scholarly journals Exploring the intersection of functional recurrence, patient-reported sexual function, and treatment satisfaction after anterior buccal mucosal graft urethroplasty

2021 ◽  
Author(s):  
Malte W. Vetterlein ◽  
◽  
Almut Gödde ◽  
Valentin Zumstein ◽  
Philipp Gild ◽  
...  
Keyword(s):  
Sexual Function ◽  
Treatment Satisfaction ◽  
Previous Treatment ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Urethral Reconstruction ◽  
Buccal Mucosal Graft ◽  
Kaplan Meier ◽  
Patient Reported ◽  
Before And After

Abstract Purpose To evaluate the interplay of stricture recurrence, sexual function, and treatment satisfaction after substitution urethroplasty. Methods Observational study of men undergoing 1-stage buccal mucosal graft urethroplasty for anterior urethral stricture between 2009 and 2016. Patients were dichotomized by self-reported treatment satisfaction. Sexual function was assessed by validated and non-validated patient-reported outcome measures. Functional recurrence was defined as symptomatic need of re-intervention. Bivariate analyses, Kaplan–Meier estimates, qualitative and quantitative analyses by uni- and multivariable regression were employed to evaluate the interplay of sexual function, functional recurrence, and treatment satisfaction. Results Of 534 men with bulbar (82%), penobulbar (11%), and penile strictures (7.3%), 451 (84%) were satisfied with the surgery. There were no differences in stricture location, previous treatment, graft length, or surgical technique between satisfied and unsatisfied patients (all p  ≥  0.2). Recurrence-free survival was 85% at a median follow-up of 33 mo and decreased significantly with each Likert item towards increasing dissatisfaction (p  <  0.001). Dissatisfied patients more often reported postoperative loss of rigidity, tumescence, reduced ejaculatory volume, ejaculatory pain, and reduced penile length (all p  ≤  0.042). In 83 dissatisfied men, functional recurrence (28%) and oral morbidity (20%) were the main drivers of dissatisfaction in qualitative analysis. Multivariable analyses revealed functional recurrence and impaired postoperative ejaculatory function as independent predictors of treatment dissatisfaction (all p  ≤  0.029) after adjusting for confounders. Conclusion We found an association of both functional success and sexual function with patient-reported treatment satisfaction after substitution urethroplasty. Such findings validate the clinical significance of defining the symptomatic need for re-intervention as an endpoint and underline the importance of further research evaluating sexual function before and after open urethral reconstruction.

scholarly journals Validity of the French version of Catquest-9SF and use of an electronic notepad for entering patient-reported outcome measures

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Gregory Katz ◽  
Alexandra Rouquette ◽  
François Lignereux ◽  
Thierry Mourgues ◽  
Michel Weber ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Psychometric Properties ◽  
Rasch Analysis ◽  
Item Difficulty ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Good Precision ◽  
French Version ◽  
Patient Reported ◽  
Before And After

Abstract Background The Catquest-9SF questionnaire is a patient reported outcome measure that quantifies the visual benefits from cataract surgery. The purpose of this study was to translate and adapt the Catquest-9SF questionnaire for France, to assess its psychometric properties via Rasch analysis, and to assess its validity when completed using an electronic notepad. Methods The Catquest-9SF questionnaire was translated following the guidelines of the International Society for Pharmacoeconomics and Outcomes Research. Catquest-9SF and clinical data were collected from patients before and after routine cataract surgery. All questionnaire data were collected via an electronic notepad. Rasch analysis was performed to assess psychometric properties, and sensitivity to change was analysed for patients with complete paired pre- and post-operative questionnaires. Results A complete filled-in preoperative questionnaire was obtained for 848 patients. Rasch analysis showed good precision (person separation: 2.32, person reliability: 0.84), ordered category probability curves, no item misfit, and unidimensionality. The respondents were slightly more able than the level of item difficulty (targeting: −1.12 logits). Sensitivity was analysed on 211 paired questionnaires, and the postoperative questionnaires showed a clear ceiling effect. The effect size was 2.6. The use of an electronic notepad for completing the questionnaire worked out very well after some adjustments. Conclusions The French version of Catquest-9SF has good psychometric properties and is suitable for use in French-speaking patients. The use of the Catquest-9SF questionnaire in an electronic format showed good validity.

