Quantifying the extent of visit irregularity in longitudinal data

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Armend Lokku ◽  
Catherine S Birken ◽  
Jonathon L Maguire ◽  
Eleanor M Pullenayegum
Keyword(s):  
Longitudinal Data ◽  
Repeated Measures ◽  
Area Under The Curve ◽  
Healthy Children ◽  
Single Score ◽  
The Mean ◽  
Irregular Data ◽  
Early Life Exposures ◽  
The Relationship

Abstract The timings of visits in observational longitudinal data may depend on the study outcome, and this can result in bias if ignored. Assessing the extent of visit irregularity is important because it can help determine whether visits can be treated as repeated measures or as irregular data. We propose plotting the mean proportions of individuals with 0 visits per bin against the mean proportions of individuals with >1 visit per bin as bin width is varied and using the area under the curve (AUC) to assess the extent of irregularity. The AUC is a single score which can be used to quantify the extent of irregularity and assess how closely visits resemble repeated measures. Simulation results confirm that the AUC increases with increasing irregularity while being invariant to sample size and the number of scheduled measurement occasions. A demonstration of the AUC was performed on the TARGet Kids! study which enrolls healthy children aged 0–5 years with the aim of investigating the relationship between early life exposures and later health problems. The quality of statistical analyses can be improved by using the AUC as a guide to select the appropriate analytic outcome approach and minimize the potential for biased results.

scholarly journals A Taxonomic Review of Patient Complaints in Adult Hospital Medicine

2021 ◽  
Vol 8 ◽  
pp. 237437352110073
Author(s):  
Richard M Elias ◽  
Karen M Fischer ◽  
Mustaqeem A Siddiqui ◽  
Trevor Coons ◽  
Cindy A Meyerhofer ◽  
...  
Keyword(s):  
Hospital Admissions ◽  
Hospital Medicine ◽  
Patient Complaints ◽  
Period Data ◽  
The Mean ◽  
Key Features ◽  
Person Characteristics ◽  
The Relationship ◽  
Adult Hospital

Previous studies show that patient complaints can identify gaps in quality of care, but it is difficult to identify trends without categorization. We conducted a review of complaints relating to admissions on hospital internal medicine (HIM) services over a 26-month period. Data were collected on person characteristics and key features of the complaint. The complaints were also categorized into a previously published taxonomy. Seventy-six unsolicited complaints were identified, (3.5 per 1000 hospital admissions). Complaints were more likely on resident services. The mean duration between encounter and complaint was 18 days, and it took an average of 12 days to resolve the complaint. Most patients (59%) had a complaint in the Relationship domain. Thirty-nine percent of complaints mentioned a specific clinician. When a clinician was mentioned, complaints regarding communication and humaneness predominated (68%). The results indicate that the efforts to reduce patient complaints in HIM should focus on the Relationships domain.

scholarly journals AB0101 THE IMPACT OF TIME SPAN TO ACHIEVE BOOLEAN REMISSION FOR MAINTAINING DISEASE ACTIVITY AFTER ACQUISITION IN RHEUMATOID ARTHRITIS PATIENT

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1079.1-1079
Author(s):  
I. Yoshii
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Disease Duration ◽  
Remission Rate ◽  
Mean Value ◽  
Time Span ◽  
Mean Values ◽  
The Mean ◽  
The Relationship

