healthcare services from the perspective of healthcare staff. METHODS Individual semi-structured interviews were completed from September 2020 to March 2021 with 26 staff from two multi-disciplinary community healthcare services in Melbourne, Australia. Interviews explored their experiences of using the EQ-5D-5L in their routine care. Interviews were recorded and transcribed verbatim. Data were analysed according to a framework approach, using inductive and deductive techniques. RESULTS Participants discussed the acceptability of the EQ-5D-5L with reference to four themes: practicalities of use; holistic nature; influence on client care; and influence on health service. Participants found the EQ-5D-5L quick and easy to administer, and appreciated that it measured multiple domains of health that were relevant to their clients' care. They believed the EQ-5D-5L helped to identify client problems, and inform service delivery. They also reported features that were less acceptable, including a lack of item specificity to some healthcare disciplines. Participants reported the challenge of managing conflict between their assessment of the client's health and the client's perspective of their own health, leading some to question whether the client could provide an accurate reflection of their own health. CONCLUSIONS The EQ-5D-5L has several features that healthcare staff viewed as acceptable for routine collection and use in healthcare. Training on the validity of the patient reported perspective and broadening the scope of PROMs collection beyond the EQ-5D-5L should be considered to facilitate large-scale implementation.
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Affiliation(s)
- David A Snowdon
- National Centre for Healthy Ageing, Melbourne, VIC, Australia.
- Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, VIC, Australia.
- Academic Unit, Peninsula Health, Frankston, VIC, Australia.
| | - Velandai Srikanth
- National Centre for Healthy Ageing, Melbourne, VIC, Australia
- Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, VIC, Australia
- Academic Unit, Peninsula Health, Frankston, VIC, Australia
| | - Richard Beare
- National Centre for Healthy Ageing, Melbourne, VIC, Australia
- Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, VIC, Australia
- Academic Unit, Peninsula Health, Frankston, VIC, Australia
- Developmental Imaging, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Kate E Noeske
- Academic Unit, Peninsula Health, Frankston, VIC, Australia
| | - Elizabeth Le
- National Centre for Healthy Ageing, Melbourne, VIC, Australia
- Academic Unit, Peninsula Health, Frankston, VIC, Australia
| | - Bridget O'Bree
- Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, VIC, Australia
- Academic Unit, Peninsula Health, Frankston, VIC, Australia
| | - Nadine E Andrew
- National Centre for Healthy Ageing, Melbourne, VIC, Australia
- Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, VIC, Australia
- Academic Unit, Peninsula Health, Frankston, VIC, Australia
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Bhardwaj T, Arora N, Paul A, Chowdhary P. Cultural Adaptation of Patient Health Questionnaire-9 in Hindi for Use with Patients with Cancer in Community Palliative Care Settings. Indian J Palliat Care 2023; 29:292-311. [PMID: 37700900 PMCID: PMC10493686 DOI: 10.25259/ijpc_96_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 08/14/2023] [Indexed: 09/14/2023] Open
Abstract
Objectives Patient Health Questionnaire-9 (PHQ-9) in Indian settings is yet not very often used in palliative care with the Hindi-speaking population. The Hindi version of PHQ-9 is available but its cultural adaptation to the Hindi-speaking population in North India receiving palliative care services is required to be tested. PHQ-9 as a depression screening questionnaire may help to identify depression symptoms among patients with cancer. This study aimed to examine the cultural equivalence of PHQ-9 Hindi for use with patients with cancer receiving palliative care services in North India. Material and Methods Based on the standard methodology of translation and adaptation of the scale, the following process was used: (i) Two focused group discussions with 17 experts working in a cancer palliative care setting, (ii) qualitative interviewing with 11 patients, and (iii) research team review. All interviews were audio recorded, transcribed, and item-wise content analysis was conducted. Results A few difficult phrases in the original PHQ-9 were 'dilchaspi', 'avasadgrast', 'kam urja', 'nakaam', parivar ko neecha dhikhana and 'ashthir' which were changed to Kam Mann Lagna, Mann Dukhi hona, kamjori, saksham nahi hain' 'asafal', Parivar ko nirash karna' and 'bechain,' respectively. Two items, namely no. 6 and 8 were changed to shorten the length for appropriately conveying the meaning. Conclusion Hindi language involves various dialects which change from region to region bringing variations in understanding the meaning of the words. It is recommended that culturally equivalent scales are used in practice and research. PHQ-9 is now culturally adapted for the Hindi-speaking population in North India. PHQ-9 will help identidy depressive symptoms at an early stage. Psychometric testing of PHQ-9 is underway.
