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1

Outcomes Measurement  

Cancer.gov

Evaluating and improving methods for measuring cancer outcomes is critically important for NCI's initiatives to enhance the quality of cancer care, reduce cancer-related health disparities, and better understand the individual and population burden of disease. The Applied Research Program’s initiatives in this area include developing resources for researchers to learn about psychometric and other tools that aid in assessing and developing outcomes measures.

2

Measuring Course Learning Outcomes  

ERIC Educational Resources Information Center

Accreditation criteria of programs require effective learning outcomes, assessment with documented procedures, tools, results, and actions to close the assessment loop with broad faculty involvement. This article describes a methodology for providing quantitative measurement of a course's learning outcomes. The methodology uses a linkage matrix…

Keshavarz, Mohsen

2011-01-01

3

Are Children Improving? Results from Outcome Measurement in a Large Mental Health System  

Microsoft Academic Search

Standardized outcome assessment was implemented in a large county mental health system. This study examines changes in children’s\\u000a emotional and behavioral problems after 6 months of treatment and identifies factors associated with treatment improvement.\\u000a Results from 3,215 youth indicated that externalizing and internalizing problems significantly decreased from intake to 6 months\\u000a and that ethnicity, gender, and age were associated with caregiver-reported changes

Emily V. TraskAnn; Ann F. Garland

4

Measuring and recording outcome.  

PubMed

Achieving good health outcomes for patients is the fundamental purpose of healthcare. What really matters to patients is the outcome of an intervention and the effect it will have on their wellbeing and life expectancy. After media coverage, and public enquiry into high mortality rates for paediatric cardiac surgery at the Bristol Royal Infirmary during the early 1990s, mortality rates for paediatric cardiac surgical procedures decreased dramatically both in Bristol and nationally. There can be little doubt that one of the prime 'drivers for change' was the placement of outcome data into the public domain. After events in Bristol, the Society for Cardiothoracic Surgery in Britain and Ireland (SCTS) has taken the lead in measuring and publishing clinical outcome data. It has also discussed how outcome data could be used to assess an individual's clinical performance and how, in the future, this might be linked to continuing professional development, appraisal, and revalidation. Measuring quality and outcome in healthcare is complex. Ideal outcome measures should be specific, sensitive, reliable, responsive, validated, timely, and easy to measure. Monitoring of outcomes can be 'process' orientated or 'clinically' orientated. The 2010 National Health Service (NHS) White Paper aimed for an NHS which 'moves away from centrally driven process targets and focuses on delivering outcomes which matter to people'. Measuring outcome in anaesthesia is problematic. There are issues around clinical coding, risk adjustment, the influence of clinical teamworking, and environmental factors. The National Institute of Academic Anaesthesia (NIAA) has identified that the description of clinical practice in anaesthesia and perioperative medicine is currently limited by a lack of valid, reliable quality measures. The NIAA suggests that there is a requirement for further research into identifying the anaesthetic outcome indicators which are most relevant to patients, and then benchmarking the performance of anaesthetic departments and anaesthetists. PMID:22654098

Murphy, P J

2012-07-01

5

Reliability of instrumented movement analysis as outcome measure in Charcot-Marie-Tooth disease: results from a multitask locomotor protocol.  

PubMed

Some neurodegenerative diseases at early stage may not drastically affect basic gait ability, whereas more demanding locomotor tasks are more prone to disease-induced abnormalities. In this study, we evaluated the interday test-retest reliability, 4-6 weeks apart, of instrumented movement analysis on a group of 20 subjects with Charcot-Marie-Tooth (CMT) disease considering a set of kinematic and kinetic curves and related parameters obtained during natural walking (NW) and faster walking, heel and toe-walking, step ascending and descending. Results showed that the reliability was good for NW, with the exception of trunk curves, pelvic tilt and EMG profiles (moderate reliability), and trunk ROM in sagittal/transverse plane (poor reliability). Comparing our results with literature, CMT patients did not present a greater variability during NW than healthy subjects or patients with diseases of CNS. Additional locomotor tasks showed a slight reduction of reliability, although the moderate-to-good level shown in NW was almost never reduced to poor. Most of SEM values (absolute measurement errors) were smaller than 5°, a clinically acceptable threshold. In particular THS, an ankle joint related parameter computed across heel and toe-walking tasks, showed an optimal reliability (ICC=0.95, SEM=2.7°) and correlation with CMT clinical scores. Toe and heel-walking and step ascending tasks maximised the number of parameters with a moderate-to-good correlation with patients' clinical status. We concluded that, in addition to natural walking, more challenging locomotor tasks are good candidates to provide reliable and sensitive outcome measures for CMT patients. PMID:21511477

