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1.
J Frailty Aging ; 8(4): 180-185, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31637403

RESUMO

BACKGROUND: Due to differences in the definition of frailty, many different screening instruments have been developed. However, the predictive validity of these instruments among community-dwelling older people remains uncertain. OBJECTIVE: To investigate whether combined (i.e. sequential or parallel) use of available frailty instruments improves the predictive power of dependency in (instrumental) activities of daily living ((I)ADL), mortality and hospitalization. DESIGN, SETTING AND PARTICIPANTS: A prospective cohort study with two-year follow-up was conducted among pre-frail and frail community-dwelling older people in the Netherlands. MEASUREMENTS: Four combinations of two highly specific frailty instruments (Frailty Phenotype, Frailty Index) and two highly sensitive instruments (Tilburg Frailty Indicator, Groningen Frailty Indicator) were investigated. We calculated sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for all single instruments as well as for the four combinations, sequential and parallel. RESULTS: 2,420 individuals participated (mean age 76.3 ± 6.6 years, 60.5% female) in our study. Sequential use increased the levels of specificity, as expected, whereas the PPV hardly increased. Parallel use increased the levels of sensitivity, although the NPV hardly increased. CONCLUSIONS: Applying two frailty instruments sequential or parallel might not be a solution for achieving better predictions of frailty in community-dwelling older people. Our results show that the combination of different screening instruments does not improve predictive validity. However, as this is one of the first studies to investigate the combined use of screening instruments, we recommend further exploration of other combinations of instruments among other study populations.


Assuntos
Atividades Cotidianas , Avaliação Geriátrica/métodos , Hospitalização , Mortalidade , Idoso , Idoso de 80 Anos ou mais , Feminino , Idoso Fragilizado , Humanos , Masculino , Países Baixos/epidemiologia , Valor Preditivo dos Testes , Estudos Prospectivos
2.
Adm Policy Ment Health ; 46(1): 34-43, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30120618

RESUMO

This study aims to validate the HIC monitor as a model-fidelity scale to the High and Intensive Care (HIC) model, a recently developed model for acute psychiatric wards. To assess the psychometric properties of the HIC monitor, 37 audits were held on closed inpatient wards at 20 psychiatric hospitals in the Netherlands. Interrater reliability, construct validity and content validity were examined. Our results suggest that the HIC monitor has good psychometric properties. It can be used as a tool for assessing the implementation of the HIC model on acute psychiatric wards in the Netherlands, and for quality assessment and improvement.

3.
Qual Life Res ; 28(1): 211-220, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30203302

RESUMO

BACKGROUND: The Patient-Reported Outcomes Measurement Information System (PROMIS) item banks 'Ability to Participate in Social Roles and Activities' (35 items) and 'Satisfaction with Social Roles and Activities' (44 items) were developed to measure (satisfaction with) participation more efficiently and precisely than current instruments, by using Computerized Adaptive Testing (CAT). We validated these item banks in a Dutch general population. METHODS: Participants in an internet panel completed both item banks. Unidimensionality, local dependence, monotonicity, Graded Response Model item fit, Differential Item Functioning (DIF) for age, gender, education, region, ethnicity, and language (Dutch compared to US Social Supplement), and reliability were assessed. RESULTS: A representative Dutch sample of 1002 people participated. We found for the Ability to Participate and Satisfaction with Participation item banks, respectively, sufficient unidimensionality (CFI: 0.971, 0.960; TLI: 0.970, 0.958; RMSEA: 0.108, 0.108), no local dependence, sufficient monotonicity (H: 0.75, 0.73), good item fit (2 out of 35 items, 1 out of 44 items with S-X2p-value < 0.001). No DIF was found. We found a reliability of at least 0.90 with simulated CATs in 86% and 94% of the participants with on average 4.7 (range 2-12) and 4.3 (range 3-12) items, respectively. DISCUSSION: The PROMIS participation item banks showed sufficient psychometric properties in a general Dutch population and can be used as CAT. PROMIS CATs allow reliable and valid measurement of participation in an efficient and user-friendly way with limited administration time.


