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Adaptation and validation of the Bulgarian version of the Systemic Lupus Erythematosus Quality of Life Questionnaire (L-QoL). Clin Rheumatol 2023:10.1007/s10067-023-06523-w. [PMID: 36913029 DOI: 10.1007/s10067-023-06523-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 01/23/2023] [Accepted: 01/24/2023] [Indexed: 03/14/2023]
Abstract
OBJECTIVE Systemic lupus erythematosus (SLE) is a heterogeneous disease with multiple clinical manifestations, which causes a significant deterioration in the quality of life (QoL). The Systemic Lupus Erythematosus Quality of Life Questionnaire (L-QoL) is a lupus-specific measure used to determine the burden of the disease and it applies the need-based model of QoL. Our aim was to produce the first successfully validated foreign language version of the questionnaire. METHODS The development of the Bulgarian version involved three stages: translation, field testing and psychometric evaluation. Translation was conducted by an expert linguist working with a developer of the original L-QoL, followed by interviews with monolingual lay individuals. Face and content validity of the translation were assessed by cognitive debriefing interviews with Bulgarian SLE patients. Finally, the L-QoL was validated by administering the questionnaire to a random sample of SLE patients on two occasions, 2 weeks apart to evaluate its reliability and validity. RESULTS In the validation survey, the new Bulgarian version demonstrated high internal consistency (the Cronbach's alpha coefficient was 0.92), and test-retest reliability (0.97). Additionally, scores on the L-QoL were correlated with those on the SF-36 sections to determine convergent validity and the strongest correlation was observed between L-QoL scores and the social functioning section of the SF-36. Known group validity was established by testing the ability of the Bulgarian L-QoL to distinguish between subgroups of patients from the study pool. CONCLUSIONS The demonstrated excellent psychometric properties ensure that the Bulgarian L-QoL accurately captures the impact of SLE on the quality of life. Key points • The Bulgarian version of the L-QoL is a valid and reliable measure of QoL in lupus patients. • The Bulgarian version of the L-QoL can be used as an outcome measure in research, clinical trials and routine clinical practice.
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Stefanac S, Oppenauer C, Zauner M, Durechova M, Dioso D, Aletaha D, Hobusch G, Windhager R, Stamm T. From individualised treatment goals to personalised rehabilitation in osteoarthritis: a longitudinal prospective mapping study using the WHO international classification for functioning, disability and health. Ann Med 2022; 54:2816-2827. [PMID: 36259346 PMCID: PMC9586611 DOI: 10.1080/07853890.2022.2131326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND/OBJECTIVE(S)/INTRODUCTION In clinical practice, treatment goals are often set up without exploring what patients really want. We, therefore, collected individualised treatment goals of patients with osteoarthritis (OA), categorised and mapped them to the World Health Organisation International Classification for Functioning, Disability and Health (ICF). PATIENTS/MATERIALS AND METHODS A longitudinal prospective cohort study was conducted (2019-2021). We used descriptive statistics and Chi2/Fisher's Exact Tests, where appropriate, as well as Kruskal-Wallis-Tests for the mean score ranks of the patients' goals. RESULTS In total, 305 goals reported by 132 participants were analysed (267 women vs. 38 men). The top 3 ICF categories were sensation of pain (ICF:b280), mobility of joint (ICF:b710) and muscle power functions (ICF:b730). Overall, 51% of all individually reported functional goals were achieved after 3 months. Men were more likely to achieve their goals than women (p = 0.009). The majority of the "very important" goals (51%) and "very difficult" goals (57%) was not improved. Goals' mean score ranks significantly differed between baseline and follow-up. CONCLUSION(S) As the human lifespan as well as the number of people affected by OA worldwide increase, there is a growing need to identify and evaluate rehabilitation outcomes that are relevant to people with OA.Key MessagesTreat-to-target agreements between patients and health care providers present a step towards more personalised precision medicine, which will eventually lead to better reported functional and health outcomes.In patients with osteoarthritis, the Goal Attainment Scale instrument can be used to measure health outcomes at different time points and its content may be linked to ICF providing a unified language and conceptual scientific basis.
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Affiliation(s)
- Sinisa Stefanac
- Institute for Outcomes Research, Centre for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria.,Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria
| | - Claudia Oppenauer
- Karl Landsteiner Private University for Health Sciences, Krems, Lower Austria
| | - Michael Zauner
- Clinical Department of Rheumatology, Medical University of Vienna, Vienna, Austria
| | - Martina Durechova
- Clinical Department of Rheumatology, Medical University of Vienna, Vienna, Austria
| | - Daffodil Dioso
- Clinical Department of Rheumatology, Medical University of Vienna, Vienna, Austria
| | - Daniel Aletaha
- Clinical Department of Rheumatology, Medical University of Vienna, Vienna, Austria
| | - Gerhard Hobusch
- Department of Orthopaedics, Medical University of Vienna, Vienna, Austria
| | - Reinhard Windhager
- Department of Orthopaedics, Medical University of Vienna, Vienna, Austria
| | - Tanja Stamm
- Institute for Outcomes Research, Centre for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria.,Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria
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Kumar V, Malhotra V, Sinha V. Evaluation of Individual Quality of Life (QOL) Among Patients with Tracheostomy Using WHO-QOL BREF Questionnaire. Indian J Otolaryngol Head Neck Surg 2022; 74:5207-5216. [PMID: 36742676 PMCID: PMC9895232 DOI: 10.1007/s12070-020-02052-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 08/10/2020] [Indexed: 02/07/2023] Open
Abstract
Tracheostomy is one of the most frequently performed surgical procedures worldwide. The placement of tracheostomy in a patient is associated with significant morbidities as apart from the physical impact of the procedure, a profound and persistent effect on psychosocial, financial, environmental and other aspects of global health of the patient becomes inevitable. However, there is a surprising paucity of literature assessing the Quality of Life (QOL) in patients with tracheostomy tube placement. This study was undertaken with the objective to assess the effect of tracheostomy on Quality of Life (QOL) of patients in an urban tertiary health care setup in India. Patients who underwent tracheostomy tube placement irrespective of the indication were included in the study and followed up for a period of up to 3 months to determine the effect of tracheostomy tube placement on the Quality of Life. A questionnaire based on World Health Organisation (WHO) QOL BREF scheme was utilized to evaluate QOL in the immediate post operative period and again appraised after a period of 3 months. The results were statistically analyzed, tabulated and compared using paired t test to evaluate the 'p' value in every domain i.e., physical, social, psychological and environmental, of the WHO QOL-BREF evaluation tool. 63 patients were enrolled in the study after excluding the patients not fulfilling the selection criteria. The majority of patients were male over the age of 50 years (mean age 57 years). There was a noteworthy depreciation in QOL score in patients as WHO-QOL-BREF scores in all the 4 domains were significantly lower after 3 months. The most affected were the Environmental domain (p value 5E-15) whereas the domain of Psychological showed least depreciation of mean QOL score (p value 7.7E-5). Insertion of a tracheostomy tube has a significant impact on the quality of life of the patient and the amount of burden increases with worsening quality of life. A holistic and scientific approach to assess and manage tracheostomy induced morbidity on the patient is necessary. The patients' views of the aspects of life should be used by health policy makers, clinicians, and caregivers as a reliable guide to the most important priorities for treatment and medical interventions. Large prospective multicenter studies may be undertaken for the developement of a standardized and internationally accepted tracheostomy specific quality of life evaluation tool.
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Affiliation(s)
- Vivek Kumar
- Department of ENT, PMCH, Ashok Rajpath, Patna, 800004 India
| | | | - Vineet Sinha
- Department of ENT, PMCH, Ashok Rajpath, Patna, 800004 India
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Bissenbakker K, Møller A, Brodersen JB, Jønsson ABR. Conceptualisation of a measurement framework for Needs-based Quality of Life among patients with multimorbidity. J Patient Rep Outcomes 2022; 6:83. [PMID: 35895139 PMCID: PMC9329502 DOI: 10.1186/s41687-022-00489-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 07/13/2022] [Indexed: 11/13/2022] Open
Abstract
Background Multimorbidity is both an individual and societal problem. For society, patients with multimorbidity increase healthcare costs. For the individual, living with multimorbidity is complex, and there is an inverse relationship between a patient's Quality of Life (QoL) and their number of chronic conditions. Numerous intervention studies target these problems, yet there is no multimorbidity-specific patient-reported outcome measure (PROM) developed specifically for this group with adequate measurement properties to assess QoL. This study explores what overall needs regarding QoL are affected by living with multimorbidity through qualitative interviews. With this, we conceptualise Needs-based QoL specifically for this group, ensuring high content validity (regarding relevance and comprehensiveness) of using the Needs-based approach to measure their QoL. This is essential as this preliminary study leads to the development of the MultiMorbidity Questionnaire (MMQ), a PROM measuring QoL among patients with multimorbidity. Methods This study draws upon qualitative interviews with fifteen patients with multimorbidity based on a semi-structured interview guide following the Needs-based approach. This approach allowed the patients to cover needs relevant for their QoL in relation to the complexities of living with multimorbidity. The transcribed interviews were thematically analysed, inspired by Braun and Clarke’s reflexive approach.
Results Analysis of the interviews resulted in the construction of six intertwined domains relevant to patients with multimorbidity, covering their Needs-based QoL; “Physical ability”, “Self-determination”, “Security”, “Partner and social life”, “Self-image”, and “Personal finances”. “Physical limitations” and “Personal finances” were stated as core needs implicating the other domains. Conclusion This study shows six intertwined overall domains relevant for patients with multimorbidity regarding their Needs-based QoL; “Physical ability”, “Self-determination”, “Security”, “Partner and social life”, “Self-image”, and “Personal finances”. These needs are relevant in a Danish context, with a generally high standard of living. Based on this conceptual framework of Need-based QoL for patients with multimorbidity, we will develop items for a new patient-reported outcome measure called the MMQ. Supplementary Information The online version contains supplementary material available at 10.1186/s41687-022-00489-0.
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Prieto-Moreno R, Estévez-López F, Molina-Garcia P, Mora-Traverso M, Deschamps K, Claeys K, de Buyser J, Ariza-Vega P. ActiveHip+: A feasible mHealth system for the recovery of older adults after hip surgery during the COVID-19 pandemic. Digit Health 2022; 8:20552076221139694. [PMID: 36420319 PMCID: PMC9677169 DOI: 10.1177/20552076221139694] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 11/01/2022] [Indexed: 08/03/2023] Open
Abstract
OBJECTIVE Half of older adults undergoing hip surgery do not recover their previous functional status. mHealth is a promising tool for rehabilitating older adults after hip surgery. This study aimed to test the feasibility of the ActiveHip+ mHealth system in older adults after hip surgery. METHODS Sixty-nine older adults who had undergone hip surgery and their family caregivers were recruited from hospitals in Spain and Belgium and used the ActiveHip+ mHealth system for 12 weeks. Assessments were made during hospital stay and 3 months after surgery. Feasibility assessment included: adoption (participation proportion), usage (access to the app), satisfaction with the app (Net Promoter Score) and user perception of the quality of the app (Mobile App Rating Scale). Clinical assessment included: patient-reported outcomes, such as functional status (Functional Independence Measure) and performance-based outcomes, such as physical fitness (Short Physical Performance Battery). RESULTS The ActiveHip+ mHealth system obtained satisfactory feasibility results in both countries. In Spain, we observed 85% adoption, 64% usage, 8.86/10 in satisfaction with the app and 4.42/5 in perceived quality of the app. In Belgium, we observed 82% adoption, 84% usage, 5.16/10 in satisfaction with the app and 3.52/5 in app's perceived quality. The intervention had positive effects on levels of functional status, pain and physical fitness. CONCLUSIONS The ActiveHip+ mHealth system is a feasible tool to conduct the rehabilitation in older adults after hip surgery. Although the intervention seemed beneficial clinically, we do not recommend its implementation in clinical settings until appropriately designed randomised clinical trials confirm these results.
