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Alsoghier A, Alnutaifi A, Alotaibi O, Alotaibi A, Alharbi A, Almubarak N, Albassam S. Barriers and facilitators for oral health screening among tobacco users: a mixed-methods study. BMC Oral Health 2024; 24:306. [PMID: 38443882 PMCID: PMC10913556 DOI: 10.1186/s12903-024-04084-1] [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: 07/06/2023] [Accepted: 02/27/2024] [Indexed: 03/07/2024] Open
Abstract
OBJECTIVES Tobacco consumption adversely affects general and oral health and is considered one of the significant public health burdens globally. The present study aims to assess the barriers and facilitators for attending oral and dental health screening among tobacco users who seek cessation advice. METHODOLOGY The present mixed-methods study used group concept mapping (GCM) to identify the facilitators/barriers to attending oral health screening among young adults attending face-to-face and virtual Tobacco Cessation Clinic at King Saud University (Riyadh, Saudi Arabia) between September 2022 and April 2023. Study investigators included healthcare social workers, dental interns, and oral and maxillofacial medicinists. Information about demographics, general health, oral/dental health and tobacco use were collected using self-completed questionnaires. The barriers and facilitators were assessed following GCM by brainstorming, sorting, rating, and interpretation activities. Descriptive, multidimensional scaling and hierarchical cluster analysis were used to describe the study participants and produce concept maps of the generated statements. RESULTS The study included 148 participants who generated 67 statements summarised into 28 statements as facilitators or barriers. Based on a 5-point importance scale, the participants indicated the importance of facilitators under health-related cluster [e.g. when I feel pain] as the highest, followed by personal [e.g. to maintain my mouth hygiene], social [e.g. the quality of treatment] and financial clusters [e.g. the reasonable cost]. Concerning barriers, financial factors [e.g. high cost] acted as the highest-rated barrier, followed by personal [e.g. lack of dental appointments] and health-related [e.g. worry that dental problems will worsen]. The social factors were the least considerable barrier [e.g. lack of time]. Clustering these facilitators/barriers on the concept map indicated their conceptual similarity by an average stress value of 0.23. CONCLUSION Pain was the most important facilitator to attending oral health screening by young adults seeking tobacco cessation advice. Notable barriers included the high cost of dental treatment and the lack of scheduled appointments. Thus, oral health care providers need to consider scheduling periodic and timely dental check-ups to prevent and reduce the burden of tobacco-associated and pain-causing oral diseases.
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Affiliation(s)
- Abdullah Alsoghier
- Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, Riyadh, 12372, Saudi Arabia.
| | - Abdulrahman Alnutaifi
- Dental Internship Training Programme, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Obaid Alotaibi
- Dental Internship Training Programme, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Abdulaziz Alotaibi
- Dental Internship Training Programme, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah Alharbi
- Smoking Cessation Clinic, Counselling and Guidance Center, Deanship of Student Affairs, King Saud University, Riyadh, Saudi Arabia
| | - Nada Almubarak
- College of Humanities and Social Sciences, Social Studies Department, King Saud University, Riyadh, Saudi Arabia
| | - Sara Albassam
- Department of Basic Dental Sciences, College of Dentistry, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
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Singh A, Schooley B, Floyd SB, Pill SG, Brooks JM. Patient preferences as human factors for health data recommender systems and shared decision making in orthopaedic practice. Front Digit Health 2023; 5:1137066. [PMID: 37408539 PMCID: PMC10318339 DOI: 10.3389/fdgth.2023.1137066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 06/05/2023] [Indexed: 07/07/2023] Open
Abstract
Background A core set of requirements for designing AI-based Health Recommender Systems (HRS) is a thorough understanding of human factors in a decision-making process. Patient preferences regarding treatment outcomes can be one important human factor. For orthopaedic medicine, limited communication may occur between a patient and a provider during the short duration of a clinical visit, limiting the opportunity for the patient to express treatment outcome preferences (TOP). This may occur despite patient preferences having a significant impact on achieving patient satisfaction, shared decision making and treatment success. Inclusion of patient preferences during patient intake and/or during the early phases of patient contact and information gathering can lead to better treatment recommendations. Aim We aim to explore patient treatment outcome preferences as significant human factors in treatment decision making in orthopedics. The goal of this research is to design, build, and test an app that collects baseline TOPs across orthopaedic outcomes and reports this information to providers during a clinical visit. This data may also be used to inform the design of HRSs for orthopaedic treatment decision making. Methods We created a mobile app to collect TOPs using a direct weighting (DW) technique. We used a mixed methods approach to pilot test the app with 23 first-time orthopaedic visit patients presenting with joint pain and/or function deficiency by presenting the app for utilization and conducting qualitative interviews and quantitative surveys post utilization. Results The study validated five core TOP domains, with most users dividing their 100-point DW allocation across 1-3 domains. The tool received moderate to high usability scores. Thematic analysis of patient interviews provides insights into TOPs that are important to patients, how they can be communicated effectively, and incorporated into a clinical visit with meaningful patient-provider communication that leads to shared decision making. Conclusion Patient TOPs may be important human factors to consider in determining treatment options that may be helpful for automating patient treatment recommendations. We conclude that inclusion of patient TOPs to inform the design of HRSs results in creating more robust patient treatment profiles in the EHR thus enhancing opportunities for treatment recommendations and future AI applications.
