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Powell PA, Carlton J, Peasgood T, Chandler F, Godfrey J, Reuben E. Understanding the health-related quality of life impacts of caring for children and adolescents with rare progressive life-limiting conditions: key challenges and future research priorities. Qual Life Res 2025; 34:1579-1585. [PMID: 40035966 PMCID: PMC12119705 DOI: 10.1007/s11136-025-03937-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2025] [Indexed: 03/06/2025]
Abstract
The inclusion of health-related quality of life (HRQoL) impacts on informal carers in health technology assessments (HTAs) is lacking due, primarily, to a deficiency in evidence and methodological issues on how informal carer HRQoL is captured and incorporated into economic models. These issues are magnified in areas of significant burden, such as caring for children and adolescents with rare, progressive, life-limiting conditions. In this commentary we outline key challenges in measuring, and incorporating in HTA submissions, informal carer HRQoL data in rare, progressive, paediatric, life-limiting conditions and identify future research priorities in this space. We argue that: (i) a generic model of carer HRQoL is likely inadequate to characterise the HRQoL impacts in this population; (ii) the underlying evidence-base is underdeveloped, including understanding commonalities across conditions, impact beyond the primary carer, and differences over time; and (iii) methodological challenges in modelling informal carer HRQoL in cost-effectiveness analysis are inhibiting progress. A research agenda is proposed that addresses these challenges by focusing first on in-depth qualitative research to develop an appropriate, content valid 'disease-group-specific' model for understanding informal carer HRQoL in rare, progressive, paediatric, life-limiting conditions. This model can be used to inform the appropriate measurement of carer HRQoL in this population, which, alongside methodological research on addressing modelling challenges, can help to facilitate the recommended inclusion of informal carer HRQoL data in HTA submissions for children and adolescents living with rare, progressive, life-limiting conditions.
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Affiliation(s)
- Philip A Powell
- Sheffield Centre for Health and Related Research, University of Sheffield, Sheffield, UK.
| | - Jill Carlton
- Sheffield Centre for Health and Related Research, University of Sheffield, Sheffield, UK
| | - Tessa Peasgood
- Sheffield Centre for Health and Related Research, University of Sheffield, Sheffield, UK
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Cueva A, Ali FM, Johns J, Finlay AY, Salek S. Psychometric validation of the Spanish for Ecuador Family Reported Outcome Measure (FROM-16) and its application to measure impact on family members of patients with skin diseases. J Patient Rep Outcomes 2025; 9:51. [PMID: 40343584 PMCID: PMC12064521 DOI: 10.1186/s41687-025-00866-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2024] [Accepted: 03/13/2025] [Indexed: 05/11/2025] Open
Abstract
BACKGROUND The Family Reported Outcome Measure (FROM-16) is a generic tool to measure the impact of health conditions on patients' family members and partners (FMs). This study aimed to translate, validate, evaluate, and implement FROM-16 in Ecuadorian Spanish and to assess the quality of life (QoL) of FMs of patients with skin diseases. METHODS A cross-sectional study of patients and their FMs was performed using FROM-16 and a five-point-Likert scale to evaluate patient´s skin health by the FM and physician. Construct validity, confirmatory factor analysis and item response modelling of FROM-16 were assessed. RESULTS 195 FMs completed Ecuadorian FROM-16. Inter-item correlation was 0.40 and factor analysis confirmed the original two-factor model: Cronbach's alpha 0.89, with factor loadings of 0.44-0.76. Mean age of patients = 41.8 ± 31.1 years and of FMs = 47.3 ± 7; diseases were classified as inflammatory (n = 88) or non-inflammatory (n = 107). The mean FROM-16 score was 12.5 ± 7 meaning "a moderate effect on QoL;" however, scores of 29.2% (57 of 195) indicated a "very large" (n = 47) or "extremely large" (n = 10) effect. Populations with the highest burden were adult children main carers, not cohabiting with their sick parents (mean FROM-16 = 17 ± 7.7, n = 8, p = 0.05 versus those cohabiting), and FM of patients with inflammatory conditions (mean = 14 ± 6.9, n = 88, p = 0.006 versus those with non-inflammatory dermatoses). CONCLUSION The FROM-16 is a succinct, well-structured two-domain instrument. It can be used to identify the largely overlooked impact on FMs of dermatology patients. Understanding this impact may contribute to better holistic care, inform physicians' decisions, and encourage further support for families.
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Affiliation(s)
- Andrea Cueva
- Dermatology Outpatient Clinic, Hospital Carlos Andrade Marin, Quito, Ecuador.
- InnovaDerm, Quito, Ecuador.
| | - Faraz M Ali
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, CF144XN, UK
| | - Jeffrey Johns
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, CF144XN, UK
| | - Andrew Y Finlay
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, CF144XN, UK
| | - Sam Salek
- School of Life & Medical Sciences, University of Hertfordshire, Hatfield, UK
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Shah R, Salek S, Ali FM, Otwombe K. Multiple sclerosis greatly impacts family members/partners: Evidence using the Family Reported Outcome Measure (FROM-16). Mult Scler J Exp Transl Clin 2025; 11:20552173251338762. [PMID: 40444034 PMCID: PMC12120303 DOI: 10.1177/20552173251338762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2025] [Accepted: 04/11/2025] [Indexed: 06/02/2025] Open
Abstract
Background Multiple sclerosis (MS) may have a major impact on the physical, social and psychological wellbeing of people with multiple sclerosis (pwMS) and their family members/partners. Aim To measure the impact of a person's MS on the quality of life of their family members/partner, and the associates of impact among family members, using a validated generic family-specific quality of life instrument, the Family Reported Outcome Measure (FROM-16). Methods An online cross-sectional study was conducted to recruit family members/partners of pwMS through UK patient support groups. Results A total of 219 family members/partners (mean age = 49.3 years, SD = 13.7; females = 55.3%) of pwMS (mean age = 50.1, SD = 12.5; females = 56.6%) completed the FROM-16. The FROM-16 mean total score was 16.9 (SD = 7.8), indicating 'a very large effect' on family members' quality of life. The increasing age of pwMS, being a male person with MS, and being a female carer were significant predictors of family impact. 50.7% of family members had FROM-16 scores ≥17. Spouses/partners (170/219) of pwMS reported a significant impact on their sex life compared to other relationships (p < 0.001). Conclusion MS substantially impacts the quality of life of family members/partners of pwMS, indicating a need to assess this impact routinely. The FROM-16 could be used to measure the MS family impact in routine practice to support family members appropriately and to include this impact in health economic appraisal and therapeutic clinical trials.
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Affiliation(s)
- Rubina Shah
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - Sam Salek
- School of Life & Medical Sciences, University of Hertfordshire, Hatfield, UK
- Institute of Medicines Development, Cardiff, UK
| | - Faraz M Ali
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - Kennedy Otwombe
- Statistics and Data Management Centre, Perinatal HIV Research Unit, Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Mundt JM, Franklin RC, Horsnell M, Garza V. Families of adults with idiopathic hypersomnia and narcolepsy: psychosocial impact and contribution to symptom management. J Clin Sleep Med 2025; 21:683-694. [PMID: 39745457 PMCID: PMC11965091 DOI: 10.5664/jcsm.11526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2024] [Revised: 12/11/2024] [Accepted: 12/17/2024] [Indexed: 04/05/2025]
Abstract
STUDY OBJECTIVES This study examined the impact of central disorders of hypersomnolence (CDH) on family members of adult patients, the ways family members assist with managing CDH, and family members' utilization and satisfaction with information and support. METHODS Participants were adults (n = 100) with an adult family member diagnosed with idiopathic hypersomnia or narcolepsy. They completed a survey which included the Family Reported Outcome Measure, checklists, satisfaction ratings, and open-response questions. RESULTS The Family Reported Outcome Measure sample mean (14.2, standard deviation = 6.8) corresponded to a moderate effect on quality of life. Compared to parents, partners reported a higher impact on the personal and social life domain (P = .04, d = .44). The most frequently endorsed sources of support were family (60.0%) and friends (50.0%), whereas information was most commonly obtained from hypersomnia organizations (69.0%) and medical professionals (61.0%). Only 8.0% of participants were satisfied with support, and 9.0% were satisfied with information. Participants endorsed assisting with managing CDH, such as picking up prescriptions (61.0%), attending medical visits (50.0%), reminding to take medication (48.0%), and coordinating medical care (39.0%). Qualitative data indicated that relationships underwent a transformation from conflict and confusion (prediagnosis) to clarity (postdiagnosis), followed by adjusting expectations. Caregiving strain, effects on shared activities, and negative psychosocial impacts on family also emerged as themes. CONCLUSIONS Family members play an important role in supporting adults with CDH in many ways, including tasks related to managing CDH. Family members experience many psychosocial impacts from CDH, and data from this study indicate unmet needs for support. CITATION Mundt JM, Franklin R-C, Horsnell M, Garza V. Families of adults with idiopathic hypersomnia and narcolepsy: psychosocial impact and contribution to symptom management. J Clin Sleep Med. 2025;21(4):683-694.
