scholarly journals Plasma Fibrinogen Along with Patient-reported Outcome Measures Enhances Management of Polymyalgia Rheumatica: A Prospective Study

2014 ◽  
Vol 41 (5) ◽  
pp. 931-937 ◽  
Author(s):  
Eoghan M. McCarthy ◽  
Paul A. MacMullan ◽  
Shibeb Al-Mudhaffer ◽  
Anne Madigan ◽  
Suzanne Donnelly ◽  
...  
Keyword(s):  
Disease Activity ◽  
Polymyalgia Rheumatica ◽  
Health Assessment ◽  
Correlation Coefficients ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Plasma Fibrinogen ◽  
Response To Treatment ◽  
Receiver Operating Curve ◽  
Patient Reported

Objective.We sought to prospectively examine the responsiveness of a number of patient-reported outcome (PRO) measures in polymyalgia rheumatica (PMR), as well as their relationship to the biomarkers erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and plasma fibrinogen.Methods.Sixty patients with PMR were divided into active (n = 25) or inactive (n = 35) disease groups based on symptoms; physician assessment; and the biomarkers ESR, CRP, and plasma fibrinogen. Groups underwent assessment at baseline and 6 weeks. Disease activity measures and relevant PRO measures were recorded. Measures of responsiveness were compared for all PRO and biomarkers.Results.Visual analog scale disease activity (VASDA) and VAS quality of life (VASQOL) are more responsive to change in disease activity than VAS pain, morning stiffness, Health Assessment Questionnaire (HAQ), and PMR-activity score (AS). Analysis of PMR-AS versus VASDA, VASQOL, and HAQ showed correlation coefficients of 0.87 (p < 0.001), 0.80 (p < 0.001), and 0.68 (p < 0.001), respectively. Receiver-operating curve (ROC) analysis revealed VASDA to be more specific than either HAQ (0.95 vs 0.85; p < 0.001) or VASQOL (0.95 vs 0.93; p < 0.001) for the detection of response to treatment in active PMR. Overall, fibrinogen showed superior correlation coefficients with the various PRO than either of the standard biomarkers ESR or CRP. In addition, standardized response means for fibrinogen, ESR, and CRP were 1.63, 1.2, and 1.05, respectively, indicating that plasma fibrinogen was the most responsive biomarker for assessment of change in disease activity.Conclusion.VASDA and VASQOL are the most responsive PRO to changes in disease activity in PMR. In addition, plasma fibrinogen demonstrated greater responsiveness to changes in disease activity and superior correlation with the various PRO measures recorded than did the standard biomarkers ESR and CRP.

Comparing the Measurement Properties and Preferability of Patient Reported Outcome Measures in Pediatric Rheumatology: PROMIS versus CHAQ

2020 ◽  
pp. jrheum.200943
Author(s):  
Joshua Craig ◽  
Brian M. Feldman ◽  
Lynn Spiegel ◽  
Saunya Dover
Keyword(s):  
Physical Activity ◽  
Disease Activity ◽  
Pediatric Rheumatology ◽  
Health Assessment ◽  
Patient Reported Outcome Measures ◽  
Pain Interference ◽  
Measurement Properties ◽  
Measurement Information ◽  
Patient Reported ◽  
Ceiling Effects

Objective The Childhood Health Assessment Questionnaire (CHAQ), though widely used for assessments in pediatric rheumatology, has drawbacks, including low correlation to disease activity and ceiling effects. We sought to determine if any tools from the Patient Reported Outcomes Measurement Information System (PROMIS) improve on these shortcomings and/or are preferred by patients. Methods Patients 5-17 years of age, with childhood arthritis (JIA) or juvenile dermatomyositis (JDM) were recruited from the rheumatology clinics at a Canadian children’s hospital. Participants completed the CHAQ, 3 PROMIS measures (pain interference, mobility, and physical activity), and underwent a standard clinical assessment. Results 52 patients participated, 25 with JIA and 27 with JDM. None of the PROMIS measures suffered from ceiling effects, while the CHAQ disability index (DI) and pain visual analog scales both did, with 50% and 20% of patients achieving the best possible scores respectively. The PROMIS mobility was moderately correlated CHAQ DI (rs = -0.60, 95%CI = -0.75--0.40) and the PROMIS pain interference was strongly correlated to the CHAQ pain score (rs = 0.65, 95%CI = 0.43-0.80). No measures correlated with disease activity. Patients preferred the PROMIS to the CHAQ. Conclusion The PROMIS pain interference, mobility and physical activity measures improve in some areas where the CHAQ is weak: they do not suffer from ceiling effects and patients prefer the PROMIS tools. More work is needed to determine the correlation and responsiveness of the PROMIS tools to changes in disease activity over time before they should be widely adopted for clinical use.

