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Oberdhan D, Yarlas A, Bjorner JB, Krasa H. Patient-Reported Outcomes Measures, Polycystic Kidney Disease Burden, and Outcomes in Autosomal Dominant Polycystic Kidney Disease. Kidney Med 2024; 6:100755. [PMID: 38192435 PMCID: PMC10772284 DOI: 10.1016/j.xkme.2023.100755] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024] Open
Abstract
Rationale & Objective Using OVERTURE (NCT01430494) study data on patient-perceived health, health care utilization, and productivity in autosomal dominant polycystic kidney disease (ADPKD), this research was conducted to characterize the burden of illness in patients with ADPKD and assess whether patient-reported outcome (PRO) assessment scores predict clinical and health-economic outcomes. Study Design Data were analyzed from a prospective, observational study. Setting & Participants The study cohort comprised 3,409 individuals with ADPKD in 20 countries who were aged 12-78 years and were in chronic kidney disease (CKD) stages G1-G5 and Mayo risk subclasses 1A-1E. Predictors Scores on PRO instruments, including disease-specific assessments [ADPKD-Impact Scale (ADPKD-IS), and ADPKD-Urinary Impact Scale (ADPKD-UIS)] and generic measures were assessed. Outcomes Clinical variables [eg, height-adjusted total kidney volume (htTKV), estimated glomerular filtration rate (eGFR), and abdominal girth] and health-economic outcomes were assessed. Analytical Approach Associations among variables were evaluated using Spearman correlations, logistic regression, and generalized linear mixed effects repeated measures models. Results Baseline CKD stage and Mayo risk classification showed little correlation with baseline PRO scores; however, scores on disease-specific instruments and measures of physical functioning were worse at more severe CKD stages. PRO scores predicted hospitalizations and sick days at 6-18 months, with strongest associations noted for the ADPKD-IS. PRO scores were not associated with htTKV and eGFR, but worse PRO scores were associated with greater abdominal girth. Poor baseline ADPKD-IS scores were positively associated with occurrence of ADPKD-related symptoms up to 18 months, including kidney pain (OR, 5.30; 95% CI, 2.75-10.24), hematuria (OR, 4.58; 95% CI, 1.99-10.53), and urinary tract infection (OR, 4.41; 95% CI, 1.93-10.11; P < 0.001 for all). Limitations A limitation of the study was the maximum 18 months of follow-up available to assess outcomes. Conclusions PRO scores predicted clinical and health-economic outcomes, such as hospitalization and absence from work, underscoring the importance of quality of life assessment of individuals with ADPKD. Plain-Language Summary Patient-reported outcomes (PROs) are increasingly recognized as important parameters for assessing the clinical and humanistic burden of autosomal dominant polycystic kidney disease (ADPKD). We analyzed data from the observational OVERTURE study to better characterize disease impact on quality of life and determine whether patient-perceived burden might predict outcomes. Scores on PRO assessment instruments predicted hospitalizations and sick days at 6-18 months, with associations strongest for the disease-specific ADPKD-Impact Scale. Compared to patients who rated their health-related quality of life as good, those with poor baseline scores were significantly more likely to report ADPKD-related signs and symptoms up to 18 months of follow-up. These findings support using disease-specific PRO assessment instruments to assess and predict the impact of ADPKD.
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Affiliation(s)
- Dorothee Oberdhan
- Otsuka Pharmaceutical Development & Commercialization, Inc., Rockville, MD
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Tinajero-Chávez LI, Mora-Romo JF, Bravo-Doddoli A, Cruz-Narciso BV, Calleja N, Toledano-Toledano F. Design, Development, and Validation of the Self-Perceived Health Scale (SPHS). Healthcare (Basel) 2023; 11:2007. [PMID: 37510448 PMCID: PMC10379989 DOI: 10.3390/healthcare11142007] [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: 06/02/2023] [Revised: 06/19/2023] [Accepted: 06/29/2023] [Indexed: 07/30/2023] Open
Abstract
Health is a multidimensional concept with notable psychological factors, such as self-perceived health (SPH). SPH is defined as the subjective assessment of individual health status, and it integrates information related to both physical and psychological aspects, such as lifestyle. This study describes the development of the Self-Perceived Health Scale (SPHS), and its validation in a Mexican sample (n = 600). Exploratory factor analysis (n = 303) and confirmatory factor analysis (n = 293) were carried out, and they supported the three-dimensionality of the SPH construct: physical health, psychological health, and healthy lifestyle. A final 12-item scale was obtained, and the scale showed adequate validity and reliability, as well as measurement invariance between sexes, indicating its robustness.
