1
|
McDonald C, Camino E, Escandon R, Finkel RS, Fischer R, Flanigan K, Furlong P, Juhasz R, Martin AS, Villa C, Sweeney HL. Draft Guidance for Industry Duchenne Muscular Dystrophy, Becker Muscular Dystrophy, and Related Dystrophinopathies - Developing Potential Treatments for the Entire Spectrum of Disease. J Neuromuscul Dis 2024; 11:499-523. [PMID: 38363616 DOI: 10.3233/jnd-230219] [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: 02/17/2024]
Abstract
Background Duchenne muscular dystrophy (DMD) and related dystrophinopathies are neuromuscular conditions with great unmet medical needs that require the development of effective medical treatments. Objective To aid sponsors in clinical development of drugs and therapeutic biological products for treating DMD across the disease spectrum by integrating advancements, patient registries, natural history studies, and more into a comprehensive guidance. Methods This guidance emerged from collaboration between the FDA, the Duchenne community, and industry stakeholders. It entailed a structured approach, involving multiple committees and boards. From its inception in 2014, the guidance underwent revisions incorporating insights from gene therapy studies, cardiac function research, and innovative clinical trial designs. Results The guidance provides a deeper understanding of DMD and its variants, focusing on patient engagement, diagnostic criteria, natural history, biomarkers, and clinical trials. It underscores patient-focused drug development, the significance of dystrophin as a biomarker, and the pivotal role of magnetic resonance imaging in assessing disease progression. Additionally, the guidance addresses cardiomyopathy's prominence in DMD and the burgeoning field of gene therapy. Conclusions The updated guidance offers a comprehensive understanding of DMD, emphasizing patient-centric approaches, innovative trial designs, and the importance of biomarkers. The focus on cardiomyopathy and gene therapy signifies the evolving realm of DMD research. It acts as a crucial roadmap for sponsors, potentially leading to improved treatments for DMD.
Collapse
Affiliation(s)
| | - Eric Camino
- Parent Project Muscular Dystrophy, Washington, DC, USA
| | - Rafael Escandon
- DGBI Consulting, LLC, Bainbridge Island, Washington, DC, USA
| | | | - Ryan Fischer
- Parent Project Muscular Dystrophy, Washington, DC, USA
| | - Kevin Flanigan
- Center for Experimental Neurotherapeutics, Department of Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Pat Furlong
- Parent Project Muscular Dystrophy, Washington, DC, USA
| | - Rose Juhasz
- Nationwide Children's Hospital, Columbus, OH, USA
| | - Ann S Martin
- Parent Project Muscular Dystrophy, Washington, DC, USA
| | - Chet Villa
- Trinity Health Michigan, Grand Rapids, MI, USA
| | - H Lee Sweeney
- Cincinnati Children's Hospital Medical Center within the UC Department of Pediatrics, Cincinnati, OH, USA
| |
Collapse
|
2
|
Harrop C, Bodfish J, Lecavalier L, Dallman AR, Jones D, Pritchett J, Whitten A, Boyd BA. Refining our Understanding of Anxiety in Autistic Youth: Examining the Role of Behavioral Inflexibility. J Autism Dev Disord 2023:10.1007/s10803-023-06079-3. [PMID: 37530916 DOI: 10.1007/s10803-023-06079-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2023] [Indexed: 08/03/2023]
Abstract
Prior research has demonstrated that cognitive inflexibility is associated with anxiety in autistic individuals. Everyday patterns of behavioral inflexibility (e.g. observable inflexible behavior in the context of the need to change or adapt and that is manifested in real-world everyday settings) is common in autism and can be distinguished from performance on discrete cognitive tasks that tap flexible attention, learning, or decision-making. The purpose of this study was to extend this prior work on inflexibility in autism but with measures specifically developed with input from stakeholders (caregivers and clinicians) for autistic youth designed to measure everyday behavioral inflexibility (BI). We characterized anxiety in a large sample of autistic (N = 145) and non-autistic youth (N = 91), ages 3 to 17 years, using the Parent Rated Anxiety Scale for Autism Spectrum Disorder (PRAS-ASD). Further, we sought to understand how BI, measured via the Behavioral Inflexibility Scale (BIS), predicted anxiety compared to other variables known to increase anxiety in youth (chronological age, IQ, autism diagnosis, assigned sex at birth). Autistic youth had higher parent-related anxiety and BI compared to non-autistic youth. BI was the strongest predictor of anxiety scores, irrespective of diagnosis. Overall, our findings highlight the importance of BI to the understanding of anxiety in autistic youth.
Collapse
Affiliation(s)
- Clare Harrop
- University of North Carolina at Chapel Hill, Bondurant Hall, Chapel Hill, NC, USA.
| | - James Bodfish
- Vanderbilt University Medical Center, Nashville, USA
| | | | | | | | | | | | - Brian A Boyd
- University of North Carolina at Chapel Hill, Bondurant Hall, Chapel Hill, NC, USA
| |
Collapse
|
3
|
Sousa CO, Nascimento JDS, Pozzi F, Kardouni JR, Michener LA. Shoulder Performance Activity Test (SPAT) for People With Shoulder Pain: Feasibility, Reliability, and Validity. Phys Ther 2023; 103:pzad006. [PMID: 37172131 PMCID: PMC10410097 DOI: 10.1093/ptj/pzad006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 08/19/2022] [Accepted: 11/13/2022] [Indexed: 01/31/2023]
Abstract
OBJECTIVE The purpose of this study was to assess feasibility, reliability, and validity of a new performance-based test, the Shoulder Performance Activity Test (SPAT). METHODS People with shoulder pain (n = 93) and without shoulder pain (n = 43) were included. The SPAT consists of overhead reach, hand behind head, and hand behind back tasks, each performed with 20 repetitions and rated by time, pain, and effort. The SPAT scores were summed for time, pain, and effort, and a total score across the 3 tasks. Feasibility was assessed by the percentage of SPAT task completion, test-retest reliability by intraclass correlation coefficient (ICC), standard error measurement, minimal detectable change, and known-groups construct validity by comparing between groups (shoulder pain and no pain) and between shoulders in those with pain. RESULTS All participants performed the 3 SPAT tasks. The ICC was 0.74-0.91, and the minimal detectable change was 3.1-4.7 for task scores and 10.0 points for the total score. Individuals with pain presented higher tasks and total scores compared with those without pain. The moderate/severe pain group had higher scores than the low pain and no shoulder pain groups, and the low pain group had higher scores than the no pain group. Scores were higher in the involved shoulder compared with the uninvolved shoulder. CONCLUSION The SPAT is a feasible and reliable performance-based test for use in patients with shoulder pain and can differentiate between individuals with and without pain, among different levels of pain, and between involved and uninvolved shoulders. IMPACT The SPAT provides a standardized method for clinicians to assess shoulder functional performance tasks, which can enable a comprehensive assessment of shoulder disability and clinical decision making. The error metrics can be used to determine meaningful changes in performance.
Collapse
Affiliation(s)
- Catarina O Sousa
- Department of Physical Therapy, Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
| | - José Diego S Nascimento
- Department of Physical Therapy, Federal University of Paraíba (UFPB), João Pessoa, Paraíba, Brazil
| | - Federico Pozzi
- Department of Physical Therapy, University of Florida, Gainesville, Florida, USA
| | - Joseph R Kardouni
- Surgeon Directorate, U.S. Army Forces Command (FORSCOM) Headquarters, Fort Bragg, North Carolina, USA
| | - Lori A Michener
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, California, USA
| |
Collapse
|
4
|
Carlyle K, Day S. Outcome Measures Used to Assess Hand Activity in Amputee and Intact Populations: a Literature Review. Can Prosthet Orthot J 2022; 5:39023. [PMID: 37614636 PMCID: PMC10443517 DOI: 10.33137/cpoj.v5i2.39023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 12/12/2022] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The human hand is critical in assisting with activities of daily living (ADL). Amputation of the hand can affect a person physically, socially and psychologically. Knowledge of outcome measures used to assess upper limb activity of intact and amputee populations may aid in guiding research to develop applicable measurement tools specific to the amputee population. Tools could aid developments in prosthetic design and prescription, which benefit both users and healthcare researchers. OBJECTIVES This literature review examined outcome measurement tools used with non-amputee and amputee populations to assess hand activity. The objectives were to identify which characteristics of hand activity are captured by currently available measurement tools. METHODOLOGY Searches were conducted using PubMed, Cochrane and ProQuest for studies investigating hand activity for amputee and non-amputee populations. A total of 15 studies were included. PRISMA guidelines were used to assist with study selection. Data extraction and narrative synthesis were carried out. FINDINGS A total of 32 outcome measures were found. Frequently used tools were: Box and Block Test, Swedish Disabilities of the Arm Shoulder and Hand Questionnaire, and range of motion. Studies employed a combination of 2 to 12 tools. Themes extracted were: importance of function and quality of life, the need for realistic tasks, and the need for outcome measures specific of the population. CONCLUSION There is a gap in research surrounding outcome measurement tools used to assess hand activity in the amputee population. A combination of outcome measures are required to obtain insight into the hand activities of intact and amputee populations. Function and quality of life are important aspects to consider when describing hand activity.
