PRO64 Psychometric Validation of the Brief Fatigue Inventory (BFI) and Brief Pain Inventory Short-Form (BPI-SF) in Tumor-Induced Osteomalacia (TIO)

Abstract Abstract 3807 Intro: Multiple myeloma (MM) is an incurable clonal plasma cell cancer characterized by a microenvironment of inflammatory cytokines, specifically IL-6, VEGF, TNF-α, and marrow stromal cells that all support the growth of myeloma cells. Given the connection between depression with pro-inflammatory cytokines (Kiecolt-Glaser, et al. 2003) and a postulated connection with cancer relapse (Marx 2004), we hypothesized that these inflammatory cytokines not only promote disease progression, but also are associated with the patient's quality of life (Maes, et al. 1997) and that traditional definitions of high-risk disease will correlate with measures of depression and fatigue via circulating inflammatory cytokines. In fact, fatigue and depression might influence disease progression rather than being an obvious consequence. Methods: For this pilot cohort study, we developed web-based versions of the Brief Fatigue Inventory (BFI), Brief Pain Inventory short form (BPI-SF), Functional Assessment of Cancer Therapy – General (FACT-G), and Center for Epidemiologic Studies Depression Scale-short form (CES-D) and administered the survey by tablet computer connected to our Wi-Fi in the myeloma clinic. This was a cohort study of five different patient groups – untreated patients, patients receiving lenalidomide-based therapy, patients 0–2 months post-treatment, patients 6–12 months after completion of treatment, and patients without treatment for more than 12 months. The first 10 patients were filled out feasibility questionnaires to provide data on patients' experience using a tablet computer. Plasma during the visit was cryopreserved and evaluated by RayBioTech's Quantibody Human Inflammation Array platform, a multiplexed sandwich ELISA-based technique of 40 different inflammatory cytokines. Results: We recruited 65 consecutive myeloma patients with complete quality of life data available in 42 patients. The majority of patients found the tablet-based method easy to use and understand, but more than a third did not find the experience enjoyable. On all scales, there was a non-significant worsening in fatigue, pain, and depression with decreased functional well-being in patients from diagnosis through initial treatment compared to patients >6 months from the most recent treatment. The FACT-G functional well-being yielded a mean summed score of 18.2+/−6 in this group compared to 21+/−6 in 652 lymphoma patients that were >2 years from diagnosis (Crespi CM et al, 2010). The brief fatigue inventory global fatigue score was 2.8+/−2.4. The brief pain inventory short-form mean severity score (the mean of the “worst,” “least,” “average,” and pain “now”) was 2.34. And the weighted sum from the CES-D was 7.19+/− 5.1, similar to breast cancer at least one year from diagnosis (van Wilgen et al, 2006). Quantitative data of the tested inflammatory cytokines will be presented. Conclusion: There have been few efforts to explore the neuropsychoimmunologic axis in myeloma patients. Information generated from this work will allow us to further explore the connection between quality of life measures, myeloma cytogenetics, and circulating inflammatory cytokines, and ultimately devise interventions to improve quality of life of myeloma patients. Disclosures: No relevant conflicts of interest to declare.

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Burosumab treatment in adults with X-linked hypophosphataemia: 96-week patient-reported outcomes and ambulatory function from a randomised phase 3 trial and open-label extension

RMD Open ◽

10.1136/rmdopen-2021-001714 ◽

2021 ◽

Vol 7 (3) ◽

pp. e001714

Author(s):

Karine Briot ◽

Anthony A Portale ◽

Maria Luisa Brandi ◽

Thomas O Carpenter ◽

Hae Ii Cheong ◽

...

