scholarly journals Affordance Based Assessment of Ligament Healing in the Knee Joint

2021 ◽  
Vol 2 (1) ◽  
pp. 1-3
Author(s):  
Wangdo Kim
Keyword(s):  
Knee Joint ◽  
Patient Reported Outcome ◽  
Sensory Function ◽  
Assessment Process ◽  
Patient Specific ◽  
Musculoskeletal Tissues ◽  
Reliable Assessment ◽  
Patient Reported ◽  
Ligament Healing ◽  
Correct Estimation

There is increasing awareness of the need to include patient-reported outcome (PRO) instruments in the evaluation of ligament healing in the knee Joint. Surgical design in personalized medicine is often based on native anatomy, which may not accurately reflect the sensory function of the joint structure, including native musculoskeletal tissues and biomechanical artifacts. To overcome this problem, researchers have developed alternative approaches based on affordance-based assessment. Estimating the instantaneous knee screw (IKS) axis is crucial to implanting a prosthesis and accessing joint kinematics. The correct estimation of the patient-specific joint axis of the knee is essential for achieving a reliable assessment of musculoskeletal kinematics and dynamics. We found that active touch and posture refer to what is ordinarily called touching-variations in skin stimulation caused by surfaces are altered together by motor activity variations. This affordance of “walk-on-able” is worth noting because it is often neglected that locomotion and its surfaces form an inseparable pair. The assessment process can be viewed in terms of action possibilities provided by the active sets of organs residing that can obtain and utilize information about the tissue environments in which the grafts are to be located.

scholarly journals Systematic review: measurement properties of patient-reported outcome measures evaluated with childhood brain tumor survivors or other acquired brain injury

2019 ◽  
Vol 7 (3) ◽  
pp. 277-287
Author(s):  
Kim S Bull ◽  
Samantha Hornsey ◽  
Colin R Kennedy ◽  
Anne-Sophie E Darlington ◽  
Martha A Grootenhuis ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Acquired Brain Injury ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Measurement Properties ◽  
Conflicting Evidence ◽  
Reliable Assessment ◽  
Patient Reported ◽  
Responsiveness To Change

Abstract Background Survivors of childhood brain tumors or other acquired brain injury (ABI) are at risk of poor health-related quality of life (HRQoL); its valid and reliable assessment is essential to evaluate the effect of their illness on their lives. The aim of this review was to critically appraise psychometric properties of patient-reported outcome measures (PROMs) of HRQoL for these children, to be able to make informed decisions about the most suitable PROM for use in clinical practice. Methods We searched MEDLINE, EMBASE, and PsycINFO for studies evaluating measurement properties of HRQoL PROMs in children treated for brain tumors or other ABI. Methodological quality of relevant studies was evaluated using the consensus-based standards for the selection of health status measurement instruments checklist. Results Eight papers reported measurement properties of 4 questionnaires: Health Utilities Index (HUI), PedsQL Core and Brain Tumor Modules, and Child and Family Follow-up Survey (CFFS). Only the CFFS had evidence of content and structural validity. It also demonstrated good internal consistency, whereas both PedsQL modules had conflicting evidence regarding this. Conflicting evidence regarding test-retest reliability was reported for the HUI and PedsQL Core Module only. Evidence of measurement error/precision was favorable for HUI and CFFS and absent for both PedsQL modules. All 4 PROMs had some evidence of construct validity/hypothesis testing but no evidence of responsiveness to change. Conclusions Valid and reliable assessment is essential to evaluate impact of ABI on young lives. However, measurement properties of PROMs evaluating HRQoL appropriate for this population require further evaluation, specifically construct validity, internal consistency, and responsiveness to change.

scholarly journals Patient-reported outcome measures following revision knee replacement: a review of PROM instrument utilisation and measurement properties using the COSMIN checklist

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e046169
Author(s):  
Shiraz A Sabah ◽  
Elizabeth A Hedge ◽  
Simon G F Abram ◽  
Abtin Alvand ◽  
Andrew J Price ◽  
...  
Keyword(s):  
Health Status ◽  
Knee Joint ◽  
Joint Replacement ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Measurement Properties ◽  
Knee Joint Replacement ◽  
Cosmin Checklist ◽  
Patient Reported