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Affiliation(s)
- Jennifer M. Mundt
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Center for Circadian and Sleep Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, Utah
| | - Rachel-Clair Franklin
- Patient advocate
- Department of Psychology, Mississippi State University, Starkville, Mississippi
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Brilliant CD, Finlay AY, Salek SM, Shah R, Bacon E, Laing H. Validation of the FROM-16 in family members of patients receiving advanced therapy medicinal product (ATMP). Qual Life Res 2025; 34:949-962. [PMID: 39862357 PMCID: PMC11982087 DOI: 10.1007/s11136-024-03880-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2024] [Indexed: 01/27/2025]
Abstract
PURPOSE Outcome-based pricing models which consider domains of value not previously considered in healthcare, such as societal outcomes, are of increasing interest for healthcare systems. Societal outcomes can include family-reported outcome measures (FROMs), which measure the impact of disease upon the patient's family members. The FROM-16 is a generic and easy-to-use family quality of life tool, but it has never been used in the context of patients undergoing advanced therapy medicinal product (ATMP) treatment. The use of potentially curative ATMPs is limited due their high cost and the low number of eligible patients. Using the FROM-16 to collect the impact on family of disease and treatment in ATMP patients may demonstrate additional value created by an ATMP intervention and strengthen the case for its use. METHODS This feasibility study aimed to test the validity of the FROM-16 in family members of ATMP patients as a prelude for its use in ATMP value estimation. Patients and family members (n = 24) were recruited from ATMP treatment centres in England and Wales. Family members completed the FROM-16 and were invited to a short debriefing interview. RESULTS The FROM-16 showed high validity demonstrated by strong internal consistency (Cronbach's alpha = 0.917) and intraclass correlation (0.803, 95%). Interviews identified that whilst the FROM-16 covered most areas of quality-of-life impact experienced by the participants, some explained that they also experienced other impacts upon their personal health and future outlook. CONCLUSION This feasibility study provides evidence that the FROM-16 could be used as part of a structured systematic approach to measure family quality of life impact in ATMP patients.
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Affiliation(s)
- Charles D Brilliant
- Value-based Health & Care Academy, School of Management, Swansea University, Swansea, SA1 8EN, UK
| | - Andrew Y Finlay
- Division of Infection and Immunity, Cardiff University School of Medicine, Cardiff, CF14 4XN, UK
| | - Sam M Salek
- Public Health & Patient Safety Research Group, School of Life & Medical Sciences, University of Hertfordshire, Hatfield, AL10 9AB, UK
- Institute of Medicines Development, Paddock End House, Bucks, SL9 8BL, UK
| | - Rubina Shah
- Division of Infection and Immunity, Cardiff University School of Medicine, Cardiff, CF14 4XN, UK
| | - Emily Bacon
- Value-based Health & Care Academy, School of Management, Swansea University, Swansea, SA1 8EN, UK.
| | - Hamish Laing
- Value-based Health & Care Academy, School of Management, Swansea University, Swansea, SA1 8EN, UK
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Ali FM, Finlay AY. Uncovering the Life-long Impact of Skin Disease on Major Life Changing Decisions. Acta Derm Venereol 2025; 105:adv43472. [PMID: 40171704 PMCID: PMC11977407 DOI: 10.2340/actadv.v105.43472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2025] [Accepted: 03/27/2025] [Indexed: 04/04/2025] Open
Affiliation(s)
- Faraz M Ali
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Andrew Y Finlay
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, United Kingdom.
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Zanin A, Patti M, Rosato I, Divisic A, Rusalen F, Maghini I, Agosto C, Benini F. Early assessment of clinical complexity and home care in patients affected by trisomy 13 and 18. Eur J Pediatr 2025; 184:194. [PMID: 39937286 PMCID: PMC11821786 DOI: 10.1007/s00431-025-06020-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2024] [Revised: 01/23/2025] [Accepted: 01/29/2025] [Indexed: 02/13/2025]
Abstract
PURPOSE Trisomy 13 and 18 consist of a recurrent pattern of multiple congenital anomalies. The aim of this study was to analyze the clinical characteristics and disease trajectory of a cohort of children with trisomy 13 and 18 followed up by an Italian pediatric palliative care service. METHODS A single-center retrospective observational study was conducted examining the medical records of patients with trisomy 13 and 18 seen in the Pediatric Palliatives Care (PPC) center of the University Hospital of Padua from 2007 to 2022. RESULTS Seventeen patients were included in the analysis. All were born alive; four children are still alive and only three (23%) died at home. All presented high care complexity, as estimated by ACCAPED index (median 86, range 38-129). The median time to receive care from PPC was 3 months (0-108). All patients' parents shared an advance care plan with the PPC team: 13/17 patients (76%) accepted a do not resuscitate (DNR) order. Approximately 12% of patients received at least one surgery. The trend of survival compared with other cohorts reported in the literature does not appear to differ significantly after the initial stages. CONCLUSIONS The possible recognition of an early evolution toward medical complexity and the availability of home care resources and programs are crucial factors in the management of these children. These indices could become a driving factor in the definition of new outcomes that are more patient-oriented, in addition to mortality. WHAT IS KNOWN • Trisomy 13 and 18 are serious genetic conditions with high mortality rates. In the last years medical interventions including surgery are being offered more frequently, though the appropriateness of these interventions is still debated. WHAT IS NEW • The study emphasizes the crucial role of early referral to specialized pediatric palliative care teams and the coordination they provide enabling families to care for their children at home, even with complex medical needs.
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Affiliation(s)
- Anna Zanin
- Palliative Care and Pain Service, Department of Women's and Children's Health, University of Padua, Via Giustiniani 3, 35128, Padua, Italy
| | - Matteo Patti
- Department of Women's and Children's Health, University of Padua, Padua, Italy
| | - Isabella Rosato
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Antuan Divisic
- Palliative Care and Pain Service, Department of Women's and Children's Health, University of Padua, Via Giustiniani 3, 35128, Padua, Italy
| | - Francesca Rusalen
- Palliative Care and Pain Service, Department of Women's and Children's Health, University of Padua, Via Giustiniani 3, 35128, Padua, Italy
| | - Irene Maghini
- Palliative Care and Pain Service, Department of Women's and Children's Health, University of Padua, Via Giustiniani 3, 35128, Padua, Italy
| | - Caterina Agosto
- Palliative Care and Pain Service, Department of Women's and Children's Health, University of Padua, Via Giustiniani 3, 35128, Padua, Italy
| | - Franca Benini
- Palliative Care and Pain Service, Department of Women's and Children's Health, University of Padua, Via Giustiniani 3, 35128, Padua, Italy.
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Shah R, Finlay AY, Ali FM, Otwombe K, Nixon SJ, George L, Evans M, Ingram JR, Salek S. Comparison of the impact of type 1 and type 2 diabetes on quality of life of families of patients: A UK cross-sectional study. Diabetes Obes Metab 2025; 27:652-662. [PMID: 39582116 DOI: 10.1111/dom.16058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2024] [Revised: 10/21/2024] [Accepted: 10/23/2024] [Indexed: 11/26/2024]
Abstract
AIM To measure the impact of type 1 and 2 diabetes mellitus (T1D and T2D) on the QoL of a person's family members/partner and assess if there is any difference in family impact. METHODS A cross-sectional study, recruited online through patient support groups, involved UK family members/partners of people with diabetes completing the Family Reported Outcome Measure-16 (FROM-16). RESULTS Two hundred and sixty-one family members/partners (mean age = 57.9 years, SD = 13.8; females = 68.2%) of people with diabetes (mean age = 57.7, SD = 20.6; females = 38.3%; T1D n = 100; T2D n = 161) completed the FROM-16. The overall FROM-16 mean score was 10.47, SD = 7.8, suggesting a moderate effect on the QoL of family members of people with diabetes. A quarter (24.5%) of family members experienced a 'very large effect' or 'extremely large effect' on their QoL. The family impact of T1D (mean FROM-16 = 12.61, SD = 7.9) was greater than that of T2D (mean = 9.15, SD = 7.5, p < 0.01), with being 'female' and 'parents of children and adolescents' rendered as significant predictors of greater impact. Family members of T2D had a lower risk of experiencing a high family impact (FROM-16 score >16) compared with T1D (RR 0.561, 95% CI 0.371-0.849). CONCLUSIONS Compared to T2D, family members of T1D experience a greater impact on their QoL, particularly those caring for children and adolescents. These findings have clinical and resource implications, indicating a need to assess this impact as a part of routine diabetes care to support impacted family members. The FROM-16 could assess this impact in routine practice and further facilitate referral of family members to appropriate support services.
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Affiliation(s)
- Rubina Shah
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - Andrew Y Finlay
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - Faraz M Ali
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - Kennedy Otwombe
- Statistics and Data Management Centre, Perinatal HIV Research Unit, Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Lindsay George
- Department of Diabetes, University Hospital Llandough, Cardiff, UK
| | - Marc Evans
- Department of Diabetes, University Hospital Llandough, Cardiff, UK
| | - John R Ingram
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - Sam Salek
- School of Life & Medical Sciences, University of Hertfordshire, Hatfield, UK
- Institute of Medicines Development, Cardiff, UK
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Blomberg K, Farnik M, Eriksson M. Translation, adaptation, and psychometric evaluation of the Quality of Life in a Child's Chronic Disease Questionnaire for the Swedish context. Eur J Pediatr 2024; 184:76. [PMID: 39663236 PMCID: PMC11634934 DOI: 10.1007/s00431-024-05888-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2024] [Revised: 11/02/2024] [Accepted: 11/13/2024] [Indexed: 12/13/2024]
Abstract
The aim of this study was to translate, adapt, and psychometrically evaluate the Quality of Life in a Child's Chronic Disease Questionnaire (QLCCDQ) for the Swedish context. The QLCCDQ was translated into Swedish and adapted to the Swedish context. Data for psychometric testing were obtained through a survey of parents of children and adolescents (n = 627) with chronic diseases: asthma and type 1 diabetes mellitus, with a total of 173 responses (27.6%). Face and content validity of the instrument was assessed, and floor and ceiling effects were measured. Internal consistency was measured with Cronbach's alpha and an exploratory factor analysis (EFA) was conducted. The EFA gave a two-factor solution with an eigenvalue > 1 explaining 73.9% of total variance for the Swedish version. The new subscales are family life and activities (eight questions) and emotions and symptoms (four questions). Three questions concerning anxiety, worry, and guilt loaded < 0.6 and were excluded. CONCLUSION The study concludes that the Swedish version of the QLCCDQ is a reliable and valid questionnaire. The instrument may be useful for clinical screening of families who have the greatest need for supportive interventions. However, this should be further evaluated. WHAT IS KNOWN • A child's chronic disease influences quality of life of its family members. • Few instruments are designed to measure the impact on families. WHAT IS NEW • The Swedish version of the Quality of Life in a Child's Chronic Disease Questionnaire has two subscales compared to the original's five. • The instrument may potentially be useful for clinical screening of families who have the greatest need for supportive interventions.
