Inflammatory bowel disease-specific health-related quality of life instruments: a systematic review of measurement properties

Background

This review aims to critically appraise and compare the measurement properties of inflammatory bowel disease (IBD)-specific health-related quality of life instruments.

Methods

Medline, EMBASE and ISI Web of Knowledge were searched from their inception to May 2016. IBD-specific instruments for patients with Crohn’s disease, ulcerative colitis or IBD were enrolled. The basic characteristics and domains of the instruments were collected. The methodological quality of measurement properties and measurement properties of the instruments were assessed.

Results

Fifteen IBD-specific instruments were included, which included twelve instruments for adult IBD patients and three for paediatric IBD patients. All of the instruments were developed in North American and European countries. The following common domains were identified: IBD-related symptoms, physical, emotional and social domain. The methodological quality was satisfactory for content validity; fair in internal consistency, reliability, structural validity, hypotheses testing and criterion validity; and poor in measurement error, cross-cultural validity and responsiveness. For adult IBD patients, the IBDQ-32 and its short version (SIBDQ) had good measurement properties and were the most widely used worldwide. For paediatric IBD patients, the IMPACT-III had good measurement properties and had more translated versions.

Conclusions

Most methodological quality should be promoted, especially measurement error, cross-cultural validity and responsiveness. The IBDQ-32 was the most widely used instrument with good reliability and validity, followed by the SIBDQ and IMPACT-III. Further validation studies are necessary to support the use of other instruments.

Electronic supplementary material

The online version of this article (10.1186/s12955-017-0753-2) contains supplementary material, which is available to authorized users.

Development and validation of quality of life scale of nasopharyngeal carcinoma patients: the QOL-NPC (version 2)

Background

The aim was to develop and validate the quality of life scale for nasopharyngeal carcinoma (NPC) patients, the QOL-NPC (version 2), a specific instrument to measure quality of life for NPC patients.

Methods

The QOL-NPC was developed and validated according to standard procedures. The patients were assessed using the QOL-NPC, FACT-G, and FACT-H&N. Classical test theory was used to evaluate the reliability, validity, and responsiveness of the QOL-NPC.

Results

A total of 487 patients (97.4 %) completed the questionnaire. The QOL-NPC comprised four domains, as follows: physical function (eight items); psychological function (five items); social function (five items); and side effects (eight items). All of the items had a lower proportion of missing data. Cronbach's alpha values of the domains ranged from 0.72 to 0.84. The split-half reliability coefficients ranged from 0.77 to 0.84. All of the intra-class correlation coefficients were > 0.8. The normed fit index, non-normed fit index, and comparative fit index were >0.89. The root mean square error of approximation was 0.097, with a 90 % confidence interval (0.093, 0.100). The domain scores of the QOL-NPC were significantly correlated with the FACT-G and FACT-H&N (P < 0.05). All of the domain scores of patients using different amounts of radiotherapy were significantly different (P < 0.001). All domain scores decreased at the completion of radiotherapy, with effect sizes ranging from −0.82 to −0.22.

Conclusions

The QOL-NPC is valid for measuring QOL with good reliability, validity, and responsiveness. The QOL-NPC is recommended to measure the QOL for Chinese NPC patients.

Quality of life and radiotherapy complications of Chinese nasopharyngeal carcinoma patients at different 3DCRT

PURPOSE

the study aimed to compare the quality of life (QOL) and radiotherapy complications among Chinese nasopharyngeal carcinoma (NPC) patients at different 3-dimensional conformal radiotherapy (3DCRT) stages adjusting for other variables.

METHODS

511 NPC patients at different 3DCRT stages were enrolled. They were interviewed regarding SF-36, complications and socio-demographic variables and cancer- or treatment- related variables. Analysis of covariance (ANCOVA) based on SF-36, complications scores as dependent variables, 3DCRT stages as independent variables, and other variables as covariate were established.

RESULTS

The influencing factors of PCS included 3DCRT stages and age group. The influencing factors of MCS included 3DCRT stages and income. Most QOL scores of NPC patients were significantly associated with 3DCRT stage, after accounting for other variables. QOL scores of the patients receiving 3DCRT were the lowest, QOL scores of people after 3DCRT gradually increased. PCS scores of people greater than 5 years after 3DCRT was improved to or even better than the level before 3DCRT. The complications with significantly different scores of patients at different 3DCRT status included xerostomia, throat ache, hypogeusia, caries, hearing loss, snuffles.

CONCLUSIONS

Clinicians should pay more attention to older NPC patients and patients with lower income. When patients receive 3DCRT, measures should be taken to reduce radiation injury to improve the patients' QOL.

Phytotherapy versus hormonal therapy for postmenopausal bone loss: a meta-analysis

This meta-analysis included 14 randomized controlled trials involving 780 patients to compare phytotherapy with hormonal therapy in the treatment of postmenopausal bone loss. Current evidence suggests that phytotherapy may possess a similar effect on bone mineral density (BMD) values but clinically is not associated with a high incidence of uterine bleeding and breast pain as is hormonal therapy. Clinical trials indicate that phytotherapy may be a potential treatment for postmenopausal osteoporosis. The objective of this meta-analysis was to compare the efficacy and safety of phytotherapy with that of hormonal therapy, to assess the quality of phytotherapy trials, and to identify herbs used commonly in the treatment of postmenopausal bone loss. A total of 43 electronic databases were searched. The quality of eligible trials was assessed using Jadad's scale. Outcome measures were BMD values and adverse events. Revman 5.0 software was used for data syntheses and meta-analyses. The database search revealed 14 randomized controlled trials involving 780 patients that met the inclusion criteria, and four trials were graded as high quality (score 3-5). There was no significant difference in lumbar, femoral or forearm BMD values between subjects treated with phytotherapy and those treated with hormonal therapy (P>0.05), but the incidence of uterine bleeding and breast pain was significantly lower in those treated with phytotherapy than in those treated with hormonal therapy (P = 0.002 and P = 0.01). The six most commonly used herbs in the included trials were identified. Phytotherapy may not show effects beyond hormonal therapy, but may be safer than hormonal therapy in the treatment of postmenopausal bone loss. Further trials with high-quality study designs should be conducted in this field.