Keyword(s):

Patient Reported Outcomes ◽

Short Form ◽

Brief Pain Inventory ◽

Open Label ◽

Link Type ◽

Patient Reported ◽

Brief Fatigue Inventory ◽

Open Label Extension ◽

Double Blinded ◽

The Impact

ObjectivesTo report the impact of burosumab on patient-reported outcomes (PROs) and ambulatory function in adults with X-linked hypophosphataemia (XLH) through 96 weeks.MethodsAdults diagnosed with XLH were randomised 1:1 in a double-blinded trial to receive subcutaneous burosumab 1 mg/kg or placebo every 4 weeks for 24 weeks (NCT02526160). Thereafter, all subjects received burosumab every 4 weeks until week 96. PROs were measured using the Western Ontario and the McMaster Universities Osteoarthritis Index (WOMAC), Brief Pain Inventory-Short Form (BPI-SF) and Brief Fatigue Inventory (BFI), and ambulatory function was measured with the 6 min walk test (6MWT).ResultsSubjects (N=134) were randomised to burosumab (n=68) or placebo (n=66) for 24 weeks. At baseline, subjects experienced pain, stiffness, and impaired physical and ambulatory function. At week 24, subjects receiving burosumab achieved statistically significant improvement in some BPI-SF scores, BFI worst fatigue (average and greatest) and WOMAC stiffness. At week 48, all WOMAC and BPI-SF scores achieved statistically significant improvement, with some WOMAC and BFI scores achieving meaningful and significant change from baseline. At week 96, all WOMAC, BPI-SF and BFI achieved statistically significant improvement, with selected scores in all measures also achieving meaningful change. Improvement in 6MWT distance and percent predicted were statistically significant at all time points from 24 weeks.ConclusionsAdults with XLH have substantial burden of disease as assessed by PROs and 6MWT. Burosumab treatment improved phosphate homoeostasis and was associated with a steady and consistent improvement in PROs and ambulatory function.Trial registration numberNCT02526160.

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THU0422 Psychometric Properties of the Brief Fatigue Inventory-Short Form in Systemic Lupus Erythematosus

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2014-eular.2055 ◽

2014 ◽

Vol 73 (Suppl 2) ◽

pp. 328.2-328

Author(s):

S. Al Sawah ◽

A.N. Naegeli

Keyword(s):

Systemic Lupus Erythematosus ◽

Psychometric Properties ◽

Lupus Erythematosus ◽

Short Form ◽

Systemic Lupus ◽

Brief Fatigue Inventory

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The nature and prevalence of chronic pain in homeless persons: an observational study

F1000Research ◽

10.12688/f1000research.2-164.v1 ◽

2013 ◽

Vol 2 ◽

pp. 164 ◽

Cited By ~ 10

Author(s):

Rebecca Fisher ◽

Judith Ewing ◽

Alice Garrett ◽

E Katherine Harrison ◽

Kimberly KT Lwin ◽

...

Keyword(s):

Chronic Pain ◽

Neuropathic Pain ◽

Short Form ◽

Homeless People ◽

Brief Pain Inventory ◽

Homeless Persons ◽

Lower Limbs ◽

Mcgill Pain Questionnaire ◽

Wide Range

Background: Homeless people are known to suffer disproportionately with health problems that reduce physical functioning and quality of life, and shorten life expectancy. They suffer from a wide range of diseases that are known to be painful, but little information is available about the nature and prevalence of chronic pain in this vulnerable group. This study aimed to estimate the prevalence of chronic pain among homeless people, and to examine its location, effect on activities of daily living, and relationship with alcohol and drugs.Methods: We conducted face-to-face interviews with users of homeless shelters in four major cities in the United Kingdom, in the winters of 2009-11. Participants completed the Brief Pain Inventory, Short Form McGill Pain questionnaire, Leeds Assessment of Neuropathic Symptoms and Signs, and detailed their intake of prescribed and unprescribed medications and alcohol. We also recorded each participant’s reasons for homelessness, and whether they slept rough or in shelters.Findings: Of 168 shelter users approached, 150 (89.3%) participated: 93 participants (63%) reported experiencing pain lasting longer than three months; the mean duration of pain experienced was 82.2 months. The lower limbs were most frequently affected. Opioids appeared to afford a degree of analgesia for some, but whilst many reported symptoms suggestive of neuropathic pain, very few were taking anti-neuropathic drugs.Interpretation: The prevalence of chronic pain in the homeless appears to be substantially higher than the general population, is poorly controlled, and adversely affects general activity, walking and sleeping. It is hard to discern whether chronic pain is a cause or effect of homelessness, or both. Pain is a symptom, but in this challenging group it might not always be possible to treat the underlying cause. Exploring the diagnosis and treatment of neuropathic pain may offer a means of improving the quality of these vulnerable people’s lives.