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Affiliation(s)
- Karin Blomberg
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, S-70182, Örebro, Sweden.
| | | | - Mats Eriksson
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, S-70182, Örebro, Sweden
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Shah R, Salek M, Ali F, Nixon S, Otwombe K, Ingram J, Finlay A. Dementia and Its Profound Impact on Family Members and Partners: A Large UK Cross-Sectional Study. Alzheimer Dis Assoc Disord 2024; 38:338-343. [PMID: 39506214 PMCID: PMC11584184 DOI: 10.1097/wad.0000000000000647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2024] [Accepted: 09/23/2024] [Indexed: 11/08/2024]
Abstract
INTRODUCTION Dementia can adversely affect the quality of life (QoL) of family members/partners of those affected. Measuring this often-neglected burden is critical to planning and providing appropriate support services. This study measures this impact using the Family-Reported Outcome Measure (FROM-16). METHODS A large UK cross-sectional online study through patient research platforms, recruited family members/partners of people with dementia, to complete the FROM-16. RESULTS Totally, 711 family members/partners (mean age=58.7 y, SD=12.5; females=81.3%) of patients (mean age=81.6, SD=9.6; females=66.9) with dementia completed the FROM-16. The FROM-16 mean total score was 17.5 (SD=6.8), meaning "a very large effect" on QoL of family members, with females being more adversely impacted. CONCLUSIONS Dementia profoundly impacts the QoL of family members/partners of patients. Routine use of FROM-16 could signpost provision of care support, reducing family members' burnout. Such routine data could be used in economic analysis of the burden of dementia as well as in predicting institutionalization.
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Affiliation(s)
- R. Shah
- Division of Infection and Immunity, School of Medicine, Cardiff University
| | - M.S. Salek
- Institute of Medicines Development
- School of Life & Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - F.M. Ali
- Division of Infection and Immunity, School of Medicine, Cardiff University
| | | | - K. Otwombe
- Statistics and Data Management Centre, Perinatal HIV Research Unit, Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa
| | - J.R. Ingram
- Division of Infection and Immunity, School of Medicine, Cardiff University
| | - A.Y. Finlay
- Division of Infection and Immunity, School of Medicine, Cardiff University
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Muirhead NL, Vyas J, Ephgrave R, Singh R, Finlay AY. Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Impact on Quality of Life (QoL) of Persons with ME/CFS. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1215. [PMID: 39202496 PMCID: PMC11356561 DOI: 10.3390/medicina60081215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Revised: 07/04/2024] [Accepted: 07/16/2024] [Indexed: 09/03/2024]
Abstract
Background and Objectives: We previously reported on the impact of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) on the QoL of persons with ME/CFS and their family members. Here, we present the findings of the impact on the QoL of individuals with ME/CFS whose family members did not participate in the survey. Materials and Methods: A prospective multinational online survey was disseminated via patient charities, support groups and social media. Persons with ME/CFS completed the EuroQoL questionnaire (EQ-5D-3L). Results: Data were analysed from 876 participants from 26 countries who reported a health care professional diagnosis of ME/CFS. In total, 742 participants identified as female, 124 male and 10 preferred not to say. The mean age of the participants was 47 years (range 18-82), and the mean time to diagnosis was 14 years. The mean overall health status on a visual analogue scale for people with ME/CFS was 36.4 (100 = best health). People with ME/CFS were most often affected by inability to perform usual activities (n = 852, 97%), followed by pain (n = 809, 92%), impaired mobility (n = 724, 83%), difficulty in self-care (n = 561, 64%) and least often affected by anxiety and depression (n = 540, 62%). Conclusions: The QoL of people with ME/CFS is significantly affected globally. There was no significant difference in quality of life compared with previously published data on those with ME/CFS who did have a family member complete the family member quality of life questionnaire (FROM16). Contrary to popular misconception, anxiety and depression are the least often affected areas in persons with ME/CFS who are most impacted by their inability to perform usual activities.
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Affiliation(s)
- Nina L. Muirhead
- Department of Dermatology, Buckinghamshire Healthcare NHS Trust, Amersham HP7 0JD, UK;
| | - Jui Vyas
- Centre for Medical Education, School of Medicine, Cardiff University, Cardiff CF14 4YS, UK
| | | | - Ravinder Singh
- Medical Research Council, Polaris House, Swindon SN2 IFL, UK;
| | - Andrew Y. Finlay
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff CF14 4YS, UK;
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Shah R, Finlay AY, Ali FM, Allen H, Nixon SJ, Nixon M, Otwombe K, Ingram JR, Salek MS. Measurement of the major ignored burden of multiple myeloma, pernicious anaemia and of other haematological conditions on partners and family members: A cross-sectional study. Eur J Haematol 2024; 113:117-126. [PMID: 38577720 DOI: 10.1111/ejh.14206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/09/2024] [Accepted: 02/12/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Having a haematological condition can adversely affect the quality of life (QoL) of family members/partners of patients. It is important to measure this often ignored burden in order to implement appropriate supportive interventions. OBJECTIVE To measure current impact of haematological conditions on the QoL of family members/partners of patients, using the Family Reported Outcome Measure-16 (FROM-16). METHODS A cross-sectional study, recruited online through patient support groups, involved UK family members/partners of people with haematological conditions completing the FROM-16. RESULTS 183 family members/partners (mean age = 60.5 years, SD = 13.2; females = 62.8%) of patients (mean age = 64.1, SD = 12.8; females = 46.4%) with 12 haematological conditions completed the FROM-16. The FROM-16 mean total score was 14.0 (SD = 7.2), meaning 'a moderate effect on QoL'. The mean FROM-16 scores of family members of people with multiple myeloma (mean = 15.8, SD = 6.3, n = 99) and other haematological malignancies (mean = 13.9, SD = 7.8, n = 29) were higher than of people with pernicious anaemia (mean = 10.7, SD = 7.5, n = 47) and other non-malignant conditions (mean = 11, SD = 7.4, n = 56, p < .01). Over one third (36.1%, n = 183) of family members experienced a 'very large effect' (FROM-16 score>16) on their quality of life. CONCLUSIONS Haematological conditions, in particular those of malignant type, impact the QoL of family members/partners of patients. Healthcare professionals can now, using FROM-16, identify those most affected and should consider how to provide appropriate holistic support within routine practice.
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Affiliation(s)
- R Shah
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - A Y Finlay
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - F M Ali
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | | | - S J Nixon
- Multiple Sclerosis Society, Cardiff, UK
| | - M Nixon
- Multiple Sclerosis Society, Cardiff, UK
| | - K Otwombe
- Statistics and Data Management Centre, Perinatal HIV Research Unit, Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa
| | - J R Ingram
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - M S Salek
- School of Life & Medical Sciences, University of Hertfordshire, Hatfield, UK
- Institute of Medicines Development, Cardiff, UK
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13
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Ramessur R, Dand N, Langan SM, Saklatvala J, Fritzsche MC, Holland S, Arents BWM, McAteer H, Proctor A, McMahon D, Greenwood M, Buyx AM, Messer T, Weiler N, Hicks A, Hecht P, Weidinger S, Ndlovu MN, Chengliang D, Hübenthal M, Egeberg A, Paternoster L, Skov L, De Jong EMGJ, Middelkamp-Hup MA, Mahil SK, Barker JN, Flohr C, Brown SJ, Smith CH. Defining disease severity in atopic dermatitis and psoriasis for the application to biomarker research: an interdisciplinary perspective. Br J Dermatol 2024; 191:14-23. [PMID: 38419411 PMCID: PMC11188926 DOI: 10.1093/bjd/ljae080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 02/12/2024] [Accepted: 02/14/2024] [Indexed: 03/02/2024]
Abstract
More severe atopic dermatitis and psoriasis are associated with a higher cumulative impact on quality of life, multimorbidity and healthcare costs. Proactive, early intervention in those most at risk of severe disease may reduce this cumulative burden and modify the disease trajectory to limit progression. The lack of reliable biomarkers for this at-risk group represents a barrier to such a paradigm shift in practice. To expedite discovery and validation, the BIOMarkers in Atopic Dermatitis and Psoriasis (BIOMAP) consortium (a large-scale European, interdisciplinary research initiative) has curated clinical and molecular data across diverse study designs and sources including cross-sectional and cohort studies (small-scale studies through to large multicentre registries), clinical trials, electronic health records and large-scale population-based biobanks. We map all dataset disease severity instruments and measures to three key domains (symptoms, inflammatory activity and disease course), and describe important codependencies and relationships across variables and domains. We prioritize definitions for more severe disease with reference to international consensus, reference standards and/or expert opinion. Key factors to consider when analysing datasets across these diverse study types include explicit early consideration of biomarker purpose and clinical context, candidate biomarkers associated with disease severity at a particular point in time and over time and how they are related, taking the stage of biomarker development into account when selecting disease severity measures for analyses, and validating biomarker associations with disease severity outcomes using both physician- and patient-reported measures and across domains. The outputs from this exercise will ensure coherence and focus across the BIOMAP consortium so that mechanistic insights and biomarkers are clinically relevant, patient-centric and more generalizable to current and future research efforts.
