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Australian private healthcare staff perspectives on patient reported experience measures (PREMs): a qualitative interview study. 澳大利亚私立医疗机构员工对患者报告体验措施(PREMs)的看法:定性访谈研究。
IF 2.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-11-06 DOI: 10.1186/s41687-024-00809-6
Krista Verlis, Kirsten McCaffery, Tessa Copp, Rachael Dodd, Brooke Nickel, Rebekah Laidsaar-Powell

Objective: Patient reported experience measures (PREMs) are common tools utilised in hospitals to support quality improvements, allow consumers to provide feedback on care experiences and can be used to support consumers' hospital selections. This study aimed to understand the views and opinions of private hospital staff on PREM use and the utility of PREMs as a consumer decision-making tool.

Method: Qualitative, semi-structured interview study conducted via telephone between March-June 2023. Participants (n = 10) were recruited from major private healthcare providers in Australia with half representing hospital-based staff and the other half corporate head office staff who work in patient experience and quality. Interviews were audio-recorded, transcribed, and analysed thematically.

Results: PREM benefits included an understanding of patient experience that improved provision of patient centred care with feedback acting as catalyst for change, to corporate-level strategic initiatives that address specific issues. Drawbacks of PREM reporting included concerns around skewed results by biased respondents, and completion based on hard to alter items (e.g., infrastructure) or on matters outside of hospital control (e.g., insurance). Staff had mixed reactions to consumers using PREMs results when selecting a hospital, some advocated for transparency while others feared consumers would misinterpret the data.

Conclusions: Improved real-time reporting of PREMs, learning from other industries about recording customer experience, and mandatory reporting by private hospitals could further the benefits of PREM measurement in private healthcare. Recognised was the need for PREMs to be displayed in a readily understood way so those with limited health literacy can correctly interpret.

目的:患者报告体验测量(PREMs)是医院常用的工具,可帮助医院提高质量,让消费者就护理体验提供反馈意见,并可用于帮助消费者选择医院。本研究旨在了解私立医院员工对 PREM 使用情况的看法和意见,以及 PREM 作为消费者决策工具的效用:方法:2023 年 3 月至 6 月期间,通过电话进行半结构化定性访谈研究。参与者(n = 10)来自澳大利亚主要的私立医疗机构,其中一半代表医院员工,另一半代表公司总部从事患者体验和质量工作的员工。对访谈进行了录音、转录和专题分析:PREM 的益处包括对患者体验的了解,从而改善以患者为中心的护理服务,同时反馈意见也是变革的催化剂,还包括解决具体问题的企业级战略举措。PREM 报告的缺点包括:受访者的偏见会导致结果偏差,完成报告的依据是难以改变的项目(如基础设施)或医院无法控制的事项(如保险)。员工对消费者在选择医院时使用 PREMs 结果的反应不一,有些人主张透明,有些人则担心消费者会曲解数据:结论:改进 PREMs 的实时报告、学习其他行业记录客户体验的经验以及私立医院的强制报告,可以进一步提高私立医疗机构 PREM 测量的效益。我们认识到,PREM 必须以易于理解的方式显示,以便医疗知识有限的人能够正确解读。
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引用次数: 0
Coping difficulties after inpatient hospital treatment: validity and reliability of the German version of the post-discharge coping difficulty scale. 住院治疗后的应对困难:德文版出院后应对困难量表的有效性和可靠性。
IF 2.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-11-05 DOI: 10.1186/s41687-024-00806-9
Matthias Marsall, Thorsten Hornung, Alexander Bäuerle, Marianne E Weiss, Martin Teufel, Matthias Weigl

Background: Patients transitioning between different care contexts are at increased risk of experiencing adverse events. In particular, being discharged to home after inpatient treatment involves significant risks. However, there is a lack of valid and internationally comparable assessment tools on patients' experiences of difficulties following hospital discharge. Therefore, this study aimed to adapt and validate the German version of the post-discharge coping difficulty scale (PDCDS-G).

Methods: Patients were recruited at a German university hospital. 815 adult patients participated in a self-report survey following an inpatient stay of at least three days. Factorial validity of the PDCDS-G was evaluated via factor analyses. Further, examination of measurement invariance was performed. To establish criterion validity, associations with patients' self-reported health status and occurrence of patient safety were determined. Further, group differences regarding patient characteristics, hospitalization factors, and survey-related variables were examined.

Results: Factorial validity of the PDCDS-G was confirmed by a two-factorial model with good model fit. Both factors showed good to excellent reliability. The two-factor model achieved measurement invariance across all patient characteristics, hospitalization factors, and survey-related variables. Significant relationships with patients' health status and the occurrence of patient safety incidents corroborate criterion validity of the PDCDS-G. Differential associations of the two PDCDS-G factors regarding patient characteristics, hospitalization, and survey-related variables were found.