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Affiliation(s)
- Akanksha Singh
- Department of Integrated Information Technology, College of Engineering and Computing, University of South Carolina, Columbia, SC, United States
- Center for Effectiveness Research in Orthopaedics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Benjamin Schooley
- Center for Effectiveness Research in Orthopaedics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
- Department of Electrical and Computer Engineering, Ira A. Fulton College of Engineering, Brigham Young University, Provo, UT, United States
| | - Sarah B. Floyd
- Center for Effectiveness Research in Orthopaedics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
- Department of Public Health Sciences, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, SC, United States
| | - Stephen G. Pill
- Orthopedic Sports Medicine, Shoulder Orthopedic Surgery, PRISMA Health, Greenville, SC, United States
| | - John M. Brooks
- Center for Effectiveness Research in Orthopaedics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
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Kuliński W, Wrzesińska M. Quality of Life in Patients After Hip Arthroplasty. ACTA BALNEOLOGICA 2022. [DOI: 10.36740/abal202205101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Aim: The aim of this study was to assess the efficacy of rehabilitation after hip arthroplasty and compare the quality of life in patients before and after surgery.
Material and Methods: A total of 30 patients after hip arthroplasty were examined at the ConcordiaSalus Inpatient Rehabilitation Centre in Osieczek. Study patients participated in a physical therapy and rehabilitation programme, which included kinesiotherapy, massage and physical therapy procedures. A 28 -question survey questionnaire was used as a research tool.
Results: 1. Pain severity in patients after hip arthroplasty and rehabilitation was lower than that experienced before surgery.2. Hip arthroplasty visibly improved the quality of life.3.The postoperative level of physical fitness was considerably higher than the preoperative level of fitness.4. Patients are happy and satisfied with the effects of hip arthroplasty.
Conclusions: Physical therapy and rehabilitation constitute an important and basic part of treatment in patients following hip arthroplasty.
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Affiliation(s)
- Włodzisław Kuliński
- Department of Rehabilitation, Military Institute of Medicine, Warsaw, Poland
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Kennedy BL, Currie GR, Kania-Richmond A, Emery CA, MacKean G, Marshall DA. Factors That Patients Consider in Their Choice of Non-Surgical Management for Hip and Knee Osteoarthritis: Formative Qualitative Research for a Discrete Choice Experiment. THE PATIENT 2022; 15:537-550. [PMID: 35292937 DOI: 10.1007/s40271-022-00577-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/17/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Approximately half of patients with hip and knee osteoarthritis have tried non-surgical management before surgical consultation. Understanding the many factors affecting the uptake of recommended strategies is important to inform future development of such management strategies. OBJECTIVES The aim of this study was to explore and identify factors that patients with osteoarthritis consider when choosing non-surgical management for hip and knee osteoarthritis, as formative research for a study of patient preferences for non-surgical management programs for osteoarthritis. METHODS A qualitative research design was used. Participants were recruited using a combination of stratified and convenience sampling. Interviews were conducted, using a semi-structured interview guide, with English-speaking patients who had self-reported hip and/or knee osteoarthritis and at least one joint that had not undergone replacement surgery. Data were thematically analyzed. RESULTS Thirteen patients participated in these interviews. Sixteen factors that participants considered when choosing non-surgical osteoarthritis management were identified. Eleven were extrinsic, relating to features of programs and services, and are categorized as types of interventions, general program and service details, and program-specific details. Five were intrinsic to the individual and influenced how decisions for osteoarthritis management were approached and the options available to choose from. Three novel factors included participants' desire for further management, their views about joint replacement surgery, and whether they felt personal choice was available in osteoarthritis management strategies. CONCLUSION Key factors were identified that patients considered when making decisions about non-surgical management for their osteoarthritis that will be used to inform a discrete choice experiment (DCE) that aims to measure preferences for these factors.