Collapse
Affiliation(s)
- K Carlyle
- Department of Biomedical Engineering, Faculty of Engineering, University of Strathclyde, Glasgow, United Kingdom
- EPSRC Centre for Doctoral Training in Prosthetics and Orthotics, University of Salford, United Kingdom
| | - S Day
- Department of Biomedical Engineering, Faculty of Engineering, University of Strathclyde, Glasgow, United Kingdom
| |
Collapse
|
5
|
Stockert B, Macauley K, Bradford J, Gorman SL, Greenwood KC, Nordon-Craft A, Quiben M, Rucker J, Silberman N. Simulation-Based Education in Physical Therapist Education: A Survey of Current Practice. Phys Ther 2022; 102:pzac134. [PMID: 36200392 DOI: 10.1093/ptj/pzac134] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 01/27/2022] [Accepted: 08/07/2022] [Indexed: 11/14/2022]
Abstract
OBJECTIVES The purposes of this study were to describe the current use of (1) simulation in student physical therapist professional education programs and (2) standards of best practice (SOBP) for simulation-based education (SBE) in physical therapist education. METHODS Two surveys were created about current use of SBE in student physical therapist professional education programs in the United States. The first survey contained questions about the program, including the best contact person regarding simulation. The second survey investigated simulation use within the context of SOBP. Survey data were analyzed using descriptive statistics. RESULTS Survey 1 was sent to the program director at all fully accredited physical therapist programs (N = 236), and 143 responses were returned (61% response rate). Survey 2 was sent to the 136 individuals identified in Survey 1, and we received 81 completed surveys (60%). Over 90% of programs reported including SBE in their curricula, with 86% providing 3 or more experiences. A median of 1 core faculty at each program reported training in SBE, but 23% reported no training. A lack of training in specific elements of the SOBP for SBE was reported by 40% to 50% of faculty. Limited use of SOBP was reported, and use of outcome measures without validation was common. CONCLUSION Although SBE is commonly used in physical therapist education, many faculties (1) do not have training in SBE, (2) do not consistently follow the SOBP, and (3) utilize unvalidated outcome measures. Limited faculty training in SBE and inconsistent inclusion of the SOBP suggest student learning in simulation is not optimized. IMPACT These results show that, despite increased use of simulation in physical therapist education programs, there is a dearth of faculty trained in SBE and inconsistent use of SOBP. Addressing these deficiencies could help to optimize the benefits of SBE in physical therapist education.
Collapse
Affiliation(s)
- Brad Stockert
- California State University, Department of Physical Therapy, Sacramento, California, USA
| | - Kelly Macauley
- Husson University, College of Health and Pharmacy, Bangor, Maine, USA
- Department of Physical Therapy, Rasmussen University, Eagan, Minnesota, USA
| | - Jacque Bradford
- University of Tennessee Health Science Center, Department of Physical Therapy, College of Health Professions, Memphis, Tennessee, USA
| | - Sharon L Gorman
- Samuel Merritt University, Department of Physical Therapy, Oakland, California, USA
| | - Kristin Curry Greenwood
- Bouve College of Health Sciences, Department of Physical Therapy, Movement and Rehabilitation Sciences, Northeastern University, Boston, Massachusetts, USA
| | - Amy Nordon-Craft
- University of Colorado, Denver, Anschutz Medical Campus, Physical Therapy Program, Aurora, Colorado, USA
| | - Myla Quiben
- University of North Texas Health Science Center, Department of Physical Therapy, Fort Worth, Texas, USA
| | - Jason Rucker
- University of Kansas Medical Center, Department of Physical Therapy, Rehabilitation Science and Athletic Training, Kansas City, Kansas, USA
| | - Nicki Silberman
- Hunter College, Department of Physical Therapy, City University of New York, New York, New York, USA
| |
Collapse
|
6
|
Stockert B, Silberman N, Rucker J, Bradford J, Gorman SL, Greenwood KC, Macauley K, Nordon-Craft A, Quiben M. Simulation-Based Education in Physical Therapist Professional Education: A Scoping Review. Phys Ther 2022; 102:pzac133. [PMID: 36200401 DOI: 10.1093/ptj/pzac133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 06/16/2022] [Accepted: 08/07/2022] [Indexed: 11/13/2022]
Abstract
OBJECTIVES The purposes of this study were to (1) describe and summarize the use of simulation-based education (SBE) with student physical therapists in the international literature and (2) describe the application and integration of standards of best practice (SOBP) for SBE reported in published physical therapy education research. METHODS Ovid MEDLINE, CINAHL, Web of Science, and ERIC databases were searched. The search included any published study that involved the use of SBE with student physical therapists. Because this was a scoping review, only descriptive statistics were compiled; no methodological quality assessment was performed. RESULTS This scoping review revealed a significant increase in literature describing SBE with student physical therapists in the past 10 years. Simulation was used to address learning objectives across a variety of content areas and clinical settings. Communication skills were the most common objectives for simulation. Limited use of SOBP, published in 2016, was reported, and use of author-generated outcome measures without validation was common. CONCLUSIONS Although there has been an increase in literature reporting the use of SBE with student physical therapists across many practice areas and settings, many articles reported limited use and integration of published SOBP and frequently utilized outcome measures that had not been validated. IMPACT The findings show that limited use of validated outcome measures and SOBP constrain the capacity for reproducing studies, comparing findings among studies, and completing systematic reviews that could inform and optimize best practices for the use of SBE in physical therapist professional education. Further research on SBE in physical therapy would benefit from investigations that integrated and reported the use of SOBP for standardized patients, simulation design, and delivery and assessment of learning outcomes over time at multiple Kirkpatrick learning levels.
Collapse
Affiliation(s)
- Brad Stockert
- California State University, Department of Physical Therapy, Sacramento, California, USA
| | - Nicki Silberman
- Hunter College, Department of Physical Therapy, New York, New York, USA
| | - Jason Rucker
- University of Kansas Medical Center, Department of Physical Therapy, Rehabilitation Science and Athletic Training, Kansas City, Kansas, USA
| | - Jacque Bradford
- University of Tennessee Health Science Center, College of Health Professions, Department of Physical Therapy, Memphis, Tennessee, USA
| | - Sharon L Gorman
- Samuel Merritt University, Department of Physical Therapy, Oakland, California, USA
| | - Kristin Curry Greenwood
- Bouve College of Health Sciences; Department of Physical Therapy, Movement and Rehabilitation Sciences, Northeastern University, Boston, Massachusetts, USA
| | - Kelly Macauley
- College of Health and Pharmacy, Husson University, Bangor, Maine, USA
| | - Amy Nordon-Craft
- University of Colorado, Denver, Anschutz Medical Campus, Physical Therapy Program, Aurora, Colorado, USA
| | - Myla Quiben
- University of North Texas Health Science Center, Department of Physical Therapy, Fort Worth, Texas, USA
| |
Collapse
|
7
|
Quiben M, Greenwood KC, Gorman SL, Bradford J, Macauley K, Nordon-Craft A, Rucker J, Silberman N, Stockert B. Simulation-Based Education in Physical Therapist Education: Perspectives From the Strategic Initiative Panel on Simulation in Physical Therapist Education. Phys Ther 2022; 102:pzac135. [PMID: 36200400 DOI: 10.1093/ptj/pzac135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 05/06/2022] [Accepted: 08/07/2022] [Indexed: 11/13/2022]
Abstract
In the summer of 2018, The American Council of Academic Physical Therapy appointed 9 individuals versed in simulation education to form the Strategic Initiative Panel on Simulation to (1) investigate the use of simulation in physical therapist education, (2) explore the role of simulation in meeting accreditation standards and curriculum elements related to clinical education and interprofessional education, and (3) describe models and best practices for the use of simulation in physical therapist education. Over the 3 years of Strategic Initiative Panel on Simulation work, the panel identified several significant gaps in simulation education and research practice. This paper clarifies the essential elements required to optimize the delivery of simulation-based education in physical therapy following best practices, frames the existing challenges to move the profession forward, and recommends specific actions needed to address the many continued questions related to the effective use of simulation-based education in physical therapist education.
Collapse
Affiliation(s)
- Myla Quiben
- University of North Texas Health Science Center, Department of Physical Therapy, Fort Worth, Texas, USA
| | - Kristin Curry Greenwood
- Northeastern University, Department of Physical Therapy, Movement & Rehabilitation Science, Boston, Massachusetts, USA
| | - Sharon L Gorman
- Samuel Merritt University, Department of Physical Therapy, Oakland, California, USA
| | - Jacque Bradford
- University of Tennessee Health Science Center, College of Health Professions, Department of Physical Therapy, Memphis, Tennessee, USA
| | - Kelly Macauley
- Husson University, College of Health and Pharmacy, Bangor, USA
- Department of Physical Therapy, Rasmussen University, Eagan, Minnesota, USA
| | - Amy Nordon-Craft
- University of Colorado Denver Anschutz Medical Campus, Physical Therapy Program, Aurora, Colorado, USA
| | - Jason Rucker
- University of Kansas Medical Center, Department of Physical Therapy, Rehabilitation Science and Athletic Training, Kansas City, Kansas, USA
| | - Nicki Silberman
- Hunter College, Department of Physical Therapy, City University of New York, New York, New York, USA
| | - Brad Stockert
- California State University, Department of Physical Therapy, Sacramento, California, USA
| |
Collapse
|
8
|
Abstract
This Editorial presents an overview of the uptake of clinical outcome measures in the prosthetics and orthotics sector and considers how the use of objective measures contribute to demonstrating value provided. A decade ago, payors began to demand objective data to document costs vs. benefits from prosthetic and orthotic providers. The speed with which the sector responded to help develop measures and to begin to integrate them into practice is remarkable. This suggests an encouraging resilience and ability to adapt on the part of the sector as other trends such as Values-Based Health Care emerge to challenge the sector.
