1
|
Yuen SKK, Bower W, Ng CF, Chiu PKF, Teoh JYC, Li CSY, Kwok HSW, Chan CK, Hou SSM. Cross-cultural translation into Chinese and psychometric evaluation of a screening tool for nocturia: the Targeting the individual's Aetiology of Nocturia to Guide Outcomes (TANGO) questionnaire. Hong Kong Med J 2023; 29:311-321. [PMID: 37532669 DOI: 10.12809/hkmj219261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2023] Open
Abstract
INTRODUCTION We conducted translation and psychometric validation of a self-administered, 22-item dichotomous response-based questionnaire to identify nocturia aetiologies and co-morbidities in adult patients. METHODS The Targeting the individual's Aetiology of Nocturia to Guide Outcomes (TANGO) questionnaire was forward- and backward-translated, then finalised using a standardised methodology. The resulting version, a Chinese version of the TANGO [TANGO (CV)], was evaluated for internal consistency, test-retest reliability, content validity, convergent validity, criterion validity, and discriminant validity via responses from 65 participants (46 men and 19 women; mean age, 67 years, range, 50-88), in comparison with other validated questionnaires and a 4-day bladder/sleep diary. RESULTS Only 0.4% of responses were missing; 3% of participants required assistance with comprehension. The Kuder-Richardson Formula 20 (KR-20) coefficient for the whole tool was 0.711. Kappa values for individual domains and the whole tool varied from 0.871 to 0.866, indicating satisfactory test-retest reliability. There was strong agreement between the sum of positive responses to each domain and the whole tool (intra-class correlation coefficient=0.878-1.000). Modest correlations (ρ=0.4-0.6) were detected between the tool and bladder/sleep diary-based parameters for convergent validity. Criterion validity was confirmed for each domain and the whole tool [ρ=0.287-0.687]. In receiver operating characteristic analysis, the tool could distinguish patients (≥2 nocturia episodes/night) from controls (≤1 nocturia episode/night) [Youden's J statistic=0.453, area under the curve=0.818, 95% confidence interval (CI)=0.683-0.953] and patients with significant nocturia distress from patients with mild nocturia distress (Youden's J statistic=0.398, area under the curve=0.729, 95% CI=0.581-0.878). CONCLUSION The TANGO (CV) was formally crossculturally adapted and translated. Its psychometric properties (except sensitivity to change) were validated.
Collapse
Affiliation(s)
- S K K Yuen
- SH Ho Urology Centre, Division of Urology, Department of Surgery, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - W Bower
- SH Ho Urology Centre, Division of Urology, Department of Surgery, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - C F Ng
- SH Ho Urology Centre, Division of Urology, Department of Surgery, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - P K F Chiu
- SH Ho Urology Centre, Division of Urology, Department of Surgery, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - J Y C Teoh
- SH Ho Urology Centre, Division of Urology, Department of Surgery, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - C S Y Li
- SH Ho Urology Centre, Division of Urology, Department of Surgery, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - H S W Kwok
- SH Ho Urology Centre, Division of Urology, Department of Surgery, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - C K Chan
- SH Ho Urology Centre, Division of Urology, Department of Surgery, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - S S M Hou
- SH Ho Urology Centre, Division of Urology, Department of Surgery, The Chinese University of Hong Kong, Hong Kong SAR, China
| |
Collapse
|
2
|
Ng CF, Mak CWH, Chan SYS, Li ML, Leung CH, Teoh JYC, Chiu PKF, Chu PSK. Disease-related complications in patients with metastatic hormone-sensitive prostate cancer. Hong Kong Med J 2023; 29:324-329. [PMID: 37424071 DOI: 10.12809/hkmj219523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023] Open
Abstract
INTRODUCTION Prostate-specific antigen-based screening for prostate cancer reportedly does not improve cancer-specific survival. However, there remain concerns about the increasing incidence of advanced disease at initial presentation. Here, we investigated the incidences and types of complications that occur during the course of disease in patients with metastatic hormone-sensitive prostate cancer (mHSPC). METHODS This study included 100 consecutive patients who were diagnosed with mHSPC at five hospitals from January 2016 to August 2017. Analyses were conducted using patient data extracted from a prospectively collected database, along with information about complications and readmission obtained from electronic medical records. RESULTS The median patient age was 74 years and the median serum prostate-specific antigen level at diagnosis was 202.5 ng/mL. Ninety-nine patients received androgen deprivation therapy; 17 of these patients also received chemotherapy. During a mean follow-up period of 32.9 months, 41 patients reported bone pain; of these patients, 21 developed pathologic fractures and eight had cord compression. Twenty-eight patients developed retention of urine; of these patients, 10 (36%) required surgery and 11 (39%) required long-term urethral catheter use. Among 15 patients who developed ureteral obstruction, four (27%) required ureteral stenting and four (27%) required long-term nephrostomy drainage. Other complications included anaemia (41%) and deep vein thrombosis (4%). Fifty-nine (59%) patients had ≥1 unplanned hospital admission during the course of disease; 16% of such patients had >5 episodes of readmission. CONCLUSION Among patients with mHSPC, 70% experienced disease-related complications and unplanned hospital admissions, which substantially burdened both patients and the healthcare system.
