scholarly journals Individual Patient Factors Associated with Effective Tinnitus Treatment

2014 ◽  
Vol 25 (07) ◽  
pp. 631-643 ◽  
Author(s):  
Sarah M. Theodoroff ◽  
Andrew Schuette ◽  
Susan Griest ◽  
James A. Henry
Keyword(s):  
Logistic Regression ◽  
Treatment Outcome ◽  
Clinical Study ◽  
Emotional Health ◽  
The Other ◽  
Self Report ◽  
Patient Factors ◽  
Tinnitus Handicap Inventory ◽  
Factors Associated ◽  
Controlled Clinical Study

Background: Little is known about patient factors that might influence outcomes of tinnitus interventions. Determining such factors would offer insights into why some individuals benefit from tinnitus intervention whereas others do not. Purpose: The purpose of this study was to evaluate selected patient factors that may be associated with outcomes of tinnitus intervention. Factors studied include demographics, tinnitus characteristics, psychoacoustic tinnitus measures, audiometric data, and overall physical/emotional health status. Research Design: A retrospective analysis was performed on data obtained from a controlled clinical study that compared factors associated with tinnitus relief after tinnitus masking and tinnitus retraining therapy. Study Sample: A total of 126 military veterans participated in this controlled clinical study. Of these, 89 completed outcome measures at both baseline and 12 mo and were included in the present analysis. Data Collection and Analysis: A “responder” to intervention was identified as having a decrease (improvement) of 20 or more points on the Tinnitus Handicap Inventory between baseline and 12 mo. A “nonresponder” did not achieve a 20-point improvement on the Tinnitus Handicap Inventory. Individual patient factors were examined using independent t-tests or χ2 analysis. A logistic regression model was used to determine how well each factor predicted treatment outcome (responder or nonresponder) while controlling for each of the other factors. Results: Five patient factors were significantly different (p ≤ 0.05) between responders and nonresponders. Responders tended to (1) be younger in age; (2) have better low-frequency hearing sensitivity; (3) have greater problems with overall hearing; (4) be more likely to have tinnitus for shorter durations; and (5) perceive their tinnitus to be located “in the head” versus “in the ears.” A logistic regression was then performed to determine how well each factor predicted the treatment outcome (responder versus nonresponder) while controlling for each of the other factors. Results from the logistic regression revealed two of the five factors, localization of tinnitus and self-report of hearing problems, to be statistically significant. Conclusions: Examining the association of individual patient factors to a specific tinnitus intervention yielded several significant findings. Although these findings are not definitive, they reveal the capability that exists to perform these kinds of analyses to investigate relationships between individual patient characteristics and outcomes of intervention for tinnitus. Prospective research using systematic approaches is needed to identify these relationships that would contribute toward the ability to differentially predict outcomes of various tinnitus interventions. Obtaining this information would lead to more targeted therapy and ultimately more effective intervention.

scholarly journals Pulmonary Tuberculosis: Treatment Outcomes and Factors Associated with Poor Treatment Outcome in Pahang, Malaysia

2018 ◽  
Vol 17 (1) ◽  
Author(s):  
Zafirah Amalina binti Zulkipli ◽  
Muhammad Amir Hafiz bin Mohd Salleh ◽  
Musaab Nassereldeen Ahmed
Keyword(s):  
Logistic Regression ◽  
Treatment Outcome ◽  
Pulmonary Tuberculosis ◽  
Success Rate ◽  
Treatment Outcomes ◽  
Treatment Success ◽  
Treatment Success Rate ◽  
Health Concern ◽  
Multiple Logistic Regression ◽  
Factors Associated