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Affiliation(s)
- Ravi Ramessur
- St John’s Institute of Dermatology
- Department of Medical and Molecular Genetics, School of Basic and Medical Biosciences, Faculty of Life Sciences & Medicine, King’s College London, London, UK
| | - Nick Dand
- Department of Medical and Molecular Genetics, School of Basic and Medical Biosciences, Faculty of Life Sciences & Medicine, King’s College London, London, UK
| | | | - Jake Saklatvala
- Department of Medical and Molecular Genetics, School of Basic and Medical Biosciences, Faculty of Life Sciences & Medicine, King’s College London, London, UK
| | - Marie-Christine Fritzsche
- Institute of History and Ethics in Medicine, TUM School of Medicine
- Department of Science, Technology and Society, School of Social Sciences and Technology, Technical University of Munich, Munich, Germany
| | | | - Bernd W M Arents
- Dutch Association for People with Atopic Dermatitis, Nijkerk, the Netherlands
| | | | | | | | | | - Alena M Buyx
- Institute of History and Ethics in Medicine, TUM School of Medicine
- Department of Science, Technology and Society, School of Social Sciences and Technology, Technical University of Munich, Munich, Germany
| | - Tamara Messer
- EURICE – European Research and Project Office GmbH, St. Ingbert, Germany
| | - Nina Weiler
- EURICE – European Research and Project Office GmbH, St. Ingbert, Germany
| | - Alexandra Hicks
- Immunology & Inflammation Research Therapeutic Area, Sanofi, Cambridge, MA, USA
| | - Peter Hecht
- Public Private Partnerships, Sanofi Partnering, Frankfurt, Germany
| | - Stephan Weidinger
- Department of Dermatology, Venerology and Allergology, University Hospital Schleswig-Holstein, Kiel, Germany
| | | | | | - Matthias Hübenthal
- Department of Dermatology, Quincke Research Center, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Alexander Egeberg
- Department of Dermatology, Bispebjerg Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Lavinia Paternoster
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, Bristol, Bristol, UK
| | - Lone Skov
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Dermatology and Allergy, Copenhagen University Hospital – Herlev and Gentofte, Copenhagen, Denmark
| | - Elke M G J De Jong
- Department of Dermatology, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Maritza A Middelkamp-Hup
- Department of Dermatology, Amsterdam Public Health, Infection and Immunity, Amsterdam UMC, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Satveer K Mahil
- St John’s Institute of Dermatology
- Department of Medical and Molecular Genetics, School of Basic and Medical Biosciences, Faculty of Life Sciences & Medicine, King’s College London, London, UK
| | - Jonathan N Barker
- St John’s Institute of Dermatology
- Department of Medical and Molecular Genetics, School of Basic and Medical Biosciences, Faculty of Life Sciences & Medicine, King’s College London, London, UK
| | - Carsten Flohr
- Unit for Paediatric and Population-Based Dermatology Research, St John’s Institute of Dermatology, Guy’s and St Thomas’ NHS Foundation Trust and King’s College London, London, UK
| | - Sara J Brown
- Centre for Genomic and Experimental Medicine, University of Edinburgh, Edinburgh, UK
- Department of Dermatology, NHS Lothian, Edinburgh, UK
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14
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Shah R, Salek MS, Finlay AY, Kay R, Nixon SJ, Otwombe K, Ali FM, Ingram JR. Mapping of Family Reported Outcome Measure (FROM-16) scores to EQ-5D: algorithm to calculate utility values. Qual Life Res 2024; 33:1107-1119. [PMID: 38402530 PMCID: PMC10973087 DOI: 10.1007/s11136-023-03590-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2023] [Indexed: 02/26/2024]
Abstract
OBJECTIVE Although decision scientists and health economists encourage inclusion of family member/informal carer utility in health economic evaluation, there is a lack of suitable utility measures comparable to patient utility measures such those based on the EQ-5D. This study aims to predict EQ-5D-3L utility values from Family Reported Outcome Measure (FROM-16) scores, to allow the use of FROM-16 data in health economic evaluation when EQ-5D data is not available. METHODS Data from 4228 family members/partners of patients recruited to an online cross-sectional study through 58 UK-based patient support groups, three research support platforms and Welsh social services departments were randomly divided five times into two groups, to derive and test a mapping model. Split-half cross-validation was employed, resulting in a total of ten multinomial logistic regression models. The Monte Carlo simulation procedure was used to generate predicted EQ-5D-3L responses, and utility scores were calculated and compared against observed values. Mean error and mean absolute error were calculated for all ten validation models. The final model algorithm was derived using the entire sample. RESULTS The model was highly predictive, and its repeated fitting using multinomial logistic regression demonstrated a stable model. The mean differences between predicted and observed health utility estimates ranged from 0.005 to 0.029 across the ten modelling exercises, with an average overall difference of 0.015 (a 2.2% overestimate, not of clinical importance). CONCLUSIONS The algorithm developed will enable researchers and decision scientists to calculate EQ-5D health utility estimates from FROM-16 scores, thus allowing the inclusion of the family impact of disease in health economic evaluation of medical interventions when EQ-5D data is not available.
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Affiliation(s)
- R Shah
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK.
| | - M S Salek
- School of Life & Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - A Y Finlay
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - R Kay
- RK Statistics, Bakewell, UK
| | - S J Nixon
- Multiple Sclerosis Society, Cardiff, UK
| | - K Otwombe
- Statistics and Data Management Centre, Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - F M Ali
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - J R Ingram
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
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15
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Shah R, Finlay AY, Salek MS, Allen H, Nixon SJ, Nixon M, Otwombe K, Ali FM, Ingram JR. Responsiveness and minimal important change of the Family Reported Outcome Measure (FROM-16). J Patient Rep Outcomes 2024; 8:38. [PMID: 38530614 PMCID: PMC10965873 DOI: 10.1186/s41687-024-00703-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 02/15/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND The FROM-16 is a generic family quality of life (QoL) instrument that measures the QoL impact of patients' disease on their family members/partners. The study aimed to assess the responsiveness of FROM-16 to change and determine Minimal Important Change (MIC). METHODS Responsiveness and MIC for FROM-16 were assessed prospectively with patients and their family members recruited from outpatient departments of the University Hospital Wales and University Hospital Llandough, Cardiff, United Kingdom. Patients completed the EQ-5D-3L and a global severity question (GSQ) online at baseline and at 3-month follow-up. Family members completed FROM-16 at baseline and a Global Rating of Change (GRC) in addition to FROM-16 at follow-up. Responsiveness was assessed using the distribution-based (effect size-ES, standardized response mean -SRM) and anchor-based (area under the receiver operating characteristics curve ROC-AUC) approaches and by testing hypotheses on expected correlation strength between FROM-16 change score and patient assessment tools (GSQ and EQ-5D). Cohen's criteria were used for assessing ES. The AUC ≥ 0.7 was considered a good measure of responsiveness. MIC was calculated using anchor-based (ROC analysis and adjusted predictive modelling) and distribution methods based on standard deviation (SD) and standard error of the measurement (SEM). RESULTS Eighty-three patients with 15 different health conditions and their relatives completed baseline and follow-up questionnaires and were included in the responsiveness analysis. The mean FROM-16 change over 3 months = 1.43 (SD = 4.98). The mean patient EQ-5D change over 3 months = -0.059 (SD = 0.14). The responsiveness analysis showed that the FROM-16 was responsive to change (ES = 0.2, SRM = 0.3; p < 0.01). The ES and SRM of FROM-16 change score ranged from small (ES = 0.2; SRM = 0.3) for the distribution-based method to large (ES = 0.8, SRM = 0.85) for anchor-based methods. The AUC value was above 0.7, indicating good responsiveness. There was a significant positive correlation between the FROM-16 change scores and the patient's disease severity change scores (p < 0.001). The MIC analysis was based on data from 100 family members of 100 patients. The MIC value of 4 was suggested for FROM-16. CONCLUSIONS The results of this study confirm the longitudinal validity of FROM-16 which refers to the degree to which an instrument is able to measure change in the construct to be measured. The results yield a MIC value of 4 for FROM-16. These psychometric attributes of the FROM-16 instrument are useful in both clinical research as well as clinical practice.
