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van der Knaap-Kind LS, Ombashi S, Van Roey V, Kragt L, Peterson P, Jabbari F, Wolvius EB, Versnel SL. Evaluation and recommendations of the oral health, oral function, and orofacial aesthetics-related measures of the ICHOM Standard Set for Cleft Lip and Palate. Int J Oral Maxillofac Surg 2024; 53:563-570. [PMID: 38228465 DOI: 10.1016/j.ijom.2024.01.001] [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: 05/26/2023] [Revised: 12/18/2023] [Accepted: 01/02/2024] [Indexed: 01/18/2024]
Abstract
This study was performed to evaluate the efficacy of outcome measures for the orofacial domain included in the International Consortium for Health Outcomes Measurement Standard Set for Cleft Lip and Palate (ICHOM-SCS). In this multicentre study involving two cleft centres, suggestions to optimize the type and timing of outcome measures were made based on data and clinical experience. Patient-reported outcome measures (PROMs) (CLEFT-Q Jaw, Teeth, Eating/Drinking; Child Oral Health Impact Profile-Oral Symptoms Scale (COHIP-OSS)) and clinical outcome measures (caries experience and dental occlusion) data were collected retrospectively for age 5, 8, 10, 12, 19, and 22 years. The data were categorized by cleft type and analysed within and between age groups using Spearman correlation, the distribution of responses per item, a two-sample test for equality of proportions, and effect plots. Most correlations between PROMs and clinical outcome measures were weak (r < 0.5), suggesting PROMs and clinical outcome measures complement each other. The COHIP-OSS and CLEFT-Q Eating/Drinking barely detected problems in any patient category and are no longer recommended. A suitable alternative appears complex to find; outcomes of this study and the recent literature doubt an added value. Similar problems were found in the CLEFT-Q Jaw at time-point 12 years. Therefore, time-points 15 and 17 years are currently suggested.
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Affiliation(s)
- L S van der Knaap-Kind
- Department of Oral and Maxillofacial Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands.
| | - S Ombashi
- Department of Plastic and Reconstructive Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands; European Reference Network for Rare and/or Complex Craniofacial Anomalies and Ear, Nose And Throat Disorders, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - V Van Roey
- Department of Plastic and Reconstructive Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands; European Reference Network for Rare and/or Complex Craniofacial Anomalies and Ear, Nose And Throat Disorders, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - L Kragt
- Department of Oral and Maxillofacial Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - P Peterson
- Department of Reconstructive Plastic Surgery, Stockholm Craniofacial Team, Karolinska University Hospital, Stockholm, Sweden
| | - F Jabbari
- Department of Dental Medicine, Orthodontics and Paediatric Dentistry, Stockholm Craniofacial Team, Karolinska University Hospital, Stockholm, Sweden
| | - E B Wolvius
- Department of Oral and Maxillofacial Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands; European Reference Network for Rare and/or Complex Craniofacial Anomalies and Ear, Nose And Throat Disorders, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - S L Versnel
- Department of Plastic and Reconstructive Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands; European Reference Network for Rare and/or Complex Craniofacial Anomalies and Ear, Nose And Throat Disorders, Erasmus University Medical Center, Rotterdam, the Netherlands
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Kandasamy S, Rowe T, Kwan MYW. Community-academic partnerships catalyze and sustain impact in research activities: A commentary. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2024:10.17269/s41997-024-00894-6. [PMID: 38896195 DOI: 10.17269/s41997-024-00894-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 04/29/2024] [Indexed: 06/21/2024]
Abstract
This commentary explores the position that community-academic partnerships (CAPs) can guide collaborative, equitable, and innovative research activities, enhancing knowledge mobilization and overall research impact. We use an example within behavioural sciences (with the broader goal of improving physical literacy development and physical activity for newcomer children and youth) to apply key practices that build bidirectional and trustworthy relationships between researchers, practitioners, and policy-makers, ultimately leading to equity-centered outputs. We report on our experiences both narratively and in video format by interweaving the perspectives of diverse and multi-sectoral team members and describing efforts to continue to engage and drive the momentum of research network activities.
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Affiliation(s)
- Sujane Kandasamy
- INfant, Child & Youth Health (INCH) Lab, Department of Child & Youth Studies, Brock University, St. Catharines, ON, Canada
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Taylor Rowe
- INfant, Child & Youth Health (INCH) Lab, Department of Child & Youth Studies, Brock University, St. Catharines, ON, Canada
| | - Matthew Y W Kwan
- INfant, Child & Youth Health (INCH) Lab, Department of Child & Youth Studies, Brock University, St. Catharines, ON, Canada.
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada.
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Lee EL, Harrison J, Barnes J. Exploring the Use of Traditional Medicines, Natural Health Products and Conventional Medicines: Development and Testing of the New Zealand 'All-Medicines' Questionnaire. Drugs Real World Outcomes 2024; 11:13-32. [PMID: 37936052 DOI: 10.1007/s40801-023-00389-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2023] [Indexed: 11/09/2023] Open
Abstract
INTRODUCTION Traditional, complementary and alternative medicine (TCAM) are popular healthcare choices among consumers globally. The latest national data on the use of TCAM practitioners in New Zealand (NZ) were collected over a decade ago. Robust data on the use of natural health products (NHPs) and TCAM practices alongside conventional medicines are not yet available in NZ. OBJECTIVES This study aimed to develop and test a bespoke questionnaire (All-MedsNZ) that included comprehensive data collection elements exploring NHPs' and conventional medicines' use. METHODS This was a questionnaire design study involving expert panel feedback, and engagement with TCAM users, in the development process. This work comprised questionnaire development (stage 1) followed by a questionnaire-testing study (stage 2). The questionnaire was developed on the basis of literature review findings and the research team's expertise. The questionnaire content was then validated by an expert panel comprising practitioners in TCAM and conventional medicine. Then, a two-phase study was utilised to test the questionnaire. Phase 1 involved participants (NHP users) completing the web-based questionnaire and providing feedback by answering probing questions added throughout the questionnaire to evaluate users' comprehension of the questions and to identify issues with the questionnaire. In phase 2, selected participants were interviewed online to gain in-depth insights into issues identified in phase one. Based on these findings, the questionnaire was revised. RESULTS The expert panel (n = 9) confirmed the questionnaire had high face and content validity; most original questions were retained. In the questionnaire-testing study, 95 and 27 participants completed the phase 1 and 2 studies, respectively. Most questions achieved a high response rate of ≥ 90%, and participants had no major issues understanding and answering the questionnaire. Problematic questions were those relating to providing product barcodes and photographs, and information on product costs. Most of the NHPs data entered by participants included the brand/generic name, manufacturer/company name, main ingredient(s) and dose form. Generally, these NHP-related data were of acceptable quality. However, information on the main ingredient(s) of products entered by participants was less satisfactory: approximately one-third of the 143 NHPs recorded in the study had the main ingredient(s) missing or incorrectly stated. Interviews with participants reiterated the issues identified in the phase 1 study. The low response rates for some of the questions were partly due to participants' unpreparedness (i.e. not having NHPs/medicines on hand) to complete the questionnaire. In addition, a lack of clarity for the term 'natural health practitioner' led to confusion among some participants. CONCLUSION Overall, no major design-, method- or questionnaire-related issues were identified in this development and testing work. The questionnaire demonstrated adequate face and content validity and acceptability among participants. The data collected were reasonably complete and of sufficient quality for analysis. Future studies should pilot the revised All-MedsNZ questionnaire with a larger, nationally representative sample to ascertain its feasibility and utility.
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Affiliation(s)
- E Lyn Lee
- School of Pharmacy, University of Auckland, 85 Park Rd, Grafton, Auckland, 1023, New Zealand
| | - Jeff Harrison
- School of Pharmacy, University of Auckland, 85 Park Rd, Grafton, Auckland, 1023, New Zealand
| | - Joanne Barnes
- School of Pharmacy, University of Auckland, 85 Park Rd, Grafton, Auckland, 1023, New Zealand.
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Hassanein MM, Huri HZ, Baig K, Abduelkarem AR, Al-Momani M. Development and validation of the genitourinary syndrome of menopause symptoms and vaginal treatments acceptability questionnaire (GSM-SVTAQ): An electronic patient-reported outcomes measure. Int J Gynaecol Obstet 2024; 164:613-623. [PMID: 37702968 DOI: 10.1002/ijgo.15106] [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: 07/01/2023] [Revised: 08/12/2023] [Accepted: 08/22/2023] [Indexed: 09/14/2023]
Abstract
OBJECTIVES To develop and validate an electronic, patient-reported outcomes measure (PROM) specific for genitourinary syndrome of menopause (GSM) patients. The PROM aimed to accurately assess the burden of GSM symptoms, their impact on health-related and sexual quality of life, and the acceptability of vaginal treatments. METHODS The study encompassed a comprehensive three-stage approach to the development and validation of the PROM. Initially, during the preliminary design stage, the necessity for a new PROM was recognized, an expert panel was formed, and semi-structured qualitative interviews were carried out with GSM patients. In the second stage, the study used the five-step pre-validation methodology established by Prior et al. to generate and refine the PROM items. The third and final stage encompassed the determination of scale and item content validity indexes to ensure validity. Additionally, the reliability of each construct was evaluated using Cronbach's α. RESULTS The resulting PROM was named GSM-SVTAQ (GSM-symptoms and vaginal treatments acceptability questionnaire). It demonstrated excellent validity in assessing symptoms burden, health-related and sexual quality of life, and vaginal treatment acceptability, with high content validity indices and strong internal consistency. The scale content validity indices and Cronbach's α coefficients for the three domains were (0.926, 0.939), (0.875, 0.947), and (0.824, 0.855), respectively. CONCLUSION The GSM-SVTAQ stands as the first GSM-specific, valid, and reliable PROM capable of comprehensively measuring the three components of GSM and the acceptability of vaginal treatments. Its implementation has the potential to significantly enhance patient care and outcomes in GSM management.
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Affiliation(s)
- Mohammed M Hassanein
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Hasniza Zaman Huri
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Kauser Baig
- Department of Obstetrics and Gynecology, University Hospital Sharjah, Sharjah, United Arab Emirates
| | - Abduelmula R Abduelkarem
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
| | - Marwan Al-Momani
- Department of Mathematics, College of Science, University of Sharjah, Sharjah, United Arab Emirates
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Alamrani S, Gardner A, Falla D, Russell E, Rushton AB, Heneghan NR. Outcome measures for young people with adolescent idiopathic scoliosis: A qualitative exploration of healthcare professionals' perceptions and practices. PLoS One 2024; 19:e0297339. [PMID: 38277344 PMCID: PMC10817127 DOI: 10.1371/journal.pone.0297339] [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: 09/07/2023] [Accepted: 01/03/2024] [Indexed: 01/28/2024] Open
Abstract
BACKGROUND Limited knowledge exists on current use of patient reported outcome measures (PROMs) and performance measures for adolescents with idiopathic scoliosis (AIS), as well as health care professionals' (HCPs) perceived barriers and facilitators towards their use. This study's objectives were: 1) to explore current practice of HCPs when assessing outcomes for AIS 2) to understand perceived barriers and facilitators of HCPs to use PROMs 3) to understand perceived barriers and facilitators of HCPs to use performance measures. METHODS A qualitative study recruited a purposive sample of HCPs from a tertiary hospital in the United Kingdom. Mean years of experience managing individuals with AIS was 11.8 years; and included surgeons, physiotherapists and nurses, educated at Bachelor, Masters and Doctoral level. Consent to participate and demographic information were collected in advance of the interviews. In-depth, virtual semi-structured interviews were informed by a topic guide based on current evidence. Interviews of approximately 45 minutes were audio and video recorded and transcribed verbatim alongside written field notes. Data were coded and analysed using inductive thematic analysis, involving researchers with topic and methodological expertise and input from a patient representative. RESULTS Two themes emerged regarding current practice of using PROMs routine practice and personal evaluations. Four themes emerged as barriers to using PROMs for individuals with AIS: priority and support (e.g., HCPs focus on providing care), practical challenges (e.g., inadequate PROMs), patient-related challenges (e.g., patient preferences) and knowledge, education, and perceived value. Two themes emerged as facilitators: quality existing measure (e.g., sufficient psychometric properties), and priority and support (e.g., research department/culture). Themes for barriers to use performance measures were practicality (e.g., need physical space) and perceived value and knowledge (e.g., PROMs are more important), while the one theme for facilitators was practical consideration (e.g., acceptability). CONCLUSIONS Although HCPs perceived the value of using outcome measures, current practice indicates limited use for individuals with AIS. The findings revealed different barriers and facilitators to implement PROMs in practice. Adopting performance measure are limited due to lack of knowledge and perceived value alongside the practicality, while considering practical factors can improve the use of these measures in practice.
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Affiliation(s)
- Samia Alamrani
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
- Physical Therapy Department, College of Applied Medical Science, University of Tabuk, Tabuk, Saudi Arabia
| | - Adrian Gardner
- Spine Unit, The Royal Orthopaedic Hospital NHS Foundation Trust, Northfield, Birmingham, United Kingdom
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Emily Russell
- Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Alison B. Rushton
- School of Physical Therapy, Western University, London, Ontario, Canada
| | - Nicola R. Heneghan
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
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Stano F, Pellicciari L, La Porta F, Piscitelli D, Angilecchia D, Signorelli M, Giovannico G, Pournajaf S, Caselli S. Rasch analysis of the forgotten joint score in patients with total hip arthroplasty. J Rehabil Med 2024; 56:jrm15774. [PMID: 38197243 PMCID: PMC10795689 DOI: 10.2340/jrm.v56.15774] [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: 07/06/2023] [Accepted: 11/14/2023] [Indexed: 01/11/2024] Open
Abstract
OBJECTIVE To assess the internal construct validity, including local independence, unidimensionality, monotonicity, and invariance, reliability, and targeting of the Forgotten Joint Score within the Rasch Measurement Theory framework. DESIGN Cross-sectional study. PATIENTS A total of 111 patients with total hip arthroplasty at least 3 months after surgery. METHODS The Forgotten Joint Score was submitted to each subject during their rehabilitative treatment in an Italian centre and then to Rasch analysis. RESULTS The base Rasch analysis showed a satisfactory fit to the model with strict unidimensionality and no differential item functioning. However, monotonicity (11 out of 12 items showed disordered thresholds) and local independence were violated. After rescoring 10 items and creating 5 subtests to account for local dependence, the scale satisfied all the other Rasch model requirements (i.e. invariance, local independence, monotonicity, unidimensionality, and multi-group invariance), with reliability indexes (> 0.850) for measurement at the individual level and proper targeting. A raw-score-to-measure conversion table was provided. CONCLUSION After structural (i.e. collapsing items categories) and non-structural (i.e. creating subtests) strategies, the Forgotten Joint Score satisfied the measurement requirements of the Rasch model, and it can be used in patients with total hip arthroplasty in clinical and research settings.