Discussion: Construct and criterion validity, as well as the reliability of the PDCDS-G, were verified. Further, instrument's measurement invariance was confirmed allowing use of the scale for the interpretation of group differences and comparisons between studies.

Conclusions: The PDCDS-G provides a validated and comparable patient-reported outcomes measure for patient experiences after hospital discharge to home. The PDCDS-G can be used for patient surveys in quality or patient safety improvement in care transition processes.

背景:在不同护理环境之间转换的患者发生不良事件的风险会增加。尤其是在住院治疗后出院回家,会面临很大的风险。然而,目前还缺乏有效且具有国际可比性的评估工具来评估患者在出院后遇到的困难。因此,本研究旨在改编并验证德国版出院后应对困难量表(PDCDS-G):方法:在一家德国大学医院招募患者。815 名成年患者在住院至少三天后参加了自我报告调查。通过因子分析评估了 PDCDS-G 的因子有效性。此外,还对测量不变性进行了检查。为了确定标准效度,还确定了患者自我报告的健康状况与患者安全事件之间的关联。此外,还检查了患者特征、住院因素和调查相关变量的组间差异:结果:双因子模型证实了 PDCDS-G 的因子有效性,模型拟合度良好。两个因子均显示出良好至卓越的可靠性。双因子模型在所有患者特征、住院因素和调查相关变量之间都实现了测量不变性。与患者健康状况和患者安全事件发生率之间的显著关系证实了 PDCDS-G 的标准有效性。PDCDS-G的两个因子与患者特征、住院情况和调查相关变量之间存在差异:讨论:PDCDS-G 的结构效度和标准效度以及可靠性均得到了验证。此外,该量表的测量不变性也得到了证实,可用于解释群体差异和比较不同研究:PDCDS-G为患者出院回家后的经历提供了一个经过验证且具有可比性的患者报告结果测量方法。PDCDS-G可用于患者调查,以改善护理过渡流程中的质量或患者安全。
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引用次数: 0
Machine learning models including patient-reported outcome data in oncology: a systematic literature review and analysis of their reporting quality. 包含肿瘤学患者报告结果数据的机器学习模型:系统性文献综述及其报告质量分析。
IF 2.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-11-05 DOI: 10.1186/s41687-024-00808-7
Daniela Krepper, Matteo Cesari, Niclas J Hubel, Philipp Zelger, Monika J Sztankay

Purpose: To critically examine the current state of machine learning (ML) models including patient-reported outcome measure (PROM) scores in cancer research, by investigating the reporting quality of currently available studies and proposing areas of improvement for future use of ML in the field.

Methods: PubMed and Web of Science were systematically searched for publications of studies on patients with cancer applying ML models with PROM scores as either predictors or outcomes. The reporting quality of applied ML models was assessed utilizing an adapted version of the MI-CLAIM (Minimum Information about CLinical Artificial Intelligence Modelling) checklist. The key variables of the checklist are study design, data preparation, model development, optimization, performance, and examination. Reproducibility and transparency complement the reporting quality criteria.

Results: The literature search yielded 1634 hits, of which 52 (3.2%) were eligible. Thirty-six (69.2%) publications included PROM scores as a predictor and 32 (61.5%) as an outcome. Results of the reporting quality appraisal indicate a potential for improvement, especially in the areas of model examination. According to the standards of the MI-CLAIM checklist, the reporting quality of ML models in included studies proved to be low. Only nine (17.3%) publications present a discussion about the clinical applicability of the developed model and reproducibility and only three (5.8%) provide a code to reproduce the model and the results.

Conclusion: The herein performed critical examination of the status quo of the application of ML models including PROM scores in published oncological studies allowed the identification of areas of improvement for reporting and future use of ML in the field.

