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Aldhabi R, Albadi M, Kahraman T, Alsobhi M. Cross-cultural adaptation, validation and psychometric properties of the Arabic version of the Nordic Musculoskeletal Questionnaire in office working population from Saudi Arabia. Musculoskelet Sci Pract 2024; 72:103102. [PMID: 38896911 DOI: 10.1016/j.msksp.2024.103102] [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: 02/19/2024] [Revised: 06/02/2024] [Accepted: 06/05/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND Office-workers who suffer from musculoskeletal pain/disability may experience reduced productivity and absenteeism from work. The Nordic Musculoskeletal Questionnaire (NMQ) is a valid, simple screening tool for the history and presence of self-perceived musculoskeletal symptoms in both general public and occupational settings. OBJECTIVE To translate and culturally adapt the NMQ into Arabic language and examine its psychometric properties. METHODS The published guidelines were followed to translate and adapt the NMQ into Arabic using a forward-backward process. Construct validity involved comparing NMQ responses with disability-related musculoskeletal questionnaires in different body regions, including the Neck Disability Index (NDI), Oswestry Disability Index (ODI), Quick-Disability of the Arm, Shoulder, and Hand (Quick-DASH), and Reduced Western Ontario and McMaster Universities Osteoarthritis Index (ArWOMAC). The reliability was evaluated using Cronbach's alpha for internal consistency and prevalence-adjusted bias-adjusted kappa (PABAK) for test-retest reliability. RESULTS The Arabic NMQ (Ar-NMQ) revealed excellent internal consistency (Cronbach's alpha = 0.85). For the test-retest reliability, the PABAK coefficient ranged between 0.50 and 1. The Ar-NMQ demonstrated strong construct validity. Participants reporting neck pain showed significantly elevated disability scores on the NDI (p < 0.05), while those with back pain exhibited higher ODI scores (p < 0.05). Moreover, individuals reporting shoulder, elbow, and wrist pain and disability displayed elevated Quick-DASH scores (p < 0.05). Similarly, participants reporting hip/thighs, knees, and ankle/feet pain/disability demonstrated significantly higher disability in ArWOMAC (p < 0.05). CONCLUSION The NMQ was successfully translated and adapted into Arabic language, providing a reliable and valid instrument for assessing pain in specific body regions in the Arabic-speaking population.
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Affiliation(s)
- Rawan Aldhabi
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Majed Albadi
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Turhan Kahraman
- Department of Health Professions, Faculty of Health and Education, Manchester Metropolitan University, Manchester, United Kingdom; Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey.
| | - Mashael Alsobhi
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia.
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Sprizon GS, Pereira ND, Almeida LO, Dos Anjos SM, Morris DM, Ilha J. A semi-structured interview to capture manual wheelchair use for mobility activities among individuals with spinal cord injury in real-life situations: development and content validity of the Wheelchair Mobility Activity Log (WC-MAL). Spinal Cord 2024; 62:468-478. [PMID: 38907085 DOI: 10.1038/s41393-024-01011-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 06/13/2024] [Accepted: 06/14/2024] [Indexed: 06/23/2024]
Abstract
STUDY DESIGN Mixed-method approach. OBJECTIVES To develop and assess the content validity of a semi-structured interview that captures the lived experience of using a manual wheelchair among individuals with SCI in the real world, the Wheelchair Mobility Activity Log (WC-MAL). SETTING SCIR-Group (UDESC)/Brazil. METHODS Developing the WC-MAL comprised five steps: (1) defining the construct-based on the International Classification of Functioning, Disability and Health (ICF); (2) identifying relevant activities from other assessment instruments and interviews with the end-users (14 Individuals with SCI and 13 rehabilitation professionals); (3) Selecting the items - activities were linked to ICF codes and grouped into sets; (4) developing the scoring scales based on interviews with the end-users; and, (5) evaluating content validity in accordance with the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). The content validity ratio (CVR) for each item and scale and the overall instrument content validity index (CVI) were calculated. RESULTS From an initial draft of 295 activities identified, a set of 222 activities was linked to the ICF domain of "Mobility (d4)" and further refined to generate the 23 items in the WC-MAL. Three scales were developed to assess Frequency (how often), Performance (how well), and Assistance (assistance needed) levels. The items and scales showed a CVR superior to the critical value established (≥0.64). The general CVI value was 0.96. CONCLUSION The WC-MAL is a promising clinical instrument with adequate content validity to assess the spontaneous use of the manual wheelchair in the real world among individuals with SCI.
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Affiliation(s)
- Giovana S Sprizon
- Department of Physiotherapy, Spinal Cord Injury Rehabilitation Research Group (SCIR-Group), Physiotherapy Graduate Program, Universidade do Estado de Santa Catarina (UDESC), Florianópolis, Santa Catarina, Brazil
| | - Natália D Pereira
- Department of Physical Therapy, Universidade Federal de São Carlos (UFSCar), São Carlos, São Paulo, Brazil
| | - Lorena O Almeida
- Department of Physiotherapy, Spinal Cord Injury Rehabilitation Research Group (SCIR-Group), Physiotherapy Graduate Program, Universidade do Estado de Santa Catarina (UDESC), Florianópolis, Santa Catarina, Brazil
| | - Sarah M Dos Anjos
- Department of Occupational Therapy, The University of Alabama at Birmingham (UAB), Birmingham, AL, USA
- Department of Physical Therapy, The University of Alabama at Birmingham (UAB), Birmingham, AL, USA
| | - David M Morris
- Department of Physical Therapy, The University of Alabama at Birmingham (UAB), Birmingham, AL, USA
| | - Jocemar Ilha
- Department of Physiotherapy, Spinal Cord Injury Rehabilitation Research Group (SCIR-Group), Physiotherapy Graduate Program, Universidade do Estado de Santa Catarina (UDESC), Florianópolis, Santa Catarina, Brazil.
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Klassen AF, Mansouri J, Kaur M, Rae C, Poulsen L, Dayan S, Cano SJ, Pusic AL. Development and validation of a patient-reported outcome measure for hair loss treatment: The HAIR-Q. J Cosmet Dermatol 2024. [PMID: 39013033 DOI: 10.1111/jocd.16465] [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: 01/05/2024] [Revised: 06/20/2024] [Accepted: 07/03/2024] [Indexed: 07/18/2024]
Abstract
BACKGROUND Patient-reported outcome measures (PROMs) for hair loss focus mainly on Alopecia Areata. We created a PROM (i.e., HAIR-Q) that is applicable to any hair loss condition. The HAIR-Q measures satisfaction with hair. PATIENTS/METHODS Concept elicitation interviews were conducted and analyzed to develop a draft scale. Content validity was established through multiple rounds of patient and expert input. Psychometric properties of the scale were examined in an online sample (i.e., Prolific) using Rasch measurement theory (RMT) analysis. Test-retest reliability and tests of construct validation were examined. RESULTS Content validity of a 22-item draft scale was established with input from 11 patients, 12 experts and an online Prolific sample of 59 people who had a variety of hair loss treatments. In the RMT analysis (n = 390), 8 items were dropped. Data for the 14-item scale fit the Rasch model (χ2 = 89.85, df = 70, p = 0.06). All 14 items had ordered thresholds and good item fit. Reliability was high with person separation index and Cronbach alpha values ≥0.91, and intraclass correlation coefficient of 0.94 based on a sample of 97 participants. Higher (better) scores on the scale were associated with having more hair, looking younger than ones' age, satisfaction with hair overall, being less bothered by hair loss, and for those who had a hair loss treatment in the past year, being more satisfied with their hair now than before treatment (p < 0.001). CONCLUSION The HAIR-Q evidenced reliability and validity and can be used in research and to inform clinical care to measure satisfaction with hair from the patient perspective.
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Affiliation(s)
- Anne F Klassen
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Jasmine Mansouri
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Manraj Kaur
- Department of Surgery, Patient Reported Outcome, Value, and Experience (PROVE) Center, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Charlene Rae
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Lotte Poulsen
- Research Unit for Plastic Surgery, Odense University Hospital, Odense, Denmark
- Løntoft, Nyhøj and Poulsen Plastic Surgery, Odense, Denmark
| | - Steven Dayan
- Dayan Facial Plastic Surgery, Chicago, Illinois, USA
| | - Stefan J Cano
- Modus Outcomes (A Division of Thread), Cheltenham, UK
| | - Andrea L Pusic
- Department of Surgery, Patient Reported Outcome, Value, and Experience (PROVE) Center, Brigham and Women's Hospital, Boston, Massachusetts, USA
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Tong Y, Rajahraman V, Gupta R, Davidovitch RI, Schwarzkopf R, Rozell JC. Patient Demographic Factors Affect Response Rates to Patient-Reported Outcome Measures for Total Hip Arthroplasty Patients. J Arthroplasty 2024:S0883-5403(24)00633-8. [PMID: 38959987 DOI: 10.1016/j.arth.2024.06.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 06/13/2024] [Accepted: 06/14/2024] [Indexed: 07/05/2024] Open
Abstract
BACKGROUND The Hip Disability and Osteoarthritis Outcome Score (HOOS JR) is a widely used patient-reported outcome measures questionnaire for total hip arthroplasty (THA). However, not all patients choose to complete HOOS JR, and thus, a subset of the THA population may be underrepresented. This study aims to investigate the association between patient demographic factors and HOOS JR response rates. METHODS This was a retrospective cohort study of adult, English-speaking patients who underwent primary THA by a fellowship-trained arthroplasty surgeon between 2017 and 2023 at a single, high-volume academic institution. The HOOS JR completion status-complete or incomplete-was recorded for each patient within 90 days of surgery. Standard statistical analyses were performed to assess completion against multiple patient demographic factors. RESULTS Of the 2,908 total patients, 2,112 (72.6%) had complete and 796 (27.4%) had incomplete HOOS JR questionnaires. Multivariate analysis yielded statistical significance (P < .05) for the distribution of patient age, race, insurance, marital status, and income quartile with respect to questionnaire completion. Patient sex or religion did not affect response rates. Failure to complete HOOS JR (all P < .001) was associated with patients aged 18 to 39 (59.8%), who identified as Black (36.4%) or "other" race (39.6%), were never married (38%), and were in the lower half income quartiles (43.9%, 35.9%) when compared to the overall incomplete rate. CONCLUSIONS Multiple patient demographic factors may affect the HOOS JR response rate. Overall, our analyses suggest that older patients who identify as White and are of higher socioeconomic status are more likely to participate in the questionnaire. Efforts should focus on capturing patient groups less likely to participate to elucidate more generalizable trends in arthroplasty outcomes.
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Affiliation(s)
- Yixuan Tong
- Department of Orthopedic Surgery, NYU Langone Health, New York, New York
| | - Vinaya Rajahraman
- Department of Orthopedic Surgery, NYU Langone Health, New York, New York
| | - Rajan Gupta
- Department of Orthopedic Surgery, NYU Langone Health, New York, New York
| | - Roy I Davidovitch
- Department of Orthopedic Surgery, NYU Langone Health, New York, New York
| | - Ran Schwarzkopf
- Department of Orthopedic Surgery, NYU Langone Health, New York, New York
| | - Joshua C Rozell
- Department of Orthopedic Surgery, NYU Langone Health, New York, New York
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Wittich L, Tsatsaronis C, Kuklinski D, Schöner L, Steinbeck V, Busse R, Rombey T. Patient-Reported Outcome Measures as an Intervention: A Comprehensive Overview of Systematic Reviews on the Effects of Feedback. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2024:S1098-3015(24)02400-8. [PMID: 38843978 DOI: 10.1016/j.jval.2024.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 05/30/2024] [Accepted: 05/30/2024] [Indexed: 06/28/2024]
Abstract
OBJECTIVES Patient-reported outcome measures (PROMs) have emerged as a promising approach to involve patients in their treatment process. Beyond serving as outcome measures, PROMs can be applied to provide feedback to healthcare providers and patients, thereby offering valuable insights that can improve health outcomes and care processes. This overview offers a comprehensive synthesis of the effects of PROM feedback, contributing to the evidence-based discussion on PROMs' potential to enhance patient care. METHODS Following Cochrane Collaboration recommendations, this overview included literature reviews across diverse treatment areas, investigating the impact of PROM feedback on patient health outcomes (including quality of life, symptoms, or survival) and care process outcomes (including communication, symptom identification, or clinical practice). The methodological quality of the evidence was assessed with a modified version of A Measurement Tool to Assess Systematic Reviews 2, and the potential overlap of primary studies was quantified. Results were narratively synthesized. RESULTS Forty reviews grouped into 4 categories of treatment areas were included. Overall, their methodological quality was low. The overall overlap of primary studies was 2.2%, reaching up to 15.7% within specific treatment areas. The results indicate that PROM feedback may enhance the quality-of-care processes, whereas its effects on patient health outcomes remained less conclusive. CONCLUSIONS PROM feedback positively influences the interaction between physicians and patients across the included treatment areas. Further research is needed to comprehend the trickle-down effects of PROM feedback and how to enhance its potential in yielding health benefits for patients.
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Affiliation(s)
- Laura Wittich
- Department of Health Care Management, School of Economics and Management, Technical University Berlin, Berlin, Germany.
| | - Chrissa Tsatsaronis
- Department of Health Care Management, School of Economics and Management, Technical University Berlin, Berlin, Germany
| | - David Kuklinski
- Department of Health Care Management, School of Medicine, University of St. Gallen, St. Gallen, Switzerland
| | - Lukas Schöner
- Department of Health Care Management, School of Economics and Management, Technical University Berlin, Berlin, Germany
| | - Viktoria Steinbeck
- Department of Health Care Management, School of Economics and Management, Technical University Berlin, Berlin, Germany
| | - Reinhard Busse
- Department of Health Care Management, School of Economics and Management, Technical University Berlin, Berlin, Germany
| | - Tanja Rombey
- Department of Health Care Management, School of Economics and Management, Technical University Berlin, Berlin, Germany
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Gomes F, Khatoon B, Sawyer C, Punnett G, Farrington N, Yorke J. Patient-reported outcomes and experiences from a prospective cohort study of older patients with cancer on checkpoint inhibitors: The ELDERS study. J Geriatr Oncol 2024; 15:101777. [PMID: 38704912 DOI: 10.1016/j.jgo.2024.101777] [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: 01/06/2024] [Revised: 03/15/2024] [Accepted: 04/19/2024] [Indexed: 05/07/2024]
Abstract
INTRODUCTION Checkpoint inhibitors (CPI) are widely used across different tumour types in older cancer patients. The ELDERS study investigated primarily the safety of CPI in older patients, and secondarily its impact on health-related quality of life (HRQoL), comparing older and younger patients. Here we describe the results from its secondary aim. MATERIALS AND METHODS This was an observational, mixed methods study, consisting of questionnaires and qualitative interviews. Patients completed the EORTC QLQ-C30 at baseline and at three-monthly reviews (up to four over the planned 12 months on study). RESULTS One hundred and forty patients, 70 in each age cohort (older: ≥70 years of age, younger: <70 years of age), were recruited. Twenty-four patients, 12 in each age cohort, were interviewed. The mean baseline EORTC QLQ-C30 score was 65/100 for both cohorts combined, and the score for the full QLQ-C30 assessment was 78/100 and 75/100 for older and younger, respectively. The physical functioning score was the only subscale to change significantly between baseline and the first and second reviews (p = 0.03 and 0.04, respectively), resulting from some improvement in the mean score (from baseline) within the younger cohort and some decline within the older cohort. However, when focusing on each cohort separately, the change over time was not statistically significant for either. Two main themes from the interviews were 'expectations' (thoughts about treatment before commencing) and 'experience' (lived experience during treatment). DISCUSSION Quantitatively, there was no difference in the effect of CPIs on HRQoL between the cohorts, although qualitative data from interviews suggested that there were some experiential differences. People in the older cohort were less likely to seek additional information about CPIs and were more likely to report side effects. In terms of both 'expectations' and 'experience,' the older cohort was a heterogenous group, highlighting that an individualised approach is needed when supporting this group. This study shows that older patients can be reassured that immunotherapy is unlikely to negatively impact their HRQoL more than younger patients, and it should be considered a viable treatment option.
