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Twiss J, Whalley D, Doward L, Balp MM, Brass CA, Cryer D, Sanyal A, Anstee QM. Validation of NASH-CHECK: a novel patient-reported outcome measure for nonalcoholic steatohepatitis. J Patient Rep Outcomes 2023; 7:69. [PMID: 37450086 PMCID: PMC10349018 DOI: 10.1186/s41687-023-00589-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 05/04/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Standardized measures for evaluating patients' experiences with nonalcoholic steatohepatitis (NASH) and their perceived changes with treatment in clinical trials have been limited. To meet this need, a patient-reported outcome (PRO) measure, NASH-CHECK, was developed to evaluate symptoms and health-related quality of life for patients with NASH. The objective of this study was to conduct a quantitative evaluation of the psychometric properties of NASH-CHECK. METHODS The study used data from a phase 2, randomized controlled trial of adult patients with NASH (NCT02855164). Analyses were conducted to determine the optimal scoring of NASH-CHECK and to evaluate reliability, construct validity, and ability to detect change in NASH-CHECK scale scores. RESULTS Data were available for 253 patients with NASH (61% female; mean [standard deviation] age = 53 [12] years). Following initial item-level analyses, including correlations and exploratory factor analysis, three items were removed from the measure. Confirmatory factor analysis supported the formation of four multi-item scales (Cognitive Symptoms, Activity Limitations, Social Impact, and Emotional Impact) and five single-item scales (Abdominal Pain, Abdominal Bloating, Fatigue, Sleep, and Itchy Skin). Psychometric analyses of the final NASH-CHECK scales provided support for their internal reliability, test-retest reliability, construct validity, and ability to detect change. CONCLUSION The results support NASH-CHECK as a reliable, valid, and responsive measure to assess patients' perspectives of symptoms and the health-related quality of life impact of NASH in clinical trials and in routine practice.
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Affiliation(s)
- James Twiss
- RTI Health Solutions, Manchester, M20 2LS, UK.
| | | | | | | | | | | | - Arun Sanyal
- Virginia Commonwealth University, Richmond, VA, USA
| | - Quentin M Anstee
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
- Newcastle NIHR Biomedical Research Centre, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle Upon Tyne, UK
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2
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Khan AH, Kosa K, De Prado Gomez L, Whalley D, Kamat S, Clark M. Content Validation of Patient-Reported Sleep Measures and Development of a Conceptual Model of Sleep Disturbance in Patients with Moderate-to-Severe, Uncontrolled Asthma. Patient Relat Outcome Meas 2023; 14:57-71. [PMID: 36992797 PMCID: PMC10042243 DOI: 10.2147/prom.s392666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 02/18/2023] [Indexed: 03/31/2023] Open
Abstract
Purpose Sleep disturbance is common in patients with asthma and can lead to subsequent impacts on health-related quality of life (HRQOL). Fit-for-purpose patient-reported outcome measures (PROMs) assessing asthma-related sleep disturbance and next-day HRQOL impact (next-day impact) are needed to evaluate disease burden and treatment effects. Patients and Methods Adults (18-65 years) from three US clinics were recruited for semistructured interviews. Concept elicitation (CE) identified how asthma affects participants' sleep and how asthma-related sleep disturbances impact their daily lives, which informed conceptual model development. Cognitive debriefing (CD) of the Asthma Sleep Disturbance Questionnaire (ASDQ), Sleep Diary, and Patient-Reported Outcomes Measurement Information System Sleep-Related Impairment Short Form 8a (PROMIS SRI SF8a) was completed to assess each measure's content validity. Results Twelve individuals participated in two interview rounds (6 individuals per round). Participants most frequently reported asthma-related nighttime awakening and decreased sleep quality and duration. Negative impacts of a poor night's sleep due to asthma symptoms included feeling tired/fatigue/lack of energy and subsequent negative impacts on physical functioning, emotions and mood, mental functioning, work or volunteerism, and social functioning. Across both rounds of CD interviews, participants generally found the Sleep Diary and PROMIS SRI SF8a items relevant and easy to complete with no modifications. The ASDQ was modified for clarity and consistency. Conclusion As described in the conceptual model, asthma affects multiple aspects of sleep that can cause next-day fatigue and other subsequent negative HRQOL impacts. This study demonstrates that the ASDQ, Sleep Diary, and PROMIS SRI SF8a items are comprehensive, relevant, and appropriate for patients with moderate-to-severe, uncontrolled asthma. Evaluation of psychometric properties for the ASDQ, Sleep Diary, and PROMIS SRI SF8a based on clinical trial data in patients with moderate-to-severe, uncontrolled asthma will further support their use.
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Affiliation(s)
- Asif H Khan
- Sanofi, Chilly-Mazarin, France
- Correspondence: Asif H Khan, Sanofi, Chilly-Mazarin, France, Tel +33 1 60 49 50 76, Email
| | - Katherine Kosa
- Patient-Centered Outcomes Assessment, RTI Health Solutions, Research Triangle Park, NC, USA
| | | | - Diane Whalley
- Patient-Centered Outcomes Assessment, RTI Health Solutions, Manchester, UK
| | | | - Marci Clark
- Patient-Centered Outcomes Assessment, RTI Health Solutions, Ann Arbor, MI, USA
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Butler E, Walsh JE, Grogan S, Lyons C, Whalley D, Fitzpatrick J, Gallagher L, Dockery F. 348 WHAT IS THE OLDER PATIENT’S VIEW ON RECEIVING DETAILED MEDICAL LETTERS? Age Ageing 2022. [DOI: 10.1093/ageing/afac218.305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Sending copies of clinic letters to patients involves additional work for medical staff in formatting letters, administrative staff in printing and posting and is an added cost to the healthcare service. Though seen largely as good practice in some specialities, it is not done routinely in Geriatric medical services. We introduced this practice as standard in our service and wished to evaluate whether from the patient perspective, it is worthwhile.
Methods
We sent a questionnaire to n=80 older patients who were evaluated in the home setting (by the Integrated Care Team for Older People – ICTOP) or recently attended CGA (Comprehensive Geriatric Assessment) clinic or FLS (Fracture Liaison Service) clinic. We asked their opinion on the detailed medical letter sent to their General Practitioner (GP), which they received a copy of. The questionnaire could be completed by patient/carer/relative, and returned anonymously.
Results
N=30/80 were returned. Two said they found the letter difficult to understand; 1/30 said the letter caused them to worry but all said they still preferred that they had received it. N= 2 said they would like to have contributed to the letter for accuracy. All said they felt they should receive copies of all their medical correspondence. Free text comments showed overwhelming support for the process, in allowing them to self-manage their health, enhance communication with other healthcare professionals and was a useful document to refer back to when they are trying to process information during short consultations.
Conclusion
Though a small survey and limited by low response rate, older people expressed high levels of satisfaction in receiving copies of medical letters about their health. It supports the ongoing practice and should be adopted widely.
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Affiliation(s)
- E Butler
- Beaumont Hospital , Dublin, Ireland
| | - JE Walsh
- Integrated Care Team for Older People, North Dublin , Dublin, Ireland
| | - S Grogan
- Integrated Care Team for Older People, North Dublin , Dublin, Ireland
| | - C Lyons
- Beaumont Hospital , Dublin, Ireland
| | - D Whalley
- Integrated Care Team for Older People, North Dublin , Dublin, Ireland
| | | | | | - F Dockery
- Beaumont Hospital , Dublin, Ireland
- Integrated Care Team for Older People, North Dublin , Dublin, Ireland
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Paller AS, Yosipovitch G, Weidinger S, DiBenedetti D, Whalley D, Gadkari A, Guillemin I, Zhang H, Eckert L, Chao J, Bansal A, Chuang CC, Delevry D. Development, Psychometric Validation and Responder Definition of Worst Itch Scale in Children with Severe Atopic Dermatitis. Dermatol Ther (Heidelb) 2022; 12:2839-2850. [PMID: 36269504 DOI: 10.1007/s13555-022-00804-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 08/26/2022] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Itch associated with atopic dermatitis (AD) has a profoundly negative effect on patients of all ages. Therefore, itch is a main target for AD therapeutic approaches, and treatments are perceived as beneficial when they achieve an itch reduction. In the absence of a validated scale for children aged 6-11 years that is suitable for assessing itch intensity in clinical trial settings, the Worst Itch Scale was developed. METHODS Qualitative interviews, comprising concept elicitation and cognitive debriefing, were conducted to develop and evaluate the content validity of the Worst Itch Scale. Psychometric assessments used data from the LIBERTY AD PEDS phase 3 trial of dupilumab in patients aged 6-11 years with severe AD. These included test-retest reliability, construct validity, known-groups validity and responsiveness. Thresholds for clinically meaningful change were defined using anchor- and distribution-based methods. RESULTS The Worst Itch Scale consisted of two items asking about 'worst itching' experienced 'last night' and 'today'. Worst Itch Scale scores showed large, positive correlations with existing patient-reported outcome (PRO) measures of itch, and weaker correlations with clinician-reported outcome (ClinRO) measures assessing objective signs of AD. Improvements in Worst Itch Scale scores were highly correlated with improvements in other itch PROs and moderately correlated with improvements in ClinROs. The responder definition based on the primary anchor, a 1-point improvement in the Patient Global Impression of Disease, was 2.84. Supportive anchors produced response estimates ranging from 2.43 to 4.80 points. CONCLUSIONS The Worst Itch Scale is a fit-for-purpose (e.g. well-defined, reliable, responsive and valid) scale for evaluating worst itch intensity in children aged 6-11 years with severe AD. The within-patient threshold for defining a clinically meaningful response was a ≥ 3-4-point change in the Worst Itch Scale score. TRIAL REGISTRATION NCT03345914. Video: How can we reliably assess itch intensity in children 6-11 years with severe atopic dermatitis in clinical trial settings?
