scholarly journals Black bone MRI morphometry for mandibular cortical bone measurement in head and neck cancer patients: Prospective method comparison with CT

2020 ◽  
Author(s):  
◽  
Lisanne Vania van Dijk ◽  
Juan Ventura ◽  
Kareem Wahid ◽  
Lin L Zhu ◽  
...  
Keyword(s):  
Cortical Bone ◽  
Cancer Patients ◽  
Intraclass Correlation ◽  
Bias Estimation ◽  
Limits Of Agreement ◽  
Cross Sectional ◽  
Bone Width ◽  
Mri Morphometry ◽  
Deming Regression ◽  
Mri Measurements

Objectives To determine the utility of low-flip angle black bone magnetic resonance imaging (MRI) for cortical mandibular bone assessment by comparing interdentium cortical measurements and inter-observer morphometric variability in relation to computed tomography (CT). Methods Quantification of cortical mandible bone width was performed as per Hamada et al. at 15 cross-sectional interdentium locations on pre-treatment black bone MRI and CT for 15 oropharyngeal cancer patients, with inter-observer analyses on a subset of 3 patients by 11 observers. Bland-Altman limits of agreement and bias estimation, Lin s concordance correlation (LCC), and Deming orthogonal regression were used to compare CT and MRI measurements. The absolute variance and intraclass correlation coefficient (ICC) were implemented for the inter-observer error quantification. Results Both the Bland Altman and Deming regression analyses showed CT and black bone MRI measurements were comparable within ±0.85 mm limits of agreement, and systematically smaller for MRI. LCC (0.60[0.52;0.67]) showed moderate equivalence between modalities. The average absolute variance between the observers was similar on CT (1.13±0.06 mm) and MRI (1.15 ±0.06 mm). The ICC analyses showed that measurement consistency was significantly higher (p<0.001) for the black bone MRI (0.43[0.32;0.56]) than CT (0.22[0.13;0.35]); nonetheless, the ICC was poor for both modalities. Conclusions Black bone MR sequence is usable as an alternative to CT for cortical mandible bone measurements, allowing use for early detection of cortical alteration (e.g. osteonecrosis). The cortical bone measurements showed substantive but equivalent inter-observer variation on both CT and black bone MRI. (Semi)automated measurement may mitigate this in future work.

scholarly journals Development of ADAF screening tool for emotional and coping problems in cancer patients

2021 ◽  
Author(s):  
Pedro Pérez-Segura ◽  
Santos Enrech Francés ◽  
Ignacio Juez Martel ◽  
Maria Angeles Pérez Escutia ◽  
Elena Hernández Agudo ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Sensitivity And Specificity ◽  
Intraclass Correlation ◽  
Area Under The Curve ◽  
Correlation Coefficients ◽  
P Value ◽  
Avoidance Coping ◽  
Cross Sectional ◽  
And Coping ◽  
Anxiety Depression

ABSTRACTPurposePsychological screening in patient with cancer is recommended by clinical guidelines, however most of scales have large number of items, difficulty detection and refer from routine consultations. The specific objective of the study was to develop and validate the ADAF screening for anxiety, depression and coping.Methods/PatientsCross-sectional, multicenter study performed in the medical and radiotherapy oncology services of 5 hospitals in Madrid, coordinated by the Medical Oncology Service of the Hospital Clínico San Carlos (CEIC nº19 / 265-E). To determine the psychometric properties, the ADAF screening questionnaire ADAF was administered, including 5 items (one related to anxiety symptoms, two related to depressive symptoms, one for helplessness coping and one for avoidance coping), and as a gold-standard the HADS and the MiniMAC. Intraclass correlation coefficients and receiver operating characteristic curves were performed. The p value <0.05 was considered significant.ResultsA total of 186 patients completed the evaluation. The correlation coefficients were significant for all dimensions (Anxiety, Depression, Helplessness coping, and Avoidance Coping), with p <0.001. The statistical analysis of ROC curves suggests that the cut-off point for screening is equivalent to a score > 2 points (3 in the case of depression, having two items), with a sensitivity and specificity between 62 and 90%, depending on the item, and an area under the curve above 0.8 for the first 4 items.ConclusionsADAF screening has adequate reliability, good sensitivity and specificity. This instrument is useful and easy to use to identify emotional and coping problems in cancer patients.

