Chronic spontaneous urticaria – the usefulness of assessment tools in clinical practice according to the EAACI/GA²LEN/EuroGuiDerm/APAAACI 2021 guideline

About half of patients with multiple sclerosis exhibit cognitive impairment which negatively affects their quality of life. The assessment of cognitive function in routine clinical practice is still undervalued, although various tools have been proposed for this reason. In this article, we describe the potential benefits of implementing cognitive assessment tools in routine follow -ups of MS patients. Early detection of changes in cognitive performance may provide evidence of disease activity, could unmask depression or medication side-effects and provide suitable candidates for cognitive rehabilitation. Since apathy and cognitive deficiencies are common presenting symptoms in Progressive Multifocal Leukoencephalopathy, we discuss the utility of frequent monitoring of mental status in multiple sclerosis patients at increased risk. In addition, we propose a relevant algorithm aiming to incorporate a systematic evaluation of cognitive function in every day clinical practice in multiple sclerosis.

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Cognitive assessment: A challenge for occupational therapists in Brazil

Dementia & Neuropsychologia ◽

10.1590/1980-57642016dn11-020004 ◽

2017 ◽

Vol 11 (2) ◽

pp. 121-128 ◽

Cited By ~ 1

Author(s):

Juliana Conti

Keyword(s):

Clinical Practice ◽

Cognitive Assessment ◽

Occupational Therapists ◽

Brazilian Portuguese ◽

Assessment Tools ◽

Neurological Injury ◽

Cognitive Tools ◽

Practice Methods ◽

Brazilian Culture

ABSTRACT Cognitive impairment is a common dysfunction after neurological injury. Cognitive assessment tools can help the therapist understand how impairments are affecting functional status and quality of life. Objective: The aim of the study was to identify instruments for cognitive assessment that Occupational Therapists (OT) can use in clinical practice. Methods: The instruments published in English and Portuguese between 1999 and 2016 were systematically reviewed. Results: The search identified 17 specific instruments for OT not validated in Brazilian Portuguese, 10 non-specific instruments for OT not validated in Brazilian Portuguese, and 25 instruments validated for Portuguese, only one of which was specific for OT (Lowenstein Occupational Therapy Cognitive Assessment). Conclusion: There are few assessment cognitive tools validated for use in the Brazilian culture and language. The majority of the instruments appear not to be validated for use by OT in clinical practice.

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Children with Speech Difficulties: A survey of clinical practice in the Western Cape

South African Journal of Communication Disorders ◽

10.4102/sajcd.v57i1.51 ◽

2010 ◽

Vol 57 (1) ◽

Cited By ~ 6

Author(s):

Michelle Pascoe ◽

Zinhle Maphalala ◽

Aeysha Ebrahim ◽

Daneil Hime ◽

Bathobile Mdladla ◽

...

Keyword(s):

Clinical Practice ◽

Linguistic Diversity ◽

Speech Development ◽

Assessment Tools ◽

Western Cape ◽

School Aged Children ◽

The United Kingdom ◽

Informal Assessment ◽

African Context ◽

Selection Of

This paper is based on a study by Joffe and Pring (2008) which investigated assessment and therapy methods used by Speech Language Therapists (SLTs) in the United Kingdom for children with phonological difficulties. Joffe and Pring reported SLTs’ most favoured assessments and therapy approaches in that context. Children with speech difficulties are likely to form a considerable part of SLT caseloads in South Africa, but the choice of assessments may not be so clearcut given the linguistic diversity of the region and the fact that few assessments have been developed specifically for the SA population. Linked to difficulties with assessment, selection of intervention approaches may also pose challenges. This study aimed to investigate the methods of assessment and intervention used by SLTs in the Western Cape when working with children with speech difficulties. A questionnaire was sent to SLTs working with pre and/ or primary school- aged children. Twenty-nine clinicians of varying experience responded. The majority of SLTs (89%) use informal assessment tools in combination with formal assessment. When using formal assessments, more than 50% of SLTs make modifications to better suit the population. Participants use a variety of intervention approaches, often in combination, and based on a child’s individual profile of difficulties and available resources. Forty-six percent of SLTs felt unsure about the selection of assessments and intervention for bi/multilingual children with speech difficulties. SLTs suggested that guidelines about accepted / typical speech development in the region would be helpful for their clinical practice. Clinical implications of the findings are discussed together with some suggestions for developing knowledge of children’s speech difficulties in the South African context.

