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Patient reported outcomes

Karine Danno, Gérard Duru, Jean Marie Vetel
BACKGROUND:  The increasing use of psychotropic drugs to treat anxiety and depressive disorders (ADDs) is concerning. According to the study, 'Etude Pharmacoépidémiologique de l'Impact de Santé Publique des modes de prise en charge pour 3 groupes de pathologies' (EPI3)-LASER, adult ADD patients who consult a general practitioner prescribing homeopathic medicines (GP-Ho) report less psychotropic drug use and are marginally more likely to experience clinical improvement than those receiving conventional care...
March 20, 2018: Homeopathy: the Journal of the Faculty of Homeopathy
Peter J Carr, Niall S Higgins, Marie L Cooke, Gabor Mihala, Claire M Rickard
BACKGROUND: Most people admitted to hospitals worldwide require a vascular access device (VAD). Hundreds of millions of VADs are inserted annually in the USA with reports of over a billion peripheral intravenous catheters used annually worldwide. Numerous reports suggest that a team approach for the assessment, insertion, and maintenance of VADs improves clinical outcomes, the patient experience, and healthcare processes. OBJECTIVES: To compare the use of the vascular access specialist team (VAST) for VAD insertion and care to a generalist model approach for hospital or community participants requiring a VAD in terms of insertion success, device failure, and cost-effectiveness...
March 20, 2018: Cochrane Database of Systematic Reviews
Wei-Hsin Yuan, Anna Fen-Yau Li, Yi-Hong Chou, Hui-Chen Hsu, Ying-Yuan Chen
OBJECTIVE: The purpose of this study was to determine clinical and ultrasonographic characteristics of male breast tumors. METHODS: The medical records of male patients with breast lesions were retrieved from an electronic medical record database and a pathology database and retrospectively reviewed. A total of 112 men (125 breast masses) with preoperative breast ultrasonography (US) were included (median age, 59.50 years; age range, 15-96 years). Data extracted included patient age, if the lesions were bilateral, palpable, and tender, and the presence of nipple discharge...
2018: PloS One
Chengwu Yang, Kent E Vrana
Background : Psychometric instruments such as the Repeated Battery for the Assessment of Neuropsychological Status (RBANS) are commonly used under conditions for which they were not developed or validated. They may then generate troublesome data that could conceal potential findings. Methods : Based on a previously published refinement of the RBANS, we reanalyzed the data on 303 patients from two National Institutes of Health (NIH) trails in Parkinson's disease and contrasted the results using the original versus refined scores...
March 20, 2018: Healthcare (Basel, Switzerland)
Louis B Jones, Sameer Goel, Leroy Y Hung, Matthew L Graves, Clay A Spitler, George V Russell, Patrick F Bergin
The mission of any academic orthopaedic training program can be divided into 3 general areas of focus: clinical care, academic performance, and research. Clinical care is evaluated on clinical volume, patient outcomes, patient satisfaction, and becoming increasingly focused on data-driven quality metrics. Academic performance of a department can be used to motivate individual surgeons, but objective measures are used to define a residency program. Annual in-service examinations serve as a marker of resident knowledge base, and board pass rates are clearly scrutinized...
April 2018: Journal of Orthopaedic Trauma
Sean Baran, Jeffrey G Belisle, Erin K Granger, Robert Z Tashjian
OBJECTIVES: To analyze the functional and radiographic outcomes of anatomic coracoclavicular ligament reconstruction (ACCR) using allograft tendon without interference screw fixation. DESIGN: Retrospective nonrandomized study. SETTING: Level I trauma center (University Hospital). PATIENTS: Seventeen patients (mean age of 44 years) with Rockwood III through V acromioclavicular joint disruptions. Twelve of 17 patients had a primary reconstruction, including 4 patients sustaining their injuries as part of a polytrauma incident...
April 2018: Journal of Orthopaedic Trauma
Ignacio Javier Fernandez, Francesco Maria Crocetta, Marco Demattè, Paolo Farneti, Marta Stanzani, Russel E Lewis, Martina Fornaciari, Ernesto Pasquini, Vittorio Sciarretta
Objective The aims of the present study were to evaluate the clinical significance of the delay for surgical treatment and the prognostic value of other clinical, pathologic, and microbiological variables among hematologic patients affected by acute invasive fungal rhinosinusitis (AIFRS). Furthermore, we propose our early diagnosis and treatment protocol, reporting its 10-year results. Study Design Monocentric retrospective analysis. Setting The study was conducted from 2001 to 2017 at the University Hospital of Bologna, Italy...
