scholarly journals Patient-reported outcome (PRO) measure-based algorithm for clinical decision support in epilepsy outpatient follow-up: a test–retest reliability study

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e021337 ◽  
Author(s):  
Liv Marit Valen Schougaard ◽  
Annette de Thurah ◽  
David Høyrup Christiansen ◽  
Per Sidenius ◽  
Niels Henrik Hjollund
Keyword(s):  
Decision Support ◽  
Clinical Decision Support ◽  
Clinical Decision ◽  
Patient Reported Outcome ◽  
Outpatient Clinics ◽  
Validity And Reliability ◽  
Reliability Study ◽  
Retest Reliability ◽  
Patient Reported ◽  
Test Retest Reliability

ObjectivesPatient-reported outcome (PRO) measures have been used in epilepsy outpatient clinics in Denmark since 2011. The patients’ self-reported PRO data are used by clinicians as a decision aid to support whether a patient needs contact with the outpatient clinic or not based on a PRO algorithm. Validity and reliability are fundamental to any PRO measurement used at the individual level in clinical practice. The aim of this study was to evaluate the test–retest reliability of the PRO algorithm used in epilepsy outpatient clinics and to analyse whether the method of administration (web and paper) would influence the result.Design and settingTest–retest reliability study conducted in three epilepsy outpatient clinics in Central Denmark Region, Denmark.ParticipantsA total of 554 epilepsy outpatients aged 15 years or more were included from August 2016 to April 2017. The participants completed questionnaires at two time points and were randomly divided into four test–retest groups: web–web, paper–paper, web–paper and paper–web. In total, 166 patients completed web–web, 112 paper–paper, 239 web–paper and 37 paper–web.ResultsWeighted kappa with squared weight was 0.67 (95% CI 0.60 to 0.74) for the pooled PRO algorithm, and perfect agreement was observed in 82% (95% CI 78% to 85%) of the cases. There was a tendency towards higher test–retest reliability and agreement estimates within same method of administration (web–web or paper–paper) compared with a mixture of methods (web–paper and paper–web).ConclusionsThe PRO algorithm used for clinical decision support in epilepsy outpatient clinics showed moderate to substantial test–retest reliability. Different methods of administration produced similar results, but an influence of change in administration method cannot be ruled out.

Validity and test-retest reliability of a patient-reported outcome measure for an outpatient cardiac rehabilitation programme

2019 ◽  
Vol 14 (8) ◽  
pp. 1-13
Author(s):  
Aynsley Cowie ◽  
Mario Hair ◽  
Emma Kerr ◽  
Janet McKay ◽  
Lesley Allan ◽  
...  
Keyword(s):  
Cardiac Rehabilitation ◽  
Concurrent Validity ◽  
Outcome Measure ◽  
Patient Reported Outcome ◽  
Rehabilitation Programme ◽  
Cardiac Rehabilitation Programme ◽  
Retest Reliability ◽  
Patient Reported Outcome Measure ◽  
Patient Reported ◽  
Test Retest Reliability

Background/Aims This article details how a patient-reported outcome measure (PROM), termed PROM-CR1, was tested for acceptability, validity and test-retest reliability at the end of an outpatient cardiac rehabilitation programme. Methods PROM-CR1 was completed by 138 service users (mean age 66.95 years, range 42–94 years; 115 males, 23 females; with a range of cardiac diagnoses), who used the tool at home twice: once at the end of the outpatient cardiac rehabilitation programme and 1 week later. Results PROM-CR1 demonstrated good acceptability, construct and concurrent validity, and test-retest reliability. The construct validity analysis highlighted that one item required removal from the PROM-CR1. Conclusions A finalised 30-item version of the tool will now be widely disseminated and further evaluated within cardiac rehabilitation clinical practice.