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Affiliation(s)
- Rafael Prieto-Moreno
- Instituto de Investigación Biosanitaria ibs.Granada, Granada, Spain
- PA-HELP “Physical Activity for HEaLth Promotion” Research Group, Department of Physical Education and Sports, Faculty of Sports Science, University of Granada, Granada, Spain
| | - Fernando Estévez-López
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Pablo Molina-Garcia
- Instituto de Investigación Biosanitaria ibs.Granada, Granada, Spain
- PROFITH (PROmoting FITness and Health through physical activity) Research Group, Department of Physical Education and Sports, Faculty of Sports Science, University of Granada, Granada, Spain
| | - Marta Mora-Traverso
- Instituto de Investigación Biosanitaria ibs.Granada, Granada, Spain
- PA-HELP “Physical Activity for HEaLth Promotion” Research Group, Department of Physical Education and Sports, Faculty of Sports Science, University of Granada, Granada, Spain
| | - Kevin Deschamps
- Department of Rehabilitation Sciences, KU Leuven, Musculoskeletal Rehabilitation Research Group, Campus Brugge, Leuven, Flanders, Belgium
- Clinical Motion Analysis Laboratorium, University Hospitals Leuven, Campus Pellenberg, Leuven, Flanders, Belgium
- Division of Podiatry, Haute Ecole Leonard De Vinci, Institut D’Enseignement Supérieur Parnasse Deux-Alice, Bruxelles, Belgium
- Department of Podiatry, Artevelde University College, Gent, Belgium
| | - Kurt Claeys
- Department of Rehabilitation Sciences, KU Leuven, Musculoskeletal Rehabilitation Research Group, Campus Brugge, Leuven, Flanders, Belgium
| | - Janou de Buyser
- Department of Rehabilitation Sciences, KU Leuven, Musculoskeletal Rehabilitation Research Group, Campus Brugge, Leuven, Flanders, Belgium
| | - Patrocinio Ariza-Vega
- Instituto de Investigación Biosanitaria ibs.Granada, Granada, Spain
- PA-HELP “Physical Activity for HEaLth Promotion” Research Group, Department of Physical Education and Sports, Faculty of Sports Science, University of Granada, Granada, Spain
- Department of Physiotherapy, Faculty of Health Science, University of Granada, Granada, Spain
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[Validation of the living with osteoarthritis in Spanish population]. Aten Primaria 2021; 53:102044. [PMID: 33836404 PMCID: PMC8056235 DOI: 10.1016/j.aprim.2021.102044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 10/27/2020] [Accepted: 01/07/2021] [Indexed: 11/24/2022] Open
Abstract
Objetivo Presentar los resultados psicométricos de la escala de convivencia con artrosis (EC-Artrosis) en la población española. Diseño Estudio observacional, multicéntrico y transversal, con retest en una fracción de la muestra. Emplazamiento Centros públicos y privados de atención primaria y secundaria, así como asociaciones de pacientes con artrosis de Navarra, La Rioja, Madrid, Valencia y Málaga. Participantes La muestra estuvo compuesta por un total de 291 pacientes con diagnóstico de artrosis por su médico, en cualquier estadio de la enfermedad de atención primaria o especializada, nacionalidad española, y no hospitalizados. Intervenciones De manera adicional a la EC-Artrosis, se incluyó un cuestionario sociodemográfico y escalas para evaluar el apoyo social percibido por el paciente (DUFSS), la calidad de vida relacionada con la salud (WHOQOL-BREF) y la escala de satisfacción con la vida del paciente. Mediciones principales Se analizaron las propiedades psicométricas de la escala EC-Artrosis, tales como viabilidad y aceptabilidad, fiabilidad (consistencia interna y estabilidad), precisión y validez de constructo (convergente, interna y para grupos conocidos). Resultados El 100% de los datos fueron computados. La calidad de los datos y la aceptabilidad fueron excelentes. El alfa de Cronbach para el total de la escala fue de 0,87 y el índice de homogeneidad de 0,22. El ICC para el total de la escala fue de 0,88. En cuanto a la precisión, el valor del EEM fue de 5,18 (<½DE = 7,47). Conclusiones La EC-Artrosis ha mostrado ser un instrumento válido y fiable para evaluar la convivencia del paciente con artrosis a nivel nacional.
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AlAjmi M, Al-Ghamdi S. Translation and validation of the Arabic version of the osteoarthritis quality of life questionnaire (OAQoL) in Saudi patients with osteoarthritis. Health Qual Life Outcomes 2021; 19:91. [PMID: 33731135 PMCID: PMC7972212 DOI: 10.1186/s12955-021-01741-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 03/10/2021] [Indexed: 11/11/2022] Open
Abstract
Background Osteoarthritis (OA) is a debilitating multifactorial degenerative rheumatic disease affecting millions of people around the globe. The osteoarthritis quality of life scale (OAQoL), originally produced in the English language, is an important tool used to assess the overall impact of OA and its treatment on the patient’s quality of life. Purpose The purpose of the study was to translate and validate the OAQoL in the Arabic language in order to use it on the Saudi population. Methodology A bilingual panel comprising four healthcare professionals and one external certified medical translator translated the English version of the OAQoL to the Arabic language. A back translation was subsequently performed by two English-speaking translators and any differences were resolved by conferring with the original panel. The qualitative research was performed through cognitive debriefing interviews (CDIs) with 59 native Arabic patients who had clinically and radiologically confirmed osteoarthritis of any joint. The internal consistency of the 22 items was derived by leveraging the Cronbach’s Alpha coefficient. Results 59 participants were included in the study, and more than half (52.5%) of them were men. The response rate was 100% and the mean time taken to answer the questionnaire was 10.5 min. The average Intraclass Correlation Coefficient (ICC) and Cronbach’s Alpha were determined to be 0.93 each, indicating that all the items in the OAQoL were significantly interrelated. Conclusion The translated Arabic version of the OAQoL questionnaire used in this study is a reliable and consistent tool that showed good comprehensibility and internal consistency.
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Affiliation(s)
- Mansour AlAjmi
- Department of Family and Community Medicine, College of Medicine, Prince Sattam bin Abdulaziz University, Al Kharj 11942, Saudi Arabia
| | - Sameer Al-Ghamdi
- Department of Family and Community Medicine, College of Medicine, Prince Sattam bin Abdulaziz University, Al Kharj 11942, Saudi Arabia.
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Gonçalves RSG, Heaney A, McKenna SP, Carvalho JB, Vidal MEL, de Brito MCM, Duarte ALBP. Psoriatic Arthritis Quality of Life Questionnaire: translation, cultural adaptation and validation into Brazilian Portuguese language. Adv Rheumatol 2021; 61:13. [PMID: 33632331 DOI: 10.1186/s42358-021-00168-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 02/10/2021] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Psoriatic arthritis (PsA) is a multifaceted inflammatory disease that can cause joint destruction and impair quality of life. The Psoriatic Arthritis Quality of Life Questionnaire (PsAQoL) was the first disease-specific tool for determining the impact of the disease on the quality of life of people with PsA. OBJECTIVES The primary objective was to develop and validate a Brazilian Portuguese version of the PsAQoL. METHODS The UK PsAQoL was translated into Brazilian Portuguese using two translation panels. This translation then checked for face validity and construct validity with new samples of patients. Finally, a test-retest validation study was conducted with 52 patients with PsA. The survey included the Nottingham Health Profile (NHP) as a comparator instrument. RESULTS Internal consistency and reproducibility were both excellent for the new adaptation (0.91 and 0.90 respectively Scores on the PsAQoL were found to correlate as expected with the comparator measure and the instrument was able to detect differences in score related to perceived severity of PsA, general health status and presence of a flare. CONCLUSION The Brazilian PsAQoL was found easy to understand and complete and has excellent reliability and construct validity. The new measure will be a valuable new tool for use in routine PsA practice and clinical trials.
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Affiliation(s)
| | | | - Stephen P McKenna
- Galen Research Ltd, Manchester, UK.,School of Health Sciences, University of Manchester, Manchester, UK
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Adaptation and validation of the Rheumatoid Arthritis Quality of Life (RAQoL) questionnaire for use in Bulgaria. Rheumatol Int 2020; 40:2077-2083. [PMID: 32814987 DOI: 10.1007/s00296-020-04686-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 08/11/2020] [Indexed: 10/23/2022]
Abstract
Rheumatoid arthritis (RA) is a chronic disease with an enormous impact on patients' quality of life. The Rheumatoid Arthritis Quality of Life (RAQoL) questionnaire is a disease-specific measure of QoL for individuals with rheumatoid arthritis. Our aim was to adapt and validate the RAQoL for use in Bulgaria. The development of a new language version of the RAQoL consisted of three stages: translation, field testing and psychometric evaluation. The dual-panel methodology, requiring two independent panels of Bulgarian speakers, was applied to translate the UK English version of the RAQoL into Bulgarian. Face and content validity of the translated questionnaire were assessed through cognitive debriefing interviews. Lastly, the RAQoL was administered on two occasions to a random sample of RA patients to evaluate reliability and validity. At the first occasion, the SF-36 was also administered for use as a comparator scale. The RAQoL was successfully adapted into Bulgarian and considered easy to understand, acceptable and comprehensive by RA patients. A psychometric study demonstrated that the new language version has excellent internal consistency (Cronbach's alpha coefficients = 0.93 and 0.94) and test-retest reliability (a Spearman's rank correlation coefficient = 0.97). Convergent validity was established by correlating scores on the RAQoL with a comparator measure, the SF-36. A strong correlation between RAQoL scores and the physical functioning section of the SF-36 was observed. Known group validity was established by the ability of the measure to distinguish between subgroups of patients, who differed according to their perceived general health, disease severity (p < 0.001) and whether they were experiencing a flare-up (p < 0.01). The new language version is recommended for use in future research studies, clinical trials and routine practice with Bulgarian RA patients.
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Arnold JB, Halstead J, Grainger AJ, Keenan AM, Hill CL, Redmond AC. Foot and Leg Muscle Weakness in People With Midfoot Osteoarthritis. Arthritis Care Res (Hoboken) 2020; 73:772-780. [PMID: 32170831 DOI: 10.1002/acr.24182] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 03/03/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To compare foot and leg muscle strength in people with symptomatic midfoot osteoarthritis (OA) with asymptomatic controls, and to determine the association between muscle strength, foot pain, and disability. METHODS Participants with symptomatic midfoot OA and asymptomatic controls were recruited for this cross-sectional study from general practices and community health clinics. The maximum isometric muscle strength of the ankle plantarflexors, dorsiflexors, invertors and evertors, and the hallux and lesser toe plantarflexors was measured using hand-held dynamometry. Self-reported foot pain and foot-related disability were assessed with the Manchester Foot Pain and Disability Index. Differences in muscle strength were compared between groups. Multivariable regression was used to determine the association between muscle strength, foot pain, and disability after adjusting for covariates. RESULTS People with midfoot OA (n = 52) exhibited strength deficits in all muscle groups, ranging from 19% (dorsiflexors) to 30% (invertors) relative to the control group (n = 36), with effect sizes of 0.6-1.1 (P < 0.001). In those with midfoot OA, ankle invertor muscle strength was negatively and independently associated with foot pain (β = -0.026 [95% confidence interval (95% CI) -0.051, -0.001]; P = 0.045). Invertor muscle strength was negatively associated with foot-related disability, although not after adjustment for depressive symptoms (β = -0.023 [95% CI -0.063, 0.017]; P = 0.250). CONCLUSION People with symptomatic midfoot OA demonstrate weakness in the foot and leg muscles compared to asymptomatic controls. Preliminary indications from this study suggest that strengthening of the foot and leg muscles may offer potential to reduce pain and improve function in people with midfoot OA.
