Symptom assessment in hypereosinophilic syndrome: Toward development of a patient-reported outcomes tool.
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ABSTRACT:
SUBMITTER: Kovacs N
PROVIDER: S-EPMC7554136 | biostudies-literature | 2020 Oct
REPOSITORIES: biostudies-literature
Publications
Symptom assessment in hypereosinophilic syndrome: Toward development of a patient-reported outcomes tool.
Kovacs Nicholas N Benjamin Katy K Holland-Thomas Nicole N Moshkovich Olga O Nelsen Linda M LM Ortega Hector H Schwartz Ethan J EJ Steinfeld Jonathan J Kirby Suyong Yun SY Klion Amy A Khoury Paneez P
The journal of allergy and clinical immunology. In practice 20200515 9
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Project description:IntroductionPsoriasis Area Severity Index (PASI) assessment is complex and time-consuming. A simpler assessment measure more sensitive to changes in symptom severity and predictive of patients' quality of life (Dermatology Life Quality Index, DLQI) is needed. This study aims to evaluate the Optimal Psoriasis Assessment Tool (OPAT) as an alternative to PASI.MethodsThis integrated analysis of three UNCOVER trials (NCT01474512, NCT01597245, and NCT01646177) randomized patients (N = 3866) with moderate-to-severe psoriasis to subcutaneously administered ixekizumab 80 mg Q2W or Q4W, or placebo or etanercept 50 mg Q2W. Pearson correlations were computed for clinical and patient-reported measures with PASI and DLQI.ResultsAs the correlations with PASI and BSA were high and not much higher when adding severity, body surface area (BSA) was used for the clinical measure. BSA was the main measure influencing OPAT. Week 12 regression analyses results showed that PASI had a higher correlation with BSA combined with patient assessments than with BSA alone. Sensitivity analyses were also completed for PASI 75 and 90. For DLQI, correlations with the combined measures were even stronger than with BSA alone. A comprehensive model selection procedure was conducted, which illustrated that the two-term models are preferred.ConclusionThe OPAT is a simple and time-saving alternative to PASI. It can be derived using BSA and patient-reported assessments having strong correlation with PASI and moderate correlation with DLQI.
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Project description:Background/Objectives: Traumatic craniomaxillofacial (CMF) injuries are associated with various symptoms/concerns that affect patients' quality of life. The assessment of outcomes from the patient perspective has been limited by the absence of patient-reported outcome (PRO) measures tailored to this patient population. To address this need, we employed a mixed methods, multi-step process to first identify the most important symptoms/concerns and then use this information to construct a PRO symptom battery. Methods: CMF clinicians and patients who had sustained traumatic CMF injuries participated in semi-structured interviews to elicit the symptoms/concerns considered the most important. The data were analyzed using an iterative coding procedure and symptom/concern frequency was tabulated. The findings were used to develop a conceptual model of the most important symptoms to include in a PRO battery. Existing items were modified as needed and new items were drafted to ensure adequate coverage of the symptoms. Results: The resulting AO CMF Injury Symptom Battery includes four modules specific to the injury site (oral, ocular, nasopharyngeal, ear) and five universal modules (pain/sensation, cognitive, cosmetic, psychosocial, and injury impact). Conclusions: The AO CMF Injury Symptom Battery offers promise for assessing symptoms only patients can report on in clinical research and practice. Ongoing research will examine the battery's psychometric properties.
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Project description:PurposeComputer-based, patient-reported symptom survey tools have been described for patients undergoing chemotherapy. We hypothesized that patients undergoing radiotherapy might also benefit, so we developed a computer application to acquire symptom ratings from patients and generate summaries for use at point of care office visits and conducted a randomized, controlled pilot trial to test its feasibility.MethodsSubjects were randomized prior to beginning radiotherapy. Both control and intervention group subjects completed the computerized symptom assessment, but only for the intervention group were printed symptom summaries made available before each weekly office visit. Metrics compared included the Global Distress Index (GDI), concordance of patient-reported symptoms and symptoms discussed by the physician and numbers of new and/or adjusted symptom management medications prescribed.ResultsOne hundred twelve patients completed the study: 54 in the control and 58 in the intervention arms. There were no differences in GDI over time between the control and intervention groups. In the intervention group, more patient-reported symptoms were actually discussed in radiotherapy office visits: 46/202 vs. 19/230. A sensitivity analysis to account for within-subjects correlation yielded 23.2 vs. 10.3 % (p = 0.03). Medications were started or adjusted at 15.4 % (43/280) of control visits compared to 20.4 % (65/319) of intervention visits (p = 0.07).ConclusionsThis computer application is easy to use and makes extensive patient-reported outcome data available at the point of care. Although no differences were seen in symptom trajectory, patients who had printed symptom summaries had improved communication during office visits and a trend towards a more active symptom management during radiotherapy.
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