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Assessment tools for palliative care.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.26_suppl.66 ◽

2016 ◽

Vol 34 (26_suppl) ◽

pp. 66-66

Author(s):

Sarina Isenberg ◽

Rebecca Aslakson ◽

Sydney Morss Dy ◽

Renee Wilson ◽

Julie Waldfogel ◽

...

Keyword(s):

Quality Of Life ◽

Palliative Care ◽

Clinical Practice ◽

Quality Indicators ◽

Systematic Reviews ◽

Grey Literature ◽

Care Quality ◽

Assessment Tools ◽

Patient Reported

66 Background: Recent reviews have not comprehensively addressed palliative care (PC) assessment tools. This project summarizes the extent of evidence about PC assessment tools for patients and families, and how tools have been used for clinical care, quality indicators, and evaluation of interventions. Methods: We searched MEDLINE, CINAHL, and Cochrane Database of Systematic Reviews for systematic reviews of assessment tools for PC, from January 2007 to March 2016. We searched the grey literature for domains without systematic reviews, and for domains with systematic reviews > three years old. Paired investigators independently screened search results and grey literature to determine eligibility, and assessed risk of bias of systematic reviews. The team selected the most recent and highest-quality systematic reviews for each domain. One investigator abstracted information, and a second investigator checked the information. Results: Using the National Consensus Project Palliative Care Guidelines domains, we included nine systematic reviews with 167 tools, and six tools from grey literature. Most tools were in physical, psychological, psychiatric, and social aspects of care, care at the end of life, and tools that cross domains (quality of life and caregiver-reported experience). Only two tools directly addressed spiritual aspects and none addressed cultural or patient-reported experience. Internal consistency reliability was evaluated for almost all tools; most reported construct validity; and few reported responsiveness (sensitivity to change). Few studies evaluated the use of assessment tools in quality indicators or clinical practice. A systematic review of 38 PC interventions and the assessment tools used found that at least 25 interventions included physical, psychosocial and psychiatric, and quality of life tools, but the tools varied extensively, and only nine included patient experience tools. Conclusions: Although assessment tools exist in many PC domains, tools are needed to assess spiritual and cultural aspects of care, and patient-reported experience. Research is needed concerning: tools in clinical practice and quality of care; comparison of existing tools; and evaluation and dissemination tools with evidence of responsiveness.

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Scoring Systems for Estimating the Risk of Anticoagulant-Associated Bleeding

Seminars in Thrombosis and Hemostasis ◽

10.1055/s-0037-1598061 ◽

2017 ◽

Vol 43 (05) ◽

pp. 514-524 ◽

Cited By ~ 5

Author(s):

Anna Parks ◽

Margaret Fang

Keyword(s):

Clinical Practice ◽

Risk Index ◽

Predictive Ability ◽

Scoring Systems ◽

Bleeding Risk ◽

Assessment Tools ◽

Risk Scores ◽

Bleeding Complications ◽

Individual Risk ◽

Thrombosis Risk

AbstractAnticoagulant medications are frequently used to prevent and treat thromboembolic disease. However, the benefits of anticoagulants must be balanced with a careful assessment of the risk of bleeding complications that can ensue from their use. Several bleeding risk scores are available, including the Outpatient Bleeding Risk Index, HAS-BLED, ATRIA, and HEMORR2HAGES risk assessment tools, and can be used to help estimate patients' risk for bleeding on anticoagulants. These tools vary by their individual risk components and in how they define and weigh clinical factors. However, it is not yet clear how best to integrate bleeding risk tools into clinical practice. Current bleeding risk scores generally have modest predictive ability and limited ability to predict the most devastating complication of anticoagulation, intracranial hemorrhage. In clinical practice, bleeding risk tools should be paired with a formal determination of thrombosis risk, as their results may be most influential for patients at the lower end of thrombosis risk, as well as for highlighting potentially modifiable risk factors for bleeding. Use of bleeding risk scores may assist clinicians and patients in making informed and individualized anticoagulation decisions.

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Physiotherapy Questionnaires App to Deliver Main Musculoskeletal Assessment Questionnaires: Development and Validation Study (Preprint)

10.2196/preprints.9247 ◽

2017 ◽

Author(s):

Nestor Cavalcante Teixeira Neto ◽

Yuri Lopes Lima ◽

Gabriel Peixoto Leão Almeida ◽

Márcio Almeida Bezerra ◽

Pedro Olavo De Paula Lima ◽

...

