Does it matter how we evaluate HRQOL? Longitudinal comparison of the EORTC QLQ-C30/QLQ-OG25 and FACT-E.

PURPOSE: To determine whether EORTC QLQ-C30/QLQ-OG25 and FACT-E compared longitudinally provide similar reflections of health-related quality of life (HRQOL). METHODS: Eighty-six esophageal cancer patients treated with curative intent, scheduled to complete both questionnaires at baseline and post-treatment time points until 36 months. A generalized estimating equation model utilizing a Gaussian family compared instruments longitudinally. The two-one-sided-test (TOST) method assessed equivalence between the instruments. RESULTS: Trajectories for social domain and overall quality of life differed significantly between instruments. Also, FACT-G's functional well-being post-treatment returns to baseline 3-6 months earlier than the EORTC QLQ-C30's role functioning subscale, suggesting measurement of different components. Trajectories for physical and esophageal symptom subscales are similar and are deemed equivalent. Emotional domains are comparable and bear little resemblance to the physical domain trajectories indicating reflection of emotional experience rather than a physical proxy. EORTC QLQ-C30 subscales have a trajectory similar to its physical functioning scale except for the emotional and esophageal symptoms scales. Overall HRQOL in both instruments showed a consistent return to baseline/pre-treatment levels by 6 months post-treatment. CONCLUSIONS: Overall HRQOL recovers earlier after curative-intent treatment than previously reported despite persistence of physical symptoms, with a consistent return to pre-treatment levels by 6 months after treatment. This supports the concept that HRQOL is not primarily defined by physical function. Based on this longitudinal comparison, FACT-E provides a more multidimensional assessment of HRQOL. IMPLICATIONS FOR CANCER SURVIVORS: Curative intent treatment for esophageal cancer has adverse effects on HRQOL but despite intense treatment, overall HRQOL recovers within 6 months.

Resultados de la encuesta NEI-RQL-42 en pacientes con catarata operados mediante facoemulsificación más implante de lente trifocal / Results of the NEI-RQL-42 survey in patients with cataract operated by phacoemulsifi cation and trifocal lens implant

Introducción: se encuentra reportado que a pesar de obtenerse buenos resultados de agudeza visual con los lentes multifocales, algunos pacientes no se encuentran a gusto con su visión; son pocos los artículos que describen de manera objetiva la satisfacción de los pacientes después del implante de éste tipo de lentes. Objetivo: describir los resultados de la encuesta NEI-RQL-42 en pacientes que han sido operados mediante facoemulsificación e implante de lente trifocal FineVision en ambos ojos. Diseño del estudio: estudio descriptivo de corte transversal. Método: se incluyeron pacientes operados de catarata e implante de lente trifocal FineVision en ambos ojos. Todos los pacientes fueron evaluados con Pentacam prequirúrgico y cumplieron con los criterios descritos por el doctor Maeda. Posteriormente se les aplicó la encuesta NEI-RQL-42 y se realizó una comparación de medias y proporciones, utilizando el programa SPSS, versión 19. Resultados: Los puntajes promedio para cada una de las categorías de la encuesta NEI-RQL-42 son los siguientes: "Claridad de visión": 93,75, "Expectativas": 75, "Visión cercana": 92,81, "Visión lejana": 94,83, "Fluctuaciones diurnas": 81,87, "Limitación de actividades": 95,1, "Glare/deslumbramiento": 68,75, "Síntomas": 73,56, "Dependencia de la corrección": 99,58, "Preocupación": 45, "Corrección subóptima": 100, "Apariencia": 92 y "Satisfacción con la corrección": 93. Conclusión: los 20 pacientes obtuvieron un buen puntaje en la mayoría de las categorías de la encuesta. Tener en cuenta los criterios descritos por el doctor Maeda podrían mejorar los resultados de la cirugía de catarata y facilitar la decisión del tipo de lente a implantar en cada paciente.

Background: it is reported that despite obtaining good visual results with multifocal lenses, some patients are not comfortable with their vision; There are few articles that objectively describe the satisfaction of patients after the implantation of this type of lens. Objective: To describe the results of the NEI-RQL-42 survey in patients who underwent cataract surgery with phacoemulsification and implant of a trifocal lens (FineVision) in both eyes. Study Design: Descriptive, cross-sectional study. Method: We included patients who underwent cataract surgery and a trifocal lens implant in both eyes (FineVision). All patients were evaluated with Pentacam before the surgery to ensure compliance with the criteria described by Dr. Maeda. Subsequently, the NEI-RQL-42 survey was completed and a comparison of means and proportions was made using the SPSS program version 19. Results: The average score for each category of the NEI-RQL-42 survey were the following: "Clarity of vision": 93.75, "Expectations": 75, "Near vision": 92.81, "Far vision": 94.83, "Diurnal fl uctuations": 81.87, "Activity limitations": 95.1, "Glare": 68.75, "Symptoms": 73.56, "Dependence on correction": 99.58, "Worry": 45, "Suboptimal correction": 100, "Appearance": 92 and "Satisfaction with correction": 93. Conclusion: The 20 patients interviewed obtained good results in most of the categories of the NEI-RQL-42 survey. Following the criteria described by Dr. Maeda could improve the results of cataract surgery and could facilitate the decision about the type of lens to implant in each patient.