Assuntos
Psicometria/métodos , Qualidade de Vida/psicologia , Participação Social/psicologia , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Inquéritos e Questionários , Suécia , Adulto Jovem
4.
Sleep Med ; 50: 152-165, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30056286

RESUMO

BACKGROUND: The most commonly performed surgical procedure for obstructive sleep apnea (OSA) is uvulopalatopharyngoplasty with or without tonsillectomy (UPPP ± TE). However, there is currently no review solely focusing on clinically relevant effects of standard UPPP technique with or without tonsillectomy as a monotherapy in patients with OSA. METHODS: A systematic review and meta-analysis were performed to assess the effects of isolated UPPP ± TE in patients with OSA. Studies of any design referring to adult patients with obstructive sleep apnea diagnosed via polysomnography or comparable objective measures were considered, in which isolated "standard" UPPP ± TE was performed. RESULTS: Forty-eight studies were included for the qualitative analysis. All but one study demonstrated a reduction in the frequency of respiratory events and success/response rates ranged from 35 to 95.2%. In the six studies that reported pre- and postoperative mean scores of the Epworth Sleepiness Scale (ESS), a reduction in sleepiness scores was demonstrated. Data addressing the effect of UPPP ± TE in comparison to no treatment or control were available from two randomized controlled trials (RCT). When pooling the data, UPPP ± TE was significantly more effective in reducing the apnea-hypopnea index (AHI) and Epworth Sleepiness Scale (ESS) (large effect): an AHI mean difference (MD) of -18.59 (95% CI -34.14, -3.04) and an ESS MD of -5.37 (95% CI -7,03, -3.72). Data addressing effect of UPPP ± TE in comparison to baseline was available from three RCT. When pooling the data, the AHI was reduced from a mean 35.4 to 17.9 (49.5% reduction); a MD of -20.41, 95% CI -32.78, -8.04 (-1.80, -1.15) (large effect). Various additional beneficial effects of UPPP ± TE were demonstrated including improvement in sexual function, ventricular function, sleep stages, serum lipid, depressive disorder and driving performance. CONCLUSION: UPPP ± TE reduces respiratory events and daytime sleepiness in adult patients with OSA and UPPP ± TE is superior to non-treated controls in this regard. Further research is needed to establish the long-term benefit, the impact on cardiovascular morbidity and the role of UPPP ± TE in the variety of available treatment options for OSA.


Assuntos
Palato Mole/cirurgia , Faringe/cirurgia , Procedimentos Cirúrgicos Reconstrutivos , Apneia Obstrutiva do Sono/cirurgia , Tonsilectomia , Úvula/cirurgia , Humanos , Polissonografia , Período Pós-Operatório , Fases do Sono , Resultado do Tratamento
5.
Musculoskeletal Care ; 16(3): 363-369, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-29770556

RESUMO

OBJECTIVE: The aim of the study was to determine the internal consistency, test-retest reliability and measurement error of the Animated Activity Questionnaire (AAQ) for assessing activity limitations in hip and knee osteoarthritis (HKOA) patients. METHODS: A total of 1,177 patients, from six countries (the Netherlands, UK, France, Denmark, Italy and Spain), completed the AAQ, a questionnaire consisting of videos displaying 17 activities with 3-5 levels of performance, from which patients choose the video that best matches their own performance. Unidimensionality was assessed by means of confirmatory factor analysis (CFA), using the following fit indices: the Tucker-Lewis index (TFI) >0.95, comparative fit index (CFI) >0.95, and root mean square error of approximation (RMSEA) <0.06. Cronbach's alpha was computed. In 238 patients who completed the AAQ twice, the intra-class correlation coefficient (ICC) was calculated for test-retest reliability. The standard error of measurement (SEM) and the smallest detectable change (SDC) were calculated as parameters of measurement error. RESULTS: The fit indices for unidimensionality were CFI 0.957, TLI 0.950, and RMSEA 0.144. Cronbach's alpha was 0.95. ICC for test-retest reliability was 0.93 (95% confidence interval 0.91 to 0.95), ranging from 0.85 to 0.98 across countries. SEM and SDC were 4.9 and 13.6, respectively, on a scale from 0 to 100, and ranging from 2.7 to 6.7, and from 7.5 to 18.4, respectively, across countries. The AAQ appeared to measure slightly more precisely in patients with knee problems and patients without prosthesis. CONCLUSION: The AAQ seemed to be unidimensional, and showed good internal consistency and test-retest reliability. The SDC indicated that changes in scores of at least 14% indicate real improvement in activity limitations.