Collapse
Affiliation(s)
- C F Ng
- Department of Surgery, SH Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - C W H Mak
- Department of Surgery, SH Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - S Y S Chan
- Department of Surgery, SH Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - M L Li
- Department of Surgery, Tuen Mun Hospital, Hong Kong SAR, China
| | - C H Leung
- Department of Surgery, SH Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - J Y C Teoh
- Department of Surgery, SH Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - P K F Chiu
- Department of Surgery, SH Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - P S K Chu
- Department of Surgery, Tuen Mun Hospital, Hong Kong SAR, China
| |
Collapse
|
3
|
Ng CF, Lim K, Yee CH, Chiu PKF, Teoh JYC, Lai FPT. Time for change? Feasibility of introducing micromodules into medical student education: a randomised controlled trial. Hong Kong Med J 2023; 29:208-213. [PMID: 37349137 DOI: 10.12809/hkmj219267] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023] Open
Abstract
INTRODUCTION Didactic lectures have been the foundation of learning for many medical students. However, in recent years, the flipped classroom model has become increasingly popular in medical education. This approach enhances pre-class learning, allowing the limited contact time between clinicians and medical students to be focused on practical issues. This study evaluated the effectiveness and non-inferiority of online micromodule teaching in terms of knowledge transfer concerning specific urology topics. METHODS Medical students without prior exposure to the urology subspecialty were enrolled in the study, then randomised to a traditional didactic lecture group or an online micromodule group. Knowledge transfer was assessed by pre-intervention and post-intervention multiple-choice questions and objective structured clinical examinations that involved the acquisition of medical histories from real patients. RESULTS In total, 45 medical students were enrolled (22 in the traditional didactic group and 23 in the online micromodule group). In terms of knowledge transfer (assessed by objective structured clinical examinations), the efficacy of online micromodules was comparable to traditional didactic lectures, although the difference was not statistically significant (P=0.823). There were no significant differences in terms of knowledge acquisition, retention, or clinical application between the two groups. CONCLUSION In terms of acquiring, retaining, and applying foundational urological knowledge, online micromodules can help medical students to achieve outcomes comparable with the outcomes of didactic lectures. Online micromodules may be a viable alternative to traditional didactic lectures in urology education.
Collapse
Affiliation(s)
- C F Ng
- Department of Surgery, SH Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - K Lim
- Department of Surgery, SH Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - C H Yee
- Department of Surgery, SH Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - P K F Chiu
- Department of Surgery, SH Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - J Y C Teoh
- Department of Surgery, SH Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - F P T Lai
- Department of Surgery, SH Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong SAR, China
| |
Collapse
|
4
|
Chan VWS, Ong WLK, Chiu PKF, Teoh JYC. 979 Delayed Surgery for Localised and Metastatic Renal Cell Carcinoma: A Systematic Review and Meta-Analysis for the COVID-19 Pandemic. Br J Surg 2021. [PMCID: PMC8135696 DOI: 10.1093/bjs/znab134.594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Introduction
COVID-19 have delayed treatments for cancer; hence we performed a systematic review on the oncological effects of active surveillance (AS), delayed intervention (DI) and sequencing of cytoreductive nephrectomy (CN) and target therapy (TT) on localised and metastatic renal cell carcinoma (RCC). PROSPERO: CRD42020190882
Method
Both randomised controlled trials and observational studies related to the study were included in this review after a comprehensive search and screening.