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Affiliation(s)
- John B Arnold
- University of Leeds, NIHR Leeds Biomedical Research Centre, Leeds, UK, University of South Australia, Adelaide, South Australia
| | - Jill Halstead
- University of Leeds, NIHR Leeds Biomedical Research Centre, and Leeds Community Healthcare NHS Trust, Leeds, UK
| | - Andrew J Grainger
- University of Leeds, NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Anne-Maree Keenan
- University of Leeds, NIHR Leeds Biomedical Research Centre, Leeds, UK
| | - Catherine L Hill
- The Queen Elizabeth Hospital and University of Adelaide, Adelaide, South Australia
| | - Anthony C Redmond
- University of Leeds, NIHR Leeds Biomedical Research Centre, Leeds, UK
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Langley PC. More Unnecessary Imaginary Worlds - Part 1: The Institute for Clinical and Economic Review's Evidence Report on Janus Kinase (JAK) Inhibitors in Rheumatoid Arthritis. Innov Pharm 2020; 11:10.24926/iip.v11i1.2402. [PMID: 34017631 PMCID: PMC8132526 DOI: 10.24926/iip.v11i1.2402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Previous commentaries in the Formulary Evaluation section of INNOVATIONS in Pharmacy have pointed to the lack of credibility in modeled claims for cost-effectiveness and associated recommendations for pricing by the Institute for Clinical and Economic Review (ICER). The principal objection to ICER reports has been that their modeled claims fail the standards of normal science: they are best seen as pseudoscience. The purpose of this latest commentary is to consider the recently released ICER evidence report for Janus Kinase (JAK) Inhibitors. As ICER continues, in the case of JAK Inhibitors, to apply its modeled cost utility framework with consequent recommendations for pricing adjustments, these recommendations also lack credibility. In contrast with previous ICER evidence reports, the present report adopts only a 12-month timeframe, one due, in large part, to ICER being unable to justify assumptions to drive its construction of imaginary worlds beyond 12 months. This commentary emphasizesagain, why the ICER methodology fails to meet the standards of normal science. Claims made by ICER for the competing JAK Inhibitor therapies lack credibility, are impossible to evaluate, let alone replicate across treatment settings. Even so, it is important to examine a number of key elements in the ICER invention of the 12-month JAK Inhibitor imaginary world. While this does not imply any degree of acceptance of the ICER methodology, one element that merits particular attention is thefailure of the ICER modeling to meet logically defensible measurement standards in its application of generic health related quality of life (HRQoL) ordinal metrics to create its QALY claims. The failure to meet the required standards of fundamental measurement means that the cost-per-QALY claims are invalid. This raises the issue of the application of Rasch Measurement Theory (RMT) in instrument development and the potential role of patient centric outcome (PCO) instruments that represent the patient voice in value claims. The case made here is that the ICER approach should be abandoned as an unnecessary distraction. If we are to meet standards for the discovery of new facts in therapy response then our focus must be on proposing credible, evaluable and replicable claims within disease states. Instruments, such as the Rheumatoid Arthritis Quality of Life (RAQoL)questionnaire that build on the common construct that QoL is the extent to which human needs are fulfilled should be the basis for value claims. HRQoL Instruments that are clinically focused and reflect the value calculus of providers and not patients in measuring response by symptoms and activity limitations are irrelevant. This puts to one side the belief that incremental cost-per-QALY models, the construction of imaginary worlds are, in any sense, a 'gold standard'; a meme embraced by the health technology assessment profession. Claims for incremental cost per QALY outcomes and recommendations for pricing and access driven by willingness to pay thresholds are irrelevant to formulary decisions.
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Gomes JL, Águeda AF, Heaney A, Duarte C, Lopes C, Costa T, Marona J, Rodrigues-Manica S, Maia S, Costa M, Branco JC, McKenna SP, Barcelos A, Pimentel-Santos FM. Translation, cross-cultural adaptation and validation of the Osteoarthritis Quality of Life (OAQoL) questionnaire for use in Portugal. Rheumatol Int 2018; 39:715-722. [PMID: 30415453 DOI: 10.1007/s00296-018-4197-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 11/02/2018] [Indexed: 01/12/2023]
Abstract
Osteoarthritis (OA) is the most prevalent rheumatic disease and is a leading cause of decreased quality of life (QoL). The OA Quality of Life questionnaire (OAQoL) is an OA-specific patient-reported outcome measures. The aim of this study was to translate and validate the original UK English version of the Osteoarthritis Quality of Life (OAQoL) questionnaire into European Portuguese. The translation of the questionnaire was carried out according to a dual panel methodology (bilingual panel followed by lay panel). This was followed by cognitive debriefing interviews (CDIs) with OA patients to assess comprehension and relevance of the translated questionnaire. Finally, a validation survey was conducted to assess its psychometric properties. The Portuguese OAQoL, a comparator scale (the Nottingham Health Profile-NHP) as well as questions relating to demographic and disease information were administered to OA patients. A sub-sample of patients also completed the Portuguese OAQoL two weeks later, to assess test-retest reliability. The internal consistency, construct validity and known group validity (according to perceived OA severity) of the scale was also assessed. Both the bilingual and lay panels consisted of five individuals and no major difficulties relating to the translation process were identified. A total of ten patients with OA participated in the CDIs. The mean time to complete the questionnaire was 5 min. These interviews revealed that the Portuguese version of the OAQoL was clear, relevant and easy to complete. Finally, 53 OA patients (44 females; mean age of 67.6 years) completed the validation survey. Cronbach's alpha coefficient was 0.87, demonstrating high internal consistency. Test-retest reliability, assessed by Spearman's rank correlation coefficient, was 0.86. Moderate correlations were found with the majority of the NHP sections, providing evidence of construct validity. Significant differences in OAQoL scores were found between patients who differed according to their perceived OA severity, providing evidence of known group validity. The Portuguese version of the OAQoL is a valid and reliable questionnaire that can be used to assess QoL in OA, both in clinical practice and for research purposes.
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Affiliation(s)
- João Lagoas Gomes
- Rheumatology Department, Hospital Egas Moniz (CHLO), Rua da Junqueira 126, 1349-019, Lisbon, Portugal. .,CEDOC, NOVA Medical School, Nova University of Lisbon, Rua Câmara Pestana 6, 1150-082, Lisbon, Portugal.
| | - Ana Filipa Águeda
- Rheumatology Department, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal
| | | | - Cátia Duarte
- Rheumatology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.,iCBR, Faculdade de Medicina da Universidade de Coimbra, Coimbra, Portugal
| | - Carina Lopes
- Rheumatology Department, Hospital Egas Moniz (CHLO), Rua da Junqueira 126, 1349-019, Lisbon, Portugal.,CEDOC, NOVA Medical School, Nova University of Lisbon, Rua Câmara Pestana 6, 1150-082, Lisbon, Portugal
| | - Tiago Costa
- Rheumatology Department, Hospital Egas Moniz (CHLO), Rua da Junqueira 126, 1349-019, Lisbon, Portugal.,CEDOC, NOVA Medical School, Nova University of Lisbon, Rua Câmara Pestana 6, 1150-082, Lisbon, Portugal
| | - José Marona
- Rheumatology Department, Hospital Egas Moniz (CHLO), Rua da Junqueira 126, 1349-019, Lisbon, Portugal.,CEDOC, NOVA Medical School, Nova University of Lisbon, Rua Câmara Pestana 6, 1150-082, Lisbon, Portugal
| | - Santiago Rodrigues-Manica
- Rheumatology Department, Hospital Egas Moniz (CHLO), Rua da Junqueira 126, 1349-019, Lisbon, Portugal.,CEDOC, NOVA Medical School, Nova University of Lisbon, Rua Câmara Pestana 6, 1150-082, Lisbon, Portugal
| | - Sara Maia
- CEDOC, NOVA Medical School, Nova University of Lisbon, Rua Câmara Pestana 6, 1150-082, Lisbon, Portugal
| | - Manuela Costa
- Rheumatology Department, Hospital Egas Moniz (CHLO), Rua da Junqueira 126, 1349-019, Lisbon, Portugal
| | - Jaime C Branco
- Rheumatology Department, Hospital Egas Moniz (CHLO), Rua da Junqueira 126, 1349-019, Lisbon, Portugal.,CEDOC, NOVA Medical School, Nova University of Lisbon, Rua Câmara Pestana 6, 1150-082, Lisbon, Portugal
| | | | - Anabela Barcelos
- Rheumatology Department, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal.,ibimed-Institute for Biomedicine, University of Aveiro, Aveiro, Portugal
| | - Fernando M Pimentel-Santos
- Rheumatology Department, Hospital Egas Moniz (CHLO), Rua da Junqueira 126, 1349-019, Lisbon, Portugal.,CEDOC, NOVA Medical School, Nova University of Lisbon, Rua Câmara Pestana 6, 1150-082, Lisbon, Portugal
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Ndosi M, Alcacer-Pitarch B, Allanore Y, Del Galdo F, Frerix M, García-Díaz S, Hesselstrand R, Kendall C, Matucci-Cerinic M, Mueller-Ladner U, Sandqvist G, Torrente-Segarra V, Schmeiser T, Sierakowska M, Sierakowska J, Sierakowski S, Redmond A. Common measure of quality of life for people with systemic sclerosis across seven European countries: a cross-sectional study. Ann Rheum Dis 2018; 77:1032-1038. [PMID: 29463517 PMCID: PMC6029637 DOI: 10.1136/annrheumdis-2017-212412] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 01/09/2018] [Accepted: 01/30/2018] [Indexed: 12/01/2022]
Abstract
Objectives The aim of this study was to adapt the Systemic Sclerosis Quality of Life Questionnaire (SScQoL) into six European cultures and validate it as a common measure of quality of life in systemic sclerosis (SSc). Methods This was a seven-country (Germany, France, Italy, Poland, Spain, Sweden and UK) cross-sectional study. A forward–backward translation process was used to adapt the English SScQoL into target languages. SScQoL was completed by patients with SSc, then data were validated against the Rasch model. To correct local response dependency, items were grouped into the following subscales: function, emotion, sleep, social and pain and reanalysed for fit to the model, unidimensionality and cross-cultural equivalence. Results The adaptation of the SScQoL was seamless in all countries except Germany. Cross-cultural validation included 1080 patients with a mean age 58.0 years (SD 13.9) and 87% were women. Local dependency was evident in individual country data. Grouping items into testlets corrected the local dependency in most country specific data. Fit to the model, reliability and unidimensionality was achieved in six-country data after cross-cultural adjustment for Italy in the social subscale. The SScQoL was then calibrated into an interval level scale. Conclusion The individual SScQoL items have translated well into five languages and overall, the scale maintained its construct validity, working well as a five-subscale questionnaire. Measures of quality of life in SSc can be directly compared across five countries (France, Poland Spain, Sweden and UK). Data from Italy are also comparable with the other five countries although require an adjustment.
