scholarly journals The Influence of Education and Environment on Patient-Reported Outcome Use in Athletic Training Clinical Practice

2021 ◽  
Vol 16 (3) ◽  
pp. 188-197
Author(s):  
Jennifer S. Howard ◽  
Johanna M. Hoch ◽  
Jennifer Tinsley ◽  
Aaron Sciascia
Keyword(s):  
Athletic Training ◽  
Master's Degree ◽  
Clinical Care ◽  
Educational Background ◽  
Patient Reported Outcome ◽  
Scientific Journals ◽  
Attitudes And Practices ◽  
Patient Reported ◽  
Master’S Degree ◽  
Employment Setting

Context There have been multiple education reforms aimed at incorporating patient-reported outcome measures (PROMs) into routine clinical care. However, many factors can impact PROM use, including employment setting/policies or access to literature. Objective To explore the influence of educational background and employment setting/policies on athletic trainer (AT) attitudes and practices related to PROM use in the secondary and collegiate settings. Design Cross-sectional survey. Setting Secondary schools; National Collegiate Athletic Association Division I, II, and III; National Association of Intercollegiate Athletics; and junior colleges. Patients or Other Participants Five hundred and seven ATs working in secondary and collegiate settings. Data Collection and Analysis An established scale evaluating attitudes toward PROMs was distributed to a purposeful sample of 4000 ATs. Also included were questions concerning use of PROMs, employer policies related to PROMs, access to non–National Athletic Trainers' Association (NATA) journals, and educational background. Scores on each scale were compared based on educational background, employment setting/policies, and access to non-NATA scientific journals using Kruskal-Wallis tests with a Bonferroni correction. Frequency of PROM use was evaluated using chi-square tests (α = .05). Results PROMs were viewed positively across all participants, with more positive attitudes toward PROMs observed among those with clinical doctorates (P = .029) compared to those with master's or bachelor's degrees and by those with an athletic training-–related postprofessional master's degree (P = .030) compared to a non–athletic training master's degree. There were no differences in attitudes based on timing of professional degree completion. There were no differences in the usage of PROMs based on educational background or employment setting, with only 10% of respondents reporting routine PROM use. However, access to non-NATA scientific journals (P = .016) and employer policies related to the use of PROMs were associated with increased use of PROMs (P < .001). Conclusion Educational reforms have enhanced the attitudes of practicing ATs toward PROMs; however, environmental facilitators, such as expanded access to scientific literature and policies regarding the use of PROMs, are necessary to increase the use of PROMs.

scholarly journals Capturing PROMs in Oncology Through Consistent Nutrition Risk Identification: An Opportunity to Optimize Care by Embedding Patient Participation Facilitated by eHealth Tools

2021 ◽  
pp. 1-2
Author(s):  
Susana  Couto Irving 
Keyword(s):  
Outcome Measures ◽  
Patient Participation ◽  
Cancer Care ◽  
Clinical Care ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Risk Identification ◽  
Nutrition Status ◽  
Pancreatic Tumors ◽  
Patient Reported

Patient-reported outcome measures obtained via E-Health tools ease the assessment burden and encourage patient participation in cancer care (PaCC Study). <b>Background:</b> E-health based patient-reported outcome measures (PROMs) have the potential to automate early identification of both nutrition status and distress status in cancer patients while facilitating treatment and encouraging patient participation. This cross-sectional study assessed the acceptability, accuracy, and clinical utility of PROMs collected via E-Health tools among patients undergoing treatment for stomach, colorectal, and pancreatic tumors. <b>Results:</b> Eight-nine percent mostly, or completely, agreed that PROMs via tablets should be integrated in routine clinical care. Men were significantly more likely to require help completing the questionnaires than women (inv.OR = 0.51, 95% CI = (0.27, 0.95), p = 0.035). The level of help needed increased by 3% with each 1-year increase in age (inv. OR = 1.03, 95% CI = (1.01, 1.06), p = 0.013). On average, a patient tended to declare weight which was 0.84 kg inferior to their true weight (Bland and Altman 95 % CI = (–3.9, 5.6); SD: 2.41) and a height which was 0.95 cm superior to their true height (Bland and Altman 95 % CI = (−5, 3.1); SD 2.08). Patient-reported nutrition status was significantly associated with the professionally generated assessment (95% CI = (2.27, 4.15), p &#x3c; 0.001). As nutrition status declined, the distress score increased (95%CI = (0.88, 1.68), p &#x3c; 0.001). Of the patients, 48.8% who were both distressed and malnourished requested supportive care to address their problems. <b>Conclusion:</b> Patient-reported assessments utilizing E-health tools are an accurate and efficient method to encourage patient participation in cancer care while simultaneously ensuring that regular assessment of psycho-social and nutritional aspects of care are efficiently integrated in the daily clinical routine.

