A quantitative study on the outcome of patients with breast cancer after autologous breast reconstruction and implant breast reconstruction based on multi-scaleon / 复旦学报（医学版）

Objective To evaluate the patient-reported outcome(PRO)of patients with breast cancer who underwent autologous breast reconstruction and implant breast reconstruction.Methods Patients who underwent breast reconstruction in Shanghai Cancer Center,Fudan University from Jan 2020 to Jun 2021 were selected,including 111 patients who underwent autologous breast reconstruction and 108 patients who underwent implant breast reconstruction.Chinese version Breast-Q2.0 scale,breast cancer specificity scale QLQ-BR23 and EORTC quality of life scale QLQ-C30 were used to investigate the PRO of the two groups 18 months after operation.Results The rate of stage Ⅲ breast cancer in the self-weight construction group was higher than that in the implant reconstruction group(64.9%vs.44.4%,P<0.001).The preoperative neoadjuvant therapy and postoperative radiotherapy in the autologous reconstruction group were higher than those in the implant reconstruction group(P<0.001).Postoperative chemotherapy and endocrine therapy in the autologous reconstruction group were lower than those in the implant reconstruction group(P<0.001).The study based on Breast-Q scale showed that the breast satisfaction of autologous reconstruction group was higher than that of implant reconstruction(59.28±17.20 vs.54.94±14.48,P<0.05).The study based on QLQ-BR23 showed that the self-weight construction group was higher than the implant reconstruction group in the field of arm symptoms(20.02±20.80 vs.12.65±16.18,P<0.05).The study based on QLQ-C30 scale showed that there was no significant difference in all functional areas and symptom areas of patients.There was no significant difference in the number and time of social regression between the two groups.Conclusion Breast reconstruction can improve the PRO of breast cancer patients,and oncology factors will affect the choice of breast reconstruction.Patients with autologous breast reconstruction are more satisfied with breast appearance,but upper limb symptoms such as swelling and pain are more obvious than implant reconstruction,which is related to the higher proportion of axillary lymph node dissection in patients with autologous reconstruction.There is no significant difference in quality of life and social regression between the two groups.

Research progress of patient reported outcomes measurement tools for liver transplantation / 中国实用护理杂志

Selecting high-quality patient report outcome measures for patients with liver transplantation may properly assess health condition from their perspective, assist nurses in identifying patients′ reports of health issues, and deliver targeted nursing care for them. This paper reviewed the current status of researches on measurement tools for patient reported outcomes in liver transplantation both domestically and internationally, including the content, characteristics, disadvantages and situation recommendations of the generic and specific measurement tools. The purpose is to provide a reference for choosing patient reported outcomes measurements, symptom management as well as the caring strategies in liver transplantation.

Research progress of medication-related patient-reported outcome scales / 药物流行病学杂志

Drug therapy is a common method to cure diseases and relieve symptoms.The value of patient-reported outcome(PRO)in evaluating the effect of drug therapy has been increasingly paid attention.The PRO scale is a standardized questionnaire,which can scientifically evaluate the experiences and subjective effects of drug use from a patient-centered perspective,and help patients and clinicians make more reasonable medication decisions.By reviewing and sorting out relevant global literature,this paper found that the content of the PRO scales relevant to drug therapy focused on five fields:"medication satisfaction""medication adherence""drug treatment burden""medication-related quality of life"and"adverse drug reactions".This paper described the basic information,measurement characteristics and application of common scales in recent years respectively,and summarized and analyzed the problems and enlightenment of scale development,aiming to provide theoretical reference for the selection,application and development of PRO scales.

Application status of patient-reported outcome scale in lung cancer surgery / 中国胸心血管外科临床杂志

@#Patient-reported outcome (PRO) has been paid increasing attention in lung cancer surgery. It has gradually become an important outcome indicator in clinical research of lung cancer surgery and an important tool for symptom management. Commonly used lung cancer-specific PRO measurement tools include: Lung Cancer Symptom Scale, European Organization for Research and Treatment of Cancer-Core Quality of Life Questionnaire and Lung Cancer module, Functional Assessment of Cancer Therapy-Lung, MD Anderson Symptom Inventory-Lung Cancer module, Postoperative Symptom Scale for Lung Cancer Patients, and Perioperative Symptom Assessment for Lung Surgery. The application of lung cancer-specific scales lacks authoritative implementation norms in the field of lung cancer surgery in terms of scale selection, data collection, and outcome application. This review aimed to analyze the current status of application of PRO scales in lung cancer surgery.

Ethical exploration of clinical research empowered by remote collection of digital health technology / 中国医学伦理学

In recent years， with the gradual maturity of achievable remote collection of digital health technology， more and more clinical research have applied this technology to improve the quality of data collection and reduce the burden on subjects. However， its technological characteristics of detachment from the diagnostic and treatment environment and real-time transmission of sensitive information also pose corresponding risks to the protection of subjects’ rights and interests and data standardization management， among which personal information protection and data control permissions are more prominent issues. Based on risk analysis and regulatory review， this paper explored the responsibilities of multiple parties， including the sponsors， researchers， clinical trial institutions， and ethics committee， as well as proposed five elements of special concern for ethical review， with a view to providing a reference for promoting the standardized development of digital health technology in clinical research.