Collapse
Affiliation(s)
- S.U. Raschke
- British Columbia Institute of Technology (BCIT), 3700 Willingdon Avenue, Burnaby, British Columbia, Canada
| |
Collapse
|
9
|
Elghafari A, Finkelstein J. Comparative Assessment of Completeness of CDISC Controlled Terminology. Stud Health Technol Inform 2022; 290:111-115. [PMID: 35672981 DOI: 10.3233/shti220042] [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: 06/15/2023]
Abstract
The CDISC Controlled Terminology (CT) defines the terms that may be used to represent clinical trial data in the CDISC standards. Despite its unique importance, there has been limited systematic examination of the coverage of this terminology. In this work, we performed an assessment of the completeness of CDISC CT's coverage by comparing clinical outcomes for multiple sclerosis (MS) available in CDISC CT with two independent high-fidelity benchmarks: (1) 71 expert-selected outcomes catalogued by the National Institute of Neurological Disorders and Stroke (NINDS), and, (2) 66 common outcomes used in MS trials registered on ClinicalTrials.gov (CTG). We employed a semi-automated search and term-mapping process to identify possible CDISC equivalents to the benchmarks' measures. We found that 55% of the NINDS outcomes and 52% of the CTG outcomes are absent from the CDISC Terminology, indicating a need for expanding the terminology to take into account other established standards and real-world practice.
Collapse
Affiliation(s)
- Anas Elghafari
- Center for Biomedical and Population Health Informatics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Joseph Finkelstein
- Center for Biomedical and Population Health Informatics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| |
Collapse
|
10
|
Ziaadini B, Karimi N, Panahi A, Okhovat AA, Fatehi F, Nafissi S. A retrospective study of the safety and efficacy of rituximab in Iranian patients with myasthenia gravis: A single-center experience. Curr J Neurol 2022; 21:91-97. [PMID: 38011443 PMCID: PMC9860210 DOI: 10.18502/cjn.v21i2.10492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 02/04/2022] [Indexed: 11/29/2023]
Abstract
Background: This retrospective cohort study was conducted to evaluate the efficacy and tolerance of rituximab (RTX) for the management of myasthenia gravis (MG). Methods: This retrospective cross-sectional study was conducted on 61 patients with refractory and non-refractory MG who received RTX. The Myasthenia Gravis Activities of Daily Living (MG-ADL) profile was used to assess MG symptoms and their effects on daily activities at the start of RTX and in the last follow-up. The Myasthenia Gravis Foundation of America Post-Intervention Status (MGFA-PIS) scale has been used as an outcome measure after treatment with RTX in the 12th month and the last follow-up. Results: The mean age of the patients was 40.31 ± 13.53 years (range: 15-78 years). Of 61 patients, eight (13.1%) were double seronegative, 29 (47.5%) had anti-acetylcholine receptor (AChR+) antibody, and 24 (39.3%) had anti-muscle-specific tyrosine kinase antibody (MuSK+). According to the mean rank table, the results of this study showed that the drug was more effective in improving the symptoms of MuSK+ patients compared to the other two groups (P = 0.006). The mean MG-ADL was 4.86 ± 1.83 before treatment and 1.51 ± 2.02 in the last follow-up visit. Paired t-test showed a significant association between MG-ADL before and after treatment in the last visit [t(55): 11.30, 95% confidence interval (CI): 2.79-3.99, P = 0.001)]. Conclusion: This retrospective study showed a considerable effect of RTX as induction therapy in patients with MG, especially those with MuSk+ MG.
Collapse
Affiliation(s)
- Bentolhoda Ziaadini
- Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran
- Department of Neurology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Narges Karimi
- Immunogenetics Research Center, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Neurology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Neuromuscular Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Akram Panahi
- Department of Neurology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Neuromuscular Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Asghar Okhovat
- Department of Neurology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Neuromuscular Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Neurology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzad Fatehi
- Department of Neurology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Neuromuscular Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahriar Nafissi
- Department of Neurology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Neuromuscular Research Center, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
11
|
Avila-Ortiz G, Couso-Queiruga E, Pirc M, Chambrone L, Thoma DS. Outcome measures and methods of assessment of soft tissue augmentation interventions in the context of dental implant therapy: A systematic review of clinical studies published in the last 10 years. Clin Oral Implants Res 2022; 34 Suppl 25:84-96. [PMID: 35343615 DOI: 10.1111/clr.13927] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 12/30/2021] [Accepted: 01/22/2022] [Indexed: 11/26/2022]
Abstract
AIM To identify and report outcome measures and methods of assessment on soft tissue augmentation interventions in the context of dental implant therapy reported in clinical studies published in the last 10 years. MATERIAL AND METHODS The protocol of this PRISMA 2020-compliant systematic review was registered in PROSPERO (CRD42021252214). A literature search was conducted to identify articles that met the pre-established eligibility criteria. Data of interest, with an emphasis on outcome measures, were extracted. For each outcome, specific methods and timing of assessment were described in detail. Following a critical qualitative analysis of the data, outcome measures were categorized. Primary outcomes were identified and frequency of reporting in the selected articles was calculated. Additionally, risk of bias assessments were performed for individual articles and primary outcomes. RESULTS Ninety-two articles, of which 39 reported randomized controlled trials (RCTs), 20 reported non-RCTs, and 33 reported case series studies, were selected. Outcome measures were categorized into either investigator-evaluated outcome measures (i.e., clinical, digital imaging, esthetic, histologic, biomarker, and safety) or patient-reported outcome measures (PROMs). Clinical outcomes were the most frequently reported type of outcome. Considering all categories, the most frequently reported primary outcomes were facial mucosa thickness assessed with clinical methods (22.83%), facial keratinized mucosa width assessed with clinical methods (19.57%), facial mucosal margin position / recession assessed with clinical methods (18.48%), facial mucosa thickness assessed with digital imaging methods (11.96%), facial soft tissue volume assessed with digital imaging methods (9.78%), and supracrestal tissue height assessed with clinical methods (9.78%). No distinguishable patterns of association between specific types or quality (level of bias) of clinical studies and the choice of primary outcomes were observed. CONCLUSION Clinical research on peri-implant soft tissue augmentation has progressively increased in the last 10 years. Although clinical outcome measures were the most frequently reported outcomes in the selected literature, trends in the field are indicative of a shift from traditional clinical assessment methods to the use of digital technologies. PROMs were generally underreported but should be considered an integral methodological component in future clinical studies.