Clinical decision support system to optimise symptom management in palliative medicine: focus group study

2021 ◽  
pp. bmjspcare-2021-002940
Author(s):  
Lotte van der Stap ◽  
Albert H de Heij ◽  
Agnes van der Heide ◽  
Anna KL Reyners ◽  
Yvette M van der Linden
Keyword(s):  
Palliative Care ◽  
Decision Support ◽  
Focus Group ◽  
Clinical Decision Support ◽  
Support System ◽  
Symptom Management ◽  
Clinical Decision Support System ◽  
Clinical Decision ◽  
Improve Symptom ◽  
Patient Reported

ObjectivesSuboptimal symptom control in patients with life-limiting illnesses is a major issue. A clinical decision support system (CDSS) that combines a patient-reported symptom assessment scale (SAS) and guideline-based individualised recommendations has the potential to improve symptom management. However, lacking end-user acceptance often prevents CDSS use in daily practice.We aimed to evaluate the acceptability and feasibility of a palliative care CDSS according to its targeted end-users.MethodsSix focus groups with different groups of stakeholders were conducted: (1) patient representatives; (2) community nurses; (3) hospital nurses; (4) general practitioners; (5) hospital physicians and (6) palliative care specialists. Audiotapes were transcribed verbatim and thematically analysed.ResultsFifty-one stakeholders (6–12 per focus group) participated. Six themes were discussed: effect, validity, continuity, practical usability, implementation and additional features. All participants expected a CDSS to improve symptom management, for example, by reminding clinicians of blind spots and prompting patient participation. They feared interference with professional autonomy of physicians, doubted the validity of using a patient-reported SAS as CDSS input and thought lacking care continuity would complicate CDSS use. Clinicians needed clear criteria for when to use the CDSS (eg, life-limiting illness, timing in illness trajectory). Participants preferred a patient-coordinated system but were simultaneously concerned patients may be unwilling or unable to fill out an SAS.ConclusionsA palliative care CDSS was considered useful for improving symptom management. To develop a feasible system, barriers for successful implementation must be addressed including concerns about using a patient-reported SAS, lacking care continuity and unclear indications for use.

Validity, reliability, and interpretability of the Brazilian urticaria control test

2020 ◽  
Vol 41 (3) ◽  
pp. e61-e66
Author(s):  
Sérgio Duarte Dortas Junior ◽  
Solange Oliveira Rodrigues Valle ◽  
Karsten Weller ◽  
Marcus Maurer ◽  
Omar Lupi
Keyword(s):  
Disease Control ◽  
Convergent Validity ◽  
Short Form ◽  
Internal Consistency Reliability ◽  
Patient Reported Outcome ◽  
Control Test ◽  
Validity And Reliability ◽  
Patient Reported ◽  
Excellent Internal Consistency ◽  
Test Retest Reliability

Background: The urticaria control test (UCT) is a patient-reported outcome measure designed to determine the current level of disease control in patients with chronic urticaria (CU). Recently, a Brazilian UCT was developed, but its validity and reliability are unknown. Method: The clinimetric properties of the Brazilian UCT short form (UCTsh) and its long form (UCTlg) were determined in 130 patients with CU. In parallel, the urticaria activity scores (UAS) that covers 7 days (UAS7) and 28 days (UAS28) were used to assess disease activity. Subsequently, the results were analyzed statistically to determine the validity, reliability, and interpretability of the Brazilian UCT versions. Results: A total of 107 female (82%) and 23 male patients with CU completed both versions of the Brazilian UCT. Both of the Brazilian UCT versions showed excellent internal consistency reliability. In addition, the Brazilian UCT results showed strong correlations with UAS7 and UAS28 results, which indicated high levels of convergent validity. The test-retest reliability was examined in a subsample of 27 patients with CU and was found to be excellent. Notably, the results of both Brazilian UCT versions correlated extensively, which suggested that the UCTsh can replace the UCTlg without changing the UCT results. Conclusion: The Brazilian UCT is a valid and reliable tool for assessing disease control. To facilitate the use of the Brazilian UCT in global studies and to put a stronger focus on the specificity, we propose that the same cutoff values for well-controlled disease should be used as identified in the original publication of the UCT, i.e., ≥12 points for the UCTsh.