Patient reported outcome measures in cardiovascular disease

ESC CardioMed ◽  
2018 ◽  
pp. 1399-1402
Author(s):  
Ran Kornowski ◽  
Eli I. Lev
Keyword(s):  
Coronary Revascularization ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Clinical Encounter ◽  
Normal Function ◽  
Response To Treatment ◽  
Cardiac Events ◽  
Clinical Workflow ◽  
Patient Reported ◽  
Revascularization Procedures

The patient reported outcome measure (PROM) initiative focuses on what matters to patients following medical interventions, a perspective that is often ignored or missed by the treating physicians. PROM questionnaires encompass what occurs outside the clinical encounter, such as symptom severity, the response to treatment, undesirable side effects, returning to normal function, perceived needs, and what really matters to patients in their ordinary environment. This topic is of prime importance in cardiovascular medicine, as it encompasses chronic diseases with exacerbation and various cardiac interventions. PROMs and quality of life questionnaires have been utilized mostly in congestive heart failure syndromes and following surgical and catheter-based coronary revascularization procedures. Improved scores influenced by age or sex have been obtained following revascularization procedures. Poor PROMs are specifically related to subsequent cardiac events and all-cause mortality. Some hurdles challenging the routine use of PROMs include the feasibility of implementation into the clinical workflow and getting medical staff engaged in the project. Overcoming these challenges may enable significant improvement in patient care and patient-centred cardiovascular outcomes.

scholarly journals A Single Case Narrative of Spirituality Following Aphasia from Traumatic Brain Injury: Findings about Forgiveness and Freedom Using WELLHEAD and SHALOM

Religions ◽  
2019 ◽  
Vol 10 (5) ◽  
pp. 301 ◽  
Author(s):  
Katharyn Mumby
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Single Case ◽  
Health Assessment ◽  
Case Series ◽  
Structured Interview ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Spiritual Health ◽  
Patient Reported

Rehabilitation has neglected the spirituality of people with aphasia, a neurogenic impairment of language for communication and thought processes. Aphasia reduces scope for adjustment processes where words are normal currency, such as forgiveness and reconciliation. A single case narrative was generated from a case series exploring the feasibility of spiritual health assessment in aphasia. The individual had traumatic brain injury, with the primary symptom of aphasia, giving the first detailed account of its kind. The WELLHEAD spirituality toolkit provided a structured interview approach, exploring spirituality in terms of ‘meaning and purpose’ within four dimensions, WIDE, LONG, HIGH and DEEP, incorporating patient-reported outcome measures and goal-setting, with feedback interviews. Spiritual Health and Life Orientation Measure (SHALOM) generated a comparator spiritual health assessment. The quantitative feedback measures and self-reported outcomes were complemented by detailed qualitative interview transcripts subject to systematic thematic analysis in NVivo. The findings were co-constructed and systematically verified. This non-religious narrative evidenced the accessibility, acceptability, and impact of the resources. Self-forgiveness was paramount for freedom to journey into the unknown beyond self with ‘Calm’, towards helping others and accepting help. Religion, Faith and Belief were reconceptualised. Forgiveness of self and others was integral and instrumental in recovery, offering avenues for further investigation and application.

scholarly journals A systematic review of patient-reported outcome measures in paediatric otolaryngology

2017 ◽  
Vol 132 (1) ◽  
pp. 2-7 ◽  
Author(s):  
J Powell ◽  
S Powell ◽  
A Robson
Keyword(s):  
Outcome Measures ◽  
English Language ◽  
Health Assessment ◽  
Paediatric Population ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Specific Patient ◽  
Patient Reported ◽  
The Impact

AbstractBackground:Recently, there has been increased emphasis on the development and application of patient-reported outcome measures. This drive to assess the impact of illness or interventions, from the patient's perspective, has resulted in a greater number of available questionnaires. The importance of selecting an appropriate patient-reported outcome measure is specifically emphasised in the paediatric population. The literature on patient-reported outcome measures used in paediatric otolaryngology was reviewed.Methods:A comprehensive literature search was conducted using the databases Medline, Embase, Cumulative Index to Nursing and Allied Health Literature, and PsycInfo, using the terms: ‘health assessment questionnaire’, ‘structured questionnaire’, ‘questionnaire’, ‘patient reported outcome measures’, ‘PROM’, ‘quality of life’ or ‘survey’, and ‘children’ or ‘otolaryngology’. The search was limited to English-language articles published between 1996 and 2016.Results:The search yielded 656 articles, of which 63 were considered relevant. This included general paediatric patient-reported outcome measures applied to otolaryngology, and paediatric otolaryngology disease-specific patient-reported outcome measures.Conclusion:A large collection of patient-reported outcome measures are described in the paediatric otolaryngology literature. Greater standardisation of the patient-reported outcome measures used in paediatric otolaryngology would assist in pooling of data and increase the validation of tools used.

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