Patient Related Outcome Measures最新文献

Purpose: Breast cancer screening remains a challenge in the United States. Many women do not get a mammogram because of pain associated with the exam, radiation exposure, false-positive results, and additional costs. Others who may benefit from annual screening do not qualify because of young age and radiation risk. We hypothesize that a novel volumetric transmitted breast ultrasound, Quantitative Transmission (QT) Scan may encourage more women to have annual breast cancer screening. Assessing results from patient-reported outcomes (PROs) may predict the value of newer, more desirable screening technologies.

Participants and methods: Pre- and post-menopausal women who qualified for breast cancer screening were enrolled in a prospective trial of Quantitative Transmission (QT Scan) vs traditional mammography via Digital Breast Tomosynthesis (DBT) Clinical Trials.gov NCT03052166. These women completed questionnaires to assess their experiences with QT Scan and DBT. Associations between QT Scan or DBT and differences in PRO scores were examined.

Results: A total of 430 subjects completed the PRO instrument analyzed. A total of 36 questions were asked, 34 were paired for both QT and DBT and two were asked regarding exclusively the QT Scan. Physical discomfort, perceptions of safety and low efficacy, false-positive results and additional out-of-pocket expenses were concerns identified as highest risk for opting out of screening mammography (differences between 2.1 and 2.9 indicate significant differences between means and standard deviations using the Cohen's d statistic). Student's T-test shows a significance level of <10 ^-10. Statistically significant differences in PROs between QT Scan and DBT were observed by 14 of the 17 paired experience questions (p<0.001).

Conclusion: Significant differences in PROs were found between QT scan and DBT, indicating women have significantly more negative experiences with traditional mammography via DBT and are less inclined to undergo screening mammography. Identification of PRO differences could be used to help identify a more desirable breast cancer screening modality.

Aim: Negative symptoms of schizophrenia (NSS) have been linked with poor functional outcomes. A literature review was performed to identify instruments used to assess functional outcomes and quality of life in clinical trials and observational studies conducted in groups of people with NSS.

Methods: Literature search strings were designed using Medical Subject Headings combined with free-text terms and searches were performed using the PubMed, Embase and the Cochrane Library databases. For inclusion, articles were required to be published as full-text articles, in English, over the period 2011-2021, include at least one group or treatment arm of people with NSS and report either functional outcomes or quality of life (QoL).

Results: Literature searches identified a total of 3,268 unique hits. After two rounds of screening, 37 publications (covering 35 individual studies) were included in the review. A total of fourteen different instruments were used to assess functional outcomes and eleven different instruments were used to assess QoL. In studies in people with NSS, the most frequently used functional outcome measures were the Personal and Social Performance scale and the Global Assessment of Functioning. The most frequently used QoL instruments included the Manchester Short Assessment of Quality of Life, the Heinrich Carpenter Quality of Life Scale, the Schizophrenia Quality of Life Scale and the EQ-5D.

Conclusion: A large number of measures have been used to assess functional outcomes and QoL in people with NSS, these include both generic and condition-specific as well as both interviewer-administered and self-reported instruments.

Introduction: Quality of life (QoL) is impaired in patients with acne vulgaris. The Cardiff Acne Disability Index (CADI) that assesses QoL of acne patients was initially developed in English and is being currently used widely after being validated in different languages. This study was conducted to validate the CADI in Sinhala, a language used by the majority of Sri Lanka.

Materials and methods: The CADI was translated into Sinhala, and lingually validated as per published guidelines. This CADI-Sinhala version and the Sinhala version of the Dermatology Life Quality Index (DLQI) were simultaneously administered to 150 Sinhala-speaking young adults with acne. The clinical severity of acne was assessed using the Global Acne Grading System (GAGS). The Cronbach's alpha and Spearman correlation coefficients were used to determine the internal consistency, reliability, and validity of the CADI-Sinhala. Construct validity was examined using a factor analysis.

Results: The study included 90% females and their mean age was 23 (SD, 2.5) years. The majority (97.3%) had acne of mild to moderate severity when measured by the GAGS. The CADI-Sinhala Scale showed a Cronbach's alpha coefficient of 0.819 indicating high internal consistency and reliability. The mean item-total correlation coefficient was 0.74 (range, 0.42-0.87) with CADI Q3 having the lowest correlation. CADI Sinhala showed a strong and highly significant correlation with the Sinhala DLQI (Spearman's rho = 0.66; P< 0.001) indicating concurrent validity. The correlation with GAGS was of low intensity, although it was statistically significant (p < 0.01).