目的:通过调查当前可用研究的报告质量,批判性地审视包括癌症研究中患者报告结果测量(PROM)评分在内的机器学习(ML)模型的现状,并提出未来在该领域使用 ML 的改进领域:方法:在 PubMed 和 Web of Science 上系统地搜索了有关癌症患者的研究出版物,这些研究应用了以 PROM 评分作为预测因子或结果的 ML 模型。采用改编版的 MI-CLAIM(Minimum Information about CLinical Artificial Intelligence Modelling,临床人工智能建模最低信息)核对表对应用 ML 模型的报告质量进行评估。该清单的关键变量包括研究设计、数据准备、模型开发、优化、性能和检查。可重复性和透明度是报告质量标准的补充:文献检索共搜索到 1634 篇文献,其中 52 篇(3.2%)符合条件。36篇(69.2%)文献将 PROM 评分作为预测指标,32 篇(61.5%)文献将 PROM 评分作为结果指标。报告质量评估结果表明,尤其是在模型检查方面有改进的可能。根据 MI-CLAIM 检查表的标准,所纳入研究中 ML 模型的报告质量较低。只有 9 篇(17.3%)论文讨论了所开发模型的临床适用性和可重复性,只有 3 篇(5.8%)论文提供了重现模型和结果的代码:本文对已发表的肿瘤研究中应用 ML 模型(包括 PROM 评分)的现状进行了批判性审查,从而确定了该领域报告和未来使用 ML 的改进领域。
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引用次数: 0
Tests employed in the psychometric validation of the Insulin Treatment Appraisal Scale (ITAS) in T2DM patients; a systematic review of the literature. T2DM 患者胰岛素治疗评估量表 (ITAS) 心理计量学验证中使用的测试;文献系统性回顾。
IF 2.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-25 DOI: 10.1186/s41687-024-00792-y
Saba Rasheed, Anees Ur Rehman, Zermina Tasleem, Marryam Azeem, Muhammad Fawad Rasool, Arifa Mehreen, Saleh Karamah Al-Tamimi

Background: Psychological Insulin Resistance (PIR) and negative perceptions regarding insulin treatment are noteworthy challenges in T2DM management, which hinder the timely initiation of insulin treatment. To get past these obstacles a reliable tool is required to evaluate patients' perspectives on insulin administration. Our study aims to conduct a comprehensive systematic review to evaluate the validity and reliability of different validation tests used in the psychometric validation of the ITAS in T2DM patients.

Methods: A literature search was carried out, using PubMed, Google Scholar, EMBASE, Cochrane Library and Science Direct. Only those studies assessing content validity, construct validity, concurrent validity, discriminant validity, internal consistency reliability (Cronbach' α), and items-total correlation were retrieved.

Results: A total of 14 studies illustrated the validity and reliability of ITAS in T2DM patients. Content validity results of S-CVI was 0.97, and I-CVI was 0.8-1.00. Construct validity with factor loading was greater than the threshold value of 0.3. The concurrent validity of ITAS vs. PAID, WHO-5, and SPI was 0.35 (P < 0.05), -0.14 (P < 0.05), and 0.80 (P < 0.001) respectively. The mean difference between insulin and non-insulin group was significant (P < 0.001) showing reliable discriminant validity. Reported results of Cronbach's α for the main scale (0.79-0.89), subscale-1 (0.72-0.9), and subscale-2 (0.61-0.89) showed "good to excellent" internal consistency reliability of ITAS. Item-total correlation results for the main scale, subscale-1, and subscale-2 were (0.40-0.82), (0.31-0.74) and (0.34-0.58) respectively. Test-retest reliability of ITAS was 0.571-0.87.

Conclusions: Study findings confirm the robustness of various validation tests utilized in the psychometric validation of ITAS in T2DM patients. ITAS is a well-validated and reliable tool for determining the perspectives, PIR, and changes in patients' perception over time and it can be used to overcome hurdles in the timely initiation of insulin treatment in T2DM patients.

背景:心理胰岛素抵抗(PIR)和对胰岛素治疗的负面看法是 T2DM 管理中值得注意的挑战,它们阻碍了胰岛素治疗的及时启动。为了克服这些障碍,需要一种可靠的工具来评估患者对胰岛素治疗的看法。我们的研究旨在进行一次全面的系统性回顾,以评估用于 T2DM 患者 ITAS 心理计量学验证的不同验证测试的有效性和可靠性:我们使用 PubMed、Google Scholar、EMBASE、Cochrane Library 和 Science Direct 进行了文献检索。只检索了那些评估内容效度、结构效度、并发效度、判别效度、内部一致性可靠性(Cronbach' α)和项目-总相关性的研究:共有 14 项研究说明了 ITAS 在 T2DM 患者中的有效性和可靠性。S-CVI 的内容效度为 0.97,I-CVI 为 0.8-1.00。因子载荷的结构效度大于阈值 0.3。ITAS 与 PAID、WHO-5 和 SPI 的并发效度为 0.35(P 结论:ITAS 与 PAID、WHO-5 和 SPI 的并发效度为 0.35:研究结果证实了在对 T2DM 患者进行 ITAS 心理计量学验证时所使用的各种验证测试的稳健性。ITAS 是一种经过充分验证的可靠工具,可用于确定患者的观点、PIR 以及随时间推移患者认知的变化,并可用于克服 T2DM 患者及时开始胰岛素治疗的障碍。
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引用次数: 0
Correction: Top 100 most cited articles on Patient Reported Experience Measures (PREM): insights and perspectives. 更正:关于 "患者报告体验衡量标准(PREM)"的 100 篇最常被引用的文章:见解与观点。
IF 2.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-22 DOI: 10.1186/s41687-024-00801-0
Asiya Attar, Kasturi Shukla, Preeti Mulay
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引用次数: 0
Associations between symptom-based long COVID clusters and long-term quality of life, work and daily activities among individuals testing positive for SARS-CoV-2 at a national retail pharmacy. 在一家全国性零售药店对 SARS-CoV-2 检测呈阳性的个人中,基于症状的长 COVID 群组与长期生活质量、工作和日常活动之间的关系。
IF 2.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-22 DOI: 10.1186/s41687-024-00797-7
Manuela Di Fusco, Joseph C Cappelleri, Alon Yehoshua, Kelly J Thomas Craig, Mary B Alvarez, Kristen E Allen, Thomas M Porter, Santiago M C Lopez, Laura Puzniak, Xiaowu Sun

