Efficacy of Group Conversation Intervention in Individuals with Severe Profiles of Aphasia

AbstractAn estimated 390,000 to 520,000 individuals with severe aphasia (IWSA) currently live in the United States. IWSA experience profound social isolation, which is associated with a wide range of negative health outcomes, including mortality. Treatments for severe aphasia frequently focus on compensatory communication approaches or a discrete communication act rather than on participation-based treatment. The purpose of this study was to determine whether IWSA demonstrated improved performance on standardized language measures, patient-reported outcome measures, and connected speech samples as a result of client-centered conversation group treatment. Results of assessments conducted at pretreatment, posttreatment, and maintenance intervals were variable across participants. All participants demonstrated improvement in at least one of the outcome measures considered. Importantly, none of these measures fully captured how IWSA were able to convey their thoughts in supported conversation. The results lend support for the use of conversation treatment for, and for further study in, this subpopulation of individuals with aphasia.

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Enabling patient-reported outcome measures in clinical trials, exemplified by cardiovascular trials

Health and Quality of Life Outcomes ◽

10.1186/s12955-021-01800-1 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Theresa M. Coles ◽

Adrian F. Hernandez ◽

Bryce B. Reeve ◽

Karon Cook ◽

Michael C. Edwards ◽

...

Keyword(s):

Clinical Trials ◽

Outcome Measures ◽

Contextual Factors ◽

The United States ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Think Tank ◽

Level Of Evidence ◽

Patient Reported ◽

Evidentiary Standards

Abstract Objectives There has been limited success in achieving integration of patient-reported outcomes (PROs) in clinical trials. We describe how stakeholders envision a solution to this challenge. Methods Stakeholders from academia, industry, non-profits, insurers, clinicians, and the Food and Drug Administration convened at a Think Tank meeting funded by the Duke Clinical Research Institute to discuss the challenges of incorporating PROs into clinical trials and how to address those challenges. Using examples from cardiovascular trials, this article describes a potential path forward with a focus on applications in the United States. Results Think Tank members identified one key challenge: a common understanding of the level of evidence that is necessary to support patient-reported outcome measures (PROMs) in trials. Think Tank participants discussed the possibility of creating general evidentiary standards depending upon contextual factors, but such guidelines could not be feasibly developed because many contextual factors are at play. The attendees posited that a more informative approach to PROM evidentiary standards would be to develop validity arguments akin to courtroom briefs, which would emphasize a compelling rationale (interpretation/use argument) to support a PROM within a specific context. Participants envisioned a future in which validity arguments would be publicly available via a repository, which would be indexed by contextual factors, clinical populations, and types of claims. Conclusions A publicly available repository would help stakeholders better understand what a community believes constitutes compelling support for a specific PROM in a trial. Our proposed strategy is expected to facilitate the incorporation of PROMs into cardiovascular clinical trials and trials in general.

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Perceptions of Patients, Caregivers, and Healthcare Providers of Idiopathic Inflammatory Myopathies: An International OMERACT Study

The Journal of Rheumatology ◽

10.3899/jrheum.180353 ◽

2018 ◽

Vol 46 (1) ◽

pp. 106-111 ◽

Cited By ~ 9

Author(s):

Christopher A. Mecoli ◽

Jin Kyun Park ◽

Helene Alexanderson ◽

Malin Regardt ◽

Merrilee Needham ◽

...

Keyword(s):

Outcome Measures ◽

Qualitative Content Analysis ◽

Healthcare Providers ◽

The United States ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Idiopathic Inflammatory Myopathies ◽

Inflammatory Myopathies ◽

Patient Reported ◽

Initial List

Objective.Patient-reported outcome measures (PROM) that incorporate the patient perspective have not been well established in idiopathic inflammatory myopathies (IIM). As part of our goal to develop IIM-specific PROM, the Outcome Measures in Rheumatology (OMERACT) Myositis special interest group sought to determine which aspects of disease and its effects are important to patients and healthcare providers (HCP).Methods.Based on a prior qualitative content analysis of focus groups, an initial list of 24 candidate domains was constructed. We subsequently conducted an international survey to identify the importance of each of the 24 domains to be assessed in clinical research. Patients with IIM, their caregivers, and HCP treating IIM completed the survey.Results.In this survey, a total of 638 respondents completed the survey, consisting of 510 patients, 101 HCP, and 27 caregivers from 48 countries. Overall, patients were more likely to rank “fatigue,” “cognitive impact,” and “difficulty sleeping” higher compared with HCP, who ranked “joint symptoms,” “lung symptoms,” and “dysphagia” higher. Both patients and providers rated muscle symptoms as their top domain. In general, patients from different countries were in agreement on which domains were most important. One notable exception was that patients from Sweden and the Netherlands ranked lung symptoms significantly higher compared to other countries including the United States and Australia (mean weighted rankings of 2.86 and 2.04 vs 0.76 and 0.80, respectively; p < 0.0001).Conclusion.Substantial differences exist in how IIM is perceived by patients compared to HCP, with different domains prioritized. In contrast, patients’ ratings across the world were largely similar.