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Affiliation(s)
- Lorena Ishel Tinajero-Chávez
- Facultad de Psicología, Universidad Nacional Autónoma de México, Ciudad Universitaria, Coyoacán, Mexico City 04510, Mexico
| | - José Fernando Mora-Romo
- Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla 54090, Mexico
| | - Andrea Bravo-Doddoli
- Facultad de Psicología, Universidad Nacional Autónoma de México, Ciudad Universitaria, Coyoacán, Mexico City 04510, Mexico
| | | | - Nazira Calleja
- Facultad de Psicología, Universidad Nacional Autónoma de México, Ciudad Universitaria, Coyoacán, Mexico City 04510, Mexico
| | - Filiberto Toledano-Toledano
- Unidad de Investigación en Medicina Basada en Evidencias, Hospital Infantil de México Federico Gómez Instituto Nacional de Salud, Márquez 162, Cuauhtémoc, Mexico City 06720, Mexico
- Unidad de Investigación Multidisciplinaria en Salud, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Calzada México-Xochimilco 289, Arenal de Guadalupe, Tlalpan, Mexico City 14389, Mexico
- Dirección de Investigación y Diseminación del Conocimiento, Instituto Nacional de Ciencias e Innovación para la Formación de Comunidad Científica, INDEHUS, Periférico Sur 4860, Arenal de Guadalupe, Tlalpan, Mexico City 14389, Mexico
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Gosselt HR, van Lint JA, Kosse LJ, Spuls PI, Vonkeman HE, Tas SW, Hoentjen F, Nurmohamed MT, van den Bemt BJF, van Doorn MBA, Jessurun NT. Sex differences in adverse drug reactions from Adalimumab and etanercept in patients with inflammatory rheumatic diseases. Expert Opin Drug Saf 2023; 22:501-507. [PMID: 36794307 DOI: 10.1080/14740338.2023.2181340] [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] [Received: 10/10/2022] [Accepted: 01/16/2023] [Indexed: 02/17/2023]
Abstract
BACKGROUND We examine sex differences in relation to the nature, frequency, and burden of patient-reported adverse drug reactions (ADRs) in patients with inflammatory rheumatic diseases. RESEARCH DESIGN AND METHODS Rheumatoid arthritis, psoriatic arthritis, or axial spondyloarthritis patients using etanercept or adalimumab from the Dutch Biologic Monitor were sent bimonthly questionnaires concerning experienced ADRs. Sex differences in the proportion and nature of reported ADRs were assessed. Additionally, 5-point Likert-type scales reported for the burden of ADRs, were compared between sexes. RESULTS In total 748 consecutive patients were included (59% female). From the women 55% reported ≥1 ADR, which was significantly higher than 38% of the men that reported ≥1 ADR (p < 0.001). A total of 882 ADRs were reported comprising 264 distinct ADRs. The nature of the reported ADRs differed significantly between both sexes (p = 0.02). Women in particular reported more injection site reactions than men. The burden of ADRs was similar between sexes. CONCLUSIONS Sex differences in the frequency and nature of ADRs, but not in ADR burden, exist during treatment with adalimumab and etanercept in patients with inflammatory rheumatic diseases. This should be taken into consideration when investigating and reporting results on ADRs and when counseling patients in daily clinical practice.
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Affiliation(s)
- Helen R Gosselt
- Netherlands Pharmacovigilance Centre Lareb,'s'-Hertogenbosch, Netherlands
| | - Jette A van Lint
- Netherlands Pharmacovigilance Centre Lareb,'s'-Hertogenbosch, Netherlands
| | - Leanne J Kosse
- Netherlands Pharmacovigilance Centre Lareb,'s'-Hertogenbosch, Netherlands
- Department of Pharmacy, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Phyllis I Spuls
- Department of Dermatology, Public Health and Epidemiology, Immunity and Infections, Amsterdam UMC, location Academic Medical Center, Amsterdam, The Netherlands
| | - Harald E Vonkeman
- Department of Psychology, Health & Technology, University of Twente, Enschede, The Netherlands
- Department of Rheumatology and Clinical Immunology, Medisch Spectrum Twente, Enschede, The Netherlands
| | - Sander W Tas
- Department of Rheumatology & Clinical Immunology, Amsterdam UMC, location AMC, University of Amsterdam and Amsterdam Rheumatology & Immunology Center (ARC), Amsterdam, the Netherlands
| | - Frank Hoentjen
- Department of Gastroenterology, Radboud University Medical Center, Nijmegen, The Netherlands
- Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | | | - Bart J F van den Bemt
- Department of Pharmacy, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Pharmacy, Sint Maartenskliniek, Nijmegen, Netherlands
| | - Martijn B A van Doorn
- Department of Dermatology, Erasmus MC, Rotterdam, The Netherlands
- Centre for Human Drug Research, Leiden, The Netherlands
| | - Naomi T Jessurun
- Netherlands Pharmacovigilance Centre Lareb,'s'-Hertogenbosch, Netherlands
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Lassaletta L, Calvino M, Sanchez-Cuadrado I, Skarzynski PH, Cywka KB, Czajka N, Kutyba J, Tavora-Vieira D, van de Heyning P, Mertens G, Staecker H, Humphrey B, Zernotti M, Zernotti M, Magele A, Ploder M, Zabeu JS. Using Generic and Disease-Specific Measures to Assess Quality of Life before and after 12 Months of Hearing Implant Use: A Prospective, Longitudinal, Multicenter, Observational Clinical Study. Int J Environ Res Public Health 2022; 19:2503. [PMID: 35270201 DOI: 10.3390/ijerph19052503] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/18/2022] [Accepted: 02/20/2022] [Indexed: 12/04/2022]
Abstract
