scholarly journals Accuracy of Achalasia Quality of Life and Eckardt scores for assessment of clinical improvement post treatment for achalasia

2020 ◽  
Author(s):  
Samuel Slone ◽  
Ambuj Kumar ◽  
John Jacobs ◽  
Vic Velanovich ◽  
Joel E Richter
Keyword(s):  
Quality Of Life ◽  
Predictive Validity ◽  
Symptom Severity ◽  
Medical Records ◽  
Convergent Validity ◽  
Pneumatic Dilatation ◽  
Post Treatment ◽  
Operating Characteristics ◽  
Patient Reported

Abstract Achalasia Quality of Life (ASQ) and Eckardt scores are two patient-reported instruments widely used to assess symptom severity in achalasia patients. ASQ is validated and reliable. Although Eckardt is commonly used, it has not been rigorously assessed for validity or reliability. This study aims to evaluate (i) the accuracy of Eckardt and ASQ for assessing improvement post-treatment (predictive validity), (ii) accuracy of Eckardt and ASQ for assessing improvement post-treatment with pneumatic dilatation (PD) versus surgical myotomy (predictive validity), and (iii) convergent validity of Eckardt and ASQ tools. Patients with achalasia treated between 2011 and 2018 were eligible. Both instruments were administered by telephone. Treatment failure was determined by the review of medical records by two clinicians. The predictive ability of ASQ and Eckardt instruments in identifying treatment successes and failures was determined using receiver operating characteristics analysis and summarized as area under the curve (AUC). A total of 106 patients met inclusion criteria with 39 PD, 51 Heller myotomy, and 16 per-oral endoscopic myotomy. A review of medical records and esophageal testing revealed 13 failures (12%). AUC for Eckardt was 0.96 (95% confidence interval [CI] 0.87–0.99] and ASQ 0.97 (95% CI 0.92–0.99). The Eckardt cutoff 4, and ASQ, cutoff 15, were 94% and 87% accurate in identifying treatment successes versus failures, respectively. The correlation coefficient between the two tools was 0.85. In conclusions, (i) ASQ and Eckardt scores are valid and reliable tools to assess symptom severity in achalasia patients, (ii) both instruments accurately classify treatment successes versus failures, and (iii) the choice of tool should be informed by the physicians and patients’ values and preferences and repeat physiologic testing may be reserved for treatment failures with either instrument and patients classified, as treatment successes may be spared routine physiologic testing in the long term.

135 ACCURACY OF ACHALSIA QUALITY OF LIFE AND ECKARDT SCORES FOR ASSESSMENT OF CLINICAL IMPROVEMENT POST TREATMENT FOR ACHALASIA

2020 ◽  
Vol 33 (Supplement_1) ◽  
Author(s):  
S Slone ◽  
J Richter ◽  
A Kumar ◽  
V Velanovich ◽  
J Jacobs
Keyword(s):  
Quality Of Life ◽  
Symptom Severity ◽  
Medical Records ◽  
Convergent Validity ◽  
Area Under The Curve ◽  
Pneumatic Dilatation ◽  
Post Treatment ◽  
Operating Characteristics ◽  
Patient Reported

Abstract   Achalasia Quality of Life (ASQ) and Eckardt scores are two patient-reported instruments used to assess symptom severity in achalasia patients. ASQ is validated and reliable. Although Eckardt is commonly used, it has not been assessed for validity or reliability. Our aims were to evaluate 1) the accuracy of both instruments for assessing improvement post-treatment (predictive validity) with pneumatic dilatation versus surgical myotomy and 2) convergent validity of both tools. Methods Patients with achalasia treated between 2011–2018 were eligible. Both instruments were administered by telephone. Treatment failure was determined by review of medical records by two clinicians. The predictive ability of ASQ and Eckardt instruments in identifying treatment successes and failures was determined using receiver operating characteristics analysis and summarized as Area Under the Curve (AUC). Results 106 patients met inclusion criteria with 44 PD, 52 Heller Myotomy, and 10 per-oral endoscopic myotomy. A review of medical records and esophageal testing defined 13 failures (13%). AUC for Eckardt was 0.96 [95% CI 0.87–0.99] and ASQ 0.97 [95% CI 0.92–0.99]. The Eckardt cutoff 4, and ASQ, cutoff 15, were 94% and 87% accurate in identifying treatment successes versus failures. The correlation coefficient between the two tools was 0.84. Conclusion 1) ASQ and Eckardt scores are valid and reliable tools to assess symptom severity in achalasia patients; 2) Both instruments accurately classify treatment successes versus failures. 3) The choice of tool should be informed by the physicians’ and patients’ values and preferences and repeat physiologic testing may be reserved for treatment failures with either instrument and patients classified as treatment successes may be spared routine physiologic testing in the long term.