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Affiliation(s)
- Amy S Paller
- Departments of Dermatology and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. .,Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | - Gil Yosipovitch
- Department of Dermatology and Itch Center, University of Miami, Miami, FL, USA
| | - Stephan Weidinger
- Department of Dermatology and Allergy, Center for Inflammatory Skin Diseases, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | | | - Diane Whalley
- RTI Health Solutions, Wilmslow Road, Didsbury, Manchester, UK
| | | | | | - Haixin Zhang
- Regeneron Pharmaceuticals, Inc, 777 Old Saw Mill River Rd, Tarrytown, NY, USA
| | - Laurent Eckert
- Sanofi Aventis, 1 Avenue Pierre Brossolette, 91380, Chilly-Mazarin, France
| | - Jingdong Chao
- Regeneron Pharmaceuticals, Inc, 777 Old Saw Mill River Rd, Tarrytown, NY, USA
| | - Ashish Bansal
- Regeneron Pharmaceuticals, Inc, 777 Old Saw Mill River Rd, Tarrytown, NY, USA
| | | | - Dimittri Delevry
- Regeneron Pharmaceuticals, Inc, 777 Old Saw Mill River Rd, Tarrytown, NY, USA
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Clark M, Romano C, Olayinka-Amao O, Whalley D, Crawford R, Pathak P, Brindicci C, Garg K, Kordy K, Everhard F, Patalano F, Roesler Z, Sutton T, Göransson O, Landles R, Naujoks C, Marvel J, Keininger DL. Development and content validation of a self-completed, electronic Pediatric Asthma Symptom Diary. J Patient Rep Outcomes 2022; 6:25. [PMID: 35306621 PMCID: PMC8934788 DOI: 10.1186/s41687-022-00432-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 03/03/2022] [Indexed: 11/10/2022] Open
Abstract
Background Childhood asthma is an important unmet need. To date, patient-reported outcome measures (PROMs) for children with asthma have used a combination of caregiver or proxy-reported and self-reported measures. No comprehensive measure is available to assess the severity and impact of daytime and nighttime asthma symptoms and rescue medication use for self-completion by children aged 6–11 years. This study aimed to develop a novel, interactive, electronic Pediatric Asthma Symptom Diary (ePASD) measuring self-reported key symptom severity and proximal impacts of asthma in young children with varying reading ability and disease severity, consistent with US Food and Drug Administration (FDA) PRO guidance and the International Society for Health Economics and Outcomes Research (ISPOR) good research practices. Methods A targeted literature review and clinician interviews were undertaken to characterize symptoms and impacts experienced by children with mild-to-severe asthma. Concept elicitation interviews (CEIs) were conducted with 44 children and their caregivers (30 US; 14 UK). Following item and digital application development, the ePASD was assessed for relevance, understanding, and interpretability through cognitive debriefing interviews (CDIs) with 21 US children. Face validity/translatability assessments were also performed. Results Key measurement concepts included cough, wheeze, difficulty breathing, chest tightness/discomfort, nighttime awakening, and daytime activity limitations. Concept saturation was reached during CEIs for primary asthma-related daytime and nighttime symptoms and core impacts. Most CDI participants found the ePASD items clear, understandable, and comprehensive. Standardized training is anticipated to facilitate reliable child self-report. Conclusion The ePASD, a novel PROM for children aged 6–11 years with asthma, uses an innovative multimedia approach and has been developed in accordance with FDA PRO guidance and ISPOR good research practices, directly capturing the child’s self-reported asthma symptoms, impacts on daily activities and nighttime awakening, and rescue medication use. Supplementary Information The online version contains supplementary material available at 10.1186/s41687-022-00432-3.
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Affiliation(s)
| | - Carla Romano
- RTI Health Solutions, Research Triangle Park, NC, USA
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6
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Han JK, Bachert C, Lee SE, Hopkins C, Heffler E, Hellings PW, Peters AT, Kamat S, Whalley D, Qin S, Nelson L, Siddiqui S, Khan AH, Li Y, Mannent LP, Guillemin I, Chuang CC. Estimating Clinically Meaningful Change of Efficacy Outcomes in Inadequately Controlled Chronic Rhinosinusitis with Nasal Polyposis. Laryngoscope 2021; 132:265-271. [PMID: 34850966 PMCID: PMC9299621 DOI: 10.1002/lary.29888] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 09/16/2021] [Accepted: 09/21/2021] [Indexed: 01/02/2023]
Abstract
OBJECTIVES/HYPOTHESIS Clinical trials of biologics to treat chronic rhinosinusitis with nasal polyposis (CRSwNP) have evaluated objective outcomes (e.g., University of Pennsylvania Smell Identification Test [UPSIT], nasal polyps score [NPS], and computed tomography Lund-Mackay score [CT-LMK]) and patient-reported symptoms (e.g., nasal congestion/obstruction [NC], loss of smell [LoS], and total symptom score [TSS]). We estimated anchor-based thresholds for clinically meaningful change in objective and patient-reported outcomes in patients with CRSwNP using data from LIBERTY NP SINUS-24 and SINUS-52 trials (NCT02912468; NCT02898454). METHODS Target patient-reported outcomes were NC, LoS, and TSS; target objective outcomes were UPSIT, NPS, and CT-LMK. Anchor measures were the 22-item sinonasal outcome test (SNOT-22) rhinologic symptoms domain and total score and rhinosinusitis visual analog scale (VAS). The appropriateness of each anchor measure was evaluated by reviewing correlations between change in anchor measures and target outcomes and descriptive scores on target outcomes by levels of change in the anchor measure. Established thresholds for anchor measures (3.8 points for SNOT-22 rhinologic symptoms, 8.9 points for SNOT-22 total, 1-category improvement for rhinosinusitis VAS) were used to estimate clinically meaningful score changes for each target outcome. RESULTS Based on correlations between change in anchor measures and target outcomes, SNOT-22 rhinologic symptoms domain was deemed the most appropriate anchor measure. Using this anchor measure, thresholds for clinically meaningful within-patient change were NC: 1 point; LoS: 1 point; TSS: 3 points; UPSIT: 8 points; NPS: 1 point; and CT-LMK: 5 points. CONCLUSION These thresholds support interpretation of efficacy results for target outcomes in CRSwNP trials. LEVEL OF EVIDENCE 2 Laryngoscope, 2021.
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Affiliation(s)
- Joseph K Han
- Department of Otolaryngology & Head and Neck Surgery, Eastern Virginia Medical School, Norfolk, Virginia, U.S.A
| | - Claus Bachert
- Upper Airways Research Laboratory and Department of Otorhinolaryngology, Ghent University, Ghent, Belgium.,Division of ENT Diseases, CLINTEC, Karolinska Institutet, Stockholm, Sweden.,First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Stella E Lee
- Division of Otolaryngology-Head & Neck Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Claire Hopkins
- Department of Otorhinolaryngology - Head and Neck Surgery, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Enrico Heffler
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Peter W Hellings
- Upper Airways Research Laboratory and Department of Otorhinolaryngology, Ghent University, Ghent, Belgium.,Department of Otorhinolaryngology - Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Otorhinolaryngology, Amsterdam University Medical Centres, Location AMC, Amsterdam, The Netherlands
| | - Anju T Peters
- Allergy-Immunology Division and the Sinus and Allergy Center, Feinberg School of Medicine, Northwestern University, Evanston, Illinois, U.S.A
| | - Siddhesh Kamat
- Medical Affairs, Regeneron Pharmaceuticals, Inc., Tarrytown, New York, U.S.A
| | - Diane Whalley
- Patient-Centered Outcome Assessment, RTI Health Solutions, Manchester, United Kingdom
| | - Shanshan Qin
- Patient-Centered Outcome Assessment, RTI Health Solutions, Research Triangle Park, North Carolina, U.S.A
| | - Lauren Nelson
- Patient-Centered Outcome Assessment, RTI Health Solutions, Research Triangle Park, North Carolina, U.S.A
| | - Shahid Siddiqui
- Medical Affairs, Regeneron Pharmaceuticals, Inc., Tarrytown, New York, U.S.A
| | - Asif H Khan
- Global Medical Affairs, Sanofi, Chilly-Mazarin, France
| | - Yongtao Li
- Global Medical Affairs Respiratory, Sanofi, Bridgewater, New Jersey, U.S.A
| | - Leda P Mannent
- Global Clinical Development, Sanofi, Chilly-Mazarin, France
| | | | - Chien-Chia Chuang
- Health Economics and Value Assessment, Sanofi, Cambridge, Massachusetts, U.S.A
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7
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Khan AH, Reaney M, Guillemin I, Nelson L, Qin S, Kamat S, Mannent L, Amin N, Whalley D, Hopkins C. Development of Sinonasal Outcome Test (SNOT-22) Domains in Chronic Rhinosinusitis With Nasal Polyps. Laryngoscope 2021; 132:933-941. [PMID: 34437720 PMCID: PMC9292332 DOI: 10.1002/lary.29766] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 06/14/2021] [Accepted: 07/12/2021] [Indexed: 12/30/2022]
Abstract
Objectives/Hypothesis The 22‐item Sinonasal Outcome Test (SNOT‐22) is a validated chronic rhinosinusitis health‐related quality‐of‐life outcome (HRQoL) measure; however, SNOT‐22 domains have not been validated specifically for chronic rhinosinusitis with nasal polyps (CRSwNP). Study Design Validation of SNOT‐22 domain structure, using data from 3 randomized, placebo‐controlled, double‐blinded, multicenter clinical trials of dupilumab in adults with moderate‐to‐severe CRSwNP. Methods Preliminary dimensional structure was derived by exploratory factor analyses of SNOT‐22 data from a phase 2 trial (NCT01920893) of dupilumab for the treatment of CRSwNP. Data from 2 phase 3 clinical trials (NCT02912468 and NCT02898454) were then used for confirmatory factor analysis, and evaluated for reliability, construct validity, and responsiveness. In all three trials, the SNOT‐22 was administered electronically on a tablet and trial participants were required to answer all items. Results Factor analysis supported five domains: Nasal, Ear/Facial, Sleep, Function, and Emotion. Correlations between domains were moderate to high, ranging from 0.53 (Nasal–Emotion) to 0.88 (Function–Sleep). Construct validity was mostly supported; relationships with other measures were almost always in the intended direction and magnitude. Internal consistency reliability also confirmed questionnaire structure with strong Cronbach's alpha values (all >0.80). Moderate‐to‐high correlations were observed between change in SNOT‐22 domain scores and other study patient‐reported outcome measures, along with large effect‐size estimates (≥0.7), demonstrating responsiveness of the Nasal, Sleep, and Function domains. Emotion and Ear/Facial domains had small‐to‐moderate effect sizes. Conclusions Psychometric analyses support the validity, reliability, and responsiveness of five domains of SNOT‐22 (Nasal, Ear/Facial, Sleep, Function, and Emotion) for assessing symptoms and impact on HRQoL in patients with CRSwNP. Laryngoscope, 132:933–941, 2022
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Affiliation(s)
- Asif H Khan
- Global Medical Affairs, Immunology and Inflammation Development, Sanofi, Chilly-Mazarin, France
| | - Matthew Reaney
- Patient-Centered Outcome Assessment, RTI Health Solutions, Research Triangle Park, North Carolina, U.S.A
| | - Isabelle Guillemin
- Patient-Centered Outcome Assessment, RTI Health Solutions, Research Triangle Park, North Carolina, U.S.A
| | - Lauren Nelson
- Patient-Centered Outcome Assessment, RTI Health Solutions, Research Triangle Park, North Carolina, U.S.A
| | - Shanshan Qin
- Patient-Centered Outcome Assessment, RTI Health Solutions, Research Triangle Park, North Carolina, U.S.A
| | - Siddhesh Kamat
- Health Economics and Outcomes Research, Regeneron Pharmaceuticals, Inc., Tarrytown, New York, U.S.A
| | - Leda Mannent
- Global Medical Affairs, Immunology and Inflammation Development, Sanofi, Chilly-Mazarin, France
| | - Nikhil Amin
- Health Economics and Outcomes Research, Regeneron Pharmaceuticals, Inc., Tarrytown, New York, U.S.A
| | - Diane Whalley
- Patient-Centered Outcome Assessment, RTI Health Solutions, Manchester, U.K
| | - Claire Hopkins
- ENT Department, Guy's and St Thomas' NHS Foundation Trust, London, U.K
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8
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Simpson EL, de Bruin-Weller M, Bansal A, Chen Z, Nelson L, Whalley D, Prescilla R, Guillemin I, Delevry D. Definition of Clinically Meaningful Within-Patient Changes in POEM and CDLQI in Children 6 to 11 Years of Age with Severe Atopic Dermatitis. Dermatol Ther (Heidelb) 2021; 11:1415-1422. [PMID: 34046851 PMCID: PMC8322340 DOI: 10.1007/s13555-021-00543-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION The Patient-Oriented Eczema Measure (POEM) assesses patient-reported severity of atopic dermatitis (AD) symptoms, whereas the Children's Dermatology Life Quality Index (CDLQI) measures how AD affects health-related quality of life (HRQoL) in children. Although the POEM and CDLQI have established thresholds for clinically meaningful within-patient change in adolescents (aged 12-17 years), there are no defined within-patient responder thresholds for clinically meaningful change in children aged 6-11 years. METHODS Data from the LIBERTY AD PEDS phase 3 randomized, double-blind, placebo-controlled trial of dupilumab in children aged 6-11 years with severe AD were used to define the threshold for within-patient meaningful change in POEM and CDLQI scores. Anchor-based methods were applied to estimate mean change in POEM and CDLQI scores from baseline to week 16, with anchors of a 1-point improvement in the Patient Global Impression of Disease (PGID) scale and an improvement in score of ''A little better'' on the Patient Global Impression of Change (PGIC) scale. The distribution-based methods, a one-half standard deviation (SD) at baseline and a standard error mean (SEM) were also used. RESULTS The mean POEM change scores associated with the anchors were a change of - 8.40 with the PGID anchor and - 6.30 with the PGIC anchor. Distribution-based estimates for POEM were one-half SD at baseline of 2.76, with a SEM of 3.32. Mean CDLQI change scores corresponding to the PGID and PGIC anchors were - 7.30 and - 6.80, respectively, while distribution-based estimates for CDLQI were a one-half SD at baseline of 3.69, with a SEM of 3.52. CONCLUSIONS In children with severe AD, an appropriate minimum threshold of clinically meaningful within-patient change was estimated as 6 points for both the POEM and CDLQI scores. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03345914. What is the clinically meaningful within-person change in Patient-Oriented Eczema Measure and Children's Dermatology Life Quality Index scores in children 6 to 11 years old with severe atopic dermatitis? (MP4 289443 KB).