Introduction: Tuberculosis (TB) remains a formidable public health concern in Malaysia. Malaysia’s national treatment success rate is still below the ideal 90% positive outcome recommended by the End TB Strategy (2015-2035). In this study, we evaluated the treatment outcomes and associated predictors of smear or culture positive pulmonary tuberculosis (PTB) patients. Materials and Methods: This is a retrospective cohort study conducted in chest clinic of Hospital Tengku Ampuan Afzan (HTAA), Pahang from January 2012 to December 2016. PTB cases in HTAA were crosschecked with TB registry and patients who fulfilled the inclusion criteria were selected. Data was collected using a standardized clinical report form and analyzed using multiple logistic regression. Results: There were a total of 342 patients recruited. Majority were Malaysian (94.2%), male (67.8%) and Malay (80.0%). The treatment success rate was 55.26%, with a cure rate of 42.98%. The high portion of defaulters (21.05%) in our study population was amongst the most striking findings. Multiple logistic regression analysis revealed that the factors associated with unfavourable treatment outcome were time in treatment, case after treatment interruption or failure and poor compliance. Univariate analysis revealed that male, hepatitis, smoking and intravenous drug user were found to be significant factors associated with poorer treatment outcomes. Conclusion: Achieving a higher patient retention rate is a significant factor in increasing effectiveness of treatment services. Thus, our study recommends stricter Directly Observed Treatment, Short Course (DOTS) and an enhanced understanding of the real barriers to patients’ treatment regimen adherence in order to overcome them.

Effect of diathermy on pain and healing in tonsillectomy, compared with other methods of haemostasis: a randomised study

2008 ◽  
Vol 123 (6) ◽  
pp. 648-655 ◽  
Author(s):  
C H Hahn ◽  
J A Rungby ◽  
T Overgaard ◽  
H Møller ◽  
P Schultz ◽  
...  
Keyword(s):  
Clinical Study ◽  
Outcome Measures ◽  
Local Anaesthesia ◽  
Analogue Scale ◽  
The Other ◽  
Bipolar Diathermy ◽  
Consultation Rate ◽  
Randomised Study ◽  
Pain Scores ◽  
Controlled Clinical Study

AbstractObjective:To compare three methods of haemostasis used for ‘cold steel’ tonsillectomy, in terms of pain scores and morbidity.Method and material:Prospective, randomised, single-blinded, controlled clinical study. Three haemostasis methods were compared: compression of the tonsillar fossae with gauze packs; bipolar diathermy; and local anaesthesia then pack compression. The outcome measures were pain scores (derived from a visual analogue scale), peri-operative bleeding, and post-operative episodes of blood-stained saliva, consultation rate, tonsillar bed healing and days before return to regular diet. One hundred and five patients were included.Results:Peri-operative bleeding was significantly reduced in the local anaesthesia group compared with the other two groups. Delayed post-operative tonsillar bed healing was noted in the diathermy group. No other significant differences were found between the three haemostasis groups, for any other outcome measures. The presence of blood-stained saliva was associated with higher pain scores.Conclusion:Diathermy and compression were associated with similar post-tonsillectomy morbidity.

scholarly journals Factors Associated with Treatment Outcome of Patients with Pulmonary Tuberculosis in the Philippines, 2015 to 2016

2020 ◽  
Vol 54 (5) ◽  
Author(s):  
Ian Oliver D. Macatangay ◽  
Sophia Anne S.P. Liao ◽  
Joshua Jason A. Dadural ◽  
Fatima Joy S. Gagui ◽  
Angelica Joy A. Galas ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Treatment Outcome ◽  
Logistic Regression Analysis ◽  
Multiple Logistic Regression Analysis ◽  
The Philippines ◽  
Sputum Smear ◽  
Cross Sectional ◽  
Factors Associated ◽  
Unsuccessful Treatment