The primary objectives of this study were to evaluate the effect of hearing implant (HI) use on quality of life (QoL) and to determine which QoL measure(s) quantify QoL with greater sensitivity in users of different types of HIs. Participants were adult cochlear implant (CI), active middle ear implant (VIBRANT SOUNDBRIDGE (VSB)), or active transcutaneous bone conduction implant (the BONEBRIDGE (BB)) recipients. Generic QoL and disease-specific QoL were assessed at three intervals: pre-activation, 6 months of device use, and 12 months of device use. 169 participants completed the study (110 CI, 18VSB, and 41BB). CI users' QoL significantly increased from 0-6 m device use on both the generic- and the disease-specific measures. On some device-specific measures, their QoL also significantly increased between 6 and 12 m device use. VSB users' QoL significantly increased between all tested intervals with the disease-specific measure but not the generic measure. BB users' QoL significantly increased from 0-6 m device use on both the generic- and the disease-specific measures. In sum, HI users experienced significant postoperative increases in QoL within their first 12 m of device use, especially when disease-specific measures were used. Disease-specific QoL measures appeared to be more sensitive than their generic counterparts.
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Abstract
The practice of routine outcome monitoring and providing clinical feedback has been widely studied within psychotherapy. Nevertheless, there are many outstanding questions regarding this practice. Is it an evidence-based adjunct to ongoing psychotherapies, or an ineffective complication of treatment? If it is effective, through what mechanism(s) does it act? Is it effective with all patient populations, treatment types, and service delivery mechanisms, or does its impact vary across context? What choices in the implementation process affect the utility of patient-reported data feedback on psychotherapy outcomes? The studies in this special section explore these questions using a wide variety of methods and significantly expand the reach of studies on feedback. Together, these studies represent a snapshot of a maturing field of study: Initial discoveries are developed into more robust theories and applied in a wider range of contexts, while the limits of that theory are tested. They also signal directions for future clinical and research work that may improve patient care in psychosocial interventions into the future.
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Affiliation(s)
- Andrew A McAleavey
- Center for Health Research, Helse Førde, Førde, Norway.,Weill Cornell Medical College, New York, NY, USA
| | - Christian Moltu
- District General Hospital of Førde, Førde, Norway.,Department of Health and Caring Sciences, Western Norway University of Applied Science, Førde, Norway
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Salas M, Henderson M, Wientzek-Fleischmann A, Islam Z, Tu N, Bilitou A, Elsharkawy M, Stellmacher U. Validated Instruments of Quality of Life (QOL) in Patients With Acute Myeloid Leukemia (AML) and Other Cancers. Front Pharmacol 2020; 11:1109. [PMID: 32792948 PMCID: PMC7394002 DOI: 10.3389/fphar.2020.01109] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 07/08/2020] [Indexed: 11/26/2022] Open
Abstract
Introduction Acute myeloid leukemia (AML) can negatively impact quality of life (QOL). Few QOL instruments are specific to and have been validated in AML. This review aims to identify QOL instruments that have been validated in patients with AML and other cancers and summarize their psychometric properties reported in published literature. A literature review search was performed using PubMed and OVID (Biosis, Embase, MEDLINE) databases through June 25, 2020. Search terms included: QOL, health-related QOL, patient-reported outcomes and validity, reliability, validated, tools, instruments, test-retest, and leukemia myeloid acute, leukemia, myeloid, acute, acute myeloid leukemia. Articles were included if they focused on cancer and reported psychometric properties that could be extracted. Abstracts and their references were reviewed for inclusion. Results Twelve evaluating ten instruments were included. Functional Assessment of Cancer Therapy Leukemia (FACT-Leu) showed internal consistency (IC) of α = 0.86 to >0.9, correlation with EQ-5D-3L of r > 0.50, correlation with European Organisation for Research and Treatment of Cancer (EORTC) QLQ-Leu of ρ = 0.29–0.63, test-retest reliability of κ = 0.861. FACT-F showed correlations with EORTC QLQ-C30 of r = 0.40–0.83. Hematological Malignancy Patient-Reported Outcome (HM-PRO) showed intraclass correlation coefficient (ICC) of 0.94–0.98. EORTC-8D and EQ-5D-3L showed ICC = 0.595, correlations with each other of ρ = 0.137–0.634 and with EORTC QLQ-C30 of r = 0.651–0.917. EORTC QLQ-C30 showed person separation reliability of 0.47 to 0.90 and patient-observer agreement of 0.85. Life Ingredient Profile (LIP) showed IC of α = 0.29–0.77 and test-retest reliability of κ = 0.42–1.0. QOL-E showed correlation with FACT-general of R = 0.71, internal validity of α = 0.7, and test-retest reliability of standardized Cronbach’s α = 0.7–0.92. EORTC QLQ-Leu showed IC of α = 0.6–0.79. The Acute Myeloid Leukemia–Quality of Life (AML-QOL) instrument showed IC of α = 0.72, correlations with EORTC QLQ-30 of magnitudes ρ = 0.59–0.72, and test-retest reliability of ICC = 0.52–0.91. Conclusion Although several QOL instruments have been validated, more research is needed to determine the most clinically useful instruments in patients with AML.