Assuntos
Atividades Cotidianas , Avaliação da Deficiência , Osteoartrite do Quadril/diagnóstico , Osteoartrite do Joelho/diagnóstico , Inquéritos e Questionários , Distribuição por Idade , Idoso , Assistência Ambulatorial , Europa (Continente) , Feminino , Humanos , Incidência , Internacionalidade , Masculino , Pessoa de Meia-Idade , Limitação da Mobilidade , Osteoartrite do Quadril/epidemiologia , Osteoartrite do Joelho/epidemiologia , Centros de Reabilitação , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Distribuição por Sexo
6.
Qual Life Res ; 27(5): 1159-1170, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29550964

RESUMO

BACKGROUND: Content validity is the most important measurement property of a patient-reported outcome measure (PROM) and the most challenging to assess. Our aims were to: (1) develop standards for evaluating the quality of PROM development; (2) update the original COSMIN standards for assessing the quality of content validity studies of PROMs; (3) develop criteria for what constitutes good content validity of PROMs, and (4) develop a rating system for summarizing the evidence on a PROM's content validity and grading the quality of the evidence in systematic reviews of PROMs. METHODS: An online 4-round Delphi study was performed among 159 experts from 21 countries. Panelists rated the degree to which they (dis)agreed to proposed standards, criteria, and rating issues on 5-point rating scales ('strongly disagree' to 'strongly agree'), and provided arguments for their ratings. RESULTS: Discussion focused on sample size requirements, recording and field notes, transcribing cognitive interviews, and data coding. After four rounds, the required 67% consensus was reached on all standards, criteria, and rating issues. After pilot-testing, the steering committee made some final changes. Ten criteria for good content validity were defined regarding item relevance, appropriateness of response options and recall period, comprehensiveness, and comprehensibility of the PROM. DISCUSSION: The consensus-based COSMIN methodology for content validity is more detailed, standardized, and transparent than earlier published guidelines, including the previous COSMIN standards. This methodology can contribute to the selection and use of high-quality PROMs in research and clinical practice.


Assuntos
Técnica Delfos , Medidas de Resultados Relatados pelo Paciente , Qualidade de Vida/psicologia , Inquéritos e Questionários , Estudos de Validação como Assunto , Consenso , Humanos , Pesquisa Qualitativa
7.
Qual Life Res ; 27(5): 1147-1157, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29435801

RESUMO

PURPOSE: Systematic reviews of patient-reported outcome measures (PROMs) differ from reviews of interventions and diagnostic test accuracy studies and are complex. In fact, conducting a review of one or more PROMs comprises of multiple reviews (i.e., one review for each measurement property of each PROM). In the absence of guidance specifically designed for reviews on measurement properties, our aim was to develop a guideline for conducting systematic reviews of PROMs. METHODS: Based on literature reviews and expert opinions, and in concordance with existing guidelines, the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) steering committee developed a guideline for systematic reviews of PROMs. RESULTS: A consecutive ten-step procedure for conducting a systematic review of PROMs is proposed. Steps 1-4 concern preparing and performing the literature search, and selecting relevant studies. Steps 5-8 concern the evaluation of the quality of the eligible studies, the measurement properties, and the interpretability and feasibility aspects. Steps 9 and 10 concern formulating recommendations and reporting the systematic review. CONCLUSIONS: The COSMIN guideline for systematic reviews of PROMs includes methodology to combine the methodological quality of studies on measurement properties with the quality of the PROM itself (i.e., its measurement properties). This enables reviewers to draw transparent conclusions and making evidence-based recommendations on the quality of PROMs, and supports the evidence-based selection of PROMs for use in research and in clinical practice.


Assuntos
Guias como Assunto , Medidas de Resultados Relatados pelo Paciente , Qualidade de Vida/psicologia , Humanos , Inquéritos e Questionários
8.
Qual Life Res ; 27(5): 1171-1179, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29260445

RESUMO

PURPOSE: The original COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist was developed to assess the methodological quality of single studies on measurement properties of Patient-Reported Outcome Measures (PROMs). Now it is our aim to adapt the COSMIN checklist and its four-point rating system into a version exclusively for use in systematic reviews of PROMs, aiming to assess risk of bias of studies on measurement properties. METHODS: For each standard (i.e., a design requirement or preferred statistical method), it was discussed within the COSMIN steering committee if and how it should be adapted. The adapted checklist was pilot-tested to strengthen content validity in a systematic review on the quality of PROMs for patients with hand osteoarthritis. RESULTS: Most important changes were the reordering of the measurement properties to be assessed in a systematic review of PROMs; the deletion of standards that concerned reporting issues and standards that not necessarily lead to biased results; the integration of standards on general requirements for studies on item response theory with standards for specific measurement properties; the recommendation to the review team to specify hypotheses for construct validity and responsiveness in advance, and subsequently the removal of the standards about formulating hypotheses; and the change in the labels of the four-point rating system. CONCLUSIONS: The COSMIN Risk of Bias checklist was developed exclusively for use in systematic reviews of PROMs to distinguish this application from other purposes of assessing the methodological quality of studies on measurement properties, such as guidance for designing or reporting a study on the measurement properties.