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Affiliation(s)
- Eric L Simpson
- Department of Dermatology, Oregon Health and Science University, Portland, OR, USA.
| | | | | | - Zhen Chen
- Regeneron Pharmaceuticals, Inc, Tarrytown, NY, USA
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9
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Clark M, Romano C, Olayinka-Amao O, Whalley D, Crawford R, Pathak P, Brindicci C, Garg K, Kordy K, Everhard F, Patalano F, Roesler Z, Sutton T, Goransson O, Landles R, Naujoks C, Marvel J, Keininger D. Development of a Novel, Interactive, Electronic Pediatric Asthma Diary for Self-Report of Symptom Severity and Disease Impact by Young Children With Asthma. J Allergy Clin Immunol 2021. [DOI: 10.1016/j.jaci.2020.12.210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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10
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Ervin CM, Whalley D, von Huth Smith L, Crawford R, Dine J, Fehnel SE. Development of the impact of weight on daily activities questionnaire: A patient-reported outcome measure. Clin Obes 2020; 10:e12387. [PMID: 32935465 PMCID: PMC7685113 DOI: 10.1111/cob.12387] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 06/03/2020] [Accepted: 06/07/2020] [Indexed: 12/02/2022]
Abstract
While patient-reported outcome measures are available to evaluate health-related quality of life and functioning in obesity, existing measures do not evaluate the impact of excess weight and weight loss on the ability to perform regularly occurring daily activities. Three iterative sets of qualitative interviews were conducted in two countries (United States, n = 23; United Kingdom, n = 23) with individuals with body mass index ≥30 kg/m2 to inform development of the Impact of Weight on Daily Activities Questionnaire (IWDAQ) for use in clinical trials to evaluate daily activity limitations associated with excess weight. Candidate concepts were selected based on the literature, expert opinion, and previously conducted qualitative research, after which the draft IWDAQ was developed and tested. Interviews included a brief concept elicitation phase, followed by cognitive debriefing during which the IWDAQ was refined based upon participants' feedback. The IWDAQ uses a novel, adaptive questionnaire design, such that clinical trial participants choose the three IWDAQ activities they would most like to improve with weight loss and rate the degree of limitation in each of these activities at baseline. By allowing individuals participating in trials to identify and monitor changes in the activities they most want to see improve with weight loss, the 19-item IWDAQ has the potential to detect the benefits of weight-loss treatment that individuals with obesity value most.
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Affiliation(s)
- Claire M. Ervin
- Patient‐Centered Outcomes AssessmentRTI Health SolutionsResearch Triangle ParkNorth CarolinaUSA
| | - Diane Whalley
- Patient‐Centered Outcomes AssessmentRTI Health SolutionsManchesterUK
| | | | - Rebecca Crawford
- Patient‐Centered Outcomes AssessmentRTI Health SolutionsManchesterUK
| | - Jennifer Dine
- Patient‐Centered Outcomes AssessmentRTI Health SolutionsResearch Triangle ParkNorth CarolinaUSA
| | - Sheri E Fehnel
- Patient‐Centered Outcomes AssessmentRTI Health SolutionsResearch Triangle ParkNorth CarolinaUSA
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Taylor PC, Betteridge N, Brown TM, Woolcott J, Kivitz AJ, Zerbini C, Whalley D, Olayinka-Amao O, Chen C, Dahl P, Ponce de Leon D, Gruben D, Fallon L. Treatment Mode Preferences in Rheumatoid Arthritis: Moving Toward Shared Decision-Making. Patient Prefer Adherence 2020; 14:119-131. [PMID: 32021123 PMCID: PMC6980841 DOI: 10.2147/ppa.s220714] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 12/03/2019] [Indexed: 01/02/2023] Open
Abstract
PURPOSE Current knowledge of the reasons for patients' preference for rheumatoid arthritis (RA) treatment modes is limited. This study was designed to identify preferences for four treatment modes, and to obtain in-depth information on the reasons for these preferences. PATIENTS AND METHODS In this multi-national, cross-sectional, qualitative study, in-depth interviews were conducted with adult patients with RA in the United States, France, Germany, Italy, Spain, Switzerland, the United Kingdom, and Brazil. Patients' strength of preference was evaluated using a 100-point allocation task (0-100; 100=strongest) across four treatment modes: oral, self-injection, clinic-injection, and infusion. Qualitative descriptive analysis methods were used to identify, characterize, and summarize patterns found in the interview data relating to reasons for these preferences. RESULTS 100 patients were interviewed (female, 75.0%; mean age, 53.9 years; mean 11.6 years since diagnosis). Among the four treatment modes, oral administration was allocated the highest mean (standard deviation) preference points (47.3 [33.1]) and was ranked first choice by the greatest percentage of patients (57.0%), followed by self-injection (29.7 [27.7]; 29.0%), infusion (15.4 [24.6]; 16.0%), and clinic-injection (7.5 [14.1]; 2.0%). Overall, 56.0% of patients had a "strong" first-choice preference (ie, point allocation ≥70); most of these patients chose oral (62.5%) vs self-injection (23.2%), infusion (10.7%), or clinic-injection (3.6%). Speed and/or ease of administration were the most commonly reported reasons for patients choosing oral (52.6%) or self-injection (55.2%). The most common reasons for patients not choosing oral or self-injection were not wanting to take another pill (37.2%) and avoiding pain due to needles (46.5%), respectively. CONCLUSION These data report factors important to patients regarding preferences for RA treatment modes. Patients may benefit from discussions with their healthcare professionals and/or patient support groups, regarding RA treatment modes, to facilitate shared decision-making.
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Affiliation(s)
- Peter C Taylor
- Botnar Research Centre, University of Oxford, Oxford, UK
- Correspondence: Peter C Taylor Botnar Research Centre, University of Oxford, Windmill Road, Headington, OxfordOX3 7LD, UKTel +441865 227323 Email
| | | | - T Michelle Brown
- Patient-Centered Outcomes Assessment Group, RTI Health Solutions, Research Triangle Park, NC, USA
| | - John Woolcott
- Patient and Health Impact, Health Economics and Outcomes Research, Pfizer Inc, Collegeville, PA, USA
| | - Alan J Kivitz
- Altoona Center for Clinical Research, Duncansville, PA, USA
| | - Cristiano Zerbini
- Department of Rheumatology, Centro Paulista De Investigação Clinica, São Paulo, Brazil
| | - Diane Whalley
- Patient-Centered Outcomes Assessment Group, RTI Health Solutions, Manchester, UK
| | - Oyebimpe Olayinka-Amao
- Patient-Centered Outcomes Assessment Group, RTI Health Solutions, Research Triangle Park, NC, USA
| | - Connie Chen
- Xeljanz, Rheumatology, Inflammation & Immunology Medical Affairs, Pfizer Inc, New York, NY, USA
| | - Palle Dahl
- Medical Affairs, International Developed Markets, Inflammation & Immunology, Pfizer Inc, Ballerup, Denmark
| | | | - David Gruben
- Statistical Research and Data Science Center, Pfizer Inc, Groton, CT, USA
| | - Lara Fallon
- Global Medical Affairs, Pfizer Inc, Montreal, QC, Canada
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Simpson EL, de Bruin-Weller M, Eckert L, Whalley D, Guillemin I, Reaney M, Chen Z, Nelson L, Qin S, Bansal A, Gadkari A. Responder Threshold for Patient-Oriented Eczema Measure (POEM) and Children's Dermatology Life Quality Index (CDLQI) in Adolescents with Atopic Dermatitis. Dermatol Ther (Heidelb) 2019; 9:799-805. [PMID: 31641952 PMCID: PMC6828922 DOI: 10.1007/s13555-019-00333-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION The Patient-Oriented Eczema Measure (POEM) assesses patient-reported frequency of atopic dermatitis (AD) symptoms, while the Children's Dermatology Life Quality Index (CDLQI) measures the impact of skin disease on health-related quality of life (HRQoL) in children. There is currently no threshold for clinically meaningful within-person change in POEM or CDLQI scores in adolescents. Here we empirically derive within-person thresholds of meaningful within-person change in POEM and CDLQI scores in adolescents with moderate-to-severe AD. METHODS Data were used from a phase 3, randomized, double-blind, placebo-controlled trial of dupilumab in adolescents (aged ≥ 12 to < 18 years) with moderate-to-severe AD. Anchor-based methods were employed using the mean change in POEM and CDLQI scores from baseline to week 16 linked with a 1-point improvement in Patient Global Assessment of Disease (PGAD), a score of "a little better" on the Patient Global Assessment of Treatment effect (PGAT), a 50-74% improvement from baseline in the Eczema Area and Severity Index (EASI-50-74), and a 1-point improvement in Investigator's Global Assessment (IGA) score. RESULTS A mean change of - 7.8 and - 5.6 in the POEM score was associated with PGAD and PGAT anchors, respectively. EASI-50-74 was associated with a mean change in POEM score of - 8.2, while the IGA anchor was associated with a mean change of - 7.9 in POEM score. The mean changes in CDLQI score associated with PGAD and PGAT anchors were - 6.4 and - 6.6, respectively, while CDLQI mean scores changed by - 8.3 and - 8.0 for the EASI and IGA anchors, respectively. CONCLUSION In adolescents (aged ≥ 12 to < 18 years) with moderate-to-severe AD, a within-person change of 6-8 points in POEM and CDLQI scores, independently, can be considered a reasonable responder threshold for clinically meaningful change in each of the two scales, respectively. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03054428. FUNDING Sanofi and Regeneron Pharmaceuticals, Inc.