ObjectivesTo identify: (1) patient-reported outcome measures (PROMs) used to evaluate symptoms, health status or quality of life following discretionary revision (or re-revision) knee joint replacement, and (2) validated joint-specific PROMs, their measurement properties and quality of evidence.Design(1) Scoping review; (2) systematic review following the COnsensus-based Standards for selection of health status Measurement INstruments (COSMIN) checklist.Data sourcesMEDLINE, Embase, AMED and PsycINFO were searched from inception to 1 July 2020 using the Oxford PROM filter unlimited by publication date or language.Eligibility criteria for selecting studiesStudies reporting on the development, validation or outcome of a joint-specific PROM for revision knee joint replacement were included.Results51 studies reported PROM outcomes using eight joint-specific PROMs. 27 out of 51 studies (52.9%) were published within the last 5 years. PROM development was rated ‘inadequate’ for each of the eight PROMs studied. Validation studies were available for only three joint-specific PROMs: Knee Injury and Osteoarthritis Outcome Score (KOOS), Lower Extremity Activity Scale (LEAS) and Western Ontario and McMaster Universities Arthritis Index (WOMAC). 25 out of 27 (92.6%) measurement properties were rated insufficient, indeterminate or not assessed. The quality of supporting evidence was mostly low or very low. Each of the validated PROMs was rated ‘B’ (potential for recommendation but require further evaluation).ConclusionJoint-specific PROMs are increasingly used to report outcomes following revision knee joint replacement, but these instruments have insufficient evidence for their validity. Future research should be directed toward understanding the measurement properties of these instruments in order to inform clinical trials and observational studies evaluating the outcomes from joint-specific PROMs.

scholarly journals 3D printing and unicompartmental knee arthroplasty

2018 ◽  
Vol 3 (5) ◽  
pp. 248-253 ◽  
Author(s):  
Gareth G. Jones ◽  
Susannah Clarke ◽  
Martin Jaere ◽  
Justin Cobb
Keyword(s):  
3D Printing ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Patient Specific ◽  
Unicompartmental Knee ◽  
Patient Specific Instrumentation ◽  
Patient Reported ◽  
Total Knee

In suitable patients, unicompartmental knee arthroplasty (UKA) offers a number of advantages compared with total knee arthroplasty. However, the procedure is technically demanding, with a small tolerance for error. Assistive technology has the potential to improve the accuracy of implant positioning. This review paper describes the concept of detailed UKA planning in 3D, and the 3D printing technology that enables a plan to be delivered intraoperatively using patient-specific instrumentation (PSI). The varying guide designs that enable accurate registration are discussed and described. The system accuracy is reported. Future studies need to ascertain whether accuracy for low-volume surgeons can be delivered in the operating theatre using PSI, and reflected in improved patient reported outcome measures, and lower revision rates.Cite this article: EFORT Open Rev 2018;3 DOI: 10.1302/2058-5241.3.180001

scholarly journals UK-based prospective cohort study to anglicise and validate the FACE-Q Skin Cancer Module in patients with facial skin cancer undergoing surgical reconstruction: the PROMISCR (Patient-Reported Outcome Measure in Skin Cancer Reconstruction) study

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e016182 ◽  
Author(s):  
Thomas Dobbs ◽  
Hayley A Hutchings ◽  
Iain S Whitaker
Keyword(s):  
Skin Cancer ◽  
Test Validity ◽  
Personal Data ◽  
Patient Reported Outcome ◽  
Patient Specific ◽  
Facial Skin ◽  
Cancer Module ◽  
Patient Reported ◽  
The Face ◽  
The Difference

IntroductionSkin cancer is the most common malignancy worldwide, often occurring on the face, where the cosmetic outcome of treatment is paramount. A number of skin cancer-specific patient-reported outcome measures (PROMs) exist, however none adequately consider the difference in type of reconstruction from a patient’s point of view. It is the aim of this study to ‘anglicise’ (to UK English) a recently developed US PROM for facial skin cancer (the FACE-Q Skin Cancer Module) and to validate this UK version of the PROM. The validation will also involve an assessment of the items for relevance to facial reconstruction patients. This will either validate this new measure for the use in clinical care and research of various facial reconstructive options, or provide evidence that a more specific PROM is required.Methods and analysisThis is a prospective validation study of the FACE-Q Skin Cancer Module in a UK facial skin cancer population with a specific focus on the difference between types of reconstruction. The face and content validity of the FACE-Q questionnaire will initially be assessed by a review process involving patients, skin cancer specialists and methodologists. An assessment of whether questions are relevant and any missing questions will be made. Initial validation will then be carried out by recruiting a cohort of 100 study participants with skin cancer of the face pre-operatively. All eligible patients will be invited to complete the questionnaire preoperatively and postoperatively. Psychometric analysis will be performed to test validity, reliability and responsiveness to change. Subgroup analysis will be performed on patients undergoing different forms of reconstruction postexcision of their skin cancer.Ethics and disseminationThis study has been approved by the West Midlands, Edgbaston Research Ethics Committee (Ref 16/WM/0445). All personal data collected will be anonymised and patient-specific data will only be reported in terms of group demographics. Identifiable data collected will include the patient name and date of birth. Other collected personal data will include their diagnosis, treatment performed, method of reconstruction and complications. A unique identifier will be applied to each patient so that pretreatment and post-treatment questionnaire results can be compared. All data acquisition and storage will be in accordance with the Data Protection Act 1998. Following completion of the study, all records will be stored in the Abertawe Bro Morgannwg University (AMBU) Health Board archive facility. Only qualified personnel working on the project will have access to the data.The outputs from this work will be published as widely as possible in peer-review journals and it is our aim to make this open access.

