Clinical outcomes

2016 ◽  
Author(s):  
Astrid van Tubergen ◽  
Robert Landewé
Keyword(s):  
Clinical Practice ◽  
Medical Care ◽  
Clinical Outcomes ◽  
International Society ◽  
Axial Spondyloarthritis ◽  
Response Criteria ◽  
The Core ◽  
Core Set ◽  
Core Sets ◽  
Chronic Course

In general, axial spondyloarthritis (axSpA) follows a chronic course, requiring regular medical care and monitoring. The outcome of axSpA may vary substantially due to heterogenic presentation. For both research and clinical practice, it is important to have relevant, reliable, validated instruments for measuring outcome, to evaluate patients in a standardized way and capture all disease aspects. The Assessment in SpondyloArthritis international Society has developed core sets and instruments to measure these domains, and recommends only the most important domains being measured with best available methods. This chapter provides an overview of the most important outcomes in axSpA and most commonly used instruments to measure these. Additional measures frequently used but not (yet) included in the core set are addressed, and several sets of response criteria applied in axSpA research described. This chapter also provides guidance in which setting (research versus practice) and with which frequency these measures can be used.

The Development of ICF Core Sets for Hearing Loss

2010 ◽  
Vol 6 (1) ◽  
pp. 20-23 ◽  
Author(s):  
Sarah Granberg ◽  
Berth Danermark ◽  
Jean-Pierre Gagné
Keyword(s):  
Hearing Loss ◽  
Consensus Conference ◽  
World Health ◽  
International Classification Of Functioning ◽  
Clinical Settings ◽  
Icf Core Set ◽  
The Core ◽  
Core Set ◽  
Core Sets ◽  
Icf Core Sets

The International Classification of Functioning, Disability and Health (ICF), adopted by the World Health Organization (WHO) in 2001, offers a framework for a comprehensive understanding of health. One of the main goals of the ICF is to provide a conceptual framework of health that can be applied both for research purposes and in clinical settings. In order to promote the use of the ICF in clinical settings, the WHO initiated the Core Sets project. Core Sets, targeting a specific health condition, consist of a set of ICF categories that can serve as minimal standards (Brief ICF Core Set) or as standards for comprehensive assessment (Comprehensive ICF Core Set). In 2009, a process of developing ICF Core Sets for Hearing Loss was initiated. This process involves three phases of development. In the first phase, four scientific studies are conducted to collect evidence for relevant ICF categories to be used in the Core Sets. In phase two, a consensus conference is held to establish relevant ICF categories, and in the third phase, the Core Sets that are retained are tested and validated. This paper describes the process of developing ICF Core Sets for Hearing Loss as well as an invitation to participate in the project.

Domains to be considered for the core outcome set of axial spondyloarthritis: results from a 3-round Delphi survey

2021 ◽  
pp. jrheum.210206
Author(s):  
Anne Boel ◽  
Victoria Navarro-Compán ◽  
Annelies Boonen ◽  
Philip Mease ◽  
Uta Kiltz ◽  
...  
Keyword(s):  
Disease Activity ◽  
Physical Function ◽  
Structural Damage ◽  
Axial Spondyloarthritis ◽  
Core Outcome Set ◽  
Delphi Survey ◽  
The Core ◽  
Disease Modifying Therapies ◽  
Core Set ◽  
Disease Modifying

Objective Advances in the field of axial spondyloarthritis (axSpA) and the methodology to develop core sets made the ASAS group decide to update the ASAS-OMERACT core set. An important aspect was to ensure it will be applicable to the entire spectrum of axSpA. The first step was to define the most relevant disease domains. Methods A 3-round Delphi survey was conducted to gather opinions of 188 patients and 188 axSpA experts to define the most relevant disease domains to be included in the core set. The Delphi survey evaluated two separate research settings: 1) studies assessing symptom modifying therapies; 2) studies evaluating disease modifying therapies. Importance of domains was rated on a 1–9 Likert scale. A domain was considered for inclusion if for both stakeholder groups ≥70% of participants scored the domain as critical (7-9) and ≤15% scored it as not important (1-3) after three rounds. Results A total of 132 (70%) patients and 135 (72%) experts completed at least 1 round. After three rounds, 7 domains (pain, physical function, stiffness, disease activity, mobility, overall functioning & health, peripheral manifestations) were selected for the symptom modifying therapies setting. For the disease modifying therapies setting, 6 domains (physical function, disease activity, mobility, structural damage, extra-musculoskeletal manifestations, peripheral manifestations) were selected. All domains selected by experts were also selected by patients. Patients selected all offered domains except 'emotional function'. Conclusion This study provides the domains selected by patients and axSpA experts that should be considered for the core set for axSpA.

Meaning of innovative technologies for improvement of results in treating burned patients

2020 ◽  
pp. 44-47
Author(s):  
A. A. Alekseev ◽  
A. E. Bobrovnikov ◽  
V. V. Bogdanov
Keyword(s):  
Clinical Practice ◽  
Medical Care ◽  
Clinical Effectiveness ◽  
High Tech ◽  
Comprehensive Treatment ◽  
Case Histories ◽  
Innovative Technologies ◽  
Treatment Technologies ◽  
Burn Disease ◽  
Complications And Mortality

In order to include innovative technologies in clinical recommendations, confirmation of their clinical effectiveness in comprehensive treatment of burned patients is necessary. 1,696 case histories of patients with burns were audited, which are divided into two groups depending on peculiarities of treatment. The use of innovative treatment technologies for burned patients has reduced the incidence of burn disease complications and mortality. Introduction of innovative technologies in treating burned patients into broad clinical practice improves results of provision of specialized, high-tech medical care for victims of burns.