Ferrarin, M; Bovi, G; Rabuffetti, M; Mazzoleni, P; Montesano, A; Moroni, I; Pagliano, E; Marchi, A; Marchesi, C; Beghi, E; Pareyson, D

2011-05-01

6

Reliability of instrumented movement analysis as outcome measure in Charcot–Marie–Tooth disease: Results from a multitask locomotor protocol  

PubMed Central

Some neurodegenerative diseases at early stage may not drastically affect basic gait ability, whereas more demanding locomotor tasks are more prone to disease-induced abnormalities. In this study, we evaluated the interday test–retest reliability, 4–6 weeks apart, of instrumented movement analysis on a group of 20 subjects with Charcot–Marie–Tooth (CMT) disease considering a set of kinematic and kinetic curves and related parameters obtained during natural walking (NW) and faster walking, heel and toe-walking, step ascending and descending. Results showed that the reliability was good for NW, with the exception of trunk curves, pelvic tilt and EMG profiles (moderate reliability), and trunk ROM in sagittal/transverse plane (poor reliability). Comparing our results with literature, CMT patients did not present a greater variability during NW than healthy subjects or patients with diseases of CNS. Additional locomotor tasks showed a slight reduction of reliability, although the moderate-to-good level shown in NW was almost never reduced to poor. Most of SEM values (absolute measurement errors) were smaller than 5°, a clinically acceptable threshold. In particular THS, an ankle joint related parameter computed across heel and toe-walking tasks, showed an optimal reliability (ICC = 0.95, SEM = 2.7°) and correlation with CMT clinical scores. Toe and heel-walking and step ascending tasks maximised the number of parameters with a moderate-to-good correlation with patients’ clinical status. We concluded that, in addition to natural walking, more challenging locomotor tasks are good candidates to provide reliable and sensitive outcome measures for CMT patients. PMID:21511477

Ferrarin, M.; Bovi, G.; Rabuffetti, M.; Mazzoleni, P.; Montesano, A.; Moroni, I.; Pagliano, E.; Marchi, A.; Marchesi, C.; Beghi, E.; Pareyson, D.

2011-01-01

7

Measuring Economic Outcomes of Cancer  

Microsoft Academic Search

Investigation of cancer prevention, screening, and treatment has generally centered on outcome measures related to tradition- ally conceived burden of illness—measures that reflect changes in patient symptoms, functionality, and longevity or mortality. Although the economic outcomes have not regularly been col- lected as a primary endpoint in cancer research, there appears to be an increasing incidence of trials and observational

Dennis G. Fryback; Benjamin M. Craig

2004-01-01

8

Finding the Data: A Start-Up List of Outcome Measures with Annotations. A Companion Document to "The Case for Shifting to Results-Based Accountability."  

ERIC Educational Resources Information Center

Shifting to results-based accountability is a difficult stage in reforming family and children's services. Heretofore, these services have been more concerned with the number of clients seen or papers processed than in their clients' quality of life. This document should help communities find the data they need to measure qualitative outcomes. It…

Brown, Brett; Weitz, Judith

9

Primary Versus Specialty Care Outcomes for Depressed Outpatients Managed with Measurement-Based Care: Results from STAR*D  

Microsoft Academic Search

Background  Whether the acute outcomes of major depressive disorder (MDD) treated in primary (PC) or specialty care (SC) settings are\\u000a different is unknown.\\u000a \\u000a \\u000a \\u000a Objective  To compare the treatment and outcomes for depressed outpatients treated in primary versus specialty settings with citalopram\\u000a in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study (www.star-d.org), a broadly inclusive effectiveness\\u000a trial.\\u000a \\u000a \\u000a \\u000a Design  Open clinical trial with citalopram

Bradley N. Gaynes; A. John Rush; Madhukar H. Trivedi; Stephen R. Wisniewski; G. K. Balasubramani; Patrick J. McGrath; Michael E. Thase; Michael Klinkman; Andrew A. Nierenberg; William R. Yates; Maurizio Fava

2008-01-01

10

Drug Program Evaluation: Outcome Measures.  