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Affiliation(s)
- Bryanne L Kennedy
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Gillian R Currie
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Alberta, Canada
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Alberta, Canada
- O'Brien Institute of Public Health, University of Calgary, Alberta, Canada
| | - Ania Kania-Richmond
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Alberta, Canada
- Bone and Joint Health Strategic Clinical Network, Alberta Health Services, Alberta, Canada
| | - Carolyn A Emery
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Alberta, Canada
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Alberta, Canada
- O'Brien Institute of Public Health, University of Calgary, Alberta, Canada
- Sport Injury Prevention Research Center, Faculty of Kinesiology, University of Calgary, Alberta, Canada
- McCaig Institute for Bone and Joint Health, University of Calgary, Alberta, Canada
| | - Gail MacKean
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Deborah A Marshall
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Alberta, Canada.
- Alberta Children's Hospital Research Institute, University of Calgary, Alberta, Canada.
- O'Brien Institute of Public Health, University of Calgary, Alberta, Canada.
- McCaig Institute for Bone and Joint Health, University of Calgary, Alberta, Canada.
- Health Research Innovation Centre, University of Calgary, Room 3C56, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada.
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Moreton SG, Salkeld G, Wortley S, Jeon YH, Urban H, Hunter DJ. The development and utility of a multicriteria patient decision aid for people contemplating treatment for osteoarthritis. Health Expect 2022; 25:2775-2785. [PMID: 36039824 DOI: 10.1111/hex.13505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 04/03/2022] [Accepted: 04/06/2022] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND There are a range of treatment options for osteoarthritis (OA) of the knee and hip, each with a unique profile of risks and benefits. Patient decision aids can help incorporate patient preferences in treatment decision-making. The aim of this study was to develop and test the utility of a patient decision aid for OA that was developed using a multicriteria decision analytic framework. METHODS People contemplating treatment for OA who had accessed the website myjointpain.org.au were invited to participate in the study by using the online patient decision aid. Two forms of the patient decision aid were created: A shorter form and a longer form, which allowed greater customization that was offered to respondents after they had completed the shorter form. Respondents also completed questions asking about their experience using the patient decision aid. RESULTS A total of 625 self-selected respondents completed the short-form and 180 completed the long-form. Across both forms, serious side effects, pain and function were rated as the most important treatment outcomes. Most respondents (64%) who completed the longer form reported that using the tool was a positive experience, 38% reported that using the tool had changed their mind and 48% said that using the tool would improve the quality of their decision-making. CONCLUSIONS Overall, the findings suggest that this patient decision aid may be of use to a substantial number of people in facilitating appropriate treatment decision-making. PATIENT OR PUBLIC CONTRIBUTION Service users of myjointpain.org.au were involved through their participation in the study, and their feedback will guide the development of future iterations of the tool.