Collapse
Affiliation(s)
- G Avila-Ortiz
- Department of Periodontics, University of Iowa College of Dentistry, Iowa City, IA, USA
| | - E Couso-Queiruga
- Department of Periodontics, University of Iowa College of Dentistry, Iowa City, IA, USA
| | - M Pirc
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | - L Chambrone
- Department of Periodontics, University of Iowa College of Dentistry, Iowa City, IA, USA.,Evidence-Based Hub, Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz-Cooperativa de Ensino Superior, Caparica, Almada, Portugal.,Unit of Basic Oral Investigations, School of Dentistry, Universidad El Bosque, Bogotá, Colombia
| | - D S Thoma
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| |
Collapse
|
12
|
Miyata K, Usuda S. On "Insights Into the Mini-BESTest Scoring System: Comparison of 6 Different Structural Models." Godi M, Arcolin I, Leavy B, Giardini M, Corna S, Franzén E. Phys Ther. 2021;101:pzab180. https://doi.org/10.1093/ptj/pzab180. Phys Ther 2022; 102:6519054. [PMID: 35134238 DOI: 10.1093/ptj/pzac009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 01/26/2022] [Indexed: 11/15/2022]
Affiliation(s)
- Kazuhiro Miyata
- Department of Physical Therapy, Ibaraki Prefectural University of Health Science, 4669-2, Ami-Machi, Inashiki-gun, Ibaraki, 300-0394 Japan
| | - Shigeru Usuda
- Department of Rehabilitation Sciences, Gunma University Graduate School of Health Sciences, Gunma, Japan
| |
Collapse
|
13
|
Jönsson C, Johansson K, Bjurberg M, Brogårdh C. Impedance of Extracellular Fluid, Volume, and Local Tissue Water Can Be Reliably Measured in People With Lower Limb Lymphedema. Phys Ther 2022; 102:6539714. [PMID: 35229160 PMCID: PMC9155957 DOI: 10.1093/ptj/pzac025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 09/29/2021] [Accepted: 12/27/2021] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Lower limb lymphedema (LLL) is a chronic condition. To be able to evaluate changes of LLL over time and effects of interventions, reliable measurement methods are important. Currently, there is limited knowledge of the reliability of commonly used measurement methods in LLL. The study objective was to evaluate the test-retest (intrarater) reliability of impedance of extracellular fluid, volume, and local tissue water measurements in people with unilateral or bilateral LLL and measurement errors both for a group of people and for a single individual. METHODS Forty-two people with mild to moderate unilateral or bilateral, primary or secondary LLL were measured twice, 2 weeks apart. Impedance of extracellular fluid was measured by bioimpedance spectroscopy and calculated as arm-to-leg ratio, volume with circumference measurements every 4 cm, and local tissue water with tissue dielectric constant at 14 points. Test-retest reliability was evaluated using the intraclass correlation coefficient [ICC(2,1)], changes in the mean, SE of measurement in relative terms (SEM%), and the smallest real difference in relative terms (SRD%). RESULTS For the impedance ratio, the reliability was high [ICC(2,1) = 0.79-0.90] and the measurement errors were acceptable (SEM% = 5.0%-5.2%; SRD% = 14.0%-14.4%). For volume, the reliability was high (ICC = 0.99) and the measurement errors were low (SEM% = 1.1%-1.7%; SRD% = 3.1%-4.6%). For the tissue dielectric constant, the reliability was fair to excellent [ICC(2,1) = 0.68-0.96] and the measurement errors were acceptable (SEM% = 4.2%-9.7%; SRD% = 11.7%-26.8%). CONCLUSIONS Measurements of impedance of extracellular fluid, volume, and local tissue water are reliable in people with mild to moderate LLL. The measurement errors were acceptable in all 3 methods indicating that real, clinical changes in lymphedema can be measured both for a group of people and a single individual. IMPACT The results from this test-retest reliability study can help clinicians and researchers to interpret if real clinical changes in lymphedema occur over time or after an intervention in people with mild to moderate LLL.
Collapse
Affiliation(s)
| | - Karin Johansson
- Department of Health Sciences, Lund University, Lund, Sweden
| | - Maria Bjurberg
- Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden,Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Christina Brogårdh
- Department of Health Sciences, Lund University, Lund, Sweden,Department of Neurology, Rehabilitation Medicine, Memory Disorders and Geriatrics, Skåne University Hospital, Lund, Sweden
| |
Collapse
|
14
|
Jones DR, Dallman A, Harrop C, Whitten A, Pritchett J, Lecavalier L, Bodfish JW, Boyd BA. Evaluating the Feasibility of The NIH Toolbox Cognition Battery for Autistic Children and Adolescents. J Autism Dev Disord 2022; 52:689-99. [PMID: 33761062 DOI: 10.1007/s10803-021-04965-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2021] [Indexed: 01/11/2023]
Abstract
This study evaluates the feasibility of the NIH Toolbox Cognition Battery (NIH-TCB) for use in autism spectrum disorder (ASD). 116 autistic children and adolescents and 80 typically developing (TD) controls, ages 3-17 years, completed four NIH-TCB tasks related to inhibitory control, cognitive flexibility, processing speed, and episodic memory. While the majority of autistic and TD children completed all four tasks, autistic children experienced greater difficulties with task completion. Across autistic and TD children, performance on NIH-TCB tasks was highly dependent on IQ, but significant performance differences related to ASD diagnosis were found for two of four tasks. These findings highlight the potential strengths and limitations of the NIH-TCB for use with autistic children.
Collapse
|
15
|
Avila-Ortiz G, Couso-Queiruga E, Pirc M, Chambrone L, Thoma DS. Outcome measures and methods of assessment of soft tissue augmentation interventions in the context of dental implant therapy: A systematic review of clinical studies published in the last 10 years. J Clin Periodontol 2022; 50 Suppl 25:83-95. [PMID: 35088421 DOI: 10.1111/jcpe.13597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 12/30/2021] [Accepted: 01/22/2022] [Indexed: 11/26/2022]
Abstract
AIM To identify and report outcome measures and methods of assessment on soft tissue augmentation interventions in the context of dental implant therapy reported in clinical studies published in the last 10 years. MATERIAL AND METHODS The protocol of this PRISMA 2020-compliant systematic review was registered in PROSPERO (CRD42021252214). A literature search was conducted to identify articles that met the pre-established eligibility criteria. Data of interest, with an emphasis on outcome measures, were extracted. For each outcome, specific methods and timing of assessment were described in detail. Following a critical qualitative analysis of the data, outcome measures were categorized. Primary outcomes were identified and frequency of reporting in the selected articles was calculated. Additionally, risk of bias assessments were performed for individual articles and primary outcomes. RESULTS Ninety-two articles, of which 39 reported randomized controlled trials (RCTs), 20 reported non-RCTs, and 33 reported case series studies, were selected. Outcome measures were categorized into either investigator-evaluated outcome measures (i.e., clinical, digital imaging, esthetic, histologic, biomarker, and safety) or patient-reported outcome measures (PROMs). Clinical outcomes were the most frequently reported type of outcome. Considering all categories, the most frequently reported primary outcomes were facial mucosa thickness assessed with clinical methods (22.83%), facial keratinized mucosa width assessed with clinical methods (19.57%), facial mucosal margin position / recession assessed with clinical methods (18.48%), facial mucosa thickness assessed with digital imaging methods (11.96%), facial soft tissue volume assessed with digital imaging methods (9.78%), and supracrestal tissue height assessed with clinical methods (9.78%). No distinguishable patterns of association between specific types or quality (level of bias) of clinical studies and the choice of primary outcomes were observed. CONCLUSION Clinical research on peri-implant soft tissue augmentation has progressively increased in the last 10 years. Although clinical outcome measures were the most frequently reported outcomes in the selected literature, trends in the field are indicative of a shift from traditional clinical assessment methods to the use of digital technologies. PROMs were generally underreported but should be considered an integral methodological component in future clinical studies. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- G Avila-Ortiz
- Department of Periodontics, University of Iowa College of Dentistry, Iowa City, IA, USA
| | - E Couso-Queiruga
- Department of Periodontics, University of Iowa College of Dentistry, Iowa City, IA, USA
| | - M Pirc
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | - L Chambrone
- Department of Periodontics, University of Iowa College of Dentistry, Iowa City, IA, USA.,Evidence-Based Hub, Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz-Cooperativa de Ensino Superior, Caparica, Almada, Portugal.,Unit of Basic Oral Investigations, School of Dentistry, Universidad El Bosque, Bogotá, Colombia
| | - D S Thoma
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| |
Collapse
|
16
|
Pilz F, Vill K, Rawer R, Bonfert M, Tacke M, Heussinger N, Müller-Felber W, Blaschek A. Mechanography in children: pediatric references in postural control. J Musculoskelet Neuronal Interact 2022; 22:431-454. [PMID: 36458382 PMCID: PMC9716303] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To establish pediatric age- and sex-specific references for measuring postural control with a mechanography plate in a single centre, prospective, normative data study. METHODS 739 children and adolescents (396 male/343 female) aged 4 to 17 years were studied. Each participant completed the following test sequence three times: Romberg, semi-tandem, tandem, each with eyes open and closed, and a one-leg stand with eyes open, and a single two-legged jump. Normal ranges were determined based on percentile calculations using the LMS method. Results from the two-legged jump were compared to a reference population the single two-legged jump (s2LJ) assessment in 2013. RESULTS 38 different equilibrium parameters calculated were analysed. Of all parameters Path Length, vCoFmean, Equilibrium Score and Sway Angle showed a low variation within the same age group but high dependency on age and were thus chosen for automated balance assessment. CONCLUSION Standard values of postural control in healthy children derived from automated balance testing using a mechanography plate were successfully acquired and a subset of parameters for automated balance assessment identified.