Objective. The study aims to determine the factors associated with unsuccessful treatment outcome amongpatients who have undergone tuberculosis treatment. Methods. An analytic cross-sectional study was employed through secondary data analysis of administrativedata collected by the National Tuberculosis Control Program from October 2015 to September 2016. Usingmultiple logistic regression analysis, factors associated with unsuccessful treatment outcome were determined. Results. Multiple logistic regression analysis revealed that belonging to age groups 25 to 34 (aOR=0.73; 95%CI0.54-0.99) or 35 to 44 (aOR=0.75; 95%CI 0.56-0.99), being male (aOR=1.30; 95%CI 1.03-1.64), doing craftsand related trades work (aOR=0.66; 95%CI 0.46-0.94), living in either a 4th class city (aOR=0.46; 95%CI0.26-0.82), 1st class municipality (aOR=0.75; 95%CI 0.57-0.98), 4th class municipality (aOR=0.59; 95%CI0.38-0.93), having a positive sputum smear result (aOR=1.60; 95%CI 1.29-2.00), having rifampicin-resistant/multidrug-resistant tuberculosis (aOR=9.32; 95%CI 7.28-11.93), being a treatment after lost to follow-up case(aOR=1.84; 95%CI 1.37-2.47) or a case with previously unknown treatment outcome (aOR=1.42; 95%CI 1.00-2.01)were significant correlates of unsuccessful treatment outcome. Conclusion. The study found that age, sex, occupation, residence, sputum smear results, drug resistance, andhistory of previous treatment were associated with unsuccessful treatment outcome.

Patient factors associated with onabotulinum toxin A treatment outcome in women with detrusor overactivity

2016 ◽  
Vol 36 (2) ◽  
pp. 426-431 ◽  
Author(s):  
Rhiannon K. Owen ◽  
Keith R. Abrams ◽  
Christopher Mayne ◽  
Mark Slack ◽  
Douglas G. Tincello
Keyword(s):  
Treatment Outcome ◽  
Detrusor Overactivity ◽  
Patient Factors ◽  
Toxin A ◽  
Factors Associated ◽  
Onabotulinum Toxin A

scholarly journals Success and failure for implantation of left bundle branch pacing using stylet-driven pacing leads : a single center experience

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
T So
Keyword(s):  
Logistic Regression ◽  
Retrospective Study ◽  
Interventricular Septum ◽  
The Other ◽  
Clinical Risk Factor ◽  
Single Center ◽  
Long Term Outcome ◽  
Factors Associated ◽  
Delivery Sheath ◽  
Lead Dislodgement

Abstract Funding Acknowledgements Type of funding sources: None. Background/Introduction :Left bundle area pacing is a new modality of physiological pacing. By screwing the pacing lead deep into the interventricular septum, the left bundle branch could be recruited for pacing purpose. Initially left bundle area pacing was performed with fixed helix lead supported by the delivery catheter. On the other hand, there are studies showing the feasibility of using a style-driven extendable helix with the new delivery sheath for left bundle area pacing.  Purpose :To study the feasibility of left bundle area pacing and explore factors associated with success and failure Methods :This is a retrospective study from September 2020 to January 2021 in a local hospital. Baseline patient characters, procedural characters, acute complication and reason for failure were recorded. Logistic regression was done to explore factors associated with success and failure.  Results :In 14 patients, the mean age is 81 +/- 6.8 years with 28% female. Pacing indications were sick sinus syndrome (n = 3) and atrio-ventricular block (n = 11). The success rate is 64% (n = 9/14). The average R wave sensing was 11.4 +/- 4.5mV, the average V pacing threshold was 0.88 +/- 0.23V @ 0.4ms and average impedance was 633 +/- 93.6 Ohm. There were no septal perforation nor pericardial effusion after implantation. The most common reason for failure is lead dislodgement during implantation (n = 4) and the other reason is failure to locate and capture the left bundle (n = 1). In logistic regression, there was no clinical risk factor identified to predict failure for implantation , i.e. diabetics ( OR 0.95, p =0.15), hyperlipidaemia (OR 0.87, p =0.94), chronic renal disease (OR 0.88, p = 0.94), coronary heart disease (OR 0.37, p = 0.66). Gender(OR 4.5, p = 0.37), age(OR 1.1, p = 0.32) and hypertension(OR 25, p = 0.25) may appear to predict failure for implantation but the results were not statistically significant.  Conclusion :Left bundle area pacing could be feasible and safely implanted using style-driven lead with good pacing parameters. No clinical factor is identified to predict the failure of implantation, the main reason for failure is dislodgement of lead during implantation. Similar finding was noted in a study comparing lumen-less lead and stylet-driven lead.2 In this study found that reason for failure of left bundle area pacing using style-driven lead was due to repetitive lead dislodgement after slitting the delivery sheath, fail advancement of lead into septum and loose septal endocardium. Stability and ability to screw into septum remain a great obstacle for left bundle area pacing using stylet-driven lead. This study is limited by small sampling size and single center retrospective study. Further studies are needed to see the long term outcome of left bundle area pacing using style-driven lead and investigate other methods to predict success/ failure of implantation, such as the role of imaging.