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Affiliation(s)
- Sam G Moreton
- School of Psychology, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, New South Wales, Australia
| | - Glenn Salkeld
- Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, New South Wales, Australia
| | - Sally Wortley
- Consumer Evidence and Engagement Unit, Australian Department of Health, Sydney, New South Wales, Australia
| | - Yun-Hee Jeon
- Sydney Nursing School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Hema Urban
- Rheumatology Department, Institute of Bone and Joint Research, The Kolling Institute, Royal North Shore Hospital, The University of Sydney, Sydney, New South Wales, Australia
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Arslan IG, Huls SPI, de Bekker-Grob EW, Rozendaal R, Persoons MCT, Spruijt-van Hell ME, Bindels PJE, Bierma-Zeinstra SMA, Schiphof D. Patients', healthcare providers', and insurance company employees' preferences for knee and hip osteoarthritis care: a discrete choice experiment. Osteoarthritis Cartilage 2020; 28:1316-1324. [PMID: 32682071 DOI: 10.1016/j.joca.2020.07.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 07/01/2020] [Accepted: 07/06/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine patients', healthcare providers', and insurance company employees' preferences for knee and hip osteoarthritis (KHOA) care. DESIGN In a discrete choice experiment, patients with KHOA or a joint replacement, healthcare providers, and insurance company employees were repetitively asked to choose between KHOA care alternatives that differed in six attributes: waiting times, out of pocket costs, travel distance, involved healthcare providers, duration of consultation, and access to specialist equipment. A (panel latent class) conditional logit model was used to determine preference heterogeneity and relative importance of the attributes. RESULTS Patients (n = 648) and healthcare providers (n = 76) valued low out of pocket costs most, while insurance company employees (n = 150) found a joint consultation by general practitioner (GP) and orthopaedist most important. Patients found the duration of consultation less important than healthcare providers and insurance company employees did. Patients without a joint replacement were likely to prefer healthcare with low out of pocket costs. Patients with a joint replacement and/or low disease-specific quality of life were likely to prefer healthcare from an orthopaedist. Patients who already received healthcare for knee/hip problems were likely to prefer a joint consultation by GP and orthopaedist, and direct access to specialist equipment. CONCLUSIONS Patients, healthcare providers, and insurance company employees highly prefer a joint consultation by GP and orthopaedist with low out of pocket costs. Within patients, there is substantial preference heterogeneity. These results can be used by policy makers and healthcare providers to choose the most optimal combination of KHOA care aligned to patients' preferences.
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Affiliation(s)
- I G Arslan
- Department of General Practice, Erasmus MC University Medical Center, Rotterdam, the Netherlands.
| | - S P I Huls
- Erasmus School of Health Policy & Management, Erasmus University, Rotterdam, the Netherlands; Erasmus Choice Modelling Centre, Erasmus University, Rotterdam, the Netherlands
| | - E W de Bekker-Grob
- Erasmus School of Health Policy & Management, Erasmus University, Rotterdam, the Netherlands; Erasmus Choice Modelling Centre, Erasmus University, Rotterdam, the Netherlands
| | - R Rozendaal
- Department of General Practice, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - M C T Persoons
- CZ Health Insurance, Innovation and Advice, Tilburg, the Netherlands
| | | | - P J E Bindels
- Department of General Practice, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - S M A Bierma-Zeinstra
- Department of General Practice, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Orthopaedics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - D Schiphof
- Department of General Practice, Erasmus MC University Medical Center, Rotterdam, the Netherlands
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Choojaturo S, Sindhu S, Utriyaprasit K, Viwatwongkasem C. Factors associated with access to health services and quality of life in knee osteoarthritis patients: a multilevel cross-sectional study. BMC Health Serv Res 2019; 19:688. [PMID: 31604433 PMCID: PMC6788102 DOI: 10.1186/s12913-019-4441-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 08/20/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The main purpose of health service systems is to improve patients' quality of life (QoL) and to ensure equitable access to health services. However, in reality, nearly half of knee osteoarthritis (OA) patients present to the health system do not have access to health services, and their QoL remains poor. These circumstances raise important questions about what (if any) factors can improve health care accessibility and QoL for knee OA patients. METHODS A multicenter, cross-sectional survey was performed with 618 knee OA patients who received care at 16 hospitals in Thailand. Structural equation modeling (SEM) was conducted to investigate the association of health service factors and patient factors with access to health services and QoL. RESULTS The QoL of knee OA patients was very poor (mean score = 33.8). Only 2.1% of the knee OA patients found it easy to obtain medical care when needed. Approximately 39.4% of them were able to access appropriate interventions before being referred for knee replacement. More than 85% of orthopedic health services had implemented chronic disease management (CDM) policy into practice. However, the implementation was basic, with an average score of 5.9. SEM showed that QoL was determined by both health system factors (β = .10, p = .01) and patient factors (β = .29, p = .00 for self-management and β = -.49, p = .00 for disease factors). Access to health services was determined by self-management (β = .10, p = .01), but it was not significantly associated with QoL (β = .00, p = 1.0). CONCLUSIONS This study provides compelling information about self-management, access to health services and QoL from the individual and health service system perspectives. Furthermore, it identifies a need to develop health services that are better attuned to the patient's background, such as socioeconomic status, disease severity, and self-management skills.
