Objective versus Subjective Outcomes Assessment in Rhinology

2005 ◽  
Vol 19 (5) ◽  
pp. 529-535 ◽  
Author(s):  
Michael G. Stewart ◽  
Timothy L. Smith
Keyword(s):  
Outcomes Assessment ◽  
Objective Assessment ◽  
Subjective Perception ◽  
Cross Sectional ◽  
Subjective Testing ◽  
Sectional Analysis ◽  
The Relationship ◽  
Subjective Outcomes ◽  
Tomography Scan

Background Prior studies on the relationship between computed tomography scan findings and patient-based quality of life in chronic rhinosinusitis (CRS) have found very low correlations. Whereas surprising, similar findings have been noted in other diseases. Methods We performed a cross-sectional analysis of the association between objective and subjective findings in nasal septal deformity and a systematic review and synthesis of the literature on CRS and other diseases. Results We found no association between objective anatomic findings and subjective symptoms in nasal obstruction (R = 0.03; Kruskal–Wallis test, p = 0.97). Multiple studies in CRS and other diseases—sleep apnea, hearing loss, asthma, etc.—have found similarly low correlations between objective and subjective testing. Conclusion For nasal septal deviation and CRS, the patient's subjective perception of disease severity has, at best, a very weak association with objective assessment of severity. Patient-based outcomes assessment remains important; these instruments apparently quantify an aspect of disease not detected by objective testing.

Discordance Between Subjective and Objective Measures of Smell and Taste in US Adults

2021 ◽  
pp. 019459982110183
Author(s):  
Sophie S. Jang ◽  
Janet S. Choi ◽  
James H. Kim ◽  
Natalie Kim ◽  
Elisabeth H. Ference
Keyword(s):  
Odds Ratio ◽  
Objective Assessment ◽  
Objective Measures ◽  
Subjective Perception ◽  
Sampling Weights ◽  
Cross Sectional ◽  
Health And Nutrition ◽  
The Difference ◽  
Sectional Analysis ◽  
Smell Tests

Objective Examine the rates and factors associated with under- and overreporting of subjective changes in smell or taste as compared with objective measures. Study Design Cross-sectional analysis. Setting National Health and Nutrition Examination Survey (2013-2014). Methods We examined participants ≥40 years old who completed subjective questionnaires (smell, n = 3510; taste, n = 3089), validated objective 8-odor pocket smell tests, and NaCl/quinine taste tests. Over- and underreporting was determined by the difference in subjective and objective results. Univariate and multivariate logistic regression analyses incorporated sampling weights. Results A majority of participants correctly classified impairment: smell (73.7%; 95% CI, 71.2%-76.1%) and taste (78.3%; 95% CI, 75.6%-80.7%). Age ≥65 years (odds ratio, 2.23; P = .001) was associated with underreporting impairment, and persistent cold symptoms (odds ratio, 2.15; P = .001) were associated with overreporting smell impairment. Smoke, onion, and natural gas scents were incorrectly identified more frequently by individuals aged ≥65 years after Bonferroni correction. No factors were associated with under- and overreporting taste impairment. Conclusion Although the concordance rate between subjective and objective assessment of smell and taste impairment remains high, we found that older age was associated with incorrect report of impairment. This suggests that the subjective perception of smell varies across demographical and clinical factors, and it is important to not overlook such factors in clinical practice. Potentially using a simplified odor assessment regularly in the clinical setting may aid in early detection and intervention.

scholarly journals Strength of Recommendation and Quality of Evidence for Recommendations in Current Infectious Diseases Society of America Guidelines

2021 ◽  
Vol 8 (2) ◽  
Author(s):  
Kaitlin E Miles ◽  
Ryan Rodriguez ◽  
Alan E Gross ◽  
Andre C Kalil
Keyword(s):  
Disease Management ◽  
Infectious Diseases ◽  
Systematic Approach ◽  
Good Practice ◽  
Cross Sectional ◽  
Quality Of Evidence ◽  
Assessment Development ◽  
Sectional Analysis ◽  
The Relationship