Collapse
Affiliation(s)
- Franziska Pilz
- Children’s Hospital, University Augsburg, Augsburg, Germany,Corresponding author: Astrid Blaschek, Department of Paediatric Neurology and Developmental Medicine, Dr. von Hauner Children’s Hospital, Lindwurmstr. 4, 80337 München, Germany E-mail:
| | - Katharina Vill
- Ludwig Maximilian University of Munich (LMU), Hauner Children’s Hospital, Department of Paediatric Neurology and Developmental Medicine, Munich, Germany
| | | | - Michaela Bonfert
- Ludwig Maximilian University of Munich (LMU), Hauner Children’s Hospital, Department of Paediatric Neurology and Developmental Medicine, Munich, Germany
| | - Moritz Tacke
- Ludwig Maximilian University of Munich (LMU), Hauner Children’s Hospital, Department of Paediatric Neurology and Developmental Medicine, Munich, Germany
| | - Nicole Heussinger
- Paracelsus Medical University, Department of Pediatrics, Nuremberg General Hospital, Germany
| | - Wolfgang Müller-Felber
- Ludwig Maximilian University of Munich (LMU), Hauner Children’s Hospital, Department of Paediatric Neurology and Developmental Medicine, Munich, Germany
| | - Astrid Blaschek
- Ludwig Maximilian University of Munich (LMU), Hauner Children’s Hospital, Department of Paediatric Neurology and Developmental Medicine, Munich, Germany
| |
Collapse
|
17
|
Godi M, Arcolin I, Leavy B, Giardini M, Corna S, Franzén E. Insights Into the Mini-BESTest Scoring System: Comparison of 6 Different Structural Models. Phys Ther 2021; 101:6334618. [PMID: 34339510 DOI: 10.1093/ptj/pzab180] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/10/2021] [Accepted: 05/31/2021] [Indexed: 11/14/2022]
Abstract
OBJECTIVE The Mini-Balance Evaluation Systems Test (Mini-BESTest) is a balance scale common to clinical practice, but different scoring has been proposed, that is, total score and/or subsections. This study aimed to investigate Mini-BESTest validity by comparing 6 structural models and to establish the best model for discriminating fallers from nonfallers, that is, those who did or did not report at least 2 falls in the 6 months before evaluation. METHODS In this cross-sectional validation study, data from 709 individuals with idiopathic Parkinson disease (Hoehn and Yahr stages 1-3) were analyzed. Individuals were evaluated with the Mini-BESTest, and fall history was recorded. Construct, convergent, and discriminant validity and reliability of the 6 models were analyzed. The ability of the models to adequately identify individuals with or without a history of falls was tested with receiving operating characteristic curves. RESULTS Confirmatory factor analysis showed that the unidimensional models and the 4-factor solutions showed the best fit indexes. Conversely, second-order models, which allowed reporting of both total and subsections, did not converge. Most models and factors showed a low convergent validity (average variance extracted values <0.5). Correlations among the anticipatory postural adjustments factor with both the sensory orientation and the dynamic gait factors of multidimensional models were high (r ≥ 0.85). Unidimensional model reliability was good, whereas low values were found in one-half of the subsections. Finally, both unidimensional models showed a large area under the receiving operating characteristic curve (0.81). CONCLUSION The original unidimensional Mini-BESTest model-with a total score of 28-showed the highest validity and reliability and was best at discriminating fallers from nonfallers. Conversely, its 4 subsections should not be reported separately, because they were highly correlated and had low reliability; therefore, they are not actually capable of measuring different aspects of balance. IMPACT This study shows that the Mini-BESTest should be used only with the original unidimensional scoring system in people with Parkinson disease.
Collapse
Affiliation(s)
- Marco Godi
- Division of Physical Medicine and Rehabilitation, Istituti Clinici Scientifici Maugeri IRCCS, Scientific Institute of Veruno, Gattico-Veruno (NO), Italy
| | - Ilaria Arcolin
- Division of Physical Medicine and Rehabilitation, Istituti Clinici Scientifici Maugeri IRCCS, Scientific Institute of Veruno, Gattico-Veruno (NO), Italy
| | - Breiffni Leavy
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden.,Unit of Research and Development, The Stockholm Sjukhem Foundation, Stockholm, Sweden
| | - Marica Giardini
- Division of Physical Medicine and Rehabilitation, Istituti Clinici Scientifici Maugeri IRCCS, Scientific Institute of Veruno, Gattico-Veruno (NO), Italy
| | - Stefano Corna
- Division of Physical Medicine and Rehabilitation, Istituti Clinici Scientifici Maugeri IRCCS, Scientific Institute of Veruno, Gattico-Veruno (NO), Italy
| | - Erika Franzén
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden.,Medical Unit Occupational Therapy and Physiotherapy, Theme Women's Health and Allied Health Professional, Karolinska University Hospital, Stockholm, Sweden
| |
Collapse
|
18
|
Tong ST, Morgan ZJ, Bazemore AW, Eden AR, Fitzgerald RM, Peterson LE. Practice Patterns of Family Physicians With and Without Addiction Medicine Board Certification. J Am Board Fam Med 2021; 34:814-9. [PMID: 34312274 DOI: 10.3122/jabfm.2021.04.200456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 12/15/2020] [Accepted: 12/16/2020] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND The American Board of Medical Specialties recognized addiction medicine (ADM) as a subspecialty in 2016, which was timely given the recent rise in substance use disorder (SUD). The impact of this dual board opportunity on Family Medicine has not been described. Our study enumerates and characterizes physicians dually certified in Family Medicine and ADM. METHODS We linked American Board of Medical Specialties data from March 2020 on physicians dually boarded in Family Medicine and ADM to responses on demographic and scope of practice questions in the American Board of Family Medicine (ABFM) National Graduate Survey and Family Medicine Certification Examination Registration Questionnaire. RESULTS Of current ABFM Diplomates, 0.53% (492/93,269) are also boarded in ADM. Based on survey responses from a subset of dually certified physicians, those who are dually certified are more likely to practice in federally qualified health centers and to hold a faculty position. Dually certified physicians are more likely to provide HIV/AIDS and hepatitis C management and are as likely as non-dually certified physicians to provide newborn care, obstetric deliveries, inpatient adult medicine care, and intensive care. DISCUSSION While only a small proportion of family physicians carry dual ADM board certification, those that do disproportionately serve vulnerable populations while retaining broad scope of care. Further work is needed to examine whether SUD treatment access could be addressed by implementing models that support dually certified physicians in consultative and educational efforts that would amplify their impact across the primary care workforce.
Collapse
|
19
|
Quiñones-Rivera A, Wing HE, Barr-Walker J, Yee M, Harrison JM, Gottlieb LM. Provider Impacts of Socioeconomic Risk Screening and Referral Programs: A Scoping Review. J Am Board Fam Med 2021; 34:820-31. [PMID: 34312275 DOI: 10.3122/jabfm.2021.04.210039] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 03/31/2021] [Accepted: 04/14/2021] [Indexed: 11/08/2022] Open
Abstract
Initiatives to identify and intervene on patients' socioeconomic needs in the context of health care delivery are expanding. Little information has been compiled across studies on health care providers' knowledge, attitudes, beliefs, and behaviors (KABB) regarding socioeconomic risk screening and referral interventions. METHODS: We conducted a systematic scoping review of providers' KABB related to health care-based socioeconomic risk screening and referral interventions using several search engines. Included studies assessed health care providers' KABB about screening and interventions conducted in clinical settings. RESULTS: Of 14,757 studies evaluated, 53 were eligible for inclusion. Study designs were heterogeneous. Outcome measures included attitudes and beliefs (n = 42), provider behaviors (n = 35), and provider knowledge (n = 26). The majority of providers expressed positive attitudes toward addressing patients' socioeconomic risks. Participants endorsed concerns regarding insufficient knowledge and resources, time and workflow disruption, and potential negative impacts of screening and referral programs on relationships. Exposure to screening and referral programs led to increases in providers' positive attitudes, socioeconomic risk screening rates, and reported knowledge about intervention options. CONCLUSIONS: Participation in screening and referral programs seems to influence providers' perception of implementation barriers. Future research should explore providers' concerns about addressing identified risks.
Collapse
|
20
|
Johari SF, Azman M, Mohamed AS, Baki MM. Maximum vocal intensity as a primary outcome measure in unilateral vocal fold paralysis patients. J Laryngol Otol 2020; 134:1085-93. [PMID: 33308327 DOI: 10.1017/S0022215120002558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To evaluate voice intensity as the primary outcome measurement when treating unilateral vocal fold paralysis patients. METHODS This prospective observational study comprised 34 newly diagnosed unilateral vocal fold paralysis patients undergoing surgical interventions: injection laryngoplasty or medialisation thyroplasty. Voice assessments, including maximum vocal intensity and other acoustic parameters, were performed at baseline and at one and three months post-intervention. Maximum vocal intensity was also repeated within two weeks before any surgical interventions were performed. The results were compared between different time points and between the two intervention groups. RESULTS Maximum vocal intensity showed high internal consistency. Statistically significant improvements were seen in maximum vocal intensity, Voice Handicap Index-10 and other acoustic analyses at one and three months post-intervention. A significant moderate negative correlation was demonstrated between maximum vocal intensity and Voice Handicap Index-10, shimmer and jitter. There were no significant differences in voice outcomes between injection laryngoplasty and medialisation thyroplasty patients at any time point. CONCLUSION Maximum vocal intensity can be applied as a treatment outcome measure in unilateral vocal fold paralysis patients; it can demonstrate the effectiveness of treatment and moderately correlates with self-reported outcome measures.