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Affiliation(s)
- Siriwan Choojaturo
- Department of Surgical Nursing, Faculty of Nursing, Mahidol University, Bangkok, 10700, Thailand.,Department of Biostatistics, Faculty of Public Health, Mahidol University, Bangkok, 10400, Thailand
| | - Siriorn Sindhu
- Mahidol University, Faculty of Nursing, 2 Wang Lang Road, Siriraj, Bangkoknoi, Bangkok, 10700, Thailand.
| | - Ketsarin Utriyaprasit
- Department of Surgical Nursing, Faculty of Nursing, Mahidol University, Bangkok, 10700, Thailand
| | - Chukiat Viwatwongkasem
- Department of Biostatistics, Faculty of Public Health, Mahidol University, Bangkok, 10400, Thailand
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Huber M, Kurz C, Leidl R. Predicting patient-reported outcomes following hip and knee replacement surgery using supervised machine learning. BMC Med Inform Decis Mak 2019; 19:3. [PMID: 30621670 PMCID: PMC6325823 DOI: 10.1186/s12911-018-0731-6] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 12/27/2018] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Machine-learning classifiers mostly offer good predictive performance and are increasingly used to support shared decision-making in clinical practice. Focusing on performance and practicability, this study evaluates prediction of patient-reported outcomes (PROs) by eight supervised classifiers including a linear model, following hip and knee replacement surgery. METHODS NHS PRO data (130,945 observations) from April 2015 to April 2017 were used to train and test eight classifiers to predict binary postoperative improvement based on minimal important differences. Area under the receiver operating characteristic, J-statistic and several other metrics were calculated. The dependent outcomes were generic and disease-specific improvement based on the EQ-5D-3L visual analogue scale (VAS) as well as the Oxford Hip and Knee Score (Q score). RESULTS The area under the receiver operating characteristic of the best training models was around 0.87 (VAS) and 0.78 (Q score) for hip replacement, while it was around 0.86 (VAS) and 0.70 (Q score) for knee replacement surgery. Extreme gradient boosting, random forests, multistep elastic net and linear model provided the highest overall J-statistics. Based on variable importance, the most important predictors for post-operative outcomes were preoperative VAS, Q score and single Q score dimensions. Sensitivity analysis for hip replacement VAS evaluated the influence of minimal important difference, patient selection criteria as well as additional data years. Together with a small benchmark of the NHS prediction model, robustness of our results was confirmed. CONCLUSIONS Supervised machine-learning implementations, like extreme gradient boosting, can provide better performance than linear models and should be considered, when high predictive performance is needed. Preoperative VAS, Q score and specific dimensions like limping are the most important predictors for postoperative hip and knee PROMs.
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Affiliation(s)
- Manuel Huber
- German Research Center for Environmental Health, Institute for Health Economics and Health Care Management, Helmholtz Zentrum München, Postfach 1129, 85758 Neuherberg, Germany
| | - Christoph Kurz
- German Research Center for Environmental Health, Institute for Health Economics and Health Care Management, Helmholtz Zentrum München, Postfach 1129, 85758 Neuherberg, Germany
| | - Reiner Leidl
- German Research Center for Environmental Health, Institute for Health Economics and Health Care Management, Helmholtz Zentrum München, Postfach 1129, 85758 Neuherberg, Germany
- Munich Center of Health Sciences, Ludwig-Maximilians-University, Ludwigstr. 28, 80539 Munich, RG Germany
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Hackett KL, Deane KHO, Newton JL, Deary V, Bowman SJ, Rapley T, Ng WF. Mixed-Methods Study Identifying Key Intervention Targets to Improve Participation in Daily Living Activities in Primary Sjögren's Syndrome Patients. Arthritis Care Res (Hoboken) 2018; 70:1064-1073. [PMID: 29409110 PMCID: PMC6033158 DOI: 10.1002/acr.23536] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 01/30/2018] [Indexed: 12/11/2022]
Abstract
Objective Functional ability and participation in life situations are compromised in many primary Sjögren's syndrome (SS) patients. This study aimed to identify the key barriers and priorities to participation in daily living activities, in order to develop potential future interventions. Methods Group concept mapping, a semiquantitative, mixed‐methods approach was used to identify and structure ideas from UK primary SS patients, adult household members living with a primary SS patient, and health care professionals. Brainstorming generated ideas, which were summarized into a final set of statements. Participants individually arranged these statements into themes and rated each statement for importance. Multidimensional scaling and hierarchical cluster analysis were applied to sorted and rated data to produce visual representations of the ideas (concept maps), enabling identification of agreed priority areas for interventions. Results A total of 121 patients, 43 adult household members, and 67 health care professionals took part. In sum, 463 ideas were distilled down to 94 statements. These statements were grouped into 7 clusters: Patient Empowerment, Symptoms, Wellbeing, Access and Coordination of Health Care, Knowledge and Support, Public Awareness and Support, and Friends and Family. Patient Empowerment and Symptoms were rated as priority conceptual themes. Important statements within priority clusters indicate patients should be taken seriously and supported to self‐manage symptoms of oral and ocular dryness, fatigue, pain, and poor sleep. Conclusion Our data highlighted the fact that in addition to managing primary SS symptoms, interventions aiming to improve patient empowerment, general wellbeing, access to health care, patient education, and social support are important to facilitate improved participation in daily living activities.
