Proposal of a Functional Impairment Symptom Scale for Concussion

Clinicians currently administer patient-reported symptom scales to quantify and track concussion symptoms. These scales are based on subjective ratings without reference to the degree of functional impairment caused by the symptoms. Our objective was to develop a concussion symptom scale based on functional impairment and compare it to a widely used concussion symptom checklist. We conducted a retrospective chart review evaluating 133 patients age 9-22 with an acute concussion who completed 2 symptom checklists at their initial visit—the Sport Concussion Assessment Tool (SCAT-3) symptom evaluation (22 symptoms, 0-6 scale) and the proposed Functional Impairment Scale (22 symptoms, 0-3 scale related to degree of functional impairment). Mean total symptom score was 27.2±22.9 for Sport Concussion Assessment Tool–3 and 14.7±11.9 for the Functional Impairment Scale. Pearson correlation between the scales was 0.98 ( P < .001). Mean time from concussion to first visit was 6.9±6.2 days, and median clearance time after injury was 19 (95% CI 16-21) days. After adjusting for patient and injury characteristics, an increased score on each scale was associated with longer time to clearance (5-point increase in Sport Concussion Assessment Tool–3 hazard ratio 0.885, 95% CI 0.835-0.938, P < .001; 2.5-point increase in Functional Impairment Scale hazard ratio 0.851, 95% CI 0.802-0.902, P < .001). We propose a concussion symptom scale based on functional impairment that correlates strongly with the Sport Concussion Assessment Tool–3 scale, demonstrates a similar association with time to clearance, and may provide a more intuitive approach to monitoring how symptoms are affecting patients recovering from concussion. Future research should aim to validate this scale through a prospective longitudinal study.

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A Multi centre prospective longitudinal study evaluating the integration of Patient Reported Outcomes (PROMS) with key clinical outcomes after immediate Latissimus dorsi (LD) breast reconstruction and adjuvant treatment

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2012.02.029 ◽

2012 ◽

Vol 38 (5) ◽

pp. 465

Author(s):

Zoe Winters ◽

Judith Mills ◽

Joanne Haviland ◽

Alex Reece-Smith ◽

Michelle Greenslade ◽

...

Keyword(s):

Longitudinal Study ◽

Breast Reconstruction ◽

Clinical Outcomes ◽

Adjuvant Treatment ◽

Latissimus Dorsi ◽

Patient Reported Outcomes ◽

Prospective Longitudinal Study ◽

Patient Reported ◽

Prospective Longitudinal

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Comparison of Chief Complaints and Patient-Reported Symptoms of Treatment-Naive Lung Cancer Patients Before Surgery

10.21203/rs.3.rs-173687/v1 ◽

2021 ◽

Author(s):

Yaqian Feng ◽

Wei Dai ◽

Yaqin Wang ◽

Jia Liao ◽

Xing Wei ◽

...

Keyword(s):

Lung Cancer ◽

Physical Examination ◽

Cancer Patients ◽

Patient Reported Outcome ◽

Prospective Longitudinal Study ◽

Lung Cancer Patients ◽

Outcome Instrument ◽

Patient Reported ◽

Chief Complaints ◽

Prospective Longitudinal

Abstract BackgroundLung cancer patients without chief complaints have been increasingly identified by physical examination. This study aimed to profile and compare chief complaints with patient-reported symptoms of lung cancer patients before surgery.MethodsData was extracted from a multicenter, prospective longitudinal study (CN-PRO-Lung 1) in China from November 2017 and January 2020. A comparison between chief complaints and patient-reported symptoms was analyzed using the Chi-squared test.ResultsA total of 201 (50.8%) lung cancer patients without chief complaints were found by physical examination at admission, and 195(49.2%) patients had chief complaints. The top 5 chief complaints were coughing (38.1%), expectoration (25.5%), chest pain (13.6%), hemoptysis (10.6%), and shortness of breath (5.1%). There were significantly more patients with chief complaints of coughing (38.1% vs. 15.0 %, P <0.001) and pain (20.5% vs. 6.9%, P<0.001) than those with the same symptoms rated ≥4 via MDASI-LC. There were less patients with chief complaints of fatigue (1.8% vs. 10.9%, P<0.001), nausea (0.3% vs. 2.5%, P=0.006), and vomiting (0.3% vs. 1.8%, p=0.032) than those with the same symptoms rated ≥4 via MDASI-LC. In patients without chief complaints, the five most common moderate to severe patient-reported symptoms were disturbed sleep (19.5%), distress (13.5%), dry mouth (13%), sadness (12%), and difficulty remembering (11.1%).ConclusionsSymptoms of lung cancer patients not included in the chief complaint could be identified via a patient-reported outcome instrument, suggesting the necessity of implementing the patient-reported outcome assessment before lung cancer surgery for better patient care.

