scholarly journals Applications of Wearable Technology in a Real-Life Setting in People with Knee Osteoarthritis: A Systematic Scoping Review

2021 ◽  
Vol 10 (23) ◽  
pp. 5645
Author(s):  
Tomasz Cudejko ◽  
Kate Button ◽  
Jake Willott ◽  
Mohammad Al-Amri
Keyword(s):  
Knee Osteoarthritis ◽  
Real World ◽  
Real Life ◽  
Wearable Technology ◽  
Physical Activity Assessment ◽  
Activity Assessment ◽  
Real World Setting ◽  
Real Life Setting ◽  
Clinical Potential ◽  
Provision Of Care

With the growing number of people affected by osteoarthritis, wearable technology may enable the provision of care outside a traditional clinical setting and thus transform how healthcare is delivered for this patient group. Here, we mapped the available empirical evidence on the utilization of wearable technology in a real-world setting in people with knee osteoarthritis. From an analysis of 68 studies, we found that the use of accelerometers for physical activity assessment is the most prevalent mode of use of wearable technology in this population. We identify low technical complexity and cost, ability to connect with a healthcare professional, and consistency in the analysis of the data as the most critical facilitators for the feasibility of using wearable technology in a real-world setting. To fully realize the clinical potential of wearable technology for people with knee osteoarthritis, this review highlights the need for more research employing wearables for information sharing and treatment, increased inter-study consistency through standardization and improved reporting, and increased representation of vulnerable populations.

scholarly journals AB0799 REAL-WORLD EXPERIENCE OF SECUKINUMAB FOR PSORIATIC ARTHRITIS WITH AXIAL INVOLVEMENT.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1699.3-1699
Author(s):  
M. Martin Lopez ◽  
B. Joven-Ibáñez ◽  
J. L. Pablos
Keyword(s):  
Psoriatic Arthritis ◽  
Adverse Events ◽  
Real World ◽  
Spinal Pain ◽  
Tender Joint Count ◽  
P Value ◽  
X Ray ◽  
Activity Assessment ◽  
Real World Setting ◽  
Axial Involvement

Background:Evidence on the efficacy of biologics in the treatment of psoriatic arthritis (PsA) patients with axial manifestations affecting 30-70% of PsA patients is limited. Secukinumab (SEC) has provided significant and sustained improvement in the signs and symptoms of active PsA and ankylosing spondylitis.Objectives:This study aims to analyze the experience of using SEC for PsA patients with axial involvement in real-world setting.Methods:Multicentric observational, longitudinal, retrospective study conducted in a tertiary hospital between January 2016 and December 2019. Patients with PsA (CASPAR criteria) and clinical and/or image diagnosis of axial involvement receiving at least one dose of SEC were included. Patients with non-pathological sacroiliacs x-ray and MRI had to have spinal pain VAS ≥4/10 after failure to NSAIDs, prior to the onset of SEC, to be included. Medical records were reviewed to collect demographic and clinical data, features of PsA (manifestations, treatments and activity assessment). Descriptive statistics and then a comparative analysis with the Studentt-test to analyze the effectiveness of SEC were performed.Results:Of 98 PsA patients treated with SEC, 58 (59.2%) had axial involvement, of which 41 (71%) female. Mean age was 54 y.o (SD 10) and average duration of the disease was 10 years (SD 8). All 58 patients had peripheral disease (33% joint erosions), 55 (95%) had psoriasis, 20 (34%) showed dactilitis and 39 (67%) had enthesitis. Sacroiliacs x-ray was damaged in 38 (66%) patients (grade I-IV) and 23 (40%) pathological MRI, with HLAB27+ at 8 (14%) patients. Average BMI was 29 (SD 8), with an obesity rate of 33% (19 pt). Observed comorbidities were hypertension (27 pt, 47%), diabetes mellitus (6 pt, 10%), dyslipidemia (23 pt, 40%), active smoking (18 pt, 31%) and malignancy (6 pt, 10%). Regarding previous treatments, 90% had received cDMARDs, particularly methotrexate (86%) and 40 (69%) had been exposed to at least one bDMARD (15 pt to one, 9 to two, 6 to three and 10 to four or more). 7 patients were on 300 mg dose and 51 patients on 150 mg dose (dose escalation to 300 mg was performed in 16 patients and 44% respond and maintain SEC). Average drug survival time was 1.4 (SD 1) years. At 6 months of SEC therapy, tender and swollen joint count, spinal pain VAS, CRP, ASDAS-CRP and DAPSA had significantly decreased (Table 1). 29 (50%) patients suspended SEC during follow-up due to primary ineffectiveness (8), secondary ineffectiveness (16), adverse events (3), latex allergy (1) and remission (1). Adverse events do not differ from those reported in clinical trials.Table 1.Disease activity assessment at 6 months of secukinumab therapy.Baseline6 months after SECMean differenceP valueSJC4,8±5,41,9±3,1-2,8 (IC95% -3,9 a -1,7)p<0,0001TJC7,7±5,83,9±4,1-3,8 (IC95% -5,1 a -2,4)p<0,0001Spinal pVAS6,1±3,24,2±2,9-1,9 (IC95% -2,4 a -1,4)p<0,0001CRP (mg/L)7,7±9,94,9±5,9-2,9 (IC95% -4,5 a -1,2)p=0,0009ASDAS-CRP2,5±1,91,8±1,3-0,7 (IC95% -0,9 a -0,4)p<0,0001DAPSA27,7±12,116,7±10,4-11 (IC95% -15,3 a -6,8)p<0,0001SJC: swollen joint count, TJC: tender joint count, Spinal pVAS: spinal pain visual analog scale, CRP: C-reactive protein, SEC: secukinumab.Conclusion:Secukinumab in real-world setting provided improvements in the axial and peripheral manifestations of PsA, using both the 150 mg and 300 mg doses.Disclosure of Interests:MARIA MARTIN LOPEZ: None declared, Beatriz Joven-Ibáñez Speakers bureau: Abbvie, Celgene, Janssen, Merck Sharp & Dohme, Novartis, Pfizer, José Luis Pablos: None declared