ERIC Educational Resources Information Center

Outlines a method of outcome evaluation which allows for a client to be tracked throughout a treatment episode, so that a client's behavioral status can be assessed while remaining in treatment. (Author)

Murphy, John W.

1979-01-01

11

Demographic Correlates of Fatigue in the US General Population: Results from the Patient-Reported Outcomes Measurement Information System (PROMIS) Initiative  

PubMed Central

Objective To investigate demographic correlates of fatigue in the US general population using a new instrument developed by the Patient-Reported Outcome Measurement Information System (PROMIS). First, we examined correlations between the new PROMIS instrument and the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) and the SF-36v2 Vitality subscale. Based on prior findings, we further examined several demographic correlates of fatigue: whether women would report higher levels of fatigue compared to men, and whether married people would experience lower levels of fatigue compared to unmarried people. We also explored the relationship between age, education, and fatigue. Methods Analyses were based on fatigue ratings by 666 individuals from the general population. Fatigue was assessed with the new PROMIS instrument, the FACIT-F, and the SF-36v2 Vitality subscale. Differences in fatigue were examined with independent samples t-tests and univariate ANOVAs. Results The three fatigue instruments were highly intercorrelated. Confirming prior reports, women reported higher levels of fatigue than men. Married participants reported significantly less fatigue than their unmarried counterparts. Univariate ANOVAs yielded a main effect for participants’ age; younger participants gave significantly higher fatigue ratings. We also found a main effect for participants’ education. Participants with a masters or doctoral degree had significantly lower ratings of fatigue than participants with some college education and education up to high school. Conclusion Female gender, not being married, younger age and lower educational attainment were each associated with increased fatigue in the general population and the three fatigue instruments performed equally well in detecting the observed associations. PMID:21843744

Junghaenel, Doerte U.; Christodoulou, Christopher; Lai, Jin-Shei; Stone, Arthur A.

2013-01-01

12

Use of health-related quality of life measures to predict health utility in postmenopausal osteoporotic women: results from the Multiple Outcomes of Raloxifene Evaluation study  

PubMed Central

Background The aim of this study is to examine the associations between health utility (HU), health-related quality of life (HRQoL), and patient characteristics in postmenopausal osteoporotic (PMO) women. Methods Baseline data from a subsample of 1,245 participants of the Multiple Outcomes of Raloxifene Evaluation study, a randomized, placebo-controlled, multinational clinical trial to evaluate the safety and efficacy of raloxifene, were analyzed. The study cohort included 694 participants from non-European Union (non-EU) countries and 551 participants from EU countries. All participants with complete baseline HU and HRQoL assessments were included in the following analyses: 1) HU (HUI or EQ-5D) and HRQoL (QualEFFO or OPAQ and NHP) associations; 2) HU variability explained by HRQoL domains; and 3) the percentage of HU variability explained by statistically significant (p?Results Several domains were significantly associated with HU scores. HU variance was well explained (41% to 61%) by 4 to 6 (p?measures were significant predictors of HU. HRQoL and HU scores decreased with increased vertebral and non-vertebral fractures. PMID:24192207

2013-01-01

13

Outcome measures: problems and opportunities for public health nursing.  