Background:Boolean remission criteria is one most popular and stringent criteria in treating patient with rheumatoid arthritis (RA), because it may guarantees a stable clinical course after attaining remission.Objectives:Impact of time span from initiation to achieving Boolean remission on maintaining disease activity, daily activities, and quality of life after attaining Boolean remission was investigated from daily clinical practice data.Methods:685 patients with RA since August 2010 under the T2T strategy were treated. They were monitored for their TJC, SJC, PGA, EGA, CRP, and disease activity indices such as CDAI, SDAI, DAS28, and Boolean criteria at every visit. HAQ-DI score, pain score using visual analog scale (PS-VAS), and EQ-5D were also monitored, and the quality of life score (QOLS) calculated from EQ-5D was determined at every visit from the time of diagnosis (baseline).Of 685 patients, 465 patients had achieved Boolean remission >1 times, and were consecutively followed up for >3 years. These patients were enrolled in the study. Time span from the first visit to first Boolean remission was calculated. The relationship between the time span and each of background parameters, and the relationship between the time span and each of the mean values of the SDAI score, HAQ score, PS-VAS, SHS, and QOLS at the first Boolean remission and thereafter was evaluated statistically.Patients were subsequently divided into the G ≤ 6 and G > 6 groups based on the achievement of first Boolean remission within two groups: time span G ≤ 6 months and G > 6 months. The two groups were compared with regard to the SDAI score, HAQ score, PS-VAS, SHS, and QOLS at first visit and at the time of first Boolean remission, and the mean values of these parameters after remission were evaluated statistically. Moreover, changes of these parameters and the mean Boolean remission rate after the first remission, and SDAI remission rate at the first Boolean remission to thereafter were compared between the two groups statistically.Results:Out of 465 patients, females comprised 343 (73.7%), and the mean age was 67.8 years (range, from 21–95 years). The mean disease duration at first visit was 6.1 years (range, from 1 months–45 years). The mean follow up length was 88.1 months (range: 36–122 months; median: 85 months) and mean time span from the first visit to the first Boolean remission was 8.1 months. The mean SDAI score, HAQ score, PS-VAS, and the QOLS at first visit were 13.3, 0.467, 33.2, and 0.834, respectively. Among the study parameters, PS-VAS and QOLS were significantly correlated with the time span. For parameters at the first Boolean remission, HAQ-DI score, PS-VAS, and QOLS demonstrated significant correlation with the time span, whereas SDAI, HAQ-DI score, PS-VAS, SHS, and QOLS after the Boolean remission demonstrated significant correlation with the time span.The comparison between the G ≤ 6 and the G > 6 groups revealed that the disease duration, HAQ score, and PS-VAS at baseline in the G > 6 were significantly higher than that in the G ≤ 6 group, and QOLS in the G ≤ 6 group was significantly higher than that in the G > 6 group at baseline. Similarly, the HAQ score and PS-VAS at the first Boolean remission in the G > 6 group were significantly higher than that in the G ≤ 6 group, whereas QOLS in the G ≤ 6 group demonstrated no significant difference compared with that in the G > 6 group.The mean value of the SDAI score after the first Boolean remission in the G > 6 group was significantly higher than that in the G ≤ 6 group. Similarly, the SDAI score, HAQ score, and PS-VAS after the first Boolean remission in the G > 6 group were also significantly higher than those in the G ≤ 6 group, and the mean value of the QOLS in the G ≤ 6 group were significantly higher than that in the G > 6 group. The Boolean remission rate and SDAI remission rate after the first Boolean remission were significantly higher in the G ≤ 6 group than those in the G > 6 group.Conclusion:Attaining Boolean remission ≤ 6 months for RA has significant benefit for more stable disease control, that leads good maintenance of ADL.Disclosure of Interests:None declared

scholarly journals Mediating Effect of Acceptance Action in relationship between Diabetes Self-Stigma and Quality of Life in People with Diabetes in Korea

2021 ◽  
Vol 28 (3) ◽  
pp. 384-394
Author(s):  
Kawoun Seo
Keyword(s):  
Quality Of Life ◽  
Explanatory Power ◽  
Mediating Effect ◽  
Research Approach ◽  
Mediating Effects ◽  
Descriptive Research ◽  
Patients With Diabetes ◽  
The Mean ◽  
The Relationship

Purpose: This study was done to investigate the mediating effects of acceptance action on the relationship between diabetes self-stigma and quality of life in diabetes patients.Methods: For this study a descriptive research approach was used. Patients (237) with a diagnosis of diabetes mellitus from a doctor of endocrinology were included. Data collection was done from March 26, to March 28, 2020. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson’s correlation coefficient analysis, and hierarchecal multiple regression.Results: The mean scores for diabetes self-stigma, acceptance action and quality of life were 2.67±0.71, 4.12±0.38, and 3.26±0.48, respectively. Acceptance action was found to partial mediate the relationship between diabetes self-stigma and quality of life (z=-4.20, p<.001), and its explanatory power was 17.6%.Conclusion: To improve the quality of life among patients with diabetes in diabetes self-stigma situations, it is necessary to improve their acceptance action and develop step-by-step and differentiated acceptance action enhancement programs through multidisciplinary collaboration.

