Many unexpected abdominal findings on staging computed tomography in patients with colorectal cancer.

INTRODUCTION: Computed tomography (CT) was proven to be superior to preoperative abdominal ultrasound in the preoperative setting for detection of hepatic metastases from colorectal cancer (CRC). The higher sensitivity of CT has resulted in a number of unexpected abdominal findings of varying importance; an issue that was previously studied in relation to CT colonography, but not in relation to staging CT with intravenous contrast in CRC patients. The aim of the present study was to evaluate the number and significance of such unexpected findings on staging CTs in CRC patients. MATERIAL AND METHODS: The study comprises a retrospective analysis of 247 consecutive patients who underwent colorectal cancer surgery at Roskilde Hospital, Denmark, in 2009. A preoperative abdominal staging CT was performed in 245 of these patients. All CT scans and patient records were reviewed by the authors. The unexpected CT findings were classified as being of high, moderate or low clinical importance according to whether they required treatment relatively promptly, later or did not require treatment at all, respectively. RESULTS: Overall, 114 patients (47%) had unexpected findings. Nineteen of the 137 findings (14%) or 8% in all patients were considered to be of high importance. Three per cent of all patients had abdominal aortic aneurysms, 2% had CRC metastases to the adrenal glands, 2% primary kidney tumours and 1% gynaecologic tumours. Twenty per cent of the patients had findings of moderate importance and 29% findings of low importance. CONCLUSION: Staging CT in CRC patients showed nearly 8% of unexpected abdominal findings of high clinical importance requiring relatively prompt treatment. FUNDING: not relevant. TRIAL REGISTRATION: not relevant.

A systematic review of measurement properties of patient reported outcome measures in psoriatic arthritis: A GRAPPA-OMERACT initiative.

BACKGROUND: An updated psoriatic arthritis (PsA) core outcome set (COS) for randomized controlled trials (RCTs) was endorsed at the Outcome Measures in Rheumatology (OMERACT) meeting in 2016. OBJECTIVES: To synthesize the evidence on measurement properties of patient reported outcome measures (PROMs) for PsA and thereby contribute to development of a PsA core outcome measurement set (COMS) as described by the OMERACT Filter 2.0. METHODS: A systematic literature search was performed in EMBASE, MEDLINE and PsycINFO on Jan 1, 2017 to identify full-text articles with an aim of assessing the measurement properties of PROMs in PsA. Two independent reviewers rated the quality of studies using the COnsensus based standards for the Selection of health Measurement INstruments (COSMIN) checklist, and performed a qualitative evidence synthesis. RESULTS: Fifty-five studies were included in the systematic review. Forty-four instruments and a total of 89 scales were analyzed. PROMs measuring COS domains with at least fair quality evidence for good validity and reliability (and no evidence for poor properties) included the Stockerau Activity Score for PsA (German), Psoriasis Symptom Inventory, visual analogue scale for Patient Global, 36 Item Short Form Health Survey Physical Function subscale, Health Assessment Questionnaire Disability Index, Bath Ankylosing Spondylitis Functional Index, PsA Impact of Disease questionnaire, PsA Quality of Life questionnaire, VITACORA-19, Functional Assessment of Chronic Illness Therapy Fatigue scale and Social Role Participation Questionnaire. CONCLUSIONS: At least one PROM with some evidence for aspects of validity and reliability was available for six of the eight mandatory domains of the PsA COS.