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Affiliation(s)
- R Shah
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK.
| | - A Y Finlay
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - M S Salek
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | | | - S J Nixon
- Multiple Sclerosis Society, Cardiff, UK
| | - M Nixon
- Multiple Sclerosis Society, Cardiff, UK
| | - K Otwombe
- Statistics and Data Management Centre, Perinatal HIV Research Unit, Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa
| | - F M Ali
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - J R Ingram
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
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16
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Pralong A, Herling M, Holtick U, Scheid C, Hellmich M, Hallek M, Pauli B, Reimer A, Schepers C, Simon ST. Developing a supportive and palliative care intervention for patients with allogeneic stem cell transplantation: protocol of a multicentre mixed-methods study (allo-PaS). BMJ Open 2023; 13:e066948. [PMID: 37652589 PMCID: PMC10476131 DOI: 10.1136/bmjopen-2022-066948] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 07/27/2023] [Indexed: 09/02/2023] Open
Abstract
INTRODUCTION Although allogeneic stem cell transplantation (allo-SCT) is a curative treatment for many haematological malignancies, it is often associated with a high morbidity and mortality. Yet, little is known about the needs for supportive and palliative care among allo-SCT recipients. Moreover, targeted interventions that reduce symptom burden and suffering are still lacking. The present study aims to inform a supportive-palliative care intervention for patients with allo-SCT and their informal carers by exploring their experience and assessing their needs, especially their existential concerns, regarding four research topics: symptom burden and quality of life; coexistence of a chance for cure and a relevant risk of dying; change in goals of care; dying phase. METHODS AND ANALYSIS This is a descriptive mixed-methods study in progress with a convergent parallel design. Data on the four research topics will be collected and analysed separately in three steps: (1) qualitative semi-structured interviews among 20 patients, 20 informal carers and 12 healthcare providers (HCPs) and focus groups among 12-24 HCPs; (2) a quantitative cross-sectional survey with validated questionnaires and self-developed questions among 100 patients, 100 informal carers and 50 HCPs; (3) a retrospective case analysis of all deceased patients who underwent an allo-SCT between 2010 and 2019, with collection of quantitative and qualitative data. The qualitative and quantitative data sets will be finally merged for comparison and interpretation. Results will serve to develop a supportive-palliative care intervention. ETHICS AND DISSEMINATION The Ethics Commission of the Faculty of Medicine of the University of Cologne approved this study (20-1370_2). The study results will be published in peer-review journals, be presented at congresses and will be translated into clinical practice through the development of the palliative-supportive care intervention. TRIAL REGISTRATION NUMBER DRKS00027290 (German Clinical Trials Register).
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Affiliation(s)
- Anne Pralong
- Department of Palliative Medicine, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
- Centre for Integrated Oncology Aachen-Bonn-Cologne-Duesseldorf (CIO ABCD), Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
| | - Marco Herling
- Centre for Integrated Oncology Aachen-Bonn-Cologne-Duesseldorf (CIO ABCD), Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
- Department of Hematology, Cellular Therapy, and Hemostaseology, Faculty of Medicine, University of Leipzig, Leipzig, Sachsen, Germany
- Department of Internal Medicine I, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
| | - Udo Holtick
- Centre for Integrated Oncology Aachen-Bonn-Cologne-Duesseldorf (CIO ABCD), Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
- Department of Internal Medicine I, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
| | - Christoph Scheid
- Centre for Integrated Oncology Aachen-Bonn-Cologne-Duesseldorf (CIO ABCD), Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
- Department of Internal Medicine I, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
| | - Martin Hellmich
- Institute of Medical Statistics and Computational Biology (IMSB), University of Cologne, Cologne, Germany
| | - Michael Hallek
- Centre for Integrated Oncology Aachen-Bonn-Cologne-Duesseldorf (CIO ABCD), Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
- Department of Internal Medicine I, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
| | - Berenike Pauli
- Department of Palliative Medicine, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
- Centre for Integrated Oncology Aachen-Bonn-Cologne-Duesseldorf (CIO ABCD), Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
| | - Alinda Reimer
- Department of Palliative Medicine, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
- Centre for Integrated Oncology Aachen-Bonn-Cologne-Duesseldorf (CIO ABCD), Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
| | - Carolin Schepers
- Department of Palliative Medicine, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
- Centre for Integrated Oncology Aachen-Bonn-Cologne-Duesseldorf (CIO ABCD), Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
| | - Steffen T Simon
- Department of Palliative Medicine, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
- Centre for Integrated Oncology Aachen-Bonn-Cologne-Duesseldorf (CIO ABCD), Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
- Centre for Health Services Research, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
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Shah R, Finlay AY, Salek SM, Nixon SJ, Otwombe K, Ali FM, Ingram JR. Meaning of Family Reported Outcome Measure (FROM-16) severity score bands: a cross-sectional online study in the UK. BMJ Open 2023; 13:e066168. [PMID: 36958787 PMCID: PMC10040025 DOI: 10.1136/bmjopen-2022-066168] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/25/2023] Open
Abstract
OBJECTIVE To assign clinical meanings to the Family Reported Outcome Measure (FROM-16) scores through the development of score bands using the anchor-based approach. DESIGN AND SETTING A cross-sectional online study recruited participants through UK-based patient support groups, research support platforms (HealthWise Wales, Autism Research Centre-Cambridge University database, Join Dementia Research) and through social service departments in Wales. PARTICIPANTS Family members/partners (aged ≥18 years) of patients with different health conditions. INTERVENTION Family members/partners of patients completed the FROM-16 questionnaire and a Global Question (GQ). MAIN OUTCOME MEASURE Various FROM-16 band sets were devised as a result of mapping of mean, median and mode of the GQ scores to FROM-16 total score, and receiver operating characteristic-area under the curve cut-off values. The band set with the best agreement with GQ based on weighted kappa was selected. RESULTS A total of 4413 family members/partners (male=1533, 34.7%; female=2858, 64.8%; Prefer not to say=16, 0.4%; other=6, 0.14%) of people with a health condition (male=1994, 45.2%; female=2400, 54.4%; Prefer not to say=12, 0.3%; other=7, 0.16%) completed the online survey: mean FROM-16 score=15.02 (range 0-32, SD=8.08), mean GQ score=2.32 (range 0-4, SD=1.08). The proposed FROM-16 score bandings are: 0-1=no effect on the quality of life of family member; 2-8=small effect on family member; 9-16=moderate effect on family member; 17-25=very large effect on family member; 26-32=extremely large effect on family member (weighted kappa=0.60). CONCLUSION The FROM-16 score descriptor bands provide new information to clinicians about interpreting scores and score changes, allowing better-informed treatment decisions for patients and their families. The score banding of FROM-16, along with a short administration time, demonstrates its potential to support holistic clinical practice.
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Affiliation(s)
- Rubina Shah
- Division of Infection and Immunity, Cardiff University, School of Medicine, Cardiff, UK
| | - Andrew Y Finlay
- Division of Infection and Immunity, Cardiff University, School of Medicine, Cardiff, UK
| | - Sam M Salek
- School of Life & Medical Sciences, University of Hertfordshire, Hatfield, UK
- Institute of Medicines Development, Cardiff, UK
| | | | - Kennedy Otwombe
- Statistics and Data Management Centre, Perinatal HIV Research Unit, Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa
- 6School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Faraz M Ali
- Division of Infection and Immunity, Cardiff University, School of Medicine, Cardiff, UK
| | - John R Ingram
- Division of Infection and Immunity, Cardiff University, School of Medicine, Cardiff, UK
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Vyas J, Muirhead N, Singh R, Ephgrave R, Finlay AY. Impact of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) on the quality of life of people with ME/CFS and their partners and family members: an online cross-sectional survey. BMJ Open 2022; 12:e058128. [PMID: 35501074 PMCID: PMC9062824 DOI: 10.1136/bmjopen-2021-058128] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 04/11/2022] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES The aim of this study was to assess the impact of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) on the quality of life (QoL) of people with ME/CFS and their relative or partner (family member). DESIGN A patient-partner, multinational, subject-initiated, cross-sectional online survey. SETTING International survey using ME/CFS charities, support groups and social media. PARTICIPANTS Participants were self-selected with recruitment via social media. Inclusion criteria were aged 18 years or over and reported diagnosis of ME/CFS by health professional. 1418 people with ME/CFS and their 1418 family members from 30 countries participated in the survey. Participants with ME/CFS had a mean age of 45.8 years (range 18-81) and were predominantly women (1214 (85.6%) of 1418). Family members had a mean age of 51.9 years (range 18-87) and were predominantly men (women: 504 (35.5%) of 1418). 991 (70%) family members were partners of the people with ME/CFS. INTERVENTIONS EuroQoL-5 Dimension (EQ-5D-3L), completed by people with ME/CFS, and Family Reported Outcome Measure (FROM-16) questionnaire, completed by family members. RESULTS The mean overall health status on a Visual Analogue Scale for people with ME/CFS was 33.8 (0=worst, 100=best). People with ME/CFS were most affected by ability to perform usual activities, pain, mobility, self-care and least impacted by anxiety. For family members, the overall mean FROM-16 score was 17.9 (0=no impact, 32=worst impact), demonstrating a major impact on QoL. Impact on QoL was significantly correlated between the person with ME/CFS and their family member (p<0.0001). Family members were most impacted emotionally by worry, frustration and sadness and personally by family activities, holidays, sex life and finances. CONCLUSIONS To the best of our knowledge, this is the largest study on the impact of the QoL of persons with ME/CFS and their family members. While open participation surveys are limited by selection bias, this research has revealed a significant worldwide burden of ME/CFS on the QoL of people with ME/CFS and their family members.
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Affiliation(s)
- Jui Vyas
- Centre for Medical Education, School of Medicine, Cardiff University, Cardiff, UK
| | - Nina Muirhead
- Dermatology, Buckinghamshire Healthcare NHS Trust, Amersham, UK
| | - Ravinder Singh
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | | | - Andrew Y Finlay
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
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19
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Oh HY, Shin YS. Psychometric Properties of the Korean Family Reported Outcome Measure for Family Members of Patients With Acquired Brain Injury. J Neurosci Nurs 2021; 53:256-261. [PMID: 34620801 DOI: 10.1097/jnn.0000000000000619] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT BACKGROUND: Acquired brain injury (ABI) affects not only survivors but also their family members' quality of life in various ways. The Family Reported Outcome Measure (FROM-16), a self-reported instrument, has been developed to evaluate the impact of diseases on the lives of family members of patients. This study aimed to assess the reliability and validity of the Korean FROM-16 for family members of individuals with ABI. METHODS: A total of 200 family members of patients with ABI in South Korea participated in this study. Internal consistency was assessed using Cronbach α. To establish the validity, we evaluated the semantic equivalence, content, known-group, conduct, concurrent, and convergent validity of the Korean FROM-16. For exploratory factor analysis, common factor analysis with oblique rotation, parallel analysis, an eigenvalue greater than 1.0, and a scree plot were used. RESULTS: Exploratory factor analysis revealed 2 factors for the 16 items, which explained 67.4% of the total variance. Concurrent validity was established by comparison with the Korean World Health Organization Quality of Life Scale Brief (r = -0.57), and regarding the convergent validity, the Korean FROM-16 score positively correlated with the Korean Neurobehavioral Functioning Inventory. Known-group validity was confirmed by showing that family members with advanced age, the burden of caring, and insufficient income, as well as spouses, had a statistically higher score in the Korean FROM-16. Cronbach α was .92, indicating high internal consistency reliability. CONCLUSION: The Korean FROM-16 is a valid and reliable instrument for evaluating the impact of diseases on family members of individuals with ABI in South Korea.