Keyword(s):

Clinical Practice ◽

Assessment Tools ◽

Foot And Ankle ◽

Paper Version ◽

Second Stage ◽

Patient Reported ◽

The Mean ◽

American Orthopaedic ◽

Paper Format ◽

Development And Validation

BACKGROUND Patient-reported outcomes (PROs) translate subjective outcomes into objective data that can be quantified and analyzed. Nevertheless, the use of PROs in their traditional paper format is not practical for clinical practice due to limitations associated with the analysis and management of the data. To address the need for a viable way to group and utilize the main functioning assessment tools in the field of musculoskeletal disorders, the Physiotherapy Questionnaires app was developed. OBJECTIVE This study aims to explain the development of the app, to validate it using two questionnaires, and to analyze whether participants prefer to use the app or the paper version of the questionnaires. METHODS In the first stage, the app for an Android operational system was developed. In the second stage, the aim was to select questionnaires that were most often used in musculoskeletal clinical practice and research. The Foot and Ankle Outcome Score (FAOS) and American Orthopaedic Foot and Ankle Society (AOFAS) questionnaire were selected to validate the app. In total, 50 participants completed the paper and app versions of the AOFAS and 50 completed the FAOS. The study’s outcomes were the correlation of the data between the paper and app versions as well as the preference of the participants between the two versions. RESULTS The app was approved by experts after the adaptations of the layout for mobile phones and a total of 18 questionnaires were included in the app. Moreover, the app allows the generation of PDF and Excel files with the patients’ data. In regards to validity, the mean of the total scores of the FAOS were 91.54% (SD 8.86%) for the paper version and 91.74% (SD 9.20%) for the app. There was no statistically significant differences in the means of the total scores or the subscales (P=.11-.94). The mean total scores for the AOFAS were 93.94 (SD 8.47) for the paper version and 93.96 (SD 8.48) for the app. No statistically significant differences were found for the total scores for the AOFAS or the subscales (P>.99). The app showed excellent agreement with the paper version of the FAOS, with an ICC value of 0.98 for the total score (95% CI 0.98-0.99), which was also found for the AOFAS with the ICC for the total score of 0.99 (95% CI 0.98-0.99). For compliance, 72% (36/50) of the participants in the FAOS group and 94% (47/50) in the AOFAS group preferred the app version. CONCLUSIONS The Physiotherapy Questionnaires app showed validity and high levels of compliance for the FAOS and AOFAS, which indicates it is not inferior to the paper version of these two questionnaires and confirms its viability and feasibility for use in clinical practice.

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A Mobile Technology for Collecting Patient-Reported Physical Activity and Distress Outcomes: Cross-Sectional Cohort Study

JMIR mhealth and uhealth ◽

10.2196/17320 ◽

2020 ◽

Vol 8 (5) ◽

pp. e17320

Author(s):

Miyeon Jung ◽

SaeByul Lee ◽

Jisun Kim ◽

HeeJeong Kim ◽

BeomSeok Ko ◽

...

Keyword(s):