Background: Evidence on long COVID symptom clustering patterns among patients with COVID-19 is limited. We summarized long COVID symptoms in clusters defined by number of symptoms co-occurring together, and we assessed Health-Related Quality of Life (HQRoL), Work Productivity and Activity Impairment (WPAI) outcomes across these clusters over time. We assessed associations between the clusters and BNT162b2 vaccination status.

Methods: A prospective longitudinal patient-reported outcomes (PRO) study recruited laboratory-confirmed symptomatic COVID-19 patients seeking testing from a national retail pharmacy. Long COVID-19 symptoms were self-reported by participants at 4-week, 3-month and 6-month surveys. Patient classes identified via latent class analysis (LCA) with long COVID-19 symptoms were simplified into clusters based on number of symptoms. HRQoL and WPAI outcomes were collected using EQ-ED-5L and WPAI: GH questionnaires. Mixed models for repeated measures analyses were conducted to examine associations between exposure groups and outcomes.

Results: The study included 328 participants that were segmented into three groups of long COVID-19 symptoms based on LCA and then simplified by the number of symptoms (Cluster 1 low, <2; Cluster 2 moderate, 2-6; and Cluster 3 high, >6 symptoms). The number of long COVID-19 symptoms was negatively associated with HRQoL and WPAI, whereby participants with high symptom burden (>6 symptoms) had the lowest HRQoL and WPAI scores assessed by absenteeism, presenteeism, work productivity loss, activity impairment, and hours worked metrics. Compared with those unvaccinated and not up-to-date with COVID-19 vaccination, subjects boosted with BNT162b2 consistently reported less symptom burden during the follow-up, regardless of their symptom-based cluster.

Conclusion: Three distinct patient clusters based on frequency of long COVID symptoms experienced different HRQoL and WPAI outcomes over 6 months. The cluster with more concomitant symptoms experienced greater burden than the others. Participants up-to-date with BNT162b2 reported lower symptom burden across all clusters and timeframes.

Clinical trial registration: Clinicaltrials.gov NCT05160636.

背景:有关 COVID-19 患者长 COVID 症状聚类模式的证据非常有限。我们总结了根据同时出现的症状数量定义的长COVID症状群,并评估了这些群的健康相关生活质量(HQRoL)、工作效率和活动障碍(WPAI)随时间变化的结果。我们评估了这些群组与 BNT162b2 疫苗接种状况之间的关联:一项前瞻性纵向患者报告结果(PRO)研究招募了在一家全国性零售药店寻求检测的实验室确诊的有症状 COVID-19 患者。参与者在 4 周、3 个月和 6 个月的调查中自我报告了 COVID-19 的长期症状。通过潜类分析(LCA)确定的具有长 COVID-19 症状的患者类别根据症状数量简化为群组。通过 EQ-ED-5L 和 WPAI:GH 问卷收集 HRQoL 和 WPAI 结果。对重复测量进行混合模型分析,以研究暴露群体与结果之间的关联:研究共纳入 328 名参与者,根据 LCA 将其分为三个 COVID-19 长症状组,然后根据症状数量进行简化(第 1 组低,6 个症状)。COVID-19 长症状的数量与 HRQoL 和 WPAI 呈负相关,其中症状负担重(>6 个症状)的参与者的 HRQoL 和 WPAI 分数最低,评估指标包括缺勤、缺席、工作效率损失、活动障碍和工作时间。与未接种COVID-19疫苗和未及时接种COVID-19疫苗的受试者相比,接种了BNT162b2的受试者在随访期间报告的症状负担始终较轻,无论他们的症状分组如何:根据 COVID 长期症状的频率,三个不同的患者群在 6 个月内经历了不同的 HRQoL 和 WPAI 结果。伴随症状较多的患者群比其他患者群承受了更大的负担。使用BNT162b2治疗的参与者在所有群组和时间范围内的症状负担都较低:临床试验注册:Clinicaltrials.gov NCT05160636。
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引用次数: 0
Assessing the measurement properties of PROMIS Computer Adaptive Tests, short forms and legacy patient reported outcome measures in patients undergoing total hip arthroplasty. 对接受全髋关节置换术患者的 PROMIS 计算机自适应测试、简表和传统患者报告结果测量方法的测量特性进行评估。
IF 2.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-21 DOI: 10.1186/s41687-024-00799-5
C Braaksma, N Wolterbeek, M R Veen, R W Poolman, Y Pronk, A D Klaassen, R W J G Ostelo, C B Terwee