PubMed

Increasingly, outcome measures are being used to evaluate the effectiveness of health care. There are particular difficulties in establishing outcome measures for public health nursing, especially those that would demonstrate health gain. These problems arise as a result of the role of public health nursing and the nature of outcome measures. Possible solutions are the use of caseload and community profiles or the aggregation of client-negotiated health objectives. These solutions would also provide small area health information and outcome measures which would be sensitive to health needs in local communities. PMID:7620659

Kelsey, A

1995-07-01

14

Testing Multiple Outcomes in Repeated Measures Designs  

ERIC Educational Resources Information Center

This study investigates procedures for controlling the familywise error rate (FWR) when testing hypotheses about multiple, correlated outcome variables in repeated measures (RM) designs. A content analysis of RM research articles published in 4 psychology journals revealed that 3 quarters of studies tested hypotheses about 2 or more outcome

Lix, Lisa M.; Sajobi, Tolulope

2010-01-01

15

Competency and Measured Performance Outcomes.  

ERIC Educational Resources Information Center

Evaluates the relative merits of approaches to measuring corporate and competitive performance: financial, stakeholder, admiration, reputation, and corporate logic models. Promotes a holistic framework for selecting appropriate measures that considers strategic success in terms of values, environment, and resources. (SK)

Thompson, John L.

1998-01-01

16

Measures of social outcomes in disability research  

Microsoft Academic Search

ABSTRACT. Dijkers MPJM, Whiteneck G, El-Jaroudi R. Measures of social outcomes in disability research. Arch Phys Med Rehabil 2000;81 Suppl 2:S63-S80. Objectives: To describe instruments that have been developed to quantify (aspects of) social outcomes in research on persons with a disability, and to evaluate the clinimetric characteristics of some of the more prominent and promising measures. Data Sources: Literature

Marcel P. J. M. Dijkers; Gale Whiteneck; Rana El-Jaroudi

2000-01-01

17

Outcome measures in chronic low back pain.  

PubMed

The purpose of this prospective, single site cohort quasi-experimental study was to determine the responsiveness of the numerical rating scale (NRS), Roland-Morris disability questionnaire (RMDQ), Oswestry disability index (ODI), pain self-efficacy questionnaire (PSEQ) and the patient-specific functional scale (PSFS) in order to determine which would best measure clinically meaningful change in a chronic low back pain (LBP) population. Several patient-based outcome instruments are currently used to measure treatment effect in the chronic LBP population. However, there is a lack of consensus on what constitutes a "successful" outcome, how an important improvement/deterioration has been defined and which outcome measure(s) best captures the effectiveness of therapeutic interventions for the chronic LBP population. Sixty-three consecutive patients with chronic LBP referred to a back exercise and education class participated in this study; 48 of the 63 patients had complete data. Five questionnaires were administered initially and after the 5-week back class intervention. Also at 5 weeks, patients completed a global impression of change as a reflection of meaningful change in patient status. Score changes in the five different questionnaires were subjected to both distribution- and anchor-based methods: standard error of measurement (SEM) and receiver operating characteristic (ROC) curves to define clinical improvement. From these methods, the minimal clinically important difference (MCID) defined as the smallest difference that patients and clinicians perceive to be worthwhile is presented for each instrument. Based on the SEM, a point score change of 2.4 in the NRS, 5 in the RMDQ, 17 in the ODI, 11 on the PSEQ, and 1.4 on the PSFS corresponded to the MCID. Based on ROC curve analysis, a point score change of 4 points for both the NRS and RMDQ, 8 points for the ODI, 9 points for the PSEQ and 2 points for the PSFS corresponded to the MCID. The ROC analysis demonstrated that both the PSEQ and PSFS are responsive to clinically important change over time. The NRS was found to be least responsive. The exact value of the MCID is not a fixed value and is dependent on the assessment method used to calculate the score change. Based on ROC curve analysis the PSFS and PSEQ were more responsive than the other scales in measuring change in patients with chronic LBP following participation in a back class programme. However, due to the small sample size, the lack of observed worsening of symptoms over time, the single centre and intervention studied these results which need to be interpreted with caution. PMID:20397032

Maughan, Elaine F; Lewis, Jeremy S

2010-09-01

18

Outcome measures in osteoarthritis: randomized controlled trials.  

