Fundamentals of Osteoarthritis: Outcome Evaluation with Patient-reported Measures and Functional Tests

Author(s):  
Aileen M. Davis ◽  
Lauren K. King ◽  
Ian Stanaitis ◽  
Gillian A. Hawker
2021 ◽  
pp. 761-766
Author(s):  
Marc C. Swan ◽  
Conrad J. Harrison ◽  
Tim E.E. Goodacre

Outcome assessment for cleft management is complex due to the diverse elements of function affected by the condition, and the variation in effect on patients over time. Methods of assessment are broadly separated into objectively measurable variables that can be independently validated, and patient-reported measures that are necessarily more subjective. Validated tools to evaluate outcomes are now widely adopted for speech and facial growth, with other areas of outcome presenting greater problems in development of suitable measures. In recent years, the emphasis of outcome evaluation has turned towards greater reliance on patient-reported measures that require extensive preliminary research to develop if a high degree of validity is to be ensured. Existing outcome measures that are widely used are described in this chapter, along with a perspective for future trends and a forthcoming internationally applicable tool for comparative studies (ICHOM).


Author(s):  
D. Leander Rimmele ◽  
Lisa Lebherz ◽  
Marc Frese ◽  
Hannes Appelbohm ◽  
Hans-Jürgen Bartz ◽  
...  

Abstract Introduction The impact of stroke-related impairment on activities of daily living may vary between patients, and can only be estimated by applying patient-reported outcome measures. The International Consortium for Health Outcome Measurement has developed a standard set of instruments that combine clinical and longitudinal patient-reported outcome measures for stroke. The present study was designed (1) to implement and evaluate the feasibility of the use of it as a consistent outcome measure in clinical routine at the stroke center of a German university hospital, (2) to characterize impairment in everyday life caused by stroke, and (3) to identify predictive factors associated with patient-relevant outcomes. Methods We plan to enroll 1040 consecutive patients with the diagnosis of acute ischemic stroke, transient ischemic attack, or intracerebral hemorrhage in a prospective observational study. Demographics, cardiovascular risk factors, and living situation are assessed at inpatient surveillance. At 90 days and 12 months after inclusion, follow-up assessments take place including the Patient-reported Outcomes Measurement Information System 10-Question Short Form (PROMIS-10), the Patient- Health Questionnaire-4, and the simplified modified Ranking Scale questionnaire. The acceptance and feasibility (1) will be assessed by a process evaluation through qualitative semi-structured interviews with clinical staff and patients and quantitative analyses of the data quality evaluating practicability, acceptance, adoption, and fidelity to protocol. The primary outcome of objective 2 and 3 is health-related quality of life measured with the PROMIS-10. Additional outcomes are depressive and anxiety symptoms and patient participation in their social roles. Patient-reported outcomes will be assessed in their longitudinal course using (generalized) mixed regressions. Exploratory descriptive and inference statistical analyses will be used to find patterns of patient characteristics and predictive factors of the outcome domains. Perspective The results will describe and further establish the evaluation of stroke patients of a stroke center by standardized PROMs in everyday life. Trial registration The trial is registered at ClinicalTrials.gov (NCT03795948). Approval of the local ethics committee (Ethik-Kommission der Ärztekammer Hamburg) has been obtained.


Author(s):  
Pernille F. Cromhout ◽  
Lau C. Thygesen ◽  
Philip Moons ◽  
Samer Nashef ◽  
Sune Damgaard ◽  
...  

2019 ◽  
Vol 39 (6) ◽  
pp. 673-680 ◽  
Author(s):  
Suzanne Brodney ◽  
Floyd J. Fowler ◽  
Michael J. Barry ◽  
Yuchiao Chang ◽  
Karen Sepucha

Objective. If shared decision making (SDM) is to be part of quality assessment, it is necessary to have good measures of SDM. The purpose of this study is to compare the psychometric performance of 3 short patient-reported measures of SDM. Methods. Patients who met with a specialist to discuss possible surgery for hip or knee osteoarthritis (hips/knees), lumbar herniated disc, or lumbar spinal stenosis (backs) were surveyed shortly after the visit and again 6 months later. Some of the patients saw a patient decision aid (PDA) prior to the meeting. The 3 SDM measures were the SDM Process_4 (SDMP) survey, CollaboRATE, and SURE scale. The follow-up survey included measures of decision regret, satisfaction, and decision quality. Results. Patients in the sample ( N = 649) had a mean age of 63.3 years, 51% were female, 60% were college educated, and there were more hip/knee patients than back patients (69% v. 31%). Forty-nine percent had surgery. For hips/knees, the SDMP and SURE scores were significantly associated with viewing all of the PDA compared with those who did not ( P < 0.001), but not for CollaboRATE ( P = 0.35). For backs, none of the scores were significantly associated with viewing all the PDA. All 3 scores were significantly associated with less regret and higher satisfaction ( P < 0.001) for hips/knees. For backs, only SURE and CollaboRATE were significantly associated with less regret, and only SDMP was significantly associated with higher satisfaction. For hips/knees and backs, the SDMP and SURE scales were significantly associated with an informed patient-centered decision ( P < 0.001), but this relationship was not significant for CollaboRATE (hips/knees: P = 0.24; backs: P = 0.25). Discussion. Each measure has some evidence of validity. SURE and SDMP better discriminate the use of PDAs and have higher decision quality.


2018 ◽  
Vol 27 (6) ◽  
pp. 1599-1611 ◽  
Author(s):  
Honghu Liu ◽  
Ron Hays ◽  
Yan Wang ◽  
Marvin Marcus ◽  
Carl Maida ◽  
...  

2020 ◽  
Vol 12 (01) ◽  
pp. 47-55
Author(s):  
Svenna H. W. L. Verhiel ◽  
Sezai Özkan ◽  
Christopher G. Langhammer ◽  
Neal C. Chen

Abstract Objective The main aim of this article is to report 10-year outcomes after Essex-Lopresti injury (ELI). Study Design Retrospective case series. Two level I trauma centers and one associated community hospital from 2003 to 2016. Patients Sixteen patients who sustained an ELI and were treated at one of our three regional hospitals. Intervention Initially, 4 patients (25%) were treated nonoperatively by immobilization and 12 patients (75%) were treated operatively. Proximal surgery included radial head open reduction and internal fixation (ORIF), radial head arthroplasty, radial head excision and forearm ORIF, and wound debridement. Ten patients (63%) were acutely identified with longitudinal forearm instability. Of these, four patients had the distal radioulnar joint pinned. In the other six patients, the forearm was immobilized. Overall, 16 patients underwent a total of 32 revision surgeries. Main Outcome Measure Performance of Patient-Reported Outcomes Measurement Information System Upper Extremity (PROMIS UE) Physical score, Numeric Rating Scale (NRS) score for pain-severity, and NRS score for satisfaction of overall outcome. Results Follow-up for outcome evaluation was available for 10 patients, at a median of 10 (interquartile range [IQR]: 8.0–12) years after date of injury. The median PROMIS UE Physical score was 36 (IQR: 33–38). Median NRS score for pain-severity on average was 5 (IQR: 0–6). The median NRS score for satisfaction of overall outcome was 7 (IQR: 5–8). Conclusion Patients who sustain an ELI generally have substantial deficits of upper extremity function as measured by PROMIS UE. Early radial head arthroplasty may be beneficial, but further study in a larger cohort is needed. Outcomes of nonoperative treatment and operative treatment were similar and suggest that current surgical treatments are incomplete.


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