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Affiliation(s)
- Eric L Simpson
- Department of Dermatology, Oregon Health & Science University, Portland, OR, USA.
| | | | | | | | | | | | - Zhen Chen
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY, USA
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Doward L, Svedsater H, Whalley D, Crawford R, Leather D, Lay-Flurrie J, Bosanquet N. A descriptive follow-up interview study assessing patient-centred outcomes: Salford Lung Study in Asthma (SLS Asthma). NPJ Prim Care Respir Med 2019; 29:31. [PMID: 31417102 PMCID: PMC6695403 DOI: 10.1038/s41533-019-0142-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 07/08/2019] [Indexed: 11/24/2022] Open
Abstract
The Salford Lung Study in Asthma (SLS Asthma) was a multicentre, randomised, controlled, open-label trial that assessed initiating once-daily, single-inhaler fluticasone furoate/vilanterol (FF/VI) 100 μg/25 μg or 200 μg/25 μg versus continuing usual care. A subgroup (n = 400) from SLS Asthma was enrolled in this exploratory, interview-based follow-up study. Quantitative and qualitative data were collected via questionnaires. The primary objective was to capture patient-centred outcomes (symptom experience, quality of life [QoL], disease management behaviours) and patient experience. Secondary objectives were to assess the correlation of patient-reported outcomes with pre-defined variables from SLS Asthma (Asthma Control Test [ACT] score). The follow-up sample was representative of the SLS Asthma population; half reported asthma improvement during the study. Breathlessness was the most likely symptom to improve (47.8% of patients reported improvement). Most patients reported ‘no change’ in overall QoL (57.5%) and daily life domains (functioning 66.3%, activities 68.3%, relationships 86.8%, psychological 68.5%). Functioning was reported as the most frequently improved domain (29.8% of patients). Perceived improvement in asthma control (42.5%) and confidence (37.3%) was frequent. ACT responders (defined as patients achieving an ACT score ≥20 and/or an increase of ≥3 in ACT score from baseline at Week 52) were more likely to report asthma improvement (88.7% of patients reporting ‘a lot’ of improvement) than non-responders. Patients’ asthma experiences generally improved during SLS Asthma. Clinical improvements were often associated with perceived improvement by patients, particularly among ACT responders.
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Whalley D, Globe G, Crawford R, Doward L, Tafesse E, Brazier J, Price D. Is the EQ-5D fit for purpose in asthma? Acceptability and content validity from the patient perspective. Health Qual Life Outcomes 2018; 16:160. [PMID: 30075729 PMCID: PMC6090889 DOI: 10.1186/s12955-018-0970-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 07/09/2018] [Indexed: 12/24/2022] Open
Abstract
Background The increasing emphasis on patient-reported outcomes in health care decision making has prompted greater rigor in the evidence to support the instruments used. Acceptability and content validity are important properties of any measure to ensure it assesses the relevant aspects of the target concept. The purpose of this study was to evaluate the acceptability and content validity of the EQ-5D 5-Level (EQ-5D-5L) to assess the impact of asthma on patients’ lives. Methods Qualitative interviews were conducted with 40 adults with asthma in the United Kingdom. The first 25 interviews used cognitive-debriefing methods to assess the relevance and acceptability of the EQ-5D-5L and two asthma-specific measures for comparison: an asthma-specific, preference-based measure (the Asthma Quality of Life Utility Index–5 Dimensions) and an Asthma Symptom Diary. The final 15 interviews combined concept elicitation to identify patient-perceived asthma impact, and cognitive debriefing to assess relevance and acceptability of the EQ-5D-5L and the Asthma Symptom Diary. Cognitive-debriefing feedback on the content of the measures was collated and summarized descriptively. The concept-elicitation data were analyzed thematically. Results Participants were aged 20 to 57 years and 62.5% were female. Although some participants expressed positive opinions on aspects of the EQ-5D-5L, only the usual activities dimension was consistently considered relevant to participants’ asthma experiences. The mobility and self-care dimensions prompted strong negative reactions from some participants. Variations in interpretation of the mobility dimension and difficulties with multiple concepts in the pain/discomfort and anxiety/depression dimensions also were noted. Concepts reported by participants as missing included environmental triggers, asthma symptoms, emotions, and sleep. The EQ-5D-5L was the least preferred measure to describe the impact of asthma on participants’ lives. Participants reported shortness of breath and impact on activities as especially salient issues. Conclusions The content of the EQ-5D-5L was poorly aligned with the patient-perceived impact of asthma, and the measure failed to meet basic standards for acceptability and content validity as a measure to assess the impact of asthma from the patient perspective. The shortcomings identified raise concerns regarding the appropriateness of the EQ-5D in asthma and further evaluation is warranted.
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Affiliation(s)
| | - Gary Globe
- Amgen Inc., Thousand Oaks, CA, 91320, USA
| | | | | | | | - John Brazier
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - David Price
- Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
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McDowall L, Liulu X, Chia K, Whalley D, Kanagaratnam L. Early Procedural Experience with VISITAG and Ablation Index for Pulmonary Vein Isolation. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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16
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Whalley D, Svedsater H, Doward L, Crawford R, Leather D, Lay-Flurrie J, Bosanquet N. P217 Salford lung study chronic obstructive pulmonary disease follow-up interviews: analyses by treatment comparisons and exacerbations. Ann Allergy Asthma Immunol 2017. [DOI: 10.1016/j.anai.2017.08.255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
OBJECTIVE To evaluate heart failure (HF) patients' disease knowledge and preferences for avoiding different disease outcomes. METHODS An online survey was administered to 400 individuals with a self-reported diagnosis of HF to elicit relative importance weights (RIWs) for avoiding 11 potential HF symptoms and outcomes using best-worst scaling. The survey also included questions about individuals' HF knowledge, and demographic and disease-experience characteristics. Differences in RIWs among sub-groups, defined by HF knowledge, caregiver support, age, recent hospitalization or emergency room visit for HF, health-related quality-of-life, and cardiac device experience were examined. RESULTS Relative to limitations in usual activities (RIW 1.00), respondents preferred avoiding severe, infrequent cardiovascular events (e.g. stroke [RIW 8.51], heart transplant [RIW 7.84], or heart attack [RIW 5.3]) most, followed by difficulty breathing (RIW 2.55), inability to enjoy life (RIW 1.84), cardiac device implantation (RIW 1.74), and atrial fibrillation (RIW 1.57). Patients preferred avoiding swelling (RIW 0.47) and fatigue (RIW 0.58) least. RIWs for avoiding severe, infrequent events were higher among those with high disease knowledge, those without caregivers, and those without a recent hospitalization or emergency room visit. CONCLUSIONS Patients' preferences for avoiding HF outcomes vary across outcomes and by individuals' knowledge, caregiver status, and age. Healthcare providers should solicit and incorporate insights about patients' knowledge of HF and their preferences for avoiding HF outcomes into HF education and management planning efforts.
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Affiliation(s)
- A Brett Hauber
- a RTI Health Solutions , Research Triangle Park , NC , USA
| | - Engels N Obi
- b Novartis Pharmaceuticals Corporation , East Hanover , NJ , USA
| | - Mark A Price
- a RTI Health Solutions , Research Triangle Park , NC , USA
| | | | - Chun-Lan Chang
- b Novartis Pharmaceuticals Corporation , East Hanover , NJ , USA
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Luquiens A, Owens L, Whalley D, Rahhali N, Laramée P, Crawford R, Llorca PM, Falissard B, Aubin HJ. Health-related quality of life in alcohol dependence: Similar cross-cultural impact beyond specific drinking habits. J Ethn Subst Abuse 2017; 18:279-295. [PMID: 28805530 DOI: 10.1080/15332640.2017.1355765] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This study explores sociocultural differences in alcohol-related impact on quality of life between France and United Kingdom. We included 38 alcohol-dependent patients in France and United Kingdom in 10 focus groups. We used a text-mining approach. Three classes of each corpus regarded identical themes across the countries: (a) core impact on quality of life, (b) drinking habits, (c) sources of help. Core impact was similar between the two countries. Main differences were in drinking habits and referral to sources of help. Despite differences in drinking habits, the domains of life impacted by alcohol were non-country specific.
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Affiliation(s)
- Amandine Luquiens
- a Hôpital Paul Brousse, APHP , Villejuif , France.,b CESP, Univ. Paris-Sud, UVSQ, INSERM, Université Paris-Saclay , Villejuif , France
| | - Lynn Owens
- c Royal Liverpool and Broadgreen University Hospital Trust Alcohol Services , Liverpool , United Kingdom
| | - Diane Whalley
- d RTI Health Solutions , Didsbury , Manchester , United Kingdom
| | - Nora Rahhali
- e Lundbeck S.A.S., Issy-les-Moulineaux Cedex France
| | | | | | | | - Bruno Falissard
- b CESP, Univ. Paris-Sud, UVSQ, INSERM, Université Paris-Saclay , Villejuif , France
| | - Henri-Jean Aubin
- a Hôpital Paul Brousse, APHP , Villejuif , France.,b CESP, Univ. Paris-Sud, UVSQ, INSERM, Université Paris-Saclay , Villejuif , France
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Chang J, Gandhidasan S, Finnigan R, Whalley D, Nair R, Herschtal A, Eade T, Kneebone A, Ruben J, Foote M, Siva S. Stereotactic Ablative Body Radiotherapy for the Treatment of Spinal Oligometastases. Clin Oncol (R Coll Radiol) 2017; 29:e119-e125. [DOI: 10.1016/j.clon.2017.02.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 01/06/2017] [Accepted: 01/31/2017] [Indexed: 11/30/2022]
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Whalley D, Petigara T, Rasouliyan L, Tobe K, Tunceli K. Early patient experiences with montelukast orally disintegrating tablets in Japan: a cross-sectional survey of treatment satisfaction in patients with asthma and/or allergic rhinitis. Curr Med Res Opin 2017; 33:215-223. [PMID: 27764975 DOI: 10.1080/03007995.2016.1251891] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Orally disintegrating tablets (ODTs) offer a valuable treatment option, particularly when swallowing solid tablets with water is difficult or inconvenient. Montelukast is an effective treatment for asthma and allergic rhinitis (AR), and an ODT formulation became available in Japan in 2015. This study investigated levels of satisfaction with this new formulation among adults with asthma and/or AR in Japan. METHODS Patients aged 20 years or older who were refilling a prescription for montelukast ODT in pharmacies across Japan completed questions on satisfaction with key features of montelukast ODT and the 9-item Treatment Satisfaction Questionnaire for Medication (TSQM-9). Study variables were analyzed descriptively. Factors associated with TSQM-9 global satisfaction and convenience domain scores were examined using analysis of covariance. RESULTS Of the 201 patients who participated, 89.6% reported overall satisfaction with montelukast ODT. Overall satisfaction was highest in patients with AR only (94.7% satisfied) or with asthma and AR (90.2% satisfied), and in patients with treatment duration <4 weeks (98.5% satisfied). Mean TSQM-9 global satisfaction and convenience domain scores were 58.9 and 66.7, respectively; scores were higher for patients with both asthma and AR and for those with longer disease duration. Overall ease of taking and dissolving speed were most closely associated with TSQM-9 global satisfaction scores, and ability to take without water and taste were most closely associated with TSQM-9 convenience scores. LIMITATIONS The generalizability of the findings was limited by the convenience sample and the descriptive, single-arm study design. The study was limited to adults with asthma and/or AR. CONCLUSION Montelukast ODT may be an acceptable dosage formulation for adults with mild-to-moderate asthma and/or AR in Japan. Satisfaction was high, particularly with respect to tablet size, dissolving speed, taste, and ease of taking.