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Affiliation(s)
- Maribel Salas
- Epidemiology and Clinical Safety and Pharmacovigilance, Daiichi Sankyo, Inc., Basking Ridge, NJ, USA.,Centers for Clinical Epidemiology and Biostatistics and Center for Pharmacoepidemiology Research and Training, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Mackenzie Henderson
- Epidemiology and Clinical Safety and Pharmacovigilance, Daiichi Sankyo, Inc., Basking Ridge, NJ, USA.,Rutgers Institute for Pharmaceutical Industry Fellowships, Rutgers University, Piscataway, NJ, United States
| | | | - Zahidul Islam
- Epidemiology and Clinical Safety and Pharmacovigilance, Daiichi Sankyo, Inc., Basking Ridge, NJ, USA
| | - Nora Tu
- Epidemiology and Clinical Safety and Pharmacovigilance, Daiichi Sankyo, Inc., Basking Ridge, NJ, USA
| | - Aikaterini Bilitou
- HEOR/RWE: Health Economics and Outcomes Research (HEOR)/Real-World Evidence (RWE), Market Access, DSE, Munich, Germany
| | - Maggie Elsharkawy
- Epidemiology and Clinical Safety and Pharmacovigilance, Daiichi Sankyo, Inc., Basking Ridge, NJ, USA
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Manini TM, Mendoza T, Battula M, Davoudi A, Kheirkhahan M, Young ME, Weber E, Fillingim RB, Rashidi P. Perception of Older Adults Toward Smartwatch Technology for Assessing Pain and Related Patient-Reported Outcomes: Pilot Study. JMIR Mhealth Uhealth 2019; 7:e10044. [PMID: 30912756 PMCID: PMC6454335 DOI: 10.2196/10044] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 11/09/2018] [Accepted: 01/06/2019] [Indexed: 12/23/2022] Open
Abstract
Background Chronic pain, including arthritis, affects about 100 million adults in the United States. Complexity and diversity of the pain experience across time and people and its fluctuations across and within days show the need for valid pain reports that do not rely on patient’s long-term recall capability. Smartwatches can be used as digital ecological momentary assessment (EMA) tools for real-time collection of pain scores. Smartwatches are generally less expensive than smartphones, are highly portable, and have a simpler user interface, providing an excellent medium for continuous data collection and enabling a higher compliance rate. Objective The aim of this study was to explore the attitudes and perceptions of older adults towards design and technological aspects of a smartwatch framework for measuring patient report outcomes (PRO) as an EMA tool. Methods A focus group session was conducted to explore the perception of participants towards smartwatch technology and its utility for PRO assessment. Participants included older adults (age 65+), with unilateral or bilateral symptomatic knee osteoarthritis. A preliminary user interface with server communication capability was developed and deployed on 10 Samsung Gear S3 smartwatches and provided to the users during the focus group. Pain was designated as the main PRO, while fatigue, mood, and sleep quality were included as auxiliary PROs. Pre-planned topics included participants’ attitude towards the smartwatch technology, usability of the custom-designed app interface, and suitability of the smartwatch technology for PRO assessment. Discussions were transcribed, and content analysis with theme characterization was performed to identify and code the major themes. Results We recruited 19 participants (age 65+) who consented to take part in the focus group study. The overall attitude of the participants toward the smartwatch technology was positive. They showed interest in the direct phone-call capability, availability of extra apps such as the weather apps and sensors for tracking health and wellness such as accelerometer and heart rate sensor. Nearly three-quarters of participants showed willingness to participate in a one-year study to wear the watch daily. Concerns were raised regarding usability, including accessibility (larger icons), notification customization, and intuitive interface design (unambiguous icons and assessment scales). Participants expressed interest in using smartwatch technology for PRO assessment and the availability of methods for sharing data with health care providers. Conclusions All participants had overall positive views of the smartwatch technology for measuring PROs to facilitate patient-provider communications and to provide more targeted treatments and interventions in the future. Usability concerns were the major issues that will require special consideration in future smartwatch PRO user interface designs, especially accessibility issues, notification design, and use of intuitive assessment scales.