March 1, 2018: Otolaryngology—Head and Neck Surgery
Tanya Eadie, Lauren Faust, Susan Bolt, Mara Kapsner-Smith, Rebecca Hunting Pompon, Carolyn Baylor, Neal Futran, Eduardo Méndez
Objective The purpose of this study was to examine the unique contribution of psychosocial factors, including perceived social support, depression, and resilience to communicative participation, among adult survivors of head and neck cancer (HNC). Study Design Cross-sectional. Setting University-based laboratory and speech clinic. Subjects and Methods Adult survivors of HNC who were at least 2 years posttreatment for HNC completed patient-reported outcome measures, including those related to communicative participation and psychosocial function...
March 1, 2018: Otolaryngology—Head and Neck Surgery
Beatrice Emmanouil, Katherine Browne, Dorothy Halliday, Allyson Parry
PURPOSE: Patients with Neurofibromatosis type 2 often experience debilitating neuro-otological problems which affect their mobility and balance. This study examined the efficacy of a personalised program of vestibular rehabilitation for patients with Neurofibromatosis type 2. MATERIALS AND METHODS: An observational cohort study analysing routinely collected data for 21 patients in a highly specialised Neurofibromatosis type 2 service. Vestibular rehabilitation comprised an initial one-hour assessment followed by a patient-specific exercise program reviewed in person and by email consultations...
March 20, 2018: Disability and Rehabilitation
Eoghan T Hurley, Daren Lim Fat, Shane K Farrington, Hannan Mullett
BACKGROUND: Anterior shoulder instability with significant glenoid bone loss is a challenging condition. The open Latarjet procedure is the established standard treatment method in this setting, but there is an increasing use of the arthroscopic technique. PURPOSE: To systematically review the current evidence in the literature to ascertain if the open or arthroscopic Latarjet procedure resulted in improved patient outcomes. STUDY DESIGN: Systematic review and meta-analysis...
March 1, 2018: American Journal of Sports Medicine
Neha Dewan, Joy C MacDermid, Ruby Grewal, Karen Beattie
In a prospective cohort of 113 patients followed 4 years after distal radius fracture (DRF), 24% of patients experienced a subsequent fall and 19% experienced a subsequent fracture. People with poor balance, greater fracture-specific pain/disability, low bone density, and prior falls had nearly a three times higher risk of subsequent falls. PURPOSE: To determine the extent to which modifiable risk factors alone or in combination with bone mineral density (BMD) and non-modifiable risk factors predict subsequent falls and osteoporotic (OP) fractures after distal radius fracture (DRF)...
March 20, 2018: Archives of Osteoporosis
Myrte Neijenhuis, Tom J G Gevers, Thomas D Atwell, Tim J Gunneson, Amanda C Schimek, Wietske Kievit, Joost P H Drenth, Patrick S Kamath
OBJECTIVES: As current treatments of cirrhotic ascites are not associated with survival benefit, symptom relief is the major therapeutic end point. We developed a questionnaire (Ascites-Q; modified polycystic liver disease questionnaire) and assessed validity and responsiveness for symptom assessment in cirrhotic ascites. METHODS: Ascites-Q was compared with Functional Assessment of Chronic Illness Therapy-Ascites Index (FACIT-AI; developed for malignant ascites) and Japanese Ascites Symptom Inventory-7 (ASI-7) in cirrhotics undergoing large-volume paracentesis...
March 20, 2018: American Journal of Gastroenterology
Alpesh A Patel, Shah-Nawaz M Dodwad, Barrett S Boody, Surabhi Bhatt, Jason W Savage, Wellington K Hsu, Nan E Rothrock
STUDY DESIGN: Prospective, cohort study. OBJECTIVE: Demonstrate validity of PROMIS physical function, pain interference, and pain behavior computer adaptive tests (CATs) in surgically treated lumbar stenosis patients. SUMMARY OF BACKGROUND DATA: There has been increasing attention given to patient reported outcomes associated with spinal interventions. Historical patient outcome measures have inadequate validation, demonstrate floor/ceiling effects, and infrequently used due to time constraints...
March 19, 2018: Spine
(no author information available yet)
No abstract text is available yet for this article.