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Shah R, Ali FM, Finlay AY, Salek MS. Family reported outcomes, an unmet need in the management of a patient's disease: appraisal of the literature. Health Qual Life Outcomes 2021; 19:194. [PMID: 34353345 PMCID: PMC8339395 DOI: 10.1186/s12955-021-01819-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 07/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A person's chronic health condition or disability can have a huge impact on the quality of life (QoL) of the whole family, but this important impact is often ignored. This literature review aims to understand the impact of patients' disease on family members across all medical specialities, and appraise existing generic and disease-specific family quality of life (QoL) measures. METHODS The databases Medline, EMBASE, CINHAL, ASSIA, PsycINFO and Scopus were searched for original articles in English measuring the impact of health conditions on patients' family members/partner using a valid instrument. RESULTS Of 114 articles screened, 86 met the inclusion criteria. They explored the impact of a relative's disease on 14,661 family members, mostly 'parents' or 'mothers', using 50 different instruments across 18 specialities including neurology, oncology and dermatology, in 33 countries including the USA, China and Australia. These studies revealed a huge impact of patients' illness on family members. An appraisal of family QoL instruments identified 48 instruments, 42 disease/speciality specific and six generic measures. Five of the six generics are aimed at carers of children, people with disability or restricted to chronic disease. The only generic instrument that measures the impact of any condition on family members across all specialities is the Family Reported Outcome Measure (FROM-16). Although most instruments demonstrated good reliability and validity, only 11 reported responsiveness and only one reported the minimal clinically important difference. CONCLUSIONS Family members' QoL is greatly impacted by a relative's condition. To support family members, there is a need for a generic tool that offers flexibility and brevity for use in clinical settings across all areas of medicine. FROM-16 could be the tool of choice, provided its robustness is demonstrated with further validation of its psychometric properties.
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Affiliation(s)
- R. Shah
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - F. M. Ali
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - A. Y. Finlay
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - M. S. Salek
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
- Institute of Medicines Development, Cardiff, UK
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Shah R, Ali FM, Nixon SJ, Ingram JR, Salek SM, Finlay AY. Measuring the impact of COVID-19 on the quality of life of the survivors, partners and family members: a cross-sectional international online survey. BMJ Open 2021; 11:e047680. [PMID: 34035105 PMCID: PMC8154981 DOI: 10.1136/bmjopen-2020-047680] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 04/19/2021] [Accepted: 04/20/2021] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE This study aimed to measure the impact of COVID-19 on the quality of life (QoL) of survivors and their partners and family members. DESIGN AND SETTING A prospective cross-sectional global online survey using social media. PARTICIPANTS Patients with COVID-19 and partners or family members (age ≥18 years). INTERVENTION Online survey from June to August 2020. MAIN OUTCOME MEASURE The EuroQol group five dimensions three level (EQ-5D-3L) to measure the QoL of survivors of COVID-19, and the Family Reported Outcome Measure (FROM-16) to assess the impact on their partner/family member's QoL. RESULTS The survey was completed by 735 COVID-19 survivors (mean age=48 years; females=563) at a mean of 12.8 weeks after diagnosis and by 571 partners and 164 family members (n=735; mean age=47 years; females=246) from Europe (50.6%), North America (38.5%) and rest of the world (10.9%). The EQ-5D mean score for COVID-19 survivors was 8.65 (SD=1.9, median=9; range=6-14). 81.1% (596/735) reported pain and discomfort, 79.5% (584/735) problems with usual activities, 68.7% (505/735) anxiety and depression and 56.2% (413/735) problems with mobility. Hospitalised survivors (20.1%, n=148) and survivors with existing health conditions (30.9%, n=227) reported significantly more problems with mobility and usual activities (p<0.05), with hospitalised also experiencing more impact on self-care (p≤0.001). Among 735 partners and family members, the mean FROM-16 score (maximum score=highest impact =32) was 15 (median=15, range=0-32). 93.6% (688/735) reported being worried, 81.7% (601/735) frustrated, 78.4% (676/735) sad, 83.3% (612/735) reported impact on their family activities, 68.9% (507/735) on sleep and 68.1% (500/735) on their sex life. CONCLUSION COVID-19 survivors reported a major persisting impact on their physical and psychosocial health. The lives of their partners and other family members were also severely affected. There is a need for a holistic support system sensitive to the needs of COVID-19 survivors and their family members who experience a major 'secondary burden'.
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Affiliation(s)
- Rubina Shah
- Division of Infection and Immunity, Cardiff University School of Medicine, Cardiff, UK
| | - Faraz M Ali
- Division of Infection and Immunity, Cardiff University School of Medicine, Cardiff, UK
| | | | - John R Ingram
- Division of Infection and Immunity, Cardiff University School of Medicine, Cardiff, UK
| | - Sam M Salek
- School of Life & Medical Sciences, University of Hertfordshire, Hatfield, UK
- Institute of Medicines Development, Cardiff, UK
| | - Andrew Y Finlay
- Division of Infection and Immunity, Cardiff University School of Medicine, Cardiff, UK
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22
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Elsner SA, Salek SS, Finlay AY, Hagemeier A, Bottomley CJ, Katalinic A, Waldmann A. Validation of the German version of the Family Reported Outcome Measure (FROM-16) to assess the impact of disease on the partner or family member. Health Qual Life Outcomes 2021; 19:106. [PMID: 33761949 PMCID: PMC7992821 DOI: 10.1186/s12955-021-01738-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 03/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Family Reported Outcome Measure (FROM-16) assesses the impact of a patient's chronic illness on the quality of life (QoL) of the patient's partner or family members. The aim of the study was to translate, explore the structure of and validate the FROM-16. METHODS The questionnaire was translated from English into German (forward, backward, four independent translators). Six interviews with family members were conducted to confirm the questionnaire for linguistic, conceptual, semantic and experiential equivalence and its practicability. The final German translation was tested for internal consistency, reproducibility and test validity. Criterion validity was tested by correlating the scores of the FROM-16 and the Global Health Scale (GHS). Principal component analysis, factor analysis, and confirmatory factor analysis was used to assess the questionnaire's structure and its domains. Reliability and reproducibility were tested computing the intraclass correlation coefficient (ICC) using one sample t-test for testing the hypothesis that the difference between the scores was not different from zero. RESULTS Overall, 83 family members (61% female, median age: 61 years) completed the questionnaire at two different times (mean interval: 22 days). Internal consistency was good for the FROM-16 scores (Cronbach's α for total score = 0.86). In those with stable GHS, the ICC for the total score was 0.87 and the difference was not different from zero (p = 0.262) indicating reproducible results. A bi-factor model with a general factor including all items, and two sub-factors comprising the items from the original 2-factor construct had the best fit. CONCLUSIONS The German FROM-16 has good reliability, test validity and practicability. It can be considered as an appropriate and generic tool to measure QoL of a patient's partner or family member. Due to the presence of several cross-loadings we do not recommend the reporting of the scores of the two domains proposed for the original version of FROM-16 when using the German version. Thus, in reporting the results emphasis should be put on the total score. TRIAL REGISTRATION Retrospectively registered: DRKS00021070.
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Affiliation(s)
- Susanne A Elsner
- Institute for Social Medicine and Epidemiology, University of Luebeck, Ratzeburger Allee 160, 23562, Luebeck, Germany.
| | - Sam S Salek
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, AL10 9AB, UK.,Outcomes Research, Institute for Medicines Development, Cardiff, CF23 6NP, UK
| | - Andrew Y Finlay
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, CF14 4XN, UK
| | - Anna Hagemeier
- Institute for Social Medicine and Epidemiology, University of Luebeck, Ratzeburger Allee 160, 23562, Luebeck, Germany
| | | | - Alexander Katalinic
- Institute for Social Medicine and Epidemiology, University of Luebeck, Ratzeburger Allee 160, 23562, Luebeck, Germany.,Cancer Registry Schleswig-Holstein, University of Luebeck, Luebeck, Germany
| | - Annika Waldmann
- Institute for Social Medicine and Epidemiology, University of Luebeck, Ratzeburger Allee 160, 23562, Luebeck, Germany
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23
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Brittain E, Muirhead N, Finlay AY, Vyas J. Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): Major Impact on Lives of Both Patients and Family Members. ACTA ACUST UNITED AC 2021; 57:medicina57010043. [PMID: 33430175 PMCID: PMC7825605 DOI: 10.3390/medicina57010043] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 12/23/2020] [Accepted: 12/30/2020] [Indexed: 11/16/2022]
Abstract
Background and objectives: To explore the impacts that Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) has on the patient and their family members using the WHOQOL-BREF (Abbreviated World Health Organisation Quality of Life questionnaire) and FROM-16 (Family Reported Outcome Measure-16) quality of life assessments. Materials and Methods: A quantitative research study using postal questionnaires was conducted. A total of 39 adult volunteers expressed an interest in participating in the study: 24 returned appropriately completed questionnaires. Patients with ME/CFS completed the WHOQOL-BREF and up to four of their family members completed the FROM-16 questionnaire. Results: ME/CFS negatively affects the quality of life of the patient (median scores WHOQOL-BREF: Physical health = 19, Psychological = 44, Social relationships = 37.5, Environment = 56, n = 24) and their family members' quality of life (FROM-16: Emotional = 9.5, Personal and social = 11.5, Overall = 20.5, n = 42). There was a significant correlation between the patient's reported quality of life scores and their family members' mean FROM-16 total scores. Conclusions: This study identifies the major impact that having an adult family member with ME/CFS has on the lives of partners and of other family members. Quality of life of ME/CFS patients was reduced most by physical health compared to the other domains. Quality of life of family members was particularly impacted by worry, family activities, frustration and sadness. This highlights the importance of measuring the impact on the lives of family members using tools such as the FROM-16 in the ME/CFS clinical encounter and ensuring appropriate support is widely available to family members.