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Affiliation(s)
- Mwidimi Ndosi
- Academic Rheumatology Unit, University Hospitals Bristol NHS Foundation Trust, Bristol, UK.,Department of Nursing and Midwifery, University of the West of England, Bristol, UK
| | - Begonya Alcacer-Pitarch
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.,NIHR Leeds Biomedical Research Centre, Leeds, UK
| | - Yannick Allanore
- Rheumatology A Department, Cochin Hospital, Paris Descartes University, Paris, France
| | - Francesco Del Galdo
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.,NIHR Leeds Biomedical Research Centre, Leeds, UK
| | - Marc Frerix
- Department of Rheumatology and Clinical Immunology, Justus-Liebig University Giessen, Bad Nauheim, Germany
| | - Sílvia García-Díaz
- Rheumatology Department, Hospital General Hospitalet-Moisès Broggi, Sant Joan Despí, Spain
| | | | - Christine Kendall
- Department of Rheumatology and Clinical Immunology, Justus-Liebig University Giessen, Bad Nauheim, Germany
| | - Marco Matucci-Cerinic
- Department of Experimental Medicine, University of Florence, Florence, Italy.,Department of Geriatric Medicine, Division of Rheumatology, Azienda Ospedaliero-Universitaria Careggi (AOUC), Florence, Italy
| | - Ulf Mueller-Ladner
- Department of Rheumatology and Clinical Immunology, Justus-Liebig University Giessen, Bad Nauheim, Germany
| | | | | | - Tim Schmeiser
- Department of Rheumatology and Clinical Immunology, Justus-Liebig University Giessen, Bad Nauheim, Germany.,Department of Rheumatology and Immunology, St. Josef Hospital, Wuppertal, Germany
| | - Matylda Sierakowska
- Department of Integrated Medical Care, Medical University of Bialystok, Bialystok, Poland
| | - Justyna Sierakowska
- Department of Foreign Languages, Medical University of Bialystok, Bialystok, Poland
| | - Stanslaw Sierakowski
- Department of Rheumatology and Internal Diseases, Medical University of Bialystok, Bialystok, Poland
| | - Anthony Redmond
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.,NIHR Leeds Biomedical Research Centre, Leeds, UK
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Stebbings S, Gray A, Schneiders AG, Sansom A. A randomized double-blind placebo-controlled trial to investigate the effectiveness and safety of a novel green-lipped mussel extract -BioLex® -for managing pain in moderate to severe osteoarthritis of the hip and knee. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 17:416. [PMID: 28830491 PMCID: PMC5568208 DOI: 10.1186/s12906-017-1907-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Accepted: 08/02/2017] [Indexed: 01/22/2023]
Abstract
Background Extracts from perna canaliculus, the Green Lipped Mussel (GLM) are widely used as a complimentary therapy by patients with osteoarthritis (OA). The current study investigated the potential of a novel GLM formulation as a treatment for OA. A randomized double-blind placebo-controlled trial was undertaken to assess potential impacts on pain and quality of life following 12 weeks of treatment. Methods Eighty patients with moderate to severe OA of the hip or knee were randomized to receive either 600 mg of BioLex®-GLM daily or placebo for 12 weeks. Entry criteria included a minimum 100 mm Visual Analogue Scale pain score (VAS) of 30 mm at baseline. The primary outcome was patient reported pain, measured by the Western Ontario and McMasters OA Index (WOMAC) pain subscale and VAS pain scale. Secondary outcomes included: quality of life (OAQol), total WOMAC score, WOMAC −20 responder criteria, and change in medication use over the study period. Participants were assessed at baseline, 12 weeks (end of therapy) and 15 weeks (3-weeks post-intervention). Results At week 12, there were no significant differences in VAS or WOMAC pain subscale between active and placebo groups, nor significant improvement in the WOMAC-20 responder criteria or OAQol. Joint stiffness (measured by WOMAC-B stiffness) in the GLM group improved compared with placebo (p = 0.046). There was a significant difference in paracetamol use between the GLM treated group and the placebo group after week 12 (p = 0.001). Conclusions BioLex® -GLM extract did not confer clinical benefit in moderate to severe OA over the intervention period, however, a significant difference in paracetamol use in the post-intervention period was observed between the BioLex® -GLM group and placebo group. Higher doses and/or longer treatment periods are worthy of future investigation. Trial registration Australia and New Zealand Clinical Trials Registry: no. ACTRN12611000256976.
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Leung YY, Lee W, Lui NL, Rouse M, McKenna SP, Thumboo J. Adaptation of Chinese and English versions of the Ankylosing Spondylitis quality of life (ASQoL) scale for use in Singapore. BMC Musculoskelet Disord 2017; 18:353. [PMID: 28818056 PMCID: PMC5561597 DOI: 10.1186/s12891-017-1715-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 08/10/2017] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND To cross-culturally adapt and validate the Singapore Chinese and Singapore English versions of the Ankylosing Spondylitis Quality of Life (ASQoL) scales. METHODS Translation of the ASQoL into Singapore Chinese and English was performed by professional and lay translation panels. Field-testing for face and content validity was performed by interviewing ten Chinese speaking and ten English speaking axial spondyloarthritis (AxSpA) patients. AxSpA patients (either Chinese or English speaking) were invited to take part in validation surveys. The Health Assessment Questionnaire (HAQ), Short Form Health Survey (SF-36), Bath Indices, and other measures of disease activity were used as comparator scales for convergent validity. A separate sample of AxSpA patients were invited to participate in a test-retest postal study, with 2 weeks between administrations. RESULTS The cross-sectional study included 183 patients (77% males, 82% English speaking), with a mean (SD) age of 39.4 (13.7) years. The ASQoL had excellent internal consistency (Cronbach's alpha = 0.88), and correlated moderately with all the comparator scales. The ASQoL was able to distinguish between patients grouped by disease activity and perceived general health. The ASQoL fulfilled the Rasch model analysis for fit, reliability and unidimensionality requirements. No significant differential item functioning was noted for gender, age below or above 50 years, and language of administration. Test-retest reliability was good (r = 0.81). CONCLUSIONS The ASQoL was adapted into Singapore Chinese and English language versions, and shown to be culturally relevant, valid and reliable when used with combined samples of AxSpA patients who speak either Chinese or English.
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Affiliation(s)
- Ying Ying Leung
- Department of Rheumatology & Immunology, Singapore General Hospital, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Weixian Lee
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Nai Lee Lui
- Department of Rheumatology & Immunology, Singapore General Hospital, Singapore, Singapore
| | | | - Stephen P. McKenna
- Galen Research Ltd, Manchester, UK
- School of Health Sciences, University of Manchester, Manchester, UK
| | - Julian Thumboo
- Department of Rheumatology & Immunology, Singapore General Hospital, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
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Huang KH, Hsieh RL, Lee WC. Pain, Physical Function, and Health in Patients With Knee Osteoarthritis. Rehabil Nurs 2017; 42:235-241. [DOI: 10.1002/rnj.234] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Validation of the Mini-OAKHQOL for use in patients with osteoarthritis in Spain. Clin Rheumatol 2017; 36:1855-1864. [PMID: 28353088 DOI: 10.1007/s10067-017-3611-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 03/08/2017] [Accepted: 03/19/2017] [Indexed: 10/19/2022]
Abstract
The Mini-Osteoarthritis Knee and Hip Quality of Life (Mini-OAKHQOL) questionnaire osteoarthritis is specific to individuals with knee or hip osteoarthritis. The objective of this study was to perform a validation of the Mini-OAKHQOL for use in Spain in terms of its psychometric properties of reliability, validity and responsiveness. Patients with osteoarthritis from the waiting list for a joint replacement completed the OAKHQOL, Short Form 36 Health Survey and Western Ontario and McMaster Universities Osteoarthritis Index. Reliability was assessed in terms of internal consistency and test-retest data, and convergent validity using Spearman's correlation coefficient. Structural validity was investigated by confirmatory factor analysis, and Rasch analysis was used to examine the unidimensionality of the scales. Responsiveness was assessed by calculating effect sizes. Confirmatory factor analysis confirmed the five-factor model, and the results of the Rasch analyses supported the unidimensionality assumption, with infit and outfit statistics. Cronbach's alpha ranged from 0.76 to 0.89 for all except the social dimensions. Statistically significant differences were observed between patients with different degrees of disease severity on all dimensions. There was convergent validity among dimensions expected to be correlated. The OAKHQOL questionnaire showed good responsiveness, with large changes for all dimensions apart from the two social dimensions, which had small effect sizes. Results of the study support the view that the Spanish version of the Mini-OAKHQOL questionnaire is a valid instrument to measure health-related quality of life in patients with osteoarthritis of the lower limb.
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Adaptation of the osteoarthritis-specific quality of life scale (the OAQoL) for use in Germany, Hungary, Italy, Spain and Turkey. Rheumatol Int 2017; 37:727-734. [PMID: 28197718 DOI: 10.1007/s00296-017-3664-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 01/20/2017] [Indexed: 11/26/2022]
Abstract
The Osteoarthritis Quality of Life scale (OAQoL) is specific to individuals with osteoarthritis. The present study describes the adaptation of the OAQoL for use in the following five European languages: German, Hungarian, Italian, Spanish and Turkish. The study involved three stages in each language; translation, cognitive debriefing (face and content validity) and validation. The validation stage assessed internal consistency (Cronbach's alpha), reproducibility (test-retest reliability using Spearman's rank correlations), convergent and divergent validity (correlations with the Health Assessment Questionnaire, The Western Ontario and McMaster Universities Index of osteoarthritis and Nottingham Health Profile) and known group validity. The OAQoL was successfully translated into the target languages with minimal problems. Cognitive debriefing interviewees found the measures easy to complete and identified few problems with content. Internal consistency ranged from 0.94 to 0.97 and test-retest reliability (reproducibility) from 0.87 to 0.98. These values indicate that the new language versions produce very low levels of measurement error. Median OAQoL scores were higher for patients reporting a current flare of osteoarthritis in all countries. Scores were also related, as expected, to perceived severity of osteoarthritis. The OAQoL was successfully adapted for use in Germany, Hungary, Italy, Spain and Turkey. The addition of these new language versions will prove valuable to multinational clinical trials and to clinical practice in the respective countries.
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Wilburn J, Twiss J, Kemp K, McKenna SP. A qualitative study of the impact of Crohn's disease from a patient's perspective. Frontline Gastroenterol 2017; 8:68-73. [PMID: 28839887 PMCID: PMC5369426 DOI: 10.1136/flgastro-2015-100678] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 04/12/2016] [Accepted: 04/15/2016] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE To understand how the lives of people with Crohn's disease (CD) are affected. Most research in CD has focused on symptoms and functioning rather than on how these outcomes influence quality of life (QoL). DESIGN As part of a study to develop a CD-specific patient-reported outcome measure, qualitative interviews were conducted with patients from Manchester Royal Infirmary to determine how CD affects QoL. The needs-based model was adopted for the study. The interviews, which took the form of focused conversations covering all aspects of the impact of CD and its treatment, were audio-recorded. Theoretical thematic analysis of the transcripts identified needs affected by CD. RESULTS Thirty patients (60% female) aged 25-68 years were interviewed. Participants had experienced CD for between 2 and 40 years. Nearly 1300 statements relating to the impact of CD were identified. Thirteen main need themes were identified: nutrition, hygiene, continence, freedom from infection, security, self-esteem, role, attractiveness, relationships, intimacy, clear-mindedness, pleasure and autonomy. CONCLUSIONS The findings from the interviews indicate that CD has a major impact on need-fulfilment. Such issues should be addressed in CD audit, clinical trials and when evaluating clinical practice.