Preoperative quality of life of patients with cleft lip and palate in Nigeria: a multicentre cross-sectional pilot study

Introduction: the objective of this study was to determine the quality of life (QOL) of the patient with a cleft lip or palate scheduled for surgery. Methods: this analytic multicenter cross-sectional study involved six participating Smile Train Partner Hospitals from five geopolitical zones of the country and three major ethnic groups. Patients with cleft lip or cleft palate aged between 8 to 29 years scheduled for repair were recruited. The main outcome measure was quality of life scores as measured by cleft Q. Results: thirty-four (females 18, males 16) patients were scheduled for surgery of either cleft lip n=7 (20.6%) or cleft palate n=27 (79.4). Patients scheduled for primary surgeries were more than those for secondary surgeries, 23 (68.7%) vs 10 (30.3%). Of the QOL scales, the speech distress score was the least (56.0 ± 22.6) and the psychological score highest (73.9 ± 15.8). All QOL mean scores except the psychological score fell below normative cleft Q scores. The psychological scores in males (80.9 ± 16.2) were significantly higher than in females (67.7 ± 12.9, p=0.01). Patients for lip repair had lower psychological scores than those for palatal repair (median=59 vs 73, p=0.01). Patients for palate repair demonstrated significantly lower speech function and distress scores than those for lip repair (p=0.01, p<0.01 respectively). Conclusion: most of the QOL measures in patients with cleft lip and palate in this study fell below normative values. Gender and cleft type affect the quality of life. A larger study is recommended to establish national normative data.

4-domain sports prom translation and cultural adaptation into portuguese / 4-domain sports prom: traducción y adaptación cultural al portugués / 4-domain sports prom: tradução e adaptação cultural para a língua portuguesa

ABSTRACT Introduction: The literature presents several scientifically validated and cross-culturally adapted questionnaires in the area of orthopedics and Sports Medicine scientifically validated and cross-culturally adapted. However, they are anatomically specific, and do not consider the specific needs of athletes. The "4-Domain PROM for Orthopedic and Sports Medicine" (4-Domain Sports PROM) is the first questionnaire, in the literature (International Journal of Sports Medicine - 2021), designed to assess athletes and highly active sports practitioners, and their specificities. physical and psychological. It comprises four domains: athlete without injury, after sports injury, expectation of treatment, athlete's assessment of the treatment received. Objectives: This work aims to carry out the translation and cross-cultural adaptation (TCA) to the Portuguese language. Methods: The questionnaire was self-administered by 50 participants, regular physical and sports activities practitioners. The translation and cultural adaptation process involved six steps: translation; synthesis; back translation; pre-test; review by the Expert Committee, clinical application and author approval of the original version. The Equivalence of translation and relevance of questionnaire items were evaluated. RESULTS: The Portuguese version of the 4-DOMAIN SPORTS PROM had a translation equivalence of 0.94, and item relevance was 0.98, while the percentage of agreement between patients for understanding was 0.98. Conclusion: The translation and cross-cultural adaptation of the 4 Domain Sports PROM into the Portuguese version proved to be understandable and reproducible in all questionnaire domains (agreement above 90% and content validity index of 100%) to assess the treatment of the population of athletes and regular sports practitioners. Level of Evidence II; A cross-sectional qualitative study.

RESUMEN Introducción: La literatura presenta varios cuestionarios científicamente validados y transculturalmente adaptados en el área de la ortopedia y Medicina del Deporte. Sin embargo, son anatómicamente específicos y no consideran las necesidades específicas de los atletas. El "4-Domain PROM for Orthopaedic and Sports Medicine" (4-Domain Sports PROM) es el primer cuestionario, en la literatura (International Journal of Sports Medicine - 2021), diseñado para evaluar atletas y practicantes de deportes altamente activos, y sus especificidades físicas y psicológicas. Comprende cuatro dominios: atleta sin lesión, después de una lesión deportiva, expectativa de tratamiento, evaluación del atleta sobre el tratamiento recibido. Objetivos: El objetivo de este trabajo es realizar la traducción y adaptación transcultural (TCA) a la lengua portuguesa. Métodos: El cuestionario fue autoadministrado por 50 participantes, practicantes habituales de actividades físicas y deportivas. El proceso de traducción y adaptación cultural involucró seis pasos: traducción; síntesis; traducción inversa; prueba previa; revisión por el comité de expertos; aplicación clínica y aprobación del autor de la versión original. Se evaluaron la equivalencia de traducción y la relevancia de los ítems del cuestionario. Resultados: La versión portuguesa del 4-DOMAIN SPORTS PROM tuvo una equivalencia de traducción de 0,94 y la relevancia de los ítems fue de 0,98, mientras que el porcentaje de acuerdo entre los pacientes para la comprensión fue de 0,98. Conclusión: La traducción y adaptación transcultural del 4-DOMAIN SPORTS PROM al portugués amplía las posibilidades de evaluar los diferentes momentos que involucran el tratamiento de lesiones deportivas, ya que este cuestionario fue diseñado para capturar datos sobre la percepción de los pacientes antes de la lesión, después de la lesión, expectativa y evaluación del trato recibido en deportistas y practicantes habituales de actividad física. Nivel de Evidencia II; Estudio Cualitativo Transversal.