scholarly journals Effects of Low-Load Blood-Flow Restricted Resistance Training on Functional Capacity and Patient-Reported Outcome in a Young Male Suffering From Reactive Arthritis

2021 ◽  
Vol 3 ◽  
Author(s):  
Stian Langgård Jørgensen ◽  
Inger Mechlenburg
Keyword(s):  
Blood Flow ◽  
Resistance Training ◽  
Knee Joint ◽  
Reactive Arthritis ◽  
Young Male ◽  
Patient Reported Outcome ◽  
Thigh Circumference ◽  
Patient Reported ◽  
Low Load ◽  
The Right

Introduction: Reactive arthritis (ReA) is a chronic inflammatory disease usually caused by a preceding gastrointestinal or genitourinary bacterial infection. ReA usually occurs in the lower limbs causing joint pain and joint swelling. Physiotherapy-led exercise is recommended to prevent muscle atrophy. The purpose of this case report is to describe the outcome after 12 weeks of low-load blood flow restricted resistance training (BFR-RT) as a rehabilitation method for a young male suffering from ReA.Methods and materials: A 17-year-old male suffered from ReA in the both knee joints and the left hip joint. 36 months after the incident, he suffered from another ReA incident in his right knee. Non-steroid anti-inflammatory drugs and a new arthrocentesis added with corticosteroid injection was unsuccessful in treating the ReA. The patient performed 12 weeks of BFR-RT on the right lower limb with a low amount of supervision after the first week of training. Assessment of unilateral 30-sec chair stand test (u30-sec CST), low-thigh circumference above apex patella, The Knee Injury and Osteoarthritis Outcome Score (KOOS), The Forgotten Knee Joint Score (FJS), and Numeric Ranking Scale for pain (NRS) was performed at baseline and after 3,6,9, and 12 weeks of BFR-RT.Results: The patient completed all planned exercise sessions. u30-sec CST improved with 7 repetitions (reps) on the right limb and 5 reps on the left leg. Low-thigh circumference decreased 1.1 cm on the right leg and 1.0 on the left leg. KOOS symptoms, ADL, quality of life and FJS demonstrated a clinically relevant change on 10, 14 and 23 points.Conclusion: The present case study indicates that even with low amounts of supervision BFR-RT could increase functional performance, reduce knee joint swelling and improve key patient-reported outcome.

scholarly journals Total knee arthroplasty using patient-specific instrumentation for osteoarthritis of the knee: a meta-analysis

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Kazuha Kizaki ◽  
Ajaykumar Shanmugaraj ◽  
Fumiharu Yamashita ◽  
Nicole Simunovic ◽  
Andrew Duong ◽  
...  
Keyword(s):  
Blood Loss ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Mean Difference ◽  
Patient Specific ◽  
Osteoarthritis Of The Knee ◽  
Transfusion Rate ◽  
Complication Rates ◽  
Patient Specific Instrumentation ◽  
Patient Reported

Abstract Background Total knee arthroplasty using patient-specific instrumentation (TKA-PSI), which are disposable cutting block guides generated to fit each patient’s 3-dimensional knee anatomy, has been developed to treat patients with end-stage osteoarthritis of the knee. Surrogate markers such as radiographic malalignment have been well investigated, however, patient-important outcomes are not well examined to elucidate the efficacy of TKA-PSI. The aim of this review is to determine if TKA-PSI improves patient-reported outcome measures (PROM), surgery time, blood loss, transfusion and complications (e.g. surgical site infection, deep venous thrombosis, and revision TKA). Methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, and ongoing clinical trials. For PROMs, surgery time, blood loss, and transfusion rate, we included randomized controlled trials (RCT) comparing TKA-PSI and standard TKA to treat osteoarthritis of the knee. For complications, we also included non-randomized comparative studies (non-RCT). Results This review includes 38 studies, 24 of which were RCT and 14 of which were non-RCT. These included a total of 3487 patients. The predominant population in the included studies highly reflected the general population, with 62% being female, aged over 60 and having end-stage osteoarthritis of the knee. TKA-PSI did not improve PROMs as compared to standard TKA for less than 1-year (mean difference 0.48, 95% confidence interval (CI) -1.92–0.97 in the Oxford knee score, mean 3-month follow-up) and for 1-year or more (mean difference 0.25, 95%CI − 4.39–4.89 in the WOMAC score, mean 29-month follow-up). TKA-PSI did not reduce surgery time (mean difference − 3.09 min, 95%CI -6.73–0.55). TKA-PSI decreased blood loss with a small effect size corresponding to a 0.4 g/dl hemoglobin decrease (95%CI 0.18–0.88), but did not decrease transfusion rate (risk difference − 0.04, 95%CI -0.09–0.01). TKA-PSI did not reduce complication rates (risk difference 0.00, 95%CI − 0.01–0.01 in the composite outcome). Conclusions TKA-PSI does not improve patient-reported outcome measures, surgery time, and complication rates as compared to standard TKA. TKA-PSI decreases blood loss with a small effect, which is not enough to reduce transfusion rate.