Assuntos
Lista de Checagem/métodos , Nível de Saúde , Medidas de Resultados Relatados pelo Paciente , Qualidade de Vida/psicologia , Viés , Consenso , Bases de Dados Factuais , Humanos
9.
Cleft Palate Craniofac J ; 55(7): 1006-1012, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-27996297

RESUMO

OBJECTIVE: To develop a reliable and easy-to-use method to assess the nasolabial appearance of 18-year-old patients with unilateral cleft lip and palate (CLP). DESIGN: Retrospective analysis of nasolabial aesthetics using a 5-point ordinal scale and newly developed photographic reference scale: the Cleft Aesthetic Rating Scale (CARS). Three cleft surgeons and 20 medical students scored the nasolabial appearance on standardized frontal photographs. SETTING: VU University Medical Center, Amsterdam. PATIENTS: Inclusion criteria: 18-year-old patients, unilateral cleft lip and palate, available photograph of the frontal view. EXCLUSION CRITERIA: history of facial trauma, congenital syndromes affecting facial appearance. Eighty photographs were available for scoring. MAIN OUTCOME MEASURES: The interobserver and intraobserver reliability of the CARS for 18-year-old patients when used by cleft surgeons and medical students. RESULTS: The interobserver reliability for the nose and lip together was 0.64 for the cleft surgeons and 0.61 for the medical students. There was an intraobserver reliability of 0.75 and 0.78 from the surgeons and students, respectively, on the nose and lip together. No significant difference was found between the cleft surgeons and medical students in the way they scored the nose ( P = 0.22) and lip ( P = 0.72). CONCLUSIONS: The Cleft Aesthetic Rating Scale for 18-year-old patients has a substantial overall estimated reliability when the average score is taken from three or more cleft surgeons or medical students assessing the nasolabial aesthetics of CLP patients.


Assuntos
Atitude do Pessoal de Saúde , Fenda Labial/cirurgia , Fissura Palatina/cirurgia , Estética/psicologia , Nariz/anormalidades , Adolescente , Feminino , Humanos , Masculino , Países Baixos , Fotografação , Reprodutibilidade dos Testes , Estudos Retrospectivos , Estudantes de Medicina/psicologia , Cirurgiões/psicologia
10.
Eur J Pain ; 22(1): 103-113, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-28871611

RESUMO

BACKGROUND: Information on the course of neck pain (NP) and low back pain (LBP) typically relies on data collected at few time intervals during a period of up to 1 year. METHODS: In this prospective, multicentre practice-based cohort study, patients consulting a chiropractor responded weekly for 52 weeks to text messages on their cell phones. Data from 448 patients (153 NP, 295 LBP) who had returned at least one set of answers in the first 26 weeks were used. Outcome measures were pain intensity (VAS) and functional outcome, assessed using four different questions: pain intensity, limitation in activities of daily living (ADL), number of days with pain in the previous week and number of days limited in ADL. Distinct patterns of pain were analysed with quadratic latent class growth analysis. RESULTS: The final model was a 4-class model for NP and LBP. The 'recovering from mild baseline pain' is most common (76.3% of NP patients/58.3% of LBP patients) followed by the 'recovering from severe baseline pain' class (16.3% NP/29.8% LBP). They follow similar trajectories when considered over a period of 6 months. Pain at baseline, duration of complaints, functional status, limitations in ADL and the score on psychosocial scales were the variables that most contributed to distinguish between groups. CONCLUSIONS: Most patients with NP or LBP presenting in chiropractic care show a trajectory of symptoms characterized by persistent or fluctuating pain of low or medium intensity. Only a minority either experience a rapid complete recovery or develop chronic severe pain. SIGNIFICANCE: Ninety percentage of patients with neck pain or low back pain presenting to chiropractors have a 30% improvement within 6 weeks and then show a trajectory of symptoms characterized by persistent or fluctuating pain of low or medium intensity. Only a minority either experience a rapid complete recovery or develop chronic severe pain.