scholarly journals Frequency and factors associated with sustained exergaming in adolescents (Preprint)

2019 ◽  
Author(s):  
Erin O'Loughlin ◽  
Tracie A. Barnett ◽  
Jennifer McGrath ◽  
Mia Consalvo ◽  
Lisa Kakinami
Keyword(s):  
Logistic Regression ◽  
Life Course ◽  
Self Report ◽  
Clinical Settings ◽  
Factors Associated ◽  
Longitudinal Investigation ◽  
Multivariable Logistic Regression ◽  
Grade 5 ◽  
Viable Approach ◽  
The Life Course

BACKGROUND Exergaming is increasing in popularity, but little is known about sustained exergaming. OBJECTIVE The objectives of this study were to describe the frequency and correlates/predictors of sustained exergaming. METHODS Data were available in AdoQuest (2005-11), a longitudinal investigation of 1843 grade 5 students in in Montréal, Canada. This analysis uses data from grade 9 and 11. Participants at T1 (mean age 14 (0.8) years) who reported past-week exergaming (n = 186), completed mailed self-report questionnaires at T2 (mean age 16 (0.8) years). Independent correlates (from T2)/predictors (from T1 or earlier) were identified using multivariable logistic regression. RESULTS Of 186 exergamers at T1, 81 (44%) reported exergaming at T2. Being female and having higher introjected regulation (i.e., a type of PA motivation indicative of internalization of PA as a behaviour) were independent correlates.. None of the predictors investigated were associated with sustained exergaming. CONCLUSIONS Almost 50% of grade 9 exergamers sustained for 2-3 years. In non-clinical settings, exergaming may be a viable approach to help adolescents maintain PA during adolescence, a period in the life course when PA generally declines. Sex and PA motivation should be considered in the design of exergaming interventions. CLINICALTRIAL N\A

scholarly journals Trends in multidrug-resistant tuberculosis in Scotland, 2000-7

2009 ◽  
Vol 14 (11) ◽  
Author(s):  
L F Anderson ◽  
I F Laurenson ◽  
O Blatchford ◽  
E Shakir ◽  
J McMenamin ◽  
...  
Keyword(s):  
Risk Factors ◽  
United Kingdom ◽  
Treatment Outcome ◽  
Multidrug Resistant ◽  
Control Measures ◽  
Self Report ◽  
Factors Associated ◽  
The United Kingdom ◽  
Mdr Tb

Overall numbers of multidrug-resistant (MDR) tuberculosis (TB) rose sharply in the United Kingdom and Scotland in 2007. Risk factors associated with MDR TB in the United Kingdom have been identified but there has been no previous report on risk factors associated with MDR TB in Scotland. Enhanced Surveillance of Mycobacterial Infections (ESMI) data were used to examine demographic and clinical characteristics and treatment outcome of MDR TB cases notified in Scotland between 2000-7. There was a total of 11 culture-positive cases of MDR TB, five of which were notified in 2007. The majority of patients were female, 15-44 years old and unemployed. All were born outside the United Kingdom and most had arrived within the past year from or frequently travelled to their home countries in China, the Indian subcontinent or Africa. Except for one individual, our patients did not self report a history of previous diagnosis of TB which was previously identified as a risk factor for MDR TB in the United Kingdom. Only three patients received directly observed treatment (DOT). Only two patients had completed treatment at 12 months, partially due to the inadequate length of follow-up under the current ESMI system. Our results suggest that most patients had primary resistance due to transmission of MDR TB in high incidence countries and thus point to the importance of international efforts to control MDR TB in these countries. In Scotland, national efforts should be made to increase the number of MDR TB patients receiving DOT and to extend follow-up to improve monitoring of treatment outcome. It is important to identify high risk groups for MDR TB infection in order to deliver effective community-based disease control measures.