scholarly journals A pain relieving reimbursement program? Effects of a value-based reimbursement program on patient reported outcome measures

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Thérèse Eriksson ◽  
Hans Tropp ◽  
Ann-Britt Wiréhn ◽  
Lars-Åke Levin
Keyword(s):  
Outcome Measures ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Lumbar Spine Surgery ◽  
A Value ◽  
Level Data ◽  
Patient Reported ◽  
Before And After ◽  
Cherry Picking ◽  
Inpatient And Outpatient Care

Abstract Background Value-based reimbursement programs have become increasingly common. However, little is known about the effect of such programs on patient reported outcomes. Thus, the aim of this study was to analyze the effect of introducing a value-based reimbursement program on patient reported outcome measures and to explore whether a selection bias towards less complicated patients occurred. Methods This is a retrospective observational study with a before and after design based on the introduction of a value-based reimbursement program in Region Stockholm, Sweden. We analyzed patient level data from inpatient and outpatient care of patients undergoing lumbar spine surgery during 2006–2015. Patient reported outcome measures used was Global Assessment, EQ-5D-3L and Oswestry Disability Index. The case-mix of surgically treated patients was analyzed using medical and socioeconomic factors. Results The value-based reimbursement program did not have any effect on targeted or non-targeted patient reported outcome measures. Moreover, the share of surgically treated patients with risk factors such as having comorbidities and being born outside of Europe increased after the introduction. Hence, the value-based reimbursement program did not encourage discrimination against sicker patients. However, the income was higher among patients surgically treated after the introduction of the value-based reimbursement. This indicates that a value-based reimbursement program may contribute to increased inequalities in access to healthcare. Conclusions The value-based reimbursement program did not have any effect on patient reported outcome measures. Our study contributes to the understanding of the effects of a value-based reimbursement program on patient reported outcome measures and to what extent cherry-picking arises.

scholarly journals Evaluation of the acceptability of patient-reported outcome measures in women following pelvic floor procedures

2021 ◽  
Author(s):  
Rasa Ruseckaite ◽  
Claire Bavor ◽  
Lucy Marsh ◽  
Joanne Dean ◽  
Justin O Daly ◽  
...  
Keyword(s):  
Sexual Function ◽  
Pelvic Floor ◽  
Outcome Measures ◽  
Qualitative Interviews ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Face Validity ◽  
Phone Call ◽  
Patient Global Impression ◽  
Patient Reported

Abstract Purpose. Patient-reported outcome measures (PROMs) are valuable tools in evaluating the outcomes of surgical treatment health-related quality of life (HRQoL) of women with stress urinary incontinence (SUI), and may be incorporated into related clinical quality registries. The aim of this study was to assess the feasibility and acceptability of incorporating PROMs into the Australian Pelvic Floor Procedure Registry (APFPR). Methods. Semi-structured qualitative interviews were conducted with women with SUI (N = 12) and their managing clinicians (N = 11) in Victoria, Australia. Interview topicscovered content and face validity, appropriateness, and acceptability of three incontinence-specific, two pain, one anxiety and depression, one sexual function and one patient global impression of improvement instruments identified through the literature to determine their suitability and acceptability for the APFPR. We analysed interview data into topics using conventional content analysis.Results. Study participants agreed that PROMs were needed for the APFPR. Both participant groups suggested that some of the instruments were ambiguous, therefore, only three instruments (one incontinence-specific, sexual function and patient global impression of improvement) will be included in the APFPR. Both clinicians and women agreed it would be appropriate to answer PROMs at baseline and then at six and 12 months post-surgically. Email, phone call and mail-out of the instruments were the preferred options for administration. Conclusions. Most women and clinicians supported the feasibility of incorporating PROMs in the APFPR. Participants believed the PROMs would demonstrate useful aggregate HRQoL data, facilitate research and have potential for use in individual care.