PubMed

Accepted outcome measures in randomized controlled trials (RCTs) in osteoarthritis (OA) include patient-reported assessments of physical function and health-related quality of life (HRQOL). Available data can inform treatment decisions when statistically significant changes are viewed in terms of clinically important improvements. Patient-reported outcomes validated in OA include global assessments of pain, disease activity, and disease-specific and generic measures of physical function and HRQOL. Definitions of minimum clinically important differences (MCID) have been derived from RCTs with physical therapy, nonsteroidal anti-inflammatory drugs (NSAIDs), and cyclooxygenase-2 selective agents. Definitions of MCID should serve only as guidelines based on mean changes in a treatment group, and do not necessarily reflect clinically meaningful improvements for an individual patient. They help to interpret data across treatments and patient populations. Definitions of MCID may differ for the type of intervention assessed; additional methodologic issues must be addressed when evaluating nonpharmacologic treatments. Based on RCTs in OA evaluating physical therapy, cyclooxygenase-2 agents, and NSAIDs, the Western Ontario and McMaster Osteoarthritis Index is valid, reliable, sensitive to change, and correlates closely with the generic Medical Outcomes Survey Short-Form 36 measure of HRQOL. When evaluating RCT data, understanding derivation and MCID values of outcome measures facilitates informed therapeutic decisions regarding therapeutic interventions. PMID:14713399

Strand, Vibeke; Kelman, Ariella

2004-02-01

19

Outcome Measurement in Palliative Care The Essentials  

E-print Network

Outcome Measurement in Palliative Care The Essentials Bausewein C, Daveson B, Benalia H, Simon ST Van den Eynden, Paul Vanden Berghe,Trudie van Iersel. PRISMA also thanks Barbara Antunes, Steve Rumble, andVicky Robinson for their comments on an earlier version of this guidance. The development

Kühn, Reimer

20

Applying Outcome Measurements: A Guide to Educational Outcome Measurements and Their Uses. Seminar No. 5.  

ERIC Educational Resources Information Center

This guide is essentially designed as a teaching aid for those who would inform planners, officials of educational ministries, school administrators, principals, and teachers about educational outcome measurements. In outline and graphic form, the guide presents topics for discussion in a seminar dealing with the application of outcome

Glaser, Ezra

21

The Utility of Outcome Measures in Total Knee Replacement Surgery  

PubMed Central

Total knee replacement (TKR) is the mainstay of treatment for people with end-stage knee OA among suitably “fit” candidates. As a high cost, high volume procedure with a worldwide demand that continues to grow it has become increasingly popular to measure response to surgery. While the majority who undergo TKR report improvements in pain and function following surgery, a significant proportion of patients report dissatisfaction with surgery as a result of ongoing pain or poor function. Poor outcomes of TKR require care that imposes on already overburdened health systems. Accurate and meaningful capture and interpretation of outcome data are imperative for appropriate patient selection, informing those at risk, and for developing strategies to mitigate the risk of poor results and dissatisfaction. The ways in which TKR outcomes are captured and analysed, the level of follow-up, the types of outcome measures used, and the timing of their application vary considerably within the literature. With this in mind, we reviewed four of the most commonly used joint specific outcome measures in TKR. We report on the utility, strengths, and limitations of the Oxford knee score (OKS), knee injury and osteoarthritis outcome score (KOOS), Western Ontario and McMaster Universities osteoarthritis index (WOMAC), and knee society clinical rating system (KSS). PMID:24288541

Dowsey, Michelle M.; Choong, Peter F. M.

2013-01-01

22

Outcome measures for early phase clinical trials.  

