scholarly journals Patient-Reported Outcomes of Split-Thickness Skin Grafts for Floor of Mouth Cancer Reconstruction

ORL ◽  
2021 ◽  
pp. 1-8
Author(s):  
Andrew R. Larson ◽  
Mary Han ◽  
Katherine L. Webb ◽  
Edgar Ochoa ◽  
Gaelen Stanford-Moore ◽  
...  
Keyword(s):  
Early Stage ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Cancer Center ◽  
Split Thickness Skin Graft ◽  
Cross Sectional ◽  
Floor Of Mouth ◽  
Thickness Skin ◽  
Patient Reported ◽  
Tumor Involvement

<b><i>Introduction:</i></b> Patient-reported outcome measures (PROM) on quality of life (QOL) for early-stage floor of mouth carcinoma (FOM-CA) undergoing surgical resection and split-thickness skin graft (STSG) reconstruction have not been established. We have performed a cross-sectional QOL analysis of such patients to define functional postoperative outcomes. <b><i>Methods:</i></b> Patients with pathologic stage T1/T2 FOM-CA who underwent resection and STSG reconstruction at a tertiary academic cancer center reported outcomes with the University of Washington QOL (v4) questionnaire after at least 6 months since surgery. <b><i>Results:</i></b> Twenty-four out of 49 eligible patients completed questionnaires with a mean follow-up of 41 months (range: 6–88). Subsites of tumor involvement/resection included the following: (1) lateral FOM (L-FOM) (<i>n</i> = 17), (2) anterior FOM (A-FOM) (<i>n</i> = 4), and (3) alveolar ridge with FOM, all of whom underwent lateral marginal mandibulectomy (MM-FOM) (<i>n</i> = 3). All patients reported swallowing scores of 70 (“I cannot swallow certain solid foods”) or better. Ninety-six percent (23/24) reported speech of 70 (“difficulty saying some words, but I can be understood over the phone”) or better. A-FOM patients reported worse chewing than L-FOM patients (mean: 50.0 vs. 85.3; <i>p</i> = 0.01). All 4 A-FOM patients reported a low chewing score of 50 (“I can eat soft solids but cannot chew some foods”). Otherwise, there were no significant differences between subsite groups in swallowing, speech, or taste. <b><i>Conclusion:</i></b> STSG reconstructions for pathologic T1–T2 FOM-CA appear to result in acceptable PROM QOL outcomes with the exception of A-FOM tumors having worse chewing outcomes.

scholarly journals The Correlation of Communication Effectiveness and Patient Satisfaction

2021 ◽  
Vol 8 ◽  
pp. 237437352199883
Author(s):  
Yvonne Versluijs ◽  
Maartje Lemmers ◽  
Laura E. Brown ◽  
Amanda I. Gonzalez ◽  
Joost T. P. Kortlever ◽  
...  
Keyword(s):  
Pain Intensity ◽  
Patient Reported Outcome Measures ◽  
Cross Sectional Study ◽  
Patient Reported Outcome ◽  
Communication Effectiveness ◽  
Cross Sectional ◽  
Patient Reported ◽  
Ceiling Effects ◽  
As Relationship ◽  
Current Experience

This study assessed the correlation of 9 questions addressing communication effectiveness (the Communication Effectiveness Questionnaire [CEQ]) with other patient-reported experience measures (PREMs; satisfaction, perceived empathy) as well as patient-reported outcome measures (PROMs; pain intensity, activity tolerance) in patients with musculoskeletal illness or injury. In a cross-sectional study, 210 patients visiting an orthopedic surgeon completed the CEQ and measures of satisfaction with the visit, perceived empathy, pain intensity, and activity tolerance. We evaluated correlations between CEQ and other PREMs and CEQ and PROMs. We measured ceiling effects of the PREMs. Communication effectiveness correlated moderately with other PREMs such as satisfaction (ρ = 0.54; P < .001) and perceived empathy (ρ = 0.54; P < .001). Communication effectiveness did not correlate with PROMs: pain intensity (ρ = −0.01; P = .93) and activity tolerance (ρ = −0.05; P = .44). All of the experience measures have high ceiling effects: perceived empathy 37%, satisfaction 80%, and CEQ 46%. The observation of notable correlations of various PREMs, combined with their high ceiling effects, direct us to identify a likely common statistical construct (which we hypothesize as “relationship”) accounting for variation in PREMs, and then develop a PREM which measures that construct in a manner that results in a Gaussian distribution of scores. At least within the limitations of current experience measures, there seems to be no association between illness (PROMs) and experience (PREMs).