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Affiliation(s)
- Flavia Stano
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | | | - Fabio La Porta
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | | | - Domenico Angilecchia
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy; Rehabilitation service - ASL, Bari, Italy
| | | | - Giuseppe Giovannico
- Department of Medicine and Health Scienze "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | - Sanaz Pournajaf
- Neurorehabilitation Research Lab, Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele, Rome, Italy
| | - Serena Caselli
- Unità Operativa Complessa di Medicina Riabilitativa, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
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Hanssen I, Ten Klooster P, Huijbers M, Lochmann van Bennekom M, Boere E, El Filali E, Geerling B, Goossens P, Kupka R, Speckens A, Regeer E. Development and validation of a Manic Thought Inventory. Bipolar Disord 2023; 25:564-570. [PMID: 36840434 DOI: 10.1111/bdi.13311] [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: 02/26/2023]
Abstract
OBJECTIVE This article describes the development and psychometric evaluation of the Manic Thought Inventory (MTI), a patient-driven self-report inventory to assess the presence of typical (hypo)manic cognitions. METHODS The initial item pool was generated by patients with bipolar disorder (BD) type I and assessed for suitability by five psychiatrists specialized in treating BD. Study 1 describes the item analysis and exploratory factor structure of the MTI in a sample of 251 patients with BD type I. In study 2, the factor structure was validated with confirmatory factor analysis, and convergent and divergent validity were assessed in an independent sample of 201 patients with BD type I. RESULTS Study 1 resulted in a 50-item version of the MTI measuring one underlying factor. Study 2 confirmed the essentially unidimensional underlying construct in a 47-item version of the MTI. Internal consistency of the 47-item version of the MTI was excellent (α = 0.97). The MTI showed moderate to large positive correlations with other measures related to mania. It was not correlated with measures of depression. CONCLUSION The MTI showed good psychometric properties and can be useful in research and clinical practice. Patients could use the MTI to select items that they recognize as being characteristic of their (hypo)manic episodes. By monitoring and challenging these items, the MTI could augment current psychological interventions for BD.
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Affiliation(s)
- Imke Hanssen
- Department of Psychiatry, Center for Mindfulness, Radboud University Medical Center, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition, and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Peter Ten Klooster
- Faculty of Behavioural, Management, and Social Sciences, University of Twente, Enschede, The Netherlands
| | - Marloes Huijbers
- Department of Psychiatry, Center for Mindfulness, Radboud University Medical Center, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition, and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Marc Lochmann van Bennekom
- Donders Institute for Brain, Cognition, and Behaviour, Radboud University, Nijmegen, The Netherlands
- Pro Persona Mental Health Care, Outpatient clinic for Bipolar Disorders, Nijmegen, The Netherlands
| | - Elvira Boere
- PsyQ Department of Mood Disorders, Rotterdam, The Netherlands
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Bart Geerling
- Faculty of Behavioural, Management, and Social Sciences, University of Twente, Enschede, The Netherlands
- Dimence Mental Health, Center for Bipolar Disorders, Deventer, The Netherlands
| | - Peter Goossens
- Dimence Mental Health, Center for Bipolar Disorders, Deventer, The Netherlands
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, University Centre for Nursing and Midwifery, Ghent, Belgium
| | - Ralph Kupka
- Faculty of Behavioural, Management, and Social Sciences, University of Twente, Enschede, The Netherlands
- Department of Psychiatry, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, The Netherlands
| | - Anne Speckens
- Department of Psychiatry, Center for Mindfulness, Radboud University Medical Center, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition, and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Eline Regeer
- Altrecht Institute for Mental Health Care, Outpatient clinic for Bipolar Disorders, Utrecht, The Netherlands
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Morel T, Schroeder K, Cleanthous S, Andrejack J, Blavat G, Brooks W, Gosden L, Siu C, Ratcliffe N, Slagle AF. The value of co-creating a clinical outcome assessment strategy for clinical trial research: process and lessons learnt. RESEARCH INVOLVEMENT AND ENGAGEMENT 2023; 9:98. [PMID: 37876009 PMCID: PMC10598985 DOI: 10.1186/s40900-023-00505-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 10/02/2023] [Indexed: 10/26/2023]
Abstract
BACKGROUND In support of UCB pharmaceutical research programs, the aim of this research was to implement a novel process for patient involvement in a multidisciplinary research group to co-create a clinical outcome assessment strategy to accurately reflect the experience of people living with early-stage Parkinson's. Patient experts were an integral part of the decision-making process for patient-reported outcome (PRO) research and instrument development. METHODS In partnership with two patient organizations (Parkinson's UK and the Parkinson's Foundation), 6 patient experts were recruited into a multidisciplinary research group alongside clinical, patient engagement and involvement, regulatory science, and outcome measurement experts. The group was involved across two phases of research; the first phase identified what symptoms are cardinal to the experience of living with early-stage Parkinson's and the second phase involved the development of PRO instruments to better assess the symptoms that are important to people living with early-stage Parkinson's. Patient experts were important in performing a variety of roles, in particular, qualitative study protocol design, conceptual model development, and subsequent co-creation of two PRO instruments. RESULTS Involving people with Parkinson's in PRO research ensured that the expertise of these representatives from the Parkinson's community shaped and drove the research; as such, PRO instruments were being developed with the patient at the forefront. Working with patient experts required considerable resource and time allocation for planning, communication, document development, and organizing meetings; however, their input enriched the development of PRO instruments and was vital in developing PRO instruments that are more meaningful for people with Parkinson's and clinicians. CONCLUSIONS Conducting PRO research, in the context of clinical development involving pharmaceutical companies, requires balancing regulatory and scientific rigor with tight time constraints. Incorporating a multi-stakeholder perspective, which included patient experts as joint investigators, had a strong positive impact on our research, despite the logistical complexities of their involvement. Due to the input of patient experts, the innovative clinical outcome assessment strategy and the co-created novel PRO instruments were more relevant and holistic to the patient experience of early-stage Parkinson's.
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Affiliation(s)
- Thomas Morel
- Patient-Centred Outcomes Research, UCB Pharma, Allée de La Recherche 60, 1070, Anderlecht, Brussels, Belgium.
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Ward A, Jensen AM, Ottesen AC, Thoft DS. Observations on strategies used by people with dementia to manage being assessed using validated measures: A pilot qualitative video analysis. Health Expect 2023; 26:931-939. [PMID: 36722316 PMCID: PMC10010081 DOI: 10.1111/hex.13719] [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: 01/31/2022] [Revised: 12/20/2022] [Accepted: 01/17/2023] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Analysis of video data was conducted of validated assessments with people with dementia as part of a feasibility control study comparing a lifelong learning service with other dementia services. OBJECTIVE The aim was to provide a new perspective on what occurs during the assessment process when using validated measures in research and explore which strategies people with dementia use to manage their participation. DESIGN Video recordings were made of pre- and postintervention assessments of people with dementia. An initial pilot analysis of 10 videos of the pre-assessments was conducted. SETTING Lifelong learning services and other dementia services situated in six municipalities in Northern Denmark took part in this study, with 55 people with dementia participating. RESULTS The themes identified were: 'State of mind' and 'Mental resources', showing how these aspects influenced the participants' reactions and the strategies they used. DISCUSSION The results are discussed in relation to how individual personality traits influence the assessment process and the way a person with dementia will manage the situation. CONCLUSION The assessment situation is complex and can be influenced by the strategies adopted by individuals with dementia as they try to manage the assessment process. PATIENT OR PUBLIC CONTRIBUTION People with dementia supported the decision-making for the choice of validated measure used within this study.
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Affiliation(s)
- Alison Ward
- Faculty of Health, Education and Society, University of Northampton, Northampton, UK
| | - Anne M Jensen
- Act2learn Health and Social and Neuropedagogic, University College Northern Denmark, Aalborg, Denmark
| | - Anna Camilla Ottesen
- Applied Sciences, Department of Nursing, University College Northern Denmark, Aalborg, Denmark
| | - Diana S Thoft
- Research Centre of Health and Applied Technology, Research and Development, University College Northern Denmark, Aalborg, Denmark
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Moloney J, Regan J, Walshe M. Patient Reported Outcome Measures in Dysphagia Research Following Stroke: A Scoping Review and Qualitative Analysis. Dysphagia 2023; 38:181-190. [PMID: 35467246 PMCID: PMC9873730 DOI: 10.1007/s00455-022-10448-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 03/28/2022] [Indexed: 01/28/2023]
Abstract
Patient reported outcome measures (PROMs) are commonly used to evaluate the impact of a health condition on quality of life (QOL). This study aimed to identify the range of PROMs that are currently in common use in clinical trials in dysphagia following stroke and to qualitatively analyse these PROMs by mapping the content to both the International Classification of Functioning and Disability Framework (ICF) and the Core Outcome Measures in Effectiveness Trials (COMET) Taxonomy for outcome classification. With consideration for the PRISMA-ScR checklist, a scoping review was conducted to identify commonly used PROMs in randomised controlled trials reported in persons with dysphagia stroke. A search of five databases was conducted. Studies were excluded if they included pediatric participants i.e. < 18 years of age, or if the text was not available in the English language. 110 papers met the inclusionary criteria. Twelve of these 110 papers included a dysphagia PROM. Two PROMs were identified as being in common use-the SWAL-QOL and the EAT-10. These two tools consisted of 47 items and 78 meaningful concepts, which were subsequently mapped to the ICF and the COMET Taxonomy. Mapping to the ICF showed that neither tool directly assessed the impact of 'Environmental Factors' on the experience of dysphagia. Mapping to the COMET Taxonomy showed that neither tool considered the impact of 'Role Functioning' on the person's experience of dysphagia. The development of a suitable and appropriate patient-reported assessment tool for use in those with dysphagia following stroke is warranted.
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Affiliation(s)
- Jennifer Moloney
- Department of Clinical Speech and Language Studies, Trinity College Dublin, 7-9 South Leinster Street, Dublin 2, Ireland
| | - Julie Regan
- Department of Clinical Speech and Language Studies, Trinity College Dublin, 7-9 South Leinster Street, Dublin 2, Ireland
| | - Margaret Walshe
- Department of Clinical Speech and Language Studies, Trinity College Dublin, 7-9 South Leinster Street, Dublin 2, Ireland.
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Sipma WS, de Jong MFC, Meuleman Y, Hemmelder MH, Ahaus KCTB. Facing the challenges of PROM implementation in Dutch dialysis care: Patients' and professionals' perspectives. PLoS One 2023; 18:e0285822. [PMID: 37186606 PMCID: PMC10184911 DOI: 10.1371/journal.pone.0285822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 05/02/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Patient Reported Outcome Measures (PROMs) are increasingly used in routine clinical practice to facilitate patients in sharing and discussing health-related topics with their clinician. This study focuses on the implementation experiences of healthcare professionals and patients during the early implementation phase of the newly developed Dutch set of dialysis PROMs and aims to understand the process of early implementation of PROMs from the users' perspectives. METHODS This is a qualitative study among healthcare professionals (physicians and nursing staff: n = 13) and patients (n = 14) of which 12 were receiving haemodialysis and 2 peritoneal dialysis. Semi-structured interviews were used to understand the barriers and facilitators that both professionals and patients encounter when starting to implement PROMs. RESULTS The early PROM implementation process is influenced by a variety of factors that we divided into barriers and facilitators. We identified four barriers: patient´s indifference to PROMs, scepticism on the benefits of aggregated PROM data, the limited treatment options open to doctors and organizational issues such as mergers, organizational problems and renovations. We also describe four facilitators: professional involvement and patient support, a growing understanding of the use of PROMs during the implementation, quick gains from using PROMs such as receiving instant feedback and a clear ambition on patient care such as a shared view on patient involvement and management support. CONCLUSIONS In this qualitative study carried out during the early implementation phase of the Dutch dialysis PROM set, we found that patients did not yet consider the PROM set to be a useful additional tool to share information with their doctor. This was despite the professionals' primary reason for using PROMs being to improve patient-doctor communication. Furthermore, the perceived lack of intervention options was frustrating for some of the professionals. We found that nurses could be important enablers of further implementation because of their intensive relationship with dialysis patients.
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Affiliation(s)
- Wim S Sipma
- Department of Health Services Management & Organisation, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Margriet F C de Jong
- Department of Nephrology, University Medical Centre Groningen, Groningen, The Netherlands
| | - Yvette Meuleman
- Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Marc H Hemmelder
- Department of Internal Medicine, Division of Nephrology, Maastricht University Medical Centre, Maastricht, The Netherlands
- CARIM school for cardiovascular research, University of Maastricht, Maastricht, The Netherlands
| | - Kees C T B Ahaus
- Department of Health Services Management & Organisation, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
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Zhu N, Hawke LD, Prebeg M, Hayes E, Darnay K, Iyer SN, Henderson J. Intervention outcome preferences for youth who are out of work and out of school: a qualitative study. BMC Psychol 2022; 10:180. [PMID: 35870971 PMCID: PMC9308195 DOI: 10.1186/s40359-022-00887-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 07/12/2022] [Indexed: 11/21/2022] Open
Abstract
Background While interventions have been developed and tested to help youth who have become disconnected from work and school, there is a paucity of research on young people’s intervention preferences. This study aims to understand young people’s preferred intervention outcomes and approaches for youth who are out of work and school. Methods Thirty youth participated in virtual focus groups. Transcripts were analyzed using thematic analysis. Results Youth want interventions and approaches that support them in (1) vocational readiness, (2) securing a job, and (3) mental health and well-being, while providing them with (4) high-contact, individualized, and integrated support. Conclusions Young people want interventions to be individualized and integrated, providing a high level of support for their educational and employment pursuits as well as their mental health and well-being. Incorporating youth's perspectives when designing interventions can increase intervention relevance and potentially service uptake, helping youth continue to pursue their educational and vocational goals.
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Sheldon EM, Lillington G, Simpson K, Gibson K, Chambers L, D'Afflitto M, Greig N, Stearn T, Hind D, Ainley R, Winsor G, Ridsdale K, Totton N, Lobo A. Development of an inflammatory bowel disease (IBD) Patient-Reported Experience Measure (PREM): A patient-led consensus work and 'think aloud' study for a quality improvement programme. Health Expect 2022; 26:213-225. [PMID: 36335578 PMCID: PMC9854292 DOI: 10.1111/hex.13647] [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: 05/26/2022] [Revised: 10/19/2022] [Accepted: 10/20/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Patient-Reported Experience Measures (PREMs) are key in improving healthcare quality, but no PREM exists for inflammatory bowel disease (IBD). This study aimed to co-produce a PREM with IBD service users for IBD service evaluation and quality improvement programme. METHODS A pool of 75 items was drawn from published survey instruments covering interactions with services and aspects of living with IBD. In Stage 1, during two workshops, eight expert service users reduced candidate items through a ranked-choice voting exercise and suggested further items. During Stage 2, 18 previously uninvolved people with IBD assessed the face and content validity of the candidate items in 'Think Aloud' interviews. During two final workshops (Stage 3), the expert service users removed, modified and added items based on the interview findings to produce a final version of the PREM. RESULTS Stage 1 generated a draft working PREM mapped to the following four domains: Patient-Centred Care; Quality; Accessibility; Communication and Involvement. The PREM included a set of nine items created by the expert group which shifted the emphasis from 'self-management' to 'living with IBD'. Stage 2 interviews showed that comprehension of the PREM was very good, although there were concerns about the wording, IBD-relevance and ambiguity of some items. During the final two workshops in Stage 3, the expert service users removed 7 items, modified 15 items and added seven new ones based on the interview findings, resulting in a 38-item PREM. CONCLUSIONS This study demonstrates how extensive service user involvement can inform PREM development. PATIENT OR PUBLIC CONTRIBUTION Patients were involved as active members of the research team and as research participants to co-produce and validate a PREM for IBD services. In Stage 1, eight expert service users ('the expert group') reduced candidate items for the PREM through a voting exercise and suggested new items. During Stage 2, 18 previously uninvolved people with IBD (the 'think aloud' participants) assessed the validity of the candidate items in 'Think Aloud' interviews as research participants. In Stage 3, the expert group removed, changed and added items based on the interview findings to produce a final version of the 38-item PREM. This study shows how service user involvement can meaningfully inform PREM development.