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Affiliation(s)
- Tushti Bhardwaj
- Department of Social Work, Dr. Bhim Rao Ambedkar College, University of Delhi, New Delhi, India
| | - Neha Arora
- Department of Psychology, Dr. Bhim Rao Ambedkar College, University of Delhi, New Delhi, India
| | - Anu Paul
- Home Care, CanSupport, New Delhi, India
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Newlands AF, Roberts L, Maxwell K, Kramer M, Price JL, Finlay KA. Development and psychometric validation of a patient-reported outcome measure of recurrent urinary tract infection impact: the Recurrent UTI Impact Questionnaire. Qual Life Res 2023; 32:1745-1758. [PMID: 36740638 PMCID: PMC10172217 DOI: 10.1007/s11136-023-03348-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2023] [Indexed: 02/07/2023]
Abstract
PURPOSE Recurrent urinary tract infection (rUTI) is a highly prevalent condition associated with significant poor quality of life outcomes. A patient-reported outcome measure (PROM) of rUTI-associated psychosocial impact is urgently required to supplement clinical evaluation and validate the challenges experienced by patients. This study therefore developed and validated the Recurrent UTI Impact Questionnaire (RUTIIQ). METHODS A rigorous four-stage methodology was followed: (I) concept elicitation through a qualitative survey of the experiences of people with rUTI (N = 1983); (II) Delphi expert screening of the RUTIIQ with expert rUTI clinicians (N = 15); (III) one-to-one cognitive interviews with people experiencing rUTI (N = 28) to evaluate the comprehensiveness and comprehensibility of the RUTIIQ, and (IV) full pilot testing of the RUTIIQ with people experiencing rUTI (N = 240) to perform final item reduction and psychometric analysis. RESULTS Exploratory factor analysis demonstrated a five-factor structure comprising: 'patient satisfaction', 'work and activity interference', 'social wellbeing', 'personal wellbeing', and 'sexual wellbeing', collectively accounting for 73.8% of the total variance in pilot scores. Results from expert clinicians and patients indicated strong item content validity (I-CVI > .75). The internal consistency and test-retest reliability of the RUTIIQ subscales were excellent (Cronbach's α = .81-.96, ICC = .66-.91), and construct validity was strong (Spearman's ρ > .69). CONCLUSION The RUTIIQ is a 30-item questionnaire with excellent psychometric properties, assessing the patient-reported psychosocial impact of living with rUTI symptoms and pain. This new instrument delivers the unique opportunity to enhance patient-centred care through standardised observation and monitoring of rUTI patient outcomes. TRIAL REGISTRATION This study was pre-registered with ClinicalTrials.gov (identifier: NCT05086900).
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Affiliation(s)
- Abigail F Newlands
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, RG6 7BE, UK
| | - Lindsey Roberts
- School of Psychology, University of Buckingham, Buckingham, MK18 1EG, UK
| | - Kayleigh Maxwell
- Department of Psychology, Faculty of Natural Sciences, University of Stirling, Stirling, FK9 4LA, UK
| | - Melissa Kramer
- Live UTI Free Ltd, Ardeen House, 10-11 Marine Terrace, Dun Laoghaire, Dublin, Ireland
| | - Jessica L Price
- Live UTI Free Ltd, Ardeen House, 10-11 Marine Terrace, Dun Laoghaire, Dublin, Ireland
| | - Katherine A Finlay
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, RG6 7BE, UK.
