Which attributes are the most and least important to patients when considering gout flare burden over time? A best-worst scaling choice study

2021 ◽  
pp. jrheum.210605
Author(s):  
Jeremy Holyer ◽  
William J. Taylor ◽  
Angelo Gaffo ◽  
Graham Hosie ◽  
Anne Horne ◽  
...  
Keyword(s):  
Patient Experience ◽  
Online Survey ◽  
Contributing Factors ◽  
Cumulative Impact ◽  
Best Worst Scaling ◽  
Average Pain ◽  
Intensity Duration Frequency ◽  
Gout Flare ◽  
Over Time ◽  
Gout Flares

Objective Several factors contribute to the patient experience of gout flares, including pain intensity, duration, frequency, and disability. It is unknown which of these factors are most important to patients when considering flare burden over time, including those related to the cumulative experience of all flares, or the experience of a single worst flare. This study aimed to determine which flare attributes are the most and least important to the patient experience of flare burden over time. Methods Participants with gout completed an anonymous online survey. Questions were aimed at identifying which attributes of gout flares, representing both individual and cumulative flare burden, were the most and least important over a hypothetical six-month period. A best-worst scaling method was used to determine the importance hierarchy of the included attributes. Results Fifty participants were included. Difficulty doing usual activities during the worst flare and pain of the worst flare were ranked as the most important, while average pain of all flares was considered the least important. Overall, attributes related to the single worst gout flare were considered more important than attributes related to the cumulative impact of all flares. Conclusion When thinking about the burden of gout flares over time, patients rank activity limitation and pain experienced during their worst gout flare as the most important contributing factors, while factors related to the cumulative impact of all flares over time are relatively less important.

scholarly journals THU0447 HOME-MONITORING GOUT FLARES WITH A SMARTPHONE APP – RESULTS OF A FEASIBILITY STUDY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 460.1-461
Author(s):  
B. Pouls ◽  
C. Bekker ◽  
B. Van den Bemt ◽  
A. Gaffo ◽  
M. Flendrie
Keyword(s):  
Technology Acceptance ◽  
Real Time ◽  
Technology Acceptance Model ◽  
Home Monitoring ◽  
Added Value ◽  
Smartphone App ◽  
Research Support ◽  
Acceptance Model ◽  
Gout Flare ◽  
Gout Flares