scholarly journals Patient-reported outcomes in clinical practice

Hematology ◽  
2015 ◽  
Vol 2015 (1) ◽  
pp. 501-506 ◽  
Author(s):  
Sarah Dobrozsi ◽  
Julie Panepinto
Keyword(s):  
Clinical Practice ◽  
Patient Outcomes ◽  
Patient Reported Outcomes ◽  
Clinical Care ◽  
Patient Reported Outcome ◽  
Physician Communication ◽  
Valuable Data ◽  
Patient Reported ◽  
Improve Patient

Abstract Patient-reported outcome (PRO) measurement plays an increasingly important role in health care and understanding health outcomes. PROs are any report of a patient's health status that comes directly from the patient, and can measure patient symptoms, patient function, and quality-of-life. PROs have been used successfully to assess impairment in a clinical setting. Use of PROs to systematically quantify the patient experience provides valuable data to assist with clinical care; however, initiating use of PROs in clinical practice can be daunting. Here we provide suggestions for implementation of PROs and examples of opportunities to use PROs to tailor individual patient therapy to improve patient outcomes, patient–physician communication, and the quality of care for hematology/oncology patients.

scholarly journals Student-Retention and Career-Placement Rates Between Bachelor's and Master's Degree Professional Athletic Training Programs

2015 ◽  
Vol 50 (9) ◽  
pp. 952-957 ◽  
Author(s):  
Thomas G. Bowman ◽  
Stephanie M. Mazerolle ◽  
William A. Pitney ◽  
Thomas M. Dodge ◽  
Jay Hertel
Keyword(s):  
Athletic Training ◽  
Training Programs ◽  
Master's Degree ◽  
Retention Rate ◽  
Bachelor's Degree ◽  
Retention Rates ◽  
Web Based ◽  
Professional Programs ◽  
Career Placement ◽  
Master’S Degree

Context  The debate over what the entry-level degree should be for athletic training has heightened. A comparison of retention and career-placement rates between bachelor's and master's degree professional athletic training programs may inform the debate. Objective  To compare the retention rates and career-placement rates of students in bachelor's and master's degree professional programs. Design  Cross-sectional study. Setting  Web-based survey. Patients or Other Participants  A total of 192 program directors (PDs) from bachelor's degree (n = 177) and master's degree (n = 15) professional programs. Intervention(s)  The PDs completed a Web-based survey. Main Outcome Measure(s)  We instructed the PDs to provide a retention rate and career-placement rate for the students in the programs they lead for each of the past 5 years. We also asked the PDs if they thought retention of students was a problem currently facing athletic training education. We used independent t tests to compare the responses between bachelor's and master's degree professional programs. Results  We found a higher retention rate for professional master's degree students (88.70% ± 9.02%, 95% confidence interval [CI] = 83.71, 93.69) than bachelor's degree students (80.98% ± 17.86%, 95% CI = 78.30, 83.66) (t25 = −2.86, P = .008, d = 0.55). Similarly, PDs from professional master's degree programs reported higher career-placement percentages (88.50% ± 10.68%, 95% CI = 82.33, 94.67) than bachelor's degree professional PDs (71.32% ± 18.47%, 95% CI = 68.54, 74.10) (t20 = −5.40, P &lt; .001, d = 1.14). Finally, we observed no difference between groups regarding whether retention is a problem facing athletic training (χ21 = 0.720, P = .40, Φ = .061). Conclusions  Professional master's degree education appears to facilitate higher retention rates and greater career-placement rates in athletic training than bachelor's degree education. Professional socialization, program selectivity, and student commitment and motivation levels may help to explain the differences noted.

scholarly journals Validation of novel patient-centred juvenile idiopathic arthritis-specific patient-reported outcome and experience measures (PROMs/PREMs)

2020 ◽  
Author(s):  
Laura E Lunt ◽  
Stephanie Shoop-Worrall ◽  
Nicola Smith ◽  
Gavin Cleary ◽  
Janet McDonagh ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Clinical Care ◽  
Patient Reported Outcome ◽  
Paediatric Rheumatology ◽  
Major Step ◽  
Specific Patient ◽  
Children And Young People ◽  
Face To Face ◽  
Patient Reported