RESUMO Introdução: A literatura apresenta diversos questionários cientificamente validados e adaptados transculturalmente na área de na Ortopedia e Medicina Esportiva validados cientificamente e adaptados transculturalmente. Entretanto, eles são anatomicamente específicos, e não consideram as necessidades especificas dos atletas. O "4-Domain PROM for Orthopedic and Sports Medicine" (4-Domain Sports PROM) é o primeiro questionário, na literatura (International Journal of Sports Medicine - 2021), concebido para avaliar atletas e praticantes de esportes altamente ativos, e suas especificidades físicas e psicológicas. Ele compreende quatro domínios: atleta sem lesão, após lesão esportiva, expectativa do tratamento, avaliação do atleta sobre o tratamento recebido. Objetivos: O objetivo deste trabalho é realizar a tradução e a adaptação transcultural (TCA) à língua portuguesa. Métodos: O questionário foi autoadministrado por 50 participantes, praticantes regulares de atividades físicas e esportivas. O processo de tradução e adaptação cultural envolveu seis etapas: tradução; síntese; retrotradução; pré-teste; revisão pelo comitê de experts; aplicação clínica e aprovação do autor da versão original. Foi avaliado a Equivalência da tradução e relevância de itens do questionário. Resultados: A versão em português do 4-DOMAIN SPORTS PROM apresentou equivalência da tradução de 0,94 e relevância dos itens foi de 0,98, enquanto a porcentagem de concordância entre os pacientes para compreensão foi de 0,98. Conclusão: A tradução e adequação cultural do 4-DOMAIN SPORTS PROM para língua portuguesa mostrou-se compreensível e reprodutibilidade adequada em todos os domínios do questionário (concordância acima de 90% e Índice de Validade de Conteúdo de 100%) para avaliar o tratamento de população de indivíduos atletas e praticantes regulares de esportes. Nível de Evidência II; Estudo Qualitativo Transversal.

Long-term visual acuity results from cataract surgery and its association with self-reported visual function: Catquest applicability / Resultados acuidade visual a longo prazo da cirurgia de catarata e sua associação com função visual autorreferida: aplicabilidade do Catquest

ABSTRACT Purposes: This study aimed to determine the association of the long-term refractive outcomes of cataract surgery with self-reported visual function obtained using Catquest-9SF. Methods: Patients recruited from the cataract outpatient clinic of VER MAIS Oftalmologia underwent a complete ophthalmologic examination. Patients who were diagnosed with cataract with indications for phacoemulsification and intraocular lens implantation received the Catquest-9SF questionnaire before and after surgery at 30 days and 1 year. Results: A total of 133 patients were recruited, but 32 patients were lost to follow-up; finally, data from 101 patients (48 men, 53 women) were analyzed. The crude variance explained by the data was 69.9%, and the unexplained variance in the first contrast was 2.39 eigenvalues (>2); thus, these results are different from those expected from random data. The people separation index was 2.95 (>2), and the people trust value was 0.9 (>0.8). These indices were evaluated in the assessment of skill levels. Visual acuity was the main variable that correlated with the Catquest score. Conclusions: The Catquest-9SF translated into Portuguese proved to be a one-dimensional and psychometrically valid tool to assess visual dysfunction in patients with cataract, and it is successful in objectively quantifying improvements after surgery. The results of this tool could be predictive and concordant of visual acuity improvement.

RESUMO Objetivo: Associar os resultados refrativos a longo prazo da cirurgia de catarata e a função visual autorreferida pelo questionário Catquest-9SF. Métodos: Paciente recrutados no ambulatório de catarata da VER MAIS Oftalmologia, foram submetidos a exame oftalmológico completo. Após diagnóstico de catarata com indicação de tratamento cirúrgico com facoemulsificação e implante de lente intraocular, o questionário foi aplicado antes da intervenção, 30 dias após cirurgia e 1 ano após, novamente. Resultados: Foram recrutados 133 pacientes. No decorrer do seguimento, 32 pacientes foram perdidos e ao final foram analisados os dados de 101 pacientes, dos quais 48 foram homens e 53 foram mulheres. A variância bruta explicada por dados foi de 69,9% e a inexplicada em primeiro contraste por 2,39 eigenvalores, sendo maior que 2, o que nos mostra que são resultados differentes dos esperados de dados aleatórios. O índice de separação de pessoas foi de 2.95 (>2) e o valor de confiança de pessoas foi de 0,9 (>0,8). Estes índices são os valores mínimos aceitáveis na diferenciação de níveis de habilidade. Acuidade visual foi a principal variável correlacionada com o score do Catquest. Conclusões: O Catquest-9SF traduzido para o português se demonstrou unidimensional e uma ferramenta psicometricamente válida para avaliar disfunção visual em pacientes com catarata, além de ter tido sucesso para quantificar objetivamente melhoras após a intervenção cirúrgica. Essa ferramenta pode ser utilizada como preditiva e concordante da melhora da acuidade visual.

