Dataset Information

A comparative analysis of Patient-Reported Expanded Disability Status Scale tools.

ABSTRACT:

Background

Patient-Reported Expanded Disability Status Scale (PREDSS) tools are an attractive alternative to the Expanded Disability Status Scale (EDSS) during long term or geographically challenging studies, or in pressured clinical service environments.

Objectives

Because the studies reporting these tools have used different metrics to compare the PREDSS and EDSS, we undertook an individual patient data level analysis of all available tools.

Methods

Spearman's rho and the Bland-Altman method were used to assess correlation and agreement respectively.

Results

A systematic search for validated PREDSS tools covering the full EDSS range identified eight such tools. Individual patient data were available for five PREDSS tools. Excellent correlation was observed between EDSS and PREDSS with all tools. A higher level of agreement was observed with increasing levels of disability. In all tools, the 95% limits of agreement were greater than the minimum EDSS difference considered to be clinically significant. However, the intra-class coefficient was greater than that reported for EDSS raters of mixed seniority. The visual functional system was identified as the most significant predictor of the PREDSS-EDSS difference.

Conclusion

This analysis will (1) enable researchers and service providers to make an informed choice of PREDSS tool, depending on their individual requirements, and (2) facilitate improvement of current PREDSS tools.

SUBMITTER: Collins CD

PROVIDER: S-EPMC5015760 | biostudies-literature | 2016 Sep

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

A comparative analysis of Patient-Reported Expanded Disability Status Scale tools.

Collins Christian DE CD Ivry Ben B Bowen James D JD Cheng Eric M EM Dobson Ruth R Goodin Douglas S DS Lechner-Scott Jeannette J Kappos Ludwig L Galea Ian I

Multiple sclerosis (Houndmills, Basingstoke, England) 20151112 10

<h4>Background</h4>Patient-Reported Expanded Disability Status Scale (PREDSS) tools are an attractive alternative to the Expanded Disability Status Scale (EDSS) during long term or geographically challenging studies, or in pressured clinical service environments.<h4>Objectives</h4>Because the studies reporting these tools have used different metrics to compare the PREDSS and EDSS, we undertook an individual patient data level analysis of all available tools.<h4>Methods</h4>Spearman's rho and the ...[more]

PMID: 26564998

Similar Datasets

Project description:ImportanceIndividuals with persistent unilateral vestibular deficits experience loss of quality of life and increased risk of falling, and they have few well-supported options for effective treatment.ObjectivesTo evaluate whether vestibular retraining using computerized dynamic posturography is associated with reduced participant-reported disability for patients with an objectively assessed unilateral peripheral vestibular deficit and to assess the feasibility of conducting a randomized clinical trial of vestibular retraining using computerized dynamic posturography.Design, setting, and participantsThis single-group cohort study was conducted from April 29 to July 23, 2021, in a tertiary neurotology clinic among 13 individuals with a stable unilateral vestibular deficit present for more than 6 months, confirmed with videonystagmography and vestibular evoked myogenic potential testing. Statistical analysis was performed from July 7, 2021, to January 25, 2022.InterventionsTwelve twice-weekly sessions of posturography-assisted vestibular retraining with prescribed weight shifting tasks guided by an interactive display.Main outcomes and measuresChange in scores on the Dizziness Handicap Inventory (DHI), the Activities-Specific Balance Confidence (ABC) Scale, and the Falls Efficacy Scale-International (FES-I), which participants completed before and after retraining to measure their perception of their disability. They also completed posturography measurements. Secondary outcomes included tolerability of the intervention and rate of completion of the full protocol.ResultsA total of 13 participants (8 men [62%]; median age, 51 years [range, 18-67 years]) were enrolled. All 13 participants completed the intervention and all follow-up. After treatment, the median changes in scores were -16 points (95% CI, -20 to 2) for the DHI, -9 (95% CI, -14 to 1) for the FES-I, and 11.9 (95% CI, 0-17.3) for the ABC Scale. Eight participants (62%) improved by greater than the minimum clinically important difference (MCID) for the DHI, whereas 4 (31%) exceeded the MCID for the ABC Scale, and 3 (23%) exceeded the MCID for the FES-I. Participants with moderate to severe disability at baseline (n = 7) had a larger magnitude of improvement in DHI scores than those with mild disability (n = 6) (-18 [95% CI, -78 to 2] vs -1 [95% CI, -8 to 16]). Six of the 7 patients (86%) with moderate to severe disability improved by greater than the MCID for DHI, wherease 4 of 7 patients (57%) improved by greater than the MCID for the ABC Scale, and 3 of 7 patients (43%) improved by greater than the MCID for the FES-I.Conclusions and relevanceThis cohort study suggests that computerized, dynamic posturography-assisted retraining was associated with clinically meaningful improvements in participant-reported disability among those with stable unilateral vestibular deficit and moderate to severe disability. Further studies should compare posturography-assisted vestibular retraining with conventional physical therapy rehabilitation techniques.Trial registrationClinicalTrials.gov Identifier: NCT04875013.