Collapse
|
21
|
Miller KT, Russell M, Jenks T, Surratt K, Poretti K, Eigenbrot SS, Akins JS, Major MJ. The feasibility and validity of a wearable sensor system to assess the stability of high-functioning lower-limb prosthesis users. ACTA ACUST UNITED AC 2020; Online first. [PMID: 33510564 DOI: 10.1097/JPO.0000000000000332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Introduction Lower-limb prosthesis users (LLPUs) experience increased fall risk due to gait and balance impairments. Clinical outcome measures are useful for measuring balance impairment and fall risk screening but suffer from limited resolution and ceiling effects. Recent advances in wearable sensors that can measure different components of gait stability may address these limitations. This study assessed feasibility and construct validity of a wearable sensor system (APDM Mobility Lab) to measure postural control and gait stability. Materials and Methods Lower-limb prosthesis users (n=22) and able-bodied controls (n=24) completed an Instrumented Stand-and-Walk Test (ISAW) while wearing the wearable sensors. Known-groups analysis (prosthesis versus controls) and convergence analysis (Prosthetic Limb Users Survey of Mobility [PLUS-M] and Activity-specific Balance Confidence [ABC] Scale) were performed on 20 stability-related measures. Results The system was applied without complications; however missing anticipatory postural adjustment data points for nine subjects affected the analysis. Of the 20 analyzed measures output by the sensors, only three significantly differed (p≤.05) between cohorts, and two demonstrated statistically significant correlations with the self-report measures. Conclusions The results of this study suggest the clinical feasibility but only partial construct validity of the wearable sensor system in conjunction with the ISAW test to measure LLPU stability and balance. The sample consisted of high-functioning LLPUs, so further research should evaluate a more representative sample with additional outcome measures and tasks.
Collapse
|
22
|
Acharya RS, Tveter AT, Grotle M, Khadgi B, Koju R, Eberhard-Gran M, Stuge B. Cross-Cultural Adaptation and Validation of the Nepali Version of the Pelvic Girdle Questionnaire. J Manipulative Physiol Ther 2020; 43:257-265. [PMID: 32739042 DOI: 10.1016/j.jmpt.2019.04.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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] [Received: 08/20/2018] [Revised: 04/04/2019] [Accepted: 04/07/2019] [Indexed: 01/13/2023]
Abstract
OBJECTIVE The purpose of this study was to translate, cross-culturally adapt, and assess the reliability and validity of the Pelvic Girdle Questionnaire (PGQ) in pregnant Nepalese women. METHODS The cross-cultural adaptation process was conducted according to the Guillemin guidelines. Reliability and validity were assessed using cross-sectional design. The participants responded to questionnaires of sociodemographics, the Nepali version of the PGQ, the Oswestry Disability Index, the Patient-Specific Functional Scale, the 5-item version of the Edinburgh Depression Scale, and the Numerical Pain Rating Scale. The internal consistency was assessed with Cronbach's alpha. The test-retest reliability was calculated using the intraclass correlation coefficient and smallest detectable change. Construct validity was assessed by testing 9 a priori hypotheses that examine correlations between the PGQ activity and symptom subscales, and also among the PGQ subscales and Oswestry Disability Index, Numerical Pain Rating Scale, Patient-Specific Functional Scale, and 5-item version of the Edinburgh Depression Scale. Spearman and Pearson's correlation were used to assess the correlations. RESULTS A sample of 111 pregnant women were included in the study. The Cronbach's alpha for the Nepali version of the total PGQ was good (α = 0.83), and the test-retest reliability was acceptable (ICC2.1, 0.72) with a measurement error of SDC95% 18.6 points. Seven of the 9 hypotheses found support, which confirms acceptable construct validity of the Nepali PGQ. CONCLUSION The Nepali version of the PGQ is a reliable and valid tool for assessing pelvic girdle pain in pregnant Nepalese women.
Collapse
Affiliation(s)
- Ranjeeta Shijagurumayum Acharya
- Department of Physiotherapy, Kathmandu University School of Medical Sciences, Kathmandu University Dhulikhel Hospital, Kavre, Nepal.
| | - Anne Therese Tveter
- Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Margreth Grotle
- Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway; FORMI, Oslo University Hospital, Oslo, Norway
| | - Bimika Khadgi
- Department of Physiotherapy, Kathmandu University School of Medical Sciences, Kathmandu University Dhulikhel Hospital, Kavre, Nepal
| | - Rajendra Koju
- Department of Medicine, Kathmandu University School of Medical Sciences, Kathmandu University Dhulikhel Hospital, Kavre, Nepal
| | - Malin Eberhard-Gran
- Institute of Clinical Medicine, University of Oslo, Norway; Health Services Research Unit, Akershus University Hospital, Lorenskog, Norway; Department of Child Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Britt Stuge
- Division of Orthopedic Surgery, Oslo University Hospital, Oslo, Norway
| |
Collapse
|
23
|
Ingoe HMA, Eardley W, Rangan A, Hewitt C, McDaid C. An international multi-stakeholder delphi consensus exercise to develop a core outcomes set (COS) for surgical fixation of rib fractures. Injury 2020; 51:224-229. [PMID: 31679833 DOI: 10.1016/j.injury.2019.10.031] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 10/02/2019] [Accepted: 10/14/2019] [Indexed: 02/02/2023]
Abstract
INTRODUCTION A patient-relevant, focused Core Outcome Set (COS) is essential to the design of clinical trials dealing with chest wall trauma, in order to maximise quality of evidence regarding impact of interventions and to reduce research waste. METHODS Outcome measures were collated by way of systematic review and entered into a three round Delphi consensus completed anonymously online. Participants were international clinicians and allied health professionals (AHP) involved in the treatment of rib fractures as well as patients who had experienced severe chest trauma. Consensus thresholds for statements were defined a priori as a group rating of more than 70% or less than 15% for 'important' or 'not important'. RESULTS Sixty-five participants responded to the first round and the final round Final round consisted of five AHP, two patients and 16 clinicians from eight different countries. Twenty-three outcomes were regarded as important for the COS; eight adverse events, three mortality, five clinical or physiological outcomes, six life impact and one resource-related. Health related quality of life was rated highest of the life impact outcomes but participants thought it was also important to assess disability, physical function, quality of life, return to activities and return to work. CONCLUSION Collecting serious adverse outcomes was important to all stakeholders as were life impact outcomes such as quality of life, physical function and return to activities. Resource use outcomes were considered less important. We recommend this Core Outcome Set, developed with multiple relevant stakeholders, for use in future clinical trials, following further work on the most appropriate methods and instruments for measurement.
Collapse
Affiliation(s)
- Helen M A Ingoe
- York Trials Unit, Department of Health Sciences, ARRC Building, University of York, Heslington, York, UK, YO10 5DD; The James Cook University Hospital, Marton Road, Middlesbrough, UK, TS4 3BW.
| | - William Eardley
- York Trials Unit, Department of Health Sciences, ARRC Building, University of York, Heslington, York, UK, YO10 5DD; The James Cook University Hospital, Marton Road, Middlesbrough, UK, TS4 3BW.
| | - Amar Rangan
- York Trials Unit, Department of Health Sciences, ARRC Building, University of York, Heslington, York, UK, YO10 5DD; The James Cook University Hospital, Marton Road, Middlesbrough, UK, TS4 3BW; NDORMS, University of Oxford, research supported by the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre (BRC), UK.
| | - Catherine Hewitt
- York Trials Unit, Department of Health Sciences, ARRC Building, University of York, Heslington, York, UK, YO10 5DD.
| | - Catriona McDaid
- York Trials Unit, Department of Health Sciences, ARRC Building, University of York, Heslington, York, UK, YO10 5DD.
| |
Collapse
|
24
|
Sarigiovannis P, Bradbury H, Bishop A. The development and evaluation of a data calculator to facilitate the introduction and use of a standardized outcome measure (Musculoskeletal Health Questionnaire). Musculoskeletal Care 2020; 18:211-214. [PMID: 31985146 DOI: 10.1002/msc.1449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 11/25/2019] [Accepted: 11/25/2019] [Indexed: 11/11/2022]
Affiliation(s)
| | - Hilary Bradbury
- Midlands Partnership NHS Foundation Trust, Newcastle under Lyme, UK
| | - Annette Bishop
- Primary Care Centre Versus Arthritis, School of Primary, Community and Social Care, Keele University, Keele, UK
| |
Collapse
|
25
|
van Eeghen C, Kennedy AG, Pasanen ME, MacLean CD. A New Quality Improvement Toolkit to Improve Opioid Prescribing in Primary Care. J Am Board Fam Med 2020; 33:17-26. [PMID: 31907242 DOI: 10.3122/jabfm.2019.01.190238] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 09/30/2019] [Accepted: 10/01/2019] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION The role of opioids in managing chronic pain has evolved in light of the opioid misuse epidemic and new evidence regarding risks and benefits of long-term opioid therapy. With mounting national guidelines and local regulations, providers need interventions to standardize and improve safe, responsible prescribing. This article summarizes the evolution of an opioid management toolkit using a quality improvement (QI) approach to improve prescribing. METHODS The authors developed a list of opioid-prescribing best practices and offered in-office, team-based QI projects to ambulatory clinics, updated and tested over 3 trials in the form of a toolkit. Outcome measures included pre- and postproject surveys on provider and staff satisfaction, toolkit completion, and process measures. The toolkit supports workflow planning, redesign, and implementation. RESULTS Ten clinics participated in trial 1, completing the QI project on average in 3 months, with a mean of 9.1 hours of team time. Provider satisfaction with prescribing increased from 42% to 96% and staff satisfaction from 54% to 81%. The most common strategies in trials 1 and 2 focused on regulatory compliance (35% to 36%), whereas in Trial 3 there was a strong move toward peer support (81%). DISCUSSION Clinics responded to implementation of opioid-related best practices using QI with improved provider and staff satisfaction. Once the goals of regulatory compliance and workflow improvements were met, clinics focused on strategies supporting providers in the lead role of managing chronic pain, building on strategies that provide peer support. Using QI methods, primary care clinics can improve opioid-prescribing best practices for patients.