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Affiliation(s)
- Todd Matthew Manini
- Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, United States
| | - Tonatiuh Mendoza
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL, United States
| | - Manoj Battula
- Department of Computer and Information Science and Engineering, University of Florida, Gainesville, FL, United States
| | - Anis Davoudi
- Department of Biomedical Engineering, University of Florida, Gainesville, FL, United States
| | - Matin Kheirkhahan
- Department of Computer and Information Science and Engineering, University of Florida, Gainesville, FL, United States
| | - Mary Ellen Young
- Department of Occupational Therapy, University of Florida, Gainesville, FL, United States
| | - Eric Weber
- Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, United States
| | - Roger Benton Fillingim
- Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, United States
| | - Parisa Rashidi
- Department of Biomedical Engineering, University of Florida, Gainesville, FL, United States
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McLellan C, Frey MP, Thiboutot D, Layton A, Chren MM, Tan J. Development of a Comprehensive Quality-of-Life Measure for Facial and Torso Acne. J Cutan Med Surg 2018; 22:304-311. [PMID: 29383947 DOI: 10.1177/1203475418756379] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [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: 11/16/2022]
Abstract
Background Acne is a chronic skin disorder which generally presents in adolescence but continues into adulthood, and negatively affects both physical and psychosocial well-being. Presently, there are no validated acne-specific quality-of-life (QoL) measures that include dimensions for both facial and torso acne. OBJECTIVE The objective of this study was to develop a QoL instrument for both facial and torso acne (CompAQ) in accordance with recommended standards. METHODS A literature review and Delphi survey of patients and clinicians were used to develop the conceptual framework for outcomes perceived important to acne patients. An initial version of the measure was developed, CompAQ-v1, and pilot tested with patients via cognitive interviews. RESULTS The Delphi survey generated 4 domains (physical, psychological, sociological, and treatment) and 54 items. These, along with a literature review and input from clinical experts, informed the development of the CompAQ-v1. Eleven cognitive interviews were conducted, resulting in the second version of the measure, CompAQ-v2. Psychometric validation resulted in the final 20-item CompAQ measure comprising 5 domains. An abbreviated 5-item measure was also developed (CompAQ-SF). CONCLUSION CompAQ and CompAQ-SF are instruments intended to evaluate QoL in patients with acne on their face or torso. The former is a 21-item QoL intended for research, while the latter is intended for clinical practice.
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Affiliation(s)
- Chelsea McLellan
- 1 Department of Psychology, University of Windsor, Windsor, ON, Canada
| | - Marc P Frey
- 1 Department of Psychology, University of Windsor, Windsor, ON, Canada
| | | | - Alison Layton
- 4 Harrogate & District NHS Foundation Trust Harrogate and District NHS Foundation Trust, Harrogate, England
| | - Mary-Margaret Chren
- 5 University of California at San Francisco, Department of Dermatology, San Francisco, CA, USA
| | - Jerry Tan
- 2 Windsor Clinical Research, Inc, Windsor, ON, Canada.,6 Department of Medicine, University of Western Ontario, London, ON, Canada
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Koller M, Hjermstad MJ, Tomaszewski KA, Tomaszewska IM, Hornslien K, Harle A, Arraras JI, Morag O, Pompili C, Ioannidis G, Georgiou M, Navarra C, Chie WC, Johnson CD, Himpel A, Schulz C, Bohrer T, Janssens A, Kuliś D, Bottomley A. An international study to revise the EORTC questionnaire for assessing quality of life in lung cancer patients. Ann Oncol 2017; 28:2874-2881. [PMID: 28945875 DOI: 10.1093/annonc/mdx453] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [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: 12/21/2022] Open
Abstract
BACKGROUND The European Organization for Research and Treatment of Cancer (EORTC) QLQ-LC13 was the first module to be used in conjunction with the core questionnaire, the QLQ-C30. Since the publication of the LC13 in 1994, major advances have occurred in the treatment of lung cancer. Given this, an update of the EORTC QLQ-LC13 was undertaken. METHODS The study followed phases I to III of the EORTC Module Development Guidelines. Phase I generated relevant quality-of-life issues using a mix of sources including the involvement of 108 lung cancer patients. Phase II transformed issues into questionnaire items. In an international multicenter study (phase III), patients completed both the EORTC QLQ-C30 and the 48-item provisional lung cancer module generated in phases I and II. Patients rated each of the items regarding relevance, comprehensibility, and acceptance. Patient ratings were assessed against a set of prespecified statistical criteria. Descriptive statistics and basic psychometric analyses were carried out. RESULTS The phase III study enrolled 200 patients with histologically confirmed lung cancer from 12 centers in nine countries (Cyprus, Germany, Italy, Israel, Spain, Norway, Poland, Taiwan, and the UK). Mean age was 64 years (39 - 91), 59% of the patients were male, 82% had non-small-cell lung cancer, and 56% were treated with palliative intent. Twenty-nine of the 48 questions met the criteria for inclusion. CONCLUSIONS The resulting module with 29 questions, thus currently named EORTC QLQ-LC29, retained 12 of the 13 original items, supplemented with 17 items that primarily assess treatment side-effects of traditional and newer therapies.