scholarly journals Patient-reported outcome measures in hemodialysis patients: results of the first multicenter cross-sectional ePROMs study in France

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Abdallah Guerraoui ◽  
Mathilde Prezelin-Reydit ◽  
Anne Kolko ◽  
Marie Lino-Daniel ◽  
Charlotte Dumas de Roque ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Recovery Time ◽  
Patient Characteristics ◽  
Patient Reported Outcome Measures ◽  
Cross Sectional Study ◽  
Patient Reported Outcome ◽  
Dialysis Session ◽  
Cross Sectional ◽  
Cardiovascular Comorbidities ◽  
Patient Reported

Abstract Background Kidney failure with replacement therapy and hemodialysis are associated with a decrease in quality of life (QOL). Self-reported QOL symptoms are not always prioritized by the medical team, potentially leading to conflicting priorities with patients. Electronic patient-reported outcome measures (ePROMs) allow physicians to better identify these symptoms. The objective was to describe the prevalence of symptoms self-reported by hemodialysis (HD) patients. Methods A multicenter cross-sectional study was conducted in three HD centers. Patients were included if they were 18 years old or over treated with HD for at least 3 months in a center. Data were collected by the patient via a self-administered ePROMs questionnaire. Data included patient characteristics, post-dialysis fatigue and intensity, recovery time after a session, perceived stress, impaired sleep the day before the dialysis session, current state of health and the change from the past year. A multivariate analysis was conducted to identify relations between symptoms. Results In total, we included 173 patients with a mean age of 66.2 years, a mean ± SD hemodialysis duration of 48.9 ± 58.02 months. The prevalence of fatigue was 72%. 66% had a high level of stress (level B or C). Recovery time was more than 6 h after a HD session for 25% of patients and 78% declared they had a better or unchanged health status than the previous year. Sleep disturbance was associated with cardiovascular comorbidities (OR 5.08 [95% CI, 1.56 to 16.59], p = 0.007). Conclusions Fatigue and stress were the main symptoms reported by HD patients. The patient’s care teams should better consider these symptoms.

scholarly journals Digital patient-reported outcome measures (PROMs) for remote monitoring of patients on cancer treatment: a cross-sectional questionnaire feasibility study (Preprint)

2020 ◽  
Author(s):  
Mayuran Ananth Sivanandan ◽  
Catherine Sharma ◽  
Pippa Bullard ◽  
Judith Christian
Keyword(s):  
Cancer Treatment ◽  
Outcome Measures ◽  
Remote Monitoring ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Severe Toxicity ◽  
Cross Sectional ◽  
Treatment Pathways ◽  
Face To Face ◽  
Patient Reported

BACKGROUND Oncology has increasing outpatient activity related to increased cancer incidence, better survival rates and more treatments. Innovative technological solutions could help deal with this increasing demand and digital patient-reported outcome measures (PROMs) to identify those patients that need a face-to-face (FTF) appointment is one potential approach. OBJECTIVE Our study aimed to assess the feasibility of digital PROM questionnaires to enable remote symptom monitoring for patients on cancer treatment and their ability to determine the requirement for a FTF appointment. METHODS This study was performed at a tertiary oncology centre between December 2018 and February 2019. Target clinics covered both systemic therapy and radiotherapy cohorts. The Common Terminology Criteria for Adverse Events (CTCAE) helped form the basis for acute toxicity questionnaires which were adapted into patient-friendly language. Treatment-specific digital PROM questionnaires were answered by patients and their clinicians alongside face-to-face appointments. Patients and clinicians did not see each other’s results, which were not used for clinical decisions. Agreement between patients and clinicians was assessed through descriptive statistics. Patient and staff feedback was also obtained. RESULTS 90 patients took part in the study across 10 different treatment pathways. By comparing paired patient and clinician responses, the sensitivity of the patient-completed questionnaires in correctly determining the need for FTF review was 93.6% and no patients with severe toxicity would have been missed with the questionnaires. Digital PROMs revealed 28.9% of participating patients did not need FTF review based on their symptoms. Certain oncological treatment pathways, such as immunotherapy, were found to have a larger proportion of patients with minimal symptoms compared to others, such as conventional chemotherapy. Patient and staff feedback showed high approval with digital PROMs and their potential for use in remote monitoring. CONCLUSIONS Digital PROM questionnaires can feasibly determine the need for FTF review in ‘on treatment’ oncology clinics. Their use with specific treatments could safely reduce the requirement for FTF care and future work should evaluate their application in the remote monitoring of patients.