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Affiliation(s)
- Elena M. Sheldon
- Sheffield Health and Related ResearchThe University of SheffieldSheffieldUK
| | - George Lillington
- Sheffield Health and Related ResearchThe University of SheffieldSheffieldUK
| | - Kati Simpson
- Sheffield Health and Related ResearchThe University of SheffieldSheffieldUK
| | - Kirsty Gibson
- Sheffield Health and Related ResearchThe University of SheffieldSheffieldUK
| | - Lucy Chambers
- Sheffield Health and Related ResearchThe University of SheffieldSheffieldUK
| | | | - Nancy Greig
- Sheffield Health and Related ResearchThe University of SheffieldSheffieldUK
| | - Theresa Stearn
- Sheffield Health and Related ResearchThe University of SheffieldSheffieldUK
| | - Daniel Hind
- Sheffield Health and Related ResearchThe University of SheffieldSheffieldUK
| | | | | | - Katie Ridsdale
- Sheffield Health and Related ResearchThe University of SheffieldSheffieldUK
| | - Nikki Totton
- Sheffield Health and Related ResearchThe University of SheffieldSheffieldUK
| | - Alan Lobo
- Gastroenterology and Liver Unit, Royal Hallamshire HospitalSheffield Teaching Hospitals NHS Foundation TrustSheffieldUK
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Walter N, Loew T, Alt V, Rupp M. Effect of functional relaxation on the quality of life in patients with periprosthetic joint infection: Protocol for a randomised controlled trial. BMJ Open 2022; 12:e066066. [PMID: 36253042 PMCID: PMC9577919 DOI: 10.1136/bmjopen-2022-066066] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 10/07/2022] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Periprosthetic joint infection (PJI) is a devastating complication in orthopaedic and trauma surgery, which puts a high burden on the patients involving recurrent hospitalisation, prolonged courses of antibiotic medication, severe pain and long periods of immobility as well as high levels of psychological distress. Thus, this multicentre study aims at implementing body-oriented psychotherapy in clinical practice and evaluating its therapeutic effect on the quality of life. METHODS AND ANALYSIS A prospective, parallel two-armed randomised controlled trial with approximately n=270 patients with verified PJI treated surgically with a one-staged exchange, or a two-staged exchange will be conducted. Functional relaxation (FR) therapy will be implemented as a group therapy. FR originally belongs to the psychodynamically based body-oriented psychotherapy. Intervention techniques consist of minute movements of small joints, which are performed during relaxed expiration accompanied by an exploration of differences of body feelings. A group will include 3-8 patients, led by a specialist physiotherapist certified in FR once a week. The participants are consecutively admitted to the class and participate in 12 sessions. The control group will consist of patients receiving an unspecific 'placebo relaxation' intervention for the same duration. The primary efficacy endpoint is the mental component summary and physical component summary of quality of life assessed by the 36-Item Short Form Health Survey (SF-36) after 6 months. Secondary outcomes include SF-36 scores after 12 months, consumption of pain medication, mobility measured by the Parker mobility score and the physical activity measured by daily steps with an accelerometer (actibelt). ETHICS AND DISSEMINATION Approval from the Ethical Committee of the University Hospital Regensburg was received (file number: 21-2226-101). Written, informed consent to participate will be obtained from all participants. Results will be made available in the form of peer-reviewed publications and presentation in congresses. TRIAL REGISTRATION NUMBER DRKS00028881; German Clinical Trials Register.
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Affiliation(s)
- Nike Walter
- Department of Psychosomatic Medicine, University Hospital Regensburg, Regensburg, Germany
| | - Thomas Loew
- Department of Psychosomatic Medicine, University Hospital Regensburg, Regensburg, Germany
| | - Volker Alt
- Department of Trauma Surgery, Universitätsklinikum Regensburg, Regensburg, Germany
| | - Markus Rupp
- Department of Trauma Surgery, University Medical Center Regensburg, Regensburg, Germany
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The importance of children and young person involvement in scoping the need for a paediatric glucocorticoid-associated patient reported outcome measure. BMC Rheumatol 2022; 6:80. [PMID: 36243873 PMCID: PMC9568975 DOI: 10.1186/s41927-022-00312-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 10/05/2022] [Indexed: 11/30/2022] Open
Abstract
Background For many children and young people (CYP) with paediatric rheumatic conditions, glucocorticoid medications and their associated side-effects have a substantial impact on disease experience. Whilst there are physician-rated measures of glucocorticoid toxicity, no parallel patient reported measure has been developed to date for CYP with rheumatic disease. This manuscript describes a series of public patient involvement (PPI) events to inform the development of a future paediatric glucocorticoid-associated patient reported outcome measure (PROM). Methods One large group PPI event was advertised to CYP with experience of glucocorticoid medication use and their parents through clinicians, charities and existing PPI groups. This featured education on the team’s research into glucocorticoid medication and interactive polls/structured discussion to help participants share their experiences. Further engagement was sought for PPI group work to co-develop future glucocorticoid studies, including development of a glucocorticoid associated PROM. Quantitative and qualitative feedback was collected from online questionnaires. The initiative was held virtually due to the Covid-19 pandemic. Results Nine families (n = 15) including 6 CYP joined the large group PPI event. Online pre-attendance and post-attendance questionnaires showed improvement in mean self-reported confidence [1 = not at all confident, 5 = very confident] in the following: what steroid medications are (pre = 3.9, post = 4.8), steroid side effects (pre = 3.8, post = 4.6), patient-reported outcome measures (pre = 2.0, post = 4.5), available research on steroids (pre = 2.2, post = 3.5). Five families (n = 7) were involved in a monthly PPI group who worked alongside the research team to identify priorities in glucocorticoid research, produce age-appropriate study materials, identify barriers to study participation (e.g. accessibility & convenience) and recommend appropriate modalities for dissemination. The participants found discussing shared experiences and learning about research to be the most enjoyable aspects of the initiative. Conclusions This PPI initiative provided a valuable forum for families, including young children, to share their perspectives. Here, the authors explore the effective use of PPI in a virtual setting and provide a unique case study for the involvement of CYP in PROM development. The monthly PPI group also identified a need for the development of a new PROM related to glucocorticoid medication use and provided unique insights into how such a study could be structured. Supplementary Information The online version contains supplementary material available at 10.1186/s41927-022-00312-9.
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Haywood KL, Southern C, Tutton E, Swindell P, Ellard D, Pearson NA, Parsons H, Couper K, Daintyi KN, Agarwal S, Perkins GD. An international collaborative study to co-produce a patient-reported outcome measure of cardiac arrest survivorship and health-related quality of life (CASHQoL): A protocol for developing the long-form measure. Resusc Plus 2022; 11:100288. [PMID: 36059385 PMCID: PMC9437904 DOI: 10.1016/j.resplu.2022.100288] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/21/2022] [Accepted: 08/01/2022] [Indexed: 11/18/2022] Open
Abstract
Background Current measures of health-related quality of life are neither sufficiently sensitive or specific to capture the complex and heterogenous nature of the recovery and survivorship associated with cardiac arrest. To address this critical practice gap, we plan a mixed-methods study to co-produce and evaluate a new cardiac arrest-specific patient/survivor-reported outcome measure (PROM). Methods International guidelines have informed a two-stage, iterative, and interactive process. Stage one will establish what is important to measure following cardiac arrest. A meta-ethnography of published qualitative research and a qualitative exploration of the experiences of survivors and their key supporters will inform the development of a measurement framework. This will be supplemented by existing, extensive reviews describing concepts that have previously been measured in this population. Focus groups with survivors, key supporters, and healthcare professionals, followed by further interviews with survivors and key supporters, will inform the iterative refinement of the framework, candidate items, and PROM structure. Stage two will involve a psychometric evaluation following completion by a large cohort of survivors. Measurement theory will inform: the identification of items that best measure important outcomes; item reduction; and provide robust evidence of measurement and practical properties. Discussion An international, collaborative approach to PROM development will engage survivors, key supporters, researchers, and health professionals from study commencement. Successful co-production of the cardiac arrest survivorship and health-related quality of life (CASHQoL) measure will provide a robust, relevant, and internationally applicable measure, suitable for completion by adult survivors, and integration into research, registries, and routine care settings. Ethical approval: University of Warwick Biomedical & Scientific Research Ethics Committee (BSREC 22/20-21 granted 10/11/20).
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Affiliation(s)
- Kirstie L. Haywood
- Warwick Research in Nursing, Warwick Medical School, University of Warwick, Gibbet Hill, Coventry CV4 7AL, United Kingdom
- Corresponding author.
| | - Charlotte Southern
- Doctoral Student. Warwick Research in Nursing, Warwick Medical School, University of Warwick, Gibbet Hill, Coventry CV4 7AL, United Kingdom
| | - Elizabeth Tutton
- Kadoorie, Oxford Trauma and Emergency Care, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, and Oxford University Hospitals NHS Foundation Trust, United Kingdom
| | - Paul Swindell
- Founder and Chair Sudden Cardiac Arrest UK (SCA-UK), United Kingdom
| | - David Ellard
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Gibbet Hill, Coventry CV4 7AL, United Kingdom
- University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK
| | - Nathan A. Pearson
- Warwick Research in Nursing, Warwick Medical School, University of Warwick, Gibbet Hill, Coventry CV4 7AL, United Kingdom
| | - Helen Parsons
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Gibbet Hill, Coventry CV4 7AL, United Kingdom
| | - Keith Couper
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Gibbet Hill, Coventry CV4 7AL, United Kingdom
- Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham B9 5SS, United Kingdom
| | - Katie N. Daintyi
- North York General Hospital, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Sachin Agarwal
- Department of Neurology, Division of Critical Care & Hospitalist Neurology, Columbia University Irving Medical Center, New York Presbyterian Hospital, New York 10032, United States
| | - Gavin D. Perkins
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Gibbet Hill, Coventry CV4 7AL, United Kingdom
- Critical Care Unit, University Hospitals, Birmingham B9 5SS, United Kingdom
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Eriksen J, Bygholm A, Bertelsen P. The association between patient-reported outcomes (PROs) and patient participation in chronic care: A scoping review. PATIENT EDUCATION AND COUNSELING 2022; 105:1852-1864. [PMID: 35090802 DOI: 10.1016/j.pec.2022.01.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 01/18/2022] [Accepted: 01/20/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVES Patient-reported outcomes (PROs) are increasingly applied in chronic care due to their many functionalities and synergies with current healthcare policies. The participatory potential of PROs is especially emphasised in the Danish context. This review scrutinises the association between PRO and patient participation in chronic care. METHODS This scoping review adheres to PRISMA-ScR guidelines, and the synthesis is based on narrative and thematic analyses. RESULTS Eighty-four articles were deemed eligible. The association between PRO and patient participation regards seven themes: PRO development, response rates and patient burden, patient empowerment and self-management, display and quality of data, patient-clinician communication, shared decision-making, and organisational and attitudinal aspects. Lack of knowledge, actor attitudes, organisational setup, and technological infrastructure act as the main barriers. CONCLUSION The connection between PROs and patient participation is dialectic and unfolds in three phases-before, during, and after patient-clinician consultation. Knowledge regarding the last phase is particularly scarce. Henceforth, studies should address how to include a broader segment of patients, PROs participatory effects over time and PROs impact on patients' everyday lives. PRACTICE IMPLICATIONS The review provides knowledge concerning the association between PROs and patient participation to enhance future chronic care, research, and discussions in the area.
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Affiliation(s)
- Jeppe Eriksen
- Department of Planning, Techno-Anthropology, Aalborg University, Aalborg, Denmark.
| | - Ann Bygholm
- Department of Communication and Psychology, Aalborg University, Aalborg, Denmark.
| | - Pernille Bertelsen
- Department of Planning, Techno-Anthropology, Aalborg University, Aalborg, Denmark.
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Assessing multidimensional complexity in home care: congruencies and discrepancies between patients and nurses. BMC Nurs 2022; 21:166. [PMID: 35751082 PMCID: PMC9230082 DOI: 10.1186/s12912-022-00942-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 06/16/2022] [Indexed: 11/23/2022] Open
Abstract
Background Person-centered care allows for the inclusion of the totality of a person’s needs and preferences, beyond just the clinical or medical aspect. This approach requires the development of tools to allow for the integration of the patient in his/her healthcare. Based on a 30-item tool developed for nurses to evaluate the complexity of home care situations (COMID), this study proposed a version for the patients (i.e. COMID-P). Both instruments were used, independently by nurses and patients, to rate the complexity of individual situations, in order to compare ratings. Methods The COMID-P and the COMID were completed during the fraXity study at the patients’ homes, independently by patients (aged 65 and over) and nurses. Item-level and scale-level analyses were performed using, Kappa and McNemar tests, and intra-class correlation (ICC). Results A total of 159 pairs of COMID and COMID-P ratings were retained for analyses. Results demonstrated a high degree of patient/nurse agreement for 12/30 items, a moderate agreement for 10/30 items, and a low degree of agreement for 7/30 items. The intra-class correlation between the COMID-P and the COMID was high (ICC= .826, 95%CI [.761-.873]). Conclusions The results demonstrate that patients and nurses can assess complexity using tools that have comparable structural properties. They also reveal congruencies and discrepancies in scoring the components of complexity, highlighting the need of reaching consensus in designing care plans. Further work is needed to demonstrate the benefits of joint assessment in developing care plans that truly meet patients’ needs. Trial registration The fraXity study was registered in ClinicalTrials.gov, NCT03883425, on March 20, 2019.
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Patient experiences with patient-reported outcome measures in metastatic breast cancer trials: qualitative interviews. J Patient Rep Outcomes 2022; 6:60. [PMID: 35657533 PMCID: PMC9166921 DOI: 10.1186/s41687-022-00460-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 05/04/2022] [Indexed: 11/20/2022] Open
Abstract
Background Patient-reported outcome (PRO) measures are critical for assessing treatment benefit of anticancer treatments. Although PRO measures have been developed with the intention of capturing patient-centric concepts, a gap exists in understanding the patient experience with these tools. We characterized the experience of patients with metastatic breast cancer (mBC) with PRO measures in an oncology clinical trial setting to determine the importance, relevance, barriers, and facilitators for PRO completion. Methods The multicenter, qualitative design included semistructured interviews with 18 women with mBC who completed PRO measures in a clinical trial setting within 1 year of screening. Interviews began with concept elicitation to understand symptom characterization, decision to participate in a clinical trial, pre-trial expectations, and thoughts on study-related questionnaires. Cognitive debriefing was conducted to determine if items in a commonly used PRO instrument were relevant to the patient experience. Qualitative data were analyzed using a constant comparative approach. Results Participants described the need for detailed explanation of PRO measures at study start, including information about how the PRO data will likely be used to support drug development. Respondents who felt connected to clinical trial research were more likely to feel as if the measures adequately captured their experiences. Items that were deemed irrelevant or out of date to the patient experience may cause a respondent to feel marginalized and adds to the overall burden of PRO measure completion. Mode of PRO measure administration (electronic/paper) was important to some, but placement of the instrument completion within a study visit appeared to influence respondent willingness to fully engage with the measures. A lack of any type of feedback loop to allow respondents to learn from the captured PRO data was noted as important but missing from the patient experience. Conclusions PRO measures need to include content that is relevant to the patient experience over the course of the clinical trial period to be considered meaningful to respondents, and administration techniques also impact engagement. Robust communication strategies that socialize the intent, use, and results of PRO data may enrich the patient experience and support greater adherence to PRO completion in future studies.
