Validity of overall self-rated health as an outcome measure in small samples: a pilot study involving a case series

Objectives Radiological balloon dilatation of lower oesophageal strictures is common practice. Other than some early reports from our own centre, there is little published regarding radiological dilatation of pharyngeal and upper oesophageal strictures and less still on radiological balloon dilatation of post-total laryngectomy and pharyngolaryngectomy neo-pharyngeal strictures. Standard practise is bouginage under general anaesthaesia. The objective of this study is to assess the efficacy of radiological balloon dilatation for the treatment of dysphagia secondary to neopharyngeal strictures in patients who have undergone laryngectomy. Methods A tertiary care centre case series of 20 consecutive patients (17 males and 3 females aged 40 to 84) with pharyngeal stricture and dysphagia post-total laryngectomy or pharyngolaryngectomy who underwent balloon dilatation of the stricture under radiological guidance. Maintenance of swallowing was the main outcome measure. Results 5 patients gained relief of their dysphagia with 1 balloon dilatation only. 9 patients required more than 1 dilatation to maintain swallowing. 2 patients had balloon dilatation procedures and stent insertion for palliative relief of dysphagia from known recurrent malignant disease. 3 patients failed to maintain swallowing with repeat dilatations. No patients suffered any significant complications such as perforation. Conclusions Balloon dilatation is minimally invasive and less traumatic than rigid pharyngoscopy with bouginage dilatation. It is well tolerated. It may be repeated frequently and can successfully relieve strictures of the pharynx in patients who have undergone total laryngectomy or pharyngolaryngectomy.

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Symptom Cluster-Matching Antidepressant Treatment: A Case Series Pilot Study

Pharmaceuticals ◽

10.3390/ph14060526 ◽

2021 ◽

Vol 14 (6) ◽

pp. 526

Author(s):

Sławomir Murawiec ◽

Marek Krzystanek

Keyword(s):

Depressive Symptoms ◽

Pilot Study ◽

Antidepressant Treatment ◽

Case Series ◽

Symptom Cluster ◽

Study Results ◽

Cluster Matching ◽

The Individual ◽

Meta Analyses ◽

Effectiveness Studies

Despite treating depression with antidepressants, their effectiveness is often insufficient. Comparative effectiveness studies and meta-analyses show the effectiveness of antidepressants; however, they do not provide clear indications as to the choice of a specific antidepressant. The rational choice of antidepressants may be based on matching their mechanisms of action to the symptomatic profiles of depression, reflecting the heterogeneity of symptoms in different patients. The authors presented a series of cases of patients diagnosed with depression in whom at least one previous antidepressant treatment was shown to be ineffective before drug targeted symptom cluster-matching treatment (SCMT). The presented pilot study shows for the first time the effectiveness of SCMT in the different clusters of depressive symptoms. All the described patients obtained recovery from depressive symptoms after introducing drug-targeted SCMT. Once validated in clinical trials, SCMT might become an effective and rational method of selecting an antidepressant according to the individual profile of depressive symptoms, the mechanism of their formation, and the mechanism of drug action. Although the study results are preliminary, SCMT can be a way to personalize treatment, increasing the likelihood of improvement even in patients who meet criteria for treatment-resistant depression.

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A case series evaluation of a modified version of interpersonal psychotherapy (IPT) for the treatment of bulimic eating disorders: A pilot study

European Eating Disorders Review ◽

10.1002/erv.932 ◽

2009 ◽

Vol 17 (4) ◽

pp. 260-268 ◽

Cited By ~ 24

Author(s):

Jon Arcelus ◽

Debbie Whight ◽

Christopher Langham ◽

Jonathan Baggott ◽

Lesley McGrain ◽

...