Cross-cultural adaptation and validation of nasal obstruction symptom evaluation questionnaire in Slovenian language.

OBJECTIVES: Nasal obstruction is highly subjective perception with numerous efforts being made towards objective measuring. Many instruments in quality of life studies encompass subjective symptom of nasal obstruction, but only NOSE has been properly validated and is easy to use in every day practice. METHODS: Multicenter prospective instrument validation and cross-cultural adaptation cohort study was conducted on patients with deviated nasal septum, with or without inferior turbinate hypertrophy, to develop the Slovenian version of NOSE questionnaire. A cross-cultural adaptation of the original questionnaire was done in five steps, producing Slovenian NOSE-si, used on a pilot group to confirm the quality of adapted tools and, afterwards, on the main study and control group. Symptoms were lasting for more than 12 months and all had an indication for septal surgery. A control group was selected from a pool of healthy subjects, self-assessed as having no rhinological complaints. RESULTS: NOSE-si was used on 116 patients (58 from the study group vs. 58 from the control group). High degree of internal consistency - Cronbach's a 0.971 and reliability after retesting - Goodman-Kruskal gamma coefficient 0.984 was proven. Responsiveness was confirmed in the surgery subgroup with standardized response mean (SRM) 2.76 (p<0.001). CONCLUSIONS: The study produced a valid Slovenian version of NOSE questionnaire through rigorous and well defined five-phase effort to maintain scientifically comparable QoL instrument, and may be used by clinicians and researchers.

Calidad de vida relacionada con la salud infantil: una aproximación desde la enfermedad crónica / Health-related quality of life infantile: an approach from chronic illness

Resumen El propósito de este estudio es presentar una aproximación sobre el constructo calidad de vida relacionada con la salud infantil. Para esto se menciona el desarrollo histórico del concepto de calidad de vida hasta llegar al constructo CvRs en niños y adolescentes, retomando los instrumentos de medida que han sido adaptados y validados para evaluar la CVRSI en idioma español en muestras poblacionales de niños con alguna patología y los dominios que lo conforman, enfatizándose un modelo conceptual que describe las dimensiones y factores asociados con la calidad de vida relacionada con la salud en las etapas de la niñez a la adolescencia para luego describir las temáticas que recientemente se han estudiado en el área. Por último, se plantea la necesidad del desarrollo de más investigaciones, especialmente en América Latina abordados desde las ciencias sociales, ya que la investigación ha estado focalizada en el ámbito de la medicina pediátrica con énfasis en las manifestaciones físicas.

Abstract The following is a review of evidence-based literature on the construct health-related quality of life infantile. There is described the historical and conceptual development of this term up to coming to the first studies in the infancy. It mentions the development of measuring instruments that have been adapted and validated to assess the health-related quality of life infantile in Spanish language so much generic as specifics and the domains that shape them. There is defined a conceptual model who describes the dimensions and factors associated with health-related quality of life in the stages of the childhood and the adolescence. And there are described the subject matters that recently have been studied in the field. Finally, there is a need of researches development, especially in Latin America approached from the social sciences, since the research has been focused in the field of the pediatric medicine, with emphasis on the physical manifestations.

Challenges in measuring outcomes following digital replantation.

In the early period of replantation surgery, the emphasis was on digit survival. Subsequently, with better microsurgical techniques and instrumentation, the focus has shifted to function and in recent years to consideration of cost-effectiveness. Despite over 40 years of effort in refining digital replantation surgery, a rigorous evaluation of the outcomes of digital replantation has not been performed. This is because of the many confounding variables that influence outcome comparisons. These variables include the mechanism of injury (guillotine, crush, avulsion), the injury itself (total, near total, subtotal, partial amputation), and the surgical procedure (replantation, revascularization). In addition, the traditional outcome measures (two-point discrimination, range of motion, grip strength, or the ability to return to work) are reported inconsistently and vary widely among publications. All these factors make meaningful comparison of outcomes difficult. The recent emphasis on outcome research and cost-effectiveness necessitates a rethinking in the way we report outcomes of digital replantation. In this article, the authors summarize the challenges in assessing outcomes of digital replantation and explain the need to measure outcomes using rigorous clinical research designs that incorporate cost-effectiveness studies in the research protocol.