Patient reported outcome on endourethrotomy combined with Amplatz dilatation for treatment of incompletely obliterated posterior urethral stricture following pelvic trauma: Validation in the era of urethroplasty

Pelvic Trauma ◽

Cross Sectional ◽

Introduction: Direct vision internal urethrotomy (DVIU) is gaining revival among urologists, the procedure having the advantages of being minimally invasive as well as keeping continence and sexual function unaffected. The recurrence rate at 12 months was diminished by combination of DVIU with a Amplatz dilatation at the time of the procedure. Objectives are of present work is to present the outcome of the procedure. Materials and methods: This is an observational study with a cross-sectional approach. Patients underwent combined endo-urethrotomy and Amplatz dilation for posterior urethral strictures between February 2015 and January2020 were purposively recruited. We performed a retrospective review of the records of 48 patients who completed 12 months follow-up . Patient-reported outcome measures for urethral stricture surgery (USS-PROMs) and sexual function were assessed at 12 months follow-up questionnaire was used to assess quality of life. The patients in the study filled the questionnaire and returned to the researchers. Correlation between status before and after treatment were analyzed using simple statistical analysis to evaluate the effect of treatment on quality of life. Clinician-driven outcome were uroflowmetry, retrograde urethrogram, and reporting of complications. Results: Mean length of stricture segment was 2 cm (range 1-2.5 cm). At 12 months follow up patients reported very satisfactory. Restenosis that was treated with redo was reported in 2%. Mild stenosis that was treated with Amplatz dilatation was in 3%. Patients reported very satisfactory or satisfactory for USS-PROSMs, sexual function in comparison to pre-trauma status. Conclusions: Endourethrotomy combined with Amplatz dilation is an effective treatment for short segment passable posterior urethral stricture

P06.03 Child, parent, and clinician selection of patient-reported outcome measures to use in pediatric neuro-oncology outpatient follow-up clinics

Neuro-Oncology ◽

10.1093/neuonc/noab180.081 ◽

2021 ◽

Vol 23 (Supplement_2) ◽

pp. ii24-ii24

Author(s):

K S Bull ◽

S Stubley ◽

A Freeman ◽

C Liossi ◽

A E Darlington ◽

...

Keyword(s):

Quality Of Life ◽

Psychometric Properties ◽

Outcome Measures ◽

Cross Sectional ◽

Patient Reported ◽

Perceived Relevance

Abstract BACKGROUND Survivors of childhood brain tumours are at risk of poor health-related quality of life (HRQoL). Appropriate and relevant measures can be used to monitor HRQoL so that timely interventions may be made for issues thus identified. We had previously selected patient-reported outcome measures (PROMs) with good psychometric properties that had emerged as well-suited for this use in two systematic reviews. The aim of the present study was to ascertain the views of families regarding the suitability of the selected measures for use in paediatric neuro-oncology follow-up clinics. These views were then used to inform the choice of PROMs for use on the KLIK PROM portal, a website designed to gather HRQoL information from families. MATERIAL AND METHODS As part of the PROMOTE study, we used a multi-centre, multi-informant, cross-sectional, qualitative methods research design. Using ‘think aloud’ audio-recorded interviews, children aged 8–17 years diagnosed within the previous five years with a brain tumour, off treatment and receiving outpatient care, and their parents, were shown a total of nine PROMs and asked to express their views on which they preferred. Detailed notes were made of all audio-recordings by two independent researchers. The final choice of PROMs to be included on the KLIK PROM portal was agreed through discussion of the PROMs selected by families with an expert panel of clinicians, researchers, and parent representatives. RESULTS 16 children and 17 parents participated and of these 2 children and 2 parents did not express a preference. The Pediatric Quality of Life Inventory (PedsQL) Core module was the most popular among the children and parents with 7/14 (50%) of children selecting it as either their 1st or 2nd choice citing that they liked the questions and felt them to be most relevant to them, and 8/15 (53%) of parents citing that it was easy, quick and simple, the wording was easy, and they liked the questions about emotional, social, and school functioning. The least popular questionnaires, with no participants selecting them as first choices, were the Kidscreen-10 and the Health Utilities Index. The latter 2 were selected only as 2nd or lower choices by 1 child and 3 parents respectively. CONCLUSION The PROMs that were finally selected for the KLIK PROM portal were the parent- and child-report PedsQL-Core measures of HRQoL due to their good psychometric properties, family and clinician preference and perceived relevance to follow-up care, and for clinical utility on the KLIK PROM portal.