Effects of Matrine on release of interferon and pathological changes in concanavalin A-induced liver injury in mice

AIM: To investigate the effects of matrine on the release of interferon-gamma (IFN-γ) and tumor necrosis factor alpha (TNF-α), and the hepatic histopathology in mice with concanavalin A (Con A) induced liver injury.

METHODS: Forty-eight NIH mice were randomly divided into 4 groups: control group (group A), model group (group B), big dosage group of matrine (25 mg/kg, group C), small dosage group of matrine (12.5 mg/kg, group D) and bifendate group (group E). All mice except group A were injected with Con A (20 mg/kg) via the tail vein at the first day of experiment. Group C and group D were injected with matrine (25 mg/kg and 12.5 mg/kg, respectively) via the tail vein. Mice in group E were orally administered with bifendate (150 mg/kg). All the drugs were given once daily for 3 days consecutively. Four hours after the last administration of the drugs, mice were injected with Con A once again at the same dosage. Blood samples for determining aminotransferase (ALT) activity, IFN-γ and TNF-α concentration were collected at the 8th hour after Con A administration. Histopathological examination was also performed for liver tissue.

RESULTS: Serum IFN-γ and TNF-α in group C and group D were obviously lower than that in group B(IFN-γ: 25.5±6.1 vs 69.3±33.6 ng/L, 26.5±2.5 vs 69.3±33.6 ng/L, t = 4.0, 4.0, respectively, P<0.01; TNF-α: 49.1±11.9 vs 106.7±64.4 ng/L, 52.9±5.2 vs 106.7±64.4 ng/L, t = 2.9, 2.9, respectively, P<0.01, but there was no significant difference compared with group E(P >0.05). Serum ALT activity in group C and group D were apparently lower than that of group B (1 086.9±675.8 vs 2 477.2±529.9 nkat/L, 1 121.9±957.4 vs 2 477.2±529.9 nkat/L, t = 5.1, 3.9, respectively, P<0.01). Hepatic histopathology changes were alleviated in both group C and group D compared with group E (P<0.05).

CONCLUSION: Matrine has a remarkable therapeutic effect on liver injury in mice by suppressing the release of IFN-γ and TNF-α, and alleviating the pathological changes in liver tissue.

The in vivo and in vitro effects of chicken interferon alpha on infectious bursal disease virus and Newcastle disease virus infection

The in vitro and in vivo effects of chicken interferon alpha on infectious bursal disease virus (IBDV) infection were investigated in this study. A cDNA of interferon alpha was first cloned from a Chinese strain chicken Shiqi by reverse transcription-polymerase chain reaction. The deduced amino acid sequence has one amino acid substitution with chicken interferon alpha 1 at residue 65 (N to S) and two amino acid substitutions with chicken interferon alpha 2 at residues 50 (N to S) and 58 (P to L), respectively. A prokaryotic expression system was employed to produce a large quantity of recombinant protein. Recombinant interferon was purified in a one-step process, and an optimal refolding process was devised. About 51% recombinant protein from inclusion bodies was refolded, and the final yield of the recombinant interferon reached 24.66 mg/liter culture. The recombinant interferon suppressed IBDV plaque formation in a dose-dependent manner and ameliorated IBDV and Newcastle disease virus infection in both specific-pathogen-free (SPF) and commercial chickens. The antiviral effect of interferon alpha is more significant in commercial chickens than in SPF chickens, and the route of administration affects the efficacy of interferon therapy. This is the first reported study of the effects of interferon alpha on IBDV infection.

Adaptation of very virulent infectious bursal disease virus to chicken embryonic fibroblasts by site-directed mutagenesis of residues 279 and 284 of viral coat protein VP2

The full-length RNA genomes of a chicken embryonic fibroblast (CEF)-nonpermissive, very virulent infectious bursal disease virus (IBDV) (strain HK46) were amplified into cDNAs by reverse transcription-PCR. The full-length cDNAs were sequenced and subcloned into a eukaryotic expression vector, from which point mutations were introduced into the VP2 region by site-directed mutagenesis. The wild-type and mutated plasmids were transfected directly into CEFs to examine their ability to generate CEF-permissive recombinant viruses. Substitution of amino acid residues 279 (Asp-->Asn) and 284 (Ala-->Thr) of the VP2 protein yielded a recombinant virus which was able to be passaged in CEFs, whereas the wild-type cDNAs and an amino acid substitution at residue 330 (Ser-->Arg) of the VP2 protein alone did not yield viable virus. The results indicated that mutation of other viral proteins, including VP1, VP3, VP4, and VP5, was not required for CEF adaptation of the virus. The same approach may be used to produce CEF-adapted strains from newly evolved IBDVs or to manipulate the antigenicity of the virus.