scholarly journals Does the severity of pain correlate with severity of functional disability? Factors influencing ‘patient reported outcome measures’ in spinal patients

SICOT-J ◽  
2018 ◽  
Vol 4 ◽  
pp. 43
Author(s):  
Andrew P. MacCormick ◽  
Himanshu Sharma
Keyword(s):  
Sexual Function ◽  
Pain Score ◽  
Outcome Measures ◽  
Subgroup Analysis ◽  
Functional Disability ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Patient Factors ◽  
Time Of Surgery ◽  
Patient Reported

Aims: To assess correlation between the Visual Analogue Scale (VAS) pain score and the Oswestry Disability Index (ODI) and which patient factors can influence patient-reported outcome measures (PROMs). This study also aims to assess the response to the sexual function question of the ODI. Methods: Retrospective analysis of 200 consecutive patients undergoing a range of different lumbar spinal procedures between July 2012 and September 2015 was performed. Subgroup analysis was also performed on the 122 patients who underwent microdiscectomy and/or decompression procedures only. Data from notes and clinical letters from the patient's first clinic appointment were collected. In addition to these outcome measures, data were also extracted regarding patients' gender, age, smoking status, alcohol use, employment and mental health status. Results: Significant correlation was found between VAS pain score and ODI (p = 0.002) and between VAS pain score and question 1 of ODI (p = 0.0001). A lower ODI score was reported at time of surgery by those in employment compared to those who are unemployed (p = 0.008). In addition to this, a lower ODI score was reported in those who are self-employed compared to those in employment (p = 0.048) in both cohorts. A significantly higher mean ODI score was shown within the subgroup analysis for current smokers (p = 0.02). None of the other patient factors that were analysed were found to affect PROMs. 65% of patients answered the sexual function question of the ODI. Conclusions: Significant correlation was demonstrated between VAS pain score and ODI. Those who are in employment are far more likely to report a lower ODI score than those who are unemployed at the time of surgery. Self-employed patients were found to have reported a significantly lower ODI score than those who are in employment. Smoking cessation should be encouraged as those who are current smokers may be more likely to report a higher ODI. As 65% of patients decided to answer the sexual function question of the ODI, this supports its further use.

scholarly journals Patient-reported outcomes after hip and knee arthroplasty

2021 ◽  
Vol 2 (6) ◽  
pp. 422-432
Author(s):  
Emma Louise Heath ◽  
Ilana N. Ackerman ◽  
Kara Cashman ◽  
Michelle Lorimer ◽  
Stephen E. Graves ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Patient Profile ◽  
Patient Reported ◽  
Before And After ◽  
Hip And Knee Arthroplasty ◽  
National Cohort ◽  
Five Dimension ◽  
Preoperative Expectations