Assuntos
Dor Lombar/fisiopatologia , Cervicalgia/fisiopatologia , Atividades Cotidianas , Adulto , Progressão da Doença , Feminino , Humanos , Dor Lombar/terapia , Masculino , Manipulação Quiroprática , Pessoa de Meia-Idade , Modelos Teóricos , Cervicalgia/terapia , Medição da Dor , Estudos Prospectivos
11.
BMC Med Inform Decis Mak ; 17(1): 144, 2017 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-28969629

RESUMO

BACKGROUND: Individually tailored cancer treatment is essential to ensure optimal treatment and resource use. Treatments for incurable metastatic non-small cell lung cancer (NSCLC) are evolving rapidly, and decision support systems (DSS) for this patient population have been developed to balance benefits and harms for decision-making. The aim of this systematic review was to inventory DSS for stage IIIB/IV NSCLC patients. METHODS: A systematic literature search was performed in Pubmed, Embase and the Cochrane Library. DSS were described extensively, including their predictors, model performances (i.e., discriminative ability and calibration), levels of validation and user friendliness. RESULTS: The systematic search yielded 3531 articles. In total, 67 articles were included after additional reference tracking. The 39 identified DSS aim to predict overall survival and/or progression-free survival, but give no information about toxicity or cost-effectiveness. Various predictors were incorporated, such as performance status, serum and inflammatory markers, and patient and tumor characteristics. Some DSS were developed for the entire incurable NSCLC population, whereas others were specifically for patients with brain or spinal metastases. Few DSS had been validated externally using recent clinical data, and the discrimination and calibration were often poor. CONCLUSIONS: Many DSS have been developed for incurable NSCLC patients, but DSS are still lacking that are up-to-date with a good model performance, while covering the entire treatment spectrum. Future DSS should incorporate genetic and biological markers based on state-of-the-art evidence, and compare multiple treatment options to estimate survival, toxicity and cost-effectiveness.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/terapia , Sistemas de Apoio a Decisões Clínicas , Neoplasias Pulmonares/terapia , Cuidados Paliativos/métodos , Carcinoma Pulmonar de Células não Pequenas/mortalidade , Técnicas de Apoio para a Decisão , Humanos , Neoplasias Pulmonares/mortalidade , Prognóstico
12.
Ned Tijdschr Geneeskd ; 161: D1167, 2017.
Artigo em Holandês | MEDLINE | ID: mdl-28247837

RESUMO

OBJECTIVES: Record review is the most used method to quantify patient safety. We systematically reviewed the reliability and validity of adverse event detection with record review. DESIGN: A systematic review of the literature. METHODS: We searched PubMed, EMBASE, CINAHL, PsycINFO and the Cochrane Library and from their inception through February 2015. We included all studies that aimed to describe the reliability and/or validity of record review. Two reviewers conducted data extraction. We pooled κ values (κ) and analysed the differences in subgroups according to number of reviewers, reviewer experience and training level, adjusted for the prevalence of adverse events. RESULTS: In 25 studies, the psychometric data of the Global Trigger Tool (GTT) and the Harvard Medical Practice Study (HMPS) were reported and 24 studies were included for statistical pooling. The inter-raterreliability of the GTT and HMPS showed a pooled κ of 0.65 and 0.55, respectively. The inter-rater agreement was statistically significantly higher when the group of reviewers within a study consisted of a maximum five reviewers. We found no studies reporting on the validity of the GTT and HMPS. CONCLUSIONS: The reliability of record review is moderate to substantial and improved when a small group of reviewers carried out record review. The validity of the record review method has never been evaluated, while clinical data registries, autopsy or direct observations of patient care are methods that can be used to test concurrent validity.

13.
Breast ; 29: 82-9, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27476082

RESUMO

The inverted nipple is a frequently encountered problem which can cause difficulties with breastfeeding, sexuality, and aesthetic dissatisfaction. Up to now, no consensus exists on a preferred treatment method. We performed a systematic review to identify the best treatment method for correction of benign inverted nipples. Treatment techniques were subdivided in the categories lactiferous duct preserving and lactiferous duct damaging. A systematic review was performed using the PRISMA statement. Inclusion criteria were: female patients with congenital or acquired inverted nipples, a minimum sample size of 10 nipples, and studies reporting recurrence of inversion with a minimum follow-up of six months. Exclusion criteria were nipple inversion caused by malignancy. Thirteen studies met the inclusion criteria which all had a level of evidence IV. No non-invasive treatment techniques were identified. In the duct preserving category eight studies were included with a recurrence rate of 0.6% (2/350) versus 9.9% (16/161) in the duct damaging category (n = 5). Other outcome parameters were not systematically reported in all studies. Because of a small number of low quality studies with heterogeneous interventions and outcomes a meta-analysis could not be performed and no preferred treatment method was identified. Based on the available data there is no statistical evidence that duct damaging treatment is superior to duct preserving treatment. We recommend that the first method of choice should be a duct preserving treatment method. In the future, more studies of better methodological quality are required and recommendations were made on how these could be conducted.