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Affiliation(s)
- M Koller
- Center for Clinical Studies, University Hospital Regensburg, Regensburg, Germany.
| | - M J Hjermstad
- Regional Advisory Unit for Palliative Care, Department of Oncology, Oslo University Hospital, Oslo, and European Palliative Care Research Center (PRC), Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, Norwegian University of Science and Technology and St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - K A Tomaszewski
- Health Outcomes Research Unit, Faculty of Education, Ignatianum Academy, Krakow, Poland
| | - I M Tomaszewska
- Department of Medical Education, Jagiellonian University Medical College, Krakow, Poland
| | - K Hornslien
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - A Harle
- Poole Hospital NHS Foundation Trust, and The Christie NHS Foundation Trust, Manchester, UK
| | - J I Arraras
- Oncology Departments, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - O Morag
- Chaim Sheba Medical Center, Ramat-Gan, Israel
| | - C Pompili
- St.James's University Hospital, Leeds, UK
| | - G Ioannidis
- Oncology Department, Nicosia General Hospital Cyprus, Nicosia, Cyprus
| | - M Georgiou
- Bank of Cyprus Oncology Center, Nicosia, Cyprus
| | - C Navarra
- Azienda Ospedaliera Sant'Andrea, Rome, Italy
| | - W-C Chie
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei; Department of Public Health, College of Public Health, National Taiwan University, Taipei, Republic of Taiwan
| | - C D Johnson
- Surgical Unit, University of Southampton, Southampton, UK
| | - A Himpel
- Center for Clinical Studies, University Hospital Regensburg, Regensburg, Germany
| | - C Schulz
- Department of Internal Medicine, University Hospital Regensburg, Regensburg
| | - T Bohrer
- Department of Thoracic Surgery, Bamberg, Germany
| | - A Janssens
- Thoracic Oncology, MOCA, Antwerp University Hospital, Edegem
| | - D Kuliś
- Quality of Life Department, EORTC, Brussels, Belgium
| | - A Bottomley
- Quality of Life Department, EORTC, Brussels, Belgium
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10
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Abstract
BACKGROUND Hidradenitis suppurativa (HS) is a chronic skin disorder with adverse impacts on both physical and psychosocial well-being. There is presently no validated HS-specific quality-of-life (QoL) measure. OBJECTIVE The objective of this study is to develop a QoL instrument for HS (HS-QoL) in accordance with recommended standards. METHODS Patient interviews (concept elicitation) and expert input were used to develop the conceptual framework for outcomes perceived important to patients with HS. A HS-QoL-v1 measure was developed, and cognitive interviews with patients were conducted for pilot testing. RESULTS Concept elicitation interviews with patients with HS (n = 21) generated 12 themes. Most frequently reported were impacts on daily activities and symptoms due to HS. These themes, along with literature review and input from clinical experts, informed development of the HS-QoL-v1. Nine cognitive interviews were conducted in a pilot test and resulted in the HS-QoL-v2 measure. CONCLUSION The HS-QoL-v2 is a preliminary QoL instrument for which further psychometric validation and establishment of clinimetric properties will be undertaken.
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Affiliation(s)
- Mia Sisic
- 1 Department of Psychology, University of Windsor, Windsor, Ontario, Canada
| | | | | | - Lisa Plant
- 1 Department of Psychology, University of Windsor, Windsor, Ontario, Canada
| | - Chelsea McLellan
- 1 Department of Psychology, University of Windsor, Windsor, Ontario, Canada
| | - Jerry Tan
- 3 Windsor Clinical Research, Inc, Windsor, Ontario, Canada.,4 Department of Medicine, University of Western Ontario, London, Ontario, Canada
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11
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Gelhorn HL, Tong S, McQuarrie K, Vernon C, Hanlon J, Maclaine G, Lenderking W, Ye X, Speck RM, Lackman RD, Bukata SV, Healey JH, Keedy VL, Anthony SP, Wagner AJ, Von Hoff DD, Singh AS, Becerra CR, Hsu HH, Lin PS, Tap WD. Patient-reported Symptoms of Tenosynovial Giant Cell Tumors. Clin Ther 2016; 38:778-93. [PMID: 27041409 PMCID: PMC5469507 DOI: 10.1016/j.clinthera.2016.03.008] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [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: 12/29/2015] [Revised: 03/01/2016] [Accepted: 03/07/2016] [Indexed: 01/03/2023]
Abstract