Abstract 12926: Transition Readiness Assessment in Adolescents and Young Adults With Heart Disease: Can We Improve the Outcome?

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Karen Uzark ◽  
Cynthia Smith ◽  
Sunkyung Yu ◽  
Janet Donohue ◽  
Katherine Afton ◽  
...  
Keyword(s):  
Young Adults ◽  
Heart Disease ◽  
Self Efficacy ◽  
Self Management ◽  
Transition Readiness ◽  
Knowledge Deficit ◽  
The Mean ◽  
Knowledge Deficits ◽  
The Relationship

Objective: Transition is defined as “the process by which adolescents and young adults with chronic childhood illnesses are prepared to take charge of their lives and their health in adulthood”. We previously reported common knowledge deficits and lack of transition readiness (TR) in 13-25 year olds with congenital or acquired heart disease. The aims of this study were to re-evaluate TR in these patients at follow-up (F/U) and to examine the relationship between changes in TR and quality of life (QOL). Methods: Patients (n=106) completed the TR Assessment and Pediatric Quality of Life Inventory (PedsQL) utilizing an e-tablet, web-based format at a routine F/U clinic visit. Changes from initial to F/U scores were evaluated. Results: Median patient age was 18.7 yrs at a median F/U time of 1.02 yrs. Average perceived knowledge deficit score (% of items with no knowledge) at F/U was 18.0 ± 15.2%, decreased from 24.7 ± 16.5%, p<.0001. On a 100-point scale, the mean score for self-efficacy increased from 71.4 ± 17.0 to 76.7 ± 18.2 (p=.004) and for self-management increased from 47.9 ± 18.4 to 52.0 ± 20.7 (p=.0004). While physical QOL did not change, the mean psychosocial QOL score increased significantly from 80.2 ± 13.3 to 82.5 ± 12.0, p=.02. A decrease in knowledge deficit score at F/U was significantly associated with an increased psychosocial QOL score, p=.03. An increase in self-efficacy score was associated with an increase in psychosocial QOL score (p=.04), especially social QOL (p=.02). Among patients who reported receiving specific information after initial TR assessment, knowledge deficits decreased related to medication (p=.002), symptoms to call for (p=.02), how to contact heart doctor (p=.02), and health insurance (p=.10). Self-efficacy scores improved in patients reporting receipt of information regarding how to contact the heart doctor (p=.06) and how to communicate with healthcare team (p=.05). Conclusion: While deficits in knowledge and self-management skills persist, TR assessment and recognition of deficits can improve transition readiness with improved psychosocial QOL. Routine TR assessment is important to identify transition needs. Further studies are needed to examine the relationship between TR and outcomes in young adults with heart disease.

P101 The leeds paediatric brain arteriovenous malformation (BAVM) outcomes

2019 ◽  
Vol 90 (3) ◽  
pp. e49.1-e49
Author(s):  
N Kalra ◽  
SP Solanki ◽  
AK Tyagi
Keyword(s):  
Quality Of Life ◽  
Functional Outcomes ◽  
Cohort Analysis ◽  
Paediatric Population ◽  
Healthy Children ◽  
Hrqol Score ◽  
Related Quality ◽  
The Mean