Keyword(s):

Eating Disorders ◽

Pilot Study ◽

Case Series ◽

Interpersonal Psychotherapy ◽

Series Evaluation

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Evaluation of Absenteeism, Pain, and Disability in Nurses With Persistent Low Back Pain Following Cognitive Functional Therapy: A Case Series Pilot Study With 3-Year Follow-Up

Physical Therapy ◽

10.1093/ptj/pzaa164 ◽

2020 ◽

Author(s):

Wannes Van Hoof ◽

Kieran O’Sullivan ◽

Sabine Verschueren ◽

Peter O’Sullivan ◽

Wim Dankaerts

Keyword(s):

Health Care ◽

Low Back Pain ◽

Pilot Study ◽

Case Series ◽

Health Care Seeking ◽

Low Back ◽

Care Seeking ◽

Functional Therapy ◽

Secondary Outcomes

Abstract Objective Persistent low back pain (PLBP) is a common and costly health problem worldwide. Better strategies to manage it are required. The purpose of this study was to longitudinally evaluate absenteeism, pain, and disability in nurses with PLBP following a cognitive functional therapy (CFT) intervention. Methods In this case series pilot study, 33 eligible nurses with PLBP were recruited. During the baseline phase (phase A; no intervention), outcome measures were collected on 2 occasions 6 months apart (A1 and A2). During phase B, participants received an individualized CFT intervention for 14 weeks. During phase C (no intervention), outcomes were measured immediately after the intervention, as well as 3, 6, 9, 12, and 36 months after the intervention (secondary outcomes only until 12 months). LBP-related work absenteeism, pain intensity (numerical pain rating scale) and disability (Oswestry Disability Index) were the primary outcomes. Health care seeking, a range of psychological and lifestyle variables, and global perceived effect were secondary outcomes. Results Days of absenteeism due to LBP were significantly reduced in the first and second calendar years after the CFT intervention but not the third and fourth. Disability was significantly reduced immediately after (−4.4; 95% CI = −6.5 to −2.2) and at 3 months (−4.3; 95% CI = −6.6 to −2.0), 9 months (−6.0; 95% CI = −8.1 to −3.9), and 12 months (−4.9; 95% CI = −7.0 to −2.8) after the intervention. Pain was significantly reduced immediately after (−1.2; 95% CI = −1.7 to −0.8) and at 3 months (−1.5; 95% CI = −2.0 to −0.9), 9 months (−1.1; 95% CI = −1.9 to −0.3), and 12 months (−0.9; 95% CI = −1.5 to −0.2) after the intervention. Total health care seeking (consults and proportion of participants) was significantly reduced after the intervention. All psychosocial variables, except for 1, demonstrated significant improvements at all follow-up assessments. Conclusions This case series pilot study demonstrated significant reductions in LBP-related absenteeism, pain intensity, disability, health care seeking, and several psychological and lifestyle behaviors until the 1-year follow-up among nurses with PLBP following an individualized CFT intervention. Further evaluation of the efficacy of CFT in high-quality randomized clinical trials among nurses is recommended.

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Inter- and intra-rater reliability and clinical utility of the Brachial Plexus Outcome Measure: A pilot study

Hand Therapy ◽

10.1177/1758998319861655 ◽

2019 ◽

Vol 24 (4) ◽

pp. 123-129

Author(s):

Hazel Brown ◽

Paul Bassett ◽

Tom J Quick

Keyword(s):

Pilot Study ◽

Brachial Plexus ◽

Clinical Utility ◽

Outcome Measure ◽

Rater Reliability

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Preventability of hospital onset bacteremia and fungemia: A pilot study of a potential healthcare-associated infection outcome measure

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2018.339 ◽

2019 ◽

Vol 40 (3) ◽

pp. 358-361 ◽

Cited By ~ 4

Author(s):

Raymund B. Dantes ◽

Clare Rock ◽

Aaron M. Milstone ◽

Jesse T. Jacob ◽

Sheri Chernetsky-Tejedor ◽

...

Keyword(s):

Pilot Study ◽

Outcome Measure ◽

Healthcare Associated Infections ◽

Healthcare Associated Infection ◽

Follow Up Studies ◽

Potential Measure ◽

Healthcare Associated

AbstractHospital-onset bacteremia and fungemia (HOB), a potential measure of healthcare-associated infections, was evaluated in a pilot study among 60 patients across 3 hospitals. Two-thirds of all HOB events and half of nonskin commensal HOB events were judged as potentially preventable. Follow-up studies are needed to further develop this measure.

