Cross-Cultural Adaptation and Validation of the Chinese Version of the Brace Questionnaire

Objective: To adapt the questionnaire cross-culturally and to analyze the adaptation and validation of the Chinese version of the Brace Questionnaire (C-BrQ).Methods: The adaptation was based on the International Quality of Life Assessment Project guidelines. A total of 79 patients with AIS were included to examine the psychometric properties of the C-BrQ. The reliability was assessed using internal consistency (the Cronbach's alpha coefficient) and test–retest reliability (intraclass correlation coefficient ICC2.1, 95% CI). Floor and ceiling effects were calculated. Lin's concordance correlation coefficient (CCC, 95% CI) was used to compare the agreement between the Scoliosis Research Society-22 patient questionnaire (SRS-22) and C-BrQ.Results: There were strong correlations between each item and its corresponding domain significantly. The correlations between the C-BrQ domains and their related questions vary from moderate to strong (r = 0.311–0.933, P < 0.05). The Cronbach's was 0.891, showing good internal consistency of each domain of the BrQ, and the ICC in test–retest was 0.860 (0.8776, 0.912), which means an excellent test–retest reliability. The Lin's CCC between SRS-22 and C-BrQ was 0.773 (0.669, 0.848), showing great agreement. However, no significant floor and ceiling effects in C-BrQ was observed except the ceiling effect in school activity and bodily pain.Conclusion: BrQ was translated and cross-culturally adapted for use in China with good internal consistency and excellent test–retest reliability.

Tissue Stromal Vascular Fraction Improves Early Scar Healing: A Prospective Randomized Multicenter Clinical Trial

Background Wound healing and scar formation depends on a plethora of factors. Given the impact of abnormal scar formation, interventions aimed to improve scar formation would be most advantageous. Tissue stromal vascular fraction (tSVF) of adipose tissue is composed of a heterogenous mixture of cells embedded in extracellular matrix. It contains growth factors and cytokines involved in wound healing processes, eg, parenchymal proliferation, inflammation, angiogenesis, and matrix remodeling. Objectives In this study, we hypothesized that tSVF reduces post-surgical scar formation. Methods This prospective, double-blind, placebo-controlled, randomized trial was conducted between 2016 and 2020. Forty mammoplasty patients were enrolled and followed for 1 year. At the end of the mammoplasty procedure, all patients received tSVF in the lateral 5 cm of the horizontal scar of one breast and a placebo injection in the contralateral breast to serve as an intra-patient control. Primary outcome was scar quality using the patient and observer scar assessment scale (POSAS). Secondary outcomes were obtained with photograph evaluation and histological analysis of scar tissue samples. Results Thirty-four of 40 patients completed follow-up. Six months postoperatively, injection of tSVF had significantly improved postoperative scar appearance as assessed by POSAS questionnaire (observer and patient questionnaire). No difference was observed at 12 months postoperatively. No improvement was seen based on the evaluation of photographs and histological analysis of postoperative scars between both groups. Conclusions Injection of tSVF resulted in improved wound healing and reduced scar formation at 6 months postoperative, without any noticeable advantageous effects seen at 12 months.

The COPE-Trial—Communicating prognosis to parents in the neonatal ICU: Optimistic vs. PEssimistic: study protocol for a randomized controlled crossover trial using two different scripted video vignettes to explore communication preferences of parents of preterm infants

Background One of the numerous challenges preterm birth poses for parents and physicians is prognostic disclosure. Prognoses are based on scientific evidence and medical experience. They are subject to individual assessment and will generally remain uncertain with regard to the individual. This can result in differences in prognostic framing and thus affect the recipients’ perception. In neonatology, data on the effects of prognostic framing are scarce. In particular, it is unclear whether parents prefer a more optimistic or a more pessimistic prognostic framing. Objective To explore parents’ preferences concerning prognostic framing and its effects on parent-reported outcomes and experiences. To identify predictors (demographic, psychological) of parents’ communication preferences. Design, setting, participants Unblinded, randomized controlled crossover trial (RCT) at the Division of Neonatology of the University Medical Center Mainz, Germany, including German-speaking parents or guardians of infants born preterm between 2010 and 2019 with a birth weight < 1500 g. Inclusion of up to 204 families is planned, with possible revision according to a blinded sample size reassessment. Intervention Embedded in an online survey and in pre-specified order, participants will watch two video vignettes depicting a more optimistic vs. a more pessimistic framing in prognostic disclosure to parents of a preterm infant. Apart from prognostic framing, all other aspects of physician-parent communication are standardized in both videos. Main outcomes and measures At baseline and after each video, participants complete a two-part online questionnaire (baseline and post-intervention). Primary outcome is the preference for either a more optimistic or a more pessimistic prognostic framing. Secondary outcomes include changes in state-anxiety (STAI-SKD), satisfaction with prognostic framing, evaluation of prognosis, future optimism and hope, preparedness for shared decision-making (each assessed using customized questions), and general impression (customized question), professionalism (adapted from GMC Patient Questionnaire) and compassion (Physician Compassion Questionnaire) of the consulting physician. Discussion This RCT will explore parents’ preferences concerning prognostic framing and its effects on physician-parent communication. Results may contribute to a better understanding of parental needs in prognostic disclosure and will be instrumental for a broad audience of clinicians, scientists, and ethicists. Trial registration German Clinical Trials Register DRKS00024466. Registered on April 16, 2021.

