Knee pain during the first three months after unilateral total knee arthroplasty: a multi-centre prospective cohort study.

Many patients have an unfavourable pain outcome post total knee arthroplasty (TKA). This multi-centre prospective cohort study recorded weekly pain scores one week before TKA and 12 weeks post TKA. 96 patients were enrolled into the study. Patients kept a record of their weekly scores pre-operation and post-operation by using the visual acuity score. Pain was divided into "best" pain score (lowest pain score) and "worst" pain score (highest pain score). Patients with a pre-operative pain scores ≤ 4 were identified as an at risk group for poor pain outcome. Female gender, age and anaesthetics type were not identified as risk factors for poor pain outcome. Pain trajectory analysis also identified general patterns of pain response post TKA.

Good test-retest reproducibility for an instrument to capture self-reported melanoma risk factors.

OBJECTIVE: To examine the test-retest reliability and validity of self-reported items capturing phenotypic characteristics and sun exposure measures in the baseline survey instrument used for a prospective study of skin cancer and melanoma. STUDY DESIGN AND SETTING: Repeatability/validity study conducted among 114 participants randomly selected from the cohort to complete the survey instrument a second time and to undergo a physician skin examination. We calculated intraclass correlation coefficients (ICCs) and kappa (κ) statistics as measures of agreement for continuous and categorical measures, respectively. RESULTS: Measures of phenotypic characteristics showed moderate-to-high agreement (e.g., eye color, κ=0.87; 95% confidence interval [CI]: 0.80, 0.94). Measures of sun exposure had slightly lower estimates of agreement. The repeatability of items relating to medical and family history of skin cancer was high (e.g., the number of skin cancers removed surgically, κ(w)=0.79; 95% CI: 0.71, 0.88). Physician counts of nevi correlated well with categorical measures of self-reported nevus density at the age of 21 years but correlated only modestly with absolute nevus counts conducted by participants (ICC, 0.38; 95% CI: 0.19, 0.54). CONCLUSION: Our survey instrument demonstrated fair-to-good test-retest reliability for most self-reported risk factors for melanoma, indicating the suitability of these items for developing risk prediction tools in the future.

Information on the Internet about head injury pertaining to intensive care: less quantity and more quality is needed.

OBJECTIVE: Published data suggest that the quality of information on diseases accessible on the Internet using non-medical search engines is poor. Such data do not exist for illnesses requiring intensive care. This study investigated the accuracy of health information about head injury pertaining to intensive care on the Internet, and correlated website characteristics with the quality of their content. METHODS: A cross-sectional survey was conducted of the first 20 websites retrieved by the seven most frequently used search engines, with the information evaluated by two independent observers. Inter-observer reliability was evaluated using the kappa statistic. Website information on head injury was compared with "gold standard" guidelines from the Brain Trauma Foundation. Website characteristics were assessed, and their correlation with quality of website content was analysed. RESULTS: 58 websites were assessed. Weighted kappa for interobserver agreement on quality scores was 0.72. The median content score was 2 (interquartile range, 0-4) out of a possible maximum of 23. Logistic regression analysis suggested that medical authors, government sponsors, and being in the second 10 websites retrieved by a search engine were associated with higher website quality scores, while financial incentive and advertisement were associated with lower quality scores. CONCLUSION: This study demonstrated that information retrieved by the public on head injury from non-medical websites may be incomplete and inaccurate. It also identified website characteristics associated with poor content quality.