Test–retest reliability and limits of agreement of the Six-Spot Step Test in people with Parkinson’s disease

2019 ◽  
Vol 33 (2) ◽  
pp. 285-292 ◽  
Author(s):  
John Brincks ◽  
Jacob Callesen ◽  
Ulrik Dalgas ◽  
Erik Johnsen
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Intraclass Correlation ◽  
Step Test ◽  
Outpatient Clinics ◽  
Learning Effects ◽  
Disabled People ◽  
Limits Of Agreement ◽  
Cross Sectional ◽  
Test Retest Reliability

Objective: The aim of this study was to evaluate the within-day and day-to-day agreement and reliability of the Six-Spot Step Test in mild to moderately disabled people with Parkinson’s disease. Design: Cross-sectional cohort study. Setting: Outpatient clinics. Subjects: Forty-four people with Parkinson’s disease. Main measure: The Six-Spot Step Test was completed twice on day 1. Two days later, the Six-Spot Step Test was completed again. The agreement was estimated by Bland–Altman statistics with 95% limits of agreement, and reliability was estimated by the intraclass correlation coefficient. Results: Subjects had a mean (SD) age of 67.8 (6.8) years, a median (range) Hoehn and Yahr score of 2.5 (1–4) and a mean (SD) Six-Spot Step Test score of 8.1 (1.8), 7.6 (1.7) and 7.6 (1.6) seconds on test occasions 1 to 3. An agreement for within-day and day-to-day of ±1.8 (±23.7%) and ±2.2 (±26.7%) seconds was found, respectively. The reliability was 0.81 and 0.76 within-day and day-to-day, respectively. A small learning effect was observed ( P < 0.05) between the first and second Six-Spot Step Test, but there was no learning between the second and third occasions. Conclusion: The Six-Spot Step Test has an acceptable within-day and day-to-day agreement and reliability in mild to moderately disabled people with Parkinson’s disease. A change of 2.2 seconds can be regarded as a true change. To minimize learning effects, test trials of the Six-Spot Step Test are recommended before use.

scholarly journals Development of a Danish Language Version of the Manchester Foot Pain and Disability Index: Reproducibility and Construct Validity Testing

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Christian K. Pedersen ◽  
Bente Danneskiold-Samsøe ◽  
Adam P. Garrow ◽  
Eva E. Wæhrens ◽  
Henning Bliddal ◽  
...  
Keyword(s):  
Construct Validity ◽  
Short Form ◽  
Intraclass Correlation ◽  
Adult Patients ◽  
Foot Pain ◽  
Limits Of Agreement ◽  
Good Reliability ◽  
Cross Sectional ◽  
Language Version ◽  
Sf 36

Introduction. The Manchester Foot Pain and Disability Index (MFPDI) is a 19-item questionnaire for the assessment of disability caused by foot pain. The aim was to develop a Danish language version of the MFPDI (MFPDI-DK) and evaluate its reproducibility and construct validity. Methods. A Danish version was created, following a forward-backward translation procedure. A sample of 84 adult patients with foot pain was recruited. Participants completed two copies of the MFPDI-DK within a 24- to 48-hour interval, along with the Medical Outcomes Study Short Form 36 (SF-36), and a pain Visual Analog Scale (VAS). Reproducibility was assessed using the intraclass correlation coefficient (ICC) and 95% limits of agreement (Bland-Altman plot). Construct validity was evaluated with Pearson’s Rho, using a priori hypothesized correlations with SF-36 subscales and VASmean. Results. The MFPDI-DK showed very good reliability with an ICC of 0.92 (0.88–0.95). The 95% limits of agreement ranged from −6.03 to 6.03 points. Construct validity was supported by moderate to very strong correlations with the SF-36 physical subscales and VASmean. Conclusion. The MFPDI-DK appears to be a valid and reproducible instrument in evaluating foot-pain-related disability in Danish adult patients in cross-sectional samples. Further research is needed to test the responsiveness of the MFPDI-DK.