April 2018: Journal of Trauma and Acute Care Surgery
Ramsey Hachem, Paul Corris
BACKGROUND: Lung transplantation is a therapeutic option for select patients with end-stage lung disease. However, successful lung transplantation is hampered by chronic lung allograft dysfunction (CLAD), in particular bronchiolitis obliterans syndrome (BOS). Although there is no approved or standard treatment for BOS, which may have several distinct phenotypes, extracorporeal photopheresis (ECP) has shown promising results in patients who develop BOS refractory to azithromycin treatment...
March 19, 2018: Transplantation
Alexej Barg, Clayton C Bettin, Albert H Burstein, Charles L Saltzman, Jeremy Gililland
BACKGROUND: In the last 2 decades, total ankle replacement has gained greater acceptance as a treatment option in patients with end-stage ankle osteoarthritis. However, there is a lack of literature on total ankle replacement using a lateral transfibular approach. Therefore, we sought to report early clinical and radiographic results for a patient cohort treated with total ankle replacement using a lateral transfibular approach, performed by a single surgeon. METHODS: From October 2012 to December 2014, 55 primary total ankle arthroplasties using the Zimmer Trabecular Metal Total Ankle implant were performed in 54 patients (29 male and 25 female; mean age, 67...
March 21, 2018: Journal of Bone and Joint Surgery. American Volume
Rénuka S Birbal, Shugi Hsien, Vasiliki Zygoura, Jack S Parker, Lisanne Ham, Korine van Dijk, Isabel Dapena, Lamis Baydoun, Gerrit R J Melles
PURPOSE: To report the mid-term outcomes of hemi-Descemet membrane endothelial keratoplasty (hemi-DMEK) performed for Fuchs endothelial corneal dystrophy (FECD). METHODS: In this prospective, interventional case series, we evaluated clinical outcomes of 10 eyes from 10 patients who underwent hemi-DMEK for FECD. Main outcome measures were best-corrected visual acuity (BCVA), endothelial cell density (ECD), central pachymetry, and postoperative complications. RESULTS: At 1 year postoperatively, 7/7 eyes (excluding 2 eyes with low visual potential) reached a BCVA of ≥20/40 (≥0...
March 19, 2018: Cornea
Chun-De Liao, Jau-Yih Tsauo, Hung-Chou Chen, Tsan-Hon Liou
OBJECTIVE: Extracorporeal shock wave therapy (ESWT), including radial shock wave (RaSW) and focused shock wave (FoSW) types, is widely used for managing tendinopathies. The difference in efficacy between the 2 shock wave characteristics with different dosage levels remains controversial, and the purpose of this meta-analysis was to examine it for patients with lower extremity (LE) tendinopathy. DESIGN: A comprehensive search of online databases and search engines was performed...
March 19, 2018: American Journal of Physical Medicine & Rehabilitation
Sanjay V Desai, David A Asch, Lisa M Bellini, Krisda H Chaiyachati, Manqing Liu, Alice L Sternberg, James Tonascia, Alyssa M Yeager, Jeremy M Asch, Joel T Katz, Mathias Basner, David W Bates, Karl Y Bilimoria, David F Dinges, Orit Even-Shoshan, David M Shade, Jeffrey H Silber, Dylan S Small, Kevin G Volpp, Judy A Shea
Background Concern persists that inflexible duty-hour rules in medical residency programs may adversely affect the training of physicians. Methods We randomly assigned 63 internal medicine residency programs in the United States to be governed by standard duty-hour policies of the 2011 Accreditation Council for Graduate Medical Education (ACGME) or by more flexible policies that did not specify limits on shift length or mandatory time off between shifts. Measures of educational experience included observations of the activities of interns (first-year residents), surveys of trainees (both interns and residents) and faculty, and intern examination scores...
March 20, 2018: New England Journal of Medicine
Daniel O Scharfstein, Aidan McDermott
Randomized trials with patient-reported outcomes are commonly plagued by missing data. The analysis of such trials relies on untestable assumptions about the missing data mechanism. To address this issue, it has been recommended that the sensitivity of the trial results to assumptions should be a mandatory reporting requirement. In this paper, we discuss a recently developed methodology (Scharfstein et al., Biometrics, 2018) for conducting sensitivity analysis of randomized trials in which outcomes are scheduled to be measured at fixed points in time after randomization and some subjects prematurely withdraw from study participation...
January 1, 2018: Statistical Methods in Medical Research
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