Feasibility and acceptability of patient-reported outcomes data collection for clinical care following breast reconstruction.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 9042-9042 ◽  
Author(s):  
Andrea Pusic ◽  
Anne Klassen ◽  
Amie Scott ◽  
Stefan Cano ◽  
Marwan Shouery ◽  
...  
Keyword(s):  
Data Collection ◽  
Breast Reconstruction ◽  
Patient Reported Outcomes ◽  
Breast Surgery ◽  
Clinical Care ◽  
Well Being ◽  
Privacy And Security ◽  
Patient Reports ◽  
Patient Reported ◽  
The Impact

9042 Background: To date, systematic measurement of patient-reported outcomes (PROs) has played an important role in cancer research, but not in routine clinical care. Our objective was to evaluate the feasibility of developing and piloting an electronic PRO data collection in clinical care among breast reconstruction patients using the BREAST-Q, a previously developed condition-specific PRO measure for breast surgery patients that measures quality of life (e.g. psychosocial, physical and sexual well-being) as well as patient satisfaction (e.g. satisfaction with breasts, with information, with surgeon). Methods: The BREAST-Q was loaded to the MSKCC WebCore, a generic electronic patient-reporting platform adhering to strict privacy and security standards. Patients attending visits at the MSKCC Breast Reconstruction Clinic were asked to complete the BREAST-Q electronically prior to scheduled visits. For patients with email addresses, a reminder with web-link to the questionnaire was emailed automatically prior to the visit. Results: Over a 9 month start-up period, BREAST-Q surveys were completed by 1442 patients. Patients completed the questionnaire at set time points before and after surgery. A total of 2340 BREAST-Q surveys were completed overall. Mean completion time was 5:53 minutes. Acceptability was high with both patients and clinical staff contributing positive comments along with suggestions for improvement via email. Conclusions: This pilot experience suggests that ePRO data can be efficiently collected among outpatient breast surgery patients with high acceptability. In the next phase of this project, we will introduce real-time individual patient reports to the clinical team and evaluate the impact of this information on clinical care and quality improvement.

scholarly journals The impact of age on patient-reported outcomes after oncoplastic versus conventional breast cancer surgery

2021 ◽  
Author(s):  
M. Ritter ◽  
B. M. Ling ◽  
I. Oberhauser ◽  
G. Montagna ◽  
L. Zehnpfennig ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Patient Reported Outcomes ◽  
Breast Surgery ◽  
Perforator Flap ◽  
Well Being ◽  
Breast Cancer Surgery ◽  
Oncoplastic Breast Surgery ◽  
Age Related ◽  
Patient Reported ◽  
The Impact

Abstract Purpose Some studies have indicated age-specific differences in quality of life (QoL) among breast cancer (BC) patients. The aim of this study was to compare patient-reported outcomes after conventional and oncoplastic breast surgery in two distinct age groups. Methods Patients who underwent oncoplastic and conventional breast surgery for stage I-III BC, between 6/2011–3/2019, were identified from a prospectively maintained database. QoL was prospectively evaluated using the Breast-Q questionnaire. Comparisons were made between women < 60 and ≥ 60 years. Results One hundred thirty-three patients were included. Seventy-three of them were ≥ 60 years old. 15 (20.5%) of them received a round-block technique (RB) / oncoplastic breast-conserving surgeries (OBCS), 10 (13.7%) underwent nipple-sparing mastectomies (NSM) with deep inferior epigastric perforator flap (DIEP) reconstruction, 23 (31.5%) underwent conventional breast-conserving surgeries (CBCS), and 25 (34.2%) received total mastectomy (TM). Sixty patients were younger than 60 years, 15 (25%) thereof received RB/OBCS, 22 (36.7%) NSM/DIEP, 17 (28.3%) CBCS, and 6 (10%) TM. Physical well-being chest and psychosocial well-being scores were significantly higher in older women compared to younger patients (88.05 vs 75.10; p < 0.001 and 90.46 vs 80.71; p = 0.002, respectively). In multivariate linear regression, longer time intervals had a significantly positive effect on the scales Physical Well-being Chest (p = 0.014) and Satisfaction with Breasts (p = 0.004). No significant results were found concerning different types of surgery. Conclusion Our findings indicate that age does have a relevant impact on postoperative QoL. Patient counseling should include age-related considerations, however, age itself cannot be regarded as a contraindication for oncoplastic surgery.

scholarly journals Impact of Contralateral Symmetry Procedures on Long-Term Patient-Reported Outcomes following Unilateral Prosthetic Breast Reconstruction