scholarly journals Crossing Virtual Doors: A New Method to Study Gait Impairments and Freezing of Gait in Parkinson’s Disease

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Luis I. Gómez-Jordana ◽  
James Stafford ◽  
C. (Lieke) E. Peper ◽  
Cathy M. Craig
Keyword(s):  
Real World ◽  
Ecological Validity ◽  
Freezing Of Gait ◽  
Real Life ◽  
Step Length ◽  
Gait Variability ◽  
Healthy Controls ◽  
Real World Setting ◽  
History Of ◽  
Gait Impairments

Studying freezing of gait (FOG) in the lab has proven problematic. This has primarily been due to the difficulty in designing experimental setups that maintain high levels of ecological validity whilst also permitting sufficient levels of experimental control. To help overcome these challenges, we have developed a virtual reality (VR) environment with virtual doorways, a situation known to illicit FOG in real life. To examine the validity of this VR environment, an experiment was conducted, and the results were compared to a previous “real-world” experiment. A group of healthy controls (N = 10) and a group of idiopathic Parkinson disease (PD) patients without any FOG episodes (N = 6) and with a history of freezing (PD-f, N = 4) walked under three different virtual conditions (no door, narrow doorway (100% of shoulder width) and standard doorway (125% of shoulder width)). The results were similar to those obtained in the real-world setting. Virtual doorways reduced step length and velocity while increasing general gait variability. The PD-f group always walked slower, with a smaller step length, and showed the largest increases in gait variability. The narrow doorway induced FOG in 66% of the trials, while the standard doorway caused FOG in 29% of the trials. Our results closely mirrored those obtained with real doors. In short, this methodology provides a safe, personalized yet adequately controlled means to examine FOG in Parkinson’s patients, along with possible interventions.

scholarly journals Guselkumab Treatment Outcomes and Persistence in a Nationwide Real-world Cohort of Patients with Plaque Psoriasis

2021 ◽  
Author(s):  
Tarja Mälkönen ◽  
Pauliina Nuutinen ◽  
Taru Hallinen ◽  
Erkki Soini ◽  
Riikka Nissinen ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Real World ◽  
Plaque Psoriasis ◽  
Treatment Duration ◽  
Real Life ◽  
Severity Index ◽  
Biologic Therapies ◽  
Treatment Persistence ◽  
Real Life Setting