Background: The commonly used ('legacy') PROMs evaluating outcomes of total hip arthroplasty (THA), have several limitations regarding their measurement properties and interpretation of scores. One innovation in PROMs is the use of Computerized Adaptive Testing (CAT). The Patient-Reported Outcomes Measurement Information System (PROMIS®) is a validated system of CATs. The aim of this study was to assess the measurement properties of PROMIS and legacy instruments in patients undergoing THA.

Methodology: Patients in this multicenter study filled out a questionnaire twice, including Dutch-Flemish PROMIS v1.2 Physical Function (PROMIS-PF) and v1.1 Pain Interference (PROMIS-PI) CATs and short forms, PROMIS v1.0 Pain Intensity, and legacy PROMs (Hip disability and Osteoarthritis Outcome Score (HOOS), HOOS-Physical function Shortform (HOOS-PS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Oxford Hip Score (OHS), and two numeric rating scales measuring pain). The reliability, measurement precision (Standard Error of Measurement (SEM)), smallest detectable change (SDC), and burden of PROMIS instruments were presented head-to-head to legacy PROMs. Furthermore, construct validity was assessed.

Results: 208 patients were included. All instruments had a sufficient test-retest reliability (range ICC: 0.83-0.96). The SEM of PROMIS CATs and short forms ranged from 1.8 to 2.2 T-score points, the SEM of legacy instruments 2.6-11.1. The SDC of PROMIS instruments ranged from 2.1 to 7.3 T-score points, the SDC of legacy instruments 7.2-30.9. The construct validity of PROMIS CAT and short forms were found sufficient, except for the PROMIS-PI short form. The burden of PROMIS CATs was smaller than PROMIS short forms (range 4.8-5.2 versus 8-20 items, respectively). The burden of legacy instruments measuring physical functioning ranged from 5 to 40 items.

Conclusions: The PROMIS-PF is less burdensome, with high measurement precision, and almost no minimal or maximal scores, and an equal reliability compared to legacy instruments measuring physical functioning in patients undergoing THA. The PROMIS Pain Intensity 1a is comparable to the legacy pain instruments in terms of burden, reliability and SDC. Measuring the construct Pain Interference may not have additional value in this population because of its high correlation with instruments measuring physical functioning. The SDC values presented in this study can be used for individual patient monitoring.

背景:评估全髋关节置换术(THA)效果的常用("传统")PROM 在测量特性和分数解释方面存在一些局限性。患者报告结果管理系统(PROMs)的一项创新是使用计算机自适应测试(CAT)。患者报告结果测量信息系统(PROMIS®)是一个经过验证的 CAT 系统。本研究的目的是评估 PROMIS 和传统工具在 THA 患者中的测量特性:这项多中心研究中的患者填写了两次问卷,包括荷兰语-弗莱芒语 PROMIS v1.2 物理功能(PROMIS-PF)和 v1.1 疼痛干扰(PROMIS-PI)CAT 和简表、PROMIS v1.0 疼痛强度,以及传统的 PROMs(髋关节残疾和骨关节炎结果评分 (HOOS)、髋关节残疾和骨关节炎结果评分简表 (HOOS-PS)、西安大略和麦克马斯特大学骨关节炎指数 (WOMAC)、牛津髋关节评分 (OHS) 和两个测量疼痛的数字评分量表)。PROMIS 工具的可靠性、测量精度(测量标准误差 (SEM))、最小可检测变化 (SDC) 和负担与传统的 PROMs 进行了对比。结果:共纳入 208 名患者。所有工具都具有足够的测试-再测试可靠性(ICC范围:0.83-0.96)。PROMIS CAT 和简表的 SEM 在 1.8 到 2.2 个 T 分数点之间,传统工具的 SEM 在 2.6 到 11.1 之间。PROMIS 工具的 SDC 为 2.1 到 7.3 个 T 分数点,传统工具的 SDC 为 7.2 到 30.9 个 T 分数点。除 PROMIS-PI 短表外,PROMIS CAT 和短表的构造效度均足够高。PROMIS CAT 的负担小于 PROMIS 短表(范围分别为 4.8-5.2 项和 8-20 项)。测量身体功能的传统工具的负担范围为 5 至 40 个项目:结论:PROMIS-PF的负担较轻,测量精度高,几乎没有最小或最大评分,与传统的THA患者身体功能测量工具相比具有相同的可靠性。PROMIS 疼痛强度 1a 在负担、可靠性和 SDC 方面与传统的疼痛工具相当。由于疼痛干扰与身体功能测量工具的相关性较高,因此对该人群进行疼痛干扰测量可能没有额外的价值。本研究提供的 SDC 值可用于个体患者监测。
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引用次数: 0
Validation of 11 added items of the outpatient version of the Utrecht Symptom Diary in patients receiving chemotherapy or targeted therapy. 验证乌得勒支症状日记门诊版中针对化疗或靶向治疗患者增加的 11 个项目。
IF 2.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-18 DOI: 10.1186/s41687-024-00794-w
Josephine J Koldenhof, Bernice O Akpobome, Danielle Zweers, Stance Klaasse, Saskia C C M Teunissen, Petronella O Witteveen, Karijn P M Suijkerbuijk, Alexander de Graeff, Frederieke H van der Baan