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Affiliation(s)
- Diane Whalley
- a RTI Health Solutions , Manchester , United Kingdom
| | - Tanaz Petigara
- b Merck & Co. Inc. , Kenilworth , NJ , United States of America
| | | | | | - Kaan Tunceli
- b Merck & Co. Inc. , Kenilworth , NJ , United States of America
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Fry N, Liu C, Garcia A, Galougahi GK, Hamilton E, Harris J, Nelson G, Whalley D, Bundgaard H, Rasmussen H. From Bench-Based PhD Project to First-in-Man Use of β3 Adrenergic Agonist in Patients with Treatment-Resistant Decompensated Congestive Heart Failure. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Whalley D, Hruby G, Alfieri F, Kneebone A, Eade T. SpaceOAR Hydrogel in Dose-escalated Prostate Cancer Radiotherapy: Rectal Dosimetry and Late Toxicity. Clin Oncol (R Coll Radiol) 2016; 28:e148-54. [DOI: 10.1016/j.clon.2016.05.005] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2015] [Revised: 04/21/2016] [Accepted: 04/26/2016] [Indexed: 02/07/2023]
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Chang CL, Hauber AB, Price M, Whalley D, Obi EN. Patients' Self-Reported Value of Avoiding Key Heart Failure Outcomes Differs Based on Disease Knowledge. J Card Fail 2016. [DOI: 10.1016/j.cardfail.2016.06.319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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24
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Liulu X, Straiton N, Whalley D, Kanagaratnam L. Lung Disease Predicts Atrial Fibrillation Recurrence and Need for Repeat Procedures After Pulmonary Vein Isolation. Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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25
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Greenberg J, Palmer JB, Chan WW, Correia CE, Whalley D, Shannon P, Sawicki GS. Treatment satisfaction in cystic fibrosis: early patient experience with tobramycin inhalation powder. Patient Prefer Adherence 2016; 10:2163-2169. [PMID: 27822017 PMCID: PMC5087789 DOI: 10.2147/ppa.s102234] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND This study assessed treatment satisfaction of cystic fibrosis (CF) patients in a routine clinical setting for tobramycin inhalation powder (TIP), the first dry powder-inhaled antibiotic for Pseudomonas aeruginosa infection. METHODS CF patients aged 6 years or older treated with at least one cycle of TIP completed a web survey on experience with TIP, including the Treatment Satisfaction Questionnaire for Medication (TSQM). Regression analysis determined the factors associated with TSQM global satisfaction. RESULTS Eighty patients (mean age ± standard deviation: 24.4±9.4 years; 57.5% female; mean forced expiratory volume in 1 second ± standard deviation: 67.1%±27.3% predicted) completed the survey. The majority expressed satisfaction with TIP's administration time (100%), time to clean (97.1%), portability (97.1%), and ease of use (94.3%). Effectiveness was significantly associated with TSQM global satisfaction (regression R-squared: 0.54). CONCLUSION Patient preferences for TIP were based on administration time and ease of use. Global satisfaction was related to greater patient-perceived effectiveness.
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Affiliation(s)
- Jonathan Greenberg
- Division of Respiratory Diseases, Boston Children’s Hospital, Boston, MA
- Correspondence: Jonathan Greenberg, Boston Children’s Hospital, 300 Longwood Avenue, Boston, MA, USA, Email
| | | | - Wing W Chan
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | | | | | | | - Gregory S Sawicki
- Division of Respiratory Diseases, Boston Children’s Hospital, Boston, MA
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Whalley D, Caine H, McCloud P, Guo L, Kneebone A, Eade T. Promising results with image guided intensity modulated radiotherapy for muscle invasive bladder cancer. Radiat Oncol 2015; 10:205. [PMID: 26407726 PMCID: PMC4583158 DOI: 10.1186/s13014-015-0499-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2015] [Accepted: 09/03/2015] [Indexed: 01/06/2023] Open
Abstract
AIM To describe the feasibility of image guided intensity modulated radiotherapy (IG-IMRT) using daily soft tissue matching in the treatment of bladder cancer. METHODS Twenty-eight patients with muscle-invasive carcinoma of the bladder were recruited to a protocol of definitive radiation using IMRT with accelerated hypofractionation with simultaneous integrated boost (SIB). Isotropic margins of .5 and 1 cm were used to generate the high risk and intermediate risk planning target volumes respectively. Cone beam CT (CBCT) was acquired daily and a soft tissue match was performed. Cystoscopy was scheduled 6 weeks post treatment. RESULTS The median age was 83 years (range 58-92). Twenty patients had stage II or III disease, and eight were stage IV. Gross disease received 66 Gy in 30 fractions in 11 patients (ten with concurrent chemotherapy) or 55 Gy in 20 fractions for those of poorer performance status or with palliative intent. All patients completed radiation treatment as planned. Three patients ceased chemotherapy early due to toxicity. Six patients (21 %) had acute Grade ≥ 2 genitourinary (GU) toxicity and six (21 %) had acute Grade ≥ 2 gastrointestinal (GI) toxicity. Five patients (18 %) developed Grade ≥2 late GU toxicity and no ≥2 late GI toxicity was observed. Nineteen patients underwent cystoscopy following radiation, with complete response (CR) in 16 cases (86 %), including all patients treated with chemoradiotherapy. Eight patients relapsed, four of which were local relapses. Of the patients with local recurrence, one underwent salvage cystectomy. For patients treated with definitive intent, freedom from locoregional recurrence (FFLR) and overall survival (OS) was 90 %/100 % for chemoradiotherapy versus 86 %/69 % for radiotherapy alone. CONCLUSION IG- IMRT using daily soft tissue matching is a feasible in the treatment of bladder cancer, enabling the delivery of accelerated synchronous integrated boost with good early local control outcomes and low toxicity.
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Affiliation(s)
- D Whalley
- Northern Sydney Cancer Centre, Radiation Oncology, Royal North Shore Hospital, Reserve Road, St Leonards, Sydney, NSW, 2065, Australia.
| | - H Caine
- Northern Sydney Cancer Centre, Radiation Oncology, Royal North Shore Hospital, Reserve Road, St Leonards, Sydney, NSW, 2065, Australia.
| | - P McCloud
- Northern Sydney Cancer Centre, Radiation Oncology, Royal North Shore Hospital, Reserve Road, St Leonards, Sydney, NSW, 2065, Australia. .,McCloud Consulting Group, 7-9 Merriwa Street, Gordon, NSW, 2072, Australia.
| | - L Guo
- Northern Sydney Cancer Centre, Radiation Oncology, Royal North Shore Hospital, Reserve Road, St Leonards, Sydney, NSW, 2065, Australia.
| | - A Kneebone
- Northern Sydney Cancer Centre, Radiation Oncology, Royal North Shore Hospital, Reserve Road, St Leonards, Sydney, NSW, 2065, Australia. .,McCloud Consulting Group, 7-9 Merriwa Street, Gordon, NSW, 2072, Australia.
| | - T Eade
- Northern Sydney Cancer Centre, Radiation Oncology, Royal North Shore Hospital, Reserve Road, St Leonards, Sydney, NSW, 2065, Australia. .,Northern Clinical School, University of Sydney, Camperdown, NSW, 2050, Australia.
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Siva S, Kirby K, Caine H, Pham D, Kron T, Te Marvelde L, Whalley D, Stevens MJ, Foroudi F, MacManus M, Ball D, Eade T. Comparison of Single-fraction and Multi-fraction Stereotactic Radiotherapy for Patients with 18F-fluorodeoxyglucose Positron Emission Tomography-staged Pulmonary Oligometastases. Clin Oncol (R Coll Radiol) 2015; 27:353-61. [PMID: 25698068 DOI: 10.1016/j.clon.2015.01.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Revised: 11/17/2014] [Accepted: 11/24/2014] [Indexed: 01/12/2023]
Abstract
AIM To compare outcomes of single-fraction and multi-fraction stereotactic ablative body radiotherapy (SABR) for pulmonary metastases. MATERIALS AND METHODS A retrospective review from two academic institutions of patients with one to three pulmonary metastases staged with (18)F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) scans. For single-fraction SABR, 26 Gy was prescribed for peripheral targets and 18 Gy for central targets. In the multi-fraction cohort, 48 Gy/4 or 50 Gy/5 was prescribed for peripheral targets and 50 Gy/5 was prescribed for central targets. Three-dimensional conformal radiotherapy (3D-CRT), intensity-modulated radiotherapy (IMRT) and volumetric-modulated arc therapy (VMAT) plans were delivered using heterogeneity corrections. Conformity indices at an intermediate dose (R50%) and at a high dose (R100%) were used to assess a relationship with the planning target volume (PTV). Overall survival, local and distant progression and toxicity rates were analysed from the date of treatment completion. RESULTS Between February 2010 and June 2013, 65 patients with 85 pulmonary metastases were reviewed. The median follow-up was 2.1 years. Metastases most commonly originated from colorectal cancer (31%), followed by non-small cell lung cancer (25%). 3D-CRT was used in 52 targets, IMRT in 21 and VMAT in 12. 3D-CRT showed a lower median R50% (P=0.01), but a higher median R100% than IMRT/VMAT (P=0.04). The R50% index was inversely correlated to the PTV with all techniques (P=0.01). Overall survival at 1 and 2 years in all patients was 93% (95% confidence interval 87-100%) and 71% (95% confidence interval 58-86%), respectively. The 2 year freedom from local and distant progression was 93% (95% confidence interval 86-100%) and 38% (95% confidence interval 27-55%), respectively. There were no significant differences between overall survival (P=0 .14), time to distant progression (P=0.06) or toxicity rates (P=0.75) between single- and multi-fraction cohorts. CONCLUSION We report comparable local control, overall survival and toxicity rates between single-fraction and multi-fraction SABR treatments in patients with FDG-PET-staged pulmonary oligometastases. We propose a guideline for R50% conformity incorporating 3D-CRT/IMRT/VMAT techniques with heterogeneity corrected planning algorithms.