PubMed

As the number of potential neuroprotective agents for ALS increases, the need for early phase trials that screen drugs before proceeding to efficacy trials also grows. However, it is not known which outcome measures perform best and also provide the most meaningful information in brief small trials. We assessed the performance of different outcome measures for use in early phase clinical trials in ALS, and determined what degree of change in the ALSFRS-R that patients could perceive. Thirty patients underwent six monthly ALS Functional Rating Scale (ALSFRS-R), forced vital capacity, manual muscle testing (MMT) and quality of life assessments. Patients rated their perceived level of change with algorithm scales. Linear mixed effects models assessed the associations among variables and Cox proportional-hazards models examined the ability to predict survival. The quantity of missing data was assessed using descriptive statistics. Correlations were found between all variables. The ALSFRS-R provided the most complete data (99.5%), showed a large within-subject correlation (0.91), and best predicted survival (p = 0.002). One-unit change in patient-perceived clinical function paralleled a 9-point decrease in the ALSFRS-R (p = 0.025; 95% CI 8, 10). This trial assessed just 30 patients over six months, but the standard outcome measures each performed dependably; all could be used in short-duration, early phase trials. The ALSFRS-R most strongly predicted survival and provided the most complete data, but large changes may be necessary before patients perceive treatment effects. PMID:17852017

Gordon, Paul H; Cheng, Bin; Montes, Jacqueline; Doorish, Carolyn; Albert, Steven M; Mitsumoto, Hiroshi

2007-10-01

23

Network meta-analysis of multiple outcome measures accounting for borrowing of information across outcomes  

PubMed Central

Background Network meta-analysis (NMA) enables simultaneous comparison of multiple treatments while preserving randomisation. When summarising evidence to inform an economic evaluation, it is important that the analysis accurately reflects the dependency structure within the data, as correlations between outcomes may have implication for estimating the net benefit associated with treatment. A multivariate NMA offers a framework for evaluating multiple treatments across multiple outcome measures while accounting for the correlation structure between outcomes. Methods The standard NMA model is extended to multiple outcome settings in two stages. In the first stage, information is borrowed across outcomes as well across studies through modelling the within-study and between-study correlation structure. In the second stage, we make use of the additional assumption that intervention effects are exchangeable between outcomes to predict effect estimates for all outcomes, including effect estimates on outcomes where evidence is either sparse or the treatment had not been considered by any one of the studies included in the analysis. We apply the methods to binary outcome data from a systematic review evaluating the effectiveness of nine home safety interventions on uptake of three poisoning prevention practices (safe storage of medicines, safe storage of other household products, and possession of poison centre control telephone number) in households with children. Analyses are conducted in WinBUGS using Markov Chain Monte Carlo (MCMC) simulations. Results Univariate and the first stage multivariate models produced broadly similar point estimates of intervention effects but the uncertainty around the multivariate estimates varied depending on the prior distribution specified for the between-study covariance structure. The second stage multivariate analyses produced more precise effect estimates while enabling intervention effects to be predicted for all outcomes, including intervention effects on outcomes not directly considered by the studies included in the analysis. Conclusions Accounting for the dependency between outcomes in a multivariate meta-analysis may or may not improve the precision of effect estimates from a network meta-analysis compared to analysing each outcome separately. PMID:25047164

2014-01-01

24

Comparative responsiveness of outcome measures for total knee arthroplasty  

PubMed Central

Summary Objective The aim of this study was to compare the responsiveness of various patient-reported outcome measures (PROMs) and clinician-reported outcomes following total knee arthroplasty (TKA) over a 2-year period. Methods Data were collected in a prospective cohort study of primary TKA. Patients who had completed Forgotten Joint Score-12 (FJS-12), Western Ontario and McMaster Universities (WOMAC) osteoarthritis (OA) index, EQ-5D, Knee Society Score and range of movement (ROM) assessment were included. Five time points were assessed: pre-operative, 2 months, 6 months, 1 year and 2 years post-operative. Results Data from 98 TKAs were available for analysis. Largest effect sizes (ES) for change from pre-operative to 2-month follow-up were observed for the Knee Society Score (KSS) Knee score (1.70) and WOMAC Total (?1.50). For the period from 6 months to 1 year the largest ES for change were shown by the FJS-12 (0.99) and the KSS Function Score (0.88). The EQ-5D showed the strongest ceiling effect at 1-year follow-up with 84.4% of patients scoring the maximum score. ES for the time from 1- to 2-year follow-up were largest for the FJS-12 (0.50). All other outcome measures showed ES equal or below 0.30. Conclusion Outcome measures differ considerably in responsiveness, especially beyond one year post-operatively. Joint-specific outcome measures are more responsive than clinician-reported or generic health outcome tools. The FJS-12 was the most responsive of the tools assessed; suggesting that joint awareness may be a more discerning measure of patient outcome than traditional PROMs. PMID:24262431

Giesinger, K.; Hamilton, D.F.; Jost, B.; Holzner, B.; Giesinger, J.M.

