scholarly journals An Analysis of Change in Patient-Reported Outcome Measures Following First Metatarsophalangeal Joint Arthrodesis: Do Baseline Scores or Comorbidities Make a Difference?

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0025
Author(s):  
Linzy Houchen-Wolloff ◽  
Maitravaarun Burgula ◽  
Nikhil Nanavati ◽  
Alistair J. Best ◽  
Patricia Allen ChB ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Metatarsophalangeal Joint ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
First Metatarsophalangeal Joint ◽  
Radiographic Findings ◽  
Patient Reported ◽  
End Stage ◽  
The Impact ◽  
Domain Scores

Category: Midfoot/Forefoot Introduction/Purpose: First metatarsal phalangeal joint (MTPJ) arthrodesis is a well established procedure in the treatment of end-stage arthritis. Patient reported outcome measures (PROMs) are an important part of the modern healthcare system. The aim of surgery is to improve pain, function and health related quality of life (HRQoL). The Manchester-Oxford Foot Questionnaire (region-specific) and the Euro-QOL 5 dimension (generic) are both PROMs, known to be sensitive to change following foot/ ankle surgery at 6-months post-procedure (Maher & Kilmartin, J of Foot & Ankle Res, 5: 17, 2012). However we don’t know if baseline scores and the presence of comorbidities influence the change in these PROMs. This is important to understand so that we can identify which patients to offer MTPJ arthrodesis surgery to. Methods: Aims 1. To identify the change in two patient-reported outcome measures (PROMs) following MTPJ arthrodesis: The Manchester-Oxford Foot Questionnaire (MOxFQ) and the Euro-QOL 5 dimension tool. Do baseline scores make a difference to the change? 2. To describe the impact of co-morbidities on the change in both PROMs. Data was collected prospectively from patients who had undergone a first MTPJ arthrodesis. Patients with complete pre- and post-PROMs data were included in the analysis. PROMs data was collected on average 5.2 months post-operatively. Surgery notes were crosschecked with radiographic findings. A comparative analysis was done between pre and post-operative data using SPSS (version 20). The MOxFQ generates a total score, as well as 3 sub-domain scores for pain, walking/ standing and social interaction. The EQ5D generates a total score and a health today score (visual analogue scale: VAS from 0-100). Results: 90 patients were identified, 52 had complete data. Mean (SD) age 56.9(17.8) years, 78% female. Comorbidities: diabetes 2%, hypertension 21%, rheumatoid arthritis (RA) 43%, current smokers 10%, average (SD) weekly units of alcohol 5.2 (9.1). Most cases were unilateral (94%) and fixed with two screws (87%). 37% had other foot procedures carried out concurrently.Table 1 shows the change in MoxFQ total, domain scores and the EQ5D total score, health today (VAS). The correlation between baseline EQ5D total and the change for this outcome was r=0.6 (p<0.001). The correlation between baseline MOxFQ total and the change for this outcome was r=0.5 (p<0.001). The only comorbidity to have an influence on PROMs was RA- the presence of RA significantly reduced change in EQ5D total (p<0.05). Conclusion: Following MTPJ arthrodesis, statistically and clinically significant changes were observed in EQ5D total score, MOxFQ total scores (and all sub-domains). The EQ5D VAS did not change. Baseline scores in both PROMs were correlated with the change scores following surgery- suggesting that we may be able to identify a baseline score which could predict the outcome in PROMs and target who we offer surgery to as a consequence. Comorbidities had little influence on the change in both PROMs following surgery, other than the presence of RA dampening the change in EQ5D total score. Again this is useful to inform pre- operative discussions. [Table: see text]

scholarly journals A systematic review of patient-reported outcome measures in paediatric otolaryngology

2017 ◽  
Vol 132 (1) ◽  
pp. 2-7 ◽  
Author(s):  
J Powell ◽  
S Powell ◽  
A Robson
Keyword(s):  
Outcome Measures ◽  
English Language ◽  
Health Assessment ◽  
Paediatric Population ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Specific Patient ◽  
Patient Reported ◽  
The Impact