Patients with longstanding psoriatic arthritis can achieve DAPSA remission or low disease activity and it correlates to better functional outcomes: results from a Latin-American real-life cohort

Abstract Background Patients with psoriatic arthritis (PsA) experience reduced physical function and impaired quality of life. Better patient-reported functional outcomes are found when lower disease activity is achieved. Objectives To evaluate the variation of physical function by HAQ-DI over time in PsA patients treated with standard therapy in a real-life setting: to verify predictors of achieving a minimum clinically important difference (MCID) in function by HAQ-DI (ΔHAQ-DI ≤ − 0.35) and to measure the impact of achieving REM/LDA on long-term function by HAQ-DI. Methods This is a longitudinal analysis of a real-life retrospective cohort. Data from PsA patients with at least 4 years of follow-up in the PsA clinic from 2011 to 2019 were extracted from electronic medical records. The variations of physical function by HAQ-DI and disease activity by DAPSA over time were calculated. A multivariate hierarchical regression model was applied to verify predictors of MCID in HAQ-DI. A comparison of HAQ-DI variation between patients with DAPSA REM, LDA, moderate and high disease activity was made using the generalized estimating equation model (GEE), adjusted by Bonferroni test. The Spearman correlation method was applied to verify the correlation of ΔDAPSA and ΔHAQ-DI over time. Statistical analysis was performed in SPSS program version 21.0. Results Seventy-three patients were included in the analysis. Physical function measured by HAQ-DI was determined by PsA disease activity measured by DAPSA (p < 0.000). A moderate and statistically significant correlation between ΔDAPSA and ΔHAQ-DI was observed (rs = 0.60; p < 0.001). Only patients in DAPSA REM demonstrated a constant decline in HAQ-DI scores during the follow-up. White ethnicity and older age at baseline were predictors for not achieving MCID in HAQ-DI [RR 0.33 (0.16-0.6795% CI p = 0.002) and RR 0.96 (0.93-0.9895% CI p < 0.000), respectively, while higher scores of HAQ-DI at baseline were predictors of achieving MCID [RR 1.71 (1.12-2.6095%CI p = 0.013)]. Conclusion In PsA, patients who maintained DAPSA REM/LDA over time had better long-term functional outcomes. Higher HAQ-DI scores at baseline, non-white ethnicity and younger age were predictors for achieving a clinical meaningful improvement of HAQ-DI.

The Brazilian version of the High-Activity Arthroplasty Score: cross-cultural adaptation

ABSTRACT BACKGROUND: The High Activity Arthroplasty Score (HAAS) is a self-administered questionnaire, developed in British English, that reliably and validly measures the levels of sports activities in patients following hip and knee arthroplasty surgery. OBJECTIVE: To cross-culturally adapt the HAAS to Brazilian Portuguese language. DESIGN AND SETTING: A cross-sectional study was conducted at a public university hospital in Brazil. METHODS: The Brazilian version of the HAAS was created through a six-step process: translation, synthesis, committee review, pretesting, back-translation, and submission to developers. The translation step was conducted by two independent bilingual translators, both native speakers of Brazilian Portuguese. The back-translation was performed by an independent translator, a native speaker of British English. To ensure the questionnaire's comprehensibility, 46 volunteers (51% men; average age 34-63) participated in the pre-testing step. RESULTS: The cross-cultural adaptation process necessitated modifications to certain terms and expressions to achieve cultural equivalence with the original HAAS. CONCLUSION: The HAAS has been translated from English into Brazilian Portuguese and culturally adapted for Brazil. The validation process for HAAS-Brazil is currently underway.

Patient Health Questionnaire-9: a clinimetric analysis

Objective: The Patient Health Questionnaire-9 (PHQ-9) is a widely used self-report measure of depression whose psychometric properties were found to be merely acceptable. Insufficient attention has been devoted to its clinimetric validity, while its clinical utility is still debated, particularly for assessing depression severity. This is the first study to test the PHQ-9 construct validity and clinical utility based on clinimetric principles. Methods: An online survey of 3,398 participants was conducted. Item response theory models (Rasch and Mokken analyses) were used to assess the PHQ-9 validity and determine its clinical utility. Results: Fit to the Rasch model was achieved after adjusting the sample size. Items 2, 4, 6, and 9 over-discriminated, while items 1, 5, and 7 under-discriminated. Local dependency between items 2 and 6 was indicated. The PHQ-9 was not unidimensional. A Loevinger's coefficient of 0.49 was found, indicating an acceptable level of scalability. Conclusion: The PHQ-9 is an instrument with potential clinical utility as an overall index of depression, mainly for screening purposes. Substantial revision, particularly in the wording of over- and under-discriminating items, is needed.