Conclusion: The CADI-Sinhala is a reliable and valid tool for assessing the QoL of Sinhala-speaking acne patients. This five-item tool will help clinicians to provide holistic treatment through improved understanding of patient's perspectives.

Background: The High Activity Arthroplasty Score (HAAS) is a validated score that assesses functional outcomes after lower limb arthroplasty, with fewer ceiling effects than other scores. The aim is to translate and cross-culturally adapt the HAAS into a Chinese version (HAAS-C) and to evaluate the psychometric properties of HAAS-C in patients after primary total knee arthroplasty (TKA).

Methods: A total of 104 patients diagnosed with knee osteoarthritis who had undergone TKA at least 12 months prior were recruited. A forward and backward translation procedure was performed for developing a culturally acceptable HAAS-C. Internal consistency was assessed using Cronbach's α, and test-retest reliability was measured using the intraclass correlation coefficient (ICC) within a 10-day interval. Construct validity was assessed by examining the correlations between HAAS-C and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), EuroQoL Group's five-dimension questionnaire (EQ-5D-5L), and Oxford knee score (OKS).

Results: HAAS-C demonstrated adequate Internal consistency reliability, as indicated by Cronbach's α coefficient of 0.75. Test-retest reliability yielded excellent results, with an ICC value of 0.98. Content validity indices were high, with a scale-level validity index of 0.9 and item-level validity indices greater than or equal to 0.8. HAAS-C showed a strong correlation with WOMAC (r = 0.69), a moderate correlation with EQ-5D-5L (r = 0.43), and OKS (r = 0.53) while exhibiting no floor or ceiling effects.

Conclusion: The validated HAAS-C questionnaire is a valid instrument for assessing patients undergoing TKA in mainland China.

Background: A time-motion study is a scientific method for recording time spent on various tasks in a narrow range of specialized work settings, beginning with initial enrollment in ART provision. Therefore, the study aimed to assess the time motion of patient satisfaction with antiretroviral therapy services in Central Ethiopia.

Methods: A facility-based cross-sectional study was conducted on a sample of 422 patients from June 14 to July 30, 2021. We used a simple random sampling technique to select the participants. Structural input-related qualitative data were collected using an in-depth interview and used for concurrent triangulation with quantitative. Quantitative data were collected using a standardized and pre-tested questionnaire and analyzed using SPSS version 24.0. Bivariate and multivariable logistic regressions were used to identify independent predictors of time motion and patient satisfaction. The degree of association between the outcome and independent variables was assessed by using an odds ratio with a 95% CI.

Results: The time motion of patient satisfaction study found that 53.1% (224/422) of the study participants were satisfied. As independent predictors, time spent (time motion) waiting to be seen by a health professional (AOR = 0.228, 95% CI = 0.079-0.661), patient-provider interaction (AOR = 3.72, 95% CI = 2.111-5.771), perceived privacy (AOR = 2.912, 95% CI = 1.76-2.78), sex (AOR = 2.499, 95% CI = 1.556-4.009), and income class (AOR = 0.228, 95% CI = 0.073-0.707) were associated with outcome variable.

Conclusion: The study found low patient satisfaction with ART services, indicating the need for further improvement to enhance patient-centered services with the given time motion. Therefore, further research is needed to assess the intensity and reach of the information through an analysis of pre- and post-intervention that provides a complete picture of conceptualizations of time motion studies.

Background: The provision of intensive care services is advancing globally. However, in resource-limited settings, it is lagging far behind and intensive care unit mortality is still higher due to various reasons. This study aimed to assess determinants of mortality among medical patients admitted to the intensive care unit.

Methods: A five-year facility-based retrospective Cohort Study was conducted. A total of 546 medical patients admitted to the intensive care unit from March 2017 to February 2022 were included. Document review using a structured questionnaire was implemented to collect data. Data entered into Epi Data were analyzed by STATA and summarized using frequency tables and graphs. Binary and multivariate logistic regression analyses were performed to identify determinants of mortality.

Results: The overall mortality was 35.9%. Approximately half of the deaths were attributed to septic shock, congestive heart failure, severe community-acquired pneumonia, and stroke. The most common immediate cause of death was cardio-respiratory arrest. Source of admission, GCS level at admission, duration of ICU stay, treatment with inotropes, septic shock, and retroviral infection status were found to have a statistically significant association with ICU mortality.

Conclusion and recommendations: This study revealed a significantly higher mortality rate among patients admitted to the intensive care unit. Early identification and admission of patients to the intensive care unit are important factors that could decrease mortality. Patient selection is essential since some patients with a high likelihood of mortality might not benefit from intensive care unit admission in an area with high resource limitations.