Collapse
|
26
|
Hadjiioannou I, Wong K, Lindup H, Mayes J, Castle E, Greenwood S. Test-Retest Reliability for Physical Function Measures in Patients with Chronic Kidney Disease. J Ren Care 2019; 46:25-34. [PMID: 31845535 DOI: 10.1111/jorc.12310] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 11/26/2022]
Abstract
BACKGROUND It is important to determine relative and absolute reliability values in outcome measures that are used in clinical practice so as to discriminate between true changes following exercise interventions for patients with chronic kidney disease (CKD). OBJECTIVE The study aimed to assess test-retest reliability of the incremental shuttle walk test (ISWT), sit-to-stand transfers in 60 seconds (STS-60), timed up and go (TUAG), Duke's activity status index (DASI) and hospital anxiety and depression scale (HAD) in patients with CKD. STUDY DESIGN This study was a pragmatic non-randomised controlled trial. METHODS Forty people attended two study visits within a 16-day window involving the ISWT, STS-60, TUAG, DASI and HAD tests. Relative reliability was assessed using intraclass correlation coefficient (ICC) and absolute reliability using the standard error of measurement (SEM) and minimal detectable change (MDC). RESULTS Good test-retest reliability was found for the entire sample size across all outcome measures, with TUAG having the highest (ICC = 0.96) and HAD the lowest (ICC = 0.71). The MDC scores at 90% confidence interval (CI) were: 79.6 m for the ISWT, 2.9 seconds for the TUAG, 7.0 repetitions for the STS-60, 8.4 for the DASI, 3.8 for the anxiety HAD subscale and 4.4 for the depression HAD subscale. CONCLUSIONS This study demonstrated good test-retest reliability for all outcome measures across the CKD trajectory but caution needs to be taken when interpreting the findings for each CKD sub-group separately. The MDC scores at 90% CI can support therapists in determining a true improvement in CKD patients' physical or mental performance.
Collapse
Affiliation(s)
- Ioulia Hadjiioannou
- Physiotherapy, Department of Physiotherapy, School of Bioscience Education, King's College London, London, UK
| | - Katy Wong
- Physiotherapy, Department of Physiotherapy, School of Bioscience Education, King's College London, London, UK
| | - Herolin Lindup
- Department of Therapies, King's College Hospital, London, UK
| | - Juliet Mayes
- Department of Therapies, King's College Hospital, London, UK
| | - Ellen Castle
- Department of Therapies, King's College Hospital, London, UK.,Department of Renal Medicine, King's College Hospital, London, UK.,Renal Sciences, Department of Transplantation, Inflammation and Mucosal Biology, King's College London, London, UK
| | - Sharlene Greenwood
- Department of Therapies, King's College Hospital, London, UK.,Department of Renal Medicine, King's College Hospital, London, UK.,Renal Sciences, Department of Transplantation, Inflammation and Mucosal Biology, King's College London, London, UK
| |
Collapse
|
27
|
Marra G, Drury A, Tran L, Veale D, Muir GH. Systematic Review of Surgical and Nonsurgical Interventions in Normal Men Complaining of Small Penis Size. Sex Med Rev 2020; 8:158-80. [PMID: 31027932 DOI: 10.1016/j.sxmr.2019.01.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 01/16/2019] [Accepted: 01/18/2019] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Evidence on penile enhancement interventions is lacking. Nonetheless, many non-evidence-based solutions are readily available. AIM To investigate enhancement and nonenhancement interventions in men without penile abnormalities seeking to increase penis size. METHODS We performed a systematic review with no time restrictions adhering to the PRISMA guidelines. Studies with fewer than 10 cases or including men with organic penile pathologies or previous penile surgeries were excluded. MAIN OUTCOME MEASURES When available, treatment efficacy was evaluated based on patient satisfaction, penile size increase, and complications. RESULTS We included 17 studies, assessing a total of 21 interventions in 1,192 men screened, with 773 followed up after nonsurgical (n = 248) or surgical (n = 525) treatment. The quality of the studies was poor in terms of methodology for patient selection and outcomes assessment. The vast majority of series reported normal penile size. Among nonsurgical treatments, extenders increased flaccid length (but by <2 cm), injectables increased girth but were associated with a high complication rate, and vacuum devices did not increase size. Surgical interventions included suspensory ligament incision (the most used method; n = 12), tissue grafting (autologous, n = 2; dermal fat, n = 3, ex vivo, n = 2), flaps (n = 2), and penile disassembly (n = 1). Some men reported a significant size increase; however, complications were not infrequent, and none of the techniques was externally validated. When provided, counseling was effective, with the majority of men coming to understand that their penis was normal and unwilling to undergo any further treatment. CONCLUSION Treatment of small penis in normal men is supported by scant, low-quality evidence. Structured counseling should be always performed, with extenders eventually used by those still seeking enhancement. Injectables and surgery should remain a last option, considered unethical outside of clinical trials. Marra G, Drury A, Tran L, et al. Systematic Review of Surgical and Nonsurgical Interventions in Normal Men Complaining of Small Penis Size. Sex Med Rev 2020;8:158-180.
Collapse
|
28
|
Haye R, Døsen LK, Tarangen M, Shiryaeva O. Good correlation between visual analogue scale and numerical rating scale in the assessment of nasal obstruction. J Laryngol Otol 2018; 132:327-8. [PMID: 29444717 DOI: 10.1017/S0022215118000257] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Results from telephone interviews may be needed to supplement those from mailed questionnaires when response rates are inadequate. This study assessed the correlation between visual analogue scale ratings used in mailed questionnaires and numerical rating scale scores used in telephone interviews. METHODS Patients scheduled for nasal septal surgery routinely respond to a visual analogue scale of obstruction during the day and at night. In this study, they were also asked to verbally rate their sense of obstruction using whole numbers. RESULTS There was no significant difference between visual analogue scale and numerical rating scale obstruction scores. CONCLUSION Ratings of nasal obstruction obtained with a numerical rating scale in telephone interviews are comparable to visual analogue scale scores in mailed questionnaires.
Collapse
|
29
|
Tomoum MO, Askar MH, Mandour MF, Amer MA, Saafan ME. Stentless mirrored L-shaped septonasal flap versus stented flapless technique for endoscopic endonasal repair of bilateral congenital choanal atresia: a prospective randomised controlled study. J Laryngol Otol 2018; 132:329-35. [PMID: 29335043 DOI: 10.1017/S0022215117002614] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To compare the outcomes of endoscopic repair of bilateral congenital choanal atresia using a flap technique without stenting versus endoscopic repair using stenting without a flap. METHODS A prospective randomised controlled study was conducted, comprising 72 patients with bilateral congenital choanal atresia. The patients were randomised into two groups. Group A (42 patients) underwent endoscopic repair using a mirrored L-shaped flap without stenting, and group B (30 patients) underwent endoscopic repair using stenting without a flap. RESULTS At a mean follow-up period of 18.2 months, endoscopic assessment revealed a patent posterior choana in 81 per cent and 83.33 per cent of patients in group A and group B respectively. Choanal stenosis occurred in 21.40 per cent and 33.33 per cent of patients in group A and group B respectively. Granulation tissue was observed in 28.6 per cent and 53.3 per cent of patients in group A and group B respectively. CONCLUSION The endoscopic approach utilising a flap without stenting is safe and effective, with a high success rate.
Collapse
|
30
|
Ten Brinck RM, van Steenbergen HW, Mangnus L, Burgers LE, Reijnierse M, Huizinga TW, van der Helm-van Mil AH. Functional limitations in the phase of clinically suspect arthralgia are as serious as in early clinical arthritis; a longitudinal study. RMD Open 2017; 3:e000419. [PMID: 28879045 PMCID: PMC5574454 DOI: 10.1136/rmdopen-2016-000419] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 02/04/2017] [Accepted: 02/14/2017] [Indexed: 12/22/2022] Open
Abstract
Introduction A phase of arthralgia may precede the emergence of rheumatoid arthritis (RA). Although several studies have focused on biomarkers, the relevance of this phase for patients is less studied. It is unknown if patients already have functional limitations and if this is correlated to the extent of subclinical inflammation. Therefore, we assessed functional disability in patients with clinically suspect arthralgia (CSA), its association with MRI-detected subclinical inflammation and its course during progression to clinical arthritis. Methods From April 2012 to March 2015, 241 patients had arthralgia for <1 year and were, based on clinical presentation, considered at risk for RA by their rheumatologists. At baseline, Health Assessment Questionnaire (HAQ) scores were determined and unilateral 1.5 T MRI of metacarpophalangeal, wrist and metatarsophalangeal joints were made. Presence of MRI-detected subclinical inflammation was assessed by summing synovitis, tenosynovitis and bone marrow oedema scores (range 0–189). Patients were followed on arthritis development and HAQ scores were repeated when clinical arthritis had developed. Results The median HAQ score at presentation with CSA was 0.50. Higher MRI-inflammation scores were associated with higher HAQ scores (β=0.017, 95% CI=0.004 to 0.030). During median 103 weeks follow-up, 44 patients progressed to clinical arthritis. HAQ scores ≥1.0 were associated with arthritis development (HR=2.50, 95% CI=1.03 to 6.10). Within converters, median HAQ scores did not increase from presentation with CSA to arthritis development (0.88 and 0.75, p=0.36). Conclusions HAQ scores ≥1.0 at presentation were associated with the development of clinical arthritis. Functional limitations in the prearthritis phase of CSA were as serious as in the early clinical phase, demonstrating the relevance of CSA from patients’ perspectives.