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Affiliation(s)
| | | | - Karen Kemp
- Department of Gastroenterology, Manchester Royal Infirmary, Manchester, UK
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Zlatkovic-Svenda M, Rouse M, Radak-Perovic M, Stojanovic R, Vujasinovic-Stupar N, Lazovic-Popovic B, Wilburn J, McKenna SP. Adaptation and validation of the Rheumatoid Arthritis Quality of Life (RAQoL) questionnaire for use in Serbia. Rheumatol Int 2016; 37:641-646. [PMID: 27796523 DOI: 10.1007/s00296-016-3586-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 10/21/2016] [Indexed: 11/25/2022]
Abstract
Rheumatoid arthritis (RA) is one of the most prevalent inflammatory rheumatic diseases. As it is a chronic and a lifelong destructive disease, the aim of the treatment is to reduce disability and improve quality of life. The Rheumatoid Arthritis Quality of Life (RAQoL) questionnaire is a patient-reported outcome measure, specific to RA. To adapt and validate the RAQoL for use in Serbia, two translation panels were involved to produce the Serbian RAQoL. After successful translation, face and content validity was determined via cognitive debriefing interviews. The psychometric properties of the questionnaire were examined, including reliability and construct validity, by using the Nottingham Health Profile (NHP) as a comparator scale. The RAQoL was translated successfully and rated as applicable, relevant and comprehensive by respondents. The questionnaire had high internal consistency (alpha = 0.94 at both time points) and test-retest reliability (r = 0.92). Moderately high correlations were found between the RAQoL and physical mobility, pain and energy level sections of the NHP, providing evidence of convergent validity. The RAQoL was able to distinguish between patients grouped by perceived general health, incidence of flare-up and disease severity. The Serbian language version of the RAQoL showed strong evidence of reliability and validity and is recommended for use in clinical trials and routine general practice in RA.
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Affiliation(s)
- Mirjana Zlatkovic-Svenda
- Institute of Rheumatology, Belgrade, Serbia. .,University of Belgrade School of Medicine, Belgrade, Serbia.
| | | | - Marija Radak-Perovic
- Institute of Rheumatology, Belgrade, Serbia.,University of Belgrade School of Medicine, Belgrade, Serbia
| | - Roksanda Stojanovic
- Institute of Rheumatology, Belgrade, Serbia.,University of Belgrade School of Medicine, Belgrade, Serbia
| | - Nada Vujasinovic-Stupar
- Institute of Rheumatology, Belgrade, Serbia.,University of Belgrade School of Medicine, Belgrade, Serbia
| | - Biljana Lazovic-Popovic
- University of Belgrade School of Medicine, Belgrade, Serbia.,University Clinical Hospital Center Zemun, Belgrade, Serbia
| | | | - Stephen P McKenna
- School of Health Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, UK
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Leung YY, Thumboo J, Rouse M, McKenna SP. Adaptation of Chinese and English versions of the Psoriatic Arthritis Quality of Life (PsAQoL) scale for use in Singapore. BMC Musculoskelet Disord 2016; 17:432. [PMID: 27756259 PMCID: PMC5069879 DOI: 10.1186/s12891-016-1292-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 10/11/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND To develop Singapore Chinese and English versions of the Psoriatic Arthritis Quality of Life (PsAQoL) scale that were equivalent to and met the same psychometric and acceptability standards as the original UK measure. METHODS Translation of the original PsAQoL into contextualised English and Chinese versions for use in Singapore was performed by professional and lay translation panels. Ten Chinese speaking and ten English speaking local patients were interviewed to assess face and content validity. Psoriatic arthritis (PsA) patients (either Chinese or English speaking) fulfilling the Classification criteria of Psoriatic Arthritis were then invited to participate in a validation survey. Clinical variables, the Health Assessment Questionnaire (HAQ) and the Medical Outcome Short-form 36 (SF-36) were used as comparator instruments for convergent validity. A separate sample of PsA patients were invited to participate in a test-retest postal study, with two weeks between administrations. RESULTS The validation sample included 98 patients (51 % men) with a mean (SD) age of 51.5 (13.8) years. The PsAQoL had excellent internal consistency (Cronbach's α = 0.92) and scores on the measure were moderately correlated with health status measures (pain, HAQ score, SF-36 scores) and patient and physician global assessments. The scale was able to distinguish between groups with active or inactive disease assessed by composite scores, HAQ and minimal disease activity. Test-retest reliability was excellent (r = 0.92). CONCLUSIONS This study provides evidence that the adapted English and Chinese versions of the PsAQoL can be used in clinical studies with PsA patients in Singapore.
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Affiliation(s)
- Ying Ying Leung
- Department of Rheumatology & Immunology, Singapore General Hospital, The Academia, level 4, 20 College Road, Singapore, S169856, Singapore. .,Duke-NUS Medical School, Singapore, Singapore.
| | - Julian Thumboo
- Department of Rheumatology & Immunology, Singapore General Hospital, The Academia, level 4, 20 College Road, Singapore, S169856, Singapore.,Duke-NUS Medical School, Singapore, Singapore
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Development and preliminary evaluation of the OsteoArthritis Questionnaire (OA-Quest): a psychometric study. Osteoarthritis Cartilage 2016; 24:1357-66. [PMID: 27038491 DOI: 10.1016/j.joca.2016.03.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 03/11/2016] [Accepted: 03/22/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE This study reports the development of the OsteoArthritis Questionnaire (OA-Quest) - a new measure designed to comprehensively capture the potentially modifiable burden of osteoarthritis. DESIGN Item development was guided by the a priori conceptual framework of the Personal Burden of Osteoarthritis (PBO) which captures 8 dimensions of osteoarthritis burden (Physical distress, Fatigue, Physical limitations, Psychosocial distress, Physical de-conditioning, Financial hardship, Sleep disturbances, Lost productivity). One hundred and twenty three candidate items were pretested in a clinical sample of 18 osteoarthritis patients. The measurement properties of the OA-Quest were assessed with exploratory factor analysis (EFA), Rasch modelling, and confirmatory factor analysis (CFA) in a community-based sample (n = 792). RESULTS EFA replicated 7 of the 8 PBO domains. An exception was PBO Fatigue domain, with items merging into the Physical distress subscale in the OA-Quest. Following item analysis, a 42-item 7-subscale questionnaire was constructed, measuring Physical distress (seven items, Cronbach's α = 0.93), Physical limitations (11 items, α = 0.95), Psychosocial distress (seven items, α = 0.93), Physical de-conditioning (four items, α = 0.87), Financial hardship (four items, α = 0.93), Sleep disturbances (five items, α = 0.96), and Lost productivity (four items α = 0.90). A highly restricted 7-factor CFA model had excellent fit with the data (χ(2)(113) = 316.36, P < 0.001; chi-square/degrees of freedom = 2.8; comparative fit index [CFI] = 0.97; root mean square error of approximation [RMSEA] = 0.07), supporting construct validity of the new measure. CONCLUSIONS The OA-Quest is a new measure of osteoarthritis burden that is founded on a comprehensive conceptual model. It has strong evidence of construct validity and provides reliable measurement across a broad range of osteoarthritis burden.
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Abstract
PURPOSE OF REVIEW This article walks through some of the ideas behind patient-reported outcome measurement and quality of life research against the backdrop of urethral stricture disease and conditions of the lower urinary tract more generally, why measurement matters at all, future areas for research and development and potential opportunities for misuse and manipulation. RECENT FINDINGS It is the authors' opinion that only one published study has substantially advanced our understanding of the way men with urethral stricture disease manage this condition in the real world, and, in turn, the outcomes those men seek when they consent to surgery and its associated risks. There is, however, almost certainly greater acceptance now by reconstructive urologists of the utility of patient-reported outcome measures in audit; surgical performance evaluation; clinical research; and fair, logical and transparent healthcare resource allocation at a population level. This is evidenced by the recent proliferation of studies incorporating patient-reported outcomes, which appear today to be on parity at least with those that surgeons historically gave priority to. SUMMARY The next frontier in urethral stricture disease outcomes research is a better understanding of the impact of this condition on men's daily lives. That level of insight is likely to be gained through a mixture of qualitative and quantitative research methods applied to collaborative research ventures with men with the condition who, as those that have the most to gain and lose, must be majority stakeholders in this process.
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Couraud G, Escalas C, Etcheto A, Rannou F, Poiraudeau S. French adaptation and validation of the Osteoarthritis Quality of Life scale. Ann Phys Rehabil Med 2015; 58:336-42. [PMID: 26596580 DOI: 10.1016/j.rehab.2015.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 09/06/2015] [Accepted: 09/27/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The Osteoarthritis Quality of Life scale (OAQoL) is an osteoarthritis-specific measure developed in the United Kingdom by a needs-based approach. This study describes the adaptation and validation of this English scale into French. METHODS The OAQoL was translated into French by a dual-panel technique followed by cognitive debriefing interviews. Internal consistency was assessed by the Cronbach α. Construct validity was tested by exploratory and confirmatory factor analyses and by convergent and divergent correlations with other patient-reported outcome measures by the Spearman rho (ρ). Reliability was explored by Spearman rho as well as the Bland and Altman method for the total score and Cohen's kappa for each item score. RESULTS Cognitive debriefing revealed the French OAQoL to be clear, relevant and comprehensive. The Cronbach α was 0.91. Exploratory factor analysis extracted 4 groups of items. After eliminating 4 items, confirmatory factor analysis of the remaining 18 items confirmed higher intra-factor than inter-factor correlations. The expected convergent and divergent correlations were observed. Test-retest reliability was good (ρ 0.93) and was confirmed by Bland and Altman analysis; most items (12/18) had kappa values from 0.61 to 0.80. CONCLUSION The French OAQoL is an easy-to-use 18-item questionnaire with good content and construct validity to assess the impact of osteoarthritis on quality of life for French-speaking patients.
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Affiliation(s)
- G Couraud
- Inserm U1153, université Paris Descartes, hôpital Cochin, AP-HP, 75619 Paris, France.
| | - C Escalas
- Inserm U1153, université Paris Descartes, hôpital Cochin, AP-HP, 75619 Paris, France
| | - A Etcheto
- Inserm U1153, université Paris Descartes, hôpital Cochin, AP-HP, 75619 Paris, France
| | - F Rannou
- Inserm U1153, université Paris Descartes, hôpital Cochin, AP-HP, 75619 Paris, France
| | - S Poiraudeau
- Inserm U1153, université Paris Descartes, hôpital Cochin, AP-HP, 75619 Paris, France.
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The Mini-OAKHQOL for knee and hip osteoarthritis quality of life was obtained following recent shortening guidelines. J Clin Epidemiol 2015; 69:70-8. [PMID: 26111768 DOI: 10.1016/j.jclinepi.2015.06.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2014] [Revised: 05/22/2015] [Accepted: 06/16/2015] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To develop a short form of the knee and hip osteoarthritis quality of life questionnaire, the Mini-OAKHQOL, preserving the conceptual model and, as far as possible, the content and the psychometric properties of the original instrument. STUDY DESIGN AND SETTING A two-step shortening procedure was used: (1) a consensus Delphi method, with a panel of patients and another of professionals independently asked to select items and (2) a nominal group, where patients, professionals, and methodologists reached consensus on the final selection of items, using information from the panels and from modern measurement and classical test theory analyses. The psychometric properties of the Mini-OAKHQOL were assessed in an independent population-based sample of 581 subjects with knee or hip osteoarthritis. RESULTS The two-step shortening procedure resulted in a 20-item questionnaire. Confirmatory factor analysis showed preservation of the original five-dimensional structure. Rasch analyses showed the unidimensionality and invariance by sex, age, and joint of the main dimensions. Convergent validity, reproducibility, and internal consistency were similar to or better than those of the original OAKHQOL. CONCLUSIONS The 20-item Mini-OAKHQOL has good psychometric properties and can be used for the measurement of quality of life in subjects with osteoarthritis of the lower limbs.