Pilot analysis exploring the potential value of an integrated electronic patient reported outcome (PRO) application specifically designed for use in oncology practice.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18246-e18246
Author(s):  
Thomas Hopkins
Keyword(s):  
Performance Indicators ◽  
Text Message ◽  
Key Performance Indicators ◽  
Patient Reported Outcome ◽  
Patient Specific ◽  
Software Application ◽  
Patient Reported ◽  
Infusion Systems ◽  
Oncology Practice ◽  
Pro Tools

e18246 Background: PROs may soon be used as indicators of the quality of care provided and to support comparative effectiveness research (CER). Many oncology practices are developing tools to deploy PRO tools electronically to improve effectiveness of data capture, enhance the clinical utility of the data for providers and integrate PRO data with local and national registries. Here we describe our preliminary experience with developing software for this purpose. Methods: We created a software application and a HIPAA compliant cloud-based data architecture to obtain, store, clean and normalize PRO data and infusion system data needed to define, create, measure and analyze clinical and operational key performance indicators, which are then integrated into reports and displayed to end-users on a dashboard in an actionable format. The application supports efficient data collection and interfaces with patients via secure text message or email link. The dashboard component of the application is a legible, single-page, real-time interface, depicting a tabular and graphical presentation of current and historical key performance indicators that enable instantaneous and informed decisions. Results: Figure I depicts the application patient demographics page, which allows clinicians and clinical support staff to enter patient data and enroll the patient in customized templates, which allow flexible delivery of content on a customized predetermined timeline. Figure II illustrates the PRO patient-facing interface, as displayed on a mobile device. Figure III illustrates the analytics function of the application, which displays patient-specific summary or population aggregate data and has the capacity to combine PRO data with objective data obtained from infusion systems. Conclusions: In this abstract, we describe our experience with creating an application that will collect and deliver accurate, reliable and ultimately actionable clinical and operational data to clinicians and operational leaders in oncology practices. The application is currently being evaluated for clinical and research use at our institution.

Affordance-Based Assessment Cuts Across The Dichotomy Of Subjective-Objective Outcome Measure At The Knee Joint

2019 ◽  
pp. 1-4
Author(s):  
Wangdo Kim ◽  
Keyword(s):  
Outcome Measurement ◽  
Patient Reported Outcome ◽  
Assessment Process ◽  
Active Sets ◽  
Patient Reported ◽  
Objective Outcomes ◽  
Objective Outcome ◽  
Subjective Outcomes ◽  
Pro Instruments ◽  
Inseparable Pair

There is increasing awareness of the need to include patient-reported outcome (PRO) instruments in evaluating the measurement of clinical outcomes, with an increasing focus placed on the patients’ perspective. Scientists have tried to link PROs with objective outcomes, providing unique information for managing patient care. Traditionally, objective and patient-reported outcomes (such as the Knee Injury and Osteoarthritis Outcome Score (KOOS)) are considered two distinct constructs, which cannot serve as a direct proxy for each other. Can Gibson´s affordance theory specify more about objective outcome measurements vs. subjective outcomes measurement and unify them? The present article develops a theoretical framework called entrainment of touch and posture that advocates the vis viva (living force) as the proper gauge for the dynamical action of a force, and that could explain “possibilities for action or affordance” during outcome measurement. We found that active touch and posture refer to what is ordinarily called touchingvariations in skin stimulation caused by surfaces are altered together by motor activity variations. This affordance of “walk-on-able” is worth noting because it is often neglected that locomotion and its surfaces form an inseparable pair. The assessment process can be viewed in terms of action possibilities provided by the active sets of organs residing that can obtain and utilize information about the tissue environments in which the grafts are to be located.

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