Introduction: The Utrecht Symptom Diary (USD) is a validated Dutch patient-reported outcome measurement (PROM) tool - based on the Edmonton Symptom Assessment System - to assess and monitor symptoms in cancer patients. The USD contains 11 items concerning frequently occurring symptoms in cancer patients (pain, sleeping problems, dry mouth, dysphagia, lack of appetite, abnormal stool, nausea, shortness of breath, fatigue, anxiety and depressed mood) and an item on overall well-being. For the outpatient USD 11 items concerning frequently occurring signs and symptoms in patients receiving chemotherapy and/or targeted therapy were added to the USD: taste alteration, oral pain, weight loss, diarrhoea, hair changes, skin problems, nail problems, eye problems, tingling, concentration problems and problems with sexuality. This current study aimed to evaluate the 11 added items on this treatment specific outpatient USD in cancer patients receiving intravenous chemotherapy and/or targeted therapy.

Methods: Observational longitudinal retrospective cohort study including all adult outpatients with cancer receiving intravenous chemotherapy and/or targeted therapy in an academic hospital in the Netherlands who completed at least one outpatient USD as part of routine care (2012-2021). Relevance, comprehensiveness as well as criterion and construct validity were assessed.

Results: 1733 patients who completed ≥ 1 outpatient USD during intravenous chemotherapy and/or targeted therapy were included for analysis. Relevance as well as comprehensiveness of the items on the outpatient USD in this patient population was shown. Criterion validation was demonstrated for all added items of the outpatient USD - except for the item on oral pain. An additional analysis showed that mouth problems were detected with both outpatient USD items oral pain and dry mouth. Construct validity was demonstrated for the items hair changes and skin and nail problems. Construct validity on eye problems was not tested due to the low number of paired outpatient USDs.

Conclusions: The treatment specific outpatient USD is a validated PROM in outpatients with cancer receiving intravenous chemotherapy and/or targeted therapy. Considering its validity in this broad group of patients, we think the treatment-specific outpatient USD is widely applicable. In addition to providing tailored supportive symptom care, the USD-data can be used to increase knowledge about symptom burden in daily practice in this population.

简介:乌得勒支症状日记(USD)是一种经过验证的荷兰患者报告结果测量(PROM)工具,以埃德蒙顿症状评估系统为基础,用于评估和监测癌症患者的症状。USD包含11个项目,涉及癌症患者经常出现的症状(疼痛、睡眠问题、口干、吞咽困难、食欲不振、大便异常、恶心、呼吸急促、疲劳、焦虑和情绪低落)以及一个关于整体健康的项目。在门诊病人综合症状量表中增加了 11 个项目,涉及接受化疗和/或靶向治疗的病人经常出现的体征和症状:味觉改变、口腔疼痛、体重减轻、腹泻、毛发变化、皮肤问题、指甲问题、眼部问题、刺痛、注意力不集中和性生活问题。本研究旨在对接受静脉化疗和/或靶向治疗的癌症患者在这一针对特定治疗的门诊USD中增加的11个项目进行评估:观察性纵向回顾性队列研究,包括在荷兰一家学术医院接受静脉化疗和/或靶向治疗的所有成年门诊癌症患者,这些患者在常规治疗中至少完成了一次门诊USD(2012-2021年)。对其相关性、全面性以及标准和构建有效性进行了评估:共纳入了1733名在静脉化疗和/或靶向治疗期间完成了≥1次门诊USD的患者进行分析。结果表明,门诊综合症的项目在这一患者群体中具有相关性和全面性。除口腔疼痛项目外,门诊病人综合数据表的所有新增项目均通过了标准验证。额外的分析表明,门诊综合症的口腔疼痛和口干两个项目都能检测出口腔问题。毛发变化和皮肤及指甲问题这两个项目的结构效度得到了验证。由于配对的门诊综合数据库数量较少,因此未对眼部问题的结构有效性进行测试:结论:针对特定治疗的门诊病人USD是一项经过验证的PROM,适用于接受静脉化疗和/或靶向治疗的门诊癌症患者。考虑到其在这一广泛患者群体中的有效性,我们认为特定治疗门诊综合管理系统具有广泛的适用性。除了提供量身定制的支持性症状护理外,USD 数据还可用于增加该人群在日常实践中对症状负担的了解。
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引用次数: 0
The patient-reported outcome measure for older people living with frailty receiving acute care (PROM-OPAC): field-testing and validation. 针对接受急症护理的体弱老年人的患者报告结果测量法(PROM-OPAC):现场测试与验证。
IF 2.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-16 DOI: 10.1186/s41687-024-00796-8
James D van Oppen, Simon P Conroy, Jagruti Lalseta, Nicola Mackintosh, Peter Riley, Vivien Richardson, Jose M Valderas, Timothy J Coats