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Hossain FS, Konan S, Patel S, Rodriguez-Merchan EC, Haddad FS. The assessment of outcome after total knee arthroplasty: are we there yet? Bone Joint J 2015; 97-B:3-9. [PMID: 25568406 DOI: 10.1302/0301-620x.97b1.34434] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The routine use of patient reported outcome measures (PROMs) in evaluating the outcome after arthroplasty by healthcare organisations reflects a growing recognition of the importance of patients' perspectives in improving treatment. Although widely embraced in the NHS, there are concerns that PROMs are being used beyond their means due to a poor understanding of their limitations. This paper reviews some of the current challenges in using PROMs to evaluate total knee arthroplasty. It highlights alternative methods that have been used to improve the assessment of outcome.
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Affiliation(s)
- F S Hossain
- Yorkshire and Humber Deanery Orthopaedic Training Rotation, Leeds General Infirmary, Great George Street, Leeds, LS1 3EX, UK
| | - S Konan
- NE(UCH) Orthopaedic Training Rotation, University College London Hospitals NHS Trust, 350 Euston Road, London, NW1 2BU, UK
| | - S Patel
- NE(UCH) Orthopaedic Training Rotation, University College London Hospitals NHS Trust, 350 Euston Road, London, NW1 2BU, UK
| | - E C Rodriguez-Merchan
- Department of Orthopaedic Surgery, La Paz University Hospital, Paseo de la Castellana 261, 28046-Madrid, Spain
| | - F S Haddad
- University College London Hospitals, Euston Road, London NW1 2BU, UK
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Assessing quality of life in Crohn’s disease: development and validation of the Crohn’s Life Impact Questionnaire (CLIQ). Qual Life Res 2015; 24:2279-88. [DOI: 10.1007/s11136-015-0947-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2015] [Indexed: 01/14/2023]
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Ackerman IN, Busija L, Tacey MA, Bohensky MA, Ademi Z, Brand CA, Liew D. Performance of the Assessment of Quality of Life Measure in People With Hip and Knee Joint Disease and Implications for Research and Clinical Use. Arthritis Care Res (Hoboken) 2014; 66:481-8. [DOI: 10.1002/acr.22129] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Accepted: 08/13/2013] [Indexed: 01/07/2023]
Affiliation(s)
- Ilana N. Ackerman
- Melbourne EpiCentre, Royal Melbourne Hospital, and The University of Melbourne; Parkville, Victoria Australia
| | - Lucy Busija
- EpiCentre and Melbourne Brain Centre, Royal Melbourne Hospital, and The University of Melbourne, Parkville, and Deakin University; Melbourne, Victoria Australia
| | - Mark A. Tacey
- Melbourne EpiCentre, Royal Melbourne Hospital, and The University of Melbourne; Parkville, Victoria Australia
| | - Megan A. Bohensky
- Melbourne EpiCentre, Royal Melbourne Hospital, and The University of Melbourne; Parkville, Victoria Australia
| | - Zanfina Ademi
- Melbourne EpiCentre, Royal Melbourne Hospital, and The University of Melbourne, Parkville, and Monash University; Melbourne, Victoria Australia
| | - Caroline A. Brand
- Melbourne EpiCentre, Royal Melbourne Hospital, and The University of Melbourne; Parkville, Victoria Australia
| | - Danny Liew
- Melbourne EpiCentre, Royal Melbourne Hospital, and The University of Melbourne; Parkville, Victoria Australia
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Jarl G, Holmefur M, Hermansson LMN. Test-retest reliability of the Swedish version of the Orthotics and Prosthetics Users' Survey. Prosthet Orthot Int 2014; 38:21-6. [PMID: 23652919 DOI: 10.1177/0309364613485113] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND The Orthotics and Prosthetics Users' Survey consists of five modules to assess outcomes of orthotic and prosthetic interventions: lower extremity functional status, upper extremity functional status, client satisfaction with device, client satisfaction with services and health-related quality of life. OBJECTIVES To investigate the test-retest reliability and calculate the smallest detectable difference for all modules of the Swedish Orthotics and Prosthetics Users' Survey. STUDY DESIGN Test-retest reliability study design. METHODS A total of 69 patients at a Department of Prosthetics and Orthotics completed Orthotics and Prosthetics Users' Survey on two occasions separated by a 2-week interval, giving 18 answers on lower extremity functional status, 41 on upper extremity functional status, 53 on client satisfaction with device, 12 on client satisfaction with services and 67 answers on health-related quality of life. Raw scores were converted into Orthotics and Prosthetics Users' Survey units on a 0-100 scale. Intra-class correlation coefficients, Bland-Altman plots, common person linking plots and t-tests of person mean measures were used to investigate the reliability. The 95% confidence level smallest detectable differences were calculated. RESULTS The intra-class correlation coefficients ranged from 0.77 to 0.96 for the modules, and no systematic differences were detected between the response occasions. The smallest detectable differences ranged from 7.4 to 16.6 units. CONCLUSIONS The test-retest reliability was satisfactory for all Orthotics and Prosthetics Users' Survey modules. The smallest detectable difference was large on all modules except the health-related quality of life module. CLINICAL RELEVANCE The Orthotics and Prosthetics Users' Survey modules are reliable and, thus, can be recommended for repeated measurements of patients over time. Relatively large changes are needed to achieve statistical significance when assessing individual patients.
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Affiliation(s)
- Gustav Jarl
- 1Centre for Rehabilitation Research, Örebro County Council, Örebro, Sweden
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Kingsbury SR, Gross HJ, Isherwood G, Conaghan PG. Osteoarthritis in Europe: impact on health status, work productivity and use of pharmacotherapies in five European countries. Rheumatology (Oxford) 2014; 53:937-47. [DOI: 10.1093/rheumatology/ket463] [Citation(s) in RCA: 109] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
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Comparing the impact of psoriasis and atopic dermatitis on quality of life: co-calibration of the PSORIQoL and QoLIAD. Qual Life Res 2014; 24:105-13. [DOI: 10.1007/s11136-014-0630-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2014] [Indexed: 10/25/2022]
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Short-term therapeutic effects of 890-nanometer light therapy for chronic low back pain: a double-blind randomized placebo-controlled study. Lasers Med Sci 2013; 29:671-9. [DOI: 10.1007/s10103-013-1378-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Accepted: 06/18/2013] [Indexed: 10/26/2022]
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The impact of Dupuytren disease on patient activity and quality of life. J Hand Surg Am 2013; 38:1209-14. [PMID: 23707018 DOI: 10.1016/j.jhsa.2013.03.036] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Revised: 03/08/2013] [Accepted: 03/08/2013] [Indexed: 02/02/2023]
Abstract
PURPOSE To explore the impact of Dupuytren disease (DD) from the patients' perspective. METHODS Audio-recorded interviews were conducted for patients with Dupuytren disease (DD) attending outpatient clinics. The interviews were transcribed and subjected to content analysis. This analysis highlighted key impact areas and common themes in individuals' personal experiences. These were then allocated to categories specified by the World Health Organization International Classification of Functioning, Disability, and Health (impairments and activity limitations) and the needs-based model of quality of life (QoL). RESULTS Qualitative unstructured interviews were conducted with 34 patients (74% men; age, 41-80 y; mean [SD], 64 [13] y). The sample had a wide range of severity and duration of DD (range, 0.5-40; mean [SD], 13 [10] y). Nine hundred fifty-three statements relating to the impact of DD were identified from the interview transcripts. These statements fell into 2 major categories of impact: activity limitations (10 themes including problems with dressing, gripping, and personal care) and QoL (6 need categories: physiological, safety and security, social, affection, esteem, and cognitive needs). CONCLUSIONS Findings from the interviews suggest that DD affects both performance of activities and QoL. To determine accurately the effectiveness of DD interventions from the patients' perspective, it is important to determine their impacts on both activity limitations and QoL. We intend to develop valid, reproducible, and responsive DD-specific scales for this purpose. CLINICAL RELEVANCE The study identifies key issues specific to DD that influence patients' functioning and QoL. The information reported will form the basis of DD-specific patient-reported outcomes measures for use in clinical practice and evaluations of interventions.
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Kingsbury SR, Tharmanathan P, Adamson J, Arden NK, Birrell F, Cockayne S, Dickson J, Doherty M, Dziedzic KS, Grainger A, Hewitt CE, O'Neill TW, Scott DL, Vincent TL, Wakefield RJ, Watt FE, Torgerson DJ, Conaghan PG. Hydroxychloroquine effectiveness in reducing symptoms of hand osteoarthritis (HERO): study protocol for a randomized controlled trial. Trials 2013; 14:64. [PMID: 23452375 PMCID: PMC3716636 DOI: 10.1186/1745-6215-14-64] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Accepted: 02/11/2013] [Indexed: 01/15/2023] Open
Abstract
Background Osteoarthritis (OA) is the most common type of arthritis, causing significant joint pain and disability. It is already a major cause of healthcare expenditure and its incidence will further increase with the ageing population. Current treatments for OA have major limitations and new analgesic treatments are needed. Synovitis is prevalent in OA and is associated with pain. Hydroxychloroquine is used in routine practice for treating synovitis in inflammatory arthritides, such as rheumatoid arthritis. We propose that treating patients with symptomatic hand OA with hydroxychloroquine will be a practical and safe treatment to reduce synovitis and pain. Methods/design HERO is an investigator-initiated, multicentre, randomized, double-blind, placebo-controlled trial. A total of 252 subjects with symptomatic hand OA will be recruited across primary and secondary care sites in the UK and randomized on a 1:1 basis to active treatment or placebo for 12 months. Daily medication dose will range from 200 to 400 mg according to ideal body weight. The primary endpoint is change in average hand pain during the previous two weeks (measured on a numerical rating scale (NRS)) between baseline and six months. Secondary endpoints include other self-reported pain, function and quality-of-life measures and radiographic structural change at 12 months. A health economics analysis will also be performed. An ultrasound substudy will be conducted to examine baseline levels of synovitis. Linear and logistic regression will be used to compare changes between groups using univariable and multivariable modelling analyses. All analyses will be conducted on an intention-to-treat basis. Discussion The HERO trial is designed to examine whether hydroxychloroquine is an effective analgesic treatment for OA and whether it provides any long-term structural benefit. The ultrasound substudy will address whether baseline synovitis is a predictor of therapeutic response. This will potentially provide a new treatment for OA, which could be of particular use in the primary care setting. Trial registration ISRCTN91859104.