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Comprehensive assessment of disability post-stroke using the newly developed miFUNCTION scale

International Journal of Stroke ◽

10.1177/1747493019840933 ◽

2019 ◽

Vol 15 (2) ◽

pp. 167-174 ◽

Cited By ~ 2

Author(s):

Charlotte Zerna ◽

Tyler Burley ◽

Theresa L Green ◽

Sean P Dukelow ◽

Andrew M Demchuk ◽

...

Keyword(s):

Pilot Study ◽

Confidence Interval ◽

Endovascular Treatment ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Outcome Measure ◽

Observer Agreement ◽

International Classification Of Functioning ◽

Modified Rankin Scale ◽

Escape Trial

Background and Purpose The modified Rankin Scale (mRS) is the most widely used primary outcome measure in acute stroke trials. However, substantial interobserver variability impairs outcome assessment as well as reduces power of clinical trials. Guided by the International Classification of Functioning, Disability and Health, we developed a comprehensive, hierarchical assessment tool (miFUNCTION) to address the shortcomings of the modified Rankin Scale and deliver a more thorough understanding of disability following stroke. Methods The initial construct validity of miFUNCTION was established in a pilot study of patients at an outpatient stroke prevention clinic that had been diagnosed with stroke within 60 days. To further assess criterion validity, miFUNCTION was compared against the modified Rankin Scale and other outcome measures within the Endovascular Treatment for Small Core and Anterior Circulation Proximal Occlusion With Emphasis on Minimizing CT to Recanalization Times (ESCAPE) trial. Logistic regression analysis with miFUNCTION as an outcome was used to demonstrate the beneficial effect of endovascular treatment. Results The pilot study showed moderate inter-observer agreement (k = 0.585, p < 0.005) but near perfect correlation between miFUNCTION and modified Rankin Scale (ρ = 0.821, p < 0.05). The correlation of miFUNCTION and modified Rankin Scale was near perfect again in the ESCAPE trial (ρ = 0.944). Effect size of the multivariable models using modified Rankin Scale (adjusted odds ratio: 3.45, 95% confidence interval: 2.05–5.78) and miFUNCTION (adjusted odds ratio: 3.32, 95% confidence interval: 1.99–5.55) as an outcome measure for the ESCAPE trial patients was similar. Conclusions miFUNCTION is strongly associated with the degree of disability following stroke both in an outpatient setting and a clinical trial. Further work remains to assess sensitivity to change and to improve the inter-observer reliability of the scale.

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Defining failure after parathyroidectomy for primary hyperparathyroidism: case series

The Journal of Laryngology & Otology ◽

10.1017/s0022215110002562 ◽

2011 ◽

Vol 125 (4) ◽

pp. 394-398

Author(s):

S D Charlett ◽

M Aye ◽

S L Atkin ◽

R J A England

Keyword(s):

Primary Hyperparathyroidism ◽

Outcome Measure ◽

Case Series ◽

Case Review ◽

Cure Rate ◽

Retrospective Case ◽

Diagnostic Uncertainty ◽

Primary Surgery ◽

Primary Procedure ◽

Cause Of Failure

AbstractObjective:To identify the cause of operative failure in patients who have undergone parathyroid surgery for primary hyperparathyroidism.Design:Retrospective case review.Participants:Patients who had undergone a primary procedure for primary hyperparathyroidism between July 2003 and December 2007. Cases with incomplete post-operative serum calcium data were excluded.Main outcome measure:Operative failure was defined as failure to achieve normalisation of serum adjusted calcium levels post-operatively.Results:A total of 220 primary procedures were conducted over 4.5 years. Data were not available for 16 patients. Thirteen procedures (6.4 per cent) were considered failures, and these cases were individually reviewed and classified according to the reason for failure.Conclusion:Establishing the cause of failure following surgery for primary hyperparathyroidism can be a complex task. In some instances, diagnostic uncertainty remains despite detailed biochemical and radiological assessment. This paper outlines our approach to maximising the cure rate at primary surgery.

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