Physical Activity ◽

Clinical Practice ◽

Mobile App ◽

Assessment Tools ◽

Patient Health Questionnaire ◽

Time Interval ◽

Health Questionnaire ◽

Patient Reported ◽

Patient Health ◽

Paper And Pencil

Background Electronic patient-reported outcome (PROs) provides a fast and reliable assessment of a patient’s health-related quality of life. Nevertheless, using PRO in the traditional paper format is not practical for clinical practice due to the limitations associated with data analysis and management. A questionnaire app was developed to address the need for a practical way to group and use distress and physical activity assessment tools. Objective The purpose of this study was to assess the level of agreement between electronic (mobile) and paper-and-pencil questionnaire responses. Methods We validated the app version of the distress thermometer (DT), International Physical Activity Questionnaire (IPAQ), and Patient Health Questionnaire–9 (PHQ-9). A total of 102 participants answered the paper and app versions of the DT and IPAQ, and 96 people completed the PHQ-9. The study outcomes were the correlation of the data between the paper-and-pencil and app versions. Results A total of 106 consecutive breast cancer patients were enrolled and analyzed for validation of paper and electronic (app) versions. The Spearman correlation values of paper and app surveys for patients who responded to the DT questionnaire within 7 days, within 3 days, and on the same day were .415 (P<.001), .437 (P<.001), and .603 (P<.001), respectively. Similarly, the paper and app survey correlation values of the IPAQ total physical activity metabolic equivalent of task (MET; Q2-6) were .291 (P=.003), .324 (P=.005), and .427 (P=.01), respectively. The correlation of the sum of the Patient Health Questionnaire–9 (Q1-9) according to the time interval between the paper-based questionnaire and the app-based questionnaire was .469 for 14 days (P<.001), .574 for 7 days (P<.001), .593 for 3 days (P<.001), and .512 for the same day (P=.03). These were all statistically significant. Similarly, the correlation of the PHQ (Q10) value according to the time interval between the paper-based questionnaire and the app-based questionnaire was .283 for 14 days (P=.005), .409 for 7 days (P=.001), .415 for 3 days (P=.009), and .736 for the same day (P=.001). These were all statistically significant. In the overall trend, the shorter the interval between the paper-and-pencil questionnaire and the app-based questionnaire, the higher the correlation value. Conclusions The app version of the distress and physical activity questionnaires has shown validity and a high level of association with the paper-based DT, IPAQ (Q2-6), and PHQ-9. The app-based questionnaires were not inferior to their respective paper versions and confirm the feasibility for their use in clinical practice. The high correlation between paper and mobile app data allows the use of new mobile apps to benefit the overall health care system. Trial Registration ClinicalTrials.gov NCT03072966; https://clinicaltrials.gov/ct2/show/NCT03072966

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Canadian Society of Transplantation and Canadian Society of Nephrology Commentary on the 2017 KDIGO Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors

Canadian Journal of Kidney Health and Disease ◽

10.1177/2054358120918457 ◽

2020 ◽

Vol 7 ◽

pp. 205435812091845

Author(s):

Ngan N. Lam ◽

Christine Dipchand ◽

Marie-Chantal Fortin ◽

Bethany J. Foster ◽

Anand Ghanekar ◽

...

Keyword(s):

Clinical Practice ◽

Clinical Practice Guideline ◽

Practice Guideline ◽

Assessment Tools ◽

Canadian Society ◽

Sources Of Information ◽

Kidney Donors ◽

Living Kidney Donors ◽

Kidney Paired Donation ◽

Donor Population

Purpose of review: To review an international guideline on the evaluation and care of living kidney donors and provide a commentary on the applicability of the recommendations to the Canadian donor population. Sources of information: We reviewed the 2017 Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors and compared this guideline to the Canadian 2014 Kidney Paired Donation (KPD) Protocol for Participating Donors. Methods: A working group was formed consisting of members from the Canadian Society of Transplantation and the Canadian Society of Nephrology. Members were selected to have representation from across Canada and in various subspecialties related to living kidney donation, including nephrology, surgery, transplantation, pediatrics, and ethics. Key findings: Many of the KDIGO Guideline recommendations align with the KPD Protocol recommendations. Canadian researchers have contributed to much of the evidence on donor evaluation and outcomes used to support the KDIGO Guideline recommendations. Limitations: Certain outcomes and risk assessment tools have yet to be validated in the Canadian donor population. Implications: Living kidney donors should be counseled on the risks of postdonation outcomes given recent evidence, understanding the limitations of the literature with respect to its generalizability to the Canadian donor population.

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Creating Access to Assessment Methods and Results

Testimony That Sticks ◽

10.1093/med-psych/9780190467395.003.0009 ◽

2019 ◽

pp. 146-176

Author(s):

Karen Postal

Keyword(s):

Clinical Practice ◽

Standardized Testing ◽

Neuropsychological Assessment ◽

Graduate School ◽

Assessment Methods ◽

Assessment Tools ◽

Basic Assumptions ◽

Assessment Procedures ◽

Thought Bubbles ◽

Assessment Results

Jurors may have no idea how our assessment tools and procedures work. Professionals are so used to speaking and thinking with the basic assumptions of our professions that those assumptions become invisible to us. Standardized testing and normative interpretation are a great example of this concept. After years of graduate school and clinical practice, when a neuropsychologist uses the word testing we have a very precise image in our thought bubbles of a battery of valid and reliably constructed instruments, normed on appropriate populations, administered in a standardized fashion, and interpreted in the context of the larger assessment. But very few jurors will have been exposed to the concept of normative interpretation. To ensure that jurors and triers of fact have access to our broader message regarding assessment results, we need to begin our testimony with a clear, accessible, and engaging description of our assessment tools and process. This chapter addresses strategies for explaining psychological and neuropsychological assessment procedures, as well as specific tests like the MMPI, in a clear, accessible manner.

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