Background:Gout flares are considered a key clinical and research outcome in gout. Early treatment of gout flares increases patient well-being and warrants timely notification of the treating clinician.Objectives:To test the feasibility of a smartphone app to home-monitor gout flares real-time for both patients with a suspicion of and established gout.Methods:Thirty patients were recruited during their visit at the outpatient rheumatology clinic. Inclusion criteria were age ≥ 18 years, smartphone possession, established gout (crystal proven) or a clinical suspicion of gout and at least one flare reported in the last three months.A straight-forward query app was used to incorporate an adapted version of the 2017 four-criteria gout flare definition.[1] For 90 consecutive days the app asked patients to report their current pain score on an 11-points scale as screening question. Scoring pain below 4 terminated the query, otherwise the app posed the remaining criteria: does the patient experience warm and/or swollen joints and are symptoms regarded as a gout flare. Responses were transmitted in real-time to the dashboard and the clinician was alerted via email if predefined conditions were met. End of study evaluation consisted of the number of generated alerts, duration of (possible) flares and actions taken. Patient feasibility was assessed by measuring app attrition and using a questionnaire based on the Technology Acceptance Model. [2] All constructs were analysed using descriptive statistics.Results:All 30 recruited patients finished the trial. Three minor, resolvable technical issues were reported. Seventeen participants never missed a question. In total 110 responses (4.1%) were missed with three participants responsible for 66 missings. 90% of the participants rated app usability good to excellent and 70% would recommend the app to other patients.Twelve out of thirty patients generated a total amount of 174 alerts where four patients with a suspicion of gout were responsible for 148 alerts (85%). These patients scored three out of four criteria as they had warm, swollen and painful joints but, after consultation with the clinician, their symptoms were not regarded as a gout flare.The 174 alerts belonged to 23 (possible) flares with a median duration of 5 days [IQR 3,5 – 7,5]. Twenty-one pro-active telephone calls were made which resulted in four visits to the clinic within 48 hours. Clinical guidance over the phone consisted of checking in on patient’s symptoms, giving advice and ten medication adjustments.Conclusion:This prospective study shows feasibility of a smartphone app for home-monitoring gout flares for patients because of high usability scores and low attrition rates. The app has added value for gout care because it enables clinicians to act on flares as they occur. The next step is to further implement the app whilst perpetuating investigation into the added value for patients and clinical practice alike.References:[1]Gaffo AL, Dalbeth N, Saag KG, et al. Brief Report: Validation of a Definition of Flare in Patients With Established Gout. Arthritis Rheumatol. 2018;70(3):462-467.[2]Davis Jr. FD. A Technology Acceptance Model for empirically testing new end-user information systems: theory and results. MIT PhD thesis. 1985[3]Stoyanov SR, Hides L, Kavanagh DJ, Wilson H. Development and Validation of the User Version of the Mobile Application Rating Scale (uMARS). JMIR Mhealth Uhealth. 2016;4(2):e72.Acknowledgements:This study was funded by AbbVie and Menarini.Disclosure of Interests: :Bart Pouls: None declared, Charlotte Bekker: None declared, Bart van den Bemt Grant/research support from: UCB, Pfizer and Abbvie, Consultant of: Delivered consultancy work for UCB, Novartis and Pfizer, Speakers bureau: Pfizer, AbbVie, UCB, Biogen and Sandoz., Angelo Gaffo Grant/research support from: Received a research grant from AMGEN, Marcel Flendrie Grant/research support from: M. Flendrie has received grants from Menarini and Grunenthal., Consultant of: M. Flendrie has received consultancy fees from Menarini and Grunenthal.

scholarly journals Investigating awareness, fear and control associated with norovirus and other pathogens and pollutants using best–worst scaling

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kata Farkas ◽  
Emma Green ◽  
Dan Rigby ◽  
Paul Cross ◽  
Sean Tyrrel ◽  
...  
Keyword(s):  
Foodborne Pathogens ◽  
Online Survey ◽  
Risk Mitigation ◽  
Terrorist Attack ◽  
Gastrointestinal Diseases ◽  
Resistant Bacteria ◽  
Best Worst Scaling ◽  
Important Health ◽  
Health Need ◽  
Levels Of Control

AbstractPollutants found in the water and air environment represent an ever-growing threat to human health. Contact with some air-, water- and foodborne pathogens (e.g. norovirus) results in gastrointestinal diseases and outbreaks. For future risk mitigation, we aimed to measure people’s awareness of waterborne and foodborne norovirus relative to other environment-associated pollutants (e.g. pesticides, bioaerosols, antibiotic resistant bacteria) and well-known risks (e.g. diabetes, dementia, terrorist attack). We used an online survey, which included a best–worst scaling component to elicit personal levels of control and fear prompted by norovirus relative to 15 other risks. There was a negative correlation between levels of fear vs. control for all 16 measured risks. Perceived infection control levels were higher amongst women compared to men and correlated with age and the level of qualification in both groups. Participants who had sought advice regarding the symptoms caused by norovirus appeared to have more control over the risks. Norovirus is associated with high levels of fear, however, the levels of control over it is low compared to other foodborne illnesses, e.g. Salmonella. Addressing this deficit in the public’s understanding of how to control exposure to the pathogen in an important health need.