2014-01-01

25

The Higher Education Outcome Measures Identification Study. A Descriptive Summary.  

ERIC Educational Resources Information Center

This document is intended to inform NCHEMS constituents and other interested persons about the results of the Higher Education Outcome Measures Identification Study (OMIS) conducted by the National Center for Higher Education Management Systems at WICHE in spring 1974. The purpose of the study was to help practitioners and researchers gain a…

Micek, Sidney S.; Arney, William Ray

26

Outcome Measures for Clinical Trials in Fragile X Syndrome  

PubMed Central

Objective Progress in basic neuroscience has led to identification of molecular targets for treatment in fragile X syndrome (FXS) and other neurodevelopmental disorders, however, there is a gap in translation to targeted therapies in humans. One major obstacle to the demonstration of efficacy in human trials has been the lack of generally accepted endpoints to assess improvement in function in individuals with FXS. To address this problem, the NIH convened a meeting of leading scientists and clinicians with the goal of identifying and standardizing outcome measures for use as potential endpoints in clinical trials in FXS. Methods Participants in the meeting included FXS experts, experts in the design and implementation of clinical trials and measure development, and representatives from advocacy groups, industry, and federal agencies. Results The group generated recommendations for optimal outcome measures in cognitive, behavioral, and biomarker/medical domains, including additional testing and validation of existing measures, and development of new measures in areas of need. Although no one endpoint or set of endpoints could be identified that met all criteria as an optimal measure, recommendations are presented in this report. Conclusion The report is expected to guide the selection of measures in clinical trials and lead to the use of a more consistent battery of measures across trials. Further, this will help to direct research toward gaps in the development of validated FXS-specific outcome measures, and to assist with interpretation of clinical trial data by creating templates for measurement of treatment efficacy. PMID:24042082

Berry-Kravis, Elizabeth; Hessl, David; Abbeduto, Leonard; Reiss, Allan L.; Beckel-Mitchener, Andrea; Urv, Tiina K.

2013-01-01

27

PERCEPTION AND REALITY IN DEVELOPING AN OUTCOME PERFORMANCE MEASUREMENT SYSTEM  

Microsoft Academic Search

This study examines public officials' preferences for different performance measures. Understanding these preferences is important for public officials to reach consensus on performance measurement. It finds that public officials overwhelmingly favor outcome measures, although output measures are more likely to be used in government. Public officials favor the capacities of outcome measures in addressing organizational goals and achievements. Measurement validity

XiaoHu Wang

2002-01-01

28

General Outcome Measures for Verbal Operants  

PubMed Central

A general outcome measure (GOM) can be used to show progress towards a long-term goal. GOMs should sample domains of behavior across ages, be sensitive to change over time, be inexpensive and easy to use, and facilitate decision making. Skinner's (1957) analysis of verbal behavior may benefit from the development of GOM. To develop GOM, we conducted a review of the literature on mands, tacts, echoics, and intraverbals. The four areas reviewed included (a) an examination of the participant's response form (i.e., vocal or nonvocal), (b) the type of prompt used, (c) types of materials used, and (d) timing of responses or sessions. Based on the review of the literature, we developed GOM for mands and tacts. This paper attempts to bridge the concept of GOMs with Skinner's analysis of verbal behavior. PMID:22477427

Kubina, Richard M; Wolfe, Pamela; Kostewicz, Douglas E

2009-01-01

29

Update on morphea: part II. Outcome measures and treatment.  