AbstractBackground:Recently, there has been increased emphasis on the development and application of patient-reported outcome measures. This drive to assess the impact of illness or interventions, from the patient's perspective, has resulted in a greater number of available questionnaires. The importance of selecting an appropriate patient-reported outcome measure is specifically emphasised in the paediatric population. The literature on patient-reported outcome measures used in paediatric otolaryngology was reviewed.Methods:A comprehensive literature search was conducted using the databases Medline, Embase, Cumulative Index to Nursing and Allied Health Literature, and PsycInfo, using the terms: ‘health assessment questionnaire’, ‘structured questionnaire’, ‘questionnaire’, ‘patient reported outcome measures’, ‘PROM’, ‘quality of life’ or ‘survey’, and ‘children’ or ‘otolaryngology’. The search was limited to English-language articles published between 1996 and 2016.Results:The search yielded 656 articles, of which 63 were considered relevant. This included general paediatric patient-reported outcome measures applied to otolaryngology, and paediatric otolaryngology disease-specific patient-reported outcome measures.Conclusion:A large collection of patient-reported outcome measures are described in the paediatric otolaryngology literature. Greater standardisation of the patient-reported outcome measures used in paediatric otolaryngology would assist in pooling of data and increase the validation of tools used.

scholarly journals The impact of patient-reported outcome measures in clinical practice for pain: a systematic review

2016 ◽  
Vol 26 (2) ◽  
pp. 245-257 ◽  
Author(s):  
Michelle M. Holmes ◽  
George Lewith ◽  
David Newell ◽  
Jonathan Field ◽  
Felicity L. Bishop
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Outcome Measures ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Patient Reported ◽  
The Impact

scholarly journals Capturing the experiences of patients with inherited optic neuropathies: a systematic review of patient-reported outcome measures (PROMs) and qualitative studies

2022 ◽  
Author(s):  
Benson S. Chen ◽  
Tomasz Galus ◽  
Stephanie Archer ◽  
Valerija Tadić ◽  
Mike Horton ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Status ◽  
Outcome Measures ◽  
Vision Loss ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Qualitative Studies ◽  
Psychometric Performance ◽  
Patient Reported ◽  
The Impact

Abstract Purpose To identify and comprehensively evaluate studies capturing the experience of individuals affected by an inherited optic neuropathy (ION), focusing on patient-reported outcome measures (PROMs) and qualitative studies where the health status and quality of life (QoL) of these individuals have been explored. Methods Systematic review of five databases using a search strategy combining four concepts: (1) ION; (2) QoL and health status; (3) PROMs; and (4) qualitative research. Studies assessing the impact of ION on any QoL domain using a PROM or qualitative methodology were included and appraised, using criteria based on the COSMIN checklist (for PROM studies) and the CASP checklist (for qualitative studies). Results Of 1326 unique articles identified, six studies were included. Five PROMs were identified: Visual Function Index (VF-14); Hospital Anxiety and Depression Scale (HADS); a novel graphical online assessment tool (NGOAT) for reporting emotional response to vision loss; a new PROM informed by the DSM-V Criteria for Major Depressive Disorder; and an interpersonal and career ‘impact rating’ PROM. The psychometric performance of included PROMs were poorly described. Qualitative studies found that vision loss resulted in psychosocial losses including loss of social and communication skills and loss of independence and freedom. Factors that modified the response to vision loss were also identified. Conclusion The current PROMs used by individuals with ION have poor content coverage, primarily measuring activity limitation and emotional well-being, and insufficient reporting of psychometric performance. There is a need to develop a PROM for individuals ION to report their experiences of living with their condition.

scholarly journals N07 Patient reported outcome measures collected from patients using a digital tablet: early benefits

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S660-S661
Author(s):  
P Avery ◽  
K Blackmore ◽  
C Angel
Keyword(s):  
Disease Activity ◽  
Outcome Measures ◽  
Disease Activity Score ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Activity Score ◽  
Data Set ◽  
Patient Reported ◽  
The Impact ◽  
Digital Tablet