Prioritizing the Worries of AML Patients: Quantifying Patient Experience using Best‐Worst Scaling

2021 ◽  
Author(s):  
Daniel R. Richardson ◽  
Allison H. Oakes ◽  
Norah L. Crossnohere ◽  
Gary Rathsmill ◽  
Crystal Reinhart ◽  
...  
Keyword(s):  
Patient Experience ◽  
Best Worst Scaling

Trajectory of Performance Status and Symptom Scores for Patients With Cancer During the Last Six Months of Life

2011 ◽  
Vol 29 (9) ◽  
pp. 1151-1158 ◽  
Author(s):  
Hsien Seow ◽  
Lisa Barbera ◽  
Rinku Sutradhar ◽  
Doris Howell ◽  
Deborah Dudgeon ◽  
...  
Keyword(s):  
Performance Status ◽  
Symptom Assessment ◽  
Well Being ◽  
Assessment System ◽  
Assessment Tools ◽  
Future Research ◽  
Patients With Cancer ◽  
Average Pain ◽  
Observational Cohort ◽  
Over Time

Purpose Ontario's cancer system is unique because it has implemented two standardized assessment tools population-wide to improve care: the Edmonton Symptom Assessment System (ESAS) measures severity of nine symptoms (scale 0 to 10; 10 indicates the worst) and the Palliative Performance Scale (PPS) measures performance status (scale 0 to 100; 0 indicates death). This article describes the trajectory of ESAS and PPS scores 6 months before death. Patients and Methods Observational cohort study of cancer decedents between 2007 and 2009. Decedents required ≥1 ESAS or PPS assessment in the 6 months before death for inclusion. Outcomes were the decedents' average ESAS and PPS scores per week before death. Results Ten thousand seven hundred fifty-two (ESAS) and 7,882 (PPS) decedents were included. The mean age was 65 years, half were female, and approximately 75% of assessments occurred in cancer clinics. Average PPS score declined slowly over the 6 months before death, starting at approximately 70 and ending at 40, declining more rapidly in the last month. For ESAS symptoms, average pain, nausea, anxiety, and depression scores remained relatively stable over the 6 months. Conversely, shortness of breath, drowsiness, well-being, lack of appetite, and tiredness increased in severity over time, particularly in the month before death. More than one third of the cohort reported moderate to severe scores (ie, 4 to 10) for most symptoms in the last month of life. Conclusion In this large outpatient cancer population, trajectories of mean ESAS scores followed two patterns: increasing versus generally flat. The latter was perhaps due to available treatment (eg, prescriptions) for those symptoms. Future research should prioritize addressing symptoms that worsen over time.

scholarly journals Effective but fragile? Responses to repeated nudge-based messages for preventing the spread of COVID-19 infection

2021 ◽  
Author(s):  
Shusaku Sasaki ◽  
Hirofumi Kurokawa ◽  
Fumio Ohtake
Keyword(s):  
Behavioral Change ◽  
Infection Prevention ◽  
Online Survey ◽  
Behavioral Changes ◽  
Survey Experiment ◽  
The Third ◽  
Compliance Level ◽  
Change Effect ◽  
Loss Frame ◽  
Over Time

AbstractNudge-based messages have been employed in various countries to encourage voluntary contact-avoidance and infection-prevention behaviors to control the spread of COVID-19. People have been repeatedly exposed to such messages; however, whether the messages keep exerting a significant impact over time remains unclear. From April to August 2020, we conducted a four-wave online survey experiment to examine how five types of nudge-based messages influence Japanese people’s self-reported preventive behaviors. In particular, we investigate how their behaviors are affected by repeated displays over time. The analysis with 4241 participants finds that only a gain-framed altruistic message, emphasizing their behavioral adherence would protect the lives of people close to them, reduces their frequency of going out and contacting others. We do not find similar behavioral changes in messages that contain an altruistic element but emphasize it in a loss-frame or describe their behavioral adherence as protecting both one’s own and others’ lives. Furthermore, the behavioral change effect of the gain-framed altruistic message disappears in the third and fourth waves, although its impact of reinforcing intentions remains. This message has even an adverse effect of worsening the compliance level of infection-prevention behaviors for the subgroup who went out less frequently before the experiment. The study’s results imply that when using nudge-based messages as a countermeasure for COVID-19, policymakers and practitioners need to carefully scrutinize the message elements and wording and examine to whom and how the messages should be delivered while considering their potential adverse and side effects.