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What is stable pain control? A prospective longitudinal study to assess the clinical value of a personalized pain goal

Palliative Medicine ◽

10.1177/0269216317701891 ◽

2017 ◽

Vol 31 (10) ◽

pp. 913-920 ◽

Cited By ~ 5

Author(s):

Robin Fainsinger ◽

Cheryl Nekolaichuk ◽

Lara Fainsinger ◽

Viki Muller ◽

Lisa Fainsinger ◽

...

Keyword(s):

Cancer Pain ◽

Pain Intensity ◽

Classification System ◽

Pain Control ◽

Outcome Measure ◽

Prospective Longitudinal Study ◽

Goal Definition ◽

Patient Reported ◽

Prospective Longitudinal ◽

Cognitively Intact

Background: A universal consensus regarding standardized pain outcomes does not exist. The personalized pain goal has been suggested as a clinically relevant outcome measure. Aim: To assess the feasibility of obtaining a personalized pain goal and to compare a clinically based personalized pain goal definition versus a research-based study definition for stable pain. Design: Prospective longitudinal descriptive study. Measures: The attending physician completed routine assessments, including a personalized pain goal and the Edmonton Classification System for Cancer Pain, and followed patients daily until stable pain control, death, or discharge. Stable pain for cognitively intact patients was defined as pain intensity less than or equal to desired pain intensity goal (personalized pain goal definition) or pain intensity ⩽3 (Edmonton Classification System for Cancer Pain study definition) for three consecutive days with <3 breakthroughs per day. Setting/participants: A total of 300 consecutive advanced cancer patients were recruited from two acute care hospitals and a tertiary palliative care unit. Results: In all, 231/300 patients (77%) had a pain syndrome; 169/231 (73%) provided a personalized pain goal, with 113/169 (67%) reporting a personalized pain goal ⩽3 (median = 3, range = 0–10). Using the personalized pain goal definition as the gold standard, sensitivity and specificity of the Edmonton Classification System for Cancer Pain definition were 71.3% and 98.5%, respectively. For mild (0–3), moderate (4–6), and severe (7–10) pain, the highest sensitivity was for moderate pain (90.5%), with high specificity across all three categories (95%–100%). Conclusion: The personalized pain goal is a feasible outcome measure for cognitively intact patients. The Edmonton Classification System for Cancer Pain definition closely resembles patient-reported personalized pain goals for stable pain and would be appropriate for research purposes. For clinical pain management, it would be important to include the personalized pain goal as standard practice.

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Electronic von Frey as an objective assessment tool for oxaliplatin‐induced peripheral neuropathy: A prospective longitudinal study

European Journal of Cancer Care ◽

10.1111/ecc.13360 ◽

2020 ◽

Author(s):

Priscilla A. R. Godinho ◽

Paulo G. B. Silva ◽

Mario R. P. Lisboa ◽

Bruno A. Costa ◽

Markus A. C. Gifoni ◽

...