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Affiliation(s)
- Sarah R Kingsbury
- Division of Rheumatic and Musculoskeletal Disease and National Institute of Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, University of Leeds, Leeds LS7 4SA, UK
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Validity and reliability of the Dutch adaptation of the Psoriatic Arthritis Quality of Life (PsAQoL) Questionnaire. PLoS One 2013; 8:e55912. [PMID: 23418474 PMCID: PMC3572180 DOI: 10.1371/journal.pone.0055912] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Accepted: 01/04/2013] [Indexed: 11/19/2022] Open
Abstract
Objective The Psoriatic Arthritis Quality of Life (PsAQoL) questionnaire is a disease- specific instrument developed to measure quality of life (QoL) in patients with psoriatic arthritis (PsA). The aim of this study was to translate the measure into Dutch and to determine its psychometric properties. Method Translation of the original English PsAQoL into Dutch was performed by bilingual and lay panel. Ten field-test interviews with PsA patients were performed to assess face and content validity. In total, 211 PsA patients were included in a test-retest postal survey to investigate the reliability and construct validity of the Dutch adaptation of the PsAQoL. The PsAQoL, Health Assessment Questionnaire (HAQ) and Skindex-17 were administered on two different occasions approximately two weeks apart. Results The Dutch version of the PsAQoL was found to be relevant, understandable and easy to complete in only a few minutes. It correlated as expected with the HAQ (Spearman’s ρ = 0.72) and the 2 subscales of the Skindex-17 (ρ = 0.40 for the psychosocial and ρ = 0.46 for the symptom scale). Furthermore, the measure had good internal consistency (Cronbach’s α = 0.92) and test-retest reliability (ρ = 0.89). The PsAQoL was able to define groups of patients based on self-reported general health status, self-reported severity of PsA and flare of arthritis. Duration of PsA did not influence PsAQoL scores. Conclusions The Dutch version of the PsAQoL is a valid and reliable questionnaire suitable for use in clinical or research settings to asses PsA-specific QoL.
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Kingsbury SR, Hensor EMA, Walsh CAE, Hochberg MC, Conaghan PG. How do people with knee osteoarthritis use osteoarthritis pain medications and does this change over time? Data from the Osteoarthritis Initiative. Arthritis Res Ther 2013; 15:R106. [PMID: 24008023 PMCID: PMC3978852 DOI: 10.1186/ar4286] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Revised: 05/14/2012] [Accepted: 09/04/2013] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION The aim of this analysis was to describe comprehensively the cross-sectional and longitudinal patterns of analgesic and nutraceutical medication use for knee osteoarthritis (OA) in a contemporary US cohort and to investigate associated demographic and clinical factors. METHODS Baseline, 12, 24 and 36 month data were obtained retrospectively from the National Institutes of Health Osteoarthritis Initiative. Participants had symptomatic radiographic knee OA. Multiple binary logistic regression models identified characteristics independently associated with the use of analgesics or nutraceuticals. RESULTS We included 987 subjects (55.9% female, mean age 61.5 years, 71.0% white). At baseline, 68.2% reported frequent use of a conventional analgesic or nutraceutical for joint pain (for more than half of the previous month). Non-prescription non-steroidal anti-inflammatory drugs (NSAIDs) were the most frequently reported medications (26.8%), even in those more than 75-years old. Multiple conventional analgesics were used by 11.9%. Frequent analgesic use was more likely in women (odds ratio (OR) 1.8 (95% confidence interval (CI) 1.3 to 2.3)) and people with more pain (moderate 1.7 (1.2 to 2.4); severe 3.1 (2.1 to 4.7)); nutraceutical use was less likely in non-whites (0.4 (0.3 to 0.6)), those more than 74-years old (0.6 (0.3 to 0.9)) and those with comorbidities (0.6 (0.5 to 0.9)) and more likely in people with Kellgren-Lawrence (KL) grade 4 (2.2 (1.5 to 3.3)). Overall there was no change in the proportion of participants frequently using prescription or over the counter (OTC) analgesics at 36 months, although most people had changed medication type; of those using a traditional analgesic at baseline approximately one third were still using the same type at 36 months (ranging from 26.2% of baseline prescription NSAID users to 40.6% of baseline acetaminophen users). All participants reporting baseline analgesic use also reported 36 month analgesic use. Female participants (OR 95% CI 1.2 to 3.2, P = 0.009), those with high body mass index (1.2 to 4.8, P = 0.010) and those with moderate (1.6 to 2.6, P = 0.090) or severe (1.8 to 12.0, P = 0.002) baseline pain were more likely to use pain medication during the 36 month follow-up period; participants more than 75-years old were less likely (0.2 to 1.0, P = 0.053). CONCLUSIONS Most people with knee OA used pharmacological therapies frequently, and use appeared to be according to American College of Rheumatology recommendations. Change in medication type used was common. Persistent non-prescription NSAID use in older people is an area of concern.
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Affiliation(s)
- Sarah R Kingsbury
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Musculoskeletal Biomedical Research Unit, Chapel Allerton Hospital, Chapeltown Road, Leeds, LS7 4SA, UK
| | - Elizabeth MA Hensor
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Musculoskeletal Biomedical Research Unit, Chapel Allerton Hospital, Chapeltown Road, Leeds, LS7 4SA, UK
| | - Ceara AE Walsh
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Musculoskeletal Biomedical Research Unit, Chapel Allerton Hospital, Chapeltown Road, Leeds, LS7 4SA, UK
| | - Marc C Hochberg
- University of Maryland School of Medicine, 655 West Baltimore Street, Baltimore, MD 21201-1559, USA
| | - Philip G Conaghan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Musculoskeletal Biomedical Research Unit, Chapel Allerton Hospital, Chapeltown Road, Leeds, LS7 4SA, UK
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Therapeutic effects of short-term monochromatic infrared energy therapy on patients with knee osteoarthritis: a double-blind, randomized, placebo-controlled study. J Orthop Sports Phys Ther 2012; 42:947-56. [PMID: 22960644 DOI: 10.2519/jospt.2012.3881] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
STUDY DESIGN Randomized, double-blind, placebo-controlled study. OBJECTIVES To examine the short-term therapeutic effects of monochromatic infrared energy (MIRE) on participants with knee osteoarthritis (OA). Patients were assessed according to the International Classification of Functioning, Disability and Health. BACKGROUND MIRE is commonly used in therapy for patients with peripheral neuropathies. However, research has not focused intensively on the therapeutic effects of MIRE in patients with knee OA. METHODS This study enrolled 73 participants with knee OA. Participants received six 40-minute sessions of active or placebo MIRE treatment (890-nm wavelength; power, 6.24 W; energy density, 2.08 J/cm2/min; total energy, 83.2 J/cm2) over the knee joints for 2 weeks. International Classification of Functioning, Disability and Health-related outcomes were collected weekly over 4 weeks using the Knee injury and Osteoarthritis Outcome Score, Lysholm Knee Scale, Hospital Anxiety and Depression Scale, Multidimensional Fatigue Inventory, Chronic Pain Grade questionnaire, World Health Organization Quality of Life-brief version, and OA Quality of Life Questionnaire. Data were analyzed by repeated-measures analysis of variance. RESULTS No statistically significant differences were found for the interaction of group by time for Knee injury and Osteoarthritis Outcome Score scores, including pain, other symptoms, function in daily living, function in sport and recreation, and knee-related quality of life. Scores on the Lysholm Knee Scale, Hospital Anxiety and Depression Scale, Multidimensional Fatigue Inventory, Chronic Pain Grade questionnaire, World Health Organization Quality of Life-brief version, and OA Quality of Life Questionnaire also showed no significant differences between the 2 groups at any of the 4 follow-up assessments. CONCLUSION Short-term MIRE therapy provided no beneficial effects to body functions, activities, participation, and quality of life in patients with knee OA.
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Wenham CYJ, Hensor EMA, Grainger AJ, Hodgson R, Balamoody S, Doré CJ, Emery P, Conaghan PG. A randomized, double-blind, placebo-controlled trial of low-dose oral prednisolone for treating painful hand osteoarthritis. Rheumatology (Oxford) 2012; 51:2286-94. [PMID: 22956551 DOI: 10.1093/rheumatology/kes219] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE Anti-inflammatory therapies are effective analgesics for OA. This study determined whether low-dose oral prednisolone (PNL) was an effective analgesic for hand OA. METHODS This was a randomized, double-blind, placebo-controlled trial of people with ACR criteria hand OA and baseline hand pain visual analogue scale (VAS) of >40/100 mm. Participants received 5 mg PNL or placebo daily for 4 weeks. Pain VAS, disease activity VAS, Australian/Canadian Hand Osteoarthritis Index and joint counts were performed at baseline, 4 and 12 weeks. Primary outcome was the change in hand pain VAS at 4 weeks. Analysis of covariance was used for analysis, controlling for baseline values. To explore potential mechanism of action of PNL, non-contrast 0.2 Tesla MRI was performed on the most painful hand at baseline and 4 weeks. RESULTS A total of 70 participants were recruited (57 women, mean age 61 years, mean baseline pain VAS 61.5 mm); 75% had more than one joint with definite MRI synovitis/effusion. At 4 weeks the adjusted mean reduction in pain VAS was 19.9 mm (PNL group) and 16.8 mm (placebo group) (P = 0.54). There were no statistically significant differences in VAS, Australian/Canadian Hand Osteoarthritis Index or joint counts between placebo and PNL groups at 4 or 12 weeks. A total of 20 participants in each group achieved an Outcome Measures in Rheumatology-Osteoarthritis Research Society International response. Baseline synovitis/effusion did not predict response to treatment. CONCLUSION This is the first randomized controlled trial of low-dose corticosteroid alone for painful hand OA, which demonstrated that short-term low-dose oral PNL is not an effective analgesic treatment for hand OA. TRIAL REGISTRATION International Standard Randomised Controlled Trial Number Register, www.isrctn.org, Trial number 99697616.
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Affiliation(s)
- Claire Y J Wenham
- NIHR Leeds Musculoskeletal Biomedical Research Unit, Chapel Allerton Hospital, Leeds, UK
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McKenna SP. Measuring patient-reported outcomes: moving beyond misplaced common sense to hard science. BMC Med 2011; 9:86. [PMID: 21756344 PMCID: PMC3170214 DOI: 10.1186/1741-7015-9-86] [Citation(s) in RCA: 209] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2010] [Accepted: 07/14/2011] [Indexed: 11/15/2022] Open
Abstract
Interest in the patient's views of his or her illness and treatment has increased dramatically. However, our ability to appropriately measure such issues lags far behind the level of interest and need. Too often such measurement is considered to be a simple and trivial activity that merely requires the application of common sense. However, good quality measurement of patient-reported outcomes is a complex activity requiring considerable expertise and experience. This review considers the most important issues related to such measurement in the context of chronic disease and details how instruments should be developed, validated and adapted for use in additional languages. While there is often consensus on how best to undertake these activities, there is generally little evidence to support such accord. The present article questions these orthodox views and suggests alternative approaches that have been shown to be effective.
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Affiliation(s)
- Stephen P McKenna
- Galen Research Ltd, Enterprise House, Manchester Science Park, Lloyd Street North, Manchester M15 6SE, UK.