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Affiliation(s)
- Fabio Gomes
- Medical Oncology Department, The Christie NHS Foundation Trust, Manchester, UK; Christie Patient Centred Research, The Christie NHS Foundation Trust, Manchester, UK; Senior Adult Oncology Service, The Christie NHS Foundation Trust, Manchester, UK.
| | - Binish Khatoon
- Christie Patient Centred Research, The Christie NHS Foundation Trust, Manchester, UK; Division of Nursing, Midwifery and Social Work, The University of Manchester, Manchester, UK
| | - Chelsea Sawyer
- Christie Patient Centred Research, The Christie NHS Foundation Trust, Manchester, UK; Division of Psychology and Mental Health, The University of Manchester, Manchester, UK
| | - Grant Punnett
- Christie Patient Centred Research, The Christie NHS Foundation Trust, Manchester, UK
| | - Naomi Farrington
- Senior Adult Oncology Service, The Christie NHS Foundation Trust, Manchester, UK
| | - Janelle Yorke
- Christie Patient Centred Research, The Christie NHS Foundation Trust, Manchester, UK; Division of Nursing, Midwifery and Social Work, The University of Manchester, Manchester, UK
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van Pottelberghe S, Kupper N, Scheirlynck E, Amin AS, Wilde AAM, Hofman N, Callus E, Biller R, Nekkebroeck J, Van Dooren S, Hes FJ, van der Crabben SN. Are disease-specific patient-reported outcomes measures (PROMs) used in cardiogenetics? A systematic review. Eur J Hum Genet 2024; 32:607-618. [PMID: 38097768 PMCID: PMC11153546 DOI: 10.1038/s41431-023-01510-w] [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: 07/10/2023] [Revised: 11/08/2023] [Accepted: 11/22/2023] [Indexed: 06/07/2024] Open
Abstract
Patient-reported outcome measures (PROMs) are used to facilitate patient-centered care (PCC). While studies in patients with cardiac conditions have revealed poorer health-related quality of life (HRQoL) and elevated emotional stress, studies in inherited cardiac conditions (ICC) seem rare. A systematic review evaluated which (specific domains of) PROMs are used in patients with ICC. From three databases (PubMed, PsychINFO, and Web of Science) quantitative studies investigating PROMs in patients with ICC were included. A Cochrane-based assessment tool was used to evaluate quality and potential risk of bias per subdomain. Data from 17 eligible articles were extracted. Among the included studies, risk of bias was predominantly high (35%) or unclear (30%). Most (n = 14) studies used a generic health status measure (SF-36, SF-12); 3 studies used a disease-specific PROM (KCCQ- cardiomyopathy and MLFHQ-heart failure). In addition to HRQoL measures, several studies used affective psychological measures (i.e., HADS, CAQ-18, IES-R, and IPQ). The mental health component of the PROMs showed lower scores overall in patients with ICC compared to population norms. Nine studies using HADS and GAD-7/PHQ-9 showed a prevalence of clinically significant anxiety (17-47%) and depression levels (8.3-28%) that were higher than the population norm (8.3% and 6.3%, respectively). HRQoL in patients with ICC is primarily assessed with generic PROMs. Results further confirmed high psychological morbidity in this population. Generic PROMS measures evaluate overall health status, but lack sensitivity to ICC-specific factors like heredity-related concerns. We propose developing a PROM specific for ICC to optimize PCC.
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Affiliation(s)
- Saar van Pottelberghe
- Clinical Sciences, Research Group Reproduction and Genetics, Centre for Medical Genetics, Universitair Ziekenhuis Brussel (UZ Brussel), Vrije Universiteit Brussel (VUB), Brussels, Belgium.
- Member of the European Reference Network for Rare, Low Prevalence, and/or Complex Diseases of the Heart: ERN GUARD-Heart, Amsterdam, The Netherlands.
| | - Nina Kupper
- Center of Research on Psychological Disorders and Somatic Diseases; Department of Medical & Clinical Psychology, Tilburg University, Tilburg, the Netherlands
| | - Esther Scheirlynck
- Member of the European Reference Network for Rare, Low Prevalence, and/or Complex Diseases of the Heart: ERN GUARD-Heart, Amsterdam, The Netherlands
- Cardiology Department, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Brussels, Belgium
| | - Ahmad S Amin
- Member of the European Reference Network for Rare, Low Prevalence, and/or Complex Diseases of the Heart: ERN GUARD-Heart, Amsterdam, The Netherlands
- Department of Cardiology, Amsterdam UMC Location University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Cardiovascular Sciences, Heart Failure and arrhythmias, Amsterdam, the Netherlands
| | - Arthur A M Wilde
- Member of the European Reference Network for Rare, Low Prevalence, and/or Complex Diseases of the Heart: ERN GUARD-Heart, Amsterdam, The Netherlands
- Department of Cardiology, Amsterdam UMC Location University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Cardiovascular Sciences, Heart Failure and arrhythmias, Amsterdam, the Netherlands
| | - Nynke Hofman
- Member of the European Reference Network for Rare, Low Prevalence, and/or Complex Diseases of the Heart: ERN GUARD-Heart, Amsterdam, The Netherlands
- Department of Cardiology, Amsterdam UMC Location University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Cardiovascular Sciences, Heart Failure and arrhythmias, Amsterdam, the Netherlands
| | - Edward Callus
- Member of the European Reference Network for Rare, Low Prevalence, and/or Complex Diseases of the Heart: ERN GUARD-Heart, Amsterdam, The Netherlands
- Clinical Psychology Service, IRCCS Policlinico San Donato Research and University Hospital, San Donato Milanese, Milan, Italy
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Ruth Biller
- European Patient Advocacy Group of the European Reference Network for Rare, Low Prevalence, and/or Complex Diseases of the Heart: ERN GUARD-Heart, Amsterdam, The Netherlands
- ARVC-Selbsthilfe e.V., ARVC Patient Association, Munich, Germany
| | - Julie Nekkebroeck
- Clinical Sciences, Research Group Reproduction and Genetics, Centre for Medical Genetics, Universitair Ziekenhuis Brussel (UZ Brussel), Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Member of the European Reference Network for Rare, Low Prevalence, and/or Complex Diseases of the Heart: ERN GUARD-Heart, Amsterdam, The Netherlands
| | - Sonia Van Dooren
- Clinical Sciences, Research Group Reproduction and Genetics, Centre for Medical Genetics, Universitair Ziekenhuis Brussel (UZ Brussel), Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Member of the European Reference Network for Rare, Low Prevalence, and/or Complex Diseases of the Heart: ERN GUARD-Heart, Amsterdam, The Netherlands
- Clinical Sciences, Research Group Reproduction and Genetics, Brussel Interuniversity Genomics High Throughput Core (BRIGHTcore), Universitair Ziekenhuis Brussel (UZ Brussel), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Frederik J Hes
- Clinical Sciences, Research Group Reproduction and Genetics, Centre for Medical Genetics, Universitair Ziekenhuis Brussel (UZ Brussel), Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Member of the European Reference Network for Rare, Low Prevalence, and/or Complex Diseases of the Heart: ERN GUARD-Heart, Amsterdam, The Netherlands
| | - Saskia N van der Crabben
- Member of the European Reference Network for Rare, Low Prevalence, and/or Complex Diseases of the Heart: ERN GUARD-Heart, Amsterdam, The Netherlands
- Department of Clinical Genetics, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
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Emrich Accioly JP, Bena J, Xiao H, Jeong S, Khouri RK, Angermeier KW, Dewitt-Foy M, Nemunaitis G, Wood HM. Decisional regret and impacts on quality of life following genitourinary reconstruction for neurogenic bladder: A comparison between acquired and congenital spinal cord injury. PM R 2024. [PMID: 38676469 DOI: 10.1002/pmrj.13157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 11/06/2023] [Accepted: 11/14/2023] [Indexed: 04/29/2024]
Abstract
INTRODUCTION Patient expectations and baseline health are important drivers of outcomes following major genitourinary reconstructive surgery for neurogenic bladder (NGB). Differences in expectations and quality of life (QoL) improvements among different populations with NGB remain insufficiently explored in the literature. OBJECTIVE To compare decisional regret (DR) and urinary-related QoL (UrQoL) in patients undergoing urinary diversion for NGB arising from spinal cord injury of acquired (A-SCI) and congenital (C-SCI) etiologies. We hypothesize that patients with A-SCI have higher expectations of improvement in QoL following surgery when compared with C-SCI, which may lead to higher DR and decreased UrQoL, postoperatively. DESIGN In this cross-sectional survey study, we compared A-SCI to C-SCI in terms of DR, UrQoL, and postoperative changes in self-reported physical health, mental health, and pain using validated patient-reported outcome measures. SETTING Participants were enrolled from a quaternary care institution via mail and MyChart. PARTICIPANTS The A-SCI group consistied of 17 patients with traumatic spinal cord injury the C-SCI group was composed of 20 patients with spina bifida. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES The Decisional Regret Scale, Short form- Qualiveen (SF-Qualiveen), and Patient-reported outcomes measurement Information system-10 (PROMIS-10) Global Health surveys. RESULTS The A-SCI group displayed poorer preoperative physical health than the C-SCI cohort, but absolute postoperative changes in this score, along with mental health score and pain level, were not significant after adjusting for baseline scores and follow-up time. SF-Qualiveen scores revealed significantly worse impact of NGB in UrQoL for A-SCI than for C-SCI when adjusted for other factors. No differences in DR were seen between the groups. CONCLUSIONS Patients with A-SCI demonstrate lower self-reported baseline physical health compared with patients with C-SCI, which may have implications in setting patient expectations when undergoing urinary diversion. In this small cohort, we found a milder self-reported postoperative impact of NGB in UrQoL in patients with C-SCI.
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Affiliation(s)
- João Pedro Emrich Accioly
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - James Bena
- Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Huijun Xiao
- Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Stacy Jeong
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Roger K Khouri
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Kenneth W Angermeier
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Molly Dewitt-Foy
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Gregory Nemunaitis
- Department of Physical Medicine and Rehabilitation, Neurological Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Hadley M Wood
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
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Seidenstuecker K, Fertsch S, Ghazaleh AA, Fabi A, Stoffel J, Bukowiecki J, Wolter A, Aghlmandi S, Nadella A, Halbeisen FS, Andree C, Haug MD, Schaefer DJ, Handschin TM, Kappos EA. Improving quality of life after breast cancer: a comparison of two microsurgical treatment options for breast cancer-related lymphedema (BCRL). Clin Exp Med 2024; 24:82. [PMID: 38653874 DOI: 10.1007/s10238-024-01344-w] [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: 01/02/2024] [Accepted: 04/02/2024] [Indexed: 04/25/2024]
Abstract
PURPOSE Vascularized lymph node transfer (VLNT) entails the autologous relocation of lymph nodes to a lymphedematous region of the body, whereas lymphaticovenous anastomosis (LVA) creates a direct bypass between the lymphatic and venous system. Both techniques are meant to lastingly bolster the local lymphatic drainage capacity. This study compared safety and effectiveness of VLNT and LVA in patients with chronic breast cancer related lymphedema (BCRL). METHODS A retrospective cohort study was conducted using data from our encrypted database composed of patients with chronic BCRL who were treated with either VLNT or LVA and had a minimum follow-up of two years. Patient-specific variables analyzed included pre- and postoperative arm circumferences, lymphedema stages and postoperative complications. RESULTS A total of 105 patients met the inclusion criteria, of which 96 patients demonstrated a complete follow-up period of two years. The VLNT group displayed larger preoperative circumferential measurements, evident in both in the isolated examination of the affected arm, as well as when adjusted for the contralateral unaffected arm. Significant reduction in arm volume was achieved by both groups. However, VLNT demonstrated superior relative reduction rates than LVA, neutralizing any significant arm size disparities after 24 months. Surgery duration was slightly longer for VLNT than LVA. Postoperative complications, predominantly minor, were exclusively observed in the VLNT group. CONCLUSIONS Both VLNT and LVA offer significant improvement for patients suffering from chronic BCRL. VLNT shows an even greater potential for improvement in more severe cases of BCRL, but involves a higher risk for (mostly minor) complications.
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Affiliation(s)
- Katrin Seidenstuecker
- Department of Plastic, Reconstructive and Aesthetic Surgery, Sana Hospital Düsseldorf, Düsseldorf, Germany
- Breast Center, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Sonia Fertsch
- Department of Plastic, Reconstructive and Aesthetic Surgery, Sana Hospital Düsseldorf, Düsseldorf, Germany
- Faculty of Health, University Witten-Herdecke, Witten, Germany
| | - Alina A Ghazaleh
- Department of Plastic, Reconstructive and Aesthetic Surgery, Sana Hospital Düsseldorf, Düsseldorf, Germany
| | - Adriano Fabi
- Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital of Basel, Spitalstrasse 21, 4031, Basel, Switzerland
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Julia Stoffel
- Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital of Basel, Spitalstrasse 21, 4031, Basel, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Julia Bukowiecki
- Department of Plastic, Reconstructive and Aesthetic Surgery, Sana Hospital Düsseldorf, Düsseldorf, Germany
| | - Andreas Wolter
- Department of Plastic, Reconstructive and Aesthetic Surgery, Sana Hospital Düsseldorf, Düsseldorf, Germany
- Faculty of Health, University Witten-Herdecke, Witten, Germany
| | - Soheila Aghlmandi
- Surgical Outcome Research Center, Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Anshoo Nadella
- Surgical Outcome Research Center, Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Florian S Halbeisen
- Surgical Outcome Research Center, Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Christoph Andree
- Department of Plastic, Reconstructive and Aesthetic Surgery, Sana Hospital Düsseldorf, Düsseldorf, Germany
| | - Martin D Haug
- Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital of Basel, Spitalstrasse 21, 4031, Basel, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Dirk J Schaefer
- Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital of Basel, Spitalstrasse 21, 4031, Basel, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Tristan M Handschin
- Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital of Basel, Spitalstrasse 21, 4031, Basel, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Elisabeth A Kappos
- Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital of Basel, Spitalstrasse 21, 4031, Basel, Switzerland.
- Faculty of Medicine, University of Basel, Basel, Switzerland.
- Breast Center, University Hospital of Basel, Basel, Switzerland.
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10
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Newlands AF, Kramer M, Roberts L, Maxwell K, Price JL, Finlay KA. Evaluating the quality of life impact of recurrent urinary tract infection: Validation and refinement of the Recurrent UTI Impact Questionnaire (RUTIIQ). Neurourol Urodyn 2024; 43:902-914. [PMID: 38385648 DOI: 10.1002/nau.25426] [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: 08/29/2023] [Revised: 12/08/2023] [Accepted: 02/05/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND AND AIMS Recurrent urinary tract infection (rUTI) has significant negative consequences for a wide variety of quality of life (QoL) domains. Without adequate validation and assessment of the unique insights of people living with rUTI, clinical results cannot be fully understood. The Recurrent UTI Impact Questionnaire (RUTIIQ), a novel patient-reported outcome measure of rUTI psychosocial impact, has been robustly developed with extensive patient and clinician input to facilitate enhanced rUTI management and research. This study aimed to confirm the structural validity of the RUTIIQ, assessing its strength and bifactor model fit. METHODS A sample of 389 adults experiencing rUTI (96.9% female, aged 18-87 years) completed an online cross-sectional survey comprising a demographic questionnaire and the RUTIIQ. A bifactor graded response model was fitted to the data, optimizing the questionnaire structure based on item fit, discrimination capability, local dependence, and differential item functioning. RESULTS The final RUTIIQ demonstrated excellent bifactor model fit (RMSEA = 0.054, CFI = 0.99, SRMSR = 0.052), and mean-square fit indices indicated that all included items were productive for measurement (MNSQ = 0.52-1.41). The final questionnaire comprised an 18-item general "rUTI QoL impact" factor, and five subfactor domains measuring "personal wellbeing" (three items), "social wellbeing" (four items), "work and activity interference" (four items), "patient satisfaction" (four items), and "sexual wellbeing" (three items). Together, the general factor and five subfactors explained 81.6% of the common model variance. All factor loadings were greater than 0.30 and communalities greater than 0.60, indicating good model fit and structural validity. CONCLUSIONS The 18-item RUTIIQ is a robust, patient-tested questionnaire with excellent psychometric properties, which capably assesses the patient experience of rUTI-related impact to QoL and healthcare satisfaction. Facilitating standardized patient monitoring and improved shared decision-making, the RUTIIQ delivers the unique opportunity to improve patient-centered care.