ObjectivesThe commonest cause of stroke in a paediatric population is a ruptured brain ateriovenous malformation (bAVM). We aim to assess the functional outcomes of patients who have undergone operative intervention at our unit for ruptured and non-ruptured bAVMs.DesignA single centre retrospective cohort analysis of paediatric bAVM patients.Subjects10 paediatric patients at time of surgery between January 2007 – December 2017 mean age at follow up 15.9 years, range 2–26 years, mean time to follow up 6.3 years, range 1.5–11.2 years.MethodsPatients with bAVMs were identified via the paediatric neurovascular database. They were contacted via telephone and the Paediatric Quality of Life (PedsQL) questionnaire administered via parent proxy if the patient was under 18, and by the patient if above 18. Functional outcomes were assessed using the PedsQL questionnaire score and converted in to a health-related quality of life (HRQOL) score.Results10 patients underwent resection of their bAVMS, 9 survived and 7 were contactable. The mean HRQOL score 88.9 points, range 65.2–100. Only one patient had a HRQOL score below the mean of a child with chronic disease.ConclusionsThe mean HRQOL outcome score of operated paediatric bAVM was similar to that of healthy children. Patients having bAVM surgery within our unit have had a good functional outcome. Although there are small numbers in this series, there is a low incidence of operated paediatric bAVMs. Our findings suggests that such operations should be undertaken in units with expertise.

Evaluation of the relationship between emotional and behavioral problems and quality of life of adolescents in school

2019 ◽  
Vol 24 (4) ◽  
pp. 655-663
Author(s):  
Ayla Hendekçi ◽  
Sonay Bilgin
Keyword(s):  
Quality Of Life ◽  
Behavioral Problems ◽  
Subscale Score ◽  
Emotional And Behavioral Problems ◽  
School Age ◽  
Quality Of Life Inventory ◽  
Strengths And Difficulties ◽  
The Mean ◽  
The Relationship

This study was conducted to determine the quality of life and difficulties of adolescents in school age. This descriptive study was conducted in a city center three secondary School. Similarly from each school 114,114,116 people participated in the study, 4 students could not be included in the study due to insufficient data and the study was completed with 344 students. Questionnaire developed by the researcher, the Strengths and Difficulties Questionnaire (SDQ), and the Pediatric Quality of Life Inventory (PedsQL) were used for data collection. Research was completed in line with the ethical principles. According to the evaluations, it was observed that 50.6% of the students was 13 years old, 52% was male, and 53.5% was in the seventh grade. The total score average for PedsQL was 81.58 ± 13.65, and the mean total score for SDQ was 25.02 ± 4.813. A positive and significant correlation was found between “behavioral problems” subscale score of the SDQ and all subscales of PedsQL except the “physical health” subscale as well as the positive and significant correlation between the mean total scores of PedsQL and SDQ. It was observed that the quality of life of the students is affected negatively as the difficulties experienced during adolescence increase. Some recommendations were made to reveal the problems experienced by school-age adolescents and to increase their quality of life.

Hospital-Level Factors Related to 30-Day Readmission Rates

2016 ◽  
Vol 32 (1) ◽  
pp. 48-57 ◽  
Author(s):  
Joanne R. Campione ◽  
Scott A. Smith ◽  
Russell E. Mardon
Keyword(s):  
Patient Safety ◽  
Quality Of Care ◽  
Repeated Measures ◽  
Readmission Rate ◽  
Healthcare Research ◽  
Hospital Level ◽  
Readmission Rates ◽  
Discharge Data ◽  
The Mean

This study investigates the relationship between inpatient quality of care as measured by the Agency for Healthcare Research and Quality (AHRQ) patient safety indicator (PSI) composite and all-cause, hospital-wide, 30-day readmission rates. Discharge data from 4 statewide databases were analyzed. Linear, repeated-measures regressions were performed to predict hospital-level 30-day readmission rates. The mean readmission rate was 12.9%, and the mean PSI composite ratio was 0.95 among 524 hospitals with 2592 observations. In the hospital-level analysis, the risk-adjusted AHRQ PSI composite was not significantly associated with hospital 30-day readmission rate after controlling for hospital-level characteristics, patient case mix, and sociodemographics. Inpatient quality of care appears to have less influence on hospital readmission rates than do clinical and socioeconomic factors. However, these results suggest that a patient safety composite measure that includes postdischarge complications would provide more information to assist hospitals and communities in understanding the association between quality of care and readmission rates.