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de Lara AM, Peláez-Ballestas I. Beyond Empowerment in Rheumatology Care. J Rheumatol 2022; 49:864-866. [PMID: 35569826 DOI: 10.3899/jrheum.220348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
In this issue of The Journal of Rheumatology, Carluzzo et al1 explored different factors that contribute to the empowerment of individuals with arthritis. The study used data obtained from 12,560 US participants in the Live Yes! INSIGHTS program, based on sociodemographic information and patient-reported outcome measures (PROMs) about physical and mental health, emotional support, and empowerment.
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Affiliation(s)
- Amaranta Manrique de Lara
- A. Manrique de Lara, MA, Rheumatology Unit, Hospital General de México "Dr. Eduardo Liceaga," Center for Genomic Sciences, Universidad Nacional Autónoma de México; I. Peláez-Ballestas, MD, PhD, Rheumatology Unit, Hospital General de México "Dr. Eduardo Liceaga", Mexico City, Mexico. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. I. Peláez-Ballestas, Dr. Balmis 148. Col. Doctores.Cuahtémoc 06720, Mexico City, Mexico.
| | - Ingris Peláez-Ballestas
- A. Manrique de Lara, MA, Rheumatology Unit, Hospital General de México "Dr. Eduardo Liceaga," Center for Genomic Sciences, Universidad Nacional Autónoma de México; I. Peláez-Ballestas, MD, PhD, Rheumatology Unit, Hospital General de México "Dr. Eduardo Liceaga", Mexico City, Mexico. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. I. Peláez-Ballestas, Dr. Balmis 148. Col. Doctores.Cuahtémoc 06720, Mexico City, Mexico.
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Duong V, Hunter DJ, Nicolson PJ. Predictors and Measures of Adherence to Core Treatments for Osteoarthritis. Clin Geriatr Med 2022; 38:345-360. [DOI: 10.1016/j.cger.2021.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Vanderhout S, Fergusson DA, Cook JA, Taljaard M. Patient-reported outcomes and target effect sizes in pragmatic randomized trials in ClinicalTrials.gov: A cross-sectional analysis. PLoS Med 2022; 19:e1003896. [PMID: 35134080 PMCID: PMC8824332 DOI: 10.1371/journal.pmed.1003896] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 12/21/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Use of patient-reported outcomes (PROs) and patient and public engagement are critical ingredients of pragmatic trials, which are intended to be patient centered. Engagement of patients and members of the public in selecting the primary trial outcome and determining the target difference can better ensure that the trial is designed to inform the decisions of those who ultimately stand to benefit. However, to the best of our knowledge, the use and reporting of PROs and patient and public engagement in pragmatic trials have not been described. The objectives of this study were to review a sample of pragmatic trials to describe (1) the prevalence of reporting patient and public engagement; (2) the prevalence and types of PROs used; (3) how its use varies across trial characteristics; and (4) how sample sizes and target differences are determined for trials with primary PROs. METHODS AND FINDINGS This was a methodological review of primary reports of pragmatic trials. We used a published electronic search filter in MEDLINE to identify pragmatic trials, published in English between January 1, 2014 and April 3, 2019; we identified the subset that were registered in ClinicalTrials.gov and explicitly labeled as pragmatic. Trial descriptors were downloaded from ClinicalTrials.gov; information about PROs and sample size calculations were extracted from the manuscript. Chi-squared, Cochran-Armitage, and Wilcoxon rank sum tests were used to examine associations between trial characteristics and use of PROs. Among 4,337 identified primary trial reports, 1,988 were registered in CT.gov, of which 415 were explicitly labeled as pragmatic. Use of patient and public engagement was identified in 39 (9.4%). PROs were measured in 235 (56.6%): 144 (34.7%) used PROs as primary outcomes and 91 (21.9%) as only secondary outcomes. Primary PROs were symptoms (64; 44%), health behaviors (36; 25.0%), quality of life (17; 11.8%), functional status (16; 11.1%), and patient experience (10; 6.9%). Trial characteristics with lower prevalence of use of PROs included being conducted exclusively in children or adults over age 65 years, cluster randomization, recruitment in low- and middle-income countries, and primary purpose of prevention; trials conducted in Europe had the highest prevalence of PROs. For the 144 trials with a primary PRO, 117 (81.3%) reported a sample size calculation for that outcome; of these, 71 (60.7%) justified the choice of target difference, most commonly, using estimates from pilot studies (31; 26.5%), standardized effect sizes (20; 17.1%), or evidence reviews (16; 13.7%); patient or stakeholder opinions were used to justify the target difference in 8 (6.8%). Limitations of this study are the need for trials to be registered in ClinicalTrials.gov, which may have reduced generalizability, and extracting information only from the primary trial report. CONCLUSIONS In this study, we observed that pragmatic trials rarely report patient and public engagement and do not commonly use PROs as primary outcomes. When provided, target differences are often not justified and rarely informed by patients and stakeholders. Research funders, scientific journals, and institutions should support trialists to incorporate patient engagement to fulfill the mandate of pragmatic trials to be patient centered.
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Affiliation(s)
- Shelley Vanderhout
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Dean A. Fergusson
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Jonathan A. Cook
- Centre for Statistics in Medicine & Oxford Clinical Trials Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
| | - Monica Taljaard
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
- * E-mail:
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Ronen GM, Rosenbaum PL, Streiner DL. Patient perspectives in pediatric neurology: a critical shift in the paradigm of outcome measurement. Dev Med Child Neurol 2022; 64:149-155. [PMID: 34091886 DOI: 10.1111/dmcn.14954] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/11/2021] [Indexed: 01/19/2023]
Abstract
This review explores children's self-reported outcome measurements in pediatric neurology. We examine the following questions: (1) What is meant by patient-reported health, functioning, and quality of life outcomes? (2) How can patients express whether the interventions they receive do more good than harm? (3) Why and how should pediatric neurology patients help determine the outcomes of interest? (4) What tools and recommendations are available to evaluate the outcomes of interest? Applying patients' perspectives across the processes of evaluation of medical interventions has become an important expectation. These developments, consistent with current healthcare goals, coincide with the evolution of pediatric neurology into a sophisticated diagnostic-interventional field that aims to prolong survival, decrease impairments and symptoms, and improve patients' well-being - the recognized essential endpoints of interest in all medicine.
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Affiliation(s)
- Gabriel M Ronen
- Department of Pediatrics, CanChild Centre for Childhood Disability Research, Institute for Applied Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Peter L Rosenbaum
- Department of Pediatrics, CanChild Centre for Childhood Disability Research, Institute for Applied Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - David L Streiner
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
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Abstract
Patient-reported outcome measures (PROMs) are reported by the patient and designed to capture patients' unique perspectives of their symptoms, quality of life, function, disability, and overall health status. Despite their important role in the health care landscape, it is important to recognize that PROMs have numerous shortcomings. These include weaknesses in the development of tools and interpretation of scale values, which can lead to variable patient reporting and dissimilarities in study results, potentially influencing the effectiveness of findings. This Viewpoint makes recommendations for how to interpret and best use PROMs, in spite of their shortcomings. J Orthop Sports Phys Ther 2021;51(12):562-565. Epub 16 Nov 2021. doi:10.2519/jospt.2021.10836.
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Haywood K, Potter R, Froud R, Pearce G, Box B, Muldoon L, Lipton R, Petrou S, Rendas-Baum R, Logan AM, Stewart K, Underwood M, Matharu M. Core outcome set for preventive intervention trials in chronic and episodic migraine (COSMIG): an international, consensus-derived and multistakeholder initiative. BMJ Open 2021; 11:e043242. [PMID: 34848505 PMCID: PMC8634270 DOI: 10.1136/bmjopen-2020-043242] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Typically, migraine prevention trials focus on reducing migraine days. This narrow focus may not capture all that is important to people with migraine. Inconsistency in outcome selection across trials limits the potential for data pooling and evidence synthesis. In response, we describe the development of core outcome set for migraine (COSMIG). DESIGN A two-stage approach sought to achieve international, multistakeholder consensus on both the core domain set and core measurement set. Following construction of a comprehensive list of outcomes, expert panellists (patients, healthcare professionals and researchers) completed a three-round electronic-Delphi study to support a reduction and prioritisation of core domains and outcomes. Participants in a consensus meeting finalised the core domains and methods of assessment. All stages were overseen by an international core team, including patient research partners. RESULTS There was a good representation of patients (episodic migraine (n=34) and chronic migraine (n=42)) and healthcare professionals (n=33) with high response and retention rates. The initial list of domains and outcomes was reduced from >50 to 7 core domains for consideration in the consensus meeting, during which a 2-domain core outcome set was agreed. CONCLUSION International and multistakeholder consensus emerged to describe a two-domain core outcome set for reporting research on preventive interventions for chronic and episodic migraine: migraine-specific pain and migraine-specific quality of life. Intensity of migraine pain assessed with an 11-point Numerical Rating Scale and the frequency as the number of headache/migraine days over a specified time period. Migraine-specific quality of life assessed using the Migraine Functional Impact Questionnaire.
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Affiliation(s)
- Kirstie Haywood
- Warwick Research in Nursing, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Rachel Potter
- Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - Robert Froud
- Institute of Health Sciences, Kristiania University College, Oslo, Norway
| | - Gemma Pearce
- Department of Psychology and Behavioural Sciences, Coventry University, Coventry, UK
| | - Barbara Box
- Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - Lynne Muldoon
- Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - Richard Lipton
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Stavros Petrou
- Nuffield Department of Primary Care Health Sciences, Oxford, UK
| | | | - Anne-Marie Logan
- Neurology Department, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Kimberley Stewart
- Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - Martin Underwood
- Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - Manjit Matharu
- The Headache Group, National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
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Development and validation of a self-reported questionnaire to assess occupational balance in parents of preterm infants. PLoS One 2021; 16:e0259648. [PMID: 34780508 PMCID: PMC8592439 DOI: 10.1371/journal.pone.0259648] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 10/23/2021] [Indexed: 12/30/2022] Open
Abstract
Background Parents’ meaningful activities (occupations) and occupational balance are relevant to neonatal care. Valid and reliable self-reported measurement instruments are needed to assess parents’ occupational balance and to evaluate occupational balance interventions in neonatal care. The aims of this study were to develop a self-reported questionnaire on occupational balance in informal caregivers (OBI-Care) and to examine its measurement properties including construct validity and internal consistency. Methods and findings A mixed method multicenter study design was employed. Items of the OBI-Care were created with parents of preterm infants based on qualitative research methods. Measurement properties were analyzed with quantitative data of parents of preterm infants. Construct validity was assessed by determining dimensionality, overall and item fit to a Rasch model, differential item functioning and threshold ordering. Internal consistency was examined by determining inter-item and item-total correlations, Cronbach’s alpha and Rasch’s person separation index. Fourteen parents participated in item creation. Measurement properties were explored in data of 304 parents. Twenty-two items, summarized in three subscales were compiled to the OBI-Care. Items showed an overall fit and except one item, an item fit to the Rasch model. There was no evidence of differential item functioning and all items displayed ordered thresholds. Each subscale had good values of person separation indices and Cronbach’s alpha. Conclusions The OBI-Care demonstrates construct validity and internal consistency and is thus a suitable measurement instrument to assess occupational balance of parents of preterm infants in neonatal care. OBI-Care is generic and can be applied in various health care settings.
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Lim R, Ellett LK, Roughead EE, Cheah PY, Masnoon N. Patient-Reported Questionnaires to Identify Adverse Drug Reactions: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211877. [PMID: 34831635 PMCID: PMC8624083 DOI: 10.3390/ijerph182211877] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/09/2021] [Accepted: 11/10/2021] [Indexed: 12/02/2022]
Abstract
Background: This systematic review aims to summarise available patient-reported questionnaires to detect adverse drug reactions (ADRs) that can be utilised by healthcare professionals in clinical practice and to summarise the psychometric properties (validity, reliability, and responsiveness) of the questionnaires. Methods: A systematic literature search was conducted using Medline, Pubmed, Embase, and Emcare databases to screen for articles published between January 2000 and July 2020. Data items regarding validity, reliability, and responsiveness were extracted independently by two authors. The methodological quality was assessed using the COSMIN (Consensus-Based Standards for the Selection of Health Measurement Instruments) checklist. Results: A total of 1563 unique article titles were identified after removing duplicates. Following shortlisting of relevant articles, 19 patient-reported ADR questionnaires were identified. Questionnaires most commonly focused on mental health medications (42.1%, n = 8), followed by general questionnaires applicable to any medication (21.1%, n = 4). Many questionnaires did not report assessing the validity and reliability of the measurement tool. For example, only 11 questionnaires (58%) mentioned assessing content validity, in addition to criterion or construct testing. Conclusion: This systematic review summarised the available patient-reported questionnaires that can be used in research and clinical practice to identify ADRs. Results of this systematic review highlight the need for more robust validity and reliability testing when developing patient-reported ADR questionnaires.
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Affiliation(s)
- Renly Lim
- Quality Use of Medicines and Pharmacy Research Centre, UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA 5000, Australia; (L.K.E.); (E.E.R.)
- Correspondence:
| | - Lisa Kalisch Ellett
- Quality Use of Medicines and Pharmacy Research Centre, UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA 5000, Australia; (L.K.E.); (E.E.R.)
| | - Elizabeth E. Roughead
- Quality Use of Medicines and Pharmacy Research Centre, UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA 5000, Australia; (L.K.E.); (E.E.R.)
| | - Phaik Yeong Cheah
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7FZ, UK;
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
- The Ethox Centre, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7FZ, UK
| | - Nashwa Masnoon
- Laboratory of Ageing and Pharmacology, Kolling Institute, University of Sydney, St Leonards, NSW 2064, Australia;
- Department of Pharmacy, Royal North Shore Hospital, St Leonards, NSW 2065, Australia
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Selva A, Selva C, Álvarez-Pérez Y, Torà N, López P, Terraza-Núñez R, Rodríguez V, Solà I. Satisfaction and experience with colorectal cancer screening: a systematic review of validated patient reported outcome measures. BMC Med Res Methodol 2021; 21:230. [PMID: 34706652 PMCID: PMC8549248 DOI: 10.1186/s12874-021-01430-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 10/08/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Patient satisfaction or experience with colorectal cancer screening can determine adherence to screening programs. An evaluation of validated patient reported outcome measures (PROMs) for measuring experience or satisfaction with colorectal cancer screening does not exist. Our objective was to identify and critically appraise validated questionnaires for measuring patient satisfaction or experience with colorectal cancer screening. METHODS We conducted a systematic review following the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology. We conducted searches on MEDLINE, EMBASE, PsychINFO, CINAHL and BiblioPRO and assessed the methodological quality of studies and measurement properties of questionnaires according to the COSMIN guidelines for systematic reviews of PROMs. PROSPERO registration number: CRD42019118527. RESULTS We included 80 studies that used 75 questionnaires, of which only 5 were validated. Four questionnaires measured satisfaction with endoscopy: two in the context of colorectal cancer screening (for colonoscopy and sigmoidoscopy) and two for non-screening endoscopy. One questionnaire measured satisfaction with bowel preparation. The methodological quality of studies was variable. The questionnaires with evidence for sufficient content validity and internal consistency were: the CSSQP questionnaire, which measures safety and satisfaction with screening colonoscopy, and the Post-Procedure questionnaire which measures satisfaction with non-screening endoscopic procedures. CONCLUSIONS This systematic review shows that a minority of existing PROMs for measuring patient satisfaction with colorectal cancer screening are validated. We identified two questionnaires with high potential for further use (CSSQP and the Post-Procedure questionnaire).