Assuntos
Mamilos/anormalidades , Mamilos/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/tendências , Adolescente , Adulto , Feminino , Previsões , Humanos , Pessoa de Meia-Idade , Mamilos/lesões , Procedimentos Cirúrgicos Reconstrutivos/efeitos adversos , Procedimentos Cirúrgicos Reconstrutivos/métodos , Adulto Jovem
14.
Qual Life Res ; 25(4): 767-79, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26346986

RESUMO

BACKGROUND: Systematic reviews of outcome measurement instruments are important tools for the selection of instruments for research and clinical practice. Our aim was to assess the quality of systematic reviews of health-related outcome measurement instruments and to determine whether the quality has improved since our previous study in 2007. METHODS: A systematic literature search was performed in MEDLINE and EMBASE between July 1, 2013, and June 19, 2014. The quality of the reviews was rated using a study-specific checklist. RESULTS: A total of 102 reviews were included. In many reviews the search strategy was considered not comprehensive; in only 59 % of the reviews a search was performed in EMBASE and in about half of the reviews there was doubt about the comprehensiveness of the search terms used for type of measurement instruments and measurement properties. In 41 % of the reviews, compared to 30 % in our previous study, the methodological quality of the included studies was assessed. In 58 %, compared to 55 %, the quality of the included instruments was assessed. In 42 %, compared to 7 %, a data synthesis was performed in which the results from multiple studies on the same instrument were somehow combined. CONCLUSION: Despite a clear improvement in the quality of systematic reviews of outcome measurement instruments in comparison with our previous study in 2007, there is still room for improvement with regard to the search strategy, and especially the quality assessment of the included studies and the included instruments, and the data synthesis.


Assuntos
Avaliação de Resultados da Assistência ao Paciente , Pesquisa/normas , Literatura de Revisão como Assunto , Lista de Checagem , Humanos , Qualidade de Vida
15.
Eur J Pain ; 20(2): 284-96, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26014337

RESUMO

BACKGROUND: The aims of the current study were to calibrate the item parameters of the Dutch-Flemish PROMIS Pain Behavior item bank using a sample of Dutch patients with chronic pain and to evaluate cross-cultural validity between the Dutch-Flemish and the US PROMIS Pain Behavior item banks. Furthermore, reliability and construct validity of the Dutch-Flemish PROMIS Pain Behavior item bank were evaluated. METHODS: The 39 items in the bank were completed by 1042 Dutch patients with chronic pain. To evaluate unidimensionality, a one-factor confirmatory factor analysis (CFA) was performed. A graded response model (GRM) was used to calibrate the items. To evaluate cross-cultural validity, Differential item functioning (DIF) for language (Dutch vs. English) was evaluated. Reliability of the item bank was also examined and construct validity was studied using several legacy instruments, e.g. the Roland Morris Disability Questionnaire. RESULTS: CFA supported the unidimensionality of the Dutch-Flemish PROMIS Pain Behavior item bank (CFI = 0.960, TLI = 0.958), the data also fit the GRM, and demonstrated good coverage across the pain behavior construct (threshold parameters range: -3.42 to 3.54). Analysis showed good cross-cultural validity (only six DIF items), reliability (Cronbach's α = 0.95) and construct validity (all correlations ≥0.53). CONCLUSIONS: The Dutch-Flemish PROMIS Pain Behavior item bank was found to have good cross-cultural validity, reliability and construct validity. The development of the Dutch-Flemish PROMIS Pain Behavior item bank will serve as the basis for Dutch-Flemish PROMIS short forms and computer adaptive testing (CAT).