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Affiliation(s)
- Esme Brittain
- School of Medicine, Cardiff University, Cardiff CF14 4XN, UK; (E.B.); (A.Y.F.)
| | - Nina Muirhead
- Buckinghamshire Healthcare NHS Trust, Amersham Hospital, Amersham HP7 0JD, UK;
| | - Andrew Y. Finlay
- School of Medicine, Cardiff University, Cardiff CF14 4XN, UK; (E.B.); (A.Y.F.)
| | - Jui Vyas
- School of Medicine, Cardiff University, Cardiff CF14 4XN, UK; (E.B.); (A.Y.F.)
- Correspondence:
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24
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Raja A, Wood F, Joshi HB. The impact of urinary stone disease and their treatment on patients' quality of life: a qualitative study. Urolithiasis 2019; 48:227-234. [PMID: 31240350 PMCID: PMC7220862 DOI: 10.1007/s00240-019-01142-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 05/19/2019] [Indexed: 12/22/2022]
Abstract
Urinary stone disease is a common, often recurrent disease, that can have a negative impact on patients’ health-related quality of life (HRQoL), often effecting working, productive members of society. The literature lacks data from structured, qualitative research which could give unique insight into patients’ HRQoL. The objective is to understand the impact of urinary stone disease and treatments on patients’ HRQoL, from patients’ and their relatives’ perspective using qualitative and quantitative methodologies. Semi-structured interviews and a focus group were used to understand the HRQoL issues of patients with urinary stones disease, covering the American Urology Association index stone categories. Thematic analysis was performed (using qualitative data analysis software). Familial impact was assessed using the family-related outcome measure (FROM-16©). 62 patients with stone disease and interventions (mean age 51, range 19–92) participated. Data collection stopped when data saturation was achieved. Analysis revealed negative impact of stone disease and interventions on the patients’ HRQoL, affecting domains of pain, physical symptoms, outlook on life, work/career, change in lifestyle/diet, social life, difficulties of daily living, travel/holiday problems, relationships and family member impact (106 themes grouped under ten broad headings). Sub-group analyses revealed similar impact in either sex, ureteric and renal stone groups. Recurrent stones were associated with work/financial concerns and treatment preferences varied accordingly. Our qualitative study presents detailed insights into the multidimensional impact of urinary calculi and their treatments on various domains of the HRQoL, confirming previous findings and adding new observations. The findings are expected to help in the development of patient-centric measures and communication tools.
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Affiliation(s)
- Aditya Raja
- School of Medicine, Cardiff University, Cardiff, UK.,Department of Urology, University Hospital of Wales, Heath Park, Cardiff, CF14 4XW, UK
| | - Fiona Wood
- School of Medicine, Cardiff University, Cardiff, UK.
| | - Hrishi B Joshi
- School of Medicine, Cardiff University, Cardiff, UK.,Department of Urology, University Hospital of Wales, Heath Park, Cardiff, CF14 4XW, UK
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25
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Strober BE, van der Walt JM, Armstrong AW, Bourcier M, Carvalho AVE, Chouela E, Cohen AD, de la Cruz C, Ellis CN, Finlay AY, Gottlieb AB, Gudjonsson JE, Iversen L, Kleyn CE, Leonardi CL, Lynde CW, Ryan C, Theng CT, Valenzuela F, Vender R, Wu JJ, Young HS, Kimball AB. Clinical Goals and Barriers to Effective Psoriasis Care. Dermatol Ther (Heidelb) 2019; 9:5-18. [PMID: 30578464 PMCID: PMC6380974 DOI: 10.1007/s13555-018-0279-5] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Indexed: 12/18/2022] Open
Abstract
Engaging global key opinion leaders, the International Psoriasis Council (IPC) held a day-long roundtable discussion with the primary purpose to discuss the treatment goals of psoriasis patients and worldwide barriers to optimal care. Setting clear expectations might ultimately encourage undertreated psoriasis patients to seek care in an era in which great gains in therapeutic efficacy have been achieved. Here, we discuss the option for early treatment of all categories of psoriasis to alleviate disease impact while emphasizing the need for more focused attention for psoriasis patients with mild and moderate forms of this autoimmune disease. In addition, we encourage policy changes to keep pace with the innovative therapies and clinical science and highlight the demand for greater understanding of treatment barriers in resource-poor countries.
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Affiliation(s)
- Bruce E Strober
- University of Connecticut Health Center, Farmington, CT, USA.
- Probity Medical Research, Waterloo, ON, Canada.
| | | | | | - Marc Bourcier
- Faculty of Medicine, Sherbrooke University, Sherbrooke, QC, Canada
| | | | | | - Arnon D Cohen
- Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Department of Quality Measurements and Research, Chief Physician's Office, Clalit Health Services, Tel Aviv, Israel
| | | | - Charles N Ellis
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Andrew Y Finlay
- Department of Dermatology and Academic Wound Healing, Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | | | - Johann E Gudjonsson
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Lars Iversen
- Department of Dermatology, Aarhus University Hospital, 8000, Aarhus C, Denmark
| | - C Elise Kleyn
- The Dermatology Centre, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Barnes Building, Manchester, UK
| | | | | | - Caitriona Ryan
- Blackrock Clinic Dublin and University College Dublin, Dublin, Ireland
| | - Colin T Theng
- Department of Dermatology, National Skin Centre, Singapore, Republic of Singapore
| | | | - Ronald Vender
- Dermatrials Research Inc & Venderm Innovations in Psoriasis, Hamilton, ON, Canada
| | - Jashin J Wu
- Dermatology Research and Education Foundation, Irvine, CA, USA
| | - Helen S Young
- The Dermatology Centre, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Barnes Building, Manchester, UK
| | - Alexa B Kimball
- Harvard Medical Faculty Physicians, Beth Israel Deaconess Medical Center, Boston, MA, USA
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26
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Chantarasap P, Johns NP, Pairojkul S, Sookprasert A, Wirasorn K, Cheawchanwattana A, Salek S, Subongkot S. Validation of the Thai version of the family reported outcome measure (FROM-16)© to assess the impact of disease on the partner or family members of patients with cancer. Health Qual Life Outcomes 2019; 17:32. [PMID: 30736795 PMCID: PMC6368697 DOI: 10.1186/s12955-019-1091-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Accepted: 01/14/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cancer not only impairs a patient's physical and psychosocial functional behaviour, but also contributes to negative impact on family members' health related quality of life. Currently, there is an absence of a relevant tool in Thai with which to measure such impact. The aim of this study was to translate and validate the Family Reported Outcome Measure (FROM-16) in Thai cancer patients' family members. METHODS Thai version of FROM-16 was generated by interactive forward-backward translation process following standard guidelines. This was tested for psychometric properties including reliability and validity, namely content validity, concurrent validity, known group validity, internal consistency, exploratory and confirmatory factor analysis. Construct validity was examined by comparing the Thai FROM-16 version with the WHOQOL-BREF-THAI. RESULTS The internal consistency reliability was strong (Cronbach's alpha = 0.86). A Negative moderate correlation between the Thai FROM-16 and WHOQOL-BREF-THAI was observed (r = - 0.4545, p < 0.00), and known group validity was proved by a statistically significant higher score in family members with high burden of care and insufficient income. The factor analysis supported both 3-factor and 2-factor loading model with slight difference when compared with the original version. CONCLUSIONS The Thai FROM-16 showed good reliability and validity in Thai family members of patients with cancer. A slight difference in factor analysis results compared to the original version could be due to cross-culture application.
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Affiliation(s)
| | | | - Srivieng Pairojkul
- Palliative Care Unit, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Aumkhae Sookprasert
- Medicine Unit, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Kosin Wirasorn
- Medicine Unit, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Areewan Cheawchanwattana
- Division of Social and Administrative Pharmacy, Faculty of Pharmaceutical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Sam Salek
- School of Life & Medical Sciences, University of Hertfordshire and Institute for Medicines Development, Hertfordshire, UK
| | - Suphat Subongkot
- Division of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Khon Kaen University, Khon Kaen, Thailand.