Abstract Background Grading of Recommendations Assessment, Development, and Evaluation (GRADE) is a systematic approach to grading strength of recommendation (SOR) and quality of evidence (QOE) for guideline recommendations. We aimed to assess the relationship between SOR and QOE in current Infectious Diseases Society of America (IDSA) guidelines. Methods In this cross-sectional analysis, we analyzed the frequency of SOR-QOE pairings, including discordance (defined as strong SOR based on expert opinion, very low, or low QOE) for GRADEd recommendations in IDSA guidelines published since 2010. Data for each recommendation were extracted on SOR, QOE, the domain of disease management (one or more of diagnosis, treatment, prevention, and other categories), and relevance to drug or nondrug treatment. Results Seventeen eligible guidelines provided 1042 unique GRADEd recommendations (n = 237, 711, 76, and 73 pertaining to diagnosis, treatment, prevention, and other domains, respectively; n = 574 and 137 pertaining to drug and nondrug treatment). Overall, the most common SOR was strong (71.8%; n = 748) and the most common QOE was low (48.6%; n = 506). Among all strong recommendations, 47.1% (n = 352) demonstrated discordance with QOE. By domain, strong recommendations were discordant in 36.6%, 51.4%, 29.3%, and 58.1% of recommendations pertaining to diagnosis, treatment, prevention, and other domains, respectively. Similarly, 50.7% and 54.0% of strong recommendations related to drug and nondrug treatment were discordant, respectively. We identified 39.6% of discordant recommendations to be consistent with good practice statements, which are recommended to be labeled as such without formal GRADEd designations of SOR or QOE. Conclusions Among all IDSA guideline recommendations with strong SOR, approximately half were discordant with QOE, and this frequency varied across strata of domains of disease management.

Modified Quantitative Testing and QoL in Allergic Rhinitis

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P29-P29
Author(s):  
Charles S. Coffey ◽  
Richard J. Harvey ◽  
Jamie I. Woody ◽  
Sarah K. Koepp ◽  
Patrick Sheahan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Allergic Rhinitis ◽  
Symptom Severity ◽  
Objective Assessment ◽  
Cross Sectional Study ◽  
Therapeutic Interventions ◽  
Life Questionnaire ◽  
Cross Sectional ◽  
The Relationship

Objective (1) Assess the relationship between QoL, objective assessment and confounding factors. (2) Describe a model representing the severity of pathology and predicting potential responses from therapeutic interventions beyond Quality of Life measurements alone. Methods A cross-sectional study of allergic rhinitis (AR) patients, from a teritary rhinology clinic in 2007, with Modified Quantitative Testing (MQT) and Mini-Rhinoconjuctivitis Quality of Life Questionnaire (mRQLQ) assessments was performed. Correlation and regression analyses assessed the relationship of mRQLQ, MQT endpoints, and number of reactive antigens. Results 47 patients (53% female, mean age 36.0 ± 16.3yrs) were assessed. Percentage of positive antigens was a significant factor that decreased mRQLQ (p=0.05). Maximal MQT endpoint (mMQT) correlates well to mRQLQ when controlled for percentage of positive antigens (p=0.038). In a regression analysis to predict mRQLQ, percentage of positive antigens and mMQT were good predictors (p=0.018 for percent positive antigens; p=0.038 for mMQT) and such a model was significantly linked to those factors (F=3.2, p=0.05). Conclusions Semi-quantitative measurement by MQT correlates with symptom severity in AR when broad reactivity does not exist. Adaptation in QoL scores may occur with more atopic individuals. A model for predicting QoL and symptom severity as measured by mRQLQ based upon MQT is presented. Such systems may enhance our ability to predict clinical outcomes, compare research cohorts, and better educate patients on treatment benefits.

HUBUNGAN KUALITAS KEHIDUPAN KERJA TERHADAP KINERJA PERAWAT PELAKSANA

2019 ◽  
Vol 9 (4) ◽  
pp. 413-420
Author(s):  
Amella Gusty ◽  
Dachriyanus Dachriyanus ◽  
Leni Merdawati
Keyword(s):  
District Hospital ◽  
Simple Random Sampling ◽  
Work Life ◽  
Quality Of Work Life ◽  
P Value ◽  
Work Context ◽  
Cross Sectional ◽  
Quality Of Work ◽  
The Relationship