Corrélation of EQ-5D and mRS in ischémie stroke: a multicenter cross-sectional study

Introduction: Assessing Health-Related Quality of Life (HRQOL), in addition to evaluating functional status in stroke patients could complement clinician practice. Objective: To assess HRQOL, applying EuroQol-5-dimensions (EQ-5D) in Colombian patients with stroke and correlating its results with the modified Rankin Scale (mRS). Methods: Analytical cross-sectional study in a cohort of ischemic stroke patients in Colombia at three months as a median follow-up (Q1: 1- Q3:3) after their event. We correlated EQ-5D domains, EQ-5D index, mRS with EQ-5D VAS score. We generated a simple linear regression robust model to evaluate the variability between using r2. Results: A total of 91 patients completed the EQ-5D questionnaire, with a mean age of 71.2 years; 59.3% were male. We identified an inverse correlation between EQ-5D VAS and EQ-5D domains with the highest for mobility (rs = -0.69) and the lowest for pain/discomfort (rs -0.52, p<0.001). The r2 ranged from 0.25 (pain/discomfort) to 0.47 (EQ-5D index). Patients with mRS ≥ 3 significantly reduced their EQ-5D VAS score by 25.64 points (95% CI -33.04, -18.24). Variability in EQ-5D VAS scores occurred by EQ-5D index (47%) and by mRS (34%). Conclusions: The correlation between EQ-5D and mRS was favorable. Although EQ-5D and mRS evaluated different spheres on stroke patients, applying the EQ-5D instrument in real-world clinical settings might contribute multidimensional information on how life is affected after a stroke. This kind of information serves to orientate rehabilitation strategies on specific domains such as depression, self-care, anxiety, and pain. This is especially relevant for patients with disabilities (mRS ≥ 3).

Introducción: La evaluación de la Calidad de Vida Relacionada con la Salud (CVRS) y el estado funcional de pacientes con Ataque Cerebrovascular (ACV), podría complementar la práctica clínica. Objetivo: Evaluar la CVRS, aplicando EuroQol-5-dimensiones (EQ-5D) en pacientes colombianos con ACV y correlacionar sus resultados con la escala de Rankin Modificada (mRS). Métodos: Estudio de corte transversal analítico anidado a una cohorte de pacientes con ACV isquémico en Colombia con mediana de 3 meses de seguimiento (Q1: 1- Q3:3) post-ictus. Correlacionamos los dominios del EQ-5D, índice EQ-5D y mRS con la puntuación de EQ-5D VAS. Generamos un modelo de regresión lineal simple para evaluar la variabilidad usando r2. Resultados: Un total de 91 pacientes con una edad media 71,2 años; 59,3 % hombres. Se encontró correlación inversa entre los dominios EQ-5D, mayor para movilidad (rs = -0,69) y menor para dolor/malestar (rs -0,52, p < 0,001). El r2 osciló entre 0,25 (dolor/malestar) y 0,47 (índice EQ-5D). Los pacientes con mRS ≥ 3 redujeron significativamente su puntuación EQ-5D VAS en 25,64 puntos (IC 95%: -33,04; -18,24). La variabilidad en las puntuaciones EQ-5D VAS se produjo por el índice EQ-5D (47 %) y por mRS (34 %). Conclusiones: La correlación entre EQ-5D y mRS fue favorable. Aunque EQ-5D y mRS evalúan diferentes esferas en los pacientes con ACV, la aplicación del EQ-5D en podría aportar información multidimensional sobre cómo se afecta la vida después de un ictus, así como orientar estrategias de rehabilitación en esferas como depresión, autocuidado, ansiedad y dolor; especialmente relevante para pacientes con discapacidades (mRS ≥ 3).

Adhesive Capsulitis' Patients Report Improvement in Functionality Trough International Classification of Functioning, Disability and Health Checklist and Dash After Suprascapular Nerve Blocks / Pacientes com capsulite adesiva relatam melhora da funcionalidade pela Classificação Internacional de Funcionalidade, Incapacidade e Saúde e DASH após bloqueios do nervo supraescapular

Abstract Objective To evaluate the functionality in patients with adhesive capsulitis undergoing suprascapular nerve block (SSNB). Methods A before-and-after clinical prospective study in a single center was conducted with patients with secondary adhesive capsulitis treated with four nerve blocks based on anatomical limits. The sample was non-probabilistic, and it was obtained after a routine appointment at a specialized outpatient clinic. The instruments used for evaluation were the International Classification of Functioning, Disability and Health (ICF) and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, which were applied at baseline (T0), one week after the fourth SSNB (T4), and three months after the first SSNB (T12). The paired t-test was used to compare the means of the ICF checklist items and DASH in the different: T0xT4;T4xT12;and T0xT12). The probability of rejecting the null hypothesis was 5%. Results The sample was composed of 25 individuals with a mean age of 58.16 years; 16 of them were female. The duration of the pain symptoms ranged from 2 to 16 months, with a mean of 5.92 months. The ICF checklist showed that all domains had already improved in T4 except for the environmental factors, which only improved at 03 months (p = 0.037). The patients reported improvements in shoulder function in T4, which increased more in T12, at the end of data collection (p = 0.019). Conclusion The SSNB technique is effective in patients with adhesive capsulitis after4 weeks of application, with improvements in individual's functionality lasting for 12 weeks.