Results
A total of 2065 potential eligible records were identified. 23 studies were included for quantitative analysis. In meta-analysis, no significant difference was found between the patients who underwent AS/DI and PN/RN for overall survival (OS) (HR 1.36, 95% CI 0.99-1.87, p = 0.06), while cancer-specific survival is significantly worsened (CSS) (HR 1.67, 95% CI 1.23-2.27, p < 0.01) in AS/DI patients. In other localised stages, results are contradicting amongst literature. Upfront TT followed by deferred CN is associated with better OS when compared to upfront CN followed by deferred TT (HR 0.53, 95% CI 0.41-0.69, p = 0.00) in metastatic patients.
Conclusions
Based on low quality evidence, AS and DI is no inferior to immediate surgical intervention in well selected T1a patient’s OS but not CSS. Upfront TT followed by deferred CN improves OS and progression free survival.
Collapse
Affiliation(s)
- V W S Chan
- University of Leeds, Leeds, United Kingdom
| | - W L K Ong
- Peneng General Hospital, Peneng, Malaysia
| | - P K F Chiu
- The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - J Y C Teoh
- The Chinese University of Hong Kong, Hong Kong, Hong Kong
| |
Collapse
|
5
|
Yee CH, Wong HF, Tam MHM, Yuen SKK, Chan HC, Cheung MH, Yu ATO, Chiu Y, Chan NH, Leung LH, Ng ATL, Law DMC, Ng TL, Teoh JYC, Chiu PKF, Ng CF. Effect of SARS and COVID-19 outbreaks on urology practice and training. Hong Kong Med J 2021; 27:258-265. [PMID: 33632937 DOI: 10.12809/hkmj208822] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION The objective was to investigate the changes in urology practice during coronavirus disease 2019 (COVID-19) pandemic with a perspective from our experience with severe acute respiratory syndrome (SARS) in 2003. METHODS Institutional data from all urology centres in the Hong Kong public sector during the COVID-19 pandemic (1 Feb 2020-31 Mar 2020) and a non-COVID-19 control period (1 Feb 2019-31 Mar 2019) were acquired. An online anonymous questionnaire was used to gauge the impact of COVID-19 on resident training. The clinical output of tertiary centres was compared with data from the SARS period. RESULTS The numbers of operating sessions, clinic attendance, cystoscopy sessions, prostate biopsy, and shockwave lithotripsy sessions were reduced by 40.5%, 28.5%, 49.6%, 44.8%, and 38.5%, respectively, across all the centres reviewed. The mean numbers of operating sessions before and during the COVID-19 pandemic were 85.1±30.3 and 50.6±25.7, respectively (P=0.005). All centres gave priority to cancer-related surgeries. Benign prostatic hyperplasia-related surgery (39.1%) and ureteric stone surgery (25.5%) were the most commonly delayed surgeries. The degree of reduction in urology services was less than that during SARS (47.2%, 55.3%, and 70.5% for operating sessions, cystoscopy, and biopsy, respectively). The mean numbers of operations performed by residents before and during the COVID-19 pandemic were 75.4±48.0 and 34.9±17.2, respectively (P=0.002). CONCLUSION A comprehensive review of urology practice during the COVID-19 pandemic revealed changes in every aspect of practice.