Pasture renewal in the Waikato and Bay of Plenty regions: An overview of farmer practice, experience and attitudes

2011 ◽  
Vol 15 ◽  
pp. 21-24
Author(s):  
Kelly Smith ◽  
R. Brazendale
Keyword(s):  
Decision Making ◽  
Online Survey ◽  
Information Sources ◽  
Farm Management ◽  
Dairy Farmers ◽  
Practice Experience ◽  
Rate Information ◽  
And Performance ◽  
On Farm ◽  
Over Time

Pasture persistence and performance, and associated issues such as black beetle, are of central concern to dairy farmers. The Pasture Renewal Survey 2010 aimed to better understand farmers' confidence in their ability to make informed decisions on their pasture renewal practices, their satisfaction with the success of this decision-making and the performance of their renewed pastures over time. In addition, the survey investigated their attitudes to information sources and what barriers they saw to improving pasture performance on farm. A postal and online survey elicited responses from 776 dairy farmers in the Waikato and Bay of Plenty regions. The four main findings of the work were: 1. Farmers are more confident of their ability to make appropriate on-farm management decisions for renewed pasture than they are of their ability to choose appropriate cultivars and endophyte. 2. Farmers, while generally satisfied with their own success in renewing pasture, reported decreasing levels of satisfaction with renewed pastures over the 3 successive years following renewal. 3. Farmers do not rate information sources very highly in terms of their usefulness in relation to pasture renewal. 4. Weather-related issues and pest-related issues (particularly black beetle) were the most commonly identified barriers to improving pasture performance. Keywords: farmer confidence, farmer satisfaction, information sources, pasture renewal.

scholarly journals Evaluating Mental Health and Wellbeing of Postgraduate Researchers: Prevalence and Contributing Factors

2020 ◽  
Author(s):  
Jelena Milicev ◽  
Stephany Biello ◽  
Maria Gardani
Keyword(s):  
Mental Health ◽  
Social Support ◽  
Academic Success ◽  
Online Survey ◽  
Mental Health Problems ◽  
Sleep Problems ◽  
Mental Wellbeing ◽  
Contributing Factors ◽  
Health And Wellbeing ◽  
The Uk

AbstractIntroduction: Recent research has revealed high rates of mental health issues in postgraduate researchers (PGRs). Mental ill-health is a barrier to life satisfaction and academic success. More knowledge is necessary to understand the extent and origins of mental health problems of PGRs in the UK. Aims: To assess the prevalence of anxiety, depression, sleep problems, subjective mental wellbeing, and suicide behaviours of PGRs in the UK, as well as to explore the factors that underpin these outcomes.Methods: An online survey (N=479) was used to measure the mental health outcomes, and assess the influence of demographic, trait and academic variables, and social support. Results: In this sample the prevalence of mental ill-health was high, while wellbeing was lower than in the general population. Female, non-binary and non-heterosexual PGRs had poorer mental health than their male and/or heterosexual counterparts. Researchers in the field of Arts had higher levels of wellbeing, while those in the 5th year of study or above were at a higher risk of suicidal behaviours. Resilience, adaptive perfectionism, social support and positive evaluations of progress and preparation, departmental climate, and supervisory relationship were associated with positive outcomes, while maladaptive perfectionism and workaholism were linked to the negative ones. Resilience and workaholism were the only variables that played a role in all mental health outcomes.Conclusions: The current paper contributes new knowledge about the PGR wellbeing, the prevalence of mental health symptoms, and some of the factors that shape them. Our findings imply that institutional efforts to improve PGR mental health and wellbeing should include a variety of strategies to promote equality, diversity, resilience, integration and work-life balance of PGRs.

