An electronic patient-reported outcomes measurement system in paediatric orthopaedics.

PURPOSE: The purpose of the study was to evaluate the reliability, review differences and assess patient satisfaction of electronic patient-reported outcome measures (PROMs) compared with paper PROMs. METHODS: Participants between 12 and 19 years of age with a knee-related primary complaint were randomized into two groups. Group 1 completed paper PROMs followed by electronic, while Group 2 received the electronic followed by paper. PROMs included the Pediatric International Knee Documentation Committee (Pedi-IKDC), Hospital for Special Surgery (HSS) Pediatric Functional Activity Brief Scale (HSS Pedi-FABS), Tegner Activity Level Scale, Visual Analogue Scale (VAS), PedsQL Teen and a satisfaction survey. RESULTS: In all, 87 participants were enrolled with one excluded due to incomplete PROMs. Of the 86 participants, 54 were female and 32 were male with an average age of 14.3 years (12 to 18). A high degree of reliability was found when comparing the paper and electronic versions of the Pedi-IKDC (0.946; p < 0.001), HSS Pedi-FABS (0.923; p < 0.001), PedsQL Teen (0.894; p < 0.001), Tegner Activity Level Scale before injury (0.848; p < 0.001) and the Tegner Activity Level Scale after (0.930; p < 0.001). Differences were noted between the VAS scores, with paper scores being significantly higher than electronic (5.3 versus 4.6; p < 0.001). While not significant, a trend was noted in which electronic PROMs took, overall, less time than paper (10.0 mins versus 11.2 mins; p = 0.096).Of all participants, 69.8% preferred the electronic PROMs, 67.4% felt they were faster, 93.0% stated they would complete forms at home prior to appointments and 91.8% were not concerned about the safety/privacy of electronic forms. CONCLUSION: PROMs captured electronically were reliable when compared with paper. Electronic PROMs may be quicker, will not require manual scoring and are preferred by patients. LEVEL OF EVIDENCE: II.

Impact of cranial irradiation and brain tumor location on fertility: a survey.

As survival rates of patients with childhood brain tumors have increased to 75%, treatment related side effects are of particular importance. The present study evaluated questionnaire-based fertility characteristics in cancer survivors treated with irradiation to the hypo-thalamic-pituitary-axis.A nationwide survey was conducted in collaboration with the German Childhood Cancer Registry. Questionnaire and treatment data could be retrieved for 1110 former childhood cancer patients with cranial irradiation and/or chemotherapy.Survivors receiving ≥30 gray vs. 18-29 gray and 0-17 gray to the pituitary gland reported less pregnancies or less with their partners (7.4% vs. 32.8% vs. 12.4%; p<0.001), were more often infertile (40% vs. 9.4% vs. 12.5%; p<0.001) and the female participants, had a higher frequency of permanent amenorrhea (16.7% vs. 1.7% vs. 0%; p<0.001).Irradiation of the pituitary gland ≥ 30 gray seemed to be associated with less pregnancies and increased permanent amenorrhea in women. Future studies need to be conducted to confirm these results. Increased knowledge of treatment related side effects might help brain tumor patients to improve their family planning if necessary by gonadotropine replacement.

Educational level of childhood brain tumor survivors: results from a German survey.

BACKGROUND: Among adult survivors of childhood brain tumors in Germany, we assessed their educational level and examined potentially influencing factors. PATIENTS AND METHODS: A questionnaire was sent to 505 childhood brain tumor survivors listed in the German Childhood Cancer Registry. 203/505 (40.2%) patients with treatment and educational data were included in the analysis.Of the included brain tumor survivors 54.7% (111/203) were male, the median age was 11.0 (1-15) years at diagnosis and 22.0 (19-37) years at the time of the survey. 34.8% (95%-CI 25.1-44.5) of female and 34.9% (26.0-43.8) of male survivors achieved a high school diploma. Survivors who had received irradiation had less likely obtained a high school diploma compared to those without irradiation. However, this association was statistically not significant: for either craniospinal or tumor irradiation adjusted odds ratio was 0.54 (0.08-3.76); for those with a combination of craniospinal and tumor irradiation 0.51 (0.07-3.59). Participants aged 6-10 years at diagnosis achieved a higher educational level 2.24 (0.45-11.25) compared to younger patients. CONCLUSION: A third of the childhood brain tumor survivors who participated in our survey obtained the highest school leaving certificate. This may be biased by an overrepresentation of well-educated survivors without major cancer-related late effects. The influence of the patients' strong motivation following a severe illness combined with the intensive psychosocial and/or pedagogical support on education needs to be examined in future studies.

[Measurement of hypertension in infants with sphygmomanometer-S]. / Mierzenie cisnienia tetniczego u noworodków sfigmomanometrem--S.

Hundred sixty four measurements of the arterial blood pressure were performed in 53 newborns aged between 1 and 9 days. sphygmomanometer-S used for this purpose is a microcomputer which measures arterial blood pressure basing on the amplitude of the registered pulse waves. Obtained results of the systolic and mean blood pressure values were comparable with those reported by other authors whereas diastolic blood pressure values were somewhat lower.