scholarly journals The measurement performance of the EQ-5D-5L versus EQ-5D-3L in patients with hidradenitis suppurativa

2021 ◽  
Author(s):  
Alex Bató ◽  
Valentin Brodszky ◽  
L. Hunor Gergely ◽  
Krisztián Gáspár ◽  
Norbert Wikonkál ◽  
...  
Keyword(s):  
Convergent Validity ◽  
Hidradenitis Suppurativa ◽  
Clinical Care ◽  
Intraclass Correlation ◽  
Life Quality ◽  
Measurement Properties ◽  
Economic Evaluations ◽  
Health State ◽  
Cross Sectional Survey ◽  
Cross Sectional

Abstract Purpose Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease that affects up to 1% of the population in Europe. The EQ-5D is the most commonly used generic instrument for measuring health-related quality of life among HS patients. This study aims to compare the measurement properties of the two adult versions of EQ-5D (EQ-5D-3L and EQ-5D-5L) in patients with HS. Methods We recruited 200 consecutive patients with HS (mean age 37 years, 38% severe or very severe HS) to participate in a multicentre cross-sectional survey. Patients completed the EQ-5D-3L, EQ-5D-5L, Dermatology Life Quality Index (DLQI) and Skindex-16 questionnaires. Results More than twice as many different health state profiles occurred in the EQ-5D-5L compared to the EQ-5D-3L (101 vs. 43). A significant reduction in ceiling effect was found for the mobility, self-care and usual activities dimensions. A good agreement was established between the EQ-5D-3L and EQ-5D-5L with an intraclass correlation coefficient of 0.872 (95% CI 0.830–0.903; p < 0.001) that was confirmed by a Bland-Altman plot. EQ-5D-5L improved both the absolute and relative informativity in all dimensions except for anxiety/depression. EQ-5D-3L and EQ-5D-5L demonstrated similar convergent validity with DLQI and Skindex-16. EQ-5D-5L was able to better discriminate between known groups of patients based on the number of comorbidities and disease severity (HS-Physician's Global Assessment). Conclusion In patients with HS, the EQ-5D-5L outperformed the EQ-5D-3L in feasibility, ceiling effects, informativity and known-groups validity for many important clinical characteristics. We recommend using the EQ-5D-5L in HS patients across various settings, including clinical care, research and economic evaluations.

scholarly journals High concurrent validity between digital and analogue algometers to measure pressure pain thresholds in healthy participants and people with migraine: a cross-sectional study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
René F. Castien ◽  
Michel W. Coppieters ◽  
Tom S. C. Durge ◽  
Gwendolyne G. M. Scholten-Peeters
Keyword(s):  
Concurrent Validity ◽  
Tibialis Anterior Muscle ◽  
Intraclass Correlation ◽  
Cephalic Region ◽  
Limits Of Agreement ◽  
Temporal Muscle ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Pressure Pain Thresholds ◽  
Healthy Participants