Guselkumab treatment outcomes and persistence were assessed in a real-world cohort of Finnish patients with difficult-to-treat plaque psoriasis over a median follow-up of 1 year. Data on 181 patients who initiated guselkumab at the 15 study centres were collected retrospectively from the patient charts. Prior exposure to biologic therapies was common with 56% and 35% having used at least 1 and 2 biologics, respectively. Median guselkumab treatment duration was 11 months with 21 patients (12%) discontinuing treatment during follow-up. Of 85 patients with a follow-up duration of at least 1 year, 73 (86%) were still on guselkumab at 1 year. Significant improvements during follow-up were seen in the absolute Psoriasis Area and Severity Index (PASI) scores with 32 patients (80%) having absolute PASI ≤ 2 after a 9–14-month treatment. Guselkumab treatment was effective and treatment persistence was high in the nationwide Finnish real-life setting.

scholarly journals Pomalidomide and Dexamethasone Are Effective in Relapsed or Refractory Multiple Myeloma in a Real-Life Setting: A Multicenter Retrospective Study in Taiwan

2021 ◽  
Vol 11 ◽  
Author(s):  
Yu-Chin Hung ◽  
Jyh-Pyng Gau ◽  
Shang-Yi Huang ◽  
Bor-Sheng Ko ◽  
Chieh-Lin Jerry Teng
Keyword(s):  
Multiple Myeloma ◽  
Real World ◽  
Real Life ◽  
Progression Free Survival ◽  
High Dose ◽  
Free Survival ◽  
Refractory Multiple Myeloma ◽  
High Dose Dexamethasone ◽  
Real Life Setting ◽  
Multicenter Registry

BackgroundThe therapeutic options of relapsed or refractory multiple myeloma (RRMM) remain a challenge. The MM-003 trial demonstrated that RRMM patients treated with pomalidomide and dexamethasone (Pom/Dex) have better progression-free survival (PFS) than those treated with high-dose dexamethasone alone. However, the real-world effectiveness of Pom/Dex in these patients in Taiwan remains unclear.MethodsThis multicenter, registry-based study retrospectively reviewed the medical records of 49 consecutive patients undergoing Pom/Dex treatment for RRMM. We investigated the overall response rate (ORR) and PFS in these patients. The patients were stratified into two groups: those who received two (n=33) and those who received more than two (n=16) prior lines of treatment according to the numbers of regimens before Pom/Dex therapy. The differences in ORR and PFS between these two groups were further analyzed. We also analyzed factors attributed to disease progression.ResultsThe ORR was 47.7%, and the median PFS was 4.0 months (range, 0.1−21.1). Patients who received two prior lines of treatment had a higher ORR than those who received more than two prior lines of treatment (55.2% vs. 33.3%; p=0.045). The median PFS of these groups was 4.8 and 3.9 months, respectively (p=0.805). Primary lenalidomide refractoriness reduced the risk of myeloma progression following Pom/Dex treatment (hazard ratio, 0.14; p=0.001).ConclusionsThe median PFS following Pom/Dex treatment in Taiwanese RRMM patients in a real-world setting was similar to that reported by the MM-003 trial. Primary lenalidomide refractoriness should not be an obstacle for Pom/Dex treatment in RRMM.

Atezolizumab in first-line treatment of metastatic nonsquamous non-small cell lung cancer in the real-world setting.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e21112-e21112
Author(s):  
Javier De Castro ◽  
Begoña Campos Balea ◽  
Diego Perez Parente ◽  
Letizia Polito ◽  
Marcus Lawrance ◽  
...  
Keyword(s):  
Real World ◽  
Real Life ◽  
Phase Iii ◽  
Egfr Mutations ◽  
First Line ◽  
Early Adopters ◽  
The Real ◽  
Real World Setting ◽  
Health Database