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27
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Salek MS, Ionova T, Johns JR, Oliva EN. Appraisal of patient-reported outcome measures in analogous diseases and recommendations for use in phase II and III clinical trials of pyruvate kinase deficiency. Qual Life Res 2018; 28:399-410. [PMID: 30456713 PMCID: PMC6373289 DOI: 10.1007/s11136-018-2025-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2018] [Indexed: 01/19/2023]
Abstract
PURPOSE Pyruvate kinase deficiency (PKD) is a rare disease and understanding of its epidemiology and associated burden remains limited. With no current curative therapy, clinical manifestations can be life threatening, clinically managed by maintaining adequate hemoglobin levels through transfusion and subsequent support, but with frequent complications. Treatment goals are to maintain/improve the patient's quality of life. With new therapies, reliable, valid, and relevant patient-reported outcome (PRO) tools are required for use in clinical trials. METHODS Systematic literature search identified no current PRO tools for capturing/measuring the impact of PKD and treatments in clinical trials. Therefore, the search strategy was revised to consider conditions analogous to PKD in terms of symptoms and impacts that might serve as parallels to the experience in PKD; this included sickle cell anemia, thalassemia, and hemolytic anemia. Psychometric properties, strengths, and weakness of selected appropriate PRO instruments were compared, and recommendations made for choice of PRO tools. RESULTS In adult populations, EORTC QLQ C30 and SF-36v2 are recommended, the former being a basic minimum, covering generic HRQoL, and core symptoms such as fatigue. In pediatric populations, PedsQL Generic Core Scale to measure HRQoL and PedsQL MFS scale to measure fatigue are recommended. CONCLUSIONS Some symptoms/life impacts may be unique to PKD and not observable in analogous conditions. A 'Physico-Psychosocial Model' derived from the 'Medical Model' is proposed to form the basis for a hypothesized conceptual framework to address the development of PKD-specific PRO instruments.
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Affiliation(s)
- M S Salek
- School of Life and Medical Sciences, University of Hertfordshire, College Lane, Hatfield, AL10 9AB, UK.
| | - T Ionova
- University Clinic St. Petersburg State University and Multinational Centre for Quality of Life Research, St. Petersburg, Russia
| | - J R Johns
- Institute for Medicines Development, Cardiff, UK
| | - E N Oliva
- Haematology Unit, Grande Ospedale Metropolitano Bianchi Melacrino Morelli, Reggio Calabria, Italy
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Sampogna F, Finlay A, Salek S, Chernyshov P, Dalgard F, Evers A, Linder D, Manolache L, Marron S, Poot F, Spillekom-van Koulil S, Svensson Å, Szepietowski J, Tomas-Aragones L, Abeni D. Measuring the impact of dermatological conditions on family and caregivers: a review of dermatology-specific instruments. J Eur Acad Dermatol Venereol 2017; 31:1429-1439. [DOI: 10.1111/jdv.14288] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 03/28/2017] [Indexed: 01/13/2023]
Affiliation(s)
- F. Sampogna
- Clinical Epidemiology Unit; Istituto Dermopatico dell'Immacolata (IDI)-IRCCS FLMM; Rome Italy
| | - A.Y. Finlay
- Division of Infection and Immunity; Department of Dermatology and Wound Healing; Cardiff University; Cardiff UK
| | - S.S. Salek
- Department of Pharmacy, Pharmacology and Postgraduate Medicine; School of Life & Medical Sciences; University of Hertfordshire; Hatfield UK
| | - P. Chernyshov
- Department of Dermatology and Venereology; National Medical University; Kiev Ukraine
| | - F.J. Dalgard
- Department of Dermatology and Venereology; Skåne University Hospital; Lund University; Malmö Sweden
| | - A.W.M. Evers
- Health, Medical, and Neuropsychology Unit; Leiden University; Leiden The Netherlands
| | - D. Linder
- Oslo Centre for Biostatistics and Epidemiology; University of Oslo; Oslo Norway
| | | | - S.E. Marron
- Department of Dermatology; Alcañiz Hospital; Aragon Health Sciences Institute; Zaragoza Spain
| | - F. Poot
- Department of Dermatology; ULB Erasme Hospital; Brussels Belgium
| | - S. Spillekom-van Koulil
- Department of Medical Psychology; Radboud University Medical Center; Nijmegen The Netherlands
| | - Å. Svensson
- Department of Dermatology and Venereology; Skåne University Hospital; Lund University; Malmö Sweden
| | - J.C. Szepietowski
- Department of Dermatology; Wroclaw Medical University; Wroclaw Poland
| | - L. Tomas-Aragones
- Department of Psychology; Aragon Health Sciences Institute; University of Zaragoza; Zaragoza Spain
| | - D. Abeni
- Clinical Epidemiology Unit; Istituto Dermopatico dell'Immacolata (IDI)-IRCCS FLMM; Rome Italy
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29
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Finlay A. Broader concepts of quality of life measurement, encompassing validation. J Eur Acad Dermatol Venereol 2017; 31:1254-1259. [DOI: 10.1111/jdv.14254] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 03/13/2017] [Indexed: 12/18/2022]
Affiliation(s)
- A.Y. Finlay
- Department of Dermatology and Wound Healing; Division of Infection and Immunity; School of Medicine; Cardiff University; Cardiff UK
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30
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Gooderham M, Lynde CW, Papp K, Bourcier M, Guenther L, Gulliver W, Hong CH, Poulin Y, Sussman G, Vender R. Review of Systemic Treatment Options for Adult Atopic Dermatitis. J Cutan Med Surg 2016; 21:31-39. [DOI: 10.1177/1203475416670364] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Atopic dermatitis (AD) is a chronic, pruritic inflammatory skin disease resulting from defects in skin barrier and aberrant immune responses. AD significantly affects the quality of life. Not all patients respond to topical therapies, and often systemic therapy is required to control the disease. Objective: To review the treatment options for adult AD patients including those options for patients who do not respond adequately or have contraindications to oral systemic therapy. Methods: A working group of clinicians with experience managing AD was convened to review the current literature on treatment options for adult AD patients. This review is based on the best available evidence from a published systematic review and an additional literature search. Results: Current treatments for AD are reviewed, including options for adult AD patients who do not respond or have contraindications to current systemic therapies. A new approach with targeted therapies is reviewed based on best available evidence. Conclusion: Many AD patients respond satisfactorily to topical or systemic treatments, but for those patients who do not respond or have contraindications, new biologic agents appear to be promising therapies.
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Affiliation(s)
- Melinda Gooderham
- Queen’s University, SKiN Centre for Dermatology, and Probity Medical Research, Peterborough, ON, Canada
| | - Charles W. Lynde
- Lynde Dermatology, Probity Medical Research, Markham Ontario, and Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Kim Papp
- K Papp Clinical Research and Probity Medical Research, Waterloo, ON, Canada
| | | | - Lyn Guenther
- University of Western Ontario, London ON, Canada
| | - Wayne Gulliver
- Memorial University of Newfoundland St. John’s, NL, Canada
| | - Chih-ho Hong
- Department of Dermatology and Skin Science, University of British Columbia, and Probity Medical Research, Surrey, BC, Canada
| | - Yves Poulin
- Laval University and CDQM and CRDQ, Quebec, QC, Canada
| | - Gordon Sussman
- Division of Clinical Immunology and Allergy, University of Toronto, Toronto, ON, Canada
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Raja A, Hekmati Z, Joshi HB. How Do Urinary Calculi Influence Health-Related Quality of Life and Patient Treatment Preference: A Systematic Review. J Endourol 2016; 30:727-43. [DOI: 10.1089/end.2016.0110] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Affiliation(s)
- Aditya Raja
- Cardiff University, Cardiff, United Kingdom
- Department of Urology, University Hospital of Wales, Cardiff, United Kingdom
| | | | - Hrishi B. Joshi
- Department of Urology, University Hospital of Wales, Cardiff, United Kingdom
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Finlay A. Patient-reported outcome measures in psoriasis: assessing the assessments. Br J Dermatol 2015; 172:1178-9. [DOI: 10.1111/bjd.13775] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- A.Y. Finlay
- Department of Dermatology and Wound Healing; Institute of Infection and Immunity; Cardiff University School of Medicine; Cardiff CF14 4XN U.K
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Lifschitz C. The Impact of Atopic Dermatitis on Quality of Life. ANNALS OF NUTRITION AND METABOLISM 2015; 66 Suppl 1:34-40. [DOI: 10.1159/000370226] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Approximately 5-20% of children worldwide suffer from atopic dermatitis (AD), a kind of dermatitis characterized as an inflammatory, relapsing, noncontagious and itchy skin disorder. Children often develop AD during their first year of life. An increased rate of sensitization to both food and aeroallergens has been shown to coexist in patients with AD. Sensitization to well-known allergens such as cow's milk protein can occur on average in 50% of children with AD. In general, quality of life (QoL) is perceived as the quality of an individual's daily life, that is, an assessment of their well-being or lack thereof. QoL is a broad concept that includes such things as standard of living, community, and family life. Patients with skin diseases experience a wide range of symptoms ranging from trivial problems to major handicaps which affect their lives. The misery of living with AD cannot be overstated for it may have a profoundly negative effect on the health-related QoL of children and their families in many cases. Physicians taking care of children with AD should consult parents on how their child's illness has impacted their lifestyle and recommend professional intervention if deemed necessary.
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Finlay A. Quality of life in dermatology: after 125 years, time for more rigorous reporting. Br J Dermatol 2014; 170:4-6. [DOI: 10.1111/bjd.12737] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- A.Y. Finlay
- Department of Dermatology and Wound Healing; School of Medicine; Cardiff University; Cardiff U.K
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Finlay A. The three dimensions of skin disease burden: ‘now’, ‘long term’ and ‘family’. Br J Dermatol 2013; 169:963-4. [DOI: 10.1111/bjd.12640] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- A.Y. Finlay
- Department of Dermatology and Wound Healing; Cardiff University School of Medicine; Cardiff CF14 4XN U.K
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