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Snowdon DA, Srikanth V, Beare R, Marsh L, Parker E, Naude K, Andrew NE. A landscape assessment of the use of patient reported outcome measures in research, quality improvement and clinical care across a healthcare organisation. BMC Health Serv Res 2023; 23:94. [PMID: 36707827 PMCID: PMC9883937 DOI: 10.1186/s12913-023-09050-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 11/23/2022] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Patient reported outcome measures (PROMs) can be used by healthcare organisations to inform improvements in service delivery. However, routine collection of PROMs is difficult to achieve across an entire healthcare organisation. An understanding of the use of PROMs within an organisation can provide valuable insights on the purpose, scope and practical considerations of PROMs collection, which can inform implementation of PROMs. METHODS We used multiple research methods to assess the use of PROMs in research projects, data registries and clinical care across a healthcare organisation from January 2014 to April 2021. The methods included an audit of ethics applications approved by the organisation's human research ethics committee and registries which the health organisation had contributed data to; a literature review of peer-reviewed journal articles reporting on research projects conducted at the organisation; and a survey of health professionals use of PROMs in research projects, data registries and clinical care. The scope of PROMs was determined by classifying PROMs as either 'specific' to a particular disease and/or condition, or as a 'generic' measure with further classification based on the health domains they measured, using the World Health Organization International Classification Framework. Practical considerations included mode and timing of PROMs administration. Data were described using frequency and proportion. RESULTS PROMs were used by 22% of research projects (n = 144/666), 68% of data registries (n = 13/19), and 76% of clinical specialties in their clinical care (n = 16/21). Disease specific PROMs were most commonly used: 83% of research projects (n = 130/144), 69% of clinical registries (n = 9/13), and 75% of clinical specialties (n = 12/16). Greater than 80% of research projects, clinical registries and clinical specialties measured health domains relating to both body impairments and participation in daily life activities. The most commonly used generic PROM was the EQ-5D (research projects n = 56/144, 39%; data registries n = 5/13, 38%; clinical specialties n = 4/16, 25%). PROMs used in clinical care were mostly paper-based (n = 47/55, 85%). CONCLUSIONS We have elicited information on the use of PROMs to inform a health organisation wide implementation strategy. Future work will determine clinician and patient acceptability of the EQ-5D, and co-design a system for the collection of PROMs.
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Affiliation(s)
- David A. Snowdon
- National Centre for Healthy Ageing, Melbourne, VIC Australia ,grid.1002.30000 0004 1936 7857Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, VIC Australia ,grid.466993.70000 0004 0436 2893Academic Unit, Peninsula Health, Frankston, VIC Australia
| | - Velandai Srikanth
- National Centre for Healthy Ageing, Melbourne, VIC Australia ,grid.1002.30000 0004 1936 7857Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, VIC Australia ,grid.466993.70000 0004 0436 2893Academic Unit, Peninsula Health, Frankston, VIC Australia
| | - Richard Beare
- National Centre for Healthy Ageing, Melbourne, VIC Australia ,grid.1002.30000 0004 1936 7857Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, VIC Australia ,grid.466993.70000 0004 0436 2893Academic Unit, Peninsula Health, Frankston, VIC Australia
| | - Lucy Marsh
- National Centre for Healthy Ageing, Melbourne, VIC Australia ,grid.466993.70000 0004 0436 2893Academic Unit, Peninsula Health, Frankston, VIC Australia
| | - Emily Parker
- National Centre for Healthy Ageing, Melbourne, VIC Australia ,grid.466993.70000 0004 0436 2893Academic Unit, Peninsula Health, Frankston, VIC Australia
| | - Kim Naude
- National Centre for Healthy Ageing, Melbourne, VIC Australia ,grid.466993.70000 0004 0436 2893Academic Unit, Peninsula Health, Frankston, VIC Australia
| | - Nadine E. Andrew
- National Centre for Healthy Ageing, Melbourne, VIC Australia ,grid.1002.30000 0004 1936 7857Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, VIC Australia ,grid.466993.70000 0004 0436 2893Academic Unit, Peninsula Health, Frankston, VIC Australia
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Koh ZH, Skues J, Murray G. Digital self-report instruments for repeated measurement of mental health in the general adult population: a protocol for a systematic review. BMJ Open 2023; 13:e065162. [PMID: 36693693 PMCID: PMC9884895 DOI: 10.1136/bmjopen-2022-065162] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION Digital technologies present tremendous opportunities for enabling long-term measurement of mental health in the general population. Emerging studies have established preliminary efficacy of collecting self-report data digitally. However, a key challenge when developing a new self-report instrument is navigating the abundance of existing instruments to select relevant constructs for measurements. This review is a precursor to developing a novel future integrated digital instrument for repeated measurements. We interrogate the literature as the first step towards optimal measurement of the multifaceted mental health concept, in the context of digital repeated measurement. This review aims to identify (1) digital self-report instruments administered repeatedly to measure the mental health of the general adult population; (2) their structure and format; (3) their psychometric properties; (4) their usage in empirical studies; and (5) the constructs these instruments were designed to measure (as characterised in the original publication), and the constructs the instruments have been used to measure in the identified empirical studies. METHODS AND ANALYSIS Five major electronic databases will be searched. Studies administering mental health instruments (in English) repeatedly to community dwellers in the general adult population are eligible. A reviewer will preliminarily screen for eligible studies. Then, two reviewers will independently screen the full text of the eligible articles and extract data. Both reviewers will resolve any disagreement through discussion or with a third reviewer. After the data extraction, a reviewer will manually search for the structure, format, psychometric properties and the original constructs these instruments were developed to measure. This review will synthesise the results in a narrative approach. The reporting in this review will be guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. ETHICS AND DISSEMINATION Ethical approval is not required as no data will be collected. Findings of the systematic review will be disseminated through peer-reviewed publications and conference presentations. PROSPERO REGISTRATION NUMBER CRD42022306547.
