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Parental Assessment of Status of Congenital Upper Limb Differences: Analysis of the Pediatric Outcomes Data Collection Instrument.

ABSTRACT: To determine the range of the Pediatric Outcomes Collection Instrument (PODCI) scores for children with a wide variety of congenital upper limb differences and to examine the scoring effect of the patient's surgical history, family history, severity of involvement, and syndromic associations.We reviewed the PODCI scores for 109 patients, aged 2-18 years, treated for nontraumatic upper extremity conditions. Charts were reviewed for sex, age, extent of limb involvement, laterality, family history, surgical history, and syndrome association. All patients were classified based on the Oberg, Manske, Tonkin classification with general categories of malformation, deformation, or dysplasia.Of 109 patients, 80 (73%) had a malformation, 12 (11%) had a deformation, and 17 (16%) had a dysplasia. The cohort as a whole had a happiness PODCI score that was similar to the normal population, yet a lower (worse) PODCI score for upper extremity and global function. Patients with a dysplasia had a higher upper extremity function scores than those with malformations or deformations, but they had similar happiness and global function scores. Complete upper limb involvement and lower extremity involvement statistically lowered the PODCI score within our study cohort, whereas a positive family history and syndromic association increased PODCI scores.This study showed that there was a similar level of perceived happiness between children/adolescents with congenital upper extremity conditions compared with the normal pediatric population based on PODCI scores. In contrast, the perceived upper extremity and global function was significantly decreased in patients with congenital differences compared with normal individuals. This investigation also revealed that the extent of upper extremity involvement, lower extremity involvement, family history, and syndromic association may affect PODCI scores as independent variables and should be taken into consideration in studies of upper extremity congenital anomalies.Prognostic IV.

SUBMITTER: Wall LB

PROVIDER: S-EPMC4769941 | biostudies-literature | 2016 Mar

REPOSITORIES: biostudies-literature

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Parental Assessment of Status of Congenital Upper Limb Differences: Analysis of the Pediatric Outcomes Data Collection Instrument.

Wall Lindley B LB Shen Tony T Roberts Summer S Goldfarb Charles A CA

The Journal of hand surgery 20160116 3

<h4>Purpose</h4>To determine the range of the Pediatric Outcomes Collection Instrument (PODCI) scores for children with a wide variety of congenital upper limb differences and to examine the scoring effect of the patient's surgical history, family history, severity of involvement, and syndromic associations.<h4>Methods</h4>We reviewed the PODCI scores for 109 patients, aged 2-18 years, treated for nontraumatic upper extremity conditions. Charts were reviewed for sex, age, extent of limb involvem ...[more]

PMID: 26787405

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Project description:BACKGROUND: Few validated instruments exist to measure pediatric code team skills. The goal of this study was to develop an instrument for the assessment of resuscitation competency and self-appraisal using multirater and gap analysis methodologies. METHODS: Multirater assessment with gap analysis is a robust methodology that enables the measurement of self-appraisal as well as competency, offering faculty the ability to provide enhanced feedback. The Team Performance during Simulated Crises Instrument (TPDSCI) was grounded in the Accreditation Council for Graduate Medical Education competencies. The instrument contains 5 competencies, each assessed by a series of descriptive rubrics. It was piloted during a series of simulation-based interdisciplinary pediatric crisis resource management education sessions. Course faculty assessed participants, who also did self-assessments. Internal consistency and interrater reliability were analyzed using Cronbach α and intraclass correlation (ICC) statistics. Gap analysis results were examined descriptively. RESULTS: Cronbach α for the instrument was between 0.72 and 0.69. The overall ICC was 0.82. ICC values for the medical knowledge, clinical skills, communication skills, and systems-based practice were between 0.87 and 0.72. The ICC for the professionalism domain was 0.22. Further examination of the professionalism competency revealed a positive skew, 43 simulated sessions (98%) had significant gaps for at least one of the competencies, 38 sessions (86%) had gaps indicating self-overappraisal, and 15 sessions (34%) had gaps indicating self-underappraisal. CONCLUSIONS: The TPDSCI possesses good measures of internal consistency and interrater reliability with respect to medical knowledge, clinical skills, communication skills, systems-based practice, and overall competence in the context of simulated interdisciplinary pediatric medical crises. Professionalism remains difficult to assess. These results provide an encouraging first step toward instrument validation. Gap analysis reveals disparities between faculty and self-assessments that indicate inadequate participant self-reflection. Identifying self-overappraisal can facilitate focused interventions.

Project description:The number of smartphone users globally is rapidly increasing. This study aimed to assess the level of ergonomic risk to smartphone users, and to evaluate the correlation between any self-reported musculoskeletal disorders and the level of ergonomic risk. Thirty participants completed a questionnaire, tailored specifically for smartphone users, to determine any musculoskeletal disorders. Participants were given a seated smartphone texting task and their postures were video recorded during the task. The video scenarios were evaluated by three independent researchers to determine the level of ergonomic risk using the Rapid Upper Limb Assessment (RULA) tool. RULA is an observation-based screening tool which has been widely used to assess the postural risk of IT device users. However, it has not yet been specifically utilized with smartphone users. The RULA tool scores identified ergonomics risks from using smartphones to text. Most smartphone users had a total RULA Grand Score of 6 for both sides (left side: 80.00%, right side: 90.00%), indicating the need for further investigation and changes (Action Level 3). Notably, no participants had acceptable RULA Grand Scores of 1 or 2. The correlation between musculoskeletal disorders and the ergonomic risk among smartphone users was determined using the Chi-Square test and Fisher's exact test; p<0.05 was considered statistically significant. There was a significant correlation between right RULA Grand Score and neck musculoskeletal disorder (?2 = 9.424 at p value = 0.009) and right RULA Grand Score and upper back musculoskeletal disorder (?2 = 31.717 at p value <0.001). RULA Score B (combination of neck, trunk and leg postures) and RULA Score D (combination of Score B, muscle use and force scores for group B) were also significantly correlated with neck musculoskeletal disorders (?2 = 19.286 at p value<0.001 and ?2 = 9.310 at p value = 0.002 respectively). The RULA results identified the high ergonomics risk of smartphone users, this resulted from two key risk factors: posture and muscle use. The neck, trunk and leg postures had a combined effect on neck musculoskeletal disorders. Future investigations should consider these factors when designing ergonomic interventions for smartphone users.

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Parental Assessment of Status of Congenital Upper Limb Differences: Analysis of the Pediatric Outcomes Data Collection Instrument.

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Parental Assessment of Status of Congenital Upper Limb Differences: Analysis of the Pediatric Outcomes Data Collection Instrument.

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