Aims This study aims to describe the pre- and postoperative self-reported health and quality of life from a national cohort of patients undergoing elective total conventional hip arthroplasty (THA) and total knee arthroplasty (TKA) in Australia. For context, these data will be compared with patient-reported outcome measures (PROMs) data from other international nation-wide registries. Methods Between 2018 to 2020, and nested within a nationwide arthroplasty registry, preoperative and six-month postoperative PROMs were electronically collected from patients before and after elective THA and TKA. There were 5,228 THA and 8,299 TKA preoperative procedures as well as 3,215 THA and 4,982 TKA postoperative procedures available for analysis. Validated PROMs included the EuroQol five-dimension five-level questionnaire (EQ-5D-5L; range 0 to 100; scored worst-best health), Oxford Hip/Knee Scores (OHS/OKS; range 0 to 48; scored worst-best hip/knee function) and the 12-item Hip/Knee disability and Osteoarthritis Outcome Score (HOOS-12/KOOS-12; range 0 to 100; scored best-worst hip/knee health). Additional items included preoperative expectations, patient-perceived improvement, and postoperative satisfaction. Descriptive analyses were undertaken. Results For THA and TKA patients respectively, the patient profile was 2,850 (54.5%) and 4,684 (56.4%) female, mean age 66.8 years (SD 10.6) and 67.5 (SD 8.8), and mean BMI 29.9 kg/m2 (SD 7.7) and 32.5 kg/m2 (SD 7.0). The proportion of THA and TKA patients who reported their joint as ‘much better’ was 2,946 (92.6%) and 4,020 (81.6%) respectively, and the majority of patients were ‘satisfied’ or ‘very satisfied’ with their procedure (2,754 (86.5%) and 3,981 (80.8%)). There were 311 (9.7%) of THA patients and 516 (10.5%) of TKA patients who reported ‘dissatisfied’ or ‘very dissatisfied’ with their surgery. Conclusion Large improvements in pain, function, and overall health were evident following primary THA and TKA. Approximately 10% of patients reported dissatisfaction with their surgery. Future analyses will focus on factors contributing to dissatisfaction after arthroplasty. Cite this article: Bone Jt Open 2021;2(6):422–432.

scholarly journals Patient-Reported Outcome Measures in Urethral Reconstruction

2018 ◽  
Vol 19 (7) ◽  
Author(s):  
Nima Baradaran ◽  
Lindsay A. Hampson ◽  
Todd C. Edwards ◽  
Bryan B. Voelzke ◽  
Benjamin N. Breyer
Keyword(s):  
Outcome Measures ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Urethral Reconstruction ◽  
Patient Reported

scholarly journals Patient-reported outcome measures after mitral valve repair: a comparison between minimally invasive and sternotomy

2020 ◽  
Author(s):  
Jennifer Whiteley ◽  
Caroline Toolan ◽  
Matthew Shaw ◽  
Giordano Perin ◽  
Kenneth Palmer ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Outcome Measures ◽  
Treatment Satisfaction ◽  
Recovery Time ◽  
Parameter Estimate ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Valve Repair ◽  
Patient Reported ◽  
Composite Scores

Abstract OBJECTIVES To compare patient-reported outcome measures of minimally invasive (MI) to sternotomy (ST) mitral valve repair. METHODS We included all patients undergoing isolated mitral valve surgery via either a right mini-thoracotomy (MI) or ST over a 36-month period. Patients were asked to complete a modified Composite Physical Function questionnaire. Intraoperative and postoperative outcomes, and patient-reported outcome measures were compared between 2 propensity-matched groups (n = 47/group), assessing 3 domains: ‘Recovery Time’, ‘Postoperative Pain’ (at day 2 and 1, 3, 6 and 12 weeks) and ‘Treatment Satisfaction’. Composite scores for each domain were subsequently constructed and multivariable analysis was used to determine whether surgical approach was associated with domain scores. RESULTS The response rate was 79%. There was no mortality in either group. In the matched groups, operative times were longer in the MI group (P &lt; 0.001), but postoperative outcomes were similar. Composite scores for Recovery Time [ST 51.7 (31.8–62.1) vs MI 61.7 (43.1–73.9), P = 0.03] and Pain [ST 65.7 (40.1–83.1) vs MI 79.1 (65.5–89.5), P = 0.02] significantly favoured the MI group. Scores in the Treatment Satisfaction domain were high for both surgical approaches [ST 100 (82.5–100) vs MI 100 (95.0–100), P = 0.15]. The strongest independent predictor of both faster recovery parameter estimate 12.0 [95% confidence interval (CI) 5.7–18.3, P &lt; 0.001] and less pain parameter estimate 7.6 (95% CI 0.7–14.5, P = 0.03) was MI surgery. CONCLUSIONS MI surgery was associated with faster recovery and less pain; treatment satisfaction and safety profiles were similar.

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