Abstract Background: Measuring the outcomes that matter to children and young people (CYP) with juvenile idiopathic arthritis (JIA), is a necessary precursor to patient-centred improvements in quality of clinical care. We present a two-centre validation of novel JIA patient-reported outcome and experience measures (PROM and PREM) developed as part of the CAPTURE-JIA project. Methods: CYP with JIA were recruited from paediatric rheumatology clinics, completing the CAPTURE-JIA PROM and PREM, CHAQ and CHU 9D. A subset participated in face-to-face interviews and completed the PROM/PREM one week later. The OMERACT filter was applied and the three domains of validation assessed. Truth assessments included cognitive interviewing, sensitivity analysis and Spearman’s correlations. Discrimination assessments included specificity and reliability testing. Feasibility was assessed using time to form completion and proportion of missing data. Results: Eighty-two CYP and their families were recruited; ten cognitive interviews and fifteen PROM/PREM test/retests were conducted. Truth: CYP and parents understood the PROM/PREM and felt important areas were covered. PROM criteria had high sensitivities (> 70%) against similar items on the CHU 9D, with the exception of fatigue (58%). Correlations between similar PROM and CHU 9D criteria were moderate to very strong (coefficients 0.40–0.82.) Discrimination: high specificities (> 70%) on corresponding PROM and CHU 9D domains. Feasibility: median completion times for PROM sixty seconds (IQR 38–75) and PREM forty-nine seconds (IQR 30–60) respectively. Conclusion: The CAPTURE-JIA PROM and PREM are valid and feasible in UK paediatric rheumatology clinics. Embedding routine collection into clinical care would be a major step towards improving quality of care.

scholarly journals Validation of novel patient-centred juvenile idiopathic arthritis-specific patient-reported outcome and experience measures (PROMs/PREMs)

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Laura E. Lunt ◽  
Stephanie Shoop-Worrall ◽  
Nicola Smith ◽  
Gavin Cleary ◽  
Janet McDonagh ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Clinical Care ◽  
Patient Reported Outcome ◽  
Paediatric Rheumatology ◽  
Major Step ◽  
Specific Patient ◽  
Children And Young People ◽  
Face To Face ◽  
Patient Reported

Abstract Background Measuring the outcomes that matter to children and young people (CYP) with juvenile idiopathic arthritis (JIA), is a necessary precursor to patient-centred improvements in quality of clinical care. We present a two-centre validation of novel JIA patient-reported outcome and experience measures (PROM and PREM) developed as part of the CAPTURE-JIA project. Methods CYP with JIA were recruited from paediatric rheumatology clinics, completing the CAPTURE-JIA PROM and PREM, CHAQ and CHU 9D. A subset participated in face-to-face interviews and completed the PROM/PREM 1 week later. The OMERACT filter was applied and the three domains of validation assessed. Truth assessments included cognitive interviewing, sensitivity analysis and Spearman’s correlations. Discrimination assessments included specificity and reliability testing. Feasibility was assessed using time to form completion and proportion of missing data. Results Eighty-two CYP and their families were recruited; ten cognitive interviews and fifteen PROM/PREM test/retests were conducted. Truth: CYP and parents understood the PROM/PREM and felt important areas were covered. PROM criteria had high sensitivities (> 70%) against similar items on the CHU 9D, with the exception of fatigue (58%). Correlations between similar PROM and CHU 9D criteria were moderate to very strong (coefficients 0.40–0.82.) Discrimination: high specificities (> 70%) on corresponding PROM and CHU 9D domains. Feasibility: median completion times for PROM 60 s (IQR 38–75) and PREM 49 s (IQR 30–60) respectively. Conclusion The CAPTURE-JIA PROM and PREM are valid and feasible in UK paediatric rheumatology clinics. Embedding routine collection into clinical care would be a major step towards improving quality of care.

A new symptom measure in gastrointestinal stomal tumors.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e17508-e17508 ◽  
Author(s):  
Loretta A. Williams ◽  
Dejka M. Araujo ◽  
Tito R. Mendoza ◽  
Mary L Sailors ◽  
Nazim N Ali ◽  
...  
Keyword(s):  
Symptom Severity ◽  
Clinical Care ◽  
Reliability And Validity ◽  
Symptom Burden ◽  
Patient Reported Outcome ◽  
Response To Therapy ◽  
Major Barrier ◽  
Specific Symptom ◽  
Disease Information ◽  
Patient Reported