A repeated measures study of changes in health-related quality of life during pregnancy and the relationship with obstetric factors

2014 ◽  
Vol 70 (10) ◽  
pp. 2245-2256 ◽  
Author(s):  
Shiow-Ru Chang ◽  
Kuang-Ho Chen ◽  
Ming-I Lin ◽  
Ho-Hsiung Lin ◽  
Lian-Hua Huang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Repeated Measures ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Obstetric Factors ◽  
The Relationship

scholarly journals The Relationship Between Family Support and the Quality of Post Primary PCI Patients’ Life

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Lailiyatul Munawaroh ◽  
Tuti Herawati
Keyword(s):  
Quality Of Life ◽  
Myocardial Infarction ◽  
Family Support ◽  
Coronary Intervention ◽  
Primary Pci ◽  
Percutaneous Coronary ◽  
St Elevation ◽  
The Mean ◽  
The Relationship

<div><p class="Keywords"><strong>Objective: </strong>ST elevation myocardial infarction is the most common myocardial infarction cases. The main intervention of this case is primary percutaneous coronary intervention (PPCI). After PPCI, quality of life in STEMI patients depend on their ability to control the risk factors of reinfarction. In this condition, patients need family support. Therefore, this study aimed to identify the relationship between family support and quality of patients’ life after PPCI.<strong></strong></p><p class="Keywords"><strong>Methods: </strong>This was a descriptive study with cross sectional design. We recruited a purposive sample of 34 STEMI post- Primary PCI patients. We employed the modified family support questionnaire (Hensarling Diabetes Family Support Scale) and the quality of life questionnaire to collect data. Data, then, were analyzed using univariate and bivariate analyses.<strong></strong></p><p class="Keywords"><strong>Results: </strong>The mean score of the family support was 64.44, with the minimum score of 21 and maximum score of 75.  More patients received good family support than those who received poor family support. On the other hand, the mean score of patients’ life quality was 68.36, ranging from 25.1-98.43. There was a weak and positive correlation between family support and quality of patients’ life. However, the relationship was insignificant.<strong> </strong></p><p class="Keywords"><strong>Conclusion: </strong>Family support was not significantly related to quality of STEMI patients’ life. Further studies to identify factors contributing to the quality of STEI patients’ life are needed. </p><p class="Keywords"><strong>Key words: </strong>family support, percutaneous coronary intervention, quality of life, ST elevation myocardial infarction  <strong></strong></p></div>

scholarly journals The Relationship Between Social Support From Family and Quality of Life Among Cancer Patients: A Cross-Sectional Study

2020 ◽  
Vol 30 (4) ◽  
pp. 217-223
Author(s):  
Ismail Toygar ◽  
Öznur Usta Yeşilbalkan ◽  
Merve Kürkütlü ◽  
Tuğba Akgün
Keyword(s):  
Quality Of Life ◽  
Social Support ◽  
Cancer Patients ◽  
Perceived Social Support ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Mean ◽  
The Relationship

Introduction: Improving the Quality of Life (QoL) is considered one of the main objectives in the care of cancer patients. Achieving this objective, it is essential to determine the factors affecting QoL in cancer patients. The studies in the literature have determined the effects of various factors on QoL but social support from family has remained to be studied.  Objective: The present study aimed to determine the relationship between perceived social support from family and QoL in cancer patients. Materials and Methods: This cross-sectional study was conducted in an oncology unit of a university hospital in İzmir City, Turkey, from March to October 2019. A convenience sample of 276 cancer patients participated in the study. A patient identification form, the Perceived Social Support from family scale (PSS-Family), and the Quality of Life index-cancer version (QLI-C) were used for data collection. The scores of PSS-Family and QLI-C range from 0 to 20 and from 66 to 396, respectively. Regression analysis was used to estimate the effect of perceived social support from family on QoL. Results: Of the participants, 65.2% were female. The Mean±SD age of the study sample was 47.5±14.4 years. Also, the Mean±SD scores of PSS-Family and QLI-C were 16.43±3.01 and 307.77±27.48, respectively. Regression analysis revealed that perceived social support from family was associated with a relative increase in QoL index (B=3.44, P=0.001, R2=0.141). Conclusion: Perceived social support from family is positively associated with QoL in cancer patients. Nurses should consider this relationship when they plan to improve the QoL of cancer patients.

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