2018 ◽  
Vol 35 (02) ◽  
pp. 124-128 ◽  
Author(s):  
Shantanu Razdan ◽  
Hina Panchal ◽  
Claudia Albornoz ◽  
Andrea Pusic ◽  
Colleen McCarthy ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Patient Reported Outcomes ◽  
Statistical Significance ◽  
Multivariable Analysis ◽  
Well Being ◽  
Contralateral Breast ◽  
Prosthetic Reconstruction ◽  
Patient Reported ◽  
The Impact

Background One aim of unilateral postmastectomy breast reconstruction (BR) is to restore symmetry with the contralateral breast. As such, unilateral prosthetic reconstruction often requires a contralateral symmetry procedure (CSP). There is sparse literature on the impact of CSPs on long-term patient-reported outcomes (PROs) such as satisfaction and health-related quality of life (HRQoL). This study aims to describe PROs following CSPs, using a validated PRO tool, BREAST-Q. The hypothesis is that CSPs are associated with greater patient-reported satisfaction and HRQoL. Methods This study is a single institutional analysis of prospectively collected BREAST-Q scores of patients who underwent unilateral prosthetic BR during 2011 to 2015. Women 18 years and older with BREAST-Q scores measured ≥ 9months after BR with or without CSP(s) at the time of expander replacement were included. Patients were classified into four subcohorts: augmentation, mastopexy, reduction, and no symmetry procedure (controls). Sociodemographic, clinical characteristics, and BREAST-Q scores were analyzed. Multivariable linear regression was performed. Results Of 553 patients, 67 (12%) underwent contralateral augmentation, 68 (12%) mastopexy, 93(17%) reduction, and 325 (59%) were controls. Mean follow-up time was 52 months. Satisfaction with breast and outcomes were higher in the augmentation compared with the control groups (p = 0.01). On multivariable analysis, augmentation remained an independent predictor of satisfaction with breast (p = 0.04). Physical well-being scores were lower for contralateral mastopexy and reduction compared with the controls with a trend toward statistical significance on multivariable models. Psychological and sexual well-being was similar across groups. Conclusion Prosthetic reconstruction with contralateral breast augmentation was associated with greater satisfaction with breast and reconstructive outcome. In contrast, breast reduction and mastopexy procedures demonstrated equivalent satisfaction with breasts compared with controls but may be associated with lower physical well-being. Such information can be used to improve the shared decision-making process for women who choose unilateral prosthetic BR.

scholarly journals O58: THE IMPACT OF RADIOTHERAPY ON PATIENT-REPORTED OUTCOMES OF IMMEDIATE IMPLANT-BASED BREAST RECONSTRUCTION: RESULTS OF A PROSPECTIVE MULTICENTRE COHORT STUDY

2021 ◽  
Vol 108 (Supplement_1) ◽  
Author(s):  
E Sewart ◽  
N Turner ◽  
EJ Conroy ◽  
R Cutress ◽  
J Skillman ◽  
...  
Keyword(s):  
Cohort Study ◽  
Breast Reconstruction ◽  
Patient Reported Outcomes ◽  
Random Effect ◽  
Well Being ◽  
Patient Reported Outcome ◽  
Complication Rates ◽  
Informed Decisions ◽  
Patient Reported ◽  
The Impact

Abstract Introduction Post-mastectomy radiotherapy (PMRT) is increasing given to improve breast cancer outcomes but can increase complication rates following implant-based breast reconstruction (IBBR). Little, however, is known about the impact of PMRT on patient-reported outcomes (PROs) of IBBR, especially in the context of mesh-assisted techniques. Method 2108 consecutive women undergoing IBBR at 81 UK centres were prospectively recruited between 2014 and 2016. Demographic, operative, oncological and 3-month complication data were collected, and patients who consented received post-operative questionnaires. An 18-month questionnaire assessed PROs using the validated BREAST-Q. The effect of IBBR on PROs was investigated using mixed-effects regression models adjusted for clinically relevant confounders and including a random effect to account for potential clustering by centre. Result 1693 iBRA participants underwent mastectomy for malignancy, of whom 1187 (70%) consented to receive the 18-month questionnaire and 732 (43%) completed it. Patients undergoing PMRT (n=214) reported significantly worse scores across 3 BREAST-Q domains: satisfaction with breasts (-6.27 points, p=0.008, 95% confidence interval (CI)[-10.91,-1.63]), satisfaction with outcome (-7.53 points, p=0.002, CI[-12.20,-2.85]) and physical well-being (-6.55 points, p&lt;0.001, CI[-9.43,-3.67]). Overall satisfaction was worse in the PMRT group (OR 0.497, p=0.002, CI[0.32,0.77]). Use of biological mesh did not ameliorate the impact of PMRT on patient satisfaction (interaction term p-values [0.173 - 0.826]). Conclusion: PMRT adversely affects PROs of IBBR. This should be discussed with patients considering IBBR, especially if PMRT is anticipated or indications are borderline, to enable informed decisions regarding oncological and reconstructive options. Abbrev PMRT: post-mastectomy radiotherapy, PRO: patient-reported outcome Take-home message This multicentre, prospective cohort study of 732 patients undergoing implant-based breast reconstruction demonstrates worse 18-month patient-reported outcomes in women who received post-mastectomy radiotherapy than those who did not. These data should be discussed with patients to help them make informed decisions about reconstructive surgery.

scholarly journals Breast Surgery on the Post-operative Well-being of Women: A Prospective Evaluation

2020 ◽  
Author(s):  
Jessica Ranieri ◽  
Federica Guerra ◽  
Dina Di Giacomo
Keyword(s):  
Breast Reconstruction ◽  
Breast Surgery ◽  
Radical Mastectomy ◽  
Psychological Adaptation ◽  
Well Being ◽  
Long Term Effects ◽  
Reconstruction Surgery ◽  
Level Of Satisfaction ◽  
The Impact ◽  
Mental Well Being

Abstract Background. Mammoplasty is the most common surgery that is used for both breast augmentation in healthy women (aesthetic plastic) and breast reconstruction (disease-related plastic) in women who have been diagnosed with and surgically treated for regional breast cancer with radical mastectomy (MRM). When compared to breast reconstruction surgery, aesthetic breast surgery is perceived to result in more favourable aesthetic outcomes.. This study aimed to examine the long-term effects of mammoplasty on the psychological adaptation of women.Methods. A total of 44 30–50-year-old women participated in this study. They were divided into two groups based on the type of breast surgery that they had undergone (augmentation surgery [AS] vs. reconstruction surgery [RS]) and the time that had elapsed since their surgery (≤ 3 years vs. > 3 years). Results. Our findings suggest that the psychological well-being of women who undergo AS declines over time. The women who had undergone AS ≤ 3 and > 3 years earlier did not differ in any of the indicators of emotional functioning. The only exception was their level of satisfaction with their breasts. We examined the impact of mammoplasty on the satisfaction levels and well-being of women who had undergone RS (after MRM). As expected, they were less satisfied with their breasts than those who belonged to the AS group However, this was true only among those who had undergone their surgery ≤ 3 years earlier.Conclusions. In conclusion, our findings underscore the need to provide psychological support to those who have undergone AS and RS. To shorten the adaptation process and enhance their mental well-being, personalised psychological interventions should be provided.

scholarly journals Tracking Patient Outcomes Following Foot and Ankle Surgery: The OFAR Experience 2018-2019

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0003
Author(s):  
Kenneth Hunt ◽  
Ross Benthien ◽  
Judith F. Baumhauer ◽  
Christopher DiGiovanni ◽  
Shanthan Challa ◽  
...  
Keyword(s):  
Data Collection ◽  
Patient Outcomes ◽  
Patient Reported Outcomes ◽  
Short Form ◽  
Healthy Population ◽  
Foot And Ankle ◽  
Aggregated Data ◽  
Postoperative Changes ◽  
Patient Reported ◽  
The Impact

Category: Patient Reported Outcomes Introduction/Purpose: Collection and reporting of Patient Reported Outcomes (PROs) has become an integral part of healthcare and healthcare research. In an effort to facilitate AOFAS member participation in secure and efficient patient outcomes data collection, the Orthopaedic Foot and Ankle Outcomes Research (OFAR) Network, a national collaborative surgical outcomes registry, was established in 2018 by and for AOFAS member surgeons and their patients. OFAR aims to collect, aggregate, and report PRO data using the measurement instruments developed by the National Institutes of Health (NIH) Patient Reported Outcomes Measurement Information System (PROMIS). We hypothesize that multiple sites from a variety of health systems can successfully enroll patients into a secure, web-based registry, and that foot and ankle procedures will significantly improve patient reported function and pain. Methods: Since December 2018, seven OFAR pilot sites have been enrolling patients, including three private and four academic practices. Each enrolled patient completed a pre-operative assessment as well as post-operative assessments at 3 time points. Five PROMIS metrics were collected, including Physical Function CAT (PF), Pain Intensity Short Form (PInSF), Pain Interference CAT (PInCAT), Global Health Short Form, and Depression CAT. Pathways, a secure web platform accessible by both patients and providers, was utilized for data collection and storage. The platform also includes a provider dashboard that collects diagnosis, treatment, implant and complication data. The aggregated data was analyzed using Python (v3.6) along with Pandas (v0.23.4). Results: As of December 2018, 877 patients have been enrolled in OFAR. Patients were enrolled from both academic (57%) and private practice (43%) sites. The three most frequently encountered conditions were: ankle impingement, ankle fractures and ankle arthritis. The largest pre- to postoperative changes were seen in the PF and PInCAT scores which significantly improved at 6 months and 12 months for nearly all condition groups (Figure 1). Many of these improvements averaged 20 points on the PROMIS t-score scale, which represents two standard deviations in the PROMIS scoring system, and restored PInCAT and PF to 50 or better, the US healthy population average. There was a trend toward improvement in depression scores for most conditions, with substantial improvement following fracture treatment. Conclusion: We were able to successfully onboard multiple pilot sites, including community private practices without dedicated research resources, to enroll patients in the OFAR platform. Aggregated data demonstrate a significant improvement in PROMIS scores for all conditions treated. The library of information collected is automated, extensive and comprehensive. By aggregating outcomes following treatment by orthopaedic foot and ankle surgeons across practice settings, the OFAR database empowers an unprecedented scrutiny of ‘real world’ patient outcomes and related factors. This facilitates an increasingly granular assessment of the impact of conditions and treatments, enabling patients and providers alike to share in the decision-making process.

Breast surgery on the post-operative well-being of women: a cross-sectional study

2020 ◽  
Author(s):  
Jessica Ranieri ◽  
Fabiana Fiasca ◽  
Federica Guerra ◽  
Antonella Mattei ◽  
Dina Di Giacomo
Keyword(s):  
Breast Reconstruction ◽  
Breast Surgery ◽  
Radical Mastectomy ◽  
Psychological Adaptation ◽  
Well Being ◽  
Cross Sectional Study ◽  
Long Term Effects ◽  
Cross Sectional ◽  
Reconstruction Surgery ◽  
The Impact

Abstract Background. Mammoplasty is the most common surgery that is used for both breast augmentation in healthy women (aesthetic plastic) and breast reconstruction (disease-related plastic) in women who have been diagnosed with and surgically treated for regional breast cancer with radical mastectomy (MRM). When compared to breast reconstruction surgery, aesthetic breast surgery is perceived to result in more favourable aesthetic outcomes.. This study aimed to examine the long-term effects of mammoplasty on the psychological adaptation of women.Methods. A total of 44 30–50-year-old women participated in this study. They were divided into two groups based on the type of breast surgery that they had undergone (augmentation surgery [AS] vs. reconstruction surgery [RS]) and the time that had elapsed since their surgery (≤ 3 years vs. > 3 years). Results. Our findings suggest that the psychological well-being of women who undergo AS declines over time. The women who had undergone AS ≤ 3 and > 3 years earlier did not differ in any of the indicators of emotional functioning. The only exception was their level of satisfaction with their breasts.We examined the impact of mammoplasty on the satisfaction levels and well-being of women who had undergone RS (after MRM). As expected, they were less satisfied with their breasts than those who belonged to the AS group However, this was true only among those who had undergone their surgery ≤ 3 years earlier.Conclusions. In conclusion, our findings underscore the need to provide psychological support to those who have undergone AS and RS. To shorten the adaptation process and enhance their mental well-being, personalised psychological interventions should be provided.

scholarly journals Patient Reported Outcomes in Large Vessel Vasculitides

2021 ◽  
Vol 23 (2) ◽  
Author(s):  
Joanna Robson ◽  
Sarah Mackie ◽  
Catherine Hill
Keyword(s):  
Clinical Trials ◽  
Patient Reported Outcomes ◽  
Systemic Vasculitis ◽  
Clinical Care ◽  
Large Vessel Vasculitis ◽  
Large Vessel ◽  
Patient Reported ◽  
The Impact ◽  
Large Vessel Vasculitides ◽  
Disease Specific

Abstract Purpose of Review The goal of this paper is to review current and future uses of patient-reported outcomes in large vessel vasculitis. The large vessel vasculitides comprise Giant Cell Arteritis and Takayasu arteritis; both are types of systemic vasculitis which affect the larger blood vessels. Patient-reported outcomes (PROs) capture the impact of these diseases on health-related quality of life. Recent Findings Generic PROs such as the SF-36 are currently used to compare HRQOL of people with GCA and TAK within clinical trials and observational studies and to make comparisons with the general population and HRQoL in other diseases. The development of a disease-specific PRO for GCA is currently underway. Beyond clinical trials, there is much interest in the use of PROs within routine clinical care, particularly E-PROs for remote use. Summary Further work will be needed to complete the development of disease-specific PROs for people with large vessel vasculitis and to establish feasibility, acceptability, and utility of E-PROs.

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