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Affiliation(s)
- S Siva
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia; Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne, Australia.
| | - K Kirby
- Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne, Australia
| | - H Caine
- Department of Radiation Oncology, Northern Sydney Cancer Centre, Sydney, Australia
| | - D Pham
- Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne, Australia
| | - T Kron
- Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne, Australia
| | - L Te Marvelde
- Department of Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre, East Melbourne, Australia
| | - D Whalley
- Department of Radiation Oncology, Northern Sydney Cancer Centre, Sydney, Australia
| | - M J Stevens
- Department of Radiation Oncology, Northern Sydney Cancer Centre, Sydney, Australia
| | - F Foroudi
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia; Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne, Australia
| | - M MacManus
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia; Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne, Australia
| | - D Ball
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia; Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne, Australia
| | - T Eade
- Department of Radiation Oncology, Northern Sydney Cancer Centre, Sydney, Australia
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Whalley D, Crawford SR, Laramée P, Higuchi S, Hao W, Kim SG, Luquiens A, Aubin HJ. Cultural Adaptation of the Alcohol Quality of Life Scale for Use in Japan, China, and Korea. Value Health 2014; 17:A462. [PMID: 27201299 DOI: 10.1016/j.jval.2014.08.1282] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- D Whalley
- RTI Health Solutions, Manchester, UK
| | | | - P Laramée
- Lundbeck S. A. S., Issy-les-Moulineaux cedex, France
| | - S Higuchi
- National Hospital Organization Kurihama Medical and Addiction Center, Yokosuka, Japan
| | - W Hao
- Second Xiangya Hospital of Central South University, Changsha, China
| | - S G Kim
- Pusan National University, Yangsan, South Korea
| | - A Luquiens
- Hôpital Paul Brousse, INSERM 669, Université Paris-Sud, Villejuif, France
| | - H J Aubin
- Hôpital Paul Brousse, INSERM 669, Université Paris-Sud, Villejuif, France
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Whalley D, Luquiens A, Crawford SR, Laramée P, Doward L, Price M, Hawken NA, Dorey J, Owens L, Llorca PM, Falissard B, Aubin HJ. The Patient Experience of Alcohol use Disorder. Value Health 2014; 17:A462. [PMID: 27201301 DOI: 10.1016/j.jval.2014.08.1283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- D Whalley
- RTI Health Solutions, Manchester, UK
| | - A Luquiens
- Hôpital Paul Brousse, INSERM 669, Université Paris-Sud, Villejuif, France
| | | | - P Laramée
- Lundbeck S. A. S., Issy-les-Moulineaux cedex, France
| | - L Doward
- RTI Health Solutions, Manchester, UK
| | - M Price
- (4)RTI Health Solutions, Research Triangle Park, NC, USA
| | - N A Hawken
- Creativ-Ceutical, Luxembourg, Luxembourg
| | - J Dorey
- Creativ-Ceutical USA, Chicago, IL, USA
| | - L Owens
- Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - P M Llorca
- Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - B Falissard
- Hôpital Paul Brousse, INSERM 669, Université Paris-Sud, Villejuif, France
| | - H J Aubin
- Hôpital Paul Brousse, INSERM 669, Université Paris-Sud, Villejuif, France
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Whalley D, Skappak C, Lang ES. The need to clot: a review of current management strategies for adverse bleeding events with new oral anticoagulants. Minerva Anestesiol 2014; 80:821-830. [PMID: 24226497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The new factor Xa inhibitors and direct thrombin inhibitors have offered alternatives to traditional anticoagulants, with benefits of no routine monitoring, less drug interactions, and oral administration. Current approved uses of these agents include prophylaxis of stroke in non-valvular atrial fibrillation and prevention of venous thromboembolism (VTE) following hip and knee arthroplasty. However, concern over bleeding risk in the context of having no specific antidotes available is a topic of focus for many physicians in an acute care setting. This manuscript examines the recent literature in the management of acute bleeding and the various methods of reversing anticoagulation in this setting. Literature published over the last 18 months (2011/07/01-present) was gathered from PubMed, Ovid, and Medline under a combined search strategy covering bleeding, reversal, and new oral anticoagulants, both factor Xa and direct thrombin inhibitors. The use of prothrombin complex concentrate, fresh frozen plasma, activated recombinant factor VII, activated prothrombin complex concentrate, as well as adjuncts of charcoal, hemodialysis, and antifibrinolytics are discussed. Recommendations are based on the determination of the severity of the bleed and physiological markers of anticoagulation, and involve the use of prothrombin complex concentrate, activated recombinant factor VII, and adjunctive therapy as appropriate.
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Affiliation(s)
- D Whalley
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada -
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Small N, Bower P, Chew-Graham CA, Whalley D, Protheroe J. Patient empowerment in long-term conditions: development and preliminary testing of a new measure. BMC Health Serv Res 2013; 13:263. [PMID: 23835131 PMCID: PMC3725177 DOI: 10.1186/1472-6963-13-263] [Citation(s) in RCA: 117] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Accepted: 06/21/2013] [Indexed: 11/10/2022] Open
Abstract
Background Patient empowerment is viewed by policy makers and health care practitioners as a mechanism to help patients with long-term conditions better manage their health and achieve better outcomes. However, assessing the role of empowerment is dependent on effective measures of empowerment. Although many measures of empowerment exist, no measure has been developed specifically for patients with long-term conditions in the primary care setting. This study presents preliminary data on the development and validation of such a measure. Methods We conducted two empirical studies. Study one was an interview study to understand empowerment from the perspective of patients living with long-term conditions. Qualitative analysis identified dimensions of empowerment, and the qualitative data were used to generate items relating to these dimensions. Study two was a cross-sectional postal study involving patients with different types of long-term conditions recruited from general practices. The survey was conducted to test and validate our new measure of empowerment. Factor analysis and regression were performed to test scale structure, internal consistency and construct validity. Results Sixteen predominately elderly patients with different types of long-term conditions described empowerment in terms of 5 dimensions (identity, knowledge and understanding, personal control, personal decision-making, and enabling other patients). One hundred and ninety seven survey responses were received from mainly older white females, with relatively low levels of formal education, with the majority retired from paid work. Almost half of the sample reported cardiovascular, joint or diabetes long-term conditions. Factor analysis identified a three factor solution (positive attitude and sense of control, knowledge and confidence in decision making and enabling others), although the structure lacked clarity. A total empowerment score across all items showed acceptable levels of internal consistency and relationships with other measures were generally supportive of its construct validity. Conclusion Initial analyses suggest that the new empowerment measure meets basic psychometric criteria. Reasons concerning the failure to confirm the hypothesized factor structure are discussed alongside further developments of the scale.
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Affiliation(s)
- Nicola Small
- Centre for Primary Care, Institute of Population Health, Manchester Academic Health Science Centre, University of Manchester, Oxford Road Williamson Building, Manchester, UK.
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Whalley D, Patanjali N, Jackson M, Perez G, Whittaker M, Chatfield M, Hruby G. PO-174 HDR BRACHYTHERAPY BOOST FOR LOCALISED PROSTATE CANCER: THE FIRST 150 PATIENTS FROM THE SYDNEY CANCER CENTRE. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)72140-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Affiliation(s)
- K Palin
- Pharmacy Department and Medical School, University of Nottingham, Nottingham, NG7 2RD
| | - S S Davis
- Pharmacy Department and Medical School, University of Nottingham, Nottingham, NG7 2RD
| | - A J Phillips
- Merck Sharp and Dohme Research Laboratories, Hoddesdon, Herts, EN11 9BU
| | - D Whalley
- Pharmacy Department and Medical School, University of Nottingham, Nottingham, NG7 2RD
| | - C G Wilson
- Pharmacy Department and Medical School, University of Nottingham, Nottingham, NG7 2RD
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Tabas F, Mughal N, Huang A, Hellestrand K, Whalley D, Kanagaratnam L. Patient Radiation Exposure for Pulmonary Vein Isolation is Acceptable and is Lower than that for Diagnostic Coronary Angiogram. Heart Lung Circ 2011. [DOI: 10.1016/j.hlc.2011.05.259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Doward LC, McKenna SP, Whalley D, Tennant A, Griffiths B, Emery P, Veale DJ. The development of the L-QoL: a quality-of-life instrument specific to systemic lupus erythematosus. Ann Rheum Dis 2008; 68:196-200. [PMID: 18385276 DOI: 10.1136/ard.2007.086009] [Citation(s) in RCA: 84] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Complex diseases, such as systemic lupus erythematosus (SLE), present dilemmas over choice of outcome measures. Using a battery of instruments to capture the impact of different impairments or activity limitations experienced does not provide assessment of the wider impact on quality of life (QoL). This paper describes the development and testing of a new instrument to measure QoL in systemic lupus erythematosus (L-QoL). METHODS The development combines theoretical strengths of the needs-based QoL model with statistical and diagnostic powers of the Rasch model. Content was derived from in-depth interviews with relevant patients. Cognitive debriefing interviews assessed face and content validity. Rasch analysis was applied to data from an initial postal survey to remove misfitting items. A second postal survey assessed scaling properties, reliability, internal consistency and validity. RESULTS A 55-item questionnaire was derived from interview transcripts. Cognitive debriefing confirmed acceptability. Rasch analysis of postal survey data (n = 95) removed misfitting items. A second postal survey (n = 93), produced a 25-item version with good item fit and stability, excellent test-retest reliability (0.92), internal consistency (0.92) and strict unidimensionality. CONCLUSIONS It is concluded that the L-QoL should prove a valuable instrument for assessing patient-based outcome in clinical trials and practice.
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Affiliation(s)
- L C Doward
- Galen Research, Enterprise House, Manchester Science Park, Lloyd Street North, Manchester M15 6SE, UK.
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Cheraghi-Sohi S, Hole AR, Mead N, McDonald R, Whalley D, Bower P, Roland M. What patients want from primary care consultations: a discrete choice experiment to identify patients' priorities. Ann Fam Med 2008; 6:107-15. [PMID: 18332402 PMCID: PMC2267425 DOI: 10.1370/afm.816] [Citation(s) in RCA: 167] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
PURPOSE The consultation is fundamental to the delivery of primary care, but different ways of organizing consultations may lead to different patient experiences in terms of access, continuity, technical quality of care, and communication. Patients' priorities for these different issues need to be understood, but the optimal methods for assessing priorities are unclear. This study used a discrete choice experiment to assess patients' priorities. METHODS We surveyed patients from 6 family practices in England. The patients chose between primary care consultations differing in attributes such as ease of access (wait for an appointment), choice (flexibility of appointment times), continuity (physician's knowledge of the patient), technical quality (thoroughness of physical examination), and multiple aspects of patient-centered care (interest in patient's ideas, inquiry about patient's social and emotional well-being, and involvement of patient in decision making). We used probit models to assess the relative priority patients placed on different attributes and to estimate how much they were willing to pay for them. RESULTS Analyses were based on responses from 1,193 patients (a 53% response rate). Overall, patients were willing to pay the most for a thorough physical examination ($40.87). The next most valued attributes of care were seeing a physician who knew them well ($12.18), seeing a physician with a friendly manner ($8.50), having a reduction in waiting time of 1 day ($7.22), and having flexibility of appointment times ($6.71). Patients placed similar value on the different aspects of patient-centered care ($12.06-$14.82). Responses were influenced by the scenario in which the decision was made (minor physical problem vs urgent physical problem vs ambiguous physical or psychological problem) and by patients' demographic characteristics. CONCLUSIONS Although patient-centered care is important to patients, they may place higher priority on the technical quality of care and continuity of care. Discrete choice experiments may be a useful method for assessing patients' priorities in health care.