e21112 Background: The phase III IMpower150 study showed efficacy benefits with atezolizumab in combination with bevacizumab, carboplatin and paclitaxel (ABCP; arm B) as first-line (1L) treatment for patients (pts) with metastatic non-squamous (nsq) NSCLC. The FDA approved this regimen for these pts (with no EGFR or ALK mutations [WT]) on December 2018. However, to date there is limited evidence on its use in real life. This study aimed to explore the use of ABCP in the real-world setting and to describe the characteristics of early adopters (those who received ABCP in 1L). Methods: Data were extracted from the Flatiron Health database (US population). Pts with advanced stage IIIB/IV nsq NSCLC at diagnosis receiving ABCP regimen in any line were eligible for the study. Finally, early adopters were selected. Results: A total of 67 pts received the ABCP regimen in 1L. Baseline characteristics for these pts and comparisons with the IMpower150 population are summarized in Table. Real-world (rw) response in the WT group ( n = 49; 6 pts were excluded due to EGFR mutations and 12 because minimum follow-up was not reached) was similar to that of the IMpower150 series (rwRR: 55.1% [40.2-69.3] vs. 63.5% [58.2-68.5]), despite the WT population being older with a higher proportion of ECOG PS = 1. In patients who would have met the IMpower150 inclusion criteria ( n = 24), rwRR was 70.8% (48.9-87.4). Conclusions: The ABCP regimen has been adopted in the real-world setting. In terms of efficacy, response rates and current PFS data were in line with trial results, despite the population being unselected and having a worse clinical profile. Longer follow-up is required for rwOS data. vs. arm B IMpower150 results.[Table: see text]

scholarly journals Anti-microbial effect of filtered 222nm excimer lamps in a hospital waiting area

2021 ◽  
Author(s):  
Jacob Thyrsted ◽  
Søren Helbo Skaarup ◽  
Andreas Fløe Hvass ◽  
Sara Moeslund Joensen ◽  
Stine Y. Nielsen ◽  
...  
Keyword(s):  
Real World ◽  
Pathogenic Bacteria ◽  
Bacterial Species ◽  
Bacterial Load ◽  
Real Life ◽  
University Hospital ◽  
Waiting Room ◽  
Excimer Lamps ◽  
Real Life Setting ◽  
Waiting Area

SummaryBackgroundHospital aquired infections is a considerable challenge for vulnerable patients. Ultraviolet light based on the excitation of mercury emit light at 254nm and has well established antimicrobial effects but the use hereof in populated areas is hindered by the carcinogenic properties of 254nm. This is in contrast to the recently developed excimer lamps based on krypton chloride (KrCl). These lamps emit light with a peak intensity at a wavelength of 222nm and have recently been demonstrated to have broad bactericidal and viricidal effects including efficient inactivation of SARS-CoV2. It is, however, unclear how efficiently 222nm lamps perform in a real-life setting such as a hospital waiting area. In this study we aimed to assess the antimicrobial efficacy of filtered 222nm excimer lamps in a real-world setting at an out-patient pulmonology clinic.MethodsFiltered KrCl 222nm excimer lamps (UV222 lamps) were installed in a densely populated waiting room at the out-patient waiting area at Department of Respiratory Diseases and Allergy at Aarhus University Hospital, Aarhus, Denmark. Furniture sufaces were sampled and analyzed for bacterial load in a single arm interventional longitudinal study with and without exposure to filtered 222nm UVC-light. Furthermore, bacterial species were identified using MALDI-ToF mass-spectrometry.FindingsThe exposure to filtered 222nm UVC-light significantly reduced the number of colony-forming-units, and patches with high desity of bacteria. Pathogenic bacteria such as Staphylococcus Aureus and Staphylococcus Epidermidis were detected only in the non-exposed areas suggesting that these species are highly sensitive to inactivation by 222nm UVC-light.ConclusionFiltered 222nm UVC-light is highly anti-microbial in a real-world clinical setting reducing bacterial load and eradicating clinically relevant bacteria species. Filtered 222nm UVC-light has the potential to become an important part of current and future anti-microbial prevention in the clinic.

Neuropsychology in the Real World

2014 ◽  
Vol 25 (4) ◽  
pp. 233-238 ◽  
Author(s):  
Martin Peper ◽  
Simone N. Loeffler
Keyword(s):  
Neuropsychological Assessment ◽  
Real World ◽  
Ecological Validity ◽  
Real Life ◽  
Emotional States ◽  
Context Sensitive ◽  
Traditional Assessment ◽  
Life Data ◽  
Real Life Data ◽  
Assessment And Treatment

Current ambulatory technologies are highly relevant for neuropsychological assessment and treatment as they provide a gateway to real life data. Ambulatory assessment of cognitive complaints, skills and emotional states in natural contexts provides information that has a greater ecological validity than traditional assessment approaches. This issue presents an overview of current technological and methodological innovations, opportunities, problems and limitations of these methods designed for the context-sensitive measurement of cognitive, emotional and behavioral function. The usefulness of selected ambulatory approaches is demonstrated and their relevance for an ecologically valid neuropsychology is highlighted.

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