Significance of patient-reported outcomes for occupational resumption and quality of life after cardiac rehabilitation

European Heart Journal ◽

10.1093/ehjci/ehaa946.3107 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

A Salzwedel ◽

I Koran ◽

E Langheim ◽

A Schlitt ◽

J Nothroff ◽

...

Keyword(s):

Quality Of Life ◽

Physical Performance ◽

Well Being ◽

Funding Source ◽

Patient Reported ◽

Returning To Work

Abstract Introduction Comprehensive cardiac rehabilitation (CR) programs based on the bio-psycho-social approach of the international classification of functioning and disease are carried out to achieve improved prognosis, superior health-related quality of life (HRQL) and social integration. We aimed to identify predictors of returning to work (RTW) and HRQL among cardiovascular risk factors and physical performance as well as patient-reported outcome measures (PROMs) modifiable during CR. Methods We designed a prospective observational multi-center study and enrolled 1,586 patients (2017/18) in 12 German rehabilitation centers regardless of their primary allocation diagnoses (e.g. acute myocardial infarction (AMI), coronary artery bypass grafting (CABG), coronary artery disease (CAD), valvular disease). Besides general data (e.g. age, gender, diagnoses), parameters of risk factor management (e.g. smoking, lipid profile, hypertension, lifestyle change motivation), physical performance (e.g. maximum exercise capacity, endurance training load, 6-min walking distance), and PROMs (e.g. depression, heart-focused anxiety, HRQL, subjective well-being, somatic and mental health, pain, general self-efficacy, pension desire as well as self-assessment of occupational prognosis using several questionnaires) were documented at CR admission and discharge. 6 months after discharge, status of RTW and HRQL (SF-12) were captured by a follow-up (FU) survey and analyzed in multivariable regression models with multiple imputation of missing values. Results Out of the study participants, 1,262 patients (54±7 years, 77% men) responded to the follow-up survey and could be analyzed regarding the outcome parameters. Most of them were assigned to CR primarily due to AMI (40%) or CAD without myocardial infarction (18%), followed by heart valve diseases in 12% of patients and CABG (8%). 864 patients (69%) returned to work within the follow-up period. Pension desire, negative self-assessed occupational prognosis, heart-focussed anxiety, major life events, smoking and heart failure were negatively associated with RTW, while higher endurance training load, HRQL and work stress were positively associated (Figure 1). HRQL after 6 months was determined more by PROMs (e.g. pension desire, heart-focused anxiety, physical/mental HRQL in SF-12, physical/mental health in indicators of rehab-status questionnaire (IRES-24), stress, well-being in the World Health Organization well-being index and self-efficacy expectations) than by clinical parameters or physical performance. Conclusions Patient-reported outcome measures predominantly influenced RTW and HRQL in heart-disease patients, whereas patients' pension desire and heart-focussed anxiety had a dominant impact on all investigated endpoints. Therefore, the multi-component CR approach focussing on psychosocial support is crucial for subjective health prognosis and occupational resumption. Figure 1. Predictors of returning to work Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): German pension insurance

Urethroplasty and Quality of Life: Psychometric Validation of a Dutch Version of the Urethral Stricture Surgery Patient Reported Outcome Measures

Urologia Internationalis ◽

10.1159/000479189 ◽

2017 ◽

Vol 99 (4) ◽

pp. 460-466 ◽

Cited By ~ 10

Author(s):

Wesley Verla ◽

Marjan Waterloos ◽

Nicolaas Lumen

Keyword(s):