Collapse
Affiliation(s)
- C H Yee
- SH Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong.,Department of Surgery, Prince of Wales Hospital, Shatin, Hong Kong
| | - H F Wong
- SH Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong.,Department of Surgery, Prince of Wales Hospital, Shatin, Hong Kong
| | - M H M Tam
- SH Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong.,Department of Surgery, Alice Ho Miu Ling Nethersole Hospital, Hong Kong
| | - S K K Yuen
- SH Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong.,Department of Surgery, North District Hospital, Hong Kong
| | - H C Chan
- Department of Surgery, United Christian Hospital, Hong Kong
| | - M H Cheung
- Department of Surgery, Tseung Kwan O Hospital, Hong Kong
| | - A T O Yu
- Department of Surgery, Tuen Mun Hospital, Hong Kong.,Department of Surgery, Pok Oi Hospital, Hong Kong
| | - Y Chiu
- Department of Surgery, Princess Margaret Hospital, Hong Kong
| | - N H Chan
- Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Hong Kong
| | - L H Leung
- Department of Surgery, Kwong Wah Hospital, Hong Kong
| | - A T L Ng
- Department of Surgery, Queen Mary Hospital, Hong Kong.,Department of Surgery, Tung Wah Hospital, Hong Kong
| | - D M C Law
- Department of Surgery, Caritas Medical Centre, Hong Kong
| | - T L Ng
- Department of Surgery, Queen Elizabeth Hospital, Hong Kong
| | - J Y C Teoh
- SH Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong.,Department of Surgery, Prince of Wales Hospital, Shatin, Hong Kong
| | - P K F Chiu
- SH Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong.,Department of Surgery, Prince of Wales Hospital, Shatin, Hong Kong
| | - C F Ng
- SH Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong.,Department of Surgery, Prince of Wales Hospital, Shatin, Hong Kong
| |
Collapse
|
6
|
Chiu PKF, Ng CF. Primum non nocere (first, to do no harm) in prostate biopsy. Hong Kong Med J 2019; 25:344-345. [PMID: 31761746 DOI: 10.12809/hkmj195088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- P K F Chiu
- SH Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - C F Ng
- SH Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Shatin, Hong Kong
| |
Collapse
|
7
|
Yee CH, Chan CK, Teoh JYC, Chiu PKF, Wong JHM, Chan ESY, Hou SSM, Ng CF. Survey on prevalence of lower urinary tract symptoms in an Asian population. Hong Kong Med J 2019; 25:13-20. [PMID: 30655460 DOI: 10.12809/hkmj187502] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Lower urinary tract symptoms (LUTS) have a strong effect on socio-economic and individual quality of life. The aim of the present study was to investigate the prevalence of LUTS in an Asian population. METHODS A telephone survey of individuals aged ≥40 years and of Chinese ethnicity was conducted. The survey included basic demographics, medical and health history, drinking habits, International Prostate Symptom Score, overactive bladder symptom score, Patient Health Questionnaire (PHQ-9) score, and Short Form (SF)-12v2 score. RESULTS From March to May 2017, 18 881 calls were made, of which 1543 fulfilled the inclusion criteria. In the end, 1000 successful respondents were recruited (302 men and 698 women). Age-adjusted prevalence of overactive bladder syndrome was 15.1%. The older the respondent, the more prevalent the storage symptoms and voiding symptoms (storage symptoms: r=0.434, P<0.001; voiding symptom: r=0.190, P<0.001). Presence of hypertension and diabetes were found to be significantly and positively correlated with storage and voiding symptoms. Storage and voiding symptoms were found to affect PHQ-9 scores (storage symptoms: r=0.257, P<0.001; voiding symptoms: r=0.275, P<0.001) and SF-12v2 scores (storage symptoms: r=0.467, P<0.001; voiding symptoms: r=0.335; P<0.001). Nocturia was the most prominent symptom among patients who sought medical help for their LUTS. CONCLUSIONS Lower urinary tract symptoms are common in Asian populations. Both storage and voiding symptoms have a negative impact on mental health and general well-being of individuals.
Collapse
Affiliation(s)
- C H Yee
- SH Ho Urology Centre, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - C K Chan
- SH Ho Urology Centre, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - J Y C Teoh
- SH Ho Urology Centre, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - P K F Chiu
- SH Ho Urology Centre, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - J H M Wong
- SH Ho Urology Centre, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - E S Y Chan
- SH Ho Urology Centre, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - S S M Hou
- SH Ho Urology Centre, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - C F Ng
- SH Ho Urology Centre, The Chinese University of Hong Kong, Shatin, Hong Kong
| |
Collapse
|