Assuntos
Dor Crônica/diagnóstico , Comportamento de Doença/fisiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Comparação Transcultural , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Países Baixos , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Estados Unidos , Adulto Jovem
16.
Support Care Cancer ; 24(2): 661-666, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26160463

RESUMO

PURPOSE: Anorexia is a frequently observed symptom in patients with cancer and is associated with limited food intake and decreased quality of life. Diagnostic instruments such as the Anorexia/Cachexia Subscale (A/CS) of the Functional Assessment of Anorexia/Cachexia Therapy (FAACT) questionnaire and the visual analog scale (VAS) for appetite have been recommended in the assessment of anorexia, but validated cut-off values are lacking. This study aimed to obtain cut-off values of these instruments for the assessment of anorexia in patients with cancer. METHODS: The FAACT-A/CS and the VAS for appetite were administered to patients with cancer before start of chemotherapy. As reference standard for anorexia, two external criteria were used: (1) a cut-off value of ≥2 on the anorexia symptom scale of the EORTC QLQ C-30 and (2) the question "Do you experience a decreased appetite?" (yes/no). ROC curves were used to examine the optimal cut-off values for the FAACT-A/CS and VAS. RESULTS: A total of 273 patients (58 % male; 64.0 ± 10.6 years) were included. The median score on the FAACT-A/CS was 38 (IQR 32-42) points and 77 (IQR 47-93) points on the VAS. Considering both external criteria, the optimal cut-off value for the FAACT-A/CS was ≤37 (sensitivity (se) 80 %, specificity (sp) 81 %, positive predictive value (PV(+)) 79 %, negative predictive value (PV(-)) 82 %) and for the VAS was ≤70 (se 76 %, sp 83 %, PV(+) 80 %, PV(-) 79 %). CONCLUSIONS: For the assessment of anorexia in patients with cancer, our study suggests cut-off values of ≤37 for the FAACT-A/CS and ≤70 for the VAS. Future studies should confirm our findings in other patient samples.


Assuntos
Anorexia/diagnóstico , Anorexia/etiologia , Neoplasias/complicações , Anorexia/tratamento farmacológico , Anorexia/fisiopatologia , Apetite/fisiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/fisiopatologia , Neoplasias/terapia , Qualidade de Vida , Inquéritos e Questionários , Escala Visual Analógica
17.
Atten Defic Hyperact Disord ; 8(1): 13-20, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26068984

RESUMO

Attention-deficit/hyperactivity disorder (ADHD) has been shown to continue into old age. Studies in children and younger adults show a reduction in hyperactive-impulsive symptoms, whereas the number of inattentive symptoms stays stable. The current study examined the lifetime stability of ADHD symptoms up to old age. Data on ADHD diagnosis and symptoms were collected in a two-phase side-study (N = 231) of the Longitudinal Aging Study Amsterdam. Paired t tests and ANCOVAs were used to analyze the data. Paired t test suggests continuity of the number of reported ADHD symptoms currently present and present in childhood. The change in the balance of inattentive/hyperactive-impulsive symptoms at present and in childhood is also the same in persons with ADHD. Finally, the difference in the change in the balance of inattentive/hyperactive-impulsive symptoms in those with and without ADHD suggests continuity throughout the life span. Our results suggest that diagnostic criteria developed for younger adults may be used among older adults. However, we collected our data retrospectively, which may have biased our results. Future research should follow larger cohorts of patients with ADHD prospectively over the life span.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Avaliação de Sintomas , Idoso , Feminino , Humanos , Estudos Longitudinais , Masculino , Estudos Retrospectivos
18.
Man Ther ; 21: 170-6, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26254262

RESUMO

AIM: To determine if psychosocial factors are associated with outcome in patients with neck pain or low back pain. METHODS: In a prospective, multi-center chiropractic practice-based cohort study in Belgium and The Netherlands, 917 patients, of which 326 with neck pain and 591 with low back pain, completed self-administered questionnaires at baseline, following the second visit, and at 1, 3, 6 and 12 months. Psychosocial factors assessed at baseline were: distress, depression, anxiety and somatization via the Four Dimensional Symptom Questionnaire, patient's beliefs regarding the effect of physical activity and work on their complaint via the Fear Avoidance Beliefs Questionnaire, and social support via the Feij social support scale. Primary outcome measures were perceived recovery, pain intensity, and functional status which was measured with the Neck Disability Index and Oswestry Disability Index. A univariable regression analysis to estimate the relation between each psychological variable and outcome was followed by a multivariable multilevel regression analysis. RESULTS: There were no differences in baseline patient characteristics between the patient population from Belgium and the Netherlands. Somatization scores are consistently associated with perceived recovery, functional status and pain for both neck pain and low-back pain. Depression was associated with poorer functioning in patients with LBP. There was a small association between fear and function and pain for patients with neck pain or low-back pain. CONCLUSION: Somatization was the only variable consistently found to be associated with diminished perceived recovery, higher degree of neck or low back disability, and increased neck or low back pain.