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Affiliation(s)
- Abigail F Newlands
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | | | - Lindsey Roberts
- School of Psychology, University of Buckingham, Buckingham, UK
| | - Kayleigh Maxwell
- Department of Psychology, Faculty of Natural Sciences, University of Stirling, Stirling, UK
| | | | - Katherine A Finlay
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
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11
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Shah R, Salek MS, Finlay AY, Kay R, Nixon SJ, Otwombe K, Ali FM, Ingram JR. Mapping of Family Reported Outcome Measure (FROM-16) scores to EQ-5D: algorithm to calculate utility values. Qual Life Res 2024; 33:1107-1119. [PMID: 38402530 PMCID: PMC10973087 DOI: 10.1007/s11136-023-03590-z] [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: 12/17/2023] [Indexed: 02/26/2024]
Abstract
OBJECTIVE Although decision scientists and health economists encourage inclusion of family member/informal carer utility in health economic evaluation, there is a lack of suitable utility measures comparable to patient utility measures such those based on the EQ-5D. This study aims to predict EQ-5D-3L utility values from Family Reported Outcome Measure (FROM-16) scores, to allow the use of FROM-16 data in health economic evaluation when EQ-5D data is not available. METHODS Data from 4228 family members/partners of patients recruited to an online cross-sectional study through 58 UK-based patient support groups, three research support platforms and Welsh social services departments were randomly divided five times into two groups, to derive and test a mapping model. Split-half cross-validation was employed, resulting in a total of ten multinomial logistic regression models. The Monte Carlo simulation procedure was used to generate predicted EQ-5D-3L responses, and utility scores were calculated and compared against observed values. Mean error and mean absolute error were calculated for all ten validation models. The final model algorithm was derived using the entire sample. RESULTS The model was highly predictive, and its repeated fitting using multinomial logistic regression demonstrated a stable model. The mean differences between predicted and observed health utility estimates ranged from 0.005 to 0.029 across the ten modelling exercises, with an average overall difference of 0.015 (a 2.2% overestimate, not of clinical importance). CONCLUSIONS The algorithm developed will enable researchers and decision scientists to calculate EQ-5D health utility estimates from FROM-16 scores, thus allowing the inclusion of the family impact of disease in health economic evaluation of medical interventions when EQ-5D data is not available.
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Affiliation(s)
- R Shah
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK.
| | - M S Salek
- School of Life & Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - A Y Finlay
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - R Kay
- RK Statistics, Bakewell, UK
| | - S J Nixon
- Multiple Sclerosis Society, Cardiff, UK
| | - K Otwombe
- Statistics and Data Management Centre, Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - F M Ali
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - J R Ingram
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
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12
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Gratteri M, Marangi GF, Mirra C, Arcari L, Romano FD, Cimmino A, Cogliandro A, Cagli B, Segreto F, Persichetti P. Impact of Incisional Access Site in Primary Breast Augmentation: Evaluation of Patient Satisfaction with SCAR-Q. Aesthetic Plast Surg 2024; 48:1565-1570. [PMID: 37495729 DOI: 10.1007/s00266-023-03502-z] [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: 05/17/2023] [Accepted: 06/30/2023] [Indexed: 07/28/2023]
Abstract
BACKGROUND Scarring at the incision site represents one of the most impactful outcomes in breast augmentation surgery for both the patient and the surgeon. Few studies exist with the aim of assessing patient perception of scarring outcomes in primary breast augmentation. The aim of this study was to evaluate the impact on quality of life of scars by submitting the SCAR-Q in patients who underwent primary augmentation mammoplasty. METHODS The SCAR-Q was administered at one and at 6 months after surgery to 54 consecutive patients underwent primary breast augmentation with inferior hemi-periareolar or inframammary incision. A total of 50 patients were divided into two groups of 21 patients with inferior hemi-periareolar incision and 29 patients with inframammary fold incision, respectively. Statistical analysis was performed with Prism 9. RESULTS All mean values of the three SCAR-Q scales tend to decrease at the second administration meaning that the perception of the scar is better at time 6 from the patient perspective. In the "Psychosocial scale," lower values at both 1 month and 6 months for group 2 compared to group 1 were shown. Unpaired T tests with Welch's correction showed significance for delta values variations between the two groups with P values <0.0001. CONCLUSION Data show that patients undergoing primary breast augmentation have a scar that has no significant impact. Patients with inframammary fold scar have less psychosocial impact than those with inferior hemi-periareolar scar. There were no statistically significant differences in scar-related symptoms and scar appearance between scar along the inframammary groove and inferior hemi-periareolar scar. LEVEL OF EVIDENCE IV Case series study. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Marco Gratteri
- Department of Plastic, Reconstructive and Cosmetic Surgery, Campus Bio-Medico University Hospital, Via Alvaro del Portillo 200, Rome, Italy
| | - Giovanni Francesco Marangi
- Department of Plastic, Reconstructive and Cosmetic Surgery, Campus Bio-Medico University Hospital, Via Alvaro del Portillo 200, Rome, Italy
| | - Carlo Mirra
- Department of Plastic, Reconstructive and Cosmetic Surgery, Campus Bio-Medico University Hospital, Via Alvaro del Portillo 200, Rome, Italy.
| | - Lucrezia Arcari
- Department of Plastic, Reconstructive and Cosmetic Surgery, Campus Bio-Medico University Hospital, Via Alvaro del Portillo 200, Rome, Italy
| | - Fara Desiree Romano
- Department of Plastic, Reconstructive and Cosmetic Surgery, Campus Bio-Medico University Hospital, Via Alvaro del Portillo 200, Rome, Italy
| | - Andrea Cimmino
- Department of Plastic, Reconstructive and Cosmetic Surgery, Campus Bio-Medico University Hospital, Via Alvaro del Portillo 200, Rome, Italy
| | - Annalisa Cogliandro
- Department of Plastic, Reconstructive and Cosmetic Surgery, Campus Bio-Medico University Hospital, Via Alvaro del Portillo 200, Rome, Italy
| | - Barbara Cagli
- Department of Plastic, Reconstructive and Cosmetic Surgery, Campus Bio-Medico University Hospital, Via Alvaro del Portillo 200, Rome, Italy
| | - Francesco Segreto
- Department of Plastic, Reconstructive and Cosmetic Surgery, Campus Bio-Medico University Hospital, Via Alvaro del Portillo 200, Rome, Italy
| | - Paolo Persichetti
- Department of Plastic, Reconstructive and Cosmetic Surgery, Campus Bio-Medico University Hospital, Via Alvaro del Portillo 200, Rome, Italy
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Hughes JA, Hazelwood S, Lyrstedt AL, Jones L, Brown NJ, Jarugula R, Douglas C, Chu K. Enhancing pain care with the American Pain Society Patient Outcome Questionnaire for use in the emergency department (APS-POQ-RED): validating a patient-reported outcome measure. BMJ Open Qual 2024; 13:e002295. [PMID: 38448040 PMCID: PMC10916172 DOI: 10.1136/bmjoq-2023-002295] [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: 02/01/2023] [Accepted: 12/02/2023] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND In general, the quality of pain care in emergency departments (ED) is poor, despite up to 80% of all ED patients presenting with pain. This may be due to the lack of well-validated patient-reported outcome measures (PROMs) of pain care in the ED setting. The American Pain Society-Patient Outcome Questionnaire-Revised Edition (APS-POQ-R), with slight modification for ED patients, is a potentially useful PROM for the adult ED, however it is yet to be completely validated. METHODS Adult patients, who had presented with moderate to severe acute pain, were recruited at two large inner-city EDs in Australia. A modified version of the APS-POQ-R was administered at the completion of their ED care. Responses were randomly split into three groups and underwent multiple rounds of exploratory and confirmatory factor analysis with testing for construct, convergent, divergent validity and internal consistency. RESULTS A total of 646 ED patients (55.6% female), with a median age of 48.3 years, and moderate to severe pain on arrival, completed the ED-modified APS-POQ-R. Psychometric evaluation resulted in a reduced nine-question tool, which measures three constructs (pain relief and satisfaction (α=0.891), affective distress (α=0.823) and pain interference (α=0.908)) and demonstrated construct, convergent, divergent validity, and internal consistency. CONCLUSIONS This new tool, which we refer to as the American Pain Society-Patient Outcome Questionnaire-Revised for the ED (APS-POQ-RED), should form the basis for reporting patient-reported outcomes of ED pain care in future quality improvement and research.
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Affiliation(s)
- James A Hughes
- School of Nursing, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Sarah Hazelwood
- Emergency Department, The Prince Charles Hospital, Chermside, Queensland, Australia
| | - Anna-Lisa Lyrstedt
- Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Lee Jones
- Queensland University of Technology, Brisbane, Queensland, Australia
- QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
| | - Nathan J Brown
- Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
- Faculty of Medicine, University of Queensland Faculty of Medicine and Biomedical Sciences, Herston, Queensland, Australia
| | - Rajeev Jarugula
- Emergency Department, The Prince Charles Hospital, Chermside, Queensland, Australia
| | - Clint Douglas
- Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
- Metro North Hospital and Health Service, Herston, Queensland, Australia
| | - Kevin Chu
- Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
- Faculty of Medicine, University of Queensland Faculty of Medicine and Biomedical Sciences, Herston, Queensland, Australia
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Campos JR, Costa FO, Borges-Oliveira AC, Cota LOM. Factors associated with halitosis reported by parents/caregivers in individuals with Down syndrome. SPECIAL CARE IN DENTISTRY 2024; 44:520-529. [PMID: 37210708 DOI: 10.1111/scd.12876] [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: 01/02/2023] [Revised: 04/25/2023] [Accepted: 05/05/2023] [Indexed: 05/23/2023]
Abstract
AIMS Data on halitosis among individuals with Down syndrome (DS) are scarce. The aim was to evaluate factors associated with the occurrence of halitosis reported by parents/caregivers (P/Cs) in individuals with DS. METHODS AND RESULTS A cross-sectional study was conducted in non-governmental assistance institutions in the State of Minas Gerais-Brazil. P/Cs have answered an electronic questionnaire with sociodemographic, behavioral and oral health data. Factors associated with halitosis were evaluated by multivariate logistic regression. The sample comprised 227 P/Cs (age 48.8 ± 13.2 years; 82.9% mothers) of individuals with DS (age 20.8 ± 13.5 years). The prevalence of halitosis in the total sample was 34.4% (n = 78) and its occurrence was associated: 1) in individuals with DS ≤18 years old (26.2%; n = 27)-negative perception of oral health (OR = 3.91); 2) in individuals with DS > 18 years (41.1%; n = 51)-gingival bleeding (OR = 4.53), absence of tongue brushing (OR = 4.50), negative perception of oral health (OR = 2.72). CONCLUSIONS The occurrence of halitosis in individuals with DS reported by P/Cs was relevant and associated with dental factors, having a negative impact on the perception of oral health. Oral hygiene practices, especially tongue brushing, should be reinforced to prevent and control halitosis.
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Affiliation(s)
- Julya Ribeiro Campos
- Department of Dental Clinics, Oral Pathology and Oral Surgery, Periodontology Division, Federal University of Minas Gerais, University, Belo Horizonte, Brazil
| | - Fernando Oliveira Costa
- Department of Dental Clinics, Oral Pathology and Oral Surgery, Periodontology Division, Federal University of Minas Gerais, University, Belo Horizonte, Brazil
| | - Ana Cristina Borges-Oliveira
- Department of Social and Preventive Dentistry, Federal University of Minas Gerais, University, Belo Horizonte, Brazil
| | - Luís Otávio Miranda Cota
- Department of Dental Clinics, Oral Pathology and Oral Surgery, Periodontology Division, Federal University of Minas Gerais, University, Belo Horizonte, Brazil
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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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16
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Newlands AF, Kramer M, Roberts L, Maxwell K, Price JL, Finlay KA. Confirmatory structural validation and refinement of the Recurrent Urinary Tract Infection Symptom Scale. BJUI COMPASS 2024; 5:240-252. [PMID: 38371201 PMCID: PMC10869661 DOI: 10.1002/bco2.297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 08/23/2023] [Accepted: 09/09/2023] [Indexed: 02/20/2024] Open
Abstract
Objectives To confirm the structural validity of the Recurrent Urinary Tract Infection Symptom Scale (RUTISS), determining whether a bifactor model appropriately fits the questionnaire's structure and identifying areas for refinement. Used in conjunction with established clinical testing methods, this patient-reported outcome measure addresses the urgent need to validate the patient perspective. Patients and methods A clinically and demographically diverse sample of 389 people experiencing recurrent UTI across 37 countries (96.9% female biological sex, aged 18-87 years) completed the RUTISS online. A bifactor graded response model was fitted to the data, identifying potential items for deletion if they indicated significant differential item functioning (DIF) based on sociodemographic characteristics, contributed to local item dependence or demonstrated poor fit or discrimination capability. Results The final RUTISS comprised a 3-item symptom frequency section, a 1-item global rating of change scale and an 11-item general 'rUTI symptom and pain severity' subscale with four sub-factor domains measuring 'urinary symptoms', 'urinary presentation', 'UTI pain and discomfort' and 'bodily sensations'. The bifactor model fit indices were excellent (root mean square error of approximation [RMSEA] = 0.041, comparative fit index [CFI] = 0.995, standardised root mean square residual [SRMSR] = 0.047), and the mean-square fit statistics indicated that all items were productive for measurement (mean square fit indices [MNSQ] = 0.64 - 1.29). Eighty-one per cent of the common model variance was accounted for by the general factor and sub-factors collectively, and all factor loadings were greater than 0.30 and communalities greater than 0.60. Items indicated high discrimination capability (slope parameters > 1.35). Conclusion The 15-item RUTISS is a patient-generated, psychometrically robust questionnaire that dynamically assesses the patient experience of recurrent UTI symptoms and pain. This brief tool offers the unique opportunity to enhance patient-centred care by supporting shared decision-making and patient monitoring.