Quality Of Life ◽

Outcome Measures ◽

Urethral Stricture ◽

Psychometric Validation ◽

Dutch Version ◽

Surgery Patient ◽

Excision and Primary Anastomosis for Bulbar Urethral Strictures Improves Functional Outcomes and Quality of Life: A Prospective Analysis from a Single Centre

BioMed Research International ◽

10.1155/2019/7826085 ◽

2019 ◽

Vol 2019 ◽

pp. 1-9 ◽

Cited By ~ 2

Author(s):

Pieter D’hulst ◽

Michael S. Floyd ◽

Fabio Castiglione ◽

Kathy Vander Eeckt ◽

Steven Joniau ◽

...

Keyword(s):

Quality Of Life ◽

Erectile Function ◽

Functional Outcomes ◽

International Prostate Symptom Score ◽

Urethral Stricture Disease ◽

Background. Excision and primary anastomotic (EPA) urethroplasty remains the gold standard definitive treatment for short urethral stricture disease. For patients, postoperative erectile function and quality of life are the main goals of the surgery. Patient-reported outcome measures (PROMs) are therefore of major importance. Objective. The objective of this study was to prospectively analyse functional outcomes and patient satisfaction. Design, Settings, and Participants. We prospectively evaluated 47 patients before and after EPA from August 2009 until February 2017. The first follow-up visit occurred after a median of 2.2 months (n = 47/47), with the second and third follow-ups occurring at a median of 8.5 months (n = 38/47) and 20.2 months (n = 31/47). Before surgery and at each follow-up visit, the patients received five questionnaires: the International Prostate Symptom Score (IPSS), the International Prostate Symptom Score with the Quality of Life (IPSS-QOL) score, the Urogenital Distress Inventory Short Form (UDI-6) score, the International Index of Erectile Function-5 (IIEF-5) score, and the ICIQ-Lower Urinary Tract Symptoms Quality of Life (ICIQ-LUTS-QOL) score. Surgical Procedure. Surgery was performed in all cases using the same standardized EPA technique. Outcome Measurements and Statistical Analysis. Voiding symptoms, erectile dysfunction, and quality of life were analysed using paired sample t-tests, with a multiple-testing Bonferroni correction. Any requirement for instrumentation after surgery was considered treatment failure. Results and Limitations. Patients with mild or no baseline erectile dysfunction showed significant decline in erectile function at first follow-up (mean IIEF-5 of 23.27 [standard deviation; SD: 2.60] vs. 13.91 [SD: 7.50]; p=0.002), but this had recovered completely at the third follow-up (IIEF-5: 23.25 [SD: 1.91]; p=0.659). Clinically significant improvements were noted in IPSS, IPSS-QOL-score, UDI-6-score, and ICIQ-LUTS-QOL-score at the first follow-up (p<0.0001). These improvements remained significant at the second and third follow-ups (p<0.0001) for all PROMs. Three of the patients experienced stricture recurrence. The main limitations of this study were incomplete questionnaires, loss to follow-up, and low number of patients. Conclusions. EPA results in an initial decline in erectile function, but full recovery occurred at a median of 20 months. Voiding improved significantly, and a major improvement in quality of life was noted, which persisted for up to 20 months after surgery. Patient Summary. This study showed the importance of patient-reported outcome measures in indicating the actual outcome of urethral stricture disease surgery.

More Severe Preoperative Kellgren–Lawrence Grades of Knee Osteoarthritis were Partially Associated with Better Postoperative Patient-Reported Outcomes in TKA Patients

The Journal of Knee Surgery ◽

10.1055/s-0038-1635114 ◽

2018 ◽

Vol 32 (03) ◽

pp. 211-217 ◽

Cited By ~ 9

Author(s):

Suzanne Witjes ◽

Koen Koenraadt ◽

Ruud Aarts ◽

Thomas Weert ◽

Rutger van Geenen ◽

...