scholarly journals Clinical Significance and Diagnostic Value of Pain Extent Extracted from Pain Drawings: A Scoping Review

Diagnostics ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. 604
Author(s):  
Marco Barbero ◽  
Marcos J. Navarro-Santana ◽  
María Palacios-Ceña ◽  
Ricardo Ortega-Santiago ◽  
Corrado Cescon ◽  
...  
Keyword(s):  
Cohort Studies ◽  
Outcome Measures ◽  
Scoping Review ◽  
Methodological Quality ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Cross Sectional ◽  
Patient Reported ◽  
Pain Drawings ◽  
Pain Extent

The current scoping review aimed to map current literature investigating the relationship between pain extent extracted from pain drawings with clinical, psychological, and psycho-physiological patient-reported outcome measures in people with pain. Electronic databases were searched for cross-sectional cohort studies that collected pain drawings using digital technology or a pen-on-paper approach and assessed for correlations between pain extent and clinical, psychological or psycho-physical outcomes. Data were extracted by two different reviewers. The methodological quality of studies was assessed using the Newcastle–Ottawa Quality Assessment Scale. Mapping of the results included: 1, description of included studies; 2, summary of results; and 3, identification of gaps in the existing literature. Eleven cross-sectional cohort studies were included. The pain disorders considered were heterogeneous, ranging from musculoskeletal to neuropathic conditions, and from localized to generalized pain conditions. All studies included pain and/or pain-related disability as clinical outcomes. Psychological outcomes included depression and anxiety, kinesiophobia and catastrophism. Psycho-physical measures included pressure or thermal pain thresholds. Ten studies were considered of high methodological quality. There was heterogeneity in the associations between pain extent and patient-reported outcome measures depending on the pain condition. This scoping review found that pain extent is associated with patient-reported outcome measures more so in patients presenting with musculoskeletal pain, e.g., neck pain or osteoarthritis, rather than for those with neuropathic pain or headache.

scholarly journals Clinico-demographic Profile of Undifferentiated Inflammatory Arthritis Patients

2020 ◽  
Vol 18 (2) ◽  
pp. 288-292
Author(s):  
Binit Vaidya ◽  
Manisha Bhochhibhoya ◽  
Rakshya Joshi ◽  
Bhoj raj Adhikari ◽  
Shweta Nakarmi
Keyword(s):  
Inflammatory Arthritis ◽  
Smoking Status ◽  
Health Assessment ◽  
Patient Reported Outcome Measures ◽  
Cross Sectional Study ◽  
Patient Reported Outcome ◽  
Tender Joint ◽  
Cross Sectional ◽  
Markers Of Inflammation ◽  
Patient Reported

Background: Undifferentiated inflammatory arthritis is a group of inflammatory joint diseases that do not fulfil the classification criteria for any other rheumatic or connective tissue disorders. This study aims to describe the clinical, demographic and serological features of undifferentiated inflammatory arthritis cases presenting at a tertiary level rheumatology centre from Nepal.Methods: A descriptive cross-sectional study conducted at National Centre for Rheumatic Diseases, Kathmandu, Nepal which represents a midterm analysis of the undifferentiated inflammatory arthritis registry maintained at the centre. Patients more than 18 years of age, who consented for the study having least one swollen or tender joint were enrolled. Ethical approval was obtained from Nepal Health Research Council.Results: A total of 1120 patients were enrolled in the study out of which 941 (84%) were females. The mean age at diagnosis was 46.0±12.8 years and most of them were in overweight range (mean BMI: 27.0±5.8) with 818 (73%) patients having BMI more than 24.0. Patients mostly had low disease activity at presentation (DAS 28 score of 2.5±0.8). Other markers of inflammation and patient reported outcome measures (health assessment questionnaire, patient global assessment and visual analogue scale) were also in the moderate range. Seropositivity for anti-citrullinated peptides and anti-nuclear antibodies was seen in 5 (0.45%) and 43 (3.8%) patients respectively. Majority of patients were non-smokers (77%). Inflammatory arthritis on musculoskeletal ultrasonography was seen in 638 (57%).Conclusions: Undifferentiated inflammatory arthritis was more common in overweight females. Serological markers and smoking status are not common features in these patients. Keywords: Early arthritis; Nepal; undifferentiated arthritis.