Abstract Background Pressure pain thresholds (PPTs) are commonly assessed to quantify mechanical sensitivity in various conditions, including migraine. Digital and analogue algometers are used, but the concurrent validity between these algometers is unknown. Therefore, we assessed the concurrent validity between a digital and analogue algometer to determine PPTs in healthy participants and people with migraine. Methods Twenty-six healthy participants and twenty-nine people with migraine participated in the study. PPTs were measured interictally and bilaterally at the cephalic region (temporal muscle, C1 paraspinal muscles, and trapezius muscle) and extra-cephalic region (extensor carpi radialis muscle and tibialis anterior muscle). PPTs were first determined with a digital algometer, followed by an analogue algometer. Intraclass correlation coefficients (ICC3.1) and limits of agreement were calculated to quantify concurrent validity. Results The concurrent validity between algometers in both groups was moderate to excellent (ICC3.1 ranged from 0.82 to 0.99, with 95%CI: 0.65 to 0.99). Although PPTs measured with the analogue algometer were higher at most locations in both groups (p < 0.05), the mean differences between both devices were less than 18.3 kPa. The variation in methods, such as a hand-held switch (digital algometer) versus verbal commands (analogue algometer) to indicate when the threshold was reached, may explain these differences in scores. The limits of agreement varied per location and between healthy participants and people with migraine. Conclusion The concurrent validity between the digital and analogue algometer is excellent in healthy participants and moderate in people with migraine. Both types of algometer are well-suited for research and clinical practice but are not exchangeable within a study or patient follow-up.

scholarly journals The trends of complementary alternative medicine use among cancer patients

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Abdul Rahman Jazieh ◽  
Khadega A. Abuelgasim ◽  
Husam I. Ardah ◽  
Mohammad Alkaiyat ◽  
Omar B. Da’ar
Keyword(s):  
Alternative Medicine ◽  
Cancer Patients ◽  
Clinical Information ◽  
Cross Sectional Study ◽  
Complementary Alternative Medicine ◽  
Cultural Changes ◽  
Cross Sectional ◽  
Patients With Cancer ◽  
Cam Use ◽  
The Individual

Abstract Background The use of complementary and alternative medicine (CAM) is common among cancer patients and it may reflect the individual and societal beliefs on cancer therapy. Our study aimed to evaluate the trends of CAM use among patients with cancer between 2006 and 2018. Methods We included 2 Cohorts of patients with cancer who were recruited for Cohort 1 between 2006 and 2008 and for Cohort 2 between 2016 and 2018. The study is a cross-sectional study obtaining demographic and clinical information and inquiring about the types of CAM used, the reasons to use them and the perceived benefits. We compared the changes in the patterns of CAM use and other variables between the two cohorts. Results A total of 1416 patients were included in the study, with 464 patients in Cohort 1 and 952 patients in Cohort 2. Patients in Cohort 2 used less CAM (78.9%) than Cohort 1 (96.8%). Cohort 1 was more likely to use CAM to treat cancer compared to Cohort 2 (84.4% vs. 73%, respectively, p < 0.0001,); while Cohort 2 used CAM for symptom management such as pain control and improving appetite among others. Disclosure of CAM use did not change significantly over time and remains low (31.6% in Cohort 1 and 35.7% for Cohort 2). However, physicians were more likely to express an opposing opinion against CAM use in Cohort 2 compared to Cohort 1 (48.7% vs. 19.1%, p < 0.001, respectively). Conclusion There is a significant change in CAM use among cancer patients over the decade, which reflects major societal and cultural changes in this population. Further studies and interventions are needed to improve the disclosure to physicians and to improve other aspects of care to these patients.

scholarly journals Complementary and Alternative Medicine Use in Breast Cancer Patients at a Medical Center in Taiwan: A Cross-Sectional Study

2020 ◽  
Vol 19 ◽  
pp. 153473542098391
Author(s):  
Chieh-Ying Chin ◽  
Yung-Hsiang Chen ◽  
Shin-Chung Wu ◽  
Chien-Ting Liu ◽  
Yun-Fang Lee ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Alternative Medicine ◽  
Complementary And Alternative Medicine ◽  
Cancer Patients ◽  
Medical Center ◽  
Cancer Center ◽  
Breast Cancer Patients ◽  
Cross Sectional ◽  
Cam Use ◽  
Complementary And Alternative