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Affiliation(s)
- A Selva
- Clinical Epidemiology and Cancer Screening, Parc Taulí Hospital Universitari, Corporació Sanitària Parc Taulí, Edifici Santa Fè. Parc Taulí 1, Sabadell, 08208, Barcelona, Catalonia, Spain.
- Universitat Autònoma de Barcelona, Bellaterra, Spain.
- REDISSEC (Health Services Research on Chronic Patients Network), Madrid, Spain.
| | - C Selva
- Universitat Oberta de Catalunya (Estudis de Psicologia i Ciències de l'Educació), Barcelona, Catalonia, Spain
| | - Y Álvarez-Pérez
- Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), Tenerife, Spain
| | - N Torà
- Cancer Screening Programms. Althaia Xarxa Assistencial Universitària de Manresa, Manresa, Catalonia, Spain
| | - P López
- Clinical Epidemiology and Cancer Screening, Parc Taulí Hospital Universitari, Corporació Sanitària Parc Taulí, Edifici Santa Fè. Parc Taulí 1, Sabadell, 08208, Barcelona, Catalonia, Spain
| | - R Terraza-Núñez
- Direcció General de Planificació en Salut, Departament de Salut, Generalitat de Catalunya, Barcelona, Catalonia, Spain
| | - V Rodríguez
- Tecnocampus, Universitat Pompeu Fabra, Mataró, Catalonia, Spain
| | - I Solà
- Institute of Biomedical Research, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Iberoamerican Cochrane Centre, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- CIBER Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
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Guruparan Y, Navaratinaraja TS, Selvaratnam G, Gunawardena N, Sri Ranganathan S. Development and validation of a set of patient reported outcome measures to assess effectiveness of asthma prophylaxis. BMC Pulm Med 2021; 21:295. [PMID: 34535111 PMCID: PMC8449463 DOI: 10.1186/s12890-021-01665-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 09/09/2021] [Indexed: 11/16/2022] Open
Abstract
Background In the local setting, asthma control is assessed by symptoms and signs elicited by clinicians because of the limited availability of spirometry. Hence, we intended to develop a patient reported outcome measure (PROM) with more holistic interpretation that could also serve as a tool to measure the asthma control in resource limited settings. Therefore, this study was carried out in Northern Sri Lanka to develop and validate the Asthma Control PROM (AC-PROM) Tamil to measure the effectiveness of asthma prophylaxis based on symptoms, exacerbation and limitation of activity which could also serve as an easy measure of asthma control to the provider. Methods The AC-PROM Tamil was developed in 3 steps: item generation, item reduction and psychometric evaluation. Items were generated through thematic analysis from focus group discussions among patients with asthma. Items were converted to an interviewer administered questionnaire in Tamil in the format of 5-point Likert scale. Item reduction was done by two rounds of online Delphi surveys among 10 experts and an exploratory factor analysis among 200 patients with asthma. The face and content validity were assessed by a panel of experts during Delphi survey and patients during the pre-test of the tool. Criterion validity of the tool was assessed against the forced expiratory volume in one second of 187 patients with asthma. The cut-off value to assess the asthma control was determined by receiver operating characteristic curve. Reliability was verified by Cronbach’s alpha coefficient. Results From thematic analysis of focus group discussions 10 items were generated. One item was removed during Delphi survey. Exploratory factor analysis indicated removal of another item with 8 items categorised into two factors. Cronbach’s alpha coefficient of factors 1 and 2 were 0.821 and 0.903 respectively, indicating good reliability. Observations made by experts and responses made by patients were incorporated to improve the clarity and relevance of the items. Criterion validity was demonstrated by significant correlation between the AC-PROM Tamil and forced expiratory volume in one second (r = 0.66, p = 0.001). The cut-off value of the AC-PROM Tamil to detect asthma control was 28.5 with 79% (95% CI 71.3–86.9) sensitivity and 71% (95% CI 61.9–79.6) specificity. The AC-PROM Tamil showed moderate accuracy (the area under the receiver operating characteristic curve = 0.796; 95% CI 0.73–0.86). Response rate of the AC-PROM Tamil was 100% and time taken to complete was 3–4 min. Conclusion The AC-PROM Tamil is a simple, feasible and reasonably accurate tool to assesses the effectiveness of asthma prophylaxis, particularly in resource limited settings. Supplementary Information The online version contains supplementary material available at 10.1186/s12890-021-01665-6.
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Affiliation(s)
- Yalini Guruparan
- Department of Pharmacology, Faculty of Medicine, University of Jaffna, Jaffna, Sri Lanka.
| | | | - Gowry Selvaratnam
- Department of Medicine, Faculty of Medicine, University of Jaffna, Jaffna, Sri Lanka
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Hawke LD, Hayes E, Iyer S, Killackey E, Chinnery G, Gariépy G, Thabane L, Darnay K, Alagaratnam A, Tucker-Kilfoil S, Moxness K, Hachimi-Idrissi N, Winkelmann I, Henderson J. Youth-oriented outcomes of education, employment and training interventions for upcoming youth: Protocol for a discrete choice experiment. Early Interv Psychiatry 2021; 15:942-948. [PMID: 32945127 DOI: 10.1111/eip.13039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 08/06/2020] [Accepted: 08/30/2020] [Indexed: 11/29/2022]
Abstract
AIM The issue of youth who are not engaged in education, employment or training has been a focus of policymakers for decades. Although interventions exist for these youth, they often measure success in ways that fail to capture what youth seek to gain. The project aims to address this gap by assessing youth-oriented outcomes for interventions targeting upcoming youth. Acknowledging the stigma attached to the deficit-based notion of not engaged in education, employment or training, hereafter we refer to 'upcoming youth', a term coined by youth partners on the project. This study asks what youth want to achieve by participating in an intervention for upcoming youth, with a view to guiding service and research design. METHODS A mixed-methods discrete choice experiment will be conducted with youth engaged as partners. A qualitative (focus group) stage will be conducted to design discrete-choice experiment attributes and levels. The experiment will be piloted and administered online to approx. 500 youth (aged 14-29) across Canada to identify the outcomes that youth prioritize for interventions. Latent class analyses will then be conducted to explore clusters of outcomes that different groups of youth prioritize. CONCLUSIONS From a strengths-based recovery-oriented framework, hearing the voices of the target population is important in designing and evaluating services. This youth-oriented research project will identify the intervention outcomes that are the highest priority for upcoming youth. Findings will inform the development, implementation and testing of interventions targeting relevant outcomes for youth who are not engaged in education, employment or training.
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Affiliation(s)
- Lisa D Hawke
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Em Hayes
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | | | | | | | | | | | - Karleigh Darnay
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | | | | | | | | | | | - Joanna Henderson
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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Retzer A, Calvert M, Ahmed K, Keeley T, Armes J, Brown JM, Calman L, Gavin A, Glaser AW, Greenfield DM, Lanceley A, Taylor RM, Velikova G, Brundage M, Efficace F, Mercieca‐Bebber R, King MT, Kyte D. International perspectives on suboptimal patient-reported outcome trial design and reporting in cancer clinical trials: A qualitative study. Cancer Med 2021; 10:5475-5487. [PMID: 34219395 PMCID: PMC8366078 DOI: 10.1002/cam4.4111] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 06/04/2021] [Indexed: 12/20/2022] Open
Abstract
PURPOSE Evidence suggests that the patient-reported outcome (PRO) content of cancer trial protocols is frequently inadequate and non-reporting of PRO findings is widespread. This qualitative study examined the factors influencing suboptimal PRO protocol content, implementation, and reporting, and use of PRO data during clinical interactions. METHODS Semi-structured interviews were conducted with four stakeholder groups: (1) trialists and chief investigators; (2) people with lived experience of cancer; (3) international experts in PRO cancer trial design; (4) journal editors, funding panelists, and regulatory agencies. Data were analyzed using directed thematic analysis with an iterative coding frame. RESULTS Forty-four interviews were undertaken. Several factors were identified that could influenced effective integration of PROs into trials and subsequent findings. Participants described (1) late inclusion of PROs in trial design; (2) PROs being considered a lower priority outcome compared to survival; (3) trialists' reluctance to collect or report PROs due to participant burden, missing data, and perceived reticence of journals to publish; (4) lack of staff training. Strategies to address these included training research personnel and improved communication with site staff and patients regarding the value of PROs. Examples of good practice were identified. CONCLUSION Misconceptions relating to PRO methodology and its use may undermine their planning, collection, and reporting. There is a role for funding, regulatory, methodological, and journalistic institutions to address perceptions around the value of PROs, their position within the trial outcomes hierarchy, that PRO training and guidance is available, signposted, and readily accessible, with accompanying measures to ensure compliance with international best practice guidelines.
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Affiliation(s)
- Ameeta Retzer
- Centre for Patient‐Reported Outcomes ResearchInstitute of Applied Health ResearchUniversity of BirminghamBirminghamUK
- NIHR ARC West MidlandsLondonUK
| | - Melanie Calvert
- Centre for Patient‐Reported Outcomes ResearchInstitute of Applied Health ResearchUniversity of BirminghamBirminghamUK
- NIHR ARC West MidlandsLondonUK
- Birmingham Health Partners Centre for Regulatory Science and InnovationUniversity of BirminghamBirminghamUK
- NIHR Birmingham Biomedical Research Centre and NIHR Surgical Reconstruction and Microbiology Research CentreUniversity Hospitals Birmingham NHS Foundation Trust and University of BirminghamBirminghamUK
| | - Khaled Ahmed
- Centre for Patient‐Reported Outcomes ResearchInstitute of Applied Health ResearchUniversity of BirminghamBirminghamUK
| | - Thomas Keeley
- Centre for Patient‐Reported Outcomes ResearchInstitute of Applied Health ResearchUniversity of BirminghamBirminghamUK
- GlaxoSmithKline (formerly of CPROR, University of BirminghamBirminghamUK
| | - Jo Armes
- UK National Cancer Research Institute (NCRI) Psychosocial Oncology and Survivorship CSG Subgroup: Understanding and Measuring the Consequences of Cancer and its TreatmentLondonUK
- School of Health SciencesUniversity of SurreyGuildfordUK
- NIHR ARC KentLondonUK
| | | | - Lynn Calman
- UK National Cancer Research Institute (NCRI) Psychosocial Oncology and Survivorship CSG Subgroup: Understanding and Measuring the Consequences of Cancer and its TreatmentLondonUK
- Macmillan Survivorship Research GroupHealth SciencesUniversity of SouthamptonSouthamptonUK
| | - Anna Gavin
- UK National Cancer Research Institute (NCRI) Psychosocial Oncology and Survivorship CSG Subgroup: Understanding and Measuring the Consequences of Cancer and its TreatmentLondonUK
- N. Ireland Cancer RegistryCentre for Public HealthQueens UniversityBelfastUK
| | - Adam W. Glaser
- UK National Cancer Research Institute (NCRI) Psychosocial Oncology and Survivorship CSG Subgroup: Understanding and Measuring the Consequences of Cancer and its TreatmentLondonUK
- Leeds Institute of Medical Research at St James’sUniversity of LeedsLeedsUK
| | - Diana M. Greenfield
- UK National Cancer Research Institute (NCRI) Psychosocial Oncology and Survivorship CSG Subgroup: Understanding and Measuring the Consequences of Cancer and its TreatmentLondonUK
- Sheffield Teaching Hospital NHS Foundation Trust and University of SheffieldSheffieldUK
| | - Anne Lanceley
- UK National Cancer Research Institute (NCRI) Psychosocial Oncology and Survivorship CSG Subgroup: Understanding and Measuring the Consequences of Cancer and its TreatmentLondonUK
- UCL Elizabeth Garrett Anderson Institute for Women’s HealthMedical School BuildingUniversity College LondonLondonUK
| | - Rachel M. Taylor
- UK National Cancer Research Institute (NCRI) Psychosocial Oncology and Survivorship CSG Subgroup: Understanding and Measuring the Consequences of Cancer and its TreatmentLondonUK
- Centre for Nurse, Midwife and Allied Health Profession Led Research (CNMARUniversity College London Hospitals NHS Foundation TrustLondonUK
| | - Galina Velikova
- Leeds Institute of Medical Research at St James’sUniversity of LeedsLeedsUK
| | - Michael Brundage
- Queen’s Department of OncologyQueen’s Cancer Research InstituteKingstonONCanada
| | - Fabio Efficace
- Italian Group for Adult Hematologic Diseases (GIMEMAHealth Outcomes Research UnitRomeItaly
| | - Rebecca Mercieca‐Bebber
- School of PsychologyUniversity of SydneySydneyNSWAustralia
- University of SydneyNHMRC Clinical Trials CentreSydneyNSWAustralia
| | | | - Derek Kyte
- Centre for Patient‐Reported Outcomes ResearchInstitute of Applied Health ResearchUniversity of BirminghamBirminghamUK
- NIHR Birmingham Biomedical Research Centre and NIHR Surgical Reconstruction and Microbiology Research CentreUniversity Hospitals Birmingham NHS Foundation Trust and University of BirminghamBirminghamUK
- UK National Cancer Research Institute (NCRI) Psychosocial Oncology and Survivorship CSG Subgroup: Understanding and Measuring the Consequences of Cancer and its TreatmentLondonUK
- School of Applied Health & CommunityUniversity of WorcesterWorcesterUK
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van Muilekom MM, Teela L, van Oers HA, van Goudoever JB, Grootenhuis MA, Haverman L. Patients' and parents' perspective on the implementation of Patient Reported Outcome Measures in pediatric clinical practice using the KLIK PROM portal. Qual Life Res 2021; 31:241-254. [PMID: 34324137 PMCID: PMC8800898 DOI: 10.1007/s11136-021-02950-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The KLIK Patient Reported Outcome Measures (PROM) portal ( www.hetklikt.nu ) has been implemented since 2011 in clinical practice in over 20 Dutch hospitals. Patients and/or parents complete PROMs before the outpatient consultation and answers are subsequently discussed by clinicians during consultation. This study aims to provide insight into patients' and parents' perspective on the use of the KLIK PROM portal in order to optimize its implementation in pediatric clinical practice. METHODS Patients (12-19 years) and parents (of children 0-19 years) from the Emma Children's Hospital were invited to participate. A mixed-method design was used; (1) Focus groups were held and analyzed using thematic analysis in psychology, (2) a questionnaire was sent out and analyzed using descriptive statistics. RESULTS (1) Eight patients and 17 parents participated. Patients mentioned that KLIK has an attractive layout. However, PROMs were sometimes considered irrelevant and repetitive. Parents valued that KLIK provides insight into their child's functioning, but they were not satisfied with the extent to which PROMs were discussed by clinicians. (2) 31 patients and 130 parents completed the questionnaire. Overall, patients and parents reported a satisfaction score of 7.9/10 and 7.3/10, respectively. 81% of patients and 74% of parents indicated that KLIK is easy to use. CONCLUSION Patients and parents are generally satisfied with KLIK, however, points of improvement were mentioned. These are currently being addressed by e.g., upgrading the KLIK website, implementing PROMIS item banks in KLIK to reduce irrelevancy and repetitiveness of PROMs, and implementation strategies to improve the discussion-rate. In this way, implementation of the KLIK PROM portal can be further optimized, with the ultimate goal to improve quality of care.