scholarly journals Adverse clinical outcomes associated with RAAS inhibitor discontinuation: analysis of over 400 000 patients from the UK Clinical Practice Research Datalink (CPRD)

2021 ◽  
Author(s):  
Toby J L Humphrey ◽  
Glen James ◽  
Eric T Wittbrodt ◽  
Donna Zarzuela ◽  
Thomas F Hiemstra
Keyword(s):  
Heart Failure ◽  
Acute Kidney Injury ◽  
Clinical Practice ◽  
Clinical Outcomes ◽  
Kidney Injury ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Ckd Stage ◽  
First Occurrence ◽  
Baseline Characteristics

Abstract Background Users of guideline-recommended renin–angiotensin–aldosterone system (RAAS) inhibitors may experience disruptions to their treatment, e.g. due to hyperkalaemia, hypotension or acute kidney injury. The risks associated with treatment disruption have not been comprehensively assessed; therefore, we evaluated the risk of adverse clinical outcomes in RAAS inhibitor users experiencing treatment disruptions in a large population-wide database. Methods This exploratory, retrospective analysis utilized data from the UK’s Clinical Practice Research Datalink, linked to Hospital Episodes Statistics and the Office for National Statistics databases. Adults (≥18 years) with first RAAS inhibitor use (defined as angiotensin-converting enzyme inhibitors or angiotensin receptor blockers) between 1 January 2009 and 31 December 2014 were eligible for inclusion. Time to the first occurrence of adverse clinical outcomes [all-cause mortality, all-cause hospitalization, cardiac arrhythmia, heart failure hospitalization, cardiac arrest, advancement in chronic kidney disease (CKD) stage and acute kidney injury] was compared between RAAS inhibitor users with and without interruptions or cessations to treatment during follow-up. Associations between baseline characteristics and adverse clinical outcomes were also assessed. Results Among 434 027 RAAS inhibitor users, the risk of the first occurrence of all clinical outcomes, except advancement in CKD stage, was 8–75% lower in patients without interruptions or cessations versus patients with interruptions/cessations. Baseline characteristics independently associated with increased risk of clinical outcomes included increasing age, smoking, CKD, diabetes and heart failure. Conclusions These findings highlight the need for effective management of factors associated with RAAS inhibitor interruptions or cessations in patients for whom guideline-recommended RAAS inhibitor treatment is indicated.

scholarly journals A Fast and Exact Greedy Algorithm for the Core–Periphery Problem

Symmetry ◽  
2020 ◽  
Vol 12 (1) ◽  
pp. 94 ◽  
Author(s):  
Dario Fasino ◽  
Franca Rinaldi
Keyword(s):  
Structural Analysis ◽  
Optimization Problem ◽  
Polynomial Time Algorithm ◽  
Time Algorithm ◽  
Combinatorial Optimization Problem ◽  
Connected Subgraph ◽  
Optimal Solutions ◽  
The Core ◽  
Core Set ◽  
Key Concepts

The core–periphery structure is one of the key concepts in the structural analysis of complex networks. It consists of a partitioning of the node set of a given graph or network into two groups, called core and periphery, where the core nodes induce a well-connected subgraph and share connections with peripheral nodes, while the peripheral nodes are loosely connected to the core nodes and other peripheral nodes. We propose a polynomial-time algorithm to detect core–periphery structures in networks having a symmetric adjacency matrix. The core set is defined as the solution of a combinatorial optimization problem, which has a pleasant symmetry with respect to graph complementation. We provide a complete description of the optimal solutions to that problem and an exact and efficient algorithm to compute them. The proposed approach is extended to networks with loops and oriented edges. Numerical simulations are carried out on both synthetic and real-world networks to demonstrate the effectiveness and practicability of the proposed algorithm.

Presentation of the Comprehensive and Brief International Classification of Functioning, Disability and Health Core Sets (ICF-CS) for schizophrenia

2016 ◽  
Vol 33 (S1) ◽  
pp. S365-S365
Author(s):  
O. Pino ◽  
G. Guilera ◽  
E. Rojo ◽  
J. Gómez-Benito
Keyword(s):  
Consensus Conference ◽  
International Classification Of Functioning ◽  
International Consensus ◽  
Multi Stage ◽  
Core Set ◽  
Core Sets ◽  
Competing Interest ◽  
Persons With Schizophrenia ◽  
Definition Of ◽  
Icf Core Sets

ObjectiveThe aim this presentation is present the results of the preparatory studies were presented at an international consensus conference, a multi-stage, iterative, decision-making and consensus process that took place 12–14 May 2015 in Barcelona, Spain. At this consensus conference, schizophrenia experts from different countries worldwide and working in a broad range of professions decided which ICF categories should be included in the first version of the ICF Core Sets for schizophrenia.MethodFour preliminary studies intend to capture the researcher's perspective, the patient's perspective, the expert's perspective and the clinician's perspective, respectively, on the most relevant aspects of functioning of persons living with schizophrenia. The final definition of ICF Core Sets for schizophrenia have been determined by integrating the results of preliminary studies in a consensus conference with international expert.ResultThe experts included 97 categories in the Comprehensive ICF Core Set and 25 categories in the Brief ICF-CS. The specific categories of each ICF-CS are shown in this presentation. The Comprehensive ICF-CS can guide multidisciplinary assessments of functioning in persons with schizophrenia, and the brief version is ideal for use in both clinical and epidemiological research, since it includes a small and practical number of categories, but sufficiently wide for finding utility in clinical assessments.ConclusionICF-CS are being designed with the goal of providing useful standards for research, clinical practice and teaching, and it will stimulate research and will improve understanding of functioning, health and environmental factors in schizophrenia.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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