The use of biologics to improve patient-reported outcomes in hip preservation

Abstract Despite lack of clear understanding, the use of biologic treatment methods has increased in the United States. Therapeutic methods, including platelet-rich plasma (PRP), bone marrow aspirate concentrate (BMAC) and hyaluronic acid (HA) among other biologics, are commonly associated with relief of pain in a number of different orthopedic conditions. Within the past two decades, hip preservationists have investigated the roles of these biologic treatments in both non-operative and surgical management of common hip conditions. The purpose is to review the published literature surrounding the application and efficacy of biologics, most notably PRP, BMAC and HA, in the clinical management of hip conditions. The hip conditions examined in this review include hip osteoarthritis, femoroacetabular impingement syndrome and associated labral tear pathology, avascular necrosis of the femoral head and gluteal/hamstring tendinopathy. While our review of the literature suggests that there is support for the implementation of biologics to relieve pain and improve function for hip conditions. Through further research efforts, it is important to stay updated with the clinical efficacy of biologics in hip preservation.

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Identifying Foot and Ankle Patients at Risk to Fall Based on Patient Reported Outcomes Assessments

Foot & Ankle Orthopaedics ◽

10.1177/2473011418s00026 ◽

2018 ◽

Vol 3 (3) ◽

pp. 2473011418S0002

Author(s):

Judith Baumhauer ◽

Jack Teitel ◽

Allison McIntyre ◽

David Mitten ◽

Jeff Houck

Keyword(s):

At Risk ◽

Effect Size ◽

Fall Risk ◽

Patient Reported Outcomes ◽

The United States ◽

Foot And Ankle ◽

Falls Risk ◽

Orthopaedic Patients ◽

Patient Reported ◽

Patients At Risk

Category: Other Introduction/Purpose: Each year approximately 30-40% of people over the age of 65 fall. Approximately one half of these falls result in an injury with the estimated annual direct medical costs of $30 billion. Pain, mobility issues, neuropathy and post-operative weight bearing limitations make foot and ankle patients particularly vulnerable to falls. Current approaches to determine at risk patients are cumbersome and time consuming requiring performance testing and “hands on” clinical assessment. The efficiency of obtaining PRO, such as PROMIS, in the clinical arena has been well documented. The purpose of this study is determine if patient reported outcomes (PROMIS) can identify orthopaedic and specifically foot and ankle patients at risk to fall. Methods: Prospective patient reported outcomes (PROMIS CAT physical function, pain interference and depression and CMS fall risk assessment questions) and patient demographics were collected for all patients at each clinic visit from an academic orthopaedic multi-specialty practice between January 2015 and November 2017. Standardized yes/no validated self-reported fall risk questions include: “Have you fallen in the last year?” and “Do you feel you are at risk of falling?” Histograms, t-tests, confidence intervals and effect size were used to determine the fall risk “YES” patients were different than the “NO” for ALL orthopaedic patients and specifically foot and ankle patients. Logistic Regression was used to determine if age, gender, height, weight, and PROMIS scales predicted self-reported falls risk. Results: 94,761 orthopaedic patients comprising 315,273 visits (44% male, mean age 53.7+/-17 years) and 13,720 foot/ankle patients comprising 33,480 visits (37% male, mean age 52.7+/-16.1 years) had complete data for analysis. Table 1 provides the means/SD/p-values/effect sizes for patient self-identifying at risk to fall stratified by PROMIS PF/ PI/Dep t-scores. Although all PROMIS scores demonstrated significant impairment between patients at risk designation (yes/no), PROMIS PF had the largest effect size for ALL Ortho and FOOT AND ANKLE patients (0.8 and 0.7 respectively). Patients who are at risk to fall have PROMIS PF t-scores >1.5 lower than the United States normative population while the patients not at risk are less <1 SD. In the adjusted regression models gender and PROMIS PF had the largest coefficients. Conclusion: Falls are a major threat to quality of life and independence yet prevention/treatment strategies are difficult to implement across a health system. There is also a tremendous societal cost with orthopaedic surgeons often the recipient of these debilitated patients. PROMIS assessments are part of the AOFAS OFAR initiative to track patient recovery with treatment and can additional be used to fulfill a quality indicator requirement by CMS. This study demonstrates these assessments (PROMIS threshold values) can also be linked to self-report falls risk (yes/no) and may identify patients at risk with no face to face time required from the provider.