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Affiliation(s)
- Abigail F. Newlands
- School of Psychology and Clinical Language SciencesUniversity of ReadingReadingUK
| | | | | | - Kayleigh Maxwell
- Department of Psychology, Faculty of Natural SciencesUniversity of StirlingStirlingUK
| | | | - Katherine A. Finlay
- School of Psychology and Clinical Language SciencesUniversity of ReadingReadingUK
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Howard FD, Green R, Harris J, Ross J, Nicholson C. Understanding the extent to which PROMs and PREMs used with older people with severe frailty capture their multidimensional needs: A scoping review. Palliat Med 2024; 38:184-199. [PMID: 38268061 PMCID: PMC10865766 DOI: 10.1177/02692163231223089] [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] [Indexed: 01/26/2024]
Abstract
BACKGROUND Older people with severe frailty are nearing the end of life but their needs are often unknown and unmet. Systematic ways to capture and measure the needs of this group are required. Patient reported Outcome Measures (PROMs) & Patient reported Experience Measures (PREMs) are possible tools to assist this. AIM To establish whether, and in what ways, the needs of older people living with severe frailty are represented within existing PROMs and PREMs and to examine the extent to which the measures have been validated with this patient group. DESIGN The scoping review follows the method of Arksey and O'Malley. RESULTS Seventeen papers from 9 countries meeting the inclusion criteria and 18 multi-dimensional measures were identified: 17 PROMs, and 1 PROM with PREM elements. Seven out of the 18 measures had evidence of being tested for validity with those with frailty. No measure was developed specifically for a frail population. Using the adapted framework of palliative need, five measures covered all five domains of palliative need (IPOS, ICECAP-SCM, PDI, WHOQOL-BREF, WHOQOL-OLD). The coverage of items within the domains varied between the measures. CONCLUSION Existing PROMs and PREMs are not well designed for what we know about the needs of older people with severe frailty. Future research should firstly focus on adapting and validating the existing measures to ensure they are fit for purpose, and secondly on developing a better understanding of how measures are used to deliver/better person-centred care.
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Affiliation(s)
- Faith D Howard
- Department of Health Sciences, University of Surrey, Guildford, UK
| | - Richard Green
- Department of Health Sciences, University of Surrey, Guildford, UK
| | - Jenny Harris
- Department of Health Sciences, University of Surrey, Guildford, UK
| | - Joy Ross
- St Christopher’s Hospice, London, UK
| | - Caroline Nicholson
- Department of Health Sciences, University of Surrey, Guildford, UK
- St Christopher’s Hospice, London, UK
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Ticha P, Sukop A. Patient-reported outcomes in bilateral prophylactic mastectomy with breast reconstruction: A narrative review. Breast 2024; 73:103602. [PMID: 37995427 PMCID: PMC10709055 DOI: 10.1016/j.breast.2023.103602] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 11/06/2023] [Accepted: 11/10/2023] [Indexed: 11/25/2023] Open
Abstract
In women at high risk of developing breast cancer, bilateral prophylactic mastectomy (BPM) 1 significantly reduces the risk; simultaneously, breast reconstruction preserves body integrity. Given the complex and personal nature of such surgical procedures, patient assessment of satisfaction and health-related quality of life (HRQoL) 2 is essential in evaluation of surgical outcomes. With this review, we aim to organize the current knowledge on patient-reported outcomes (PROs) 3 in bilateral prophylactic surgery. Literature search was conducted using the databases Google Scholar, PubMed, and Web of Science to address the following questions, which can help clinicians and women undergoing the procedures navigate their healthcare decision-making process: How does BPM with reconstruction influence cancer-related distress? How does the surgery impact patient satisfaction and HRQoL? How do preoperative PROs differ from postoperative outcomes? Does the type of BPM and the type of reconstruction impact patient satisfaction and HRQoL? Furthermore, we summarize available patient-reported outcome measures (PROMs) 4 that can be administered to women undergoing BPM with reconstruction. In addition, we discuss possible future directions for PRO research in prophylactic breast surgery.
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Affiliation(s)
- Pavla Ticha
- Department of Plastic Surgery, Kralovske Vinohrady University Hospital and Third Faculty of Medicine, Charles University, Srobarova 50, 10034, Praha 10, Czech Republic.
| | - Andrej Sukop
- Department of Plastic Surgery, Kralovske Vinohrady University Hospital and Third Faculty of Medicine, Charles University, Srobarova 50, 10034, Praha 10, Czech Republic.
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Lo Monaco M, Mallaci Bocchio R, Natoli G, Giardina A, Cangemi I, Scibetta S, Argano C, Corrao S. Critical importance of patient-reported outcomes for a comprehensive assessment of psoriatic arthritis patients. Front Med (Lausanne) 2024; 10:1332432. [PMID: 38293304 PMCID: PMC10826607 DOI: 10.3389/fmed.2023.1332432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 12/28/2023] [Indexed: 02/01/2024] Open
Abstract
Introduction Psoriatic arthritis (PsA) is a heterogeneous, chronic inflammatory disease that negatively impacts patients' quality of life. Patient-reported outcome measures (PROMs) are used to capture patient perspectives in disease assessment, and physicians use the Disease Activity Index for Psoriatic Arthritis (DAPSA) to evaluate disease activity in PsA. The study aimed to assess the relationship between PROMs and the DAPSA score in consecutive outpatients affected by PsA. Materials and methods A cross-sectional study was conducted from March 2018 to October 2020 at the PsA clinic of the ARNAS Civico in Palermo (Italy), enrolling outpatients with PsA. Patients were assessed for their disease activity according to the DAPSA score, and PROMs, such as PHQ-9, HAQ, FACIT-F, and PsAID, were evaluated. Linear regression analysis evaluated the relationship between the DAPSA Score and the included PROMs. Results 158 PsA consecutive peripheral subset psoriatic arthritis outpatients were recruited. The median years of illness was 10.6 (9.3-11.9), and the median DAPSA score was 19.02 (9-33.1). The regression analysis highlighted a strong relationship between the DAPSA score and the PsAID (adjR2 26%, p < 0.0001), the FACIT-F (adjR2 25.4%, p < 0.0001), the HAQ (adjR2 23.7%, p < 0.0001), and PHQ-9 (adjR2 15%, p < 0.0001). Conclusion PROMs are strongly associated with the DAPSA score, but it allows in-depth evaluation of the impact of the disease on different domains of PsA patients' life.
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Affiliation(s)
- Marika Lo Monaco
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties [PROMISE], University of Palermo, Palermo, Italy
- Department of Clinical Medicine, Internal Medicine Unit with Rheumatology, Dermatology, Diabetology and Tertiary Diabetic Foot Healthcare, National Relevance and High Specialization Hospital Trust ARNAS Civico, Di Cristina, Benfratelli, Palermo, Italy
| | - Raffaella Mallaci Bocchio
- Department of Clinical Medicine, Internal Medicine Unit with Rheumatology, Dermatology, Diabetology and Tertiary Diabetic Foot Healthcare, National Relevance and High Specialization Hospital Trust ARNAS Civico, Di Cristina, Benfratelli, Palermo, Italy
| | - Giuseppe Natoli
- Department of Clinical Medicine, Internal Medicine Unit with Rheumatology, Dermatology, Diabetology and Tertiary Diabetic Foot Healthcare, National Relevance and High Specialization Hospital Trust ARNAS Civico, Di Cristina, Benfratelli, Palermo, Italy
| | - Annarita Giardina
- Department of Clinical Medicine, Internal Medicine Unit with Rheumatology, Dermatology, Diabetology and Tertiary Diabetic Foot Healthcare, National Relevance and High Specialization Hospital Trust ARNAS Civico, Di Cristina, Benfratelli, Palermo, Italy
| | - Ignazio Cangemi
- Department of Clinical Medicine, Internal Medicine Unit with Rheumatology, Dermatology, Diabetology and Tertiary Diabetic Foot Healthcare, National Relevance and High Specialization Hospital Trust ARNAS Civico, Di Cristina, Benfratelli, Palermo, Italy
| | - Salvatore Scibetta
- Department of Clinical Medicine, Internal Medicine Unit with Rheumatology, Dermatology, Diabetology and Tertiary Diabetic Foot Healthcare, National Relevance and High Specialization Hospital Trust ARNAS Civico, Di Cristina, Benfratelli, Palermo, Italy
| | - Christiano Argano
- Department of Clinical Medicine, Internal Medicine Unit with Rheumatology, Dermatology, Diabetology and Tertiary Diabetic Foot Healthcare, National Relevance and High Specialization Hospital Trust ARNAS Civico, Di Cristina, Benfratelli, Palermo, Italy
| | - Salvatore Corrao
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties [PROMISE], University of Palermo, Palermo, Italy
- Department of Clinical Medicine, Internal Medicine Unit with Rheumatology, Dermatology, Diabetology and Tertiary Diabetic Foot Healthcare, National Relevance and High Specialization Hospital Trust ARNAS Civico, Di Cristina, Benfratelli, Palermo, Italy
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Gallée J, Tilton-Bolowsky VE, Stark BC. The Communication Success Screener: A Preliminary Investigation of Perceived Communicative Success Across Modalities, Environments, and Demands. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:149-169. [PMID: 37956866 PMCID: PMC11000814 DOI: 10.1044/2023_jslhr-23-00171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 06/10/2023] [Accepted: 09/18/2023] [Indexed: 11/15/2023]
Abstract
PURPOSE Behavioral intervention targeting speech, language, and communication concerns is an established therapeutic approach for patients with communication concerns across a range of acquired neurogenic disorders. The multidimensional factors that contribute to a person's self-identified communication challenges and strengths in their daily communication needs must be considered to provide functional and person-centered care. While assessments grounded in clinician observation or client self-report exist, there is a direct need for a screening tool that comprehensively evaluates the roles of modality (verbal, text, gesture) and environment (in-person, virtual) on self-reported success across communicative demands. In this study, we describe a preliminary approach to monitoring the progression of receptive and expressive communication skills in people with chronic poststroke aphasia in the context of communication practices of the 21st century, culminating in the development and exploratory implementation of a novel clinical instrument: the Communication Success Screener (COMSS). METHOD Thirty-three participants with aphasia due to stroke were recruited to complete and evaluate the COMSS via an online survey. Quantitative responses and open-ended participant feedback were collected to validate and propose adaptations to the COMSS. Group-level analyses and case presentations were used to highlight COMSS features and outcomes. RESULTS Participant responses to the COMSS questionnaire suggest that this screening tool creates differentiated communicative success profiles based on self-report. Participant feedback also indicated that the COMSS appropriately evaluates self-reported success across modalities of verbal, text, and gesture in the context of in-person and virtual environments. CONCLUSIONS The communication concerns experienced by people with aphasia are often heterogeneous and vary as a function of their daily activities of living, preferred language modalities, and environmental supports. We present preliminary feasibility analyses of the COMSS as a potential tool to support the monitoring of functional change by evaluating self-reported communicative success across form, modality, environment, and task demand. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.24521044.
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Affiliation(s)
- Jeanne Gallée
- Department of Psychology, Institute for Learning and Brain Sciences, University of Washington, Seattle
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Charlestown, MA
| | | | - Brielle C. Stark
- Department of Speech, Language and Hearing Sciences, Indiana University, Bloomington
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Lira MDGDA, Whitney SL, Chaves TC, de Figueiredo-Ribeiro KMOB. Brazilian Version of the Vestibular Activities and Participation Measure: Cross-Cultural Adaptation, Validity, and Reliability. J Otolaryngol Head Neck Surg 2024; 53:19160216241250353. [PMID: 39109789 PMCID: PMC11307343 DOI: 10.1177/19160216241250353] [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: 02/20/2024] [Accepted: 03/31/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND Vestibular Activities and Participation Measure (VAP) subscales assess the effect of vestibular disorders on activity and participation. This study aimed to perform the cross-cultural adaptation and assess the validity, internal consistency, reliability, and measurement error of the Brazilian version of VAP subscales. METHODS The cross-cultural adaptation followed the translation, synthesis, back-translation, review by a committee of experts, and pretesting phases. Structural validity was assessed using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), while Spearman's correlation between VAP subscales and the Dizziness Handicap Inventory (DHI) was used to assess construct validity. Cronbach's alpha measured internal consistency. Intraclass correlation coefficient (ICC) assessed intra- and inter-rater reliability, and measurement error was calculated by using the standard error of measurement (SEM) and minimal detectable change (MDC). RESULTS Additional information was included in the Brazilian version of the Vestibular Activities and Participation measure (VAP-BR) after approval by one of the developers of the instrument to improve the understanding among individuals. One factor was found in the EFA for each subscale with 50% explained variance. Regarding CFA, the subscales 1 (S1) and 2 (S2) presented, respectively, adequate model fit indices (ie, comparative fit index of 0.99 and 0.97, and standardized root mean square residual of 0.04 for both subscales), but a very low factor load in item 6 of S1 (0.08). Chronbach's alpha was 0.80 (S1) and 0.82 (S2). For intra-rater assessment, the S1 and S2 presented an ICC of 0.87 and 0.90, SEM of 0.01 and 1.16, and MDC of 0.39 and 0.46, respectively. When assessed by 2 different raters, SEM values were 1.03 and 1.53, and MDC values were 2.85 and 4.23 for S1 and S2, respectively; both subscales showed an ICC of 0.92. Correlations between DHI and VAP subscales presented coefficients above 0.57. CONCLUSION The Brazilian version of VAP subscales presents good measurement properties and may assist health professionals in identifying activity limitations and participation restrictions in individuals with vestibular disorders.
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Affiliation(s)
| | - Susan L. Whitney
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA, USA
| | - Thais Cristina Chaves
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
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Kestens K, Keppler H, Ceuleers D, Lecointre S, De Langhe F, Degeest S. The effect of age on the hearing-related quality of life in normal-hearing adults. JOURNAL OF COMMUNICATION DISORDERS 2023; 106:106386. [PMID: 37918084 DOI: 10.1016/j.jcomdis.2023.106386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 10/17/2023] [Accepted: 10/20/2023] [Indexed: 11/04/2023]
Abstract
INTRODUCTION Recently, a new holistic Patient Reported Outcome Measure (PROM) to assess hearing-related quality of life was developed, named the hearing-related quality of life questionnaire for Auditory-VIsual, COgnitive and Psychosocial functioning (hAVICOP). The purpose of the current study was to evaluate if the hAVICOP is sufficiently sensitive to detect an age effect in the hearing-related quality of life. METHODS One-hundred thirteen normal-hearing participants (mean age: 42.13; range: 19 to 69 years) filled in the entire hAVICOP questionnaire online through the Research Electronic Data Capture surface. The hAVICOP consists of 27 statements, across three major subdomains (auditory-visual, cognitive, and psychosocial functioning), which have to be rated on a visual analogue scale ranging from 0 (rarely to never) to 100 (almost always). Mean scores were calculated for each subdomain separately as well as combined within a total score; the worse one's hearing-related quality of life, the lower the score. Linear regression models were run to predict the hAVICOP total as well as the three subdomain scores from age and sex. RESULTS A significant main effect of age was observed for the total hAVICOP and all three subdomain scores, indicating a decrease in hearing-related quality of life with increasing age. For none of the analyses, a significant sex effect was found. CONCLUSION The hAVICOP is sufficiently sensitive to detect an age effect in the hearing-related quality of life within a large group of normal-hearing adults, emphasizing its clinical utility. This age effect on the hearing-related quality of life might be related to the interplay of age-related changes in the bottom-up and top-down processes involved during speech processing.