e17508 Background: Symptom burden is the combined impact of disease- and treatment-related symptoms on daily functioning. A major barrier to effective symptom management in gastrointestinal stromal tumors (GIST) is inadequate assessment. Our aim was to develop a short, valid, reliable patient-reported outcome measure of GIST symptoms for research and practice. Methods: After giving IRB-approved informed consent, 110 patients with GIST completed the 13 symptom severity and 6 interference items of the core MD Anderson Symptom Inventory (MDASI) plus 9 GIST-specific symptom items generated from patient and expert input. Items were measured on a 0-10 scale (0 = none, 10 = worst imaginable). 65 patients completed the same items 1 day later. Patients also answered a single overall quality-of-life (QOL) question. Demographic and disease information was collected on all patients. Psychometric procedures determined reliability and validity of the MDASI-GIST. Results: Mean subject age was 59.2 years (standard deviation [sd] = 11.9). 54% of the subjects were female, 85% were white, 47% were employed, 55% were on imatinib, and 30% had no evidence of disease. Mean overall QOL rating was 8.1 (best = 10, sd = 2.0). Symptoms reported as most severe were fatigue (mean [M] = 2.65, sd = 2.66), drowsiness (M = 2.36, sd = 2.55), disturbed sleep (M = 2.18, sd = 2.55), and muscle soreness/cramping (M = 2.18, sd = 2.67). Two items (abdominal swelling and malaise) were eliminated for redundancy. Internal consistency (Cronbach α) and test-retest reliability of the 20 symptom items were 0.94 and 0.93, respectively, and of the 6 interference items were 0.94 and 0.87, respectively. The mean severity of the 20 symptom items was significantly correlated with QOL rating (correlation = -0.7, P < 0.001). Mean GIST-specific symptom severity and symptom interference discriminated between patients who were employed and patients who were disabled (P = 0.05 and 0.03, respectively). Conclusions: We have validated an analytic tool, the MDASI-GIST, to quantify GIST symptom burden, assess side effects in treatment trials, and monitor symptoms in clinical care. Additional research on the longitudinal symptom burden of GIST, including differences based on type of therapy and response to therapy, is ongoing.

Identification of Patient-Reported Outcome Phenotypes Among Oncology Patients With Palliative Care Needs

2021 ◽  
pp. OP.20.00849
Author(s):  
Tara L. Kaufmann ◽  
Kelly D. Getz ◽  
Jesse Y. Hsu ◽  
Antonia V. Bennett ◽  
Samuel U. Takvorian ◽  
...  
Keyword(s):  
Palliative Care ◽  
Latent Profile Analysis ◽  
Clinical Care ◽  
Patient Reported Outcome ◽  
Assessment System ◽  
Moderate Pain ◽  
Care Needs ◽  
Oncology Patients ◽  
Patient Reported ◽  
Palliative Care Needs

PURPOSE: Despite evidence-based guidelines recommending early palliative care, it remains unclear how to identify and refer oncology patients, particularly in settings with constrained access to palliative care. We hypothesize that patient-reported outcome (PRO) data can be used to characterize patients with palliative care needs. To determine if PRO data can identify latent phenotypes that characterize indications for specialty palliative care referral. METHODS: We conducted a retrospective study of self-reported symptoms on the Edmonton Symptom Assessment System collected from solid tumor oncology patients (n = 745) referred to outpatient palliative care. Data were collected as part of routine clinical care from October 2012 to March 2018 at eight community and academic sites. We applied latent profile analysis to identify PRO phenotypes and examined the association of phenotypes with clinical and demographic characteristics using multinomial logistic regression. RESULTS: We identified four PRO phenotypes: (1) Low Symptoms (n = 295, 39.6%), (2) Moderate Pain/Fatigue + Mood (n = 180, 24.2%), (3) Moderate Pain/Fatigue + Appetite + Dyspnea (n = 201, 27.0%), and (4) High Symptoms (n = 69, 9.3%). In a secondary analysis of 421 patients, we found that two brief items assessing social and existential needs aligned with higher severity symptom and psychological distress phenotypes. CONCLUSION: Oncology patients referred to outpatient palliative care in a real-world setting can be differentiated into clinically meaningful phenotypes using brief, routinely collected PRO measures. Latent modeling provides a mechanism to use patient-reported data on a population level to identify distinct subgroups of patients with unmet palliative needs.

Implementation and early adaptation of patient-reported outcome measures into an electronic health record: A technical report

2018 ◽  
Vol 26 (1) ◽  
pp. 129-140 ◽  
Author(s):  
Heather Taffet Gold ◽  
Raj J Karia ◽  
Alissa Link ◽  
Rachel Lebwohl ◽  
Joseph D Zuckerman ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Outcome Measures ◽  
Computerized Adaptive Testing ◽  
Clinical Care ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Measurement Information ◽  
Health Record ◽  
Patient Reported ◽  
Electronic Health

We integrated and optimized patient-reported outcome measures into the electronic health record to provide quantitative, objective data regarding patients’ health status, which is important for patient care, payer contracts, and research. With a multidisciplinary team from information technology, clinical informatics, population health, and physician champions, we used formal human–computer interaction techniques and user-centered design to integrate several technology platforms and computerized adaptive testing for the National Institutes of Health Patient-Reported Outcomes Measurement Information System. The patient-reported outcome measure system leverages software frequently used by health systems and provides data for research and clinical care via a mobile-responsive web application using Symfony, with REDCap for configuring assessments and de-identified data storage. The system incorporates Oracle databases and Epic flowsheets. Patients complete patient-reported outcome measures, with data viewable in MyChart and Epic Synopsis Reports. Researchers can access data portals. The highly usable, successful patient-reported outcome measures platform is acceptable to patients and clinicians and achieved 73 percent overall completion rates.

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