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The relationship between patient-reported outcomes and physical impairments in people with early hip osteoarthritis following hip arthroscopy

Osteoarthritis and Cartilage ◽

10.1016/j.joca.2014.02.334 ◽

2014 ◽

Vol 22 ◽

pp. S177-S178 ◽

Cited By ~ 2

Author(s):

J.L. Kemp ◽

A.G. Schache ◽

M. Makdissi ◽

M.G. Pritchard ◽

K. Sims ◽

...

Keyword(s):

Hip Arthroscopy ◽

Patient Reported Outcomes ◽

Hip Osteoarthritis ◽

Physical Impairments ◽

Patient Reported ◽

The Relationship

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Describing the Spectrum of Patient Reported Outcomes after Radical Prostatectomy: Providing Information to Improve Patient Counseling and Shared Decision Making

The Journal of Urology ◽

10.1016/j.juro.2018.10.014 ◽

2019 ◽

Vol 201 (4) ◽

pp. 751-758 ◽

Cited By ~ 1

Author(s):

Christopher Martin ◽

Benjamin Haaland ◽

Alexander E. Tward ◽

Christopher Dechet ◽

Will Lowrance ◽

...

Keyword(s):

Decision Making ◽

Radical Prostatectomy ◽

Shared Decision Making ◽

Patient Reported Outcomes ◽

Shared Decision ◽

Patient Counseling ◽

Patient Reported ◽

Improve Patient

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A patient reported outcomes of treatments for desmoid tumors: An international natural history study.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.11560 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 11560-11560

Author(s):

Danielle Braggio ◽

Amanda Lucas ◽

Lynne Hernandez ◽

Kelly Mercier

Keyword(s):

Natural History ◽

Active Surveillance ◽

Desmoid Tumor ◽

Patient Reported Outcomes ◽

The United States ◽

Desmoid Tumors ◽

Targeted Agents ◽

Natural History Study ◽

Systemic Treatments ◽

Patient Reported

11560 Background: The Desmoid Tumor Research Foundation (DTRF) launched the natural history study (NHS) in 2017. At this time, there are no standard-of-care options for this rare sarcoma. The treatments, clinical descriptors, and the patient reported outcomes to pharmacologic agents are described here within. Methods: The web-based natural history study launched September 2017 in collaboration with the National Organization of Rare Disorders. It contains 15 surveys covering diagnostics, disease, treatment, care management, and quality of life. Treatment types included in the DTRF NHS were pharmacology, surgery, radiation, high-intensity focused ultrasound (HiFU), and active surveillance (watch and wait). Results: While surgery was once the primary intervention for desmoid tumor patients, the NHS participants reported that 47.6% had received active surveillance or no systemic treatment at diagnosis. This is most common for desmoid tumors located in abdominal wall (54/103; 52.4%). There were 87 reported cases of complete surgical resection, 38 incomplete resections, and 23 bowel resections. 9 amputations were reported; 8 participants reported recurrent disease following the removal of the limb. The non-surgical interventions, such as radiation and HiFU, were mostly described for participants with chest wall tumors (15 pts) and joints/extremities (10 pts). Many options for systemic therapies were described including sorafenib (44/284; 15.5%), sulindac (36/284; 12.7%), and anti-hormonal agents tamoxifen and toremifene (34/285; 10.9%) were described. Targeted agents, such as gamma secretase inhibitor, pazopanib, and sorafenib, were greater in the United States than the non-US country participants (21% vs 9%). Multiple lines of treatments were reported by 81 participants, surgery is greatest as the first intervention for all tumor locations (49/81, 60%), with the exception of those with head/neck tumors who received chemotherapy (6/11, 55%). Analysis has started to evaluate the efficacy of systemic treatments from these NHS data. The table describes the participant reported outcomes of anti-hormonal agents, chemotherapeutics, non-steroidal anti-inflammatories, and targeted agents. Both chemotherapies and targeted agents were reported to have 38.1% response rates from the participants with 34.3% and 23.8% of participants reported progressive disease on therapy, respectively. Conclusions: Desmoid tumor NHS study participants reported the use of many treatment modalities demonstrating a range of frequency of use by tumor location and efficacy. Data collection through the DTRF NHS is ongoing.[Table: see text]