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Pain Management in Cancer Center Inpatients: A Cluster Randomized Trial to Evaluate a Systematic Integrated Approach—The Edinburgh Pain Assessment and Management Tool

Journal of Clinical Oncology ◽

10.1200/jco.2017.76.1825 ◽

2018 ◽

Vol 36 (13) ◽

pp. 1284-1290 ◽

Cited By ~ 12

Author(s):

Marie Fallon ◽

Jane Walker ◽

Lesley Colvin ◽

Aryelly Rodriguez ◽

Gordon Murray ◽

...

Keyword(s):

Adverse Effects ◽

Pain Assessment ◽

Short Form ◽

Brief Pain Inventory ◽

Integrated Approach ◽

Management Tool ◽

Cancer Centers ◽

Pain Outcomes ◽

Clinically Significant ◽

Cluster Randomized

Purpose Pain is suboptimally managed in patients with cancer. We aimed to compare the effect of a policy of adding a clinician-delivered bedside pain assessment and management tool (Edinburgh Pain Assessment and management Tool [EPAT]) to usual care (UC) versus UC alone on pain outcomes. Patients and Methods In a two-arm, parallel group, cluster randomized (1:1) trial, we observed pain outcomes in 19 cancer centers in the United Kingdom and then randomly assigned the centers to either implement EPAT or to continue UC. The primary outcome was change in the percentage of study participants in each center with a clinically significant (≥ 2 point) improvement in worst pain (using the Brief Pain Inventory Short Form) from admission to 3 to 5 days after admission. Secondary outcomes included quality of analgesic prescribing and opioid-related adverse effects. Results Ten centers were randomly assigned to EPAT, and nine were assigned to UC. We enrolled 1,921 patients and obtained outcome data from 93% (n = 1,795). Participants (mean age, 60 years; 49% women) had a variety of cancer types. For centers randomly assigned to EPAT, the percentage of participants with a clinically significant improvement in worst pain increased from 47.7% to 54.1%, and for those randomly assigned to continue UC, this percentage decreased from 50.6% to 46.4%. The absolute difference was 10.7% (95% CI, 0.2% to 21.1%; P = .046) and it increased to 15.4% (95% CI, 5.8% to 25.0%; P = .004) when two centers that failed to implement EPAT were excluded. EPAT centers had greater improvements in prescribing practice and in the Brief Pain Inventory Short Form pain subscale score. Other pain and distress outcomes and opioid adverse effects did not differ between EPAT and UC. Conclusion A systematic integrated approach improves pain outcomes for inpatients in cancer centers without increasing opioid adverse effects.

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Estudo Unicêntrico Prospetivo de Avaliação Sistemática da Dor em Doentes Portugueses com Cancro da Próstata Metastizado

Acta Médica Portuguesa ◽

10.20344/amp.8820 ◽

2017 ◽

Vol 30 (11) ◽

pp. 796

Author(s):

Maria Inês Sequeira ◽

Nuno Sousa ◽

Maria Fragoso ◽

Alexandra Silva ◽

Filipa Pereira ◽

...