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Cross-cultural validation of the Educational Needs Assessment Tool in RA in 7 European countries. BMC Musculoskelet Disord 2011; 12:110. [PMID: 21609481 PMCID: PMC3126763 DOI: 10.1186/1471-2474-12-110] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2010] [Accepted: 05/24/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Educational Needs Assessment Tool (the ENAT) is a 39-item patient questionnaire originally developed in the UK to assess educational needs of patients with rheumatoid arthritis (RA). The objective of this study was to assess the cross-cultural validity of the ENAT in 7 European countries. METHODS The ENAT was translated into Dutch, Finnish, Norwegian, Portuguese, Spanish and Swedish versions by using Beaton's cross-cultural adaptation process, and was completed by a convenience sample of patients with RA in each country. The generated country-specific data were assessed for construct validity and were then pooled and assessed for cross-cultural invariance using Rasch analysis. RESULTS Individual country-specific analysis showed adequate fit to the Rasch model after adjustment for local dependency within domains. When data from the different countries were pooled, the 39 items deviated significantly from Rasch model's expectations (X(2)=977.055, DF=351, p=0.000, PSI=0.976). Again, most items within domains were found to be locally dependent, significantly affecting the fit. Consequently each domain was treated as a unit (i.e. testlet) and the ENAT was re-analysed as a seven-testlet scale resulting into a good fit to the Rasch model (X(2)=71.909; DF=63; p=0.207, PSI=0.951). A test of strict unidimensionality confirmed that all domains contributed to measuring a single construct. Cross-cultural non-invariance was discounted by splitting domains for DIF maintaining an excellent fit to the Rasch model. This allowed calibration of the ENAT into an interval scale. CONCLUSION The ENAT is a simple tool, which is a valid measure of educational needs of people with RA. Adjustment for cross-cultural non-invariance is available if data from the 7 European countries are to be pooled or compared.
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[Schulthess Hip Score (5 items) for assessing disability in patients undergoing total hip arthroplasty. Development and validation]. DER ORTHOPADE 2011; 39:834-41. [PMID: 20383491 DOI: 10.1007/s00132-010-1611-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND We developed and validated a five-item self-report questionnaire for assessing disability as defined by the International Classification of Functioning, Disability, and Health conceptual model in patients with hip osteoarthritis (OA). MATERIAL AND METHODS The psychometric properties of the new score (Schulthess hip score, SHS) were examined in 105 consecutive patients (mean age 63 years; 48 women) undergoing total hip arthroplasty (THA). RESULTS The completion rate (97%) and reproducibility (intraclass correlation coefficient 0.90) of the SHS were excellent. Exploratory factor analysis indicated that all items that loaded on one factor only that accounted for 69.4% of the total variance. Cronbach's alpha was 0.88. Evidence of validity was provided by moderate to high correlations (r=-0.37-0.78) with the scores of traditionally used self-reported outcome measures. The SHS was very responsive, with an effect size of 2.15 and a standardized response mean of 1.74 for changes recorded 6 months after THA. CONCLUSION These results provide evidence to support use of the SHS for assessing disability in patients with hip OA.
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Billing E, McKenna SP, Staun M, Lindqvist U. Adaptation of the Psoriatic Arthritis Quality of Life (PsAQoL) instrument for Sweden. Scand J Rheumatol 2010; 39:223-8. [PMID: 20063984 DOI: 10.3109/03009740903347975] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The Psoriatic Arthritis Quality of Life (PsAQoL) questionnaire is the first disease-specific patient-derived instrument for assessing QoL in patients with PsA and has been extensively validated in this population. The aim of the adaptation process reported here was to develop a Swedish version of the PsAQoL that was equivalent to, and met the same psychometric and acceptability standards as, the original instrument, which was developed in the UK. METHOD Translation of the original questionnaire into Swedish was performed by a professional and a lay panel. Field testing for face and content validity was performed by interviewing 13 patients. Finally, 123 patients with PsA were included in a test-retest postal survey designed to test reproducibility and construct validity. The PsAQoL was administered on two occasions approximately 2 weeks apart. The Nottingham Health Profile (NHP) was used as a comparator instrument. RESULTS The Swedish version of the PsAQoL questionnaire showed good reliability at both time points and, as expected, correlated with the NHP. The scale was able to distinguish between groups based on self-reported general health and flare-up. Patients with active symptoms of both arthritis and psoriasis had worse QoL. The results also indicated that duration of disease has a progressive impact on PsAQoL scores. CONCLUSIONS This study provides evidence that the adapted PsAQoL can be used for clinical studies in Swedish patients. The instrument provides valuable information on the long-term effects of PsA on QoL.
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Affiliation(s)
- E Billing
- Department of Medical Sciences, Uppsala University Hospital, Uppsala, Sweden.
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Acupuncture for pain and osteoarthritis of the knee: a pilot study for an open parallel-arm randomised controlled trial. BMC Musculoskelet Disord 2009; 10:130. [PMID: 19852841 PMCID: PMC2775018 DOI: 10.1186/1471-2474-10-130] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2009] [Accepted: 10/24/2009] [Indexed: 11/29/2022] Open
Abstract
Background There is some evidence that acupuncture for pain and osteoarthritis (OA) of the knee is more than a placebo, and short term clinical benefits have been observed when acupuncture is compared to usual care. However there is insufficient evidence on whether clinical benefits of acupuncture are sustained over the longer term. In this study our key objectives are to inform the design parameters for a fully powered pragmatic randomised controlled trial. These objectives include establishing potential recruitment rates, appropriate validated outcome measures, attendance levels for acupuncture treatment, loss to follow up and the sample size for a full scale trial. Methods Potential participants aged over 50 with pain and osteoarthritis of the knee were identified from a GP database. Eligible patients were randomised to either 'acupuncture plus usual care' and 'usual care' alone, with allocation appropriately concealed. Acupuncture consisted of up to 10 sessions usually weekly. Outcome measures included Western Ontario and McMaster Universities (WOMAC) index with the sample size for a full scale trial determined from the variance. Results From the GP database of 15,927 patients, 335 potential trial participants were identified and invited to participate. After screening responses, 78 (23%) were identified as eligible and 30 patients who responded most promptly were randomised to 'acupuncture plus usual care' (15 patients) and 'usual care' alone (15 patients). Attendance for acupuncture appointments was high at 90% of the maximum. Although the trial was not powered to detect significant changes in outcome, the WOMAC pain index showed a statistically significant reduction at 3 months in the acupuncture group compared to usual care. This was not sustained at 12 months. The sample size for a fully powered two-arm trial was estimated to be 350. Conclusion This pilot study provided the evidence that a fully powered study to explore the longer term impact of acupuncture would be worthwhile, and relevant design features for such a trial were determined. Trial registration number ISRCTN25134802.
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Doward LC, McKenna SP, Meads DM, Twiss J, Eckert BJ. The development of patient-reported outcome indices for multiple sclerosis (PRIMUS). Mult Scler 2009; 15:1092-102. [PMID: 19556315 DOI: 10.1177/1352458509106513] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Complex diseases such as multiple sclerosis (MS) present dilemmas over the choice of patient-reported outcome measures as no single scale can inform on all types of MS impact from the patient's perspective. OBJECTIVE To develop an outcome tool, the Patient-Reported Indices for Multiple Sclerosis (PRIMUS), to assess MS symptoms, activities, and quality of life. METHODS PRIMUS content was derived from qualitative interviews with UK MS patients and checked by clinical experts. Semi-structured cognitive debriefing interviews assessed scale face and content validity. PRIMUS scaling properties, reliability, and construct validity were assessed by a test-retest postal survey. RESULTS Cognitive debriefing interviews (n = 15) demonstrated scale clarity, relevance, and comprehensiveness. The postal survey was completed by 135 patients with MS. After removal of misfitting items and those exhibiting differential item functioning, all scales fitted the Rasch model, confirming unidimensionality. For all scales, test-retest reliability exceeded 0.80. Scale scores were related to perceived MS severity, general health, and symptoms of depression. Moderate correlations were observed between PRIMUS and Nottingham Health Profile scores. CONCLUSIONS Clinicians and researchers can have confidence in scores obtained by respondents on the PRIMUS. The PRIMUS will aid the assessment of the impact of MS from the patient's perspective.
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McNair PJ, Simmonds MA, Boocock MG, Larmer PJ. Exercise therapy for the management of osteoarthritis of the hip joint: a systematic review. Arthritis Res Ther 2009; 11:R98. [PMID: 19555502 PMCID: PMC2714154 DOI: 10.1186/ar2743] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2008] [Revised: 05/28/2009] [Accepted: 06/25/2009] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Recent guidelines pertaining to exercise for individuals with osteoarthritis have been released. These guidelines have been based primarily on studies of knee-joint osteoarthritis. The current study was focused on the hip joint, which has different biomechanical features and risk factors for osteoarthritis and has received much less attention in the literature. The purpose was to conduct a systematic review of the literature to evaluate the exercise programs used in intervention studies focused solely on hip-joint osteoarthritis, to decide whether their exercise regimens met the new guidelines, and to determine the level of support for exercise-therapy interventions in the management of hip-joint osteoarthritis. METHODS A systematic literature search of 14 electronic databases was undertaken to identify interventions that used exercise therapy as a treatment modality for hip osteoarthritis. The quality of each article was critically appraised and graded according to standardized methodologic approaches. A 'pattern-of-evidence' approach was used to determine the overall level of evidence in support of exercise-therapy interventions for treating hip osteoarthritis. RESULTS More than 4,000 articles were identified, of which 338 were considered suitable for abstract review. Of these, only 6 intervention studies met the inclusion criteria. Few well-designed studies specifically investigated the use of exercise-therapy management on hip-joint osteoarthritis. Insufficient evidence was found to suggest that exercise therapy can be an effective short-term management approach for reducing pain levels, improving joint function and the quality of life. CONCLUSIONS Limited information was available on which conclusions regarding the efficacy of exercise could be clearly based. No studies met the level of exercise recommended for individuals with osteoarthritis. High-quality trials are needed, and further consideration should be given to establishing the optimal exercises and exposure levels necessary for achieving long-term gains in the management of osteoarthritis of the hip.
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Affiliation(s)
- Peter J McNair
- Health and Rehabilitation Research Centre, Auckland University of Technology, Private Bag 92006, Auckland 1020, New Zealand
| | - Marion A Simmonds
- Health and Rehabilitation Research Centre, Auckland University of Technology, Private Bag 92006, Auckland 1020, New Zealand
| | - Mark G Boocock
- Health and Rehabilitation Research Centre, Auckland University of Technology, Private Bag 92006, Auckland 1020, New Zealand
| | - Peter J Larmer
- Health and Rehabilitation Research Centre, Auckland University of Technology, Private Bag 92006, Auckland 1020, New Zealand
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Alexandre TDS, Cordeiro RC, Ramos LR. Fatores associados à qualidade de vida em idosos com osteoartrite de joelho. FISIOTERAPIA E PESQUISA 2008. [DOI: 10.1590/s1809-29502008000400002] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
O estudo visou investigar se a qualidade de vida (QV) de idosos com osteoartrite (OA) de joelho pode ser influenciada por fatores sociodemográficos e/ou por parâmetros clínicos e funcionais gerados pela doença. A uma amostra de 40 idosos atendidos em ambulatório de reabilitação gerontológica na cidade de São Paulo foi aplicado o questionário de QV 36-Item Short-Form Survey (SF-36). A funcionalidade, a rigidez articular e a dor foram medidas pelo Womac - Western Ontario and MacMaster Universities Osteoarthritis Index; os dados sociodemográficos, as variáveis clínicas e o uso de recursos físicos e medicamentosos para controle da dor foram obtidos por questionário complementar. A análise de regressão linear mostrou relação independente entre o domínio funcionalidade do Womac e seis domínios do SF-36 (p<0,05). São determinantes de pior QV na amostra estudada a dificuldade na realização de atividades funcionais, usar dispositivo de auxílio à marcha, apresentar comprometimento articular bilateral, o recurso a diversos meios para alívio da dor, bem como a baixa escolaridade e o fato de morar com outro de sua geração (r=0,3; p<0,05). As atividades funcionais mais comprometidas foram as que envolvem a flexo-extensão de joelho e descarga de peso na articulação afetada. Fatores tanto sociodemográficos como clínicos e funcionais gerados pela OA influenciaram negativamente a QV de idosos com OA de joelho.
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