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Affiliation(s)
- Katrien Kestens
- Department of Rehabilitation Sciences, Ghent University, Corneel Heymanslaan 10 (2P1), 9000 Ghent, Belgium.
| | - Hannah Keppler
- Department of Rehabilitation Sciences, Ghent University, Corneel Heymanslaan 10 (2P1), 9000 Ghent, Belgium; Department of Oto-rhino-laryngology, Ghent University Hospital, Corneel Heymanslaan 10 (2P1), 9000 Ghent, Belgium
| | - Dorien Ceuleers
- Department of Head and Skin, Ghent University, Corneel Heymanslaan 10 (2P1), 9000 Ghent, Belgium
| | - Stephanie Lecointre
- Department of Rehabilitation Sciences, Ghent University, Corneel Heymanslaan 10 (2P1), 9000 Ghent, Belgium
| | - Flore De Langhe
- Department of Rehabilitation Sciences, Ghent University, Corneel Heymanslaan 10 (2P1), 9000 Ghent, Belgium
| | - Sofie Degeest
- Department of Rehabilitation Sciences, Ghent University, Corneel Heymanslaan 10 (2P1), 9000 Ghent, Belgium
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Tiwari D, Naidoo K, Eddy EZ, Chatiwala N, Kaur M. Development and validation of the activities and participation children and adolescents -neck (APCAN) measure. J Patient Rep Outcomes 2023; 7:107. [PMID: 37902895 PMCID: PMC10616032 DOI: 10.1186/s41687-023-00648-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 10/19/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND Neck pain is the fourth leading cause of years lost to disability in children warranting a comprehensive assessment of neck pain and its impact on activities and participation. Hence, the purpose of this study was to develop a new measure (i.e., Activities and Participation Children and Adolescents -neck [APCAN]) specific to evaluating activity limitation and participation restrictions in children and adolescents and to establish its content validity. METHODS Development and content validation of the APCAN was completed in four steps: (1) item development, (2) item evaluation by content experts, (3) content validity calculation, and (4) cognitive testing via interviews to ensure readability and comprehension of the items on the APCAN. RESULTS An initial pool of 52 items was created that was revised to 20 items after modified Delphi process and cognitive interviews. Each item was rated on a 0-10 numeric rating scale (0 = not difficult at all, 10 = extremely difficult) with higher scores indicating higher perceived disability secondary to neck pain. All 20 items retained the content validity ratio critical value and the overall content validity index was 0.88 indicating excellent content validity. CONCLUSION The APCAN provides an easy to use, comprehensive assessment of functional limitations associated with neck pain in children.
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Affiliation(s)
- Devashish Tiwari
- Department of Physical Therapy, MGH Institute of Health Professions, 36, 1st Ave, 02129, Boston, MA, USA.
| | - Keshrie Naidoo
- Department of Physical Therapy, MGH Institute of Health Professions, 36, 1st Ave, 02129, Boston, MA, USA
| | - Emily Z Eddy
- Department of Physical Therapy, MGH Institute of Health Professions, 36, 1st Ave, 02129, Boston, MA, USA
| | - Naseem Chatiwala
- Department of Physical Therapy, MGH Institute of Health Professions, 36, 1st Ave, 02129, Boston, MA, USA
| | - Maninderjit Kaur
- Department of Physical Therapy, MGH Institute of Health Professions, 36, 1st Ave, 02129, Boston, MA, USA
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Begum F, Ara R, Islam A, Marriott S, Williams A, Anderson R. Health System Strengthening Through Professional Midwives in Bangladesh: Best Practices, Challenges, and Successes. GLOBAL HEALTH, SCIENCE AND PRACTICE 2023; 11:e2300081. [PMID: 37903587 PMCID: PMC10615233 DOI: 10.9745/ghsp-d-23-00081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 09/13/2023] [Indexed: 11/01/2023]
Abstract
In 2008, a cadre of professional midwives was introduced in Bangladesh. Since then, 120 midwifery educational programs have been established. There are 2,556 midwives serving at 667 government health facilities, and there are more midwives working in nongovernmental organizations and the private sector. This case study documents the process of establishing a midwifery profession with distinct midwifery expertise in Bangladesh and aims to guide other low- and middle-income countries in best practices and challenges. We describe the national administrative groundwork for the profession's launch, roll-out of an education program aligned with the International Confederation of Midwives, national deployment, enabling environments in deployment, and the professional association. Bangladesh's professional midwives' roles in humanitarian response and the COVID-19 pandemic are also discussed. The first and final authors were closely involved in supporting the government's establishment of the profession, and their direct experience is drawn upon to contextualize the topics. In addition, the authors conducted a desk review of documents that supported the profession's integration into the health system and documented its results. Both routine program data and existing research studies were reviewed. Outcomes show that midwives are deployed to 95% of government subdistrict hospitals. About 50% of these hospitals are fully staffed with 4 midwives, and within the hospitals, midwives are in charge of 90% of the maternity wards and attend 75%-85% of the births. Since the midwives' deployment, significant quality improvement for most World Health Organization indicators has been found, along with increases in service utilization. The experience of establishing a new midwifery profession in Bangladesh shows that it is possible for a lower middle-income country to introduce a globally standard midwifery profession, distinct from nursing, to improve quality sexual, reproductive, maternal, newborn, and adolescent health services in both humanitarian and development settings.
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Affiliation(s)
- Farida Begum
- United Nations Population Fund, Dhaka, Bangladesh
| | - Rowsan Ara
- United Nations Population Fund, Dhaka, Bangladesh
| | - Amirul Islam
- United Nations Population Fund, Dhaka, Bangladesh
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Sandberg A, Bäck M, Cider Å, Jivegård L, Sigvant B, Nordanstig J. Impact of walk advice alone or in combination with supervised or home-based structured exercise on patient-reported physical function and generic and disease-specific health related quality of life in patients with intermittent claudication, a secondary analysis in a randomized clinical trial. Health Qual Life Outcomes 2023; 21:114. [PMID: 37872617 PMCID: PMC10594797 DOI: 10.1186/s12955-023-02198-8] [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: 06/30/2023] [Accepted: 10/11/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Supervised exercise is an integral part of the recommended first-line treatment for patients with intermittent claudication (IC). By reflecting the patients' perspectives, patient-reported outcome measurements provide additional knowledge to the biomedical endpoints and are important outcomes to include when evaluating exercise interventions in patients with IC. We aimed to evaluate the one-year impact of three strategies: unsupervised Nordic pole walk advice (WA), WA + six months of home-based structured exercise (HSEP) or WA + six months of hospital-based supervised exercise (SEP) on health-related quality of life and patient-reported physical function in patients with IC. METHODS This secondary exploratory analysis of a multi-center, randomized clinical trial compared three exercise strategies. The primary outcome of the secondary analysis was the one-year change in the 36-Item Short-Form (SF-36). Secondary outcomes were three- and six-months SF-36 changes alongside three, six- and 12-months changes in the disease-specific Vascular Quality of Life instrument (VascuQoL) and the Patient-Specific Functional Scale (PSFS). The Kruskal-Wallis test with Bonferroni-adjusted post-hoc tests were used for between-group comparisons. Effect size calculations were used to describe the size of observed treatment effects, and the clinical meaningfulness of observed changes in the VascuQoL summary score at one year was studied using established minimally important difference (MID) thresholds. RESULTS A total of 166 patients with IC, mean age: 72.1 (SD 7.4) years, 41% women, were randomized. No significant between-group differences were observed over time for the SF-36 or the PSFS scores whereas some significant between-group differences were observed in the VascuQoL domain and summary scores over time, favoring SEP and/or HSEP over WA. The observed SF-36 and VascuQoL domain and summary score effect sizes were small to moderate, and many domain score effect sizes also remained unchanged over time. A significantly higher proportion of the patients in the SEP group reached the VascuQoL summary score MID of improvement in one year. CONCLUSION Clinically important improvements were observed in SEP using the VascuQoL, while we did not observe any significant between-group differences using the SF-36. Whereas effect sizes for the observed changes over time were generally small, a significantly higher proportion of patients in SEP reached the VascuQoL MID of improvement. TRIAL REGISTRATION NCT02341716, January 19, 2015 (retrospectively registered).
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Affiliation(s)
- Anna Sandberg
- Institute of Medicine, Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
- Department of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital, Vita Stråket 13, Gothenburg, 413 45, Sweden.
| | - Maria Bäck
- Institute of Medicine, Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital, Vita Stråket 13, Gothenburg, 413 45, Sweden
| | - Åsa Cider
- Department of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital, Vita Stråket 13, Gothenburg, 413 45, Sweden
- Department of Health and Rehabilitation/Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lennart Jivegård
- Institute of Medicine, Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Health Technology Assessment Centre Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Birgitta Sigvant
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden
- Central Hospital in Karlstad, Region Varmland, Karlstad, Sweden
| | - Joakim Nordanstig
- Institute of Medicine, Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Vascular Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden
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Jervan Ø, Haukeland-Parker S, Gleditsch J, Tavoly M, Klok FA, Steine K, Johannessen HH, Spruit MA, Atar D, Holst R, Astrup Dahm AE, Sirnes PA, Stavem K, Ghanima W. The Effects of Exercise Training in Patients With Persistent Dyspnea Following Pulmonary Embolism: A Randomized Controlled Trial. Chest 2023; 164:981-991. [PMID: 37149257 DOI: 10.1016/j.chest.2023.04.042] [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: 01/22/2023] [Revised: 04/25/2023] [Accepted: 04/25/2023] [Indexed: 05/08/2023] Open
Abstract
BACKGROUND Persistent dyspnea, functional limitations, and reduced quality of life (QoL) are common following pulmonary embolism (PE). Rehabilitation is a potential treatment option, but the scientific evidence is limited. RESEARCH QUESTION Does an exercise-based rehabilitation program improve exercise capacity in PE survivors with persistent dyspnea? STUDY DESIGN AND METHODS This randomized controlled trial was conducted at two hospitals. Patients with persistent dyspnea following PE diagnosed 6 to 72 months earlier, without cardiopulmonary comorbidities, were randomized 1:1 to either the rehabilitation or the control group. The rehabilitation program consisted of two weekly sessions of physical exercise for 8 weeks and one educational session. The control group received usual care. The primary end point was the difference in Incremental Shuttle Walk Test between groups at follow-up. Secondary end points included differences in the Endurance Shuttle Walk Test (ESWT), QoL (EQ-5D and Pulmonary Embolism-QoL questionnaires) and dyspnea (Shortness of Breath questionnaire). RESULTS A total of 211 subjects were included: 108 (51%) were randomized to the rehabilitation group and 103 (49%) to the control group. At follow-up, participants allocated to the rehabilitation group performed better on the ISWT compared with the control group (mean difference, 53.0 m; 95% CI, 17.7-88.3; P = .0035). The rehabilitation group reported better scores on the Pulmonary Embolism-QoL questionnaire (mean difference, -4%; 95% CI, -0.09 to 0.00; P = .041) at follow-up, but there were no differences in generic QoL, dyspnea scores, or the ESWT. No adverse events occurred during the intervention. INTERPRETATION In patients with persistent dyspnea following PE, those who underwent rehabilitation had better exercise capacity at follow-up than those who received usual care. Rehabilitation should be considered in patients with persistent dyspnea following PE. Further research is needed, however, to assess the optimal patient selection, timing, mode, and duration of rehabilitation. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov; No.: NCT03405480; URL: www. CLINICALTRIALS gov.
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Affiliation(s)
- Øyvind Jervan
- Department of Cardiology, Østfold Hospital, Kalnes, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Stacey Haukeland-Parker
- Department of Physical Medicine and Rehabilitation, Østfold Hospital, Kalnes, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Jostein Gleditsch
- Department of Radiology, Østfold Hospital, Kalnes, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Mazdak Tavoly
- Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Frederikus A Klok
- Department of Medicine, Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands
| | - Kjetil Steine
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Cardiology, Akershus University Hospital, Lørenskog, Norway
| | - Hege Hølmo Johannessen
- Department of Physical Medicine and Rehabilitation, Østfold Hospital, Kalnes, Norway; Department of Health and Welfare, Østfold University College, Fredrikstad, Norway
| | - Martijn A Spruit
- Department of Research and Development, Ciro, Horn, The Netherlands; Department of Respiratory Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands; NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Dan Atar
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Cardiology, Oslo University Hospital Ullevål, Oslo, Norway
| | - René Holst
- Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Anders Erik Astrup Dahm
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Hematology, Akershus University Hospital, Lørenskog, Norway
| | | | - Knut Stavem
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Pulmonary Medicine, Akershus University Hospital, Lørenskog, Norway; Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
| | - Waleed Ghanima
- Clinic of Internal Medicine, Østfold Hospital, Kalnes, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Hematology, Oslo University Hospital, Oslo, Norway
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van de Water L, Kuijper S, Henselmans I, van Alphen E, Kooij E, Calff M, Beerepoot L, Buijsen J, Eshuis W, Geijsen E, Havenith S, Heesakkers F, Mook S, Muller K, Post H, Rütten H, Slingerland M, van Voorthuizen T, van Laarhoven H, Smets E. Effect of a prediction tool and communication skills training on communication of treatment outcomes: a multicenter stepped wedge clinical trial (the SOURCE trial). EClinicalMedicine 2023; 64:102244. [PMID: 37781156 PMCID: PMC10539636 DOI: 10.1016/j.eclinm.2023.102244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 09/09/2023] [Accepted: 09/12/2023] [Indexed: 10/03/2023] Open
Abstract
Background For cancer patients to effectively engage in decision making, they require comprehensive and understandable information regarding treatment options and their associated outcomes. We developed an online prediction tool and supporting communication skills training to assist healthcare providers (HCPs) in this complex task. This study aims to assess the impact of this combined intervention (prediction tool and training) on the communication practices of HCPs when discussing treatment options. Methods We conducted a multicenter intervention trial using a pragmatic stepped wedge design (NCT04232735). Standardized Patient Assessments (simulated consultations) using cases of esophageal and gastric cancer patients, were performed before and after the combined intervention (March 2020 to July 2022). Audio recordings were analyzed using an observational coding scale, rating all utterances of treatment outcome information on the primary outcome-precision of provided outcome information-and on secondary outcomes-such as: personalization, tailoring and use of visualizations. Pre vs. post measurements were compared in order to assess the effect of the intervention. Findings 31 HCPs of 11 different centers in the Netherlands participated. The tool and training significantly affected the precision of the overall communicated treatment outcome information (p = 0.001, median difference 6.93, IQR (-0.32 to 12.44)). In the curative setting, survival information was significantly more precise after the intervention (p = 0.029). In the palliative setting, information about side effects was more precise (p < 0.001). Interpretation A prediction tool and communication skills training for HCPs improves the precision of treatment information on outcomes in simulated consultations. The next step is to examine the effect of such interventions on communication in clinical practice and on patient-reported outcomes. Funding Financial support for this study was provided entirely by a grant from the Dutch Cancer Society (UVA 2014-7000).
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Affiliation(s)
- L.F. van de Water
- Department of Medical Psychology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
- Department of Medical Oncology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
- Amsterdam Public Health, Quality of Care, Amsterdam, the Netherlands
- Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands
| | - S.C. Kuijper
- Department of Medical Oncology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
- Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands
| | - I. Henselmans
- Department of Medical Psychology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
- Amsterdam Public Health, Quality of Care, Amsterdam, the Netherlands
- Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands
| | - E.N. van Alphen
- Department of Medical Oncology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
- Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands
| | - E.S. Kooij
- Department of Medical Oncology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
- Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands
| | - M.M. Calff
- Department of Medical Psychology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
| | - L.V. Beerepoot
- Department of Medical Oncology, Elisabeth-TweeSteden Ziekenhuis, Tilburg, the Netherlands
| | - J. Buijsen
- Department of Radiation Oncology (MAASTRO), Maastricht University Medical Centre, GROW School for Oncology and Developmental Biology, Maastricht, the Netherlands
| | - W.J. Eshuis
- Department of Surgery, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
| | - E.D. Geijsen
- Department of Radiation Oncology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
| | - S.H.C. Havenith
- Department of Medical Oncology, Flevoziekenhuis, Almere, the Netherlands
| | - F.F.B.M. Heesakkers
- Department of Surgery, Department of Intensive Care Medicine, Catharina Ziekenhuis, Eindhoven, the Netherlands
| | - S. Mook
- Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - K. Muller
- Department of Radiation Oncology, Radiotherapiegroep, Deventer, the Netherlands
| | - H.C. Post
- Department of Medical Oncology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
| | - H. Rütten
- Department of Radiation Oncology, Radboud University Medical Centre, Nijmegen, Netherlands
| | - M. Slingerland
- Department of Medical Oncology, Leiden University Medical Center, Leiden, the Netherlands
| | | | - H.W.M. van Laarhoven
- Department of Medical Oncology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
- Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands
| | - E.M.A. Smets
- Department of Medical Psychology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
- Amsterdam Public Health, Quality of Care, Amsterdam, the Netherlands
- Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands
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Taimeh D, Ni Riordain R, Fedele S, Leeson R. The development and cognitive testing of a patient-reported experience measure for patients with chronic pain of temporomandibular disorders. J Oral Pathol Med 2023; 52:843-848. [PMID: 37406660 DOI: 10.1111/jop.13462] [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: 04/24/2023] [Revised: 06/20/2023] [Accepted: 06/22/2023] [Indexed: 07/07/2023]
Abstract
INTRODUCTION The importance of the patients' clinical experience has been reinforced several times over the last decade by healthcare organisations and policy makers. Routine gathering of experience data can help in enhancing patient-centred care and provide guidance to quality improvement schemes. Patient-reported experience measures can help to that end. The aim of this study was to develop a patient-reported experience measure to evaluate the experience of patients with temporomandibular disorders while receiving healthcare. METHODS Input from several sources was utilised to develop the tool; previous literature, patients with temporomandibular disorders, and experts in the field. A qualitative study was conducted following the COnsensus-based Standards for the selection of health Measurement Instruments guidance to generate the items of the questionnaire, which subsequently underwent cognitive testing. RESULTS Seventeen patients took part in the qualitative study, in addition to six healthcare professionals. The preliminary questionnaire consisted of 28 questions with six response options. CONCLUSIONS This patient-reported experience measure is a brief tool to evaluate the clinical experience of patients with temporomandibular disorders. Patients' involvement ensured face and content validity of the questionnaire, in addition to the relevance, comprehensibility and comprehensiveness of the items.