Keyword(s):

Quality Of Life ◽

Cross Sectional ◽

Radiographic Severity ◽

Knee Oa ◽

Patient Reported ◽

Kellgren And Lawrence ◽

Total Knee

AbstractTotal knee arthroplasty (TKA) is a successful procedure, although up to 20% of patients remain dissatisfied. Preoperative identification of appropriate TKA candidates is essential for improving satisfaction. This study investigated if preoperative radiographic severity was associated with postoperative pain, function, and quality of life after TKA. We performed a cross-sectional cohort study including 327 TKA patients. Radiographic severity was determined by two independent radiologists using the Kellgren and Lawrence (KL) score. The Knee Injury and Osteoarthritis Outcome Score (KOOS), the New Knee Society Score (New KSS), and Anterior Knee Pain Score (AKPS) were collected. We evaluated the association between KL grade and patient-reported outcome measures (PROMs) with the use of regression analysis techniques. Out of 228 responders, 195 patients completed the questionnaire sufficiently. Forty-seven patients were classified as KL grades 1 to 2, and 144 patients were classified as KL grades 3 to 4. The inter-observer reliability between both radiologists was substantial (ϰ = 0.67). After adjusting for age, sex, and body mass index (BMI), the New KSS subscales symptoms and expectations, and the KOOS subscale quality of life were significantly higher in the KL grades 3 to 4 group. However, neither the remaining KOOS subscales and AKPS nor KOOS change scores differed between both groups. Thus, more severe osteoarthritis (OA) resulted in better outcomes after TKA, although this association was not observed for all PROMs. The use of new PROMs, such as the New KSS, could be more reliable because of lower ceiling effects than the KOOS. Investigating the value of additional methods to assess radiographic severity (such as semi-flexed knee radiographs and MRI) is imperative to reliably identify knee OA.

Features Associated With Quality of Life Impairment in Hidradenitis Suppurativa Patients

Frontiers in Medicine ◽

10.3389/fmed.2021.676241 ◽

2021 ◽

Vol 8 ◽

Author(s):

Sylke Schneider-Burrus ◽

Athanasia Tsaousi ◽

Sebastian Barbus ◽

Johannes Huss-Marp ◽

Katrin Witte ◽

...

Keyword(s):

Quality Of Life ◽

Antibiotic Treatment ◽

Hidradenitis Suppurativa ◽

Life Quality ◽

Blood Parameters ◽

Cross Sectional ◽

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease with an adverse impact on patients' quality of life (QoL).Objectives: To quantify QoL impairment in patients in Germany suffering from HS and to identify the parameters associated with QoL impairment.Methods: A non-interventional, cross-sectional, mono-centric study with 500 HS patients. QoL data (measured using the Dermatology Life Quality Index; DLQI) and demographic, anamnestic, clinical, and blood parameters were collected. All patients were examined by dermatologists that documented the skin alterations. QoL data from 462 HS patients were available and evaluated.Results: The mean (± standard deviation) DLQI score of HS patients was 13.18 ± 7.99. Approximately 40% and 20% of HS patients declared very large and extremely large QoL impairment, respectively. The degree of QoL disturbance correlated with the severity of skin alterations, blood leucocyte count and, in particular, with anogenital localization and the presence of nodules and fistulas. Furthermore, QoL impairment was associated with specific comorbidities, such as adiposity and back pain, but not with HS family history. QoL impairment was not influenced by whether or not the patients had undergone resection surgery or antibiotic treatment but was more severe in HS patients that had undergone abscess lancing compared to patients without such treatment in the past.Limitations: It was a mono-centric study and most data were obtained from self-administered patient questionnaires. The association of QoL with type of treatment was analyzed for abscess lancing, resection surgery, and antibiotic treatment. Further therapeutic modalities recommended in the guidelines were not investigated.Conclusion: A profound impairment in QoL was present in patients with HS, and this was higher than that observed in other studied dermatoses. The degree of impairment correlated with the extent of cutaneous and some extra-cutaneous alterations. Surgical and conventional medicamentous therapies of HS were not associated with long-lasting reduction of QoL impairment. Our data support the implementation of patient-reported outcome measures for the assessment of therapy responses.