Background: Current acute healthcare service metrics are not meaningful for older people living with frailty. Healthcare knowledge, situational security, and physical and psychosocial function are important outcomes typically not collected. The use of patient-reported outcome measures (PROMs) could support these assessments. Existing instruments are not comprehensive as they typically consider function, while older people with frailty also value enablement (self-determination and security in health and healthcare). This study field-tested and validated a PROM for older people with frailty receiving acute care (PROM-OPAC) to measure enablement.

Methods: People aged 65+ with Clinical Frailty Scale 5-8 were recruited within seventy-two hours of an emergency attendance. Iterations of the novel instrument were administered over three stages: (1) preliminary field-testing for reliability (response distribution and internal consistency) and structure (exploratory factor analysis, EFA); (2) intermediate field-testing of an improved instrument for reliability and structure; (3) final draft validation assessing reliability, structure (confirmatory factor analysis, CFA), and construct validity based on a priori hypotheses. Feasibility was appraised throughout using data completeness and response rates and times.

Results: 241 people participated. Three items of a preliminary seven-item measure had poor response distribution or loading and were accordingly improved. The intermediate instrument had interpretability issues and three items required further improvement. The final eight-item draft had acceptable reliability (Cronbach's alpha: 0.71), structure (two factors for self-determination and security; RMSEA: 0.065; TLI: 0.917; CFI: 0.944), and construct validity (lower scores from respondents waiting longer and requiring admission). Feasibility was promising (response rate 39%; 98% responses complete; median completion time 11 (IQR: 12) minutes).

Conclusions: Administration of the PROM-OPAC appeared feasible and the instrument had acceptable psychometric properties. Further evaluation is required to assess generalisability.

背景:目前的急症医疗保健服务指标对患有虚弱症的老年人来说意义不大。医疗保健知识、情景安全以及身体和社会心理功能是通常无法收集到的重要结果。使用患者报告的结果测量(PROMs)可以为这些评估提供支持。现有的工具并不全面,因为它们通常考虑的是功能,而体弱老年人也重视能力(健康和医疗保健方面的自决和安全)。本研究实地测试并验证了针对接受急症护理的体弱老年人的 PROM(PROM-OPAC),以衡量其能力:方法:在急诊就医 72 小时内招募临床虚弱量表为 5-8 的 65 岁以上老年人。新工具的迭代分三个阶段进行:(1) 可靠性(反应分布和内部一致性)和结构(探索性因素分析,EFA)的初步现场测试;(2) 可靠性和结构的改进工具的中期现场测试;(3) 基于先验假设的可靠性、结构(确认性因素分析,CFA)和构建有效性的最终验证草案。在整个过程中,利用数据完整性、回复率和时间对可行性进行了评估。在初步的七项目测量中,有三个项目的反应分布或负荷不佳,因此进行了改进。中间工具存在可解释性问题,有三个项目需要进一步改进。最终的八项目草案在信度(Cronbach's alpha:0.71)、结构(自我决定和安全感两个因子;RMSEA:0.065;TLI:0.917;CFI:0.944)和建构性方面都是可以接受的:0.944)和结构效度(等待时间较长和需要入院的受访者得分较低)。可行性良好(回复率为 39%;98% 的回复完整;中位数完成时间为 11 (IQR: 12) 分钟):结论:PROM-OPAC 的实施似乎是可行的,该工具的心理测量特性也是可以接受的。还需要进一步评估其普遍性。
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引用次数: 0
Psychometric evaluation of the Adelphi Adherence Questionnaire (ADAQ©) in adults with osteoarthritis. 对成人骨关节炎患者的阿德尔菲依从性问卷 (ADAQ©) 进行心理计量学评估。
IF 2.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-14 DOI: 10.1186/s41687-024-00789-7
Nathan Clarke, Andrew Trigg, Rob Arbuckle, Jan Stochl, Victoria Higgins, Sarah Bentley, James Piercy