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Affiliation(s)
- Dina Taimeh
- Department of Maxillofacial Medicine and Surgery, UCL Eastman Dental Institute, University College London, London, UK
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontology, Faculty of Dentistry, University of Jordan, Amman, Jordan
| | - Richeal Ni Riordain
- Department of Maxillofacial Medicine and Surgery, UCL Eastman Dental Institute, University College London, London, UK
- Oral Medicine Unit, Cork University Dental School and Hospital, Cork, Ireland
| | - Stefano Fedele
- Department of Maxillofacial Medicine and Surgery, UCL Eastman Dental Institute, University College London, London, UK
- Oral Medicine Unit, Eastman Dental Hospital, University College London Hospitals Trust, London, UK
- NIHR University College London Hospitals Biomedical Research Centre, London, UK
| | - Rachel Leeson
- Department of Maxillofacial Medicine and Surgery, UCL Eastman Dental Institute, University College London, London, UK
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Taimeh D, Riordain RN, Fedele S, Leeson R. Healthcare priorities in patients with chronic facial pain of temporomandibular disorders. Oral Dis 2023; 29:2878-2887. [PMID: 36565449 DOI: 10.1111/odi.14483] [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: 11/01/2022] [Revised: 12/05/2022] [Accepted: 12/20/2022] [Indexed: 12/25/2022]
Abstract
OBJECTIVES To explore the experiences of patients with temporomandibular disorders (TMDs) with the National Health Service and to discover their healthcare priorities when seeking treatment. METHODS Semi-structured interviews were used. They were directed using a topic guide covering subjects such as initial visits in primary care, referrals to secondary care, and the effect on symptoms. The discussions were audiotaped and transcribed verbatim. Thematic analysis was utilised to analyse the data. RESULTS In total, 15 participants took part in three focus groups. Six themes were identified: "access to appropriate care", "organised and coordinated care", "receiving a diagnosis and enough information", "interaction with the clinical staff", "treatment strategies and having an 'action plan'" and "support and social networks". CONCLUSIONS The participants gave accounts of the difficulties encountered in healthcare in general terms and specific to TMD. Most notable was the struggle to access appropriate care, receive a diagnosis and be understood. Our findings suggest that delays in delivering appointments with people of expertise may have caused the worsening of symptoms. However, when a pleasant experience was encountered, access to care was fast, the clinician was understanding and communication with the clinical team was good. These provided positive experiences and were appreciated by the patients.
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Affiliation(s)
- Dina Taimeh
- Department of Maxillofacial Medicine and Surgery, UCL Eastman Dental Institute, University College London, London, UK
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontology, Faculty of Dentistry, University of Jordan, Amman, Jordan
| | - Richeal Ni Riordain
- Department of Maxillofacial Medicine and Surgery, UCL Eastman Dental Institute, University College London, London, UK
- Oral Medicine Unit, Cork University Dental School and Hospital, Cork, Ireland
| | - Stefano Fedele
- Department of Maxillofacial Medicine and Surgery, UCL Eastman Dental Institute, University College London, London, UK
- Oral Medicine Unit, Eastman Dental Hospital, University College London Hospitals Trust, London, UK
- NIHR University College London Hospitals Biomedical Research Centre, London, UK
| | - Rachel Leeson
- Department of Maxillofacial Medicine and Surgery, UCL Eastman Dental Institute, University College London, London, UK
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Langenberger B, Steinbeck V, Schöner L, Busse R, Pross C, Kuklinski D. Exploring treatment effect heterogeneity of a PROMs alert intervention in knee and hip arthroplasty patients: A causal forest application. Comput Biol Med 2023; 163:107118. [PMID: 37392619 DOI: 10.1016/j.compbiomed.2023.107118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/24/2023] [Accepted: 05/30/2023] [Indexed: 07/03/2023]
Abstract
Patient reported outcome measures (PROMs) experience an uptake in use for hip (HA) and knee arthroplasty (KA) patients. As they may be used for patient monitoring interventions, it remains unclear whether their use in HA/KA patients is effective, and which patient groups benefit the most. Nonetheless, knowledge about treatment effect heterogeneity is crucial for decision makers to target interventions towards specific subgroups that benefit to a greater extend. Therefore, we evaluate the treatment effect heterogeneity of a remote PROM monitoring intervention that includes ∼8000 HA/KA patients from a randomized controlled trial conducted in nine German hospitals. The study setting gave us the unique opportunity to apply a causal forest, a recently developed machine learning method, to explore treatment effect heterogeneity of the intervention. We found that among both HA and KA patients, the intervention was especially effective for patients that were female, >65 years of age, had a blood pressure disease, were not working, reported no backpain and were adherent. When transferring the study design into standard care, policy makers should make use of the knowledge obtained in this study and allocate the treatment towards subgroups for which the treatment is especially effective.
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Woudstra-de Jong JE, Manning-Charalampidou SS, Vingerling H, Busschbach JJ, Pesudovs K. Patient-reported outcomes in patients with vitreous floaters: A systematic literature review. Surv Ophthalmol 2023; 68:875-888. [PMID: 37315741 DOI: 10.1016/j.survophthal.2023.06.003] [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: 02/06/2023] [Revised: 06/06/2023] [Accepted: 06/06/2023] [Indexed: 06/16/2023]
Abstract
Seeking treatment for bothersome vitreous floaters is patient driven. To measure the impact of floaters and treatment on an individual's quality of life, patient-reported outcome measurements (PROMs) are essential. We review all studies using a PROM for patients with floaters. We evaluated content coverage against quality-of-life domains previously identified in other ophthalmic disorders, and against a qualitative study investigating quality-of-life issues in patients with floaters. We assessed measurement properties of PROMs using an extensive range of psychometric quality criteria. We identified 59 studies using 28 different PROMs. Many PROMs were not specifically developed for patients with floaters. Floater-specific PROMs were mostly based on content validation from an ophthalmologist or researcher perspective; two included a patient perspective. Using the outcomes of the qualitative study, we found that the floater-specific PROMs were narrow in their content coverage, with most items relating to visual symptoms and activity limitations. Testing the psychometric quality of PROMs was rare, and when employed mostly limited to responsiveness and known group validity. The remarkable high number of floater-specific PROMs reveals a need for such measurements in ophthalmology. Unfortunately, reporting on psychometric quality is limited, and content development is most often done without patient involvement.
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Affiliation(s)
- Jarinne E Woudstra-de Jong
- Rotterdam Ophthalmic Institute, Eye Hospital Rotterdam, Rotterdam, the Netherlands; Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus Medical Centre, Rotterdam, the Netherlands.
| | - Sonia S Manning-Charalampidou
- Rotterdam Ophthalmic Institute, Eye Hospital Rotterdam, Rotterdam, the Netherlands; Department of Vitreoretinal Surgery, Eye Hospital Rotterdam, Rotterdam, the Netherlands
| | - Hans Vingerling
- Department of Ophthalmology, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Jan J Busschbach
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Konrad Pesudovs
- School of Optometry and Vision Science, Medicine & Health, University of New South Wales, Sydney, New South Wales, Australia
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Soares Ferreira Junior A, Pinheiro Maux Lessa M, Kaplan S, Coles TM, Terrell DR, Onwuemene OA. Patient-Reported Outcome Measures in Patients with Thrombotic Thrombocytopenic Purpura: A Systematic Review of the Literature. J Clin Med 2023; 12:5155. [PMID: 37568558 PMCID: PMC10420299 DOI: 10.3390/jcm12155155] [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] [Received: 06/14/2023] [Revised: 07/31/2023] [Accepted: 08/01/2023] [Indexed: 08/13/2023] Open
Abstract
Health-related quality of life (HRQoL) impacts of thrombotic thrombocytopenic purpura (TTP) have been captured in clinical studies using patient-reported outcome (PRO) measures (PROMs) that are validated for other diseases. However, the validity evidence to support the use of existing PROMs in patients with TTP is unknown. In a systematic review of the literature, including studies of adults and children with TTP, we assessed the validity evidence for use of PROMs in clinical research and clinical practice, characterized HRQoL, described the integration of PROMs in clinical practice and evaluated PRO scores for patients with TTP compared with reference populations. From an initial 4518 studies, we identified 14 studies using 16 PROMs to assess general HRQoL domains in patients in remission. No identified studies assessed the validity of PROMs for the context of use of TTP and no studies described PROM integration into TTP clinical practice or evaluated PROMs that were specific for patients with TTP. Moreover, PRO scores were worse in patients with TTP compared with reference populations and other chronic conditions. We conclude that, in patients with TTP, PROMs pick up on important patient experiences not captured by clinical outcomes at present. There is, therefore, a need for studies that assess the validity of existing PROMs in patients with TTP to determine if TTP-specific PROMs specific to patients with TTP should be developed.
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Affiliation(s)
| | - Morgana Pinheiro Maux Lessa
- Department of Medicine, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto 15090-000, São Paulo, Brazil
| | - Samantha Kaplan
- Medical Center Library & Archives, Duke University Medical Center, Durham, NC 27710, USA;
| | - Theresa M. Coles
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC 27710, USA;
| | - Deirdra R. Terrell
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA;
| | - Oluwatoyosi A. Onwuemene
- Division of Hematology, Department of Medicine, Duke University School of Medicine, Durham, NC 27710, USA
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Delnoij DMJ, Derks M, Koolen L, Shekary S, Suitela J. Using Patient Blogs on Social Media to Assess the Content Validity of Patient-Reported Outcome Measures: Qualitative Analysis of Patient-Written Blogs. JMIR Form Res 2023; 7:e43210. [PMID: 37505797 PMCID: PMC10422175 DOI: 10.2196/43210] [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: 10/04/2022] [Revised: 05/02/2023] [Accepted: 06/14/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND Patient-reported outcome measures (PROMs) are questionnaires that measure patient outcomes related to quality of life, health, and functioning, and are increasingly used to assess important outcomes from the patient's perspective. For PROMs to contribute to better health and better care, it is vital that their content validity be adequate. This requires patient involvement in various steps of PROM development. PROM developers not only recognize the benefits of patient involvement but also report difficulties in recruiting patients and experience patient involvement as time-consuming, logistically challenging, and expensive. OBJECTIVE This study seeks to explore different strategies for disclosing the experiential knowledge of patients, namely through analyzing patient stories on the web and social media. The research questions are as follows: (1) how do bloggers living with a disease experience their health-related quality of life? (2) How are these experiences reflected in the domains and items of PROMs related to their disease? METHODS First, a qualitative analysis of blogs written by patients was performed. Second, subthemes and underlying codes resulting from this qualitative analysis were systematically compared with the domains and items in PROMs for the respective diseases that the bloggers write about. Blogs were identified via the Google search engine between December 2019 and May 2021. RESULTS Bloggers describe a wide range of experiences regarding their physical functioning and health; mental well-being; social network and support; daily life, education, work, and leisure; coping; and self-management. Bloggers also write about their positive and negative experiences with health care delivery, the organization of health care, and health care professionals. In general, patients' experiences as described in blogs were reflected in the domains and items of the PROMs related to their disease. However, except for diabetes mellitus, in all the sets of PROMs, potentially missing topics could be identified. Similarly, with the exception of Parkinson disease, all PROMs address issues that patients did not write about in their blogs and that might therefore be redundant. CONCLUSIONS Web-based patient stories in the form of blogs reveal how people living with a certain disease experience their health-related quality of life. These stories enable analyses of patients' experiences that can be used to assess the content validity of PROMs. This can be a useful step for researchers who are looking for sets of measuring instruments that match their purposes.
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Affiliation(s)
- Diana M J Delnoij
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, Netherlands
- National Health Care Institute (Zorginstituut Nederland), Diemen, Netherlands
| | - Meggie Derks
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Laura Koolen
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Shuka Shekary
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Jozua Suitela
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, Netherlands
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Baker A, Mitchell EJ, Partlett C, Thomas KS. Evaluating the effect of weekly patient-reported symptom monitoring on trial outcomes: results of the Eczema Monitoring Online randomized controlled trial. Br J Dermatol 2023; 189:180-187. [PMID: 37194567 DOI: 10.1093/bjd/ljad163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 05/10/2023] [Accepted: 05/13/2023] [Indexed: 05/18/2023]
Abstract
BACKGROUND Patient-reported outcome measures (PROMs) are commonly used in eczema clinical trials. Several trials have used PROMs weekly for symptom monitoring. However, the increased frequency of patient-reported symptom monitoring may prompt participants to enhance the self-management of eczema and increase standard topical treatment use that can lead to improvements in outcomes over time. This is concerning as weekly symptom monitoring may constitute an unplanned intervention, which may mask small treatment effects and make it difficult to identify changes in the eczema resulting from the treatment under investigation. OBJECTIVES To evaluate the effect of weekly patient-reported symptom monitoring on participants' outcomes and to inform the design of future eczema trials. METHODS This was an online parallel-group nonblinded randomized controlled trial. Parents/carers of children with eczema and young people and adults with eczema were recruited online, excluding people scoring < 3 points on the Patient Oriented Eczema Measure (POEM), to avoid floor effects. Electronic PROMs were used for data collection. Participants were allocated using online randomization (1 : 1) to weekly POEM for 7 weeks (intervention) or no POEM during this period (control). The primary outcome was change in eczema severity based on POEM scores, assessed at baseline and week 8. Secondary outcomes included change in standard topical treatment use and data completeness at follow-up. Analyses were conducted according to randomized groups in those with complete data at week 8. RESULTS A total of 296 participants were randomized from 14 September 2021 to 16 January 2022 (71% female, 77% white, mean age 26.7 years). The follow-up completion rate was 81.7% [n = 242; intervention group, n = 118/147 (80.3%); control group n = 124/149 (83.2%)]. After adjusting for baseline disease severity and age, eczema severity improved in the intervention group (mean difference in POEM score -1.64, 95% confidence interval -2.91 to -0.38; P = 0.01). No between-group differences were noted in the use of standard topical treatments and data completeness at follow-up. CONCLUSIONS Weekly patient-reported symptom monitoring led to a small perceived improvement in eczema severity.