Expectations and Reality in Surgical Rehabilitation of Cataract Patients

The aim. To study the effect of surgical treatment of cataracts on the quality of life of patients and assess satisfaction with the results after implantation of a monofocal or multifocal intraocular lens (IOL), depending on the initial refraction. Materials and methods. We examined 140 patients (280 eyes) who underwent phacoemulsification with IOL (bilateral) according to the standard technique using multimodal anesthesia. The observation groups were divided depending on the initial type of refraction and the type of intraocular correction (mono- or multifocal IOL). The analysis of the results of surgical treatment of cataracts with IOL was assessed taking into account the initial refraction according to objective data, i.e. determination of distance and near visual acuity, and subjective data, i.e. the NEI-VFQ-25 quality of life questionnaire, patient questionnaire survey and assessment of the quality of vision in general, as well as distance, near, and night vision. Results and discussion. Before surgery, the mean values of indicators by all scales of the questionnaire of the quality of life related to the quality of vision ranged from 40 to 60 points and averaged 47 ± 0.5 points. After cataract surgery, the numerical indicator by each of the scales shifted to the range of 85 to 100 points. The difference in values by the scales “activity associated with distance vision” and “driving a car” was obtained. In patients with multifocal IOL, these indicators were lower compared with monofocal implantation. Dissatisfaction with distance vision was observed during the implantation of a multifocal IOL only in patients with hyperopia (12.5%), dissatisfaction with near vision was noted only in patients with myopia (16.7%), and no cases of dissatisfaction were observed in the group of patients with emmetropia. Analysis of night vision in patients with emmetropia also revealed the minimum percentage (2.5%) of cases of dissatisfaction in patients with hyperopia (5.0%) and the maximum in those with myopia (16.7%). Conclusions. IOL implantation is a single cataract treatment option that provides a high level of the patient’s satisfaction with the quality of life and visual functions. However, careful individual approach is required to select the type of implantable IOL, taking into account the patient’s needs and baseline refraction.

Means of occupational therapy in (individual) rehabilitation programs for people with Parkinson’s disease

The aim of the work is to develop a set of rehabilitation measures including occupational therapy classes for Parkinson’s disease and to assess the objective condition of patients on the scales of non-motor symptoms, cognitive and mental disorders. Materials and methods. The study of patients was conducted on the basis of anamnesis, objective examination and scales for assessment of non-motor symptoms, cognitive and mental disorders (scale of non-motor symptoms – NMSS, scale of mental disorders – MMSE, Montreal scale of cognitive disorders – MOCA); to assess non-motor symptoms, a patient questionnaire was additionally used to identify autonomic disorders (according to A. M. Wayne, 1998). The control and experimental groups were offered exercise, physiotherapy, massage and nutrition (diet). Occupational therapy was added for the experimental group. Results. After the physical rehabilitation, the condition of the patients significantly improved. The final score in the experimental group of patients with non-motor manifestations of Parkinson’s disease on the scale of assessment of non-motor symptoms was statistically significantly lower and was 61.04 ± 0.39 (P < 0.01). The final score on the scale of mental disorders was statistically significantly higher – 27.78 ± 0.27 (P < 0.01), on the scale of cognitive changes, it also became statistically significantly higher – 25.13 ± 0.19 (P < 0.01). According to A. M. Wayne’s questionnaire of autonomic disorders, the total score in the control group was 64.0 ± 3.2. In the experimental group of patients, the total score was 51.0 ± 5.4 points (P < 0.01). Thus, under the influence of additional occupational therapy classes, in the experimental group both on the scale of non-motor symptoms and by A. M. Wayne’s, questionnaire there was a statistically significant improvement in the condition of patients. Conclusions. Based on the results of the study, it can be concluded that there is a significant difference (P < 0.01) in the condition of patients on the final scores, with the pronounced improvement in the condition of the experimental group patients in comparison with the control group patients, following the results of all survey scales. A significant difference is observed on the scale of non-motor symptoms. A certain role in improving the condition of patients with appropriate screening using study scales and a patient questionnaire to identify autonomic disorders (according to A. M. Wayne, 1998), apparently played a component of the rehabilitation program, which further included occupational therapy classes.