Collapse
Affiliation(s)
- Robin M Ten Brinck
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Lukas Mangnus
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Leonie E Burgers
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Monique Reijnierse
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Tom Wj Huizinga
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | | |
Collapse
|
31
|
Petrou S, Rivero-Arias O, Dakin H, Longworth L, Oppe M, Froud R, Gray A. PREFERRED REPORTING ITEMS FOR STUDIES MAPPING ONTO PREFERENCE-BASED OUTCOME MEASURES: THE MAPS STATEMENT. Int J Technol Assess Health Care 2015; 31:230-5. [PMID: 26235547 DOI: 10.1017/S0266462315000379] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Background: “Mapping” onto generic preference-based outcome measures is increasingly being used as a means of generating health utilities for use within health economic evaluations. Despite publication of technical guides for the conduct of mapping research, guidance for the reporting of mapping studies is currently lacking. The MAPS (MApping onto Preference-based measures reporting Standards) statement is a new checklist, which aims to promote complete and transparent reporting of mapping studies. Methods: In the absence of previously published reporting checklists or reporting guidance documents, a de novo list of reporting items was created by a working group comprised of six health economists and one Delphi methodologist. A two-round, modified Delphi survey with representatives from academia, consultancy, health technology assessment agencies, and the biomedical journal editorial community was used to identify a list of essential reporting items from this larger list. Results: From the initial de novo list of twenty-nine candidate items, a set of twenty-three essential reporting items was developed. The items are presented numerically and categorized within six sections, namely: (i) title and abstract, (ii) introduction, (iii) methods, (iv) results, (v) discussion, and (vi) other. The MAPS statement is best applied in conjunction with the accompanying MAPS explanation and elaboration document. Conclusions: It is anticipated that the MAPS statement will improve the clarity, transparency. and completeness of reporting of mapping studies. To facilitate dissemination and uptake, the MAPS statement is being co-published by seven health economics and quality of life journals, and broader endorsement is encouraged. The MAPS working group plans to assess the need for an update of the reporting checklist in five years’ time.
Collapse
|
32
|
Petrou S, Rivero-Arias O, Dakin H, Longworth L, Oppe M, Froud R, Gray A. Preferred reporting items for studies mapping onto preference-based outcome measures: the MAPS statement. Qual Life Res 2015; 25:275-281. [PMID: 26231589 PMCID: PMC4722069 DOI: 10.1007/s11136-015-1082-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2015] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND AIM 'Mapping' onto generic preference-based outcome measures is increasingly being used as a means of generating health utilities for use within health economic evaluations. Despite publication of technical guides for the conduct of mapping research, guidance for the reporting of mapping studies is currently lacking. The MApping onto Preference-based measures reporting Standards (MAPS) statement is a new checklist, which aims to promote complete and transparent reporting of mapping studies. METHODS In the absence of previously published reporting checklists or reporting guidance documents, a de novo list of reporting items was created by a working group comprised of six health economists and one Delphi methodologist. A two-round, modified Delphi survey with representatives from academia, consultancy, health technology assessment agencies and the biomedical journal editorial community was used to identify a list of essential reporting items from this larger list. RESULTS From the initial de novo list of 29 candidate items, a set of 23 essential reporting items was developed. The items are presented numerically and categorised within six sections, namely (1) title and abstract; (2) introduction; (3) methods; (4) results; (5) discussion; and (6) other. The MAPS statement is best applied in conjunction with the accompanying MAPS explanation and elaboration document. CONCLUSIONS It is anticipated that the MAPS statement will improve the clarity, transparency and completeness of reporting of mapping studies. To facilitate dissemination and uptake, the MAPS statement is being co-published by seven health economics and quality of life journals, and broader endorsement is encouraged. The MAPS working group plans to assess the need for an update of the reporting checklist in 5 years' time.
Collapse
Affiliation(s)
- Stavros Petrou
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.
| | - Oliver Rivero-Arias
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Helen Dakin
- Nuffield Department of Population Health, Health Economics Research Centre, University of Oxford, Oxford, UK
| | - Louise Longworth
- Health Economics Research Group, Brunel University London, Uxbridge, UK
| | - Mark Oppe
- EuroQol Research Foundation, Rotterdam, The Netherlands
| | - Robert Froud
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.,Norges Helsehøyskole, Campus Kristiania, Oslo, Norway
| | - Alastair Gray
- Nuffield Department of Population Health, Health Economics Research Centre, University of Oxford, Oxford, UK
| |
Collapse
|
33
|
Abstract
'Mapping' onto generic preference-based outcome measures is increasingly being used as a means of generating health utilities for use within health economic evaluations. Despite publication of technical guides for the conduct of mapping research, guidance for the reporting of mapping studies is currently lacking. The MAPS (MApping onto Preference-based measures reporting Standards) statement is a new checklist, which aims to promote complete and transparent reporting of mapping studies. The primary audiences for the MAPS statement are researchers reporting mapping studies, the funders of the research, and peer reviewers and editors involved in assessing mapping studies for publication. A de novo list of 29 candidate reporting items and accompanying explanations was created by a working group comprised of six health economists and one Delphi methodologist. Following a two-round, modified Delphi survey with representatives from academia, consultancy, health technology assessment agencies and the biomedical journal editorial community, a final set of 23 items deemed essential for transparent reporting, and accompanying explanations, was developed. The items are contained in a user friendly 23 item checklist. They are presented numerically and categorised within six sections, namely: (i) title and abstract; (ii) introduction; (iii) methods; (iv) results; (v) discussion; and (vi) other. The MAPS statement is best applied in conjunction with the accompanying MAPS explanation and elaboration document. It is anticipated that the MAPS statement will improve the clarity, transparency and completeness of reporting of mapping studies. To facilitate dissemination and uptake, the MAPS statement is being co-published by seven health economics and quality of life journals, and broader endorsement is encouraged. The MAPS working group plans to assess the need for an update of the reporting checklist in five years' time.
Collapse
Affiliation(s)
- Stavros Petrou
- a a Warwick Clinical Trials Unit , Warwick Medical School, University of Warwick , Coventry , UK
| | - Oliver Rivero-Arias
- b b National Perinatal Epidemiology Unit, Nuffield Department of Population Health , University of Oxford , Oxford , UK
| | - Helen Dakin
- c c Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford , Oxford , UK
| | - Louise Longworth
- d d Health Economics Research Group , Brunel University London , Uxbridge , UK
| | - Mark Oppe
- e e EuroQol Research Foundation , Rotterdam , The Netherlands
| | - Robert Froud
- a a Warwick Clinical Trials Unit , Warwick Medical School, University of Warwick , Coventry , UK
- f f Norges Helsehøyskole , Campus Kristiania , Oslo , Norway
| | - Alastair Gray
- c c Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford , Oxford , UK
| |
Collapse
|
34
|
Peolsson A, Ludvigsson ML, Wibault J, Dedering Å, Peterson G. Function in patients with cervical radiculopathy or chronic whiplash-associated disorders compared with healthy volunteers. J Manipulative Physiol Ther 2014; 37:211-8. [PMID: 24747041 DOI: 10.1016/j.jmpt.2014.01.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2013] [Revised: 12/30/2013] [Accepted: 01/23/2014] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The purposes of this study were to examine whether any differences in function and health exist between patients with cervical radiculopathy (CR) due to disk disease scheduled for surgery and patients with chronic whiplash-associated disorders (WADs) and to compare measures of patients' physical function with those obtained from healthy volunteers. METHODS This is a cross-sectional study of patients with CR (n = 198) and patients with chronic WAD (n = 215). Patient data were compared with raw data previously obtained from healthy people. Physical measures included cervical active range of motion, neck muscle endurance, and hand grip strength. Self-rated measures included pain intensity (visual analog scale), neck disability (Neck Disability Index), self-efficacy (Self-Efficacy Scale), and health-related quality of life (EuroQol 5-dimensional self-classifier). RESULTS Patient groups exhibited significantly lower performance than the healthy group in all physical measures (P < .0005) except for neck muscle endurance in flexion for women (P > .09). There was a general trend toward worse results in the CR group than the WAD group, with significant differences in neck active range of motion, left hand strength for women, pain intensity, Neck Disability Index, EuroQol 5-dimensional self-classifier, and Self-Efficacy Scale (P < .0001). CONCLUSIONS Patients had worse values than healthy individuals in almost all physical measures. There was a trend toward worse results for CR than WAD patients.
Collapse
|