Resumo Objetivo Avaliar a funcionalidade em pacientes com capsulite adesiva submetidos a bloqueio do nervo supraescapular (BNSE). Métodos Um estudo clínico prospectivo do tipo antes e depois foi realizado em um único centro com pacientes com capsulite adesiva secundária tratados com quatro bloqueios baseados em limites anatômicos. A amostra foi não probabilística, tendo sido obtida após consulta de rotina em ambulatório especializado. Os instrumentos utilizados para avaliação foram a Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) e o questionário de Disfunções do Braço, Ombro e Mão (DASH), que foram aplicados antes da intervenção (T0), uma semana após o quarto BNSE (T4),etrêsapósoprimeiroBNSE(T12).AsmédiasdositensdaCIFedoDASHnos diferentes tempos (T0 x T4; T4 x T12; e T0 x T12) foram comparadas por meio do teste t pareado. A probabilidade de rejeitar a hipótese nula foi de 5%. Resultados A amostra foi composta por 25 indivíduos com média de idade de 58,16 anos; 16 eram mulheres. A duração dos sintomas dolorosos variou de 2 a 16 meses, com média de 5,92 meses. A CIF mostrou que todos os domínios já haviam melhorado em T4 à exceção dos fatores ambientais, que só melhoraram aos 3 meses (p = 0,037). Os pacientes já relataram melhora na função do ombro em T4 emaisainda em T12,ao finaldacoletadedados (p = 0,019). Conclusão A técnica de BNSE é eficaz em pacientes com capsulite adesiva após 4 semanas de aplicação, com melhora da funcionalidade do indivíduo e sua manutenção até 12 semanas.

Instrumentos de avaliação sobre qualidade de vida em adultos estomizados: protocolo de revisão sistemática / Instruments to assess quality of life in ostomized adults: a systematic review protocol

OBJETIVO: Analisar metodologicamente resultados de pesquisas que investigaram as propriedades psicométricas(confiabilidade, responsividade e validade) de instrumentos de qualidade de vida para pessoas com estomias de eliminação. MÉTODO: Revisão sistemática da literatura que será realizada de acordo com a iniciativa Consensus-based Standards for the selection oh health Measurement INstruments (COSMIN), desenvolvida em dez etapas. As buscas serão realizadas em bases de dados nacionais e internacionais, sem restrição de idiomas e temporal. Para avaliar a qualidade metodológica dos estudos, empregar-se-á o checklist de risco de viés COSMIN, aplicando-se os critérios de qualidade para boas propriedades de medida. Por último, as evidências serão compiladas, avaliando-se sua qualidade através da abordagem GRADE. Este estudo encontra-se em andamento e o protocolo está registrado na International Prospective Register of Systematic Reviews (PROSPERO) sob o número CRD42022320642

OBJECTIVE: To methodologically analyze the results of research studies that investigated psychometric properties (reliability, responsiveness and validity) of quality of life instruments for individuals with elimination ostomies. METHOD: A systematic literature review that will be conducted according to the Consensus-based Standards for selecting health Measurement Instruments (COSMIN) initiative, developed in ten stages. The searches will be conducted in national and international databases, with no language or time restrictions. To assess the methodological quality of the studies, the COSMIN risk of bias checklist will be employed by applying the quality criteria for good measuring properties. Finally, the diverse evidence will be compiled by assessing its quality through the GRADE approach. This study is ongoing and its protocol is registered at the International Prospective Register of Systematic Reviews (PROSPERO) under number CRD42022320642

Quality of life: predictors and outcomes after stroke in a Brazilian public hospital / Qualidade de vida: preditores e desfechos após acidente vascular cerebral em um hospital público brasileiro

Abstract Background Some scales are applied after stroke to measure functional independence but qualify of life (QoL) is sometimes neglected in this scenario. Objective To analyze predictors and outcomes of QoL after stroke using a validated scale in our population. Methods Our study included patients who had their first ischemic stroke and were followed in the outpatient clinic for at least 6 months from stroke index. Disability status was assessed using the modified Rankin scale (mRS), the Barthel index (BI), and the Lawton and Brody scale. Quality of life was assessed by a stroke-specific QoL (SSQoL) scale. Statistical significance was accepted for p< 0.05. The estimated measure of association was the odds ratio (OR) for which 95% confidence intervals (95%Cis) were presented. Results Of 196 patients studied, the median age was 60.4 (±13.4) years, and 89 (45.40%) of the patients were female. In a stepwise model considering risk factors, basic activities of daily living scales, satisfaction with life, and outcomes, we found four independent variables related to a poor QoL after stroke, namely hypertension, non-regular rehabilitation, not returning to work, and medical complications. The National Institutes of Health stroke scale (NIHSS) score at admission ≥ 9 was also an independent clinical marker. Approximately 30% of all participants had a negative score under 147 points in the SSQoL. Conclusions Our results showed that QoL after stroke in a developing country did not seem to differ from those of other countries, although there is a gap in rehabilitation programs in our public system. The functional scales are important tools, but they have failed to predict QoL, in some patients, when compared with specific scales.