Abstract Background At a district general hospital (DGH) on the south coast of England the inflammatory bowel disease (IBD) nurse led service introduced an eHealth system in 2015 linked to the IBD registry but limited to access via a desktop limiting flexibility. In liaison with the IBD registry and the software developer the lead nurse instigated an upgrade to the system. This allows patients access both remotely and via a digital tablet in outpatients. Discussion is being had about the best way to collect patient reported outcome measures (PROMS) both for large data analyse and local patient benefit. This presentation of the first 3 months collection of the PROMS seeks to show the benefit of these data locally Methods PROMS were gathered from both Consultant and Nurse led clinics from July 2019 to the 22 October 2019. Patients were asked to fill in the IBD control PROM (this PROM forms part of the IBD registry Data set) on a tablet before entering the consultation room. Additionally a disease activity score either the Harvey Bradshaw Score (HBI) or the Simple Clinical Colitis activity index (SCCAI) is collected at the same time. These scores were then extracted from the system and evaluated using a descriptive data analysis approach. Results After Data cleansing 200 records are shown in Table 1 covering all disease sub-types. Fatigue was the most commonly reported complication of IBD in addition,126 patients who attended outpatients reported a wellness score of above 75 out of 100 isolating the wellness score from the PROM score allowed a comparison with the corresponding disease activity score in these patients and correlated in 95% of UC Patients and CD 84% (see Table 2). Conclusion Fatigue is a widely reported symptom of IBD as well as pain and anxiety or depression. These data confirm this trend but also present the first local population information for the IBD service at this DGH. When looking at the impact of these scores there is an opportunity to identify patients that may need medically optimising. The patients that remain could then be targeted with support services and a business case for counselling is now planned. In addition to this together with self-testing with IBDoc ® the PROMs and disease activity scores provide opportunity for remote management of some patients. These PROMs collected from patients using a tablet in outpatients at a DGH show promising value for service development.

Silastic first metatarsophalangeal joint arthroplasty for the treatment of end-stage hallux rigidus

2020 ◽  
Vol 102-B (2) ◽  
pp. 220-226 ◽  
Author(s):  
Timothy M. Clough ◽  
Joseph Ring
Keyword(s):  
Metatarsophalangeal Joint ◽  
Visual Analogue Score ◽  
Patient Reported Outcome Measures ◽  
Hallux Rigidus ◽  
First Metatarsophalangeal Joint ◽  
Patient Reported ◽  
Silastic Implant ◽  
The Mean ◽  
End Stage

Aims Arthroplasty for end-stage hallux rigidus (HR) is controversial. Arthrodesis remains the gold standard for surgical treatment, although is not without its complications, with rates of up to 10% for nonunion, 14% for reoperation and 10% for metatarsalgia. The aim of this study was to analyze the outcome of a double-stemmed silastic implant (Wright-Medical, Memphis, Tennessee, USA) for patients with end-stage HR. Methods We conducted a retrospective review of 108 consecutive implants in 76 patients, between January 2005 and December 2016, with a minimum follow-up of two years. The mean age of the patients at the time of surgery was 61.6 years (42 to 84). There were 104 females and four males. Clinical, radiological, patient reported outcome measures (PROMS) data, a visual analogue score (VAS) for pain, and satisfaction scores were collected. Results The survivorship at a mean follow-up of 5.3 years (2.1 to 14.1) was 97.2%. The mean Manchester Oxford Foot and Ankle Questionnaire (MOXFQ) scores improved from 78.1 to 11.0, and VAS scores for pain from 7/10 to 1.3/10. The rate of satisfaction was 90.6%. Three implants (2.8%) required revision; one for infection, one-month postoperatively, and two for stem breakage at 10.4 and 13.3 years postoperatively. There was a 1.9% reoperation rate other than revision, 23.1% of patients developed a minor complication, and 21.1% of patients had non-progressive and asymptomatic cysts on radiological review. Conclusion We report a 97.2% survivorship at a mean follow-up of 5.3 years with this implant. We did not find progressive osteolysis, as has been previously reported. These results suggest that this double-stemmed silastic implant provides a predictable and reliable alternative with comparable outcomes to arthrodesis for the treatment of end-stage HR. Cite this article: Bone Joint J 2020;102-B(2):220–226.

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