Kinerja perawat merupakan hasil yang dicapai dalam melaksanakan asuhan keperawatan di rumah sakit. Terciptanya asuhan keperawatan yang optimal sangat diperlukan dukungan dari pihak rumah sakit salah satunya adalah menciptakan kualitas kehidupan kerja baik bagi perawat. Penelitian ini bertujuan untuk mengetahui hubungan antara kualitas kehidupan kerja terhadap kinerja perawat pelaksana di RSUD Teluk Kuantan. Jenis penelitian kuantitatif dengan pendekatan cross sectional. Jumlah sampel 120 responden yang diperoleh melalui proportionate simple random sampling. Hasil penelitian menunjukkan kualitas kehidupan kerja perawat RSUD Teluk Kuantan berada pada kategori sedang, kinerja perawat berada pada kategori kurang baik. Berdasarkan analisis kedua variabel teridentifikasi bahwa tidak ada hubungan antara kualitas kehidupan kerja dengan kinerja perawat pelaksana dengan  p value 0,817. Dimensi work context merupakan komponen yang memiliki hubungan dengan kinerja perawat pelaksana dengan p value 0,008, dimensi work life  tidak berhubungan secara signifikan dengan kinerja perawat. Kesimpulan penelitian diketahui tidak ada hubungan antara kualitas kehidupan kerja dengan kinerja perawat pelaksana. Ada hubungan dimensi work context dengan kinerja perawat pelaksana. Tidak ada hubungan dimensi work life dengan kinerja perawat.   Kata kunci: kualitas kehidupan kerja, kinerja, perawat pelaksana   THE RELATIONSHIP BETWEEN THE QUALITY OF WORK LIFE AND THE PERFORMANCE OF IMPLEMENTERS NURSES   ABSTRACT Nurse performance is the result achieved in implementing nursing care in a hospital. The creation of optimal nursing care is very much needed support from the hospital, one of which is to create a good quality of work life for nurses. This study aims to determine the relationship between the quality of work life and the performance of nurses at the Kuantan District Hospital. This type of quantitative research with cross sectional approach. The number of samples of 120 respondents obtained through proportionate simple random sampling. The results showed that the quality of work life of nurses at the Kuantan District Hospital was in the medium category, the nurses' performance was in the unfavorable category. Based on the analysis of the two variables, it was identified that there was no relationship between the quality of work life with the performance of implementing nurses with a p value of 0.817. The work context dimension is a component that has a relationship with the performance of nurses implementing with p value 0.008, the dimension of work life does not significantly correlate with nurse performance. The conclusion of the research is that there is no relationship between the quality of work life and the performance of the implementing nurses. There is a relationship between the dimensions of the work context and the performance of the nurses. There is no relationship between the dimensions of work life and nurse performance.   Keywords: quality of work life, performance, implementers nurse

scholarly journals Downregulation of exosomal let-7d and miR-16 in idiopathic pulmonary fibrosis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Donato Lacedonia ◽  
Giulia Scioscia ◽  
Piera Soccio ◽  
Massimo Conese ◽  
Lucia Catucci ◽  
...  
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Therapy Response ◽  
Down Regulation ◽  
Cross Sectional ◽  
Exosomal Mirnas ◽  
Different Types ◽  
Sectional Analysis ◽  
Made In

Abstract Background Idiopathic Pulmonary Fibrosis (IPF) is a degenerative interstitial lung disease with both a poor prognosis and quality of life once the diagnosis is made. In the last decade many features of the disease have been investigated to better understand the pathological steps that lead to the onset of the disease and, moreover, different types of biomarkers have been tested to find valid diagnostic, prognostic and therapy response predictive ones. In the complexity of IPF, microRNA (miRNAs) biomarker investigation seems to be promising. Methods We analysed the expression of five exosomal miRNAs supposed to have a role in the pathogenesis of the disease from serum of a group of IPF patients (n = 61) and we compared it with the expression of the same miRNAs in a group of healthy controls (n = 15). Results In the current study what emerged is let-7d down-regulation and, unexpectedly, miR-16 significant down-regulation. Moreover, through a cross-sectional analysis, a clustering of the expression of miR-16, miR-21 and miR-26a was found. Conclusions These findings could help the individuation of previously unknown key players in the pathophysiology of IPF and, most interestingly, more specific targets for the development of effective medications.