Keyword(s):

Prostate Cancer ◽

Pain Intensity ◽

Metastatic Prostate Cancer ◽

Short Form ◽

Brief Pain Inventory ◽

Life Assessment ◽

Medical Interventions ◽

Reduction Of Pain ◽

Prevalence Of Pain ◽

The Impact

Introduction: Pain is one of the most common symptoms reported by cancer patients and is associated with decreased quality of life. Assessment of pain with standardized questionnaires reduces variability in its interpretation and may increase effectiveness of medical interventions. Prostate cancer is the most frequent male neoplasm in Portugal. We designed this study to evaluate the impact of a standardized pain questionnaire on pain management in patients with metastatic prostate cancer.Material and Methods: Single centre prospective observational study of patients with metastatic prostate cancer. The study was designed to evaluate the benefit of systematically evaluating pain with Brief Pain Inventory-Short Form prior to a scheduled medical oncology consult. Patients reporting pain were reassessed one week later by telephone. To assess the benefit two consecutive cohorts were established based on communication of questionnaire results to the treating physician.Results: We recruited 207 patients of which 60% reported pain. Statistically significant decrease in mean pain intensity one week after the scheduled appointment was noted (3.95 vs 3.01; p < 0.001). Patients whose Brief Pain Inventory-Short Form was provided to their oncologist experienced greater reduction in pain, which was non-significant (p = 0.227). Using Brief Pain Inventory-Short Form assessment resulted in a higher probability of pain control (43.5% vs 30.9%; p = 0.193).Discussion: The prevalence of pain founded was higher than described in the literature, probably because our sample was less selected than the published in clinical trials. After the scheduled appointment, there was a statistically significant reduction in mean pain intensity, but the explicit use of this questionnaire was not associated with a statistically significant reduction of pain.Conclusion: Patients with metastatic prostate cancer have a high prevalence of pain. Evaluation and treatment by medical oncologists is associated with a reduction of mean pain intensity. The use of Brief Pain Inventory-Short Form was associated with a non-significant increased reduction of pain.

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Measurement of Disability-free Survival after Surgery

Anesthesiology ◽

10.1097/aln.0000000000000586 ◽

2015 ◽

Vol 122 (3) ◽

pp. 524-536 ◽

Cited By ~ 86

Author(s):

Mark A. Shulman ◽

Paul S. Myles ◽

Matthew T. V. Chan ◽

David R. McIlroy ◽

Sophie Wallace ◽

...

Keyword(s):

World Health Organization ◽

Convergent Validity ◽

Short Form ◽

Brief Pain Inventory ◽

Outcome Data ◽

World Health ◽

Disability Assessment ◽

Patient Centered ◽

Health Organization

Abstract Background: Survival and freedom from disability are arguably the most important patient-centered outcomes after surgery, but it is unclear how postoperative disability should be measured. The authors thus evaluated the World Health Organization Disability Assessment Schedule 2.0 in a surgical population. Methods: The authors examined the psychometric properties of World Health Organization Disability Assessment Schedule 2.0 in a diverse cohort of 510 surgical patients. The authors assessed clinical acceptability, validity, reliability, and responsiveness up to 12 months after surgery. Results: Criterion and convergent validity of World Health Organization Disability Assessment Schedule 2.0 were supported by good correlation with the 40-item quality of recovery scale at 30 days after surgery (r = −0.70) and at 3, 6, and 12 months after surgery with physical functioning (The Katz index of independence in Activities of Daily Living; r = −0.70, r = −0.60, and rho = −0.47); quality of life (EQ-5D; r = −0.57, −0.60, and −0.52); and pain interference scores (modified Brief Pain Inventory Short Form; r = 0.72, 0.74, and 0.81) (all P < 0.0005). Construct validity was supported by increased hospital stay (6.9 vs. 5.3 days, P = 0.008) and increased day 30 complications (20% vs. 11%, P = 0.042) in patients with new disability. There was excellent internal consistency with Cronbach’s α and split-half coefficients greater than 0.90 at all time points (all P < 0.0005). Responsiveness was excellent with effect sizes of 3.4, 3.0, and 1.0 at 3, 6, and 12 months after surgery, respectively. Conclusions: World Health Organization Disability Assessment Schedule 2.0 is a clinically acceptable, valid, reliable, and responsive instrument for measuring postoperative disability in a diverse surgical population. Its use as an endpoint in future perioperative studies can provide outcome data that are meaningful to clinicians and patients alike.

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