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Affiliation(s)
- Maud M van Muilekom
- Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, Amsterdam UMC, University of Amsterdam, Emma Children's Hospital, Meibergdreef 9, Amsterdam, The Netherlands
| | - Lorynn Teela
- Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, Amsterdam UMC, University of Amsterdam, Emma Children's Hospital, Meibergdreef 9, Amsterdam, The Netherlands
| | - Hedy A van Oers
- Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, Amsterdam UMC, University of Amsterdam, Emma Children's Hospital, Meibergdreef 9, Amsterdam, The Netherlands
| | - Johannes B van Goudoever
- Department of Pediatrics, Amsterdam UMC, University of Amsterdam, Vrije Universiteit Amsterdam, Emma Children's Hospital, Meibergdreef 9, Amsterdam, The Netherlands
| | | | - Lotte Haverman
- Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, Amsterdam UMC, University of Amsterdam, Emma Children's Hospital, Meibergdreef 9, Amsterdam, The Netherlands. .,Child and Adolescent Psychiatry & Psychosocial Care, G8-136, Amsterdam UMC, University of Amsterdam, Emma Children's Hospital, Amsterdam, The Netherlands, 22660, 1100 DD.
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Henry Akintobi T, Sheikhattari P, Shaffer E, Evans CL, Braun KL, Sy AU, Mancera B, Campa A, Miller ST, Sarpong D, Holliday R, Jimenez-Chavez J, Khan S, Hinton C, Sellars-Bates K, Ajewole V, Teufel-Shone NI, McMullin J, Suther S, Kimbro KS, Taylor L, Velez Vega CM, Williams C, Perry G, Zuchner S, Marzan Rodriguez M, Tchounwou PB. Community Engagement Practices at Research Centers in U.S. Minority Institutions: Priority Populations and Innovative Approaches to Advancing Health Disparities Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6675. [PMID: 34205781 PMCID: PMC8296474 DOI: 10.3390/ijerph18126675] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 06/10/2021] [Accepted: 06/11/2021] [Indexed: 11/16/2022]
Abstract
This paper details U.S. Research Centers in Minority Institutions (RCMI) Community Engagement Cores (CECs): (1) unique and cross-cutting components, focus areas, specific aims, and target populations; and (2) approaches utilized to build or sustain trust towards community participation in research. A mixed-method data collection approach was employed for this cross-sectional study of current or previously funded RCMIs. A total of 18 of the 25 institutions spanning 13 U.S. states and territories participated. CEC specific aims were to support community engaged research (94%); to translate and disseminate research findings (88%); to develop partnerships (82%); and to build capacity around community research (71%). Four open-ended questions, qualitative analysis, and comparison of the categories led to the emergence of two supporting themes: (1) establishing trust between the community-academic collaborators and within the community and (2) building collaborative relationships. An overarching theme, building community together through trust and meaningful collaborations, emerged from the supporting themes and subthemes. The RCMI institutions and their CECs serve as models to circumvent the historical and current challenges to research in communities disproportionately affected by health disparities. Lessons learned from these cores may help other institutions who want to build community trust in and capacities for research that addresses community-related health concerns.
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Affiliation(s)
- Tabia Henry Akintobi
- Prevention Research Center, Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, GA 30310, USA; (C.L.E.); (R.H.)
| | - Payam Sheikhattari
- Prevention Sciences Research Center, School of Community Health and Policy, Morgan State University, Baltimore, MD 21251, USA; (P.S.); (E.S.)
| | - Emma Shaffer
- Prevention Sciences Research Center, School of Community Health and Policy, Morgan State University, Baltimore, MD 21251, USA; (P.S.); (E.S.)
| | - Christina L. Evans
- Prevention Research Center, Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, GA 30310, USA; (C.L.E.); (R.H.)
| | - Kathryn L. Braun
- Department of Public Health Sciences, John A. Burns School of Medicine, Ola HAWAII, University of Hawai’i at Mānoa, Honolulu, HI 96822, USA; (K.L.B.); (A.U.S.)
| | - Angela U. Sy
- Department of Public Health Sciences, John A. Burns School of Medicine, Ola HAWAII, University of Hawai’i at Mānoa, Honolulu, HI 96822, USA; (K.L.B.); (A.U.S.)
| | - Bibiana Mancera
- Border Biomedical Research Center, College of Health Sciences, University of Texas at El Paso, El Paso, TX 79968, USA;
| | - Adriana Campa
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL 33199, USA;
| | | | - Daniel Sarpong
- Department of Biostatistics, Xavier University, Cagayan de Oro 9000, Philippines;
| | - Rhonda Holliday
- Prevention Research Center, Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, GA 30310, USA; (C.L.E.); (R.H.)
| | - Julio Jimenez-Chavez
- Department of Psychiatry and Human Behavior, Ponce School of Medicine and Health Sciences, Ponce, PR 00716, USA;
| | - Shafiq Khan
- Department of Biological Sciences, Clark Atlanta University, Atlanta, GA 30314, USA; (S.K.); (C.H.); (K.S.-B.)
| | - Cimona Hinton
- Department of Biological Sciences, Clark Atlanta University, Atlanta, GA 30314, USA; (S.K.); (C.H.); (K.S.-B.)
| | - Kimberly Sellars-Bates
- Department of Biological Sciences, Clark Atlanta University, Atlanta, GA 30314, USA; (S.K.); (C.H.); (K.S.-B.)
| | - Veronica Ajewole
- College of Pharmacy and Health Sciences, Texas Southern University, Houston, TX 77004, USA;
| | | | - Juliet McMullin
- Department of Anthropology, University of California, Riverside, CA 92521, USA;
| | - Sandra Suther
- College of Pharmacy and Pharmaceutical Sciences, Florida Agricultural and Mechanical University, Tallahassee, FL 32307, USA;
| | - K. Sean Kimbro
- Biological and Biomedical Sciences, North Carolina Central University, Durham, NC 27707, USA; (K.S.K.); (L.T.)
| | - Lorraine Taylor
- Biological and Biomedical Sciences, North Carolina Central University, Durham, NC 27707, USA; (K.S.K.); (L.T.)
| | - Carmen M. Velez Vega
- Center for Collaborative Research in Health Disparities, University of Puerto Rico Medical Sciences Campus, San Juan, PR 00921, USA;
| | - Carla Williams
- College of Medicine, Howard University, Washington, DC 20059, USA;
| | - George Perry
- College of Sciences, University of Texas at San Antonio, San Antonio, TX 78249, USA;
| | - Stephan Zuchner
- John P. Hussman Institute for Human Genomics, University of Miami, Coral Gables, FL 33146, USA;
| | | | - Paul B. Tchounwou
- Department of Biology, College of Science, Engineering and Technology, Jackson State University, Jackson, MS 39217, USA;
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Duong V, Daniel MS, Ferreira ML, Fritsch CG, Hunter DJ, Wang X, Wei N, Nicolson PJA. Measuring adherence to unsupervised, conservative treatment for knee osteoarthritis: A systematic review. OSTEOARTHRITIS AND CARTILAGE OPEN 2021; 3:100171. [DOI: 10.1016/j.ocarto.2021.100171] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 04/26/2021] [Indexed: 01/11/2023] Open
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White D, Englezou C, Rajabally YA. Patient perceptions of outcome measures in chronic inflammatory demyelinating polyneuropathy: A study of the Inflammatory Rasch-built Overall Disability Scale. Eur J Neurol 2021; 28:2596-2602. [PMID: 33969583 DOI: 10.1111/ene.14907] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 04/12/2021] [Accepted: 04/28/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Patients' perceptions of outcome measures used in chronic inflammatory demyelinating polyneuropathy (CIDP) are unknown. METHODS We performed a cross-sectional evaluation of patient perceptions of the Inflammatory Rasch-built Overall Disability Scale (I-RODS) from 41 subjects with CIDP through a structured questionnaire. We assessed perceived hesitation to provide a response, item importance and relevance, understanding of specific items and factors affecting responses. RESULTS Hesitation to provide a categorical answer was reported by 20% of subjects or more, for 5/24 (20.8%) items. Uncertainty was most frequent for "travel by public transport" (22.4%) and "catch an object (e.g., ball)" (24%). Six of 24 (25%) items were perceived as unimportant to their disease by at least a third of participants. Items most commonly perceived as unimportant were "travel by public transport" in 53.7%, "catch an object (e.g., ball)" in 61% and "dance" in 65.9%. Several items were frequently perceived as irrelevant. These included "move a chair" (39%), "do the dishes" (46.3%), "catch an object (e.g., ball)" (61%), "travel by public transport" (68.3%) and "stand for hours" (82.9%). The understanding of multiple items such as "read a book", "sit on a toilet" and "take a shower" was found to be highly variable. Fatigue was perceived more commonly than mood (53.7% vs. 17.1%, p = 0.001), and more commonly in younger subjects (p = 0.037), as influencing responses to the I-RODS. CONCLUSIONS Patient-perceived uncertainty, unimportance, irrelevance and poor understanding of items, as well as fatigue and mood, impact on the value of the I-RODS. Greater emphasis on individualized disability assessments requires consideration in future.
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Affiliation(s)
- Daniel White
- Inflammatory Neuropathy Clinic, Department of Neurology, University Hospitals Birmingham, Birmingham, UK
| | - Christina Englezou
- Inflammatory Neuropathy Clinic, Department of Neurology, University Hospitals Birmingham, Birmingham, UK
| | - Yusuf A Rajabally
- Inflammatory Neuropathy Clinic, Department of Neurology, University Hospitals Birmingham, Birmingham, UK.,Aston Medical School, Aston University, Birmingham, UK
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Kalluri M, Luppi F, Vancheri A, Vancheri C, Balestro E, Varone F, Mogulkoc N, Cacopardo G, Bargagli E, Renzoni E, Torrisi S, Calvello M, Libra A, Pavone M, Bonella F, Cottin V, Valenzuela C, Wijsenbeek M, Bendstrup E. Patient-reported outcomes and patient-reported outcome measures in interstitial lung disease: where to go from here? Eur Respir Rev 2021; 30:30/160/210026. [PMID: 34039675 PMCID: PMC9488962 DOI: 10.1183/16000617.0026-2021] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 04/02/2021] [Indexed: 12/03/2022] Open
Abstract
Patient-reported outcome measures (PROMs), tools to assess patient self-report of health status, are now increasingly used in research, care and policymaking. While there are two well-developed disease-specific PROMs for interstitial lung diseases (ILD) and idiopathic pulmonary fibrosis (IPF), many unmet and urgent needs remain. In December 2019, 64 international ILD experts convened in Erice, Italy to deliberate on many topics, including PROMs in ILD. This review summarises the history of PROMs in ILD, shortcomings of the existing tools, challenges of development, validation and implementation of their use in clinical trials, and the discussion held during the meeting. Development of disease-specific PROMs for ILD including IPF with robust methodology and validation in concordance with guidance from regulatory authorities have increased user confidence in PROMs. Minimal clinically important difference for bidirectional changes may need to be developed. Cross-cultural validation and linguistic adaptations are necessary in addition to robust psychometric properties for effective PROM use in multinational clinical trials. PROM burden of use should be reduced through appropriate use of digital technologies and computerised adaptive testing. Active patient engagement in all stages from development, testing, choosing and implementation of PROMs can help improve probability of success and further growth. PROMs are essential tools for research and care in ILD and IPF. They report patient perceptions of the impact of disease and its treatments on whole-person wellbeing and can guide research to make care more patient-centred.https://bit.ly/3s7Y0a8
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Affiliation(s)
- Meena Kalluri
- Division of Pulmonary Medicine, University of Alberta, Edmonton, AB, Canada .,Shared first and last authorship
| | - Fabrizio Luppi
- Respiratory Diseases Unit, University of Milano-Bicocca. "S. Gerardo" Hospital, Monza, Italy.,Shared first and last authorship
| | - Ada Vancheri
- Regional Referral Center for Rare Lung Diseases, University - Hospital "Policlinico G. Rodolico - San Marco", Catania, Italy
| | - Carlo Vancheri
- Dept of Clinical and Experimental Medicine, Regional Referral Centre for Rare Lung Diseases, University - Hospital "Policlinico G. Rodolico - San Marco", University of Catania, Catania, Italy
| | - Elisabetta Balestro
- Dept of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Francesco Varone
- UOC Pneumologia, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy
| | - Nesrin Mogulkoc
- Dept of Pulmonology, Ege University Hospiral, Bornova, Izmir, Turkey
| | - Giulia Cacopardo
- UOSD UTIR, A.R.N.A.S. Ospedali Civico Di Cristina Benfratelli, Palermo, Italy
| | - Elena Bargagli
- Respiratory Diseases Unit, Siena University, Siena, Italy
| | - Elizabeth Renzoni
- Interstitial Lung Disease Unit, Royal Brompton Hospital, Imperial College, London, UK
| | - Sebastiano Torrisi
- Dept of Clinical and Experimental Medicine, Regional Referral Centre for Rare Lung Diseases, University - Hospital "Policlinico G. Rodolico - San Marco", University of Catania, Catania, Italy
| | | | - Alessandro Libra
- Regional Referral Center for Rare Lung Diseases, University - Hospital "Policlinico G. Rodolico - San Marco", Catania, Italy
| | - Mauro Pavone
- Dept of Clinical and Experimental Medicine, Regional Referral Centre for Rare Lung Diseases, University - Hospital "Policlinico G. Rodolico - San Marco", University of Catania, Catania, Italy
| | - Francesco Bonella
- Pneumology Dept, Centre for Interstitial and Rare Lung Disease, Ruhrlandklinik University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Vincent Cottin
- Dept of Respiratory Medicine, National Reference Coordinating Center for Rare Pulmonary Diseases, Louis Pradel Hospital, Hospices Civils de Lyon, Lyon, France.,University of Lyon, INRAE, IVPC, Lyon, France
| | - Claudia Valenzuela
- Pulmonology Dept, Hospital Universitario de la Princesa, Universidad Autonoma Madrid, Madrid, Spain.,Shared first and last authorship
| | - Marlies Wijsenbeek
- Centre of excellence, Interstitial Lung Diseases and Sarcoidosis, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands.,Shared first and last authorship
| | - Elisabeth Bendstrup
- Dept of Respiratory Diseases and Allergy, Centre for Rare Lung Diseases, Aarhus University Hospital, Aarhus N, Denmark.,Shared first and last authorship
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Anthony SJ, Young K, Pol SJ, Selkirk EK, Blydt-Hansen T, Boucher S, Goldberg A, Hamiwka L, Haverman L, Mitchell J, Urschel S, Santana M, Stinson J, Sutherland K, West LJ. Patient-reported outcome measures in pediatric solid organ transplantation: Exploring stakeholder perspectives on clinical implementation through qualitative description. Qual Life Res 2021; 30:1355-1364. [PMID: 33447959 PMCID: PMC8068689 DOI: 10.1007/s11136-020-02743-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2020] [Indexed: 12/05/2022]
Abstract
PURPOSE Patient-reported outcome measures (PROMs) are standardized instruments used to collect data about the subjective assessment of medical care from the patient perspective. Implementing PROMs within pediatric clinical settings has gained increasing importance as health services prioritize patient-centred pediatric care. This study explores the perspectives of pediatric solid organ transplant patients, caregivers, and healthcare practitioners (HCPs) on implementing PROMs into clinical practice. METHODS Qualitative description methods were used to elicit stakeholder perspectives. Semi-structured interviews were conducted across five Canadian transplant centres. Purposive sampling was used to obtain maximum variation across age, gender, and transplant program for all participants, as well as discipline for HCPs. RESULTS The study included a total of 63 participants [patients (n = 20), caregivers (n = 22) and HCPs (n = 21)]. Nearly all participants endorsed the implementation of PROMs to enhance pediatric transplant clinical care. Three primary roles for PROMs emerged: (1) to bring a transplant patient's overall well-being into the clinical care conversation; (2) to improve patient communication and engagement; and, (3) to inform the practice of clinical pediatric transplant care. Insights for effective implementation included completing electronic PROMs remotely and prior to clinical appointments by patients who are eight to 10 years of age or older. CONCLUSIONS This study contributes to current research that supports the use of PROMs in clinical pediatric care and guides their effective implementation into practice. Future directions include the development, usability testing, and evaluation of a proposed electronic PROM platform that will inform future research initiatives.