Purpose Tenosynovial giant cell tumor (TGCT), a rare locally aggressive neoplasm of the synovium of joints and tendon sheaths, is associated with joint destruction, inflammation, pain, and swelling, in part due to colony-stimulating factor 1 receptor–bearing macrophages recruited to the tumor by genetic elevation of colony-stimulating factor 1 activity. The most common treatment is surgery, although promising pharmacologic treatments are in development. Patient-reported outcome (PRO) instruments are critical end points in demonstrating the clinical relevance of standard oncologic outcome measures and the overall impact of novel pharmacologic therapies in nonmalignant neoplastic conditions such as TGCT. The content validity of PROs relevant to patients with TGCT has not been formally investigated, and instruments to evaluate such outcomes do not exist for this condition. Methods PRO instruments of potential relevance were evaluated by using a literature review and by clinical and PRO experts. Patients with TGCT were recruited through clinical sites and the Internet for participation in qualitative research interviews to identify predominant symptoms and to test the relevance and content validity of several PRO measures. Select PRO measures were included in a Phase I clinical trial, and preliminary results of the PRO end points are reported descriptively. Findings Of the 22 subjects who participated in qualitative interviews, 73% were female, and their mean age was 42.5 years (range, 27–56 years). The TGCTs (19 diffuse and 3 localized) were located in the knee (n = 15), hip (n = 3), ankle (n = 2), elbow (n= 1), and forearm (n = 1). The most common symptoms cited were pain (82%), swelling (86%), stiffness (73%), reduced range of motion (64%), and joint instability (64%), which were consistent with clinical expert input and with the content of instruments chosen by PRO experts. The worst pain numeric rating scale, Patient Reported Outcomes Measurement Information System physical functioning items, and the Western Ontario and McMaster Universities Osteoarthritis Index, as well as a worst stiffness numeric rating scale developed for TGCT, were confirmed as meaningful measures of TGCT patient symptoms and were well understood in qualitative interviews. Results from the Phase I trial showed trends of improvement in both pain and stiffness over time. Implications This study is the first to gather information directly from patients with TGCT regarding their symptom experiences. Pain, stiffness, and physical functioning are important treatment outcomes in patients with TGCT. We have identified content-valid PRO measures of these concepts, which are included in an ongoing Phase III TGCT clinical trial with pexidartinib (PLX3397) (NCT02371369).
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Affiliation(s)
| | | | | | | | | | - Grant Maclaine
- Daiichi Sankyo Development Ltd, Buckinghamshire, United Kingdom
| | | | - Xin Ye
- Daiichi Sankyo Pharma Development, Edison, New Jersey
| | | | - Richard D Lackman
- Cooper University Health Center, Orthopaedic Oncology Center, Camden, New Jersey
| | - Susan V Bukata
- Ronal Reagan UCLA Medical Center, Los Angeles, California
| | - John H Healey
- Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, New York
| | - Vicki L Keedy
- Vanderbilt University Medical Center, Hematology/Oncology, Nashville, Tennessee
| | | | | | - Daniel D Von Hoff
- HonorHealth & Translational Genomics Research Institute, Scottsdale, Arizona
| | - Arun S Singh
- Ronal Reagan UCLA Medical Center, Los Angeles, California
| | | | | | | | - William D Tap
- Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, New York
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12
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Wang L, Apple AC, Schroeder MP, Ryals AJ, Voss JL, Gitelman D, Sweet JJ, Butt ZA, Cella D, Wagner LI. Reduced prefrontal activation during working and long-term memory tasks and impaired patient-reported cognition among cancer survivors postchemotherapy compared with healthy controls. Cancer 2015; 122:258-68. [PMID: 26484435 DOI: 10.1002/cncr.29737] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 08/24/2015] [Accepted: 09/08/2015] [Indexed: 11/09/2022]
Abstract
BACKGROUND Patients who receive adjuvant chemotherapy have reported cognitive impairments that may last for years after the completion of treatment. Working memory-related and long-term memory-related changes in this population are not well understood. The objective of this study was to demonstrate that cancer-related cognitive impairments are associated with the under recruitment of brain regions involved in working and recognition memory compared with controls. METHODS Oncology patients (n = 15) who were receiving adjuvant chemotherapy and had evidence of cognitive impairment according to neuropsychological testing and self-report and a group of age-matched, education group-matched, cognitively normal control participants (n = 14) underwent functional magnetic resonance imaging. During functional magnetic resonance imaging, participants performed a nonverbal n-back working memory task and a visual recognition task. RESULTS On the working memory task, when 1-back and 2-back data were averaged and contrasted with 0-back data, significantly reduced activation was observed in the right dorsolateral prefrontal cortex for oncology patients versus controls. On the recognition task, oncology patients displayed decreased activity of the left-middle hippocampus compared with controls. Neuroimaging results were not associated with patient-reported cognition. CONCLUSIONS Decreased recruitment of brain regions associated with the encoding of working memory and recognition memory was observed in the oncology patients compared with the control group. These results suggest that there is a reduction in neural functioning postchemotherapy and corroborate patient-reported cognitive difficulties after cancer treatment, although a direct association was not observed. Cancer 2016;122:258-268. © 2015 American Cancer Society.