scholarly journals Synergy of pandemics-social isolation is associated with worsened Parkinson severity and quality of life

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Indu Subramanian ◽  
Joshua Farahnik ◽  
Laurie K. Mischley
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Social Isolation ◽  
Support Groups ◽  
Symptom Severity ◽  
Social Performance ◽  
Social Distancing ◽  
Patient Reported

Abstract Social isolation and its deleterious effects on health increases with age in the general population. People with Parkinson’s Disease (PWP) are no exception. Social isolation is a risk factor for worsened health outcomes and increased mortality. Symptoms such as depression and sleep dysfunction are adversely affected by loneliness. There is a paucity of research on social isolation in Parkinson’s disease (PD), which is all the more critical now in the setting of social distancing due to COVID-19. The goal of this study was to survey individuals with PD to evaluate whether social isolation is associated with PD symptom severity and quality of life. Only individuals reporting a diagnosis of idiopathic PD were included in this analysis. The primary outcome measures were the Patient-Reported Outcomes in PD (PRO-PD) and questions from PROMIS Global related to social health. PRO-PD scores increased as social performance and social satisfaction scores diminished. Individuals who reported being lonely experienced a 55% greater symptom severity than those who were not lonely (P < 0.01). Individuals who documented having a lot of friends had 21% fewer symptoms than those with few or no friends (P < 0.01). Social isolation was associated with greater patient-reported PD severity and lower quality of life, although it is unclear whether this is the cause and/or a consequence of the disease. In essence, the Parkinson pandemic and the pandemic of social isolation have been further compounded by the recent COVID-19 pandemic. The results emphasize the need to keep PWP socially connected and prevent loneliness in this time of social distancing. Proactive use of virtual modalities for support groups and social prescribing should be explored.

scholarly journals Angioedema quality of life questionnaire (AE-QoL) - interpretability and sensitivity to change

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Kanokvalai Kulthanan ◽  
Leena Chularojanamontri ◽  
Chuda Rujitharanawong ◽  
Puncharas Weerasubpong ◽  
Marcus Maurer ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Convergent Validity ◽  
Characteristic Curve ◽  
Intraclass Correlation ◽  
Life Questionnaire ◽  
Sensitivity To Change ◽  
Validity And Reliability ◽  
Distribution Method ◽  
Patient Reported