scholarly journals Use of patient-reported outcome measures (PROMs) by orthopedic surgeons in Saudi Arabia

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Fayez Alshehri ◽  
Abdulaziz Alarabi ◽  
Mohammed Alharthi ◽  
Thamer Alanazi ◽  
Ahmed Alohali ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Outcome Measures ◽  
Clinical Work ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Hard Copy ◽  
Clinical Activity ◽  
Cross Sectional ◽  
Orthopedic Surgeons ◽  
Patient Reported

Abstract Background There is increasing literature on the usefulness of patient-reported outcome measures (PROMs), but far fewer studies to determine their use by orthopedic surgeons and the barriers they face in applying PROMs in their daily clinical activity. Methods Cross-sectional study using a questionnaire that was distributed in both soft and hard copy formats to a sample of 262 orthopedic surgeons. Participants included orthopedic surgeons who are employed by the Ministry of Health (MOH) in Riyadh and the Eastern Province, Saudi Arabia. The questionnaire was distributed through on-site visitations to orthopedic departments in MOH hospitals as well as through online correspondence by email, WhatsApp, and social media. Results The study sample included 262 orthopedic surgeons (13.7% females and 86.3% males). Surgeons aged < 34, 35–44, and 45–54 years old represented 28.66%, 38.9%, and 20.2% of the study sample, respectively. The majority of the included surgeons did not use PROMs (69.1%), and some (17.2%) used it for research purposes. Only 5% used it regularly in daily clinical work. Conclusion The clinical use of PROMs among orthopedic surgeons was negligible, even though an overwhelming majority were interested in using PROMs. The reasons provided included a lack of knowledge on how to use PROMs and the perception that it is too time-consuming to add to regular clinical routine. There should be more efforts towards training surgeons on how to use PROMs, whereas increasing compatibility with existing software tools used by MOH hospitals may help offset time-related reservations.

scholarly journals Self-Management of Hip Osteoarthritis Five Years After a Cycling and Education Treatment Pathway

Healthcare ◽  
2020 ◽  
Vol 8 (1) ◽  
pp. 37
Author(s):  
Thomas W. Wainwright ◽  
Louise C. Burgess ◽  
Tikki Immins ◽  
Robert G. Middleton
Keyword(s):  
Hip Osteoarthritis ◽  
Education Programme ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Hip Pain ◽  
Long Term Effects ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Treatment Pathway ◽  
Patient Reported

The Cycling against Hip Pain (CHAIN) programme is a six-week cycling and education treatment pathway for people with hip osteoarthritis. Preliminary results demonstrated significant improvements in clinical and patient-reported outcome measures following the course. Whilst the benefits of exercise for osteoarthritis are often reported in the short term, less is known about the long-term effects for this patient group. This study explores whether participants continued to self-manage their hip osteoarthritis five years after completing the course. A cross-sectional survey was conducted to collect data from participants who completed the CHAIN programme between October 2013 and February 2015 (n = 96). Questionnaires were sent by post in April 2019, and then non-responders were followed up again four weeks later. Eighty-three (87%) participants responded to the survey. Five years (range 4–6) after completion of a six-week cycling and education programme, 37 (45%) participants had not returned to their general practitioner for further treatment of their hip pain, and 47 (57%) had not pursued surgical intervention. All participants were still engaged in at least one physical activity per week and many reported that they had purchased a bike (29%), joined a gym (30%) or cycled regularly (indoor cycling 25%, outdoor cycling 24%). Eighty (96%) participants reported an increase in knowledge of self-managing their symptoms. The findings from this study suggest that many patients are motivated to self-manage their hip osteoarthritis, five years following a six-week cycling and education treatment pathway that encourages lifestyle change.

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