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Patient-reported outcome measures in the recovery of adults hospitalised with community-acquired pneumonia: a systematic review

European Respiratory Journal ◽

10.1183/13993003.02165-2018 ◽

2019 ◽

Vol 53 (3) ◽

pp. 1802165 ◽

Cited By ~ 2

Author(s):

Harry J. Pick ◽

Charlotte E. Bolton ◽

Wei Shen Lim ◽

Tricia M. McKeever

Keyword(s):

Systematic Review ◽

Outcome Measures ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Community Acquired Pneumonia ◽

Assessment Tools ◽

Post Discharge ◽

Wide Range ◽

Patient Reported ◽

Prisma Statement

Symptomatic and functional recovery are important patient-reported outcome measures (PROMs) in community-acquired pneumonia (CAP) that are increasingly used as trial end-points. This systematic review summarises the literature on PROMs in CAP.Comprehensive searches in accordance with the PRISMA statement were conducted to March 2017. Eligible studies included adults discharged from hospital following confirmed CAP and reporting PROMs.15 studies (n=5644 patients) were included; most were of moderate quality. Studies used a wide range of PROMs and assessment tools. At 4–6 weeks post-discharge, the commonest symptom reported was fatigue (45.0–72.6% of patients, three studies), followed by cough (35.3–69.7%) and dyspnoea (34.2–67.1%); corresponding values from studies restricted by age <65 years (two studies) were lower: fatigue 12.1–25.7%, cough 19.9–31.9% and dyspnoea 16.8–27.5%. Functional impairment 4 weeks post-discharge was reported in 18–51% of patients (two studies), while median time to return to normal activities was between 15 and 28 days (three studies).Substantial morbidity is reported by patients up to 6 weeks post-discharge. There is weak methodological consistency across existing studies. A core set of PROMs for use in future studies is suggested.

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Scar Assessment Tools: How Do They Compare?

Frontiers in Surgery ◽

10.3389/fsurg.2021.643098 ◽

2021 ◽

Vol 8 ◽

Author(s):

Amanda Min Hui Choo ◽

Yee Siang Ong ◽

Fadi Issa

Keyword(s):

Outcome Measures ◽

Clinical Relevance ◽

Treatment Strategies ◽

Well Being ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Assessment Tools ◽

Scar Assessment ◽

Wide Range ◽

Patient Reported

Healing after dermal injury is a complex but imperfect process that results in a wide range of visible scars. The degree of disfigurement is not the sole determinant of a scar's effect on patient well-being, with a number of other factors being critical to outcome. These include cosmetic appearance, symptoms such as itch and pain, functional loss, psychological or social problems, and quality of life. An accurate assessment of these domains can help clinicians measure outcomes, develop, and evaluate treatment strategies. A PubMed literature search was performed up to 31st March 2020. Ten objective scar measurements, four Clinician-Reported Outcome Measures (CROMs), six Patient-Reported Outcome Measures (PROMs), and one combined measure were evaluated for their reliability, clinical relevance, responsiveness to clinical change, and feasibility. Many quantitative tools were limited in their clinical relevance and feasibility, whereas few qualitative CROMs and PROMs have undergone rigorous assessment. This review examines currently available assessment tools, focusing primarily on subjective scar measurements (CROMs, PROMs), and offers a perspective on future directions in the field.

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Preliminary Results of USA-European Field Trial on the Use of Patient-reported Measures in a Mobile Application and Potential Uses in Refugee Populations

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.117 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S20-S21

Author(s):

W. Narrow ◽

V. Buwalda ◽

J. McIntyre

Keyword(s):

Outcome Measures ◽

Outcome Measurement ◽

Pragmatic Trial ◽

The United States ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Current Status ◽

Research Project ◽

Patient Reported ◽

Research Plan

IntroductionThe use of patient-reported outcome measures in psychiatric practices in the United States is still in its beginning phases. More research is need to determine the usefulness of such measures and the optimal methods to present them to patients and practitioners in routine care settings.ObjectivesThis presentation will describe the research plan for testing a group of patient-reported outcome measures using digital applications. Potential opportunities for use in underserved refugee populations will be presented.MethodsThe outcome measures were selected from those recommended in DSM-5 Section III, including cross-cutting symptom and disability measures. A user-friendly digital application was developed for data collection, synthesis, and presentation. The research plan has three phases: focus groups with patients and clinicians, piloting of methods, and the main study, a pragmatic trial comparing treatment outcomes using outcome measurement versus usual care.ResultsResults of the focus group sessions will be presented, along with changes made to the measures and the digital application in response to these results. Current status of the research project will be discussed.ConclusionsThe results of this research project will bring greater clarity to questions on the role of outcome measurements in improving quality of care and patient outcomes. With ever greater use of smart phones, tablets, and personal computers, digital technology has the potential to facilitate psychiatric assessment and treatment for underserved, difficult-to-reach populations such as refugees.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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