Resumo Antecedentes Algumas escalas são aplicadas após o acidente vascular cerebral (AVC) para avaliar a independência funcional, mas a qualidade de vida (QV) às vezes é negligenciada nesse cenário. Objetivo Analisar preditores e desfechos de QV após AVC utilizando uma escala validada em nossa população. Métodos Nosso estudo incluiu pacientes que tiveram seu primeiro AVC isquêmico e foram acompanhados no ambulatório por pelo menos 6 meses após o AVC. A funcionalidade foi avaliada pela escala de Rankin modificada, índice de Barthel e escala de Lawton e Brody. A QV foi avaliada pela ecala de qualidade de vida específica de acidente vascular cerebral (SSQoL). A significância estatística aceita foi p< 0,05. A medida de associação estimada foi o odds ratio (OR), para o qual foram apresentados intervalos de confiança (IC) de 95%. Resultados Dos 196 pacientes, a média de idade foi de 60,4 (±13,4) anos, sendo 89 (45,40%) do sexo feminino. Em um modelo stepwise considerando fatores de risco, escalas de atividades básicas da vida diária, satisfação com a vida e desfechos, encontramos quatro variáveis independentes relacionadas a uma QV ruim após o AVC, como hipertensão, reabilitação não regular, não retorno ao trabalho e comorbidades pós-AVC. A pontuação NIHSS na admissão ≥ 9 também foi um marcador clínico independente. Aproximadamente 30% de todos os participantes tiveram uma pontuação abaixo de 147 pontos para SSQoL. Conclusões Nossos resultados mostraram que a QV após AVC em um país em desenvolvimento não parece diferir de outros países, apesar da lacuna nos programas de reabilitação em nosso sistema público. As escalas funcionais são ferramentas importantes, mas falharam em alguns pacientes em predizer a QV quando comparadas com escalas específicas.

Research Progress in Application of Patient-Reported Outcome Measures in Total Knee Arthroplasty / 中国医学科学院学报

To summarize the clinical application of patient-reported outcome measures (PROM) in total knee arthroplasty (TKA) and provide reference for the application of PROM in perioperative evaluation of the patients receiving TKA,we reviewed the recent studies about the application of PROM in TKA and analyzed the contents and application characteristics of the PROM.The common PROM in TKA,such as the Western Ontario and McMaster Universities Osteoarthritis Index,Oxford Knee Score,and Forgotten Joint Score,principally focus on patients' subjective feelings about pain,function and other aspects of their knees.However,they have diverse ranges of application and each of them has their own advantages and disadvantages.There is a variety of PROM applied in TKA,which makes it challenging to select the proper measurement for evaluation.The PROM in TKA remains to be improved for broader use.

Patient-reported outcome measures and value-based medicine in paediatrics: a timely review

Healthcare delivery is moving towards a more personalised and patient-centric approach. There is now an appropriate emphasis on providing value in our healthcare system. Patient-reported outcome measures (PROMs) assess our patients' perceptions of the status of their health and quality of life, measured over a period of time. PROM is an integral component of a value-driven and value-based healthcare system and is key if we want to practise value-based medicine. In paediatrics and child health, PROMs, if implemented well with appropriate measurement tools that are regularly updated and validated in a self-learning healthcare ecosystem, will help to enhance personalised healthcare delivery and collectively improve the health of the community at large. This review covers the role of PROMs in paediatrics, as well as their role in value-based medicine.

Research progress on patient-reported outcomes in foot and ankle surgery / 中华骨科杂志

Patient-reported outcomes (PROs) are information that comes directly from any aspect of a patient's own health status. The traditional patient-reported outcome measures (PROMs) used in foot and ankle surgery include the American Association of Foot and Ankle Surgery series scale, the visual analogue scale, the medical outcomes study 36-item short form of health survey (SF-36), the foot and ankle outcome scale and the medical outcome study 12-item short form of health survey (SF-12). In the process of use, these PROMs can not accurately reflect the patient's feelings because of the subjective influence of doctors, only responding to specific diseases or general health conditions, and the test fatigue caused by too long questionnaires, which ultimately affect the reliability and validity of the results. The scales of the patient-reported outcome measurement information system (PROMIS) led by National Institutes of Health have been verified to have good reliability, validity and responsiveness, and its results are true and reliable, and have high clinical reference significance. The PROMIS includes short forms, short form collection and computerized adaptive test (CAT), of which the PROMIS CAT is built on scientific item response theory, with the selection of each question highly correlated with the underlying trait of the patient, and the accuracy and credibility of PROs significantly improved. The PROMIS score has been applied in clinical practice in foot and ankle surgery (including hallux valgus, flatfoot and talar neck fractures, etc.) and has demonstrated excellent and stable preoperative prediction and prognosis evaluation ability. The presentation of PROMIS and its application progress can enhance the participation of patients of foot and ankle surgery in medical activities and guide clinical decision-making in foot and ankle surgery.