The Opioid Epidemic and Homicide in the United States

2021 ◽  
pp. 002242782098684
Author(s):  
Richard Rosenfeld ◽  
Joel Wallman ◽  
Randolph Roth
Keyword(s):  
United States ◽  
Death Rate ◽  
The United States ◽  
Opioid Epidemic ◽  
Drug Markets ◽  
Cross Sectional ◽  
Homicide Rates ◽  
Overdose Death ◽  
Sectional Analysis ◽  
The Relationship

Objectives: Evaluate the relationship between the opioid epidemic and homicide rates in the United States. Methods: A county-level cross-sectional analysis covering the period 1999 to 2015. The race-specific homicide rate and the race-specific opioid-related overdose death rate are regressed on demographic, social, and economic covariates. Results: The race-specific opioid-related overdose death rate is positively associated with race-specific homicide rates, net of controls. The results are generally robust across alternative samples and model specifications. Conclusions: We interpret the results as reflecting the violent dynamics of street drug markets, although more research is needed to draw definitive conclusions about the mechanisms linking opioid demand and homicide.

Objective and Subjective Outcomes in Patients with Hearing Aids: A Cross-Sectional, Comparative, Associational Study

2021 ◽  
pp. 1-9
Author(s):  
Xunyi Wang ◽  
Yun Zheng ◽  
Gang Li ◽  
Jingzhe Lu ◽  
Yan Yin
Keyword(s):  
Hearing Aids ◽  
Patient Reported Outcomes ◽  
Cross Sectional ◽  
Patient Reported ◽  
Objective Tests ◽  
The Difference ◽  
Potential Factors ◽  
Positive Correlations ◽  
The Relationship ◽  
Subjective Outcomes

<b><i>Introduction:</i></b> Outcome assessment for hearing aids (HAs) is an essential part of HA fitting and validation. There is no consensus about the best or standard approach for evaluating HA outcomes. And, the relationship between objective and subjective measures is ambiguous. This study aimed to determine the outcomes after HA fitting, explore correlations between subjective benefit and acoustic gain improvement as well as objective audiologic tests, and investigate several variables that may improve patients’ perceived benefits. <b><i>Methods:</i></b> Eighty adults with bilateral symmetrical hearing loss using HAs for at least 1 month were included in this study. All subjects completed the pure tone average (PTA) threshold and word recognition score (WRS) tests in unaided and aided conditions. We also administered the Chinese version of International Outcome Inventory for Hearing Aids (IOI-HA), to measure participants’ subjective benefits. Objective HA benefit (acoustic gain improvement) was defined as the difference in thresholds or scores between aided and unaided conditions indicated with ΔPTA and ΔWRS. Thus, patients’ baseline hearing levels were taken into account. Correlations were assessed among objective audiologic tests (PTA and WRS), acoustic gain improvement (ΔPTA and ΔWRS), multiple potential factors, and IOI-HA overall scores. <b><i>Results:</i></b> PTA decreased significantly, but WRS did not increase when aided listening was compared to unaided listening. Negative correlations between PTAs and IOI-HA scores were significant but weak (<i>r</i> = −0.370 and <i>r</i> = −0.393, all <i>p</i> &#x3c; 0.05). Significant weak positive correlations were found between WRSs and IOI-HA (<i>r</i> = 0.386 and <i>r</i> = 0.309, all <i>p</i> &#x3c; 0.05). However, there was no correlation among ΔPTA, ΔWRS, and IOI-HA (<i>r</i> = 0.056 and <i>r</i> = −0.086, all <i>p</i> &#x3e; 0.05). Moreover, 2 nonaudiological factors (age and daily use time) were significantly correlated with IOI-HA (<i>r</i> = −0.269 and <i>r</i> = 0.242, all <i>p</i> &#x3c; 0.05). <b><i>Conclusions:</i></b> Correlations among objective audiologic tests, acoustic gain, and subjective patient-reported outcomes were weak or absent. Subjective questionnaires and objective tests do not reflect the same hearing capability. Therefore, it is advisable to evaluate both objective and subjective outcomes when analyzing HA benefits on a regular basis and pay equal attention to nonaudiological and audiological factors.

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