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Affiliation(s)
- Samantha J Anthony
- Hospital for Sick Children, 686 Bay Street, Toronto, ON, M5G 0A4, Canada.
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada.
- Canadian Donation and Transplantation Research Program, Edmonton, Canada.
| | - Katarina Young
- Hospital for Sick Children, 686 Bay Street, Toronto, ON, M5G 0A4, Canada
| | - Sarah J Pol
- Hospital for Sick Children, 686 Bay Street, Toronto, ON, M5G 0A4, Canada
| | - Enid K Selkirk
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
| | - Tom Blydt-Hansen
- Canadian Donation and Transplantation Research Program, Edmonton, Canada
- British Columbia Children's Hospital, Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Suzanne Boucher
- Canadian Donation and Transplantation Research Program, Edmonton, Canada
| | - Aviva Goldberg
- Canadian Donation and Transplantation Research Program, Edmonton, Canada
- Health Science Centre Winnipeg, Winnipeg, Canada
- Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada
| | - Lorraine Hamiwka
- Canadian Donation and Transplantation Research Program, Edmonton, Canada
- Alberta Children's Hospital, Calgary, Canada
- Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Lotte Haverman
- Amsterdam UMC, University of Amsterdam, Emma Children's Hospital, Psychosocial, Amsterdam, The Netherlands
| | - Joanna Mitchell
- Canadian Donation and Transplantation Research Program, Edmonton, Canada
| | - Simon Urschel
- Canadian Donation and Transplantation Research Program, Edmonton, Canada
- Stollery Children's Hospital, Edmonton, Canada
- Department of Pediatrics, University of Alberta, Edmonton, Canada
| | - Maria Santana
- Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Jennifer Stinson
- Hospital for Sick Children, 686 Bay Street, Toronto, ON, M5G 0A4, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Katie Sutherland
- Canadian Donation and Transplantation Research Program, Edmonton, Canada
| | - Lori J West
- Canadian Donation and Transplantation Research Program, Edmonton, Canada
- Stollery Children's Hospital, Edmonton, Canada
- Department of Pediatrics, University of Alberta, Edmonton, Canada
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Global multi-site, prospective analysis of cataract surgery outcomes following ICHOM standards: the European CAT-Community. Graefes Arch Clin Exp Ophthalmol 2021; 259:1897-1905. [PMID: 33855602 DOI: 10.1007/s00417-021-05181-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 03/25/2021] [Accepted: 04/01/2021] [Indexed: 10/21/2022] Open
Abstract
PURPOSE To evaluate in a large sample of patients from 10 different European centers the results of cataract surgery, characterizing the relationship between patient-reported outcomes (PROMs) and clinician-reported outcome measures (CROMs). METHODS Prospective non-interventional multicenter observational descriptive study analyzing the clinical outcomes of a total of 3799 cases undergoing cataract surgery (mean age: 72.7 years). In all cases, the cataract surgery standard developed by the International Consortium for Health Outcomes Measurements (ICHOM) was used to register the clinical data. Three-month postoperative visual acuity and refraction data were considered CROMs, whereas Rasch-calibrated item 2 (RCCQ2) and total Catquest-9SF score (CQ) were considered PROMs. RESULTS Postoperative corrected distance visual acuity (CDVA) was 0.3 logMAR or better in 88.7% (2505/2823) of eyes. Mean differences between preoperative and postoperative RCCQ2 and CQ scores were -3.09 and -2.39, respectively. Visual function improvement with surgery was reported by 91.5% (2163/2364) of patients. Statistically significant, although weak, correlations of postoperative CDVA with postoperative refraction, PROMs, and complications were found (0.133 ≤ r ≤0.289, p < 0.001). A predictive model (R2: 0.254) of postoperative CDVA considering 10 variables was obtained, including preoperative CDVA, different ocular comorbidities, age, gender and intraoperative complications. Likewise, another predictive model (R2: 0.148) of postoperative CQ considering a total of 14 variables was obtained, including additionally preoperative CQ, target refraction and previous surgeries. CONCLUSIONS Cataract surgery provides an improved functional vision in most of patients although this improvement can be limited by ocular comorbidities and complications. The relationship between PROMs and CROMs is multifactorial and complex.
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Mind the evidence gap: the use of patient-based evidence to create "complete HTA" in the twenty-first century. Int J Technol Assess Health Care 2021; 37:e46. [PMID: 33745475 DOI: 10.1017/s026646232100012x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The aim of this paper is to review the concept of patient-based evidence in health technology assessment (HTA), drawing on philosophical ideas of knowledge in order to judge whether current approaches to the use of evidence for HTA are complete. We draw on a number of key sources, including key papers and book chapters, discussion forums, agency reports, and conference presentations. We develop the potential dimensions of patient-based evidence, describe its key attributes, and consider its future development. Patient-based evidence has the potential to be a key concept in HTA, comprised of a series of related elements of importance to patients. We recognize that we raise more questions than can be answered, but as an emerging concept, recognition and understanding of patient-based evidence is still developing. The concepts and methods that support its application in HTA require urgent development. We conclude that clinical and economic forms of evidence are not enough for HTA. For HTA to be complete, we need to consider all relevant aspects of the phenomena, including patient-based evidence. There is now an urgent need for the global research and HTA community to work together to realize the full potential of patient-based evidence through conceptual and methodological development and wider recognition. We advocate that a task force be set up to address these urgent issues.
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Rose D, Ray E, Summers RH, Taylor M, Kruk H, North M, Gillett K, Thomas M, Wilkinson TMA. Case-finding for COPD clinic acceptability to patients in GPs across Hampshire: a qualitative study. NPJ Prim Care Respir Med 2021; 31:4. [PMID: 33542246 PMCID: PMC7862661 DOI: 10.1038/s41533-021-00216-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 11/17/2020] [Indexed: 11/23/2022] Open
Abstract
Despite high mortality and morbidity, COPD remains under-diagnosed. Case-finding strategies are possible, but patients' perspectives are unexplored. Using qualitative methods, we explored the patient perspective of a case-finding intervention among at-risk patients in primary care. Semi-structured telephone interviews were transcribed and thematic analysis utilised. Seven patients without (mean age 64.5 years (58-74), n = 4) and 8 with obstructed spirometry (mean age 63.5 (53-75), n = 4) were interviewed. Themes identified were motives, challenges and concerns regarding attending the clinic. These included wanting to be well; to help with research; concern over negative impact to life from COPD diagnosis; perceived utility of the clinic; quality of information given; staff manner, approachability and knowledge; and perceived effects of the clinic on lifestyle, self-management and symptoms. The intervention was generally deemed useful and reassuring, although shared information was too detailed or irrelevant for some. Several reported positive lifestyle changes, improved symptoms and improved self-management.
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Affiliation(s)
| | - Emma Ray
- NIHR ARC Wessex, Faculty of Health Sciences, University of Southampton, Southampton, UK
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Rachael H Summers
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Melinda Taylor
- NIHR ARC Wessex, Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Helen Kruk
- NIHR ARC Wessex, Faculty of Health Sciences, University of Southampton, Southampton, UK
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Mal North
- NIHR ARC Wessex, Faculty of Health Sciences, University of Southampton, Southampton, UK
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Kate Gillett
- NIHR ARC Wessex, Faculty of Health Sciences, University of Southampton, Southampton, UK
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Mike Thomas
- Department of Primary Care and Population Sciences, University of Southampton, Southampton, UK
| | - Tom M A Wilkinson
- Faculty of Medicine, University of Southampton, Southampton, UK.
- NIHR Biomedical Research Centre, University Hospitals Southampton NHS Foundation Trust, Southampton, UK.
- Wessex Investigational Sciences Hub, University of Southampton Faculty of Medicine, Southampton General Hospital, Southampton, UK.
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Graham T, Sooriah S, Box R, Gage H, Williams P, Clemett V, Grocott P. Participatory co-design of patient-reported outcome indicators and N-of-1 evaluation of a dressing glove for Epidermolysis bullosa. J Wound Care 2020; 29:751-762. [PMID: 33320744 DOI: 10.12968/jowc.2020.29.12.751] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE In autosomal recessive dystrophic Epidermolysis bullosa, repeat blistering results in finger webbing and severe contractures of the hands. The aim of this study was to codesign patient-reported outcome indicators for hand therapy with patients, carers and clinicians, and use these to proof-of-concept test a novel dressing glove for recessive dystrophic Epidermolysis bullosa, with cost analysis. METHOD Qualitative interviews and focus groups with patients and carers generated content for the indicators. Validity and reliability were established through expert review, piloting and consensus between patients, carers and clinicians. The indicators were self-reported by patients before and while wearing the dressing glove in an N-of-1 study. Time for dressing changes and use of conventional products were also self-reported. RESULTS A total of 11 indicators were initially generated from the thematic analysis. Expert review, piloting and consensus involved six patients, five carers and eight clinicians (total n=19). Participants agreed 14 indicators, covering hand skin condition (n=4), webbing between the digits (n=4), experiences of wearing and changing dressings (n=2), hand function (n=2), wrist function (n=1) and hand pain (n=1). In Phase 3, 12 patients scored indicators before wearing the gloves and four patients completed scoring while wearing the gloves. Statistically significant improvements between pre-glove and with-glove periods were found for most participants' experience scores. Skin appearance also improved for most participants. CONCLUSIONS The indicators generated useful data, differentiation between scores and participants demonstrating proof-of-concept for patients with recessive dystrophic Epidermolysis bullosa who could wear the dressing gloves. The indicators are being used in routine practice, supporting clinical follow up, commercialisation and regulatory governance of the dressing glove.
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Affiliation(s)
- Tanya Graham
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, UK
| | - Sangeeta Sooriah
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, UK
| | - Rachel Box
- Hand Therapy Department, Guy's and St Thomas's NHS Foundation Trust, UK
| | - Heather Gage
- Faculty of Health and Medical Sciences, University of Surrey, UK
| | | | - Victoria Clemett
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, UK
| | - Patricia Grocott
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, UK
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Parry M, Bjørnnes AK, Toupin-April K, Najam A, Wells D, Sivakumar A, Richards DP, Ceroni T, Park M, Ellis AK, Gilron I, Marlin S. Patient Engagement Partnerships in Clinical Trials: Development of Patient Partner and Investigator Decision Aids. THE PATIENT 2020; 13:745-756. [PMID: 33026639 PMCID: PMC7655585 DOI: 10.1007/s40271-020-00460-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/19/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND A 2017 systematic review suggested patient engagement in clinical trials has been limited, with little active engagement in trial design or data analysis, interpretation or dissemination. Additionally, there remains limited sex/gender reporting in clinical trial research. OBJECTIVES The overall goal of this project was to disseminate sex/gender knowledge and build capacity for patient engagement in clinical trials. Specific objectives were to (1) create capacity and identify opportunities for patient engagement in clinical trials and sponsor- or investigator-led activities (e.g. clinical trial design and conduct); and (2) enhance new/early investigator sex/gender knowledge and skills related to patient-oriented research (POR). METHODS We used the Canadian Institutes of Health Research Strategy for Patient-Oriented Research (SPOR) Capacity Development Framework and the SPOR Patient Engagement Framework to guide three phases of this project: (1) conduct a scoping review using methods described by the Evidence for Policy and Practice Information (EPPI) and the Coordinating Centre at the Institute of Education (Phase 1); (2) host a 1-day POR consultation workshop (Phase 2); and (3) deliver a new/early investigator POR training day (Phase 3). Six electronic databases (CINAHL, MEDLINE, EMBASE, PsychInfo, the Cochrane Library, and AMED) were searched from 1996 using keywords and Medical Subject Heading (MeSH) terms in accordance with the International Association for Public Participation (IAP2) and the search criteria in the bibliographic databases. Standard approaches were used to search the grey literature. RESULTS A total of 79 studies and over 150 websites were subject to data abstraction by team members, capturing information on sex/gender and SPOR's patient engagement guiding principles of inclusiveness, support, mutual respect, and co-building. Results were presented to 32 key stakeholders at the consultation workshop and input was sought on next steps using nominal group techniques. Based on the plethora of existing POR resources, relevant POR information from the scoping review was collated into two decision aids (patient and investigator) to determine readiness to engage with/as a patient partner in a clinical trial. The decision aids were presented at a POR training day with 88 new/early investigators, clinicians, patient partners and decision makers. The decision aids showed 'good' usability, assessed using the System Usability Scale (SUS). Attendees thought the decision aids were engaging, they increased their understanding of sex/gender, patient engagement and POR, and they would recommend them to others. POR principles and practices were integrated across all phases of the project. Patient partners (1) identified research priorities/search terms; (2) collected/analyzed data; (3) designed the patient partner decision aid; and (4) disseminated the results through presentation. CONCLUSION Our digital patient partner and investigator decision aids are the first to provide information technology to deliver sex/gender, POR knowledge, and decision support beyond the traditional decision aids used for health screening and/or treatment decisions. The decision aids have the potential to make a significant contribution to Canada's Strategy for POR and support the collaborative efforts of patients and investigators to build a sustainable, accessible and equitable health care system.