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Affiliation(s)
- Arabella Baker
- Centre of Evidence Based Dermatology
- Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, UK
| | - Eleanor J Mitchell
- Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, UK
| | - Christopher Partlett
- Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, UK
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Demir Y, Sjöberg H, Stark A, Salomonsson B. Western Ontario Osteoarthritis of the Shoulder Index (WOOS) - a validation for use in proximal humerus fractures treated with arthroplasty. BMC Musculoskelet Disord 2023; 24:450. [PMID: 37268955 DOI: 10.1186/s12891-023-06578-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 05/29/2023] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND The Swedish shoulder and Arthroplasty Registry (SSAR) use the Western Ontario Osteoarthritis of the Shoulder Index (WOOS) as their shoulder-specific score in the follow-up. WOOS is not yet validated for use as the Patient Reported Outcome Measurement (PROM) for proximal humerus fractures (PHF) treated with shoulder hemiarthroplasty (SHA) in the Swedish registry. The aim of this study was to examine the validity, the reliability and the responsiveness of WOOS as a PROM for proximal humerus fractures treated with shoulder arthroplasty. METHODS Data was collected from the SSAR from the 1st of January 2008 to the 31st of June 2011. A total of 72 subjects were identified with at least 1 year of follow-up. Of these 43 completed all the shoulder-specific PROM together with a clinical examination, including a WOOS retest and general health scores. A group of 29 did not undergo any clinical examination, but they completed all the questionnaires not requiring a clinical examination. The validity was assessed with WOOS compared to satisfaction level, and the Spearman rank coefficient was used for the correlation between WOOS and the shoulder-specific scores (Constant-Murley Score, Oxford Shoulder Score, American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form and EQ-5D. For reliability, Intra Class Correlation (ICC) was used for the test-retest assessment and Cronbach´s alpha for the construct reliability. RESULTS The validity for WOOS had an excellent correlation (> 0.75) with all the shoulder-specific scores and a good correlation (> 0.6) with EQ-5D. The reliability with the test-retest of the total WOOS score and the subgroups had an excellent correlation. Cronbach´s alpha also supports the construct of WOOS. There were no floor or ceiling effects. CONCLUSIONS We found that WOOS is a reliable tool for evaluating patients with SHA after PHF. Based on our study, we recommend the continued use of WOOS in shoulder arthroplasty registries and observational studies.
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Santos VS, Downie A, Kamper SJ, Yamato TP. A new version of a measurement for presence and impact of pain in children and adolescents - Presence and impact of pain in Kids (PIP-KIDS) questionnaire: Translation, cross-cultural adaptation and measurement properties into Brazilian-Portuguese. Musculoskelet Sci Pract 2023; 65:102772. [PMID: 37182390 DOI: 10.1016/j.msksp.2023.102772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 04/24/2023] [Accepted: 05/01/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND Musculoskeletal pain in children and adolescents is prevalent and responsible for high levels of disability. Instruments to measure the presence and impact of pain in this population are needed. OBJECTIVE To translate, cross-culturally adapt, then test the measurement properties (structural validity, reliability and construct validity) of a questionnaire (Presence and Impact of Pain in Kids (PIP-Kids) questionnaire) to measure the presence and impact of pain in children and adolescents. DESIGN Measurement properties study. METHODS We conducted a measurement properties study. We translated and culturally adapted the PIP-Kids questionnaire into Brazilian Portuguese. The structural validity was measured by Confirmatory Factor Analysis. Reliability was measured by Kappa Coefficient. Measurement error was measured by the percentage of agreement. Construct validity was measured by Spearman Correlation. RESULTS/FINDINGS We included 656 children and adolescents from public and private schools. During the translation and cross-cultural adaptation no changes to wording were necessary. Structural validity confirmed two domains. Reliability by Kappa Coefficient ranges from 0.20 to 0.68. Measurement error by the percentage of agreement ranged from 60.2 to 92%. Construct validity was confirmed with 80.5% in accordance with prior hypotheses. CONCLUSION The PIP-Kids questionnaire translation and cross-cultural adaptation were adequate. The PIP-Kids questionnaire also has adequate structural validity with two dimensions (presence and impact), fair reliability, good agreement, and adequate construct validity.
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Affiliation(s)
- Veronica Souza Santos
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, Sao Paulo, Brazil
| | - Aron Downie
- Faculty of Medicine and Health, Sydney School of Public Health, Institute for Musculoskeletal Health, The University of Sydney, Sydney, New South Wales, Australia; Department of Chiropractic, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Steven J Kamper
- Center for Pain, Health, and Lifestyle (CPHL), Australia; School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; Nepean Blue Mountains Local Health District, NSW, Australia
| | - Tie P Yamato
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, Sao Paulo, Brazil; Center for Pain, Health, and Lifestyle (CPHL), Australia; School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; Nepean Blue Mountains Local Health District, NSW, Australia.
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Sundin Palmeira de Oliveira N, Rocha Dias da Silva M, Bedeschi Rego de Mattos C. Use of Pediatric Outcomes Data Collection Instrument to Evaluate Functional Outcomes in Multiple Hereditary Exostoses. J Pediatr Orthop 2023; 43:332-336. [PMID: 36806113 DOI: 10.1097/bpo.0000000000002372] [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] [Indexed: 02/23/2023]
Abstract
BACKGROUND The Pediatric Outcomes Data Collection Instrument (PODCI) is a validated quality-of-life questionnaire with 6 domains designed to provide a standardized method of measuring outcomes in pediatric musculoskeletal conditions. To our knowledge there are no reports on its use in children with multiple hereditary exostosis (MHE). QUESTIONS/PURPOSES Most published studies on MHE patients have described the efficacy of specific surgical techniques or the specification of deformities. Little is known about the general health status of pediatric patients, the severity of pain, loss of function, and how MHE influences the activities of daily life. We aim to assess the functional levels of MHE pediatric patients with PODCI questionnaire. PATIENTS AND METHODS As a cross-sectional study, we prospectively administered PODCI to 34 pediatric patients diagnosed with MHE and their families. The score distributions were compared with values published earlier for children and adolescents without musculoskeletal disorders using the Student and Welch t tests. Parents and adolescents' reports were compared using Wilcoxon signed rank test. Physical examination and PODCI score relation were evaluated by Spearman test. RESULTS Children with MHE have significantly lower scores ( P <0,05) in comparison with unaffected children in all domains using the Student and Welch t test. Parents score differs from children score with statistically relevance in pain and comfort domain ( P <0,5). The Spearman test showed a negative correlation between physical examination and PODCI score with statistical significance. CONCLUSIONS These results point towards PODCI's capacity in evaluating functional outcomes of pediatric patients with MHE. LEVEL OF EVIDENCE Diagnostic Study, Level III.
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Mutagaywa RK, Cramer MJ, Chillo P, Khamis RH, Boniface R, Muhozya A, Barongo A, Byomuganyizi M, Kwesigabo G, Kamuhabwa A, Nyangasa B, Kisenge P, Chamuleau S. Health related quality of life of patients following mechanical valve replacement surgery for rheumatic mitral stenosis in Tanzania. J Cardiothorac Surg 2023; 18:159. [PMID: 37085912 PMCID: PMC10122295 DOI: 10.1186/s13019-023-02235-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 04/02/2023] [Indexed: 04/23/2023] Open
Abstract
BACKGROUND The assessment of outcomes of interventions based on the patient's perspective using patient-reported outcome measures (PROMs) has been increasingly highlighted in clinical practice. However, health related quality of life (HRQoL), one of the common constructs measured by PROMs remain unknown among patients after heart valve replacement (HVR) in Tanzania. OBJECTIVES To assess the HRQoL amongst patients operated on for rheumatic mitral stenosis at Jakaya Kikwete Cardiac Institute (JKCI). METHODS A prospective study of patients operated on due to rheumatic mitral stenosis at JKCI from January 2020 to April 2021 was undertaken. The HRQoL was assessed by using the MacNew questionnaire, addressing three domains (physical, emotional, and social function); the score ranges from 0 to 7. We categorized HRQoL as low (mean score ≤ 4.9), moderate (5-6) and high (> 6). We analysed several sociodemographic and clinical variables for HRQoL. RESULTS Out of 54 patients, there were 34 females and 20 males. Their mean (± SD) age was 37.98 (± 12.58) years. The reliability of translated Kiswahili version of MacNew was good. The mean (± SD) global scores were 3.47 ± 0.59, 4.88 ± 0.71 and 6.14 ± 0.50 preoperatively, at 3 months and 6 months respectively (p-values < 0.001 preoperatively vs. 3 months, preoperatively vs. 6 months and at 3 months vs. 6 months). The median of individual mean difference HRQoL score pre-operatively and at 6 months was 2.67. The preoperative and 6 months mean difference HRQoL scores were higher among patients with vs. without atrial fibrillation (2.95 ± 0.59 vs. 2.45 ± 0.53, p = 0.003) and those on anticoagulants (preoperatively) vs. not on anticoagulants (3.14 ± 0.58 vs. 2.57 ± 0.57, 0.009). The mean difference HRQoL scores were similar for sociodemographic and other clinical parameters, including those with stroke vs. without stroke. CONCLUSION Six months after HVR the overall MacNew HRQoL scores improved markedly. This improvement in HRQoL was regardless of the presence of comorbidities (e.g. stroke and atrial fibrillation) which underscores the importance of considering valvular surgery if they fit the criteria. Clinicians and researchers in low-resource settings should collaborate to promote the utilization of PROMs in the routine care of patients.
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Affiliation(s)
- Reuben K Mutagaywa
- School of Medicine, Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, P.O. BOX 5539, Dar es Salaam, Tanzania.
- Muhimbili Orthopaedic Institute, Dar es Salaam, Tanzania.
- Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania.
- Division of Heart and Lung, Department of Cardiology, University Medical Centre Utrecht, Utrecht, Netherlands.
| | - Maarten J Cramer
- Division of Heart and Lung, Department of Cardiology, University Medical Centre Utrecht, Utrecht, Netherlands
| | - Pilly Chillo
- School of Medicine, Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, P.O. BOX 5539, Dar es Salaam, Tanzania
- Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Ramadhan H Khamis
- School of Medicine, Department of Surgery (Cardiothoracic& vascular section), Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | | | - Anjela Muhozya
- Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Aileen Barongo
- Department of Paediatrics, Mwananyamala Regional Referral Hospital, Dar es Salaam, Tanzania
| | - Moses Byomuganyizi
- School of Medicine, Department of Surgery (Cardiothoracic& vascular section), Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Gideon Kwesigabo
- School of Public Health, Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Appolinary Kamuhabwa
- School of Pharmacy, Department of Pharmacology and Clinical Pharmacy and Pharmacology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | | | - Peter Kisenge
- Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Steven Chamuleau
- Heart Center, Department of Cardiology and Amsterdam Cardiovascular Sciences, Amsterdam University Medical Centre, Amsterdam, Netherlands
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Schubach K, Niyonsenga T, Turner M, Paterson C. Experiences of sexual well-being interventions in males affected by genitourinary cancers and their partners: an integrative systematic review. Support Care Cancer 2023; 31:265. [PMID: 37058163 PMCID: PMC10104925 DOI: 10.1007/s00520-023-07712-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 03/28/2023] [Indexed: 04/15/2023]
Abstract
PURPOSE Sexual well-being has been identified as an unmet supportive care need among many individuals with genitourinary (GU) cancers. Little is known about the experiences of using sexual well-being interventions among men and their partners. METHODS This review was reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and followed a systematic review protocol. Data extraction and methodological quality appraisal were performed, and a narrative synthesis was conducted. RESULTS A total of 21 publications (reporting on 18 studies) were included: six randomised control trials, seven cross-sectional studies, three qualitative studies, and five mixed methods studies. Sexual well-being interventions comprised medical/pharmacological and psychological support, including counselling and group discussion facilitation. The interventions were delivered using various modes: face-to-face, web-based/online, or telephone. Several themes emerged and included broadly: (1) communication with patient/partner and healthcare professionals, (2) educational and informational needs, and (3) timing and/or delivery of the interventions. CONCLUSION Sexual well-being concerns for men and their partners were evident from diagnosis and into survivorship. Participants benefited from interventions but many articulated difficulties with initiating the topic due to embarrassment and limited access to interventions in cancer services. Noteworthy, all studies were only representative of men diagnosed with prostate cancer, underscoring a significant gap in other GU cancer patient groups where sexual dysfunction is a prominent consequence of treatment. IMPLICATIONS FOR CANCER SURVIVORS This systematic review provides valuable new insights to inform future models of sexual well-being recovery interventions for patients and partners with prostate cancer, but further research is urgently needed in other GU cancer populations.
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Affiliation(s)
- Kathryn Schubach
- Faculty of Health, University of Canberra, Bruce ACT, Australia.
- Rehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce ACT, Australia.
| | - Theo Niyonsenga
- Faculty of Health, University of Canberra, Bruce ACT, Australia
- Rehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce ACT, Australia
| | - Murray Turner
- Faculty of Health, University of Canberra, Bruce ACT, Australia
- Rehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce ACT, Australia
| | - Catherine Paterson
- Faculty of Health, University of Canberra, Bruce ACT, Australia
- Rehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce ACT, Australia
- Robert Gordon University, Aberdeen, Scotland, UK
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Rejchrt M, Krhut J, Gärtner M, Blok BFM, Zvara P. Effect duration of the initial course of peroneal electrical Transcutaneous NeuroModulation in patients with overactive bladder. World J Urol 2023:10.1007/s00345-023-04394-z. [PMID: 37027023 DOI: 10.1007/s00345-023-04394-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 03/28/2023] [Indexed: 04/08/2023] Open
Abstract
PURPOSE The aim of this prospective 12-month follow-up study is to evaluate the persistence of the treatment effect achieved during the initial course of peroneal electrical Transcutaneous NeuroModulation (peroneal eTNM®) in patients with overactive bladder (OAB). METHODS This study enrolled 21 female patients who participated in two previous clinical studies designed to assess the efficacy and safety of peroneal eTNM®. The patients were left without subsequent OAB treatment and were invited to attend regular follow-up visits every 3 months. The patient's request for additional treatment was considered an indicator of the withdrawal of the treatment effect of the initial course of peroneal eTNM®. The primary objective was the proportion of patients with persisting treatment effect at follow-up visit 12 months after initial course of peroneal eTNM®. Descriptive statistics are presented using median, correlation analyses were computed using a nonparametric Spearman correlation. RESULTS The proportion of patients with persistent therapeutic effect of the initial course of peroneal eTNM® was 76%, 76%, 62% and 48% at 3, 6, 9 and 12 months, respectively. There was a significant correlation between patient reported outcomes and the number of severe urgency episodes with or without urgency incontinence as reported by patients at each follow-up visit (p = 0.0017). CONCLUSION The treatment effect achieved during the initial phase of peroneal eTNM® persists for at least 12 months in 48% of patients. It is likely that the duration of effects is dependent on the length of the initial therapy.
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Affiliation(s)
- Michal Rejchrt
- Department of Urology, 2nd Faculty of Medicine of Charles University and Motol University Hospital, Prague, Czech Republic
- Urological Office, Poliklinika RAVAK, Příbram, Czech Republic
| | - Jan Krhut
- Department of Urology, University Hospital, Ostrava, Czech Republic.