Method exploration of telephone follow-up in clinical research / 中国胸心血管外科临床杂志

@#Telephone follow-up is one of the important ways to follow up patients. High-quality follow-up can benefit both doctors and patients. However, clinical research-related follow-up is often faced with problems such as time-consuming, laborious and poor patient compliance. The authors belong to a team that has been committed to the study of patient-reported outcomes for a long time. The team has carried out long-term follow-up of symptoms, daily function and postoperative complications of more than 1 000 patients after lung cancer surgery, and accumulated certain experience. In this paper, the experience of telephone follow-up was summarized and discussed with relevant literatures from the aspects of clarifying the purpose of clinical research follow-up, understanding the needs of patients in follow-up, and using follow-up skills.

Hipersensibilidade dentinária e satisfação com a saúde mediada pela presença de impacto físico e psicossocial das condições bucais: uma análise de caminhos / Dentin hypersensitivity and health satisfaction mediated by the presence of physical and psychosocial impacts of oral conditions: a pathway analysis

Objetivo: Objetivou-se investigar associação direta e mediada pela presença de impacto físico e psicossocial das condições bucais entre HD e satisfação com a saúde entre adultos. Métodos: Estudo transversal foi realizado entre 2018-2019 com amostra probabilística por conglomerado de adultos residentes em Rio Acima (MG). Entrevista e exame bucal foram realizados por examinadoras calibradas. Satisfação com a saúde foi avaliada por meio da pergunta doWHOQoL-bref "Quão satisfeito (a) você está com a sua saúde?" e suas respostas categorizadas entre "satisfeito" e "insatisfeito". HD foi avaliada por estímulo tátil na região cervical dos dentes. Presença de impactos físicos e psicossociais das condições bucais foi definida pelas respostas "repetidamente" ou "sempre" a pelo menos um dos itens do OHIP-14. Covariáveis foram dados sociodemográficos e econômicos, comportamentos em saúde, condições de saúde bucal e uso de serviços odontológicos. Associações foram investigadas por modelos de Regressão de Poisson e Modelagem de Equações Estruturais (MEE) para estimar associações diretas e indiretas (Stata 16). Resultados: Dos 197 adultos, 132 (66,18%) declararam estar satisfeitos com sua saúde e 73 indivíduos (38,75%) apresentavam HD. Houve associação significativa entre presença de HD e presença de impacto físico e psicossocial das condições bucais (RP: 1.34; IC 95%: 1.08­1.67), enquanto para satisfação a associação com HD não foi significativa (RP: 1.08; IC 95%: 0.75-1.54) após a inclusão da variável presença de impacto físico e psicossocial das condições bucais. MEE demonstrou associação direta não significativa entre HD e satisfação, enquanto a associação indireta mediada pela presença de impacto físico e psicossocial das condições bucais foi significativa. Conclusão: Indivíduos com HD podem relatar maior insatisfação com a vida quando esta experiência dolorosa está associada com impactos físicos ou psicossociais.

Aim: Dentin Hypersensitivity (DH) is a painful condition that affects the Oral Health-related Quality of Life and can affect the satisfaction with health of individuals who have it. This study aimed to investigate the direct association mediated by the presence of physical and psychosocial impacts of oral conditions between DH and satisfaction with health among adults. Methods: A cross-sectional study was carried out between 2018-2019 with a probabilistic sample consisting of a cluster of adults living in Rio Acima (MG). Interviews and epidemiological examinations were performed using calibrated tests. The dependent variable of satisfaction with health was assessed using the WHOQoL-bref question "How satisfied are you with your health?" Participants' answers were categorized between "satisfied" and "dissatisfied". The independent DH variable was assessed by tactile stimulation in the cervical region of the teeth. The presence of physical and psychosocial impacts of oral conditions was defined by the answers "farly often" or "very often" to at least one of the OHIP-14 items. Covariates were sociodemographic and psychological data, health behavior, oral health conditions, and use of dental services. Associations were investigated by Poisson Regression and Structural Equation Modeling (SEM) models to estimate direct and indirect associations (Stata 16). Results: Of the 197 adults, 132 (66.18%) reported being satisfied with their health, and 73 individuals (38.75%) had DH. There was a significant association between the presence of DH and the presence of physical and psychosocial impacts of oral health (PR:1.34; 95% CI: 1.08­1.67), while for receiving the association with DH, it was not significant (PR:1 .08; 95% CI: 0.75-1.54) after including the presence of impact variables. SEM showed a non-significant direct association between DH and satisfaction, while the indirect association mediated by the presence of impact was significant. Conclusion: Individuals with HD may report greater dissatisfaction with life when this painful experience is associated with physical or psychosocial effects.