Hearing loss after cisplatin-based chemotherapy: Patient-reported outcomes versus audiometric assessments.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 5016-5016
Author(s):  
Shirin Ardeshirrouhanifard ◽  
Sophie Fosså ◽  
Robert A Huddart ◽  
Patrick O. Monahan ◽  
Chunkit Fung ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Logistic Regression ◽  
Cancer Survivors ◽  
Hearing Aids ◽  
Patient Reported Outcomes ◽  
Noise Exposure ◽  
Older Age ◽  
Self Report ◽  
Factors Associated ◽  
Patient Reported

5016 Background: Although pure-tone audiometry is the gold standard to evaluate hearing loss (HL), patient-reported outcomes are practically more time and cost effective. However, no data exist on factors associated with discrepancies between patient-reported and audiometrically-defined HL in adult-onset cancer survivors after cisplatin-based chemotherapy (CBCT); and few comprehensive assessments of factors associated with audiometrically-defined HL have been conducted. Methods: A total of 1,410 testicular cancer survivors (TCS) ≥6 months post-CBCT completed comprehensive audiometric assessments (0.25-12 kHz) and detailed questionnaires of sociodemographic, clinical, and health behaviors. Audiometrically-defined HL severity was defined using American Speech-Language-Hearing Association (ASHA) criteria. Multivariable multinomial logistic regression identified factors associated with discrepancies (overestimation and underestimation vs. concordance), between patient-reported and audiometrically-defined HL and multivariable ordinal logistic regression evaluated factors associated with the HL severity. Results: Overall, 34.8% of TCS self-reported HL, while 77.8% had audiometrically-defined HL. Among TCS without tinnitus, those with audiometrically-defined HL at only extended high frequencies (EHFs) (10-12 kHz) (17.8%) or at both EHFs and standard frequencies (0.25-8 kHz) (23.4%) were significantly more likely to self-report HL than those with no audiometrically-defined HL (8.1%) (OR = 2.48; 95%CI, 1.31-4.68 and OR = 3.49; 95%CL,1.89-6.44, respectively). Older age (OR = 1.09; P< 0.0001), absence of prior noise exposure (OR = 1.40; P= 0.02), and mixed/conductive HL (OR = 2.01; P= 0.0007) were associated with greater underestimation of audiometrically-defined HL severity. Hearing aid use (OR = 0.18; P= 0.003) and higher education ( P= 0.004) were associated with less underestimation of audiometrically-defined HL severity, while tinnitus was associated with greater overestimation ( P< 0.0001). Older age (OR = 1.13; P< 0.0001), cumulative cisplatin dose ( > 300 mg/m2, OR = 1.47; P= 0.0001), and hypertension (OR = 1.80; P= 0.0007) were associated with greater ASHA-defined HL severity, whereas post-graduate education (OR = 0.58; P= 0.005) was associated with less severe HL. Conclusions: Discrepancies between patient-reported and audiometrically-defined HL after CBCT are associated with several factors including age, education, tinnitus, prior noise exposure, use of hearing aids, and conductive HL. Understanding these factors will help clinicians to better interpret self-reported HL as a surrogate for audiometric assessments. For survivors who self-report HL, but have normal audiometric findings at standard frequencies, referral to an audiologist for additional testing and inclusion of EHFs in audiometric assessments, should be considered.

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