- Department of Surgical Studies, Faculty of Medicine, Ostrava University, Ostrava, Czech Republic.
| | | | - Bertil F M Blok
- Department of Urology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Peter Zvara
- Biomedical Laboratory and Research Unit of Urology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Urology, Odense University Hospital, Odense, Denmark
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Al-Ebrahim SQ, Harrison J, Chen TF, Mohammed MA. Cross-cultural adaptation and psychometric properties of patient-reported outcome measures in Arabic speaking countries: A scoping review. Res Social Adm Pharm 2023; 19:989-1006. [PMID: 36941158 DOI: 10.1016/j.sapharm.2023.03.007] [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: 08/23/2022] [Revised: 02/22/2023] [Accepted: 03/07/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND Patient-reported outcome measures (PROMs) are increasingly recognized as an indicator of healthcare quality and safety. Over the past decades, there has been a growing interest in using PROMs in Arabic-speaking populations. However, there is a paucity of data regarding the quality of their cross-cultural adaptation (CCA) and measurement properties. OBJECTIVES To identify PROMs that have been developed, validated or cross-culturally adapted to Arabic and evaluate methodological qualities of CCA and measurement properties. METHODS MEDLINE, EMBASE, CINAHL, PsycINFO, IPA, and ISI Web of Science were searched using search terms 'PROMs', 'Arabic countries', 'CCA', and 'psychometric properties'. Measurement properties were evaluated using COSMIN quality criteria and CCA quality was assessed using the Oliveria rating method. RESULTS This review included 260 studies with 317 PROMs, focusing on psychometric testing (83.8%), CCA (75.8%), utilizing PROMs as outcome measures (13.4%), and developing PROMs (2.3%). Out of the 201 cross-culturally adapted PROMs, forward translation was the most frequently reported component of CCA (n = 178), followed by back translation (n = 174). Out of the 235 PROMs that reported measurement properties, internal consistency was the most frequently reported measurement property (n = 214), followed by reliability (n = 160) and hypotheses testing (n = 143). Other measurement properties were less reported, including responsiveness (n = 36), criterion validity (n = 22), measurement error (n = 12), and cross-cultural validity (n = 10). The strongest measurement property was hypotheses testing (n = 143), followed by reliability (n = 132). CONCLUSION There are several caveats regarding the quality of CCA and measurement properties of PROMs included in this review. Only 1 out of 317 Arabic PROMs met CCA and psychometric optimal quality criteria. Therefore, there is a need to improve the methodological quality of CCA and measurement properties of PROMs. This review provides valuable information for researchers and clinicians when choosing PROMs for practice and research. There were only 5 treatment-specific PROMs, indicating the necessity for more research focusing on development and CCA of such measures.
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Affiliation(s)
- Sundos Q Al-Ebrahim
- Pharmacy Department, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.
| | - Jeff Harrison
- Pharmacy Department, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.
| | - Timothy F Chen
- Faculty of Pharmacy, The University of Sydney, Sydney, Australia.
| | - Mohammed A Mohammed
- Pharmacy Department, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.
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Kubala JT, Pannill HL, Fasczewski KS, Rivera LA, Bouldin ED, Howard JS. Comparing the Primary Concerns of Injured Collegiate Athletes With the Content of Patient-Reported Outcome Measures. J Athl Train 2023; 58:252-260. [PMID: 35622954 PMCID: PMC10176840 DOI: 10.4085/1062-6050-0516.21] [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: 11/09/2022]
Abstract
CONTEXT Patient-reported outcome measures (PROMs) have been endorsed for providing patient-centered care. However, PROMs must represent their target populations. OBJECTIVE To identify the primary concerns of collegiate athletes experiencing injury and compare those with the content of established PROMs. DESIGN Cross-sectional study. SETTING Collegiate athletic training facilities. PATIENTS OR OTHER PARTICIPANTS Collegiate athletes experiencing injury (N = 149). MAIN OUTCOME MEASURE(S) Open-ended responses to the Measure Yourself Medical Outcome Profile were used to identify primary concerns, which were linked to International Classification of Functioning, Disability and Health taxonomy codes. Items of the Patient-Reported Outcomes Measurement Information System; modified Disablement of the Physically Active Scale; Lower Extremity Functional Scale; Knee injury and Osteoarthritis Outcome Score (KOOS); International Knee Documentation Committee Subjective Knee Form (IKDC); Foot and Ankle Ability Measure; Disabilities of the Arm, Shoulder, and Hand; Functional Arm Scale for Throwers; and Kerlan-Jobe Orthopaedic Clinic questionnaire were linked to International Classification of Functioning, Disability and Health codes. We calculated χ2 single-sample goodness-of-fit tests to determine if 70% of the content was shared between PROMs and participant-generated codes. RESULTS Participant-generated concerns were primarily related to sport participation (16%) and pain (23%). Chi-square tests showed that the Lower Extremity Functional Scale and Foot and Ankle Ability Measure presented significant content differences, with common participant-generated lower extremity responses at all levels. The Patient-Reported Outcomes Measurement Information System; modified Disablement of the Physically Active Scale; KOOS; IKDC; Disabilities of the Arm, Shoulder and Hand; Functional Arm Scale for Throwers; and Kerlan-Jobe Orthopaedic Clinic questionnaire did not have significant content differences for level 2 codes; still, significant differences were present for level 3 analyses except for the KOOS and IKDC (P < .001). All measures except the IKDC contained significant superfluous content (P < .05). CONCLUSIONS The presence of significant content differences supports clinician-perceived barriers regarding the relevance of established PROMs. However, the IKDC was a relevant and efficient PROM for evaluating the primary concerns of collegiate athletes experiencing lower extremity injury. Clinicians should consider using patient-generated measures to support coverage of patient-specific concerns in care.
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Affiliation(s)
| | - Heather L Pannill
- Rehabilitation Services, Appalachian Regional Healthcare System, Boone, NC
| | - Kimberly S Fasczewski
- Department of Public Health and Exercise Science, Appalachian State University, Boone, NC
| | - Laurie A Rivera
- Department of Rehabilitation Science, Appalachian State University, Boone, NC
| | - Erin D Bouldin
- Department of Internal Medicine, University of Utah, Salt Lake City
| | - Jennifer S Howard
- Department of Rehabilitation Science, Appalachian State University, Boone, NC
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Samuel V, Arora R, Virk P. Improving Reporting on Qualitative Methods Used in the Development and Validation of Patient-Reported Outcome Measures for Mental Health Concerns. J Psychosoc Nurs Ment Health Serv 2023; 61:40-44. [PMID: 36099482 DOI: 10.3928/02793695-20220902-02] [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: 11/20/2022]
Abstract
Qualitative methodologies are recommended in the development and evaluation of psychological instruments. However, reporting on qualitative methods in instrument development studies remains variable and often insufficient to support claims surrounding content validity. In the current article, we present a commentary discussing the critical role qualitative inquiry plays in the development of patient-reported outcome measures. We outline the current state of reporting in qualitative instrument development and evaluation studies with a focus on mental health literature and highlight the clinical relevance of this topic for health care professionals. Despite challenges, we express confidence in the potential value of substantively engaging with qualitative methods and comprehensive reporting and summarize recommendations to this effect based on the current literature. [Journal of Psychosocial Nursing and Mental Health Services, 61(3), 40-44.].
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Kornowski R. Patient-reported outcome measures in cardiovascular disease. EUROPEAN HEART JOURNAL. QUALITY OF CARE & CLINICAL OUTCOMES 2023; 9:119-127. [PMID: 34370009 DOI: 10.1093/ehjqcco/qcab051] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 08/03/2021] [Indexed: 12/13/2022]
Abstract
In today's medical ecosystem, it is vital to measure the outcomes that are most important to the patients. As such, patient-reported outcome measures (PROMS) can be an essential metric to deliver high-quality cardiovascular care, particularly in the subset of patients who remain disappointed with their outcomes. PROMS should be a reproducible and reflective report of what is fundamental to a patient over time and across treatments with proper standards in the analysis, interpretation, and reporting of the collected data. These reports can also be sensitive to changes, whether improvements or deteriorations in the quality of care and medical attitude, but a lack of standardization makes it difficult to draw robust conclusions and compare findings across treatments. As a research tool, PROMS can have a significant prognostic prominence, offering a powerful instrument of comparison between different treatment modalities. With the information technology (IT) abilities of today, we can leverage mobile tools and powerful computer systems to perform sophisticated data analysis using patient-derived data and randomization. This may eliminate guesswork and generate impactful metrics to better inform the decision-making process. PROMS analysed by proper standardized algorithms can avoid physician bias and be integrated into the hospital teamwork. Therefore, there is a strong need for integration of PROMS into the evaluation of cardiovascular interventions and procedures, and establishment of international standards in the analyses of patient-reported outcomes and quality of life data to address this need and develop therapeutic recommendations.
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Affiliation(s)
- Ran Kornowski
- Rabin Medical Center, Belinson & Hasharon Hospitals, Petach Tikva & The Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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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: 4] [Impact Index Per Article: 4.0] [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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Le Corroller AG, Bonastre J. Patient-reported measures: how useful in health economics? THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2023; 24:1-4. [PMID: 36346476 DOI: 10.1007/s10198-022-01524-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/02/2022] [Indexed: 06/16/2023]
Affiliation(s)
| | - Julia Bonastre
- Bureau Biostatistique et Epidémiologie, Gustave Roussy, Université Paris-Saclay, Villejuif, France.
- Oncostat CESP, INSERM 1018, UVSQ, Labeled Ligue Contre Le Cancer, Université Paris-Saclay, Villejuif, France.
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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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Newlands AF, Roberts L, Maxwell K, Kramer M, Price JL, Finlay KA. The Recurrent Urinary Tract Infection Symptom Scale: Development and validation of a patient‐reported outcome measure. BJUI COMPASS 2023; 4:285-297. [PMID: 37025478 PMCID: PMC10071086 DOI: 10.1002/bco2.222] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 12/24/2022] [Accepted: 12/30/2022] [Indexed: 01/18/2023] Open
Abstract
Objectives This study aimed to develop and validate a tailored patient-reported outcome measure (PROM) evaluating the patient experience of recurrent urinary tract infection (rUTI) symptom severity. This measure was designed to supplement clinical testing methods, allowing full assessment of the patient experience of rUTI symptom burden, while enhancing patient-centred UTI management and monitoring. Subjects and Methods The Recurrent Urinary Tract Infection Symptom Scale (RUTISS) was developed and validated using a three-stage methodology, in accordance with gold-standard recommendations. Firstly, a two-round Delphi study was conducted to gain insights from 15 international expert clinicians working in rUTI, developing an initial pool of novel questionnaire items, assessing content validity and making item refinements. Next, two phases of one-to-one semi-structured cognitive interviews were conducted with a diverse sample of 28 people experiencing rUTI to assess questionnaire comprehensiveness and comprehensibility, making refinements after each phase. Finally, a comprehensive pilot of the RUTISS was conducted with 240 people experiencing rUTI across 24 countries, providing data for psychometric testing and item reduction. Results Exploratory factor analysis indicated a four-factor structure comprising: 'urinary pain and discomfort', 'urinary urgency', 'bodily sensations' and 'urinary presentation', together accounting for 75.4% of the total variance in data. Qualitative feedback from expert clinicians and patients indicated strong content validity for items, which was supported by high content validity indices in the Delphi study (I-CVI > 0.75). Internal consistency and test-retest reliability of the RUTISS subscales were excellent (Cronbach's α = 0.87-0.94 and ICC = 0.73-0.82, respectively), and construct validity was strong (Spearman's ρ = 0.60-0.82). Conclusion The RUTISS is a 28-item questionnaire with excellent reliability and validity, which dynamically assesses patient-reported rUTI symptoms and pain. This new PROM offers a unique opportunity to critically inform and strategically enhance the quality of rUTI management, patient-clinician interactions, and shared-decision making by monitoring key patient-reported outcomes.
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Affiliation(s)
- Abigail F. Newlands
- School of Psychology and Clinical Language Sciences University of Reading Reading UK
| | | | - Kayleigh Maxwell
- Department of Psychology, Faculty of Natural Sciences University of Stirling Stirling UK
| | | | | | - Katherine A. Finlay
- School of Psychology and Clinical Language Sciences University of Reading Reading UK
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Ceuleers D, Baudonck N, Keppler H, Kestens K, Dhooge I, Degeest S. Development of the hearing-related quality of life questionnaire for auditory-visual, cognitive and psychosocial functioning (hAVICOP). JOURNAL OF COMMUNICATION DISORDERS 2023; 101:106291. [PMID: 36508852 DOI: 10.1016/j.jcomdis.2022.106291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 11/18/2022] [Accepted: 11/27/2022] [Indexed: 06/17/2023]
Abstract
INTRODUCTION There is a need for a validated and standardized self-assessment instrument to assess the subjective effect of hearing aid (HA) use and/or cochlear implantation (CI) on different aspects of functioning in daily life. The aim of this study was to develop a new holistic Patient Reported Outcome Measure (PROM) to assess hearing-related quality of life. The new PROM is titled the hearing-related quality of life questionnaire for Auditory-VIsual, COgnitive and Psychosocial functioning (hAVICOP). METHODS A conceptual framework was set up and test items were prepared per domain. Preliminary testing involved a semi-structured interview-based assessment in normal-hearing and hearing-impaired adults and an expert panel. For the further psychometric evaluation, a new sample of 15 adult HA users, 20 adult CI users and 20 normal-hearing adults filled in the refined version of the hAVICOP, the Speech, Spatial and Qualities of Hearing Scale, the Nijmegen Cochlear Implant Questionnaire and the TNO-AZL Questionnaire for Adult's Health-Related Quality of Life. Based on these results, a factor analysis was conducted and internal consistency, discriminant validity and concurrent construct validity were determined. RESULTS The final version of the hAVICOP consists of three domains for hearing-related quality of life: (1) auditory-visual functioning, (2) cognitive functioning, and (3) psychosocial functioning. A sufficient internal consistency was found, and discriminant validity and concurrent construct validity were good. CONCLUSIONS A new PROM to assess hearing-related quality of life was developed, named the hAVICOP. In the future the validity and reliability should be examined further.
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Affiliation(s)
- Dorien Ceuleers
- Department of Head and Skin, Ghent University, Ghent, Belgium.
| | - Nele Baudonck
- Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium
| | - Hannah Keppler
- Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium; Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Katrien Kestens
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Ingeborg Dhooge
- Department of Head and Skin, Ghent University, Ghent, Belgium; Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium
| | - Sofie Degeest
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
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Combining reconstructive and ablative surgical treatment of chronic breast cancer-related lymphedema (BCRL): safe and effective. Breast Cancer Res Treat 2023; 197:83-92. [PMID: 36287309 PMCID: PMC9823021 DOI: 10.1007/s10549-022-06778-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 10/13/2022] [Indexed: 01/11/2023]
Abstract
PURPOSE We investigated whether a one-stage combination of vascularized lymph node transfer (VLNT) with water jet-assisted liposuction (WAL) can be safely performed and results in improved patient outcomes such as a greater reduction in arm volume when treating chronic breast cancer-related lymphedema (BCRL). METHODS In this retrospective cohort study, we included all patients from our encrypted lymphedema database treated for chronic BCRL with VLNT or VLNT + WAL who had a minimum follow-up of two years. We analyzed patient-specific variables including arm circumferences as well as patient-reported outcomes before and after surgery as well as surgery time, surgery-related complications and patient satisfaction. RESULTS Only the mean preoperative differences of the circumferences between the lymphedematous and the unaffected arm in individual patients showed a statistically significant difference between treatment groups (p < 0.05). Indeed, patients treated with VLNT + WAL had consistently larger differences in individual sets of arms and therefore more pronounced chronic BCRL. The mean surgery time was significantly longer in the VLNT + WAL group (p < 0.05). Complications were seldom and similar in both groups. Using a numeric rating scale, the level of patient satisfaction following treatment did not differ significantly between groups (p = 0.323). CONCLUSIONS Our findings suggest that a one-stage combination of VLNT with WAL does not result in more complications even though it also entails a longer surgery time. This is acceptable as secondary interventions resulting in overall longer surgery times and higher costs can be avoided. A one-stage combination might be especially favourable for patients suffering from more severe chronic BCRL.
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