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Affiliation(s)
- Zhao Hui Koh
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Jason Skues
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Greg Murray
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, Victoria, Australia
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Pemberton-Whiteley Z, Nier S, Geissler J, Wintrich S, Verhoeven B, Christensen RO, Salek S, Oliva EN, Ionova T, Bradley J. Understanding Quality of Life in Patients With Acute Leukemia, a Global Survey. J Patient Cent Res Rev 2023; 10:21-30. [PMID: 36714002 PMCID: PMC9851391 DOI: 10.17294/2330-0698.1951] [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: 01/18/2023] Open
Abstract
Purpose The Acute Leukemia Advocates Network (ALAN) sought to determine which factors are most associated with poor quality of life (QoL) in patients with acute leukemia and to determine key issues and unmet needs through administration of an online survey distributed worldwide via partner patient organizations. Methods ALAN developed a questionnaire informed by literature review and based extensively on the hematological malignancy-specific patient-reported outcomes (HM-PRO) measure to assess the impact of acute leukemia on QoL and its relationships with patients' demographics, disease state, disease impact, and support from health care professionals. Univariate and multivariable statistical analysis was used to investigate relationships between HM-PRO scores and the other factors. Results Of 552 respondents from 42 countries, 332 had acute myeloid leukemia, 139 had acute lymphoblastic leukemia, and 81 had acute promyelocytic leukemia (survey data collected in 2019). Younger age, female gender, and lower income were all significantly negatively associated with QoL. Weak or moderate correlations were observed between overall support, management, and impact of treatment and diagnosis of acute leukemia. Feeling isolated and having reduced ability to carry out physical or enjoyable activities were the most important individual factors, while the best predictors for QoL impact were age, gender, and income (model r2=0.16, complete case n=449). Conclusions Findings indicated key factors, particularly age, gender, and socioeconomic state, that clinicians responsible for the care of patients with acute leukemia should be aware of when designing support strategies. The importance of social functioning in relation to patient QoL also should be included in considerations.
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Affiliation(s)
- Zack Pemberton-Whiteley
- Acute Leukemia Advocates Network (ALAN), Bern, Switzerland,Leukaemia Care, Worcester, United Kingdom
| | - Samantha Nier
- Acute Leukemia Advocates Network (ALAN), Bern, Switzerland
| | - Jan Geissler
- Acute Leukemia Advocates Network (ALAN), Bern, Switzerland,LeukaNET e.V., Riemerling, Germany
| | - Sophie Wintrich
- Acute Leukemia Advocates Network (ALAN), Bern, Switzerland,MDS UK Patient Support Group, United Kingdom
| | - Bregje Verhoeven
- Acute Leukemia Advocates Network (ALAN), Bern, Switzerland,Foundation Hematon, Utrecht, Netherlands
| | - Rita O. Christensen
- Acute Leukemia Advocates Network (ALAN), Bern, Switzerland,LyLe Patientforeningenen for Lymfekræft Leukæmi og MDS, Sealand Region, Denmark
| | - Sam Salek
- University of Hertfordshire, Hatfield, United Kingdom
| | - Esther Natalie Oliva
- Division of Hematology, Azienda Ospedaliera Bianchi-Melacrino-Morelli, Reggio Calabria, Italy
| | - Tatyana Ionova
- National Medical Surgical Centre and Multinational Centre for Quality of Life Research, Saint Petersburg, Russian Federation
| | - Jennie Bradley
- Quality Health Ltd, an IQVIA company, Derbyshire, United Kingdom
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Eijsink JFH, Fabian AM, Vervoort JPM, Al Khayat MNMT, Boersma C, Postma MJ. Value-based health care in Western countries: a scoping review on the implementation of patient-reported-outcomes sets for hospital-based interventions. Expert Rev Pharmacoecon Outcomes Res 2023; 23:1-13. [PMID: 36300427 DOI: 10.1080/14737167.2023.2136168] [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: 01/17/2023]
Abstract