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Patient-Reported Outcomes From the United States Clinical Trial for a Hybrid Cochlear Implant

Otology & Neurotology ◽

10.1097/mao.0000000000001517 ◽

2017 ◽

Vol 38 (9) ◽

pp. 1251-1261 ◽

Cited By ~ 3

Author(s):

David C. Kelsall ◽

Renée J. G. Arnold ◽

Leonard Lionnet

Keyword(s):

United States ◽

Clinical Trial ◽

Cochlear Implant ◽

Patient Reported Outcomes ◽

The United States ◽

Patient Reported

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Autologous pure platelet-rich plasma injections for facial skin rejuvenation: Biometric instrumental evaluations and patient-reported outcomes to support antiaging effects

Journal of Cosmetic Dermatology ◽

10.1111/jocd.12802 ◽

2018 ◽

Vol 18 (4) ◽

pp. 985-995 ◽

Cited By ~ 3

Author(s):

Peter A Everts ◽

Pedro Contreiras Pinto ◽

Leonor Girão

Keyword(s):

Patient Reported Outcomes ◽

Platelet Rich Plasma ◽

Facial Skin ◽

Skin Rejuvenation ◽

Patient Reported

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The Development and Initial Findings of A Study of a Prospective Adult Research Cohort with Inflammatory Bowel Disease (SPARC IBD)

Inflammatory Bowel Diseases ◽

10.1093/ibd/izab071 ◽

2021 ◽

Author(s):

Laura E Raffals ◽

Sumona Saha ◽

Meenakshi Bewtra ◽

Cecile Norris ◽

Angela Dobes ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Clinical Data ◽

Bowel Disease ◽

Patient Reported Outcomes ◽

Data Entry ◽

The United States ◽

Predictors Of Response ◽

Patient Reported ◽

Inflammatory Bowel ◽

Reported Data

Abstract Background Clinical and molecular subcategories of inflammatory bowel disease (IBD) are needed to discover mechanisms of disease and predictors of response and disease relapse. We aimed to develop a study of a prospective adult research cohort with IBD (SPARC IBD) including longitudinal clinical and patient-reported data and biosamples. Methods We established a cohort of adults with IBD from a geographically diverse sample of patients across the United States with standardized data and biosample collection methods and sample processing techniques. At enrollment and at time of lower endoscopy, patient-reported outcomes (PRO), clinical data, and endoscopy scoring indices are captured. Patient-reported outcomes are collected quarterly. The quality of clinical data entry after the first year of the study was assessed. Results Through January 2020, 3029 patients were enrolled in SPARC, of whom 66.1% have Crohn’s disease (CD), 32.2% have ulcerative colitis (UC), and 1.7% have IBD-unclassified. Among patients enrolled, 990 underwent colonoscopy. Remission rates were 63.9% in the CD group and 80.6% in the UC group. In the quality study of the cohort, there was 96% agreement on year of diagnosis and 97% agreement on IBD subtype. There was 91% overall agreement describing UC extent as left-sided vs extensive or pancolitis. The overall agreement for CD behavior was 83%. Conclusion The SPARC IBD is an ongoing large prospective cohort with longitudinal standardized collection of clinical data, biosamples, and PROs representing a unique resource aimed to drive discovery of clinical and molecular markers that will meet the needs of precision medicine in IBD.

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