scholarly journals Patient‐Reported Outcomes and Patient‐Reported Experience of Patients With Atrial Fibrillation in the IMPACT‐AF Clinical Trial

2021 ◽  
Author(s):  
Brittany Humphries ◽  
Jafna L. Cox ◽  
Ratika Parkash ◽  
Lehana Thabane ◽  
Gary A. Foster ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Decision Support ◽  
Clinical Decision Support ◽  
Clinical Decision ◽  
Health Related Quality ◽  
Patient Reported ◽  
Related Quality ◽  
Health Related ◽  
And Control

Background The IMPACT‐AF (Integrated Management Program Advancing Community Treatment of Atrial Fibrillation) trial is a prospective, randomized, cluster design trial comparing atrial fibrillation management with a computerized clinical decision support system with usual care (control) in the primary care setting of Nova Scotia, Canada. The objective of this analysis was to assess and compare patient‐reported health‐related quality of life and patient‐reported experience with atrial fibrillation care between clinical decision support and control groups. Methods and Results Health‐related quality of life was measured using the EuroQol 5‐dimensional 5‐level scale, whereas patient‐reported experience was assessed using a self‐administered satisfaction questionnaire, both assessed at baseline and 12 months. Health utilities were calculated using the Canadian EuroQol 5‐dimensional 5‐level value set. Descriptive statistics and generalized estimating equations were used to compare between groups. Among 1145 patients enrolled in the trial, 717 had complete EuroQol 5‐dimensional 5‐level data at baseline. The mean age of patients was 73.53 years, and 61.87% were men. Mean utilities at baseline were 0.809 (SD, 0.157) and 0.814 (SD, 0.157) for clinical decision support and control groups, respectively. At baseline, most patients in both groups reported being “very satisfied” with the care received for their atrial fibrillation. There were no statistically significant differences in utility scores or patient satisfaction between groups at 12 months. Conclusions Health‐related quality of life of patients remained stable over 12 months, and there was no significant difference in patient satisfaction or utility scores between clinical decision support and control groups. Registration information clinicaltrials.gov. Identifier: NCT01927367.

scholarly journals Validity and Reliability of the Thai Version of the Thyroid-Related Patient-Reported Outcome—A Thyroid-specific Quality of Life Questionnaire

2020 ◽  
Author(s):  
Patorn Piromchai ◽  
Supachat Chaiudomsom ◽  
Pattaramon Wijakkanalan ◽  
Torquil Watt
Keyword(s):  
Quality Of Life ◽  
Internal Consistency ◽  
Patient Reported Outcome ◽  
Face Validity ◽  
Retest Reliability ◽  
Patient Reported ◽  
The Face ◽  
Test Retest Reliability ◽  
Benign Thyroid

Abstract Introduction The Thyroid-Related Patient-Reported Outcome (ThyPRO) is a new thyroid-specific quality of life patient-reported outcome measure for benign thyroid disorders. Objective The objective of this study was to investigate the face validity, internal consistency, and test-retest reliability of the Thai version of the ThyPRO (ThyPROth). Methods The translation of the ThyPRO questionnaire was performed using double forward translation, reconciliation, single backward translation, and cognitive debriefing, followed by a panel review. Five thyroid patients evaluated the face validity. The internal consistency and test-retest reliability were evaluated in 30 patients with thyroid diseases. Results The overall validity score was 3.75 (range 0–4). The Cronbach α coefficient ranged from 0.76 to 0.95, with a total coefficient of 0.97 (95% CI 0.962–0.959), indicating excellent internal consistency. The test-retest reliability coefficient ranged from 0.70 to 0.97. All values were 0.70 and above. The total reliability coefficient was 0.86 (95% CI 0.724–0.932), indicating excellent reliability. Conclusion The ThyPROth was found to be valid and to exhibit good internal consistency and test-retest reliability. The questionnaire is ready for implementation in the assessment of health-related quality of life in Thai patients with benign thyroid diseases.

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