Abstract Background The Angioedema Quality of Life (AE-QoL) is the first patient reported outcome measure developed for the assessment of quality of life (QoL) impairment in patients with recurrent angioedema (RAE). This study aimed to evaluate the clinimetric properties of the AE-QoL in Thai patients and to establish categories of QoL impairment assessed by the AE-QoL. Methods The validated Thai version of the Dermatology Life Quality Index (DLQI) and Patient Global Assessment of Quality of Life (PGA-QoL) were used to comparatively evaluate the Thai version of AE-QoL. Spearman correlations between the Thai AE-QoL and two other standard measurements (DLQI and PGA-QoL) were investigated to determine convergent validity. The Thai DLQI and PGA-QoL were used to categorize patients according to their QoL. Known-group validity of the Thai AE-QoL was later analyzed. The reliability of the Thai AE-QoL was investigated using Cronbach’s alpha and intraclass correlation. Three different approaches including the distribution method, receiver operating characteristic curve analysis, and the anchor based-method were used for the interpretability. Results A total of 86 patients with RAE with a median age of 38.0 ± 15.1 years (range 18–76) were enrolled. Of those, 76 patients (88%) had RAE with concomitant wheals, and 10 patients (11.6%) had RAE only. The AE-QoL assessed RAE-mediated QoL impairment with high convergent validity and known-groups validity, high internal consistency and test-retest reliability, and good sensitivity to change. Although the AE-QoL did not differentiate between patients with moderate and large effect as measured by PGA-QoL or DLQI in this study, AE-QoL total values of 0–23, 24 to 38, and ≥ 39 could define patients with “no effect”, “small effect”, and “moderate to large effect” of RAE on their QoL, respectively. Conclusions This study supports the validity and reliability of the Thai version of the AE-QoL, which is a very different language from the original version. Categories allow to classify the effect of RAE on patients’ QoL as “none”, “small”, and “moderate to large”. Further studies are needed to confirm the applicability of AE-QoL in other Asian populations”.

Patient-reported disease-specific quality-of-life and symptom severity in systemic mastocytosis

Allergy ◽  
2016 ◽  
Vol 71 (11) ◽  
pp. 1585-1593 ◽  
Author(s):  
B. van Anrooij ◽  
J. C. Kluin-Nelemans ◽  
M. Safy ◽  
B. M. J. Flokstra-de Blok ◽  
J. N. G. Oude Elberink
Keyword(s):  
Quality Of Life ◽  
Symptom Severity ◽  
Systemic Mastocytosis ◽  
Patient Reported ◽  
Disease Specific

scholarly journals The 27-Item Multiple Sclerosis Quality of Life Questionnaire: A New Brief Measure Including Treatment Burden and Work Life

2021 ◽  
Author(s):  
Helen Beckmann ◽  
Christoph Heesen ◽  
Matthias Augustin ◽  
Christine Blome
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Construct Validity ◽  
Convergent Validity ◽  
Life Questionnaire ◽  
Quality Of Life Questionnaire ◽  
Patient Reported ◽  
Disease Specific

Abstract Background: Treatment- and work-related aspects have been neglected in health-related quality of life (HRQOL) measures in multiple sclerosis (MS). We aimed to develop a brief instrument covering all important impairment-, activity-, participation-, and treatment-related aspects for use in research and practice. Methods: The 27-item Multiple Sclerosis Quality of Life Questionnaire (MS-QLQ27) was developed using open item collection, a multidisciplinary expert panel, and cognitive pretesting. It was evaluated for reliability, construct validity, and responsiveness with 100 patients presenting with relapse (84 at follow-up ~14 days later). Construct validity was analyzed by correlating the MS-QLQ27 with the disease-specific Hamburg Quality of Life Questionnaire in MS (HAQUAMS) and generic HRQOL instuments. The Expanded Disability Status Scale (EDSS) was used to analyze known-groups validity. Responsiveness was determined as the correlation of changes in MS-QLQ27 scores with changes in validation criteria. Results: Internal consistency was high (Cronbach α = 0.94 at baseline and 0.93 at follow-up). Convergent validity was supported by direction and magnitude of associations with disease-specific and generic instruments. Correlations with change in convergent criteria were strong, indicating responsiveness. The HAQUAMS showed the strongest associations with the MSQLQ27. The MS-QLQ27 showed the highest effect size compared with other patient-reported outcomes and the EDSS. It successfully distinguished between levels of disease severity. Conclusions: These results indicate that the MS-QLQ27 is a reliable, valid, and highly responsive instrument for assessing HRQOL during relapse evolution in MS. Its advantages are that it is brief yet comprehensive, covering work- and treatment-related aspects not addressed in previous measures.

Real-world use of epic for clinical practice (EPIC-CP) to assess patient-reported prostate cancer quality of life in the clinical setting.