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Affiliation(s)
- Lei Wang
- Division of Clinical Psychology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.,Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois.,Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Alexandra C Apple
- Division of Clinical Psychology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.,Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Matthew P Schroeder
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Anthony J Ryals
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Joel L Voss
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois.,Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois.,Ken and Ruth Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Darren Gitelman
- Ken and Ruth Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.,Advocate Memory Center, Advocate Lutheran General Hospital, Park Ridge, Illinois.,Department of Neurology, Chicago Medical School at Rosalind Franklin University, North Chicago, Illinois
| | - Jerry J Sweet
- Department of Psychiatry and Behavioral Sciences, NorthShore University, Evanston, Illinois
| | - Zeeshan A Butt
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - David Cella
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Lynne I Wagner
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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13
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Merks P, Kaźmierczak J, Olszewska AE, Kołtowska-Häggström M. Comparison of factors influencing patient choice of community pharmacy in Poland and in the UK, and identification of components of pharmaceutical care. Patient Prefer Adherence 2014; 8:715-26. [PMID: 24868150 PMCID: PMC4029754 DOI: 10.2147/ppa.s53829] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Several factors, which are components of pharmaceutical care, can influence a patient's choice of a community pharmacy store and contribute to frequent visits to the same pharmacy. OBJECTIVES To compare factors that influence a patient's choice of pharmacy in Poland and in the UK, to identify which of them are components of pharmaceutical care, and to relate them to patient loyalty to the same pharmacy. METHODS A self-administered, anonymous questionnaire was distributed to clients visiting pharmacies in Poland and the UK January-August 2011. Comparisons were performed using chi-square tests and logistic regression. All statistical analyses were performed using SPSS 20.0. RESULTS The response rate was 55.6% (n=417/750; 36 pharmacies) and 54.0% (n=405/750; 56 pharmacies) in Poland and in the UK, respectively. The most frequently reported factors, as defined by a percentage of responders, were in Poland: 1) location (84%); 2) professional and high-quality of service (82%); 3) good price of medicines (78%); and 4) promotions on medicines (66%). In the UK, the most commonly reported factors were: 1) professional and high quality of service (90%); 2) location (89%); 3) good advice received from the pharmacist (86%); and 4) option of discussing and consulting all health issues in a consultation room (80%). Good advice and an option of discussing personal concerns with a pharmacist are components of pharmaceutical care. Thirty-eight percent of patients in Poland and 61% in the UK declared visiting the same pharmacy. CONCLUSION Components of pharmaceutical care are important factors influencing the patient's choice of pharmacy in the UK and, to a lesser degree, in Poland. Additionally, more patients in the UK than in Poland are committed to a single pharmacy. Therefore, implementing the full pharmaceutical care in Poland may contribute to an increase in patient loyalty and thus strengthen competitiveness of pharmacy businesses.
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Affiliation(s)
- Piotr Merks
- Department of Pharmaceutical Care, Medical University of Warsaw, Poland
- Correspondence: Piotr Merks, Department of Pharmaceutical Care, Medical University of Warsaw, ul Banacha 1, 02-097 Warsaw, Poland, Tel +48 22 572 0979, Fax +48 22 572 0985, Email
| | - Justyna Kaźmierczak
- Department of Hygiene, Bioanalysis and Environmental Studies, Medical University of Silesia, Katowice, Poland
| | - Aleksandra Elzbieta Olszewska
- Department of Pharmacy, Ashford and St Peter’s Hospitals National Health Service Trust, Guildford Road, Chertsey, Surrey, United Kingdom
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Gutacker N, Bojke C, Daidone S, Devlin NJ, Parkin D, Street A. Truly inefficient or providing better quality of care? Analysing the relationship between risk-adjusted hospital costs and patients' health outcomes. Health Econ 2013; 22:931-947. [PMID: 22961956 DOI: 10.1002/hec.2871] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2011] [Revised: 07/25/2012] [Accepted: 08/10/2012] [Indexed: 05/27/2023]
Abstract
Observed variation in hospital costs may be attributable to differences in patients' health outcomes. Previous studies have resorted to inherently incomplete outcome measures such as mortality or re-admission rates to assess this claim. This study makes use of a novel dataset of routinely collected patient-reported outcome measures (PROMs) linked to inpatient records to (i) access the degree to which cost variation is associated with variation in patients' health gain and (ii) explore how far judgement about hospital cost performance changes when health outcomes are accounted for. We use multilevel modelling to address the clustering of patients in providers and isolate unexplained cost variation. We find some evidence of a U-shaped relationship between risk-adjusted costs and outcomes for hip replacement surgery. For three other procedures (knee replacement, varicose vein and groin hernia surgery), the estimated relationship is sensitive to the choice of PROM instrument. We do not observe substantial changes in cost performance estimates when outcomes are explicitly accounted for.
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Affiliation(s)
- Nils Gutacker
- Centre for Health Economics, University of York, York, UK.
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