Impact of patient-reported nasal symptoms on quality of life after endoscopic pituitary surgery: a prospective cohort study

Pituitary ◽  
2022 ◽  
Author(s):  
Merel van der Meulen ◽  
Marco J. T. Verstegen ◽  
Daniel J. Lobatto ◽  
Maarten C. Kleijwegt ◽  
Alberto M. Pereira ◽  
...  
BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e038346
Author(s):  
Russel Haque ◽  
Shakib Al-Jawazneh ◽  
Jason Hoellwarth ◽  
Muhammad Adeel Akhtar ◽  
Karan Doshi ◽  
...  

IntroductionLower extremity amputation uniformly impairs a person’s vocational, social and recreational capacity. Rehabilitation in traditional socket prostheses (TSP) is associated with a spectrum of complications involving the socket-residuum interface which lead to reduced prosthetic use and quality of life. Osseointegration has recently emerged as a novel concept to overcome these complications by eliminating this interface and anchoring the prosthesis directly to bone. Though the complications of TSPs affect both transfemoral and transtibial amputees, Osseointegration has been predominantly performed in transfemoral ones assuming a greater benefit/risk ratio. However, as the safety of the procedure has been established, we intend to extend the concept to transtibial amputees and document the outcomes.Methods and analysisThis is protocol for a prospective cohort study, with patient enrolment started in 2014 and expected to be completed by 2022. The inclusion criteria are age over 18 years, unilateral, bilateral and mixed transtibial amputation and experiencing socket-related problems. All patients receive osseointegrated implants, the type of which depend on the length of the residuum and quality of bone, which are press-fitted into the residual bone. Objective functional outcomes comprising 6-Minute Walk Test, Timed Up-and-Go test and K-level, subjective patient-reported-quality-of-life outcomes (Short Form Health Survey 36, daily prosthetic wear hours, prosthetic wear satisfaction) and adverse events are recorded preoperatively and at postoperative follow-up intervals of 3, 6, 12 months and yearly, and compared with the preoperative values using appropriate statistical tests. Multivariable multilevel logistic regression will be performed with a focus to identify factors associated with outcomes and adverse events, specifically infection, periprosthetic fracture, implant fracture and aseptic loosening.Ethics and disseminationThe Ethics approval for the study has been received from the University of Notre Dame, Sydney, Australia (014153S). The outcomes of this study will be disseminated by publications in peer-reviewed academic journals and scientific presentations at relevant orthopaedic conferences.


2020 ◽  
Author(s):  
Sara Khor ◽  
David R. Flum ◽  
Lisa L. Strate ◽  
Mariam N. Hantouli ◽  
Heather H. Harris ◽  
...  

AbstractBackground & AimsDiverticular disease can undermine health-related quality of life (HRQoL). The diverticulitis quality of life (DV-QOL) instrument was designed and validated to measure the patient-reported burden of diverticular disease. However, in order for the DV-QOL to capture longitudinal outcomes, values reflecting meaningful improvement (i.e., minimal clinically important difference (MCID)) and the patient acceptable symptom state (PASS) need to be established. We sought to establish the MCID and PASS of the DV-QOL, and describe the characteristics of those with DV-QOL above the PASS threshold.MethodsWe performed a prospective cohort study of adults with diverticular disease from 7 centers in Washington and California (2016-2018). Patients were surveyed at baseline, then quarterly up to 30 months. To determine the PASS for DV-QOL, we used an anchor-based approach and performed receiver operating characteristic analyses using baseline data. A range of MCID values were calculated using distribution-based and anchor-based approaches.ResultsThe study included 177 patients (mean age 57, 43% female). A PASS threshold of 3.2/10 distinguished between those with and without HRQoL-impacting diverticulitis with acceptable accuracy (area under the curve (AUC) 0.76). A change of 2.2 points in the DV-QOL was the most appropriate MCID: above the measurement error and corresponding to patient perception of importance of change (AUC 0.70). Patients with DV-QOL≥PASS were more often male, younger, had Medicaid, less educated, and had more serious episodes of diverticulitis.ConclusionsOur study is the first to define MCID and PASS for DV-QOL. These thresholds are critical for measuring the impact of diverticular disease and the evaluation of treatment effectiveness.


2016 ◽  
Vol 20 (12) ◽  
pp. 1950-1958 ◽  
Author(s):  
Jennifer Muir ◽  
Melyssa Aronson ◽  
Mary-Jane Esplen ◽  
Aaron Pollett ◽  
Carol J. Swallow

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