Questionnaire for initial self-assessment in post-COVID period: Recommendations of Multidisciplinary expert board on screening of post-COVID syndrome during an expanded medical check-up

The post-COVID symptom complex is wide enough and requires special vigilance during clinical examination of patients after the novel coronavirus infection. The aim of the Multidisciplinary Expert Board study was to develop a standardized questionnaire for initial self-assessment by patients who had had COVID-19 before the expanded medical check-up.Methods. The existing validated international and national questionnaires and scales were analyzed to assess their relevance, convenience, and ease of filling out. Results of the analysis were used to set up a screening for post-COVID symptoms.Results. The work of the Multidisciplinary Expert Board in June-August 2021 resulted in a new screening questionnaire for the initial assessment of the health status of patients who have COVID-19. The questionnaire is intended for self-filling before the further clinical examination.Conclusion. A new standardized patient questionnaire to screen for post-COVID symptoms may significantly optimize the doctor’s working time, increase the efficiency of diagnosis, improve the principles of selection and formation of risk groups of patients during an expanded medical check-up.

Characteristics of patients in platform C19, a COVID-19 research database combining primary care electronic health record and patient reported information

Background Data to better understand and manage the COVID-19 pandemic is urgently needed. However, there are gaps in information stored within even the best routinely-collected electronic health records (EHR) including test results, remote consultations for suspected COVID-19, shielding, physical activity, mental health, and undiagnosed or untested COVID-19 patients. Observational and Pragmatic Research Institute (OPRI) Singapore and Optimum Patient Care (OPC) UK established Platform C19, a research database combining EHR data and bespoke patient questionnaire. We describe the demographics, clinical characteristics, patient behavior, and impact of the COVID-19 pandemic using data within Platform C19. Methods EHR data from Platform C19 were extracted from 14 practices across UK participating in the OPC COVID-19 Quality Improvement program on a continuous, monthly basis. Starting 7th August 2020, consenting patients aged 18–85 years were invited in waves to fill an online questionnaire. Descriptive statistics were summarized using all data available up to 22nd January 2021. Findings From 129,978 invitees, 31,033 responded. Respondents were predominantly female (59.6%), white (93.5%), and current or ex-smokers (52.6%). Testing for COVID-19 was received by 23.8% of respondents, of which 7.9% received positive results. COVID-19 symptoms lasted ≥4 weeks in 19.5% of COVID-19 positive respondents. Up to 39% respondents reported a negative impact on questions regarding their mental health. Most (67%-76%) respondents with asthma, Chronic Obstructive Pulmonary Disease (COPD), diabetes, heart, or kidney disease reported no change in the condition of their diseases. Interpretation Platform C19 will enable research on key questions relating to COVID-19 pandemic not possible using EHR data alone.

EP.TH.81Contribution of Information on GP Referral Letters to Patient Management in a Rapid-diagnosis Breast Clinic

Aims GP referral letters to rapid-diagnosis breast clinics are often poorly scanned copies of standard 2 week-wait proforma that are difficult to read, lengthy, and contain a large amount of irrelevant information. We studied the contribution of information in referral letters in patient management and compared this with information provided by patients themselves. Methods Patients completed a standard questionnaire (one side of A4) on arrival at clinic. This included all information relevant to a breast clinic such as family history and comorbidities. A consultant surgeon then saw the patients with the questionnaire and performed clinical assessment and imaging as necessary, without referring to GP letters. The letters were read before patients left clinic. Any additional useful information was noted. Results 202 consecutive new patients, median age 44 (16-93) seen in 23 clinics by 2 consultants were studied. The median number of pages in referral letter was 5 (1-14). Patient questionnaire took less than 30 seconds to read. The presenting complaints were real or perceived lump (n = 105), pain (n = 44), both (n = 14) and others (n = 39). 21 patients had cancer. Additional useful information in the referral letter was noted in 20 patients (10%). However, in no case this affected the patient management adversely. Conclusions GP letters are lengthy but contribute relatively little to the initial assessment and management of patients in a busy rapid diagnosis breast clinic. A patient-completed targeted questionnaire is quicker and can potentially replace a GP referral letter in most patients.