Assuntos
Quiroprática/métodos , Dor Lombar/fisiopatologia , Dor Lombar/terapia , Cervicalgia/fisiopatologia , Cervicalgia/terapia , Adolescente , Adulto , Bélgica , Estudos de Coortes , Avaliação da Deficiência , Pessoas com Deficiência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Países Baixos , Manejo da Dor/métodos , Medição da Dor/métodos , Estudos Prospectivos , Índice de Gravidade de Doença , Transtornos Somatoformes/fisiopatologia , Transtornos Somatoformes/terapia , Inquéritos e Questionários , Adulto Jovem
19.
Arthritis Care Res (Hoboken) ; 67(1): 32-9, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24966068

RESUMO

OBJECTIVE: To develop an Animated Activity Questionnaire (AAQ) based on video animations for assessing activity limitations in patients with hip/knee osteoarthritis (OA) that combines the advantages of self-reported questionnaires and performance-based tests without many of their limitations and to preliminarily assess its reliability and validity. We hypothesized that the AAQ would correlate highly with performance-based tests and moderately with self-reported questionnaires. METHODS: Item selection was based on the pilot AAQ, prespecified conditions, the International Classification of Functioning, Disability, and Health core set for OA, existing measurement instruments, and focus groups of patients. Test-retest reliability was assessed in 30 of 110 patients. In 110 patients, correlations were calculated between the AAQ and the self-reported Hip Disability/Knee Injury and Osteoarthritis Outcome Score activities of daily living subscale (H/KOOS). In 45 of 110 patients, correlations with performance-based tests (stair climbing test, timed up and go test, and 30-second chair stand test) were calculated. RESULTS: In total, 17 basic daily activities were chosen for the AAQ. Video animations were made showing a person performing each activity with 3-5 different levels of difficulty. Patients were asked to select the level that best matched their own performance. Reliability was high (intraclass correlation coefficient 0.97 [95% confidence interval 0.93-0.98]); the AAQ correlated highly with performance-based tests (0.62), but higher with the H/KOOS (0.76) than expected. CONCLUSION: A computerized AAQ for assessing activity limitations was developed. Content validity was considered good. Preliminary validation results showed high reliability, but construct validity needs further study with a larger sample size. Continuing research will focus on construct validity and crosscultural validity.


Assuntos
Atividades Cotidianas , Osteoartrite do Quadril/diagnóstico , Osteoartrite do Joelho/diagnóstico , Medição da Dor/normas , Autorrelato/normas , Interface Usuário-Computador , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteoartrite do Quadril/epidemiologia , Osteoartrite do Joelho/epidemiologia , Medição da Dor/métodos , Estimulação Luminosa/métodos , Projetos Piloto , Reprodutibilidade dos Testes , Inquéritos e Questionários , Gravação em Vídeo/métodos , Gravação em Vídeo/normas
20.
Eur Spine J ; 24(1): 88-93, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24838428

RESUMO

PURPOSE: To establish an evidence-based recommendation for the pragmatic use of the Neck Disability Index-Dutch Version (NDI-DV) in primary care based on an assessment of the reliability, the responsiveness, and the interpretability of the NDI-DV. STUDY DESIGN AND SETTING/METHODS: At baseline, the NDI-DV was completed by 337 patients with neck pain presenting to 97 chiropractic clinics in Belgium and the Netherlands. Three months after inclusion, 265 patients provided data to assess the responsiveness and interpretability. Reliability was assessed in 155 patients (retested after 10 days) by calculating the intra-class correlation coefficient for agreement (ICCagreement) and the measurement error (standard error of measurement, SEM), the latter resulting in the smallest detectable change (SDC). The minimal important change (MIC) was assessed by the anchor-based MIC distribution using self-reported perceived recovery as anchor. We tested interpretability by relating SDC to MIC. RESULTS: The ICCagreement was 0.88. The SEMagreement was 1.95 resulting in a SDC of 5.40. The NDI-DV appeared to be responsive, being able to distinguish improved from stable patients with an area under the curve of 0.85. The MIC was 4.50. CONCLUSION: The NDI-DV has good reliability and responsiveness and may be used in clinical practice in Belgium and the Netherlands. A change score of 5 is important for patients, but has a 7 % chance to be due to measurement error.


Assuntos
Avaliação da Deficiência , Cervicalgia/fisiopatologia , Atenção Primária à Saúde , Inquéritos e Questionários , Adolescente , Adulto , Idoso , Bélgica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Países Baixos , Reprodutibilidade dos Testes , Adulto Jovem
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