Project description:ImportanceA primary objective in managing atrial fibrillation (AF) is to optimize patients' health status, which can be done only if physicians accurately quantify the outcomes associated with AF in patients' lives.ObjectiveTo explore physicians' estimation of the health status of patients with AF and its association with subsequent care and outcomes.Design, setting, and participantsA multicenter, prospective cohort study was conducted in 2 outpatient practices in Tokyo, Japan. Participants included patients with newly diagnosed AF or those referred for initial treatment of AF at outpatient practices and treating physicians from November 8, 2018, to April 1, 2020. Data analysis was performed from December 22, 2022, to July 7, 2023.ExposuresParticipating patients completed the Atrial Fibrillation Effect on Quality-of-Life (AFEQT) questionnaire, a 20-item tool covering 4 domains with a 7-point Likert scale; 3 domains (symptoms, daily activities, and treatment concerns) were used in this study. Blinded to patients' responses, treating physicians answered a 3-item questionnaire quantifying each patient's AFEQT domain with a single item. Patients' mean Likert scale responses within each AFEQT domain were subtracted from the physicians' assessments so that higher scores (≥0.5 points) indicate physician underestimation, while lower scores (≤0.5 points) indicate physician overestimation of the health status of patients with AF.Main outcomes and measuresThe independent association of physician-patient concordance with treatment escalation (alteration or initiation of antiarrhythmic drugs, cardioversion, or catheter ablation) and 1-year adjusted changes in AFEQT scores.ResultsAmong 330 patients (238 [72.1%] men; mean [SD] age, 67.9 [11.9] years; 163 [49.4%] with paroxysmal AF), physicians correctly estimated health status in 112 patients (33.9%), underestimated it in 42 patients (12.7%), and overestimated it in 176 patients (53.3%). Treatment escalation occurred in 63.6% of patients whose health status was correctly estimated, 47.6% of those whose health status was underestimated, and 66.3% of patients whose health status was overestimated. After multivariable adjustment, underestimation of health status was independently associated with less treatment escalation (adjusted odds ratio, 0.43; 95% CI, 0.20-0.90) and less frequent AFEQT overall summary score improvement at 1 year (underestimated, 2.5 [95% CI, -1.6 to 6.7] vs correctly and overestimated health status, 8.4 [95% CI, 7.0-9.9] points; P = .01).Conclusions and relevanceIn this cohort study, physician underestimation of the health status of patients with AF was common and associated with less aggressive treatment and less health status improvement at 1 year.

Project description:BackgroundWhile interprofessional collaboration (IPC) is widely considered a key element of comprehensive patient treatment, evidence focusing on its impact on patient-reported outcomes (PROs) is inconclusive. The aim of this study was to investigate the association between employee-rated IPC and PROs in a clinical inpatient setting.MethodsWe conducted a secondary data analysis of the entire patient and employee reported data collected by the Picker Institute Germany in cross-sectional surveys between 2003 and 2016. Individual patient data from departments within hospitals was matched with employee survey data from within 2 years of treatment at the department-level. Items assessing employee-rated IPC (independent variables) were included in Principal Component Analysis (PCA). All questions assessing PROs (overall satisfaction, less discomforts, complications, treatment success, willingness to recommend) served as main dependent variables in ordered logistic regression analyses. Results were adjusted for multiple hypothesis testing as well as patients' and employees' gender, age, and education.ResultsThe data set resulted in 6154 patients from 19 hospitals respective 103 unique departments. The PCA revealed three principal components (department-specific IPC, interprofessional organization, and overall IPC), explaining 67% of the total variance. The KMO measure of sampling adequacy was .830 and Bartlett's test of sphericity highly significant (p < 0.001). An increase of 1 SD in department-specific IPC was associated with a statistically significant chance of a higher (i.e., better) PRO-rating about complications after discharge (OR 1.07, 95% CI 1.00-1.13, p = 0.029). However, no further associations were found. Exploratory analyses revealed positive coefficients of department-specific IPC on all PROs for patients which were treated in surgical or internal medicine departments, whereas results were ambiguous for pediatric patients.ConclusionsThe association between department-level IPC and patient-level PROs remains - as documented in previous literature - unclear and results are of marginal effect sizes. Future studies should keep in mind the different types of IPC, their specific characteristics and possible effect mechanisms.Trial registrationStudy registration: Open Science Framework (DOI https://doi.org/10.17605/OSF.IO/2NYAX ); Date of registration: 09 November 2021.

Dataset Information

A comparative analysis of Patient-Reported Expanded Disability Status Scale tools.

Background

Objectives

Methods

Results

Conclusion

Publications

A comparative analysis of Patient-Reported Expanded Disability Status Scale tools.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets