Comprehensive Assessment of 1-Year Outcomes and Determination of Minimum Clinically Important Difference in Pain, Disability, and Quality of Life After Suboccipital Decompression for Chiari Malformation I in Adults

Neurosurgery ◽  
2013 ◽  
Vol 73 (4) ◽  
pp. 569-581 ◽  
Author(s):  
Scott L. Parker ◽  
Saniya S. Godil ◽  
Scott L. Zuckerman ◽  
Stephen K. Mendenhall ◽  
John A. Wells ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rating Scale ◽  
Short Form ◽  
Minimum Clinically Important Difference ◽  
Numeric Rating Scale ◽  
Pain Disability ◽  
Clinically Important Difference ◽  
Patient Reported ◽  
Difference Thresholds

Abstract BACKGROUND: To date, there has been no study to comprehensively assess the effectiveness of suboccipital craniectomy (SOC) for Chiari malformation I (CMI) using validated patient-reported outcome measures. OBJECTIVE: To determine the effectiveness and minimum clinically important difference thresholds of SOC for the treatment of adult patients with CMI using patient-reported outcome metrics. METHODS: Fifty patients undergoing first-time SOC and C1 laminectomy for CMI at a single institution were followed up for 1 year. Baseline and 1-year postoperative pain, disability, quality of life, patient satisfaction, and return to work were assessed. Minimum clinically important difference thresholds were calculated with 2 anchors: the Health Transition Index and North American Spine Society satisfaction questionnaire. RESULTS: The severity of headaches improved in 37 patients (74%). Improvement in syrinx size was seen in 12 patients (63%) and myelopathy in 12 patients (60%). All patient-reported outcomes showed significant improvement 1 year postoperatively (P < .05). Of the 38 patients (76%) employed preoperatively, 29 (76%) returned to work postoperatively at a median time of 6 weeks (interquartile range, 4-12 weeks). Minimum clinically important difference thresholds after SOC for CMI were 4.4 points for numeric rating scale for headache, 0.7 points for numeric rating scale for neck pain, 13.8 percentage points for Headache Disability Index, 14.2 percentage points for Neck Disability Index, 7.0 points for Short Form-12 Physical Component Summary, 6.1 points for Short Form-12 Mental Component Summary, 4.5 points for Zung depression, 1.7 points for modified Japanese Orthopaedic Association, and 0.34 quality-adjusted life-years for Euro-Qol-5D. CONCLUSION: Surgical management of CMI in adults via SOC provides significant and sustained improvement in pain, disability, general health, and quality of life as assessed by patient-reported outcomes. This patient-centered assessment suggests that suboccipital decompression for CMI in adults is an effective treatment strategy.

Effect of Pregabalin on Radiotherapy-Related Neuropathic Pain in Patients With Head and Neck Cancer: A Randomized Controlled Trial

2019 ◽  
Vol 37 (2) ◽  
pp. 135-143 ◽  
Author(s):  
Jingru Jiang ◽  
Yi Li ◽  
Qingyu Shen ◽  
Xiaoming Rong ◽  
Xiaolong Huang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Adverse Event ◽  
Neuropathic Pain ◽  
Rating Scale ◽  
Short Form ◽  
Controlled Trial ◽  
Numeric Rating Scale ◽  
Mood States ◽  
Numeric Rating

Purpose Neuropathic pain is an unavoidable treatment-related adverse event among patients with head and neck cancer who are undergoing radiotherapy. We aimed to test the efficacy and safety of pregabalin versus placebo in the treatment of radiotherapy-related neuropathic pain. Patients and Methods This randomized, double-blind, placebo-controlled trial was conducted in four centers in China. Eligible patients with a mean pain intensity score of 4 or more on an 11-point numeric rating scale were randomly assigned to receive either active treatment with a flexible dose of pregabalin or placebo for 16 weeks. The primary efficacy outcome was pain reduction measured on the numeric rating scale. Result There were 128 patients who received treatment as randomly assigned. Pain intensity reduction was 2.44 in the pregabalin arm and 1.58 in the placebo arm at week 16, yielding an adjusted mean difference of 0.87 (95% CI, 0.30 to 1.44; P = .003). In the pregabalin arm, 38 patients (59.4%) achieved at least 30% pain relief versus 21 (32.8%) in the placebo arm ( P = .006). Nineteen patients (29.7%) in the pregabalin group and five (7.8%) in the placebo group achieved 50% or greater pain relief ( P = .003). Total scores on the Profile of Mood States-Short Form, pain severity and functional interference of Brief Pain Inventory-Short Form, as well as the physiology and psychology domain of the WHO Quality of Life-BREF all were reduced significantly at week 16 in patients who received pregabalin compared with those who received placebo. There was no significant difference ( P = .29) in the incidence of experiencing at least one adverse event in the pregabalin arm (n = 35; 54.7%) versus the placebo arm (n = 29; 45.3%). Conclusion Patients treated with pregabalin with radiotherapy-related neuropathic pain had greater pain alleviation, better mood states, and higher quality of life compared with patients in the placebo group, with a good tolerability.

Determination of minimum clinically important difference (MCID) in pain, disability, and quality of life after revision fusion for symptomatic pseudoarthrosis

2012 ◽  
Vol 12 (12) ◽  
pp. 1122-1128 ◽  
Author(s):  
Scott L. Parker ◽  
Owoicho Adogwa ◽  
Stephen K. Mendenhall ◽  
David N. Shau ◽  
William N. Anderson ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Minimum Clinically Important Difference ◽  
Pain Disability ◽  
Clinically Important Difference

scholarly journals THE AWESCORE (Alfred Wellness Score) – a patient reported outcome measure (PROM): development, feasibility, reliability, validity and responsiveness for adults with cystic fibrosis

2021 ◽  
pp. 00120-2021
Author(s):  
Brenda M. Button ◽  
Lisa M. Wilson ◽  
Angela T. Burge ◽  
Lara Kimmel ◽  
Felicity Finlayson ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cystic Fibrosis ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Short Form ◽  
Patient Reported Outcome ◽  
Pulmonary Exacerbation ◽  
Item Score ◽  
Patient Reported

BackgroundQuality of life has improved dramatically over the past two decades in people with cystic fibrosis (CF). Quantification has been enabled by patient reported outcome measures (PROMs), however many are lengthy and can be challenging to use in routine clinical practice. We propose a short-form PROM that correlates well with established quality of life measures.MethodsWe evaluated the utility of a ten-item score (AWESCORE) by measuring reliability, validity and responsiveness in adults with CF. The questions were developed by thematic analysis of survey questions to patients in a single adult CF centre. Each question was scored using a numerical rating scale zero to 10. Total scores ranged from 0 to 100. Test-retest reliability was assessed over 24 h. To determine validity, comparisons were sought between stable subjects and those in pulmonary exacerbation, and between AWESCORE and CFQ-R. Responsiveness to pulmonary exacerbation in individual subjects was evaluated.ResultsFive domains, each with two questions, were identified for respiratory, physical, nutritional, psychological and general health. A total of 246 consecutive adults attending the Outpatient Clinic completed the AWESCORE. Scores were higher during clinical stability compared to pulmonary exacerbation (mean 73 [sd 11]) versus 48 [11], p<0.001). Each domain scored worse during an acute exacerbation (p<0.001). No differences in reliability were observed in scores on retesting using Bland-Altman comparison. The CFQ-R scores (mean 813 [sd125]) and AWESCORE (81 [13]) were moderately correlated (Pearson's r=0.649; p=0.002).ConclusionsThe AWESCORE is valid, reliable and responsive to altered health status in cystic fibrosis.

Association of Physical Morbidity and Health-Related Quality of Life in a Representative Sample of Older German People

2018 ◽  
Vol 25 (4) ◽  
pp. 140-151
Author(s):  
Markus A. Wirtz ◽  
Matthias Morfeld ◽  
Elmar Brähler ◽  
Andreas Hinz ◽  
Heide Glaesmer
Keyword(s):  
Quality Of Life ◽  
Representative Sample ◽  
Short Form ◽  
Physical Symptoms ◽  
German Population ◽  
Health Related Quality ◽  
Patient Reported ◽  
Related Quality ◽  
Health Related

Abstract. The association between health-related quality of life (HRQoL; Short-Form Health Survey-12; SF-12) and patient-reported morbidity-related symptoms measured by the Patient Health Questionnaire-15 (PHQ-15) is analyzed in a representative sample of older people in the general German population. Data from 1,659 people aged 60 to 85 years were obtained. Latent class analysis identified six classes of patients, which optimally categorize clusters of physical symptoms the participants reported: musculoskeletal impairments (39.8%), healthy (25.7%), musculoskeletal and respiratory/cardiac impairments (12.8%), musculoskeletal and respiratory impairments, along with bowel and digestion problems (12.9%), general impairments (4.9%), and general impairments with no bowel and digestion problems (4.8%). The participants’ SF-12 Physical Health Scores (η2 = .39) and their Mental Health Scores (η2 = .28) are highly associated with these latent classes. These associations remain virtually identical after controlling for age. The results provide evidence that profiles of patient-reported physical impairments correspond strongly with reduced HRQoL independently from aging processes.

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