INTRODUCTION For implementation of the value-based health-care (VBHC) concept, use of patient-reported outcome measures (PROMs), patient-reported experience measures (PREMs), and clinical outcomes is crucial. The aim of this study was to summarize published studies on implemented PROMs, PREMs, and clinical-outcomes sets in health-care practice. AREAS COVERED A scoping review was conducted by using PubMed and Embase. Our study focused on implementation examples of patient-reported outcome sets in Western countries' hospitals. Included papers were analyzed on content, in particular concerning PROMs, PREMs, and clinical outcomes. We also assessed differences between diseases, categorized as patient-reported outcomes in curative, chronic, and palliative treatments in the hospital. EXPERT OPINION A total of 20 studies were found that presented VBHC implementation examples. Results illustrate the disconnection between the development of PROMs and PREMs and the implementation phase, with implementation still in infancy. Hospital organizations should enhance organization for the implementation of VBHC. It is crucial that leading examples of successful VBHC serve as blueprints for implementation, with the participation of all relevant stakeholders. Affordability and sustainability of health care can be enhanced by scaling up successful VBHC-interventions on population levels.
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Affiliation(s)
- Job F H Eijsink
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Department of Clinical Pharmacy, Isala hospital, Zwolle, The Netherlands
| | - Annabel M Fabian
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Johanna P M Vervoort
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Mohamed N M T Al Khayat
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Department of Clinical Pharmacy, Isala hospital, Zwolle, The Netherlands
| | - Cornelis Boersma
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Department of Management Sciences, Open University, Heerlen, The Netherlands
| | - Maarten J Postma
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Department of Economics, Econometrics & Finance, University of Groningen, Faculty of Economics, Groningen, The Netherlands
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Ralphsmith M, Ahern S, Dean J, Ruseckaite R. Patient-reported outcome measures for pain in women with pelvic floor disorders: a systematic review. Int Urogynecol J 2022; 33:2325-2334. [PMID: 35233681 PMCID: PMC9427903 DOI: 10.1007/s00192-022-05126-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 02/07/2022] [Indexed: 11/26/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Patient-reported outcome measures (PROMs) are helpful instruments when measuring and reporting changes in patient health status (Al Sayah et al. J Patient Rep Outcomes 5 (Suppl 2):99, 2021) such as the health-related quality of life (HrQoL) of women with pelvic organ prolapse (POP) and stress urinary incontinence (SUI). The Australasian Pelvic Floor Procedure Registry (APFPR) aims to increase capacity for women to report surgical outcomes through the collection of HrQoL data (Ruseckaite et al. Qual Life Res. 2021) but currently lacks a pain-specific PROM for women with pelvic floor disorders (PFDs), particularly POP and SUI. This review aims to systematically review the existing literature and identify instruments that measure pain in women with POP and SUI for inclusion within the APFPR, which reports on complications from these conditions. METHODS We conducted a literature search on OVID MEDLINE, Embase, CINAHL, PsycINFO and EMCARE databases in addition to Google Scholar and grey literature to identify studies from inception to April 2021. Full-text studies were included if they used PROMs to measure pain in women with POP and SUI. Two authors independently screened articles, extracted data and assessed methodological quality. RESULTS From 2001 studies, 23 publications describing 19 different PROMs were included for analysis. Eight of these instruments were specific to the pelvic floor; four were only specific to pain and used across multiple disorders; three were generic quality of life instruments and four were other non-validated instruments such as focus group interviews. These instruments were not specific to pain in women with POP or SUI, as they did not identify all relevant domains such as the sensation, region and duration of pain, or incidents where onset of pain occurs. CONCLUSIONS The findings of this review suggest there are no current PROMs that are suitable pain-specific instruments for women with POP or SUI. This knowledge may inform and assist in the development of a new PROM to be implemented into the APFPR.
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Affiliation(s)
- Maisie Ralphsmith
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, 3004, Australia
| | - Susannah Ahern
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, 3004, Australia
| | - Joanne Dean
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, 3004, Australia
| | - Rasa Ruseckaite
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, 3004, Australia.
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