2015 ◽  
Vol 33 (7_suppl) ◽  
pp. 18-18 ◽  
Author(s):  
Peter Chang ◽  
Arie Carneiro ◽  
Ostap Dovirak ◽  
Kimberly Taylor ◽  
Catrina Crociani ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Clinical Practice ◽  
Clinical Care ◽  
Post Treatment ◽  
Rank Test ◽  
Routine Clinical Care ◽  
Patient Reported ◽  
Domain Scores

18 Background: Prostate cancer practitioners tend to underestimate patients’ treatment-related side effects. We developed the Expanded Prostate Cancer Index Composite for Clinical Practice (EPIC-CP) to facilitate patient-reported health-related quality of life (HRQOL) assessment at the point-of-care (Chang P et al, J Urol Sep 2011). We sought to demonstrate the feasibility of EPIC-CP use in routine clinical care, and to compare longitudinal patient-reported and practitioner-reported prostate cancer outcomes. Methods: We reviewed practitioner- and patient-reported HRQOL outcomes in 482 patients who underwent radical prostatectomy at our institution from 2010 to 2014. All EPIC-CP questionnaires were administered and interpreted without research personnel. Practitioner-reported outcomes were assessed using chart review. We used the paired t-test and Wilcoxon signed-rank test to compare pre- and post-treatment EPIC-CP domain scores, and Fisher’s exact test to compare patient-reported and practitioner-reported outcomes. We considered p-values < 0.05 statistically significant. Results: 708 total EPIC-CP questionnaires were completed. Mean urinary incontinence domain scores increased (worsened) significantly from baseline (0.6±0.2) to 3 (3.1±2.3) and 6 months (2.2±2.1) post-treatment, but were not statistically changed from baseline at 12 months (1.6±1.7). Patient-reported incontinence pad-free rates using EPIC-CP at 3, 6, and 12 months were 47%, 76%, and 78%, respectively, which were consistent with practitioner-reported rates. Mean sexual domain scores were significantly worse at 12 months (5.9±3.3) compared to baseline (2.4±2.8). Practitioners significantly overestimated the rate of functional erections compared to patients’ EPIC-CP-reported rates at 3 months (18% vs 12%, p < 0.05) and 12 months (45% vs 23%, p < 0.05). Bowel and vitality/hormonal scores were unchanged, and urinary irritation/obstruction scores improved after surgery. Conclusions: EPIC-CP is feasible to use in the routine clinical care of prostate cancer patients, and can help practitioners more accurately assess patients’ post-treatment symptom severity.

Association of treatment type with patient-reported quality of life in cancer distress screening.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 178-178
Author(s):  
Mohana Roy ◽  
Sarah Rosenthal ◽  
Manan P Shah ◽  
Ali Raza Khaki ◽  
Selen Bozkurt ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Post Treatment ◽  
Disease Stage ◽  
Distress Screening ◽  
Treatment Type ◽  
Significant Difference ◽  
Patient Reported ◽  
The Us ◽  
Clinically Significant

178 Background: Routine distress screening is recommended for all patients with cancer. In 2015, Stanford Cancer Center implemented such screening using a modified PROMIS-GH questionnaire. With the recent growth of oncology drugs, novel medications have been perceived as better tolerated than chemotherapy. We analyzed patient reported quality of life with global mental health (GMH) and global physical health (GPH) scores for different medication classes. Methods: Patients who completed a questionnaire at our center between 6/1/2015 and 12/31/2020 were included. Medications were classified as chemotherapy, targeted therapy, endocrine therapy, or immunotherapy using guidance from SEER.Rx ontology. Baseline (B) and treatment (Tx) questionnaires were completed before any treatment initiation of each medication type and within 3 months of each treatment, respectively. GPH and GMH scores were calculated using PROMIS T-scores stratified by medication type for B and Tx questionnaires. We analyzed for differences based on demographics and diagnoses. Clinically significant differences were defined as a 3-point difference in T-scores, which then prompted statistical comparison with t-tests to compare the B and Tx scores to each other and to the US population mean of 50. Results: We analyzed 28,180 questionnaires from 11,644 patients (59% women, median age 64; 23% stage I and II, 12% stage III, 23% stage IV, 51% missing). B and Tx mean GMH scores did not differ clinically compared to the US mean or to each other (baseline: 49.03 +/- 9.16, post: 48.5 +/- 9.1). However, both mean GPH scores were statistically and clinically lower (baseline: 44.2+/- 10.38, post: 42.4 +/- 10.1,) compared to the US mean (p < 0.001). Changes in scores by treatment category are shown in the table below. There was a statistically significant difference in post-treatment GPH scores for chemo-immunotherapy patients when compared to both corresponding baseline scores (p < 0.001) and post treatment chemotherapy alone scores (p < 0.001). There was no clinically significant difference in scores when stratified by age, sex, primary language, insurance, disease stage or type. Conclusions: In this large retrospective study, we found that patients being treated for cancer did not report worse GMH scores compared to the US mean population, but do report lower GPH scores. While most scores varied little relative to other treatment types, those receiving chemo-immunotherapy had lower GPH scores when comparing baseline to treatment and to the US mean, warranting further investigation, given increasing use.[Table: see text]