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Affiliation(s)
- Monica Parry
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Suite 130, Toronto, ON, M5T 1P8, Canada.
| | - Ann Kristin Bjørnnes
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Karine Toupin-April
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Adhiyat Najam
- Patient Partner, Diabetes Action Canada, Toronto, ON, Canada
| | - David Wells
- Patient Partner, Diabetes Action Canada, Toronto, ON, Canada
| | - Aditi Sivakumar
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | | | - Tina Ceroni
- Patient Partner, Clinical Trials Ontario, Toronto, ON, Canada
| | - Marianne Park
- Patient Partner, Network of Women with Disabilities, Woodstock, ON, Canada
| | - Anne K Ellis
- Department of Medicine, Queen's University, Kingston, ON, Canada
| | - Ian Gilron
- Departments of Anesthesiology and Perioperative Medicine, Biomedical and Molecular Sciences and School of Policy Studies, Queen's University, Kingston, ON, Canada
| | - Susan Marlin
- Patient Partner, Diabetes Action Canada, Toronto, ON, Canada
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da Silva Filho JC, Ramos Vieira Santos IC, Valença MP, Mendes Morato JE, Ferreira Dos Santos Filho SR, Lessa de Andrade A. Assessment instruments for lower urinary tract dysfunction in children: Symptoms, characteristics and psychometric properties. J Pediatr Urol 2020; 16:636-644. [PMID: 32798106 DOI: 10.1016/j.jpurol.2020.07.031] [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: 08/13/2019] [Revised: 06/04/2020] [Accepted: 07/21/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION The use of instruments to assess symptoms of the lower urinary tract has increased mainly when it comes to pediatric urology. The search for a validated and reliable one for use in clinical practice should be a concern of the professionals involved in the care of these children. OBJECTIVE The aim of this study was to analyze the assessment instruments for lower urinary tract dysfunction in children regarding: symptoms, characteristics and psychometric properties. STUDY DESIGN PubMed and Latin American and Caribbean Literature in Health Sciences databases were searched. The PICO strategy was used to construct the research question and bibliographic search. Keywords included voiding disorders, LUTS, Child, Surveys and Questionnaires. RESULTS Nine articles were identified. The construct observed by all instruments was bladder dysfunction and seven instruments also assessed bowel dysfunction. Thirty different events were addressed. In eight instruments the respondents are the parents. The age of the target population ranged from three to eighteen years and regarding the number of items, an average of 21.8 items was observed. Six instruments showed good results of reliability and four presented good results of accuracy. CONCLUSIONS The instruments included a wide range of symptoms related to dysfunction. Only two reported all validation and reliability tests, however six instruments showed good reliability results, making them eligible for the cross-cultural adaptation and validation process for use in countries other than those of the instrument's origin.
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Development and assessment of a verbal response scale for the Patient-Specific Functional Scale (PSFS) in a low-literacy, non-western population. Qual Life Res 2020; 30:613-628. [DOI: 10.1007/s11136-020-02640-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2020] [Indexed: 12/31/2022]
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Moore L, Eggleton P, Smerdon G, Newcombe J, Holley JE, Gutowski NJ, Smallwood M. Engagement of people with multiple sclerosis to enhance research into the physiological effect of hyperbaric oxygen therapy. Mult Scler Relat Disord 2020; 43:102084. [PMID: 32442882 DOI: 10.1016/j.msard.2020.102084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 03/29/2020] [Accepted: 03/30/2020] [Indexed: 01/09/2023]
Abstract
BACKGROUND Thousands of people with multiple sclerosis (MS) have used self-administered oxygen therapy in the UK. Clinical trials have been performed, with scant evidence that people with MS have been consulted to explore how they benefit from or how to optimize this treatment. The conventional MS disease disability scores used in trials seldom reflect the effects individuals report when using oxygen therapy to treat their symptoms. METHODS Three people with MS and the manager of an MS Centre formed a public involvement group and collaborated with clinicians and scientists to inform a lab-based study to investigate the physiological effects of oxygen therapy on microvascular brain endothelial cells. RESULTS People with MS often use oxygen therapy at a later stage when their symptoms worsen and only after using other treatments. The frequency of oxygen therapy sessions and hyperbaric pressure is individualized and varies for people with MS. Despite direct comparisons of efficacy proving difficult, most individuals are exposed to 100% O2 at 1.5 atmosphere absolute (ATA; 1140 mmHg absolute) for 60 min. In a laboratory-based study human brain endothelial cells were exposed in vitro to 152 mmHg O2 for 60 min with and without pressure, as this equates to 20% O2 achievable via hyperbarics, which was then replicated at atmospheric pressure. A significant reduction in endothelial cells ICAM-1 (CD54) implicated in inflammatory cell margination across the blood brain barrier was observed under oxygen treatment. CONCLUSIONS By collaborating with people living with MS, we were able to design laboratory-based experimental protocols that replicate their treatment regimens to advance our understanding of the physiological effects of hyperbaric oxygen treatment on brain cells and their role in neuroinflammation.
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Affiliation(s)
- Lucy Moore
- Institute of Biomedical and Clinical Sciences, College of Medicine & Healthcare, University of Exeter, Exeter, UK; Royal Devon and Exeter Hospital Foundation Trust, Exeter, UK
| | - Paul Eggleton
- Institute of Biomedical and Clinical Sciences, College of Medicine & Healthcare, University of Exeter, Exeter, UK; Royal Devon and Exeter Hospital Foundation Trust, Exeter, UK.
| | - Gary Smerdon
- Institute of Biomedical and Clinical Sciences, College of Medicine & Healthcare, University of Exeter, Exeter, UK; DDRC Healthcare, Hyperbaric Medical Centre, Plymouth, UK
| | - Jia Newcombe
- Institute of Biomedical and Clinical Sciences, College of Medicine & Healthcare, University of Exeter, Exeter, UK; NeuroResource, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Janet E Holley
- Institute of Biomedical and Clinical Sciences, College of Medicine & Healthcare, University of Exeter, Exeter, UK
| | - Nicholas J Gutowski
- Institute of Biomedical and Clinical Sciences, College of Medicine & Healthcare, University of Exeter, Exeter, UK; Royal Devon and Exeter Hospital Foundation Trust, Exeter, UK
| | - Miranda Smallwood
- Institute of Biomedical and Clinical Sciences, College of Medicine & Healthcare, University of Exeter, Exeter, UK; Royal Devon and Exeter Hospital Foundation Trust, Exeter, UK
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Development and psychometric properties of a new brief scale for subjective personal agency (SPA-5) in people with schizophrenia. Epidemiol Psychiatr Sci 2020; 29:e111. [PMID: 32272978 PMCID: PMC7214545 DOI: 10.1017/s2045796020000256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
AIMS Personal agency is a variable which potentially facilitates personal recovery in people with serious mental illness. This study aimed to develop a new brief measure for subjective personal agency that can be completed by people with serious mental illness. METHODS Two focus group interviews were first conducted with 11 people with schizophrenia to understand the fundamental components of subjective personal agency for people with serious mental illness living in the community. One group comprised six people with schizophrenia living in the community, while the other consisted of five people with schizophrenia working as peer-support workers. We then developed scale items through collaboration with people with schizophrenia and qualitative analysis (stage 1). A cross-sectional survey was then conducted to test the psychometric properties of the new scale among service users with schizophrenia in 18 assertive community treatment teams (stage 2). Factor validity was tested via exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). We evaluated convergent validity with the Boston University Empowerment Scale (BUES), divergent validity with the global assessment of functioning (GAF), internal consistency, and test-retest reliability. RESULTS Seven items were included in the scale at stage 1. In stage 2, 195 participants completed this scale. EFA revealed a one-factor model with five items. CFA indicated good model fit (χ2 statistics [CMIN] = 8.445, df = 5 (CMIN/df = 1.689), p = 0.133, comparative fit index = 0.974, Tucker-Lewis fit index = 0.949, root mean square error of approximation = 0.077 and standardised root mean squared residual = 0.042). The new scale was significantly correlated with total BUES score (r = 0.526, p < 0.001), but not with GAF score. Cronbach's α for internal consistency was 0.79, and intra-class correlation coefficient for test-retest reliability was 0.70. CONCLUSION We developed a new, five-item Subjective Personal Agency scale (SPA-5) that can be completed by people with serious mental illness. Further studies are needed to confirm the results outside Japan.
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Mallett R, McLean S, Holden MA, Potia T, Gee M, Haywood K. Use of the nominal group technique to identify UK stakeholder views of the measures and domains used in the assessment of therapeutic exercise adherence for patients with musculoskeletal disorders. BMJ Open 2020; 10:e031591. [PMID: 32075824 PMCID: PMC7044886 DOI: 10.1136/bmjopen-2019-031591] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES The objective was to the undertake nominal group technique (NGT) to evaluate current exercise adherence measures and isolated domains to develop stakeholder consensus on the domains to include in the measurement of therapeutic exercise adherence for patients with musculoskeletal disorders. DESIGN A 1-day NGT workshop was convened. Six exercise adherence measures were presented to the group that were identified in our recent systematic review. Discussions considered these measures and isolated domains of exercise adherence. Following discussions, consensus voting identified stakeholder agreement on the suitability of the six offered adherence measures and the inclusion of isolated domains of exercise adherence in future measurement. SETTING One stakeholder NGT workshop held in Sheffield, UK. PARTICIPANTS Key stakeholders from the UK were invited to participate from four identified populations. 14 participants represented patients, clinicians, researchers and service managers. RESULTS All six exercise adherence measures were deemed not appropriate for use in clinical research or routine practice with no measure reaching 70% group agreement for suitability, relevance, acceptability or appropriateness. Three measures were deemed feasible to use in clinical practice. 25 constructs of exercise adherence did reach consensus threshold and were supported to be included as domains in the future measurement of exercise adherence. CONCLUSION A mixed UK-based stakeholder group felt these six measures of exercise adherence were unacceptable. Differences in opinion within the stakeholder group highlighted the lack of consensus as to what should be measured, the type of assessment that is required and whose perspective should be sought when assessing exercise adherence. Previously unused domains may be needed alongside current ones, from both a clinician's and patient's perspective, to gain understanding and to inform future measurement development. Further conceptualisation of exercise adherence is required from similar mixed stakeholder groups in various socioeconomic and cultural populations.
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Affiliation(s)
- Ross Mallett
- College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Sheffield, UK
| | - Sionnadh McLean
- College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Sheffield, UK
| | - Melanie A Holden
- Primary Care Centre Versus Arthritis, Keele University, Keele, UK
| | - Tanzila Potia
- College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Sheffield, UK
| | - Melanie Gee
- Centre for Health and Social Care Research, Sheffield Hallam University, Sheffield, UK
| | - Kirstie Haywood
- Warwick Research in Nursing, University of Warwick, Coventry, UK
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Addario B, Geissler J, Horn MK, Krebs LU, Maskens D, Oliver K, Plate A, Schwartz E, Willmarth N. Including the patient voice in the development and implementation of patient-reported outcomes in cancer clinical trials. Health Expect 2020; 23:41-51. [PMID: 31722131 PMCID: PMC6978854 DOI: 10.1111/hex.12997] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 10/11/2019] [Accepted: 10/15/2019] [Indexed: 01/01/2023] Open
Abstract
CONTEXT Patient-reported outcomes (PROs) are used in parallel with clinical evidence to inform decisions made by industry, clinicians, regulators, health technology assessment bodies and other health-care decision-makers. In addition, PRO data can also guide shared decision making and individual patient choice. Yet, the quality of many PROs in cancer clinical trials is suboptimal and requires improvement to add value to health care and policy decision making. OBJECTIVE To show how the integration of the patient and/or patient advocate at all stages of PRO development can help to realize the full potential of PROs. METHODS We examined the literature to show that the patient voice is often absent from the planning and implementation of PROs in cancer clinical trials. Good practice examples from the literature were combined with guideline recommendations, training or educational resources, and our own experience to create detailed practical steps for the inclusion of patients and/or patient advocates throughout PRO development. RESULTS Patient or patient advocates can play an active role in shaping PROs that are meaningful to the patient. They can contribute to content, choice of medium and implementation in a way that may support PRO completion and minimize missing data. Patients and their advocates can work to ensure PRO findings are disseminated appropriately in a way that is accessible to patients. CONCLUSION This practical guidance aims to optimize PRO development and implementation in clinical trials, resulting in robust, relevant data that reflect the patient experience and that support decisions made by all stakeholders involved in research and health care.
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Affiliation(s)
- Bonnie Addario
- GO2 Foundation for Lung CancerSan CarlosCAWashington DCUSA
| | | | | | - Linda U. Krebs
- International Society of Nurses in Cancer CareVancouverBCCanada
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Carlton J, Peasgood T, Khan S, Barber R, Bostock J, Keetharuth AD. An emerging framework for fully incorporating public involvement (PI) into patient-reported outcome measures (PROMs). J Patient Rep Outcomes 2020; 4:4. [PMID: 31933005 PMCID: PMC6957651 DOI: 10.1186/s41687-019-0172-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 12/23/2019] [Indexed: 01/28/2023] Open
Abstract
Patient-reported outcome measures (PROMs) are widely used in the United Kingdom (UK) and internationally to report and monitor patients’ subjective assessments of their symptoms and functional status and also their quality of life. Whilst the importance of involving the public in PROM development to increase the quality of the developed PROM has been highlighted this practice is not widespread. There is a lack of guidance on how public involvement (PI) could be embedded in the development of PROMs, where the roles can be more complex than in other types of research. This paper provides a timely review and sets out an emerging framework for fully incorporating PI into PROM development.
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Affiliation(s)
- J Carlton
- University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK.
| | - T Peasgood
- University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - S Khan
- University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - R Barber
- University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - J Bostock
- University of Cambridge, Cambridge, UK.,University of Oxford, Oxford, UK.,Kings College London, London, UK
| | - A D Keetharuth
- University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
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Salvi D, Poffley E, Orchard E, Tarassenko L. The Mobile-Based 6-Minute Walk Test: Usability Study and Algorithm Development and Validation. JMIR Mhealth Uhealth 2020; 8:e13756. [PMID: 31899457 PMCID: PMC6969385 DOI: 10.2196/13756] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 06/07/2019] [Accepted: 08/31/2019] [Indexed: 12/19/2022] Open
Abstract
Background The 6-min walk test (6MWT) is a convenient method for assessing functional capacity in patients with cardiopulmonary conditions. It is usually performed in the context of a hospital clinic and thus requires the involvement of hospital staff and facilities, with their associated costs. Objective This study aimed to develop a mobile phone–based system that allows patients to perform the 6MWT in the community. Methods We developed 2 algorithms to compute the distance walked during a 6MWT using sensors embedded in a mobile phone. One algorithm makes use of the global positioning system to track the location of the phone when outdoors and hence computes the distance travelled. The other algorithm is meant to be used indoors and exploits the inertial sensors built into the phone to detect U-turns when patients walk back and forth along a corridor of fixed length. We included these algorithms in a mobile phone app, integrated with wireless pulse oximeters and a back-end server. We performed Bland-Altman analysis of the difference between the distances estimated by the phone and by a reference trundle wheel on 49 indoor tests and 30 outdoor tests, with 11 different mobile phones (both Apple iOS and Google Android operating systems). We also assessed usability aspects related to the app in a discussion group with patients and clinicians using a technology acceptance model to guide discussion. Results The mean difference between the mobile phone-estimated distances and the reference values was −2.013 m (SD 7.84 m) for the indoor algorithm and −0.80 m (SD 18.56 m) for the outdoor algorithm. The absolute maximum difference was, in both cases, below the clinically significant threshold. A total of 2 pulmonary hypertension patients, 1 cardiologist, 2 physiologists, and 1 nurse took part in the discussion group, where issues arising from the use of the 6MWT in hospital were identified. The app was demonstrated to be usable, and the 2 patients were keen to use it in the long term. Conclusions The system described in this paper allows patients to perform the 6MWT at a place of their convenience. In addition, the use of pulse oximetry allows more information to be generated about the patient’s health status and, possibly, be more relevant to the real-life impact of their condition. Preliminary assessment has shown that the developed 6MWT app is highly accurate and well accepted by its users. Further tests are needed to assess its clinical value.
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Affiliation(s)
- Dario Salvi
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, United Kingdom
| | - Emma Poffley
- Department of Cardiology, Oxford University NHS Foundation Trust, Oxford, United Kingdom
| | - Elizabeth Orchard
- Department of Cardiology, Oxford University NHS Foundation Trust, Oxford, United Kingdom
| | - Lionel Tarassenko
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, United Kingdom
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