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Affiliation(s)
- Sudeh Cheraghi-Sohi
- National Primary Care Research and Development Centre (NPCRDC), University of Manchester, Manchester, United Kingdom
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Cheraghi-Sohi S, Bower P, Mead N, McDonald R, Whalley D, Roland M. Making sense of patient priorities: applying discrete choice methods in primary care using 'think aloud' technique. Fam Pract 2007; 24:276-82. [PMID: 17478438 DOI: 10.1093/fampra/cmm007] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Delivering effective health care within limited budgets requires an understanding of patient priorities. Discrete choice experiments (DCEs) provide patients with choices, where each choice differs in terms of certain attributes (such as waiting times, quality of care). Although this technique has significant potential in examining priorities, its use raises practical and conceptual issues. This paper describes the development of a DCE evaluating patient priorities in primary care. METHODS Twenty patients completed a DCE using a 'think aloud' protocol, where they verbalized their thinking while making choices. The analysis examined their decision-making processes. RESULTS There was evidence that patients reinterpreted some attributes, and related some to others outside the task. The cost attribute was interpreted in a variety of ways, dominating some patients' decision-making, being seen as irrelevant by others and being interpreted appropriately by some. The deree to which patients exhibited trading in line with theoretical assumptions also varied. Some choices in the hypothetical task were restricted by their previous experience, but more frequently patients tested the boundaries of the task in ways which directly reflected the primary care context. CONCLUSION Patient interpretation of the discrete choice task was varied and some went beyond the formal boundaries of the task to make their choices. This highlights the importance of piloting attributes, providing clear instructions about the task and developing models of patient decision-making so that responses can be interpreted correctly.
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Affiliation(s)
- Sudeh Cheraghi-Sohi
- National Primary Care Research and Development Centre, University of Manchester, Manchester M13 9PL, UK
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McDonald R, Mead N, Cheraghi-Sohi S, Bower P, Whalley D, Roland M. Governing the ethical consumer: identity, choice and the primary care medical encounter. Sociol Health Illn 2007; 29:430-56. [PMID: 17470220 DOI: 10.1111/j.1467-9566.2007.00493.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Government policy promoting consumerism in healthcare can be seen as offering up certain preferred identities to which its citizens are encouraged to aspire. Whilst many commentators reject the notion that health services users should be conceived of as consumers, this paper outlines the relevance of the concept to our understanding of the ways in which individuals manage their health and service use. The paper examines the identity work undertaken by individuals in relation to decisions about healthcare preferences and assesses the extent to which this is compatible with the identities promoted in Government policy. We suggest that in circumstances where individuals feel both a sense of personal entitlement and a desire to be supportive of the needs of other members of the community, 'doing' ethical consumer can be fraught with discomfort and anxiety. These anxieties are exacerbated in a context where citizenship is increasingly being defined in terms of consumer identities, and making good (health) choices might be seen as distinguishing the civilised from the marginalised.
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Affiliation(s)
- Ruth McDonald
- National Primary Care Research and Development Centre, University of Manchester, Manchester, UK.
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Cheraghi-Sohi S, Bower P, Mead N, McDonald R, Whalley D, Roland M. What are the key attributes of primary care for patients? Building a conceptual 'map' of patient preferences. Health Expect 2006; 9:275-84. [PMID: 16911142 PMCID: PMC5060357 DOI: 10.1111/j.1369-7625.2006.00395.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Responding to the preferences of patients is a key focus of current health policy and is especially important in primary care. Responding effectively to patient preferences requires a clear understanding of the way in which patients assess primary care services. OBJECTIVE This study was designed to provide a 'map' of the content and structure of the key attributes of patient preferences concerning primary care. DESIGN The development of the 'map' used secondary research methods. Electronic databases were searched for published conceptual reviews of patient preferences, which were used to develop a basic 'map' through content analysis. A search for recently published primary empirical studies of patient preferences was conducted to extend and develop the 'map'. The 'map' was tested by taking a random sample of patient assessment instruments and categorizing the item content. RESULTS Seven major categories and multiple subcategories were described. The major categories were access, technical care, interpersonal care, patient-centredness, continuity, outcomes, and hotel aspects of care. The coverage of these attributes in a selection of patient assessment instruments varied widely, and the coding of a proportion of items in the patient assessment instruments according to the 'map' was problematic. CONCLUSIONS The conceptual 'map' can be used to plan comprehensive assessment of patient preferences in primary care. It also raises many theoretical issues concerning the nature of attributes and their interrelationships. The implications for the measurement of patient preferences are discussed.
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Affiliation(s)
- Sudeh Cheraghi-Sohi
- National Primary Care Research and Development Centre, University of Manchester, Manchester, UK.
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McKenna SP, Whalley D, de Prost Y, Staab D, Huels J, Paul CF, van Assche D. Treatment of paediatric atopic dermatitis with pimecrolimus (ElidelR, SDZ ASM 981): impact on quality of life and health-related quality of life. J Eur Acad Dermatol Venereol 2006; 20:248-54. [PMID: 16503881 DOI: 10.1111/j.1468-3083.2006.01383.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM To report on quality of life (QoL) and health-related quality of life (HRQL) impacts of pimecrolimus (Elidel, Novartis A.G., Basel, Switzerland, SDZ ASM 981) 1% cream in the long-term treatment of paediatric atopic dermatitis. METHODS QoL and HRQL data are presented from two 12-month international clinical trials evaluating the efficacy and safety of pimecrolimus 1% cream. Both trials were randomized and double blinded and compared two treatment strategies, one involving the use of emollients, pimecrolimus and topical corticosteroids, the other is 'usual care' (emollients plus topical corticosteroids) with a vehicle cream to maintain study blinding. The first trial (the infant trial) involved patients between ages 3 months and 2 years, whereas the children trial included patients aged 2-17 years. In both trials, QoL of the affected child's parent was evaluated with the parent's index of quality of life in atopic dermatitis (PIQoL-AD). HRQL was assessed in the children trial only with the children's dermatology life quality index (CDLQI). QoL and HRQL assessments were conducted at baseline, 6 weeks, 6 months and 12 months. RESULTS Generalized linear modelling of PIQoL-AD scores at each post-baseline visit showed a greater impact on parent's QoL for pimecrolimus compared with control at all time-points in both trials. HRQL scores showed a greater improvement from baseline for children in the pimecrolimus group compared with those in the control group at all time-points. CONCLUSIONS The results show a beneficial impact of pimecrolimus on parents' QoL in paediatric atopic dermatitis, confirming findings from earlier shorter term trials. There was also a clear benefit to the HRQL of the children treated.
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Whalley D, Bojke C, Gravelle H, Sibbald B. GP job satisfaction in view of contract reform: a national survey. Br J Gen Pract 2006; 56:87-92. [PMID: 16464320 PMCID: PMC1828251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2004] [Revised: 09/23/2004] [Accepted: 12/23/2005] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND Job satisfaction has been associated with intentions to quit and aspects of quality of care. In 2001, GP job satisfaction in England had fallen to its lowest point for over a decade. AIM To assess GP job satisfaction and stressors immediately prior to implementation of the 2004 contract. DESIGN OF STUDY National survey of a random sample of GPs. SETTING England. METHOD One thousand, nine hundred and fifty principal and salaried GPs surveyed in February 2004 were compared with 1828 principals surveyed in 1998 and 1841 principal and salaried GPs surveyed in 2001. Job satisfaction and stressor scores were adjusted for 2004 age-sex distributions. Determinants of overall satisfaction were examined through ordinary least squares regression. RESULTS The 2004 response rate was 53%. GPs were most dissatisfied with hours of work, recognition for good work and remuneration, and experienced most pressure from paperwork, increasing workloads and having insufficient time. The majority of doctors were satisfied with their job overall. Satisfaction was higher than in 2001 and approximately the same as in 1998. Overall stress in 2004 was lower than in 2001 but still higher than in 1998. After allowing for personal, practice and job characteristics, higher satisfaction was associated with lower job stress, involvement in decision making, increasing job interest and ability to meet conflicting demands. CONCLUSIONS Despite recent initiatives to enhance workforce capacity and working lives for GPs, workload, time pressures and job control remain potential areas of concern. Addressing such issues may be key to maintaining morale as the new contract is implemented.
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Affiliation(s)
- Diane Whalley
- National Primary Care Research and Development Centre, University of Manchester, Oxford Road, Manchester M13 9PL, UK.
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Roland M, Campbell S, Bailey N, Whalley D, Sibbald B. Financial incentives to improve the quality of primary care in the UK: predicting the consequences of change. Prim Health Care Res Dev 2006. [DOI: 10.1191/1463423606pc272oa] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Nijsten T, Whalley D, Gelfand J, Margolis D, McKenna SP, Stern RS. The Psychometric Properties of the Psoriasis Disability Index in United States Patients. J Invest Dermatol 2005; 125:665-72. [PMID: 16185264 DOI: 10.1111/j.0022-202x.2005.23775.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Although it has had only limited psychometric assessment in one country (the UK), the Psoriasis Disability Index (PDI) is a commonly used measure of the impact of psoriasis on patients. This study's objective was to analyze the psychometric properties of the PDI in 1196 US patients. High Cronbach's alpha coefficients suggested that the PDI's internal consistency is good. The validity of the PDI was tested using a global question on disease burden and self-assessed extent of disease and both appeared to be good predictors of the PDI. Large floor effects and the suboptimal response distribution of most items, however, suggested that the PDI is insensitive to mild functional limitation. Factor analyses indicated that the current PDI subscales are suboptimal. In the Rasch analysis, the PDI and its subscales appeared to measure multiple constructs, making the validity of deriving a single overall score questionable. The frequent presence of differential item functioning related to several patient characteristics confirmed the instrument's multidimensionality. These findings suggest that the PDI is not an optimal measure for use in US study populations. The psychometric properties of instruments designed to measure the impact of psoriasis should be tested in populations in which the instrument is to be applied.
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Affiliation(s)
- Tamar Nijsten
- Department of Dermatology, University Hospital Antwerp, Antwerp, Belgium
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McKenna SP, Whalley D, Dewar AL, Erdman RAM, Kohlmann T, Niero M, Baró E, Cook SA, Crickx B, Frech F, van Assche D. International development of the Parents’ Index of Quality of Life in Atopic Dermatitis (PIQoL-AD). Qual Life Res 2005; 14:231-41. [PMID: 15789957 DOI: 10.1007/s11136-004-4231-z] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The international development of the Parents' Index of Quality of Life in Atopic Dermatitis (PIQoL-AD), a quality of life (QoL) instrument specific to parents of children with atopic dermatitis (AD) is described. METHOD The instrument was developed simultaneously in several countries. Its content was derived from 65 qualitative interviews with parents in the UK, Netherlands and Italy. The measure was then produced for the UK, Netherlands, Italy, Germany, France, US and Spain. Field-test interviews were conducted with approximately 20 patients in each country to assess face and content validity. A two time-point survey was conducted with between 45 and 328 parents in each country to finalise the instrument through application of the Rasch model and to evaluate the psychometric properties of the final instrument. RESULTS Application of the Rasch model to the survey data identified the final 28-item version. All language versions had good item fit, test-retest reliability (above 0.85), internal consistency and promising validity. CONCLUSIONS The PIQoL-AD is a valuable instrument for inclusion in clinical trials and routine clinical practice. It provides distinct and complementary information to that of existing dermatology-specific measures and has been shown to be responsive to changes in QoL in clinical trials.