Keyword(s):

Longitudinal Study ◽

Peripheral Neuropathy ◽

Assessment Tool ◽

Objective Assessment ◽

Prospective Longitudinal Study ◽

Prospective Longitudinal

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Associations between readmission and patient-reported measures in acute psychiatric inpatients: a study protocol for a multicenter prospective longitudinal study (the ePOP-J study)

International Journal of Mental Health Systems ◽

10.1186/s13033-019-0298-3 ◽

2019 ◽

Vol 13 (1) ◽

Cited By ~ 4

Author(s):

Sosei Yamaguchi ◽

Yasutaka Ojio ◽

Junko Koike ◽

Asami Matsunaga ◽

Makoto Ogawa ◽

...

Keyword(s):

Longitudinal Study ◽

Study Protocol ◽

Psychiatric Inpatients ◽

Prospective Longitudinal Study ◽

Patient Reported ◽

Patient Reported Measures ◽

Prospective Longitudinal

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Patient-reported wellbeing and clinical disease measures over time captured by multivariate trajectories of disease activity in individuals with juvenile idiopathic arthritis in the UK: a multicentre prospective longitudinal study

The Lancet Rheumatology ◽

10.1016/s2665-9913(20)30269-1 ◽

2020 ◽

Cited By ~ 1

Author(s):

Stephanie J W Shoop-Worrall ◽

Kimme L Hyrich ◽

Lucy R Wedderburn ◽

Wendy Thomson ◽

Nophar Geifman ◽

...

Keyword(s):

Juvenile Idiopathic Arthritis ◽

Longitudinal Study ◽

Disease Activity ◽

Clinical Disease ◽

Prospective Longitudinal Study ◽

Patient Reported ◽

The Uk ◽

Prospective Longitudinal ◽

Over Time

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Digital Biomarkers of Perioperative Patient-Reported Symptom Burden in Pancreatic Surgery Patients (Preprint)

10.2196/preprints.27975 ◽

2021 ◽

Author(s):

Carissa A Low ◽

Meng Li ◽

Julio Vega ◽

Krina C Durica ◽

Denzil Ferreira ◽

...

Keyword(s):

Heart Rate ◽

Pancreatic Surgery ◽

Symptom Burden ◽

Small Sample ◽

Prospective Longitudinal Study ◽

Management Interventions ◽

Patient Reported ◽

Before And After ◽

Prospective Longitudinal ◽

Digital Biomarkers

BACKGROUND Cancer treatments can cause a variety of symptoms that impair quality of life and functioning but are frequently missed by clinicians. Smartphone and wearable sensors may capture behavioral and physiological changes indicative of symptom burden, enabling passive and remote real-time monitoring of fluctuating symptoms. OBJECTIVE The aim of this study was to examine whether smartphone and Fitbit data could be used to estimate daily symptom burden before and after pancreatic surgery. METHODS Forty-four patients scheduled for pancreatic surgery participated in this prospective longitudinal study and provided sufficient sensor and self-reported symptom data for analyses. Participants collected smartphone sensor and Fitbit data and completed daily symptom ratings starting at least two weeks before surgery, throughout their inpatient recovery, and for up to 60 days after postoperative discharge. Day-level behavioral features reflecting mobility and activity patterns, sleep, screen time, heart rate, and communication were extracted from raw smartphone and Fitbit data and used to classify the next day as high or low symptom burden, adjusted for each individual’s typical level of reported symptoms. In addition to overall symptom burden, we also examined pain, fatigue, and diarrhea specifically. RESULTS Models using LightGBM were able to correctly predict whether the next day would be a high symptom day with 73.5% accuracy, surpassing baseline models. The most important sensor features for discriminating high symptom days were related to physical activity bouts, sleep, heart rate, and location. LightGBM models predicting next day diarrhea (79.0% accuracy), fatigue (75.8% accuracy), and pain (79.6% accuracy) performed similarly. CONCLUSIONS Results suggest that digital biomarkers may be useful in predicting patient-reported symptom burden before and after cancer surgery. Although model performance in this small sample may not be adequate for clinical implementation, findings support the feasibility of collecting mobile sensor data from older acutely ill patients as well as the potential clinical value of mobile sensing for passive monitoring of cancer patients and suggests that data from devices that many patients already own and use may be useful in detecting worsening perioperative symptoms and triggering just-in-time symptom management interventions.

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