Outcomes of Care Among Patients with Gout in Europe: A cross-sectional survey

2021 ◽  
pp. jrheum.210009
Author(s):  
Ritch te Kampe ◽  
Tim L. Jansen ◽  
Caroline van Durme ◽  
Matthijs Janssen ◽  
Gudula Petersen ◽  
...  
Keyword(s):  
Patient Care ◽  
Online Survey ◽  
European Countries ◽  
Cross Sectional Survey ◽  
Patient Centered ◽  
Mixed Effect ◽  
Physician Visits ◽  
Country Level ◽  
Current Medication ◽  
Gout Flares

Objective To assess health- and patient-centered outcomes in gout across Europe, and explore patient-, care-, and country-level characteristics associated with these outcomes. Methods Patients with self-reported physician-diagnosed gout from 14 European countries completed an online survey. Multivariable mixed-effect logistic and linear regressions were computed for health outcomes (gout flare recurrence) and patient-centered outcomes (patient satisfaction with current medication, and unaddressed goals), accounting for clustering within countries. The role of patient-, care- and country-level factors was explored. Results 1029 patients, predominantly diagnosed by a general practitioner, participated. One or more gout flares were reported by 70% of patients and ≥3 flares by 32%. Gout patients reported 1.1±1.2 unaddressed goals, and 80% were satisfied with current medication. Patients with ≥3 and ≥1 flares were less likely to be treated with urate-lowering therapy (ULT) [OR:0.52(0.39-0.70) and OR:0.38(0.28-0.53), respectively], but more likely to have regular physician visits [OR:2.40(1.79-3.22) and OR:1.77(1.30- 2.41)]. Three or more gout flares were also associated with lower satisfaction [OR:0.39(0.28-0.56)], and more unaddressed goals [B:0.36(0.19-0.53)]. Notwithstanding, the predicted probability of being satisfied was still between 57% and 75% among patients with ≥3 flares but who were not receiving ULT. Finally, patients from wealthier and Northern European countries more frequently had ≥3 gout flares. Conclusion Across Europe, many gout patients remain untreated despite frequent reported flares. Remarkably, a substantial proportion of them were still satisfied with gout management. A better understanding of patients' satisfaction and its role in physicians' gout management decisions is warranted to improve quality of care and gout outcomes across Europe.

User Perception towards Ride hail Service: A case of Nagpur city, India

2021 ◽  
pp. 1-16
Author(s):  
B. Raghuram Kadali
Keyword(s):  
Public Transport ◽  
Public Transportation ◽  
Online Survey ◽  
University Campus ◽  
User Perception ◽  
Contributing Factors ◽  
Transportation Services ◽  
The Public ◽  
Shared Service

In recent times, there is an increase in the utilization of the ride-hail service (viz., mobile application-based shared service) by the younger generation due to tremendous changes in technology, extensive usage of smartphones, and perceived convenience during travelling. For evaluating ride-hail service further, it is necessary to understand the user perception towards the ride-hail service and public transportation system (viz., bus in this case) to efficiently plan the public transportation services. Hence, the present study analyzes user perception while making trips, using ride-hail service and public transport buses. A long stretch of 3.8 km has been selected in the Nagpur city for the study and the stretch attracts a good number of trips by ride-hailing and public transportation. To perform the analysis, a survey has been conducted in the stretch which includes an online survey (viz., based on the Google form) and an offline survey (viz., at selected bus stops on the route between university campus and shopping complex). A binary logit model has been developed to understand the user perception towards ride-hail service and to identify the significant contributing factors towards the preference of the ride-hail service over the public transport bus. From the model results, it has been noted that age, accessibility, waiting time, travel time, income, and travel cost of the trip are the most significant contributing factors that affect user decision for availing the ride-hail service. It has been concluded from the study that the inferences obtained would be useful in the direction of developing warrants for transport planners and policymakers to improve the service quality of public transport buses (viz., frequency and routes) in cities especially in the Indian context.

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