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McKenna SP, Doward LC, Whalley D, Tennant A, Emery P, Veale DJ. Development of the PsAQoL: a quality of life instrument specific to psoriatic arthritis. Ann Rheum Dis 2004; 63:162-9. [PMID: 14722205 PMCID: PMC1754880 DOI: 10.1136/ard.2003.006296] [Citation(s) in RCA: 183] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Patient reported outcome measures used in studies of psoriatic arthritis (PsA) have been found to be inadequate for determining the impact of the disease from the patient's perspective. OBJECTIVE To produce the PsAQoL, a PsA-specific quality of life (QoL) instrument, employing the needs based model of QoL that would be relevant and acceptable to respondents, valid, and reliable. METHODS Content was derived from qualitative interviews conducted with patients with PsA. Face and content validity were assessed by field test interviews with a new sample of patients with PsA. A postal survey was conducted to improve the scaling properties of the new measure. Finally, a test-retest postal survey was used to identify the final measure and to test its scaling properties, reliability, internal consistency, and validity. RESULTS Analysis of the qualitative interview transcripts identified a 51 item questionnaire. Field test interviews confirmed the acceptability and relevance of the measure. Analysis of data from the first postal survey (n = 94) reduced the questionnaire to 35 items. Rasch analysis of data from the test-retest survey (n = 286) identified a 20 item version of the PsAQoL with good item fit. This version had excellent internal consistency (alpha = 0.91), test-retest reliability (0.89), and validity. CONCLUSIONS The PsAQoL is a valuable tool for assessing the impact of interventions for PsA in clinical studies and trials. It is well accepted by patients, taking about three minutes to complete, is easy to administer, and has excellent scaling and psychometric properties.
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Whalley D, McKenna SP, Dewar AL, Erdman RA, Kohlmann T, Niero M, Cook SA, Crickx B, Herdman MJ, Frech F, Van Assche D. A new instrument for assessing quality of life in atopic dermatitis: international development of the Quality of Life Index for Atopic Dermatitis (QoLIAD). Br J Dermatol 2004; 150:274-83. [PMID: 14996098 DOI: 10.1111/j.1365-2133.2004.05783.x] [Citation(s) in RCA: 96] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Atopic dermatitis (AD) is a chronic or chronically relapsing inflammatory skin condition that can have a considerable impact on those affected. There are a number of instruments available to measure outcome in dermatological conditions but none have been developed specifically for AD. In addition, most measure symptoms and/or daily functioning, which are potential influences on quality of life (QoL) rather than assessments of the construct itself. OBJECTIVES The aim of the current study was to develop a new instrument specifically designed to measure QoL in adults with AD-the Quality of Life Index for Atopic Dermatitis (QoLIAD). METHODS The instrument was developed based on the needs-based model of QoL and was produced in several different countries simultaneously. Its content was derived from 65 in-depth interviews with relevant patients in the U.K., Italy and the Netherlands. The initial version of the measure was produced in U.K. English and translations were produced for the Netherlands, Italy, Germany, France and the U.S.A. using a dual translation panel methodology. A Spanish version was developed using the same adaptation process after the instrument was finalized. Field-test interviews were conducted with approximately 20 patients in each country to assess face and content validity. The instrument [in addition to the Dermatology Life Quality Index (DLQI) and the Psychological General Well-Being Schedule (PGWB)] was then administered to up to 300 AD patients in each country at two time points to finalize the instrument and test its psychometric properties. RESULTS The initial version of the QoLIAD had 56 items that reflected the areas of need fulfillment identified in the qualitative interviews as having been affected by AD: mental and emotional stimulation, physical and emotional stability, security, sharing and belonging, self-esteem, personal development and fulfillment. Comments from patients in field-test interviews resulted in the removal of 14 items, to leave a 42-item instrument that was considered relevant and acceptable. The number of patients participating in the survey were 286 in the U.K., 46 in the Netherlands, 213 in France, 187 in Germany, 178 in the U.S.A. and 83 in Spain. Application of the Rasch model to these data identified the final 25-item QoLIAD. Unidimensionality was confirmed, with deviation of the total scale from the Rasch model evident at a single time point in one country only (the U.K.). All language versions, with the exception of the Dutch measure, had test-retest reliability coefficients in excess of 0.85. The test-retest in the Netherlands was 0.80. However, this country had the smallest sample size and the corresponding reliability for the DLQI was only 0.40. The QoLIAD had adequate internal consistency and the initial indications of construct validity were good. The levels of association with the DLQI indicated that the two instruments measure related but distinct constructs. CONCLUSIONS The QoLIAD is a practical, reliable, valid and culturally applicable instrument for measuring the impact of AD and its treatment on QoL in clinical trials or in routine clinical practice.
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Affiliation(s)
- D Whalley
- Galen Research, Enterprise House, Lloyd Street North, Manchester M15 6SE, UK
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McKenna SP, Cook SA, Whalley D, Doward LC, Richards HL, Griffiths CEM, Van Assche D. Development of the PSORIQoL, a psoriasis-specific measure of quality of life designed for use in clinical practice and trials. Br J Dermatol 2003; 149:323-31. [PMID: 12932239 DOI: 10.1046/j.1365-2133.2003.05492.x] [Citation(s) in RCA: 93] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Patients with psoriasis have significant impairment in their quality of life (QoL). Several patient-completed instruments are available to measure outcome in dermatological conditions but these primarily focus on severity of disease rather than on QoL. OBJECTIVES To develop a new instrument specifically designed to measure QoL in psoriasis-the Psoriasis Index of Quality of Life (PSORIQoL). METHODS The content of the instrument was derived from qualitative interviews with 62 psoriasis patients in the U.K., Italy and the Netherlands. Content analysis of the interview transcripts from the three countries identified potential items for the questionnaire. All further stages of the project were conducted in the U.K. only. Face and content validity were determined by means of a focus group held with seven psoriasis patients and face-to-face interviews with a further 21 patients. A new draft version of the PSORIQoL, together with the Dermatology Life Quality Index (DLQI) and the General Well-Being Index (GWBI), were completed by a new sample of psoriasis patients contacted by mail, in order to determine construct validity. A subsample of the respondents completed a similar package 2 weeks later, to assess reproducibility (reliability). RESULTS The first version of the PSORIQoL consisted of 61 items covering the needs identified in the interviews as having been affected by psoriasis or its treatment. These included fear of negative reactions from others, self-consciousness and poor self-confidence, problems with socialization, physical contact and intimacy, limitations on personal freedom and impaired relaxation, sleep and emotional stability. Following the focus group and field-test interviews, a new draft measure consisting of 45 items was completed by 148 patients, 88 of whom completed and returned a similar package 2 weeks later. Application of Rasch analysis identified a final 25-item version of the PSORIQoL. This version had a test-retest reliability coefficient of 0.89, indicating good reproducibility. The levels of association with the DLQI and PGWB indicated that the PSORIQoL measures a related but distinct construct. CONCLUSIONS The PSORIQoL appears to be a practical, reliable and valid instrument for measuring the impact of psoriasis on QoL. It remains necessary to establish the instrument's responsiveness to changes in QoL associated with treatment.
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Affiliation(s)
- S P McKenna
- Galen Research, Enterprise House, Lloyd Street North, Manchester M15 6SE, UK.
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Hagell P, Whalley D, McKenna SP, Lindvall O. Health status measurement in Parkinson's disease: validity of the PDQ-39 and Nottingham Health Profile. Mov Disord 2003; 18:773-83. [PMID: 12815656 DOI: 10.1002/mds.10438] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
We assessed the feasibility and psychometric properties of two commonly used health status questionnaires in Parkinson's disease (PD): the generic Nottingham Health Profile (NHP) and the disease-specific 39-item Parkinson's disease Questionnaire (PDQ-39), from a cross-sectional postal survey of PD patients (N = 81), using traditional and Rasch measurement methodologies. Overall response rate was 88%. Both questionnaires were found feasible, although the NHP performed less well. The PDQ-39 had fewer floor effects and was better able to separate respondents into distinct groups than the NHP, whereas the latter exhibited less ambiguous dimensionality and better targeting of respondents with non-extreme scores. Reliability and validity indices were similar, and potential differential item functioning by age and gender groups was found for both questionnaires. PDQ-39 response alternatives indicated ambiguity. With few exceptions, questionnaire scales were unable to meet recommended standards fully. While preliminary, this study illustrates the need for thorough evaluation of outcome measures and has implications beyond the questionnaires used here. Although promising, both questionnaires warrant further developmental work and stronger support of measurement validity before they could be considered fully suitable for valid use in PD, in particular in earlier stages of the disease.
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Affiliation(s)
- Peter Hagell
- Section of Restorative Neurology, Department of Clinical Neuroscience, University Hospital, Lund, Sweden.
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Lucas RD, González-Enseñat MA, Giménez A, Puig L, Vicente A, Díaz JM, Whalley D, McKenna S, Baró E. Validación de las versiones españolas de los cuestionarios Parents’ Index of Quality of Life in Atopic Dermatitis (PIQoL-AD) y Quality of Life Index for Atopic Dermatitis (QoLIAD): un estudio internacional. Actas Dermo-Sifiliográficas 2003. [DOI: 10.1016/s0001-7310(03)76741-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Doward LC, Spoorenberg A, Cook SA, Whalley D, Helliwell PS, Kay LJ, McKenna SP, Tennant A, van der Heijde D, Chamberlain MA. Development of the ASQoL: a quality of life instrument specific to ankylosing spondylitis. Ann Rheum Dis 2003; 62:20-6. [PMID: 12480664 PMCID: PMC1754293 DOI: 10.1136/ard.62.1.20] [Citation(s) in RCA: 398] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Although disease-specific health status measures are available for ankylosing spondylitis (AS), no instrument exists for assessing quality of life (QoL) in the condition. OBJECTIVE To produce an AS-specific QoL measure that would be relevant and acceptable to respondents, valid, and reliable. METHODS The ASQoL employs the needs-based model of QoL and was developed in parallel in the UK and the Netherlands (NL). Content was derived from interviews with patients in each country. Face and content validity were assessed through patient field test interviews (UK and NL). A postal survey in the UK produced a more efficient version of the ASQoL, which was tested for scaling properties, reliability, internal consistency, and validity in a further postal survey in each country. RESULTS A 41 item questionnaire was derived from interview transcripts. Field testing interviews confirmed acceptability. Rasch analysis of data from the first survey (n=121) produced a 26 item questionnaire. Rasch analysis of data from the second survey (UK: n=164; NL: n=154) showed some item misfit, but showed that items formed a hierarchical order and were stable over time. Problematic items were removed giving an 18 item scale. Both language versions had excellent internal consistency (alpha=0.89-0.91), test-retest reliability (r(s)=0.92 UK and r(s)=0.91 NL), and validity. CONCLUSIONS The ASQoL provides a valuable tool for assessing the impact of interventions for AS and for evaluating models of service delivery. It is well accepted by patients, taking about four minutes to complete, and has excellent scaling and psychometric properties.
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Affiliation(s)
- L C Doward
- Galen Research, Enterprise House, Manchester Science Park, Lloyd Street North, Manchester M15 6SE, UK.
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