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Affiliation(s)
- Katie L Hackett
- Newcastle University Newcastle upon Tyne Hospitals National Health Service Foundation Trust, and Northumbria University, Newcastle upon Tyne, UK
| | | | - Julia L Newton
- Newcastle University and Newcastle upon Tyne Hospitals National Health Service Foundation Trust, Newcastle upon Tyne, UK
| | - Vincent Deary
- Newcastle upon Tyne Hospitals National Health Service Foundation Trust and Northumbria University, Newcastle upon Tyne, UK
| | | | - Tim Rapley
- Newcastle University and Northumbria University, Newcastle upon Tyne, UK
| | - Wan-Fai Ng
- Newcastle University and Newcastle upon Tyne Hospitals National Health Service Foundation Trust, Newcastle upon Tyne, UK
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Selten EMH, Vriezekolk JE, Schers HJ, Nijhof MW, van der Laan WH, van der Meulen-Dilling RG, Geenen R, van den Ende CHM. Development of the "Treatment beliefs in knee and hip OsteoArthritis (TOA)" questionnaire. BMC Musculoskelet Disord 2017; 18:402. [PMID: 28927387 PMCID: PMC5606114 DOI: 10.1186/s12891-017-1762-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 09/14/2017] [Indexed: 12/17/2022] Open
Abstract
Background Use of conservative treatment modalities in osteoarthritis (OA) is suboptimal, which appears to be partly due to patients’ beliefs about treatments. The aim of this study was to develop a research instrument assessing patients’ beliefs about various treatment modalities of hip and knee OA: the ‘Treatment beliefs in OA (TOA) questionnaire’. Methods The item pool that was retrieved from interviews with patients and healthcare providers comprised beliefs regarding five treatment modalities: physical activity, pain medication, physiotherapy, injections and arthroplasty. After an extensive selection procedure, a draft questionnaire with 200 items was constructed. Descriptive analyses and exploratory factor analyses with oblique rotation were conducted for each treatment modality separately to decide upon the final questionnaire. Internal consistency and test-retest reliability were determined. Results The final questionnaire comprised 60 items. It was completed by 351 patients with knee or hip OA. Each of the five treatment modalities yielded a two factor solution with 37% to 51% explained variance and high face validity. Factor I included ‘positive treatment beliefs’ and factor II ‘negative treatment beliefs’. Internal consistency (Cronbach α’s from 0.72 to 0.87) and test-retest reliability (i.e. intraclass correlation coefficient from 0.66–0.88; standard error of measurement from 0.06–0.11) were satisfactory to good. Conclusions The TOA questionnaire is the first questionnaire assessing positive and negative treatment beliefs regarding five treatment modalities for knee and hip OA. The instrument will help to understand whether and to what extent treatment beliefs influence treatment choices. Electronic supplementary material The online version of this article (10.1186/s12891-017-1762-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ellen M H Selten
- Department of Rheumatology, Sint Maartenskliniek, Sint Maartenskliniek, P.O. Box 9011, 6500, GM, Nijmegen, The Netherlands.
| | - Johanna E Vriezekolk
- Department of Rheumatology, Sint Maartenskliniek, Sint Maartenskliniek, P.O. Box 9011, 6500, GM, Nijmegen, The Netherlands
| | - Henk J Schers
- Department of Primary and Community Care, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Marc W Nijhof
- Department of Orthopedics, Sint Maartenskliniek, Nijmegen, The Netherlands
| | | | | | - Rinie Geenen
- Department of Psychology, Utrecht University, Utrecht, The Netherlands
| | - Cornelia H M van den Ende
- Department of Rheumatology, Sint Maartenskliniek, Sint Maartenskliniek, P.O. Box 9011, 6500, GM, Nijmegen, The Netherlands
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