Background: Medication non-adherence is a common issue in chronic illness. The World Health Organization has recognized a need for a valid and reliable method of measuring adherence to understand and mitigate non-adherence. This study aimed to psychometrically evaluate the English version of the Adelphi Adherence Questionnaire (ADAQ©), a questionnaire designed to assess patient-reported medication adherence across multiple therapy areas, in patients with Osteoarthritis (OA).

Methodology: Data from the Adelphi OA Disease Specific Programme™, a survey of physicians and their consulting adult patients with OA conducted in the United States, November 2020 to March 2021, was used to assess the psychometric properties of the ADAQ. Patients completed the ADAQ, Adherence to Refills and Medication Scale (ARMS), Western Ontario and McMaster Universities Arthritis Index (WOMAC), and EQ-5D-3L. The measurement model of the 13-item ADAQ was assessed and refined using latent variable modelling (Multiple Indicator Multiple Cause, confirmatory and exploratory factor analyses, item response theory, Mokken scaling, and bifactor analyses). Correlational analyses (Spearman's rank and polyserial as appropriate) with ARMS, WOMAC, and EQ-5D-3L scores assessed construct validity. Anchor- and distribution-based analyses were performed to estimate between-group clinically important differences (CID).

Results: Overall, 723 patients were included in this analysis (54.5% female, 69.0% aged ≥ 60). Latent variable modelling indicated a unidimensional reflective model was appropriate, with a bifactor model confirming an 11-item essentially unidimensional score. Items 12 and 13 were excluded from scoring as they measured a different concept. The ADAQ had high internal reliability with omega hierarchical and Cronbach's alpha coefficients of 0.89 and 0.97, respectively. Convergent validity was supported by moderate correlations with items of the ARMS, and physician-reported adherence and compliance. Mean differences in ADAQ score between high and low adherence groups yielded CID estimates between 0.49 and 1.05 points, with a correlation-weighted average of 0.81 points.

Conclusion: This scoring model showed strong construct validity and internal consistency reliability when assessing medication adherence in OA. Future work should focus on confirming validity across a range of disease areas.

背景:不坚持用药是慢性病的一个常见问题。世界卫生组织已认识到需要一种有效可靠的方法来衡量用药依从性,以了解和减少不依从现象。本研究旨在对阿德尔菲依从性问卷(ADAQ©)的英文版进行心理计量学评估,该问卷旨在评估骨关节炎(OA)患者在多个治疗领域的患者报告的用药依从性:2020 年 11 月至 2021 年 3 月在美国进行的阿德尔菲 OA 特定疾病计划™(Adelphi OA Disease Specific Programme™)对医生及其咨询的成年 OA 患者进行了调查,调查数据用于评估 ADAQ 的心理测量特性。患者完成了 ADAQ、坚持补药和服药量表 (ARMS)、西安大略和麦克马斯特大学关节炎指数 (WOMAC) 以及 EQ-5D-3L 的填写。采用潜变量模型(多指标多因子、确证和探索性因子分析、项目反应理论、莫肯缩放和双因子分析)对 13 个项目 ADAQ 的测量模型进行了评估和改进。与 ARMS、WOMAC 和 EQ-5D-3L 评分的相关性分析(酌情采用斯皮尔曼等级分析和多序列分析)评估了构建的有效性。为了估计组间临床重要差异(CID),还进行了基于锚和分布的分析:本次分析共纳入 723 名患者(54.5% 为女性,69.0% 年龄≥ 60 岁)。潜变量模型显示单维反映模型是合适的,双因素模型证实了11个项目基本上是单维评分。第 12 项和第 13 项不计分,因为它们测量的是不同的概念。ADAQ 具有较高的内部可靠性,Ω 层次系数和 Cronbach's alpha 系数分别为 0.89 和 0.97。ADAQ与ARMS的项目以及医生报告的依从性和顺应性之间存在适度的相关性,因此具有收敛效度。高依从性组和低依从性组之间 ADAQ 分数的平均差异产生的 CID 估计值介于 0.49 分和 1.05 分之间,相关性加权平均值为 0.81 分:该评分模型在评估OA患者的用药依从性时显示出很强的建构有效性和内部一致性可靠性。未来的工作重点应是在一系列疾病领域确认其有效性。
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引用次数: 0
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Journal of Patient-Reported Outcomes
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