Sa142 PREDICTIVE VALUE OF PATIENT-REPORTED ESOPHAGEAL SYMPTOM SEVERITY ON OBJECTIVE REFLUX BURDEN AND HEALTH-RELATED QUALITY OF LIFE IN ADVANCED LUNG DISEASE

2021 ◽  
Vol 160 (6) ◽  
pp. S-435-S-436
Author(s):  
Joyce C. Zhou ◽  
Wai-Kit Lo ◽  
Walker D. Redd ◽  
Noreen C. Okwara ◽  
Andrew Jenkins ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lung Disease ◽  
Symptom Severity ◽  
Predictive Value ◽  
Health Related Quality ◽  
Patient Reported ◽  
Related Quality ◽  
Health Related

scholarly journals Association of sex and atrial fibrillation therapies with patient-reported outcomes

Heart ◽  
2019 ◽  
Vol 105 (21) ◽  
pp. 1642-1648 ◽  
Author(s):  
Kelly Therese Gleason ◽  
Cheryl Renee Dennison Himmelfarb ◽  
Daniel Ernest Ford ◽  
Harold Lehmann ◽  
Laura Samuel ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Atrial Fibrillation ◽  
Functional Status ◽  
Rate Control ◽  
Symptom Severity ◽  
Patient Reported Outcomes ◽  
Patient Reported ◽  
Related Quality ◽  
The Impact

ObjectivesWomen report higher atrial fibrillation (AF) symptom severity and receive less AF therapies than their male counterparts. It is understudied if differences in AF therapies received explains sex differences in AF symptom severity. We investigate the impact of sex and AF therapies on patient-reported outcomes.MethodsParticipants were recruited (n=953) across four academic medical centres with an AF diagnosis and age ≥18 years. Patient-reported outcomes (AF symptom severity, AF-related quality of life, functional status and emotional status) were determined by biannual surveys. We performed multiple linear regressions on propensity-matched cohorts to determine the association of AF therapies and sex on patient-reported outcomes.ResultsOur study population (n=953) was 65% male (n=616), 93% white (n=890) and 72 (±10) years old. Individuals receiving rate control therapy reported comparatively lower AF-related quality of life (−7.22, 95% CI −11.51 to –2.92) and poorer functional status (−3.69, 95% CI −5.27 to –2.12). Individuals receiving rhythm control strategies did not report significantly different patient-reported outcomes. Women were more likely to report poorer functional status (−2.63, 95% CI −3.86 to –1.40) and poorer AF-related quality of life, higher anxiety (2.33, 95% CI 1.07 to 3.59), higher symptoms of depression (1.48, 95% CI 0.31 to 2.65) and AF symptom severity (0.29, 95% CI 0.07 to 0.52).ConclusionsFemale sex was associated with comparatively poorer AF symptom severity and quality of life, and this association remained after accounting for AF therapies received. Receiving rate control medication alone was associated with comparatively poorer AF-related quality of life and functional status.

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