Background Complementary and alternative medicine (CAM) is becoming more common in medical practice, but little is known about the concurrent use of CAM and conventional treatment. Therefore, the aim was to investigate the types of CAM used and their prevalence in a regional patient cohort with breast cancer (BC). Methods BC patients were interviewed with a structured questionnaire survey on the use of CAM in southern Taiwan at an Integrative Breast Cancer Center (IBCC). The National Centre for Complementary and Integrative Health (NCCIH) classification was used to group responses. Over a period of 8 months, all patients receiving treatment for cancer at the IBCC were approached. Results A total of 106 BC patients completed the survey (response rate: 79.7%). The prevalence of CAM use was 82.4%. Patients who were employed, were receiving radiotherapy and hormone therapy, and had cancer for a longer duration were more likely to use CAM ( P < .05). Multivariate analysis identified employment as an independent predictor of CAM use (OR = 6.92; 95% CI = 1.33-36.15). Dietary supplementation (n = 69, 82.1%) was the type of CAM most frequently used, followed by exercise (n = 48, 57.1%) and traditional Chinese medicine (n = 29, 34.5%). The main reason for using CAM was to ameliorate the side effects of conventional therapies. Almost half (46.4%) of these CAM users did not disclose that they were using it in medical consultations with their physicians. Most chose to use CAM due to recommendations from family and friends. Conclusion A large portion of BC patients at the IBCC undergoing anti-cancer treatment courses used CAM, but less than half discussed it with their physicians. Given the high prevalence of CAM, it would be justifiable to direct further resources toward this service so that cancer patients can benefit from a holistic approach to their treatment.

scholarly journals Augmenting the Clinical Data Sources for Enigmatic Diseases: A Cross-Sectional Study of Self-Tracking Data and Clinical Documentation in Endometriosis

2020 ◽  
Vol 11 (05) ◽  
pp. 769-784
Author(s):  
Ipek Ensari ◽  
Adrienne Pichon ◽  
Sharon Lipsky-Gorman ◽  
Suzanne Bakken ◽  
Noémie Elhadad
Keyword(s):  
Additional Data ◽  
Intraclass Correlation ◽  
Management Strategies ◽  
The Self ◽  
Self Management ◽  
Cross Sectional ◽  
Two Samples ◽  
Data Source ◽  
Daily Function ◽  
Over Time

Abstract Background Self-tracking through mobile health technology can augment the electronic health record (EHR) as an additional data source by providing direct patient input. This can be particularly useful in the context of enigmatic diseases and further promote patient engagement. Objectives This study aimed to investigate the additional information that can be gained through direct patient input on poorly understood diseases, beyond what is already documented in the EHR. Methods This was an observational study including two samples with a clinically confirmed endometriosis diagnosis. We analyzed data from 6,925 women with endometriosis using a research app for tracking endometriosis to assess prevalence of self-reported pain problems, between- and within-person variability in pain over time, endometriosis-affected tasks of daily function, and self-management strategies. We analyzed data from 4,389 patients identified through a large metropolitan hospital EHR to compare pain problems with the self-tracking app and to identify unique data elements that can be contributed via patient self-tracking. Results Pelvic pain was the most prevalent problem in the self-tracking sample (57.3%), followed by gastrointestinal-related (55.9%) and lower back (49.2%) pain. Unique problems that were captured by self-tracking included pain in ovaries (43.7%) and uterus (37.2%). Pain experience was highly variable both across and within participants over time. Within-person variation accounted for 58% of the total variance in pain scores, and was large in magnitude, based on the ratio of within- to between-person variability (0.92) and the intraclass correlation (0.42). Work was the most affected daily function task (49%), and there was significant within- and between-person variability in self-management effectiveness. Prevalence rates in the EHR were significantly lower, with abdominal pain being the most prevalent (36.5%). Conclusion For enigmatic diseases, patient self-tracking as an additional data source complementary to EHR can enable learning from the patient to more accurately and comprehensively evaluate patient health history and status.

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