PubMed

Morphea is a rare fibrosing disorder of the skin and underlying tissues. The underlying pathogenesis of morphea is not completely understood at this time, but ultimately results in an imbalance of collagen production and destruction. Evidence-based treatment options of morphea are limited secondary to the rarity of the disease, and the lack of universally used validated outcome measures. The most commonly used outcome measures are skin scores, computerized surface area measurement, durometer, cutometer, thermography, and ultrasound measurements. The Localized Scleroderma Cutaneous Assessment Tool is a promising recently validated skin scoring tool that allows differentiation between activity and damage, is sensitive to change, and requires no additional equipment. The most robust data in the treatment of morphea exists for methotrexate in combination with systemic steroids and ultraviolet A1. PMID:21238824

Fett, Nicole; Werth, Victoria P

2011-02-01

30

Breast Cancer EDGE Task Force Outcomes: Clinical Measures of Pain  

PubMed Central

Background Pain is one of the most commonly reported impairments after breast cancer treatment affecting anywhere from 16-73% of breast cancer survivors Despite the high reported incidence of pain from cancer and its treatments, the ability to evaluate cancer pain continues to be difficult due to the complexity of the disease and the subjective experience of pain. The Oncology Section Breast Cancer EDGE Task Force was created to evaluate the evidence behind clinical outcome measures of pain in women diagnosed with breast cancer. Methods The authors systematically reviewed the literature for pain outcome measures published in the research involving women diagnosed with breast cancer. The goal was to examine the reported psychometric properties that are reported in the literature in order to determine clinical utility. Results Visual Analog Scale, Numeric Rating Scale, Pressure Pain Threshold, McGill Pain Questionnaire, McGill Pain Questionnaire – Short Form, Brief Pain Inventory and Brief Pain Inventory – Short Form were highly recommended by the Task Force. The Task Force was unable to recommend two measures for use in the breast cancer population at the present time. Conclusions A variety of outcome measures were used to measure pain in women diagnosed with breast cancer. When assessing pain in women with breast cancer, researchers and clinicians need to determine whether a unidimensional or multidimensional tool is most appropriate as well as whether the tool has strong psychometric properties.

Harrington, Shana; Gilchrist, Laura; Sander, Antoinette

2014-01-01

31

The Day-to-Day Acute Effect of Wake Therapy in Patients with Major Depression Using the HAM-D6 as Primary Outcome Measure: Results from a Randomised Controlled Trial  

PubMed Central

Background This paper reports day-to-day data for from a one-week intervention phase, part of a 9-weeks randomised parallel study with patient having major depression (data from weekly visits have been reported). Wake therapy (sleep deprivation) has an established antidepressant effect with onset of action within hours. Deterioration on the following night’s sleep is, however, common, and we used daily light therapy and sleep time stabilisation as a preventive measure. In particular, we evaluated the day-to-day acute effect of and tolerance to sleep deprivation and examined predictors of response. Methods Patients were assessed at psychiatric inpatient wards. In the wake group (n?=?36), patients did three wake therapies in combination with light therapy each morning together with sleep time stabilisation. In the exercise group (n?=?38), patients did daily exercise. Hamilton subscale scores were primary outcome (not blinded), secondary outcome was self-assessment data from the Preskorn scale and sleep. Results Patients in the wake therapy group had an immediate, large, stable, and statistically significant better antidepressant effect than patients in the exercise group with response rates at day5 of 75.0%/25.1% and remission rates of 58.6%/6.0%, respectively. The response and remission rates were diminished at day8 with response rates of 41.9%/10.1% and remission rates of 19.4%/4.7%, respectively. Patients and ward personnel found the method applicable with few side effects. Positive diurnal variation (mood better in the evening) predicted a larger response to wake therapy. In the wake group napping on days after intervention predicted greater deterioration on day8. Conclusions The intervention induced an acute antidepressant response without relapse between wake nights but with a diminishing effect after intervention. Development is still needed to secure maintenance of response. Avoiding napping in the days after wake therapy is important. Trial Registration Clinical trials.gov NCT00149110 PMID:23840645

Martiny, Klaus; Refsgaard, Else; Lund, Vibeke; Lunde, Marianne; S?rensen, Lene; Thougaard, Britta; Lindberg, Lone; Bech, Per

2013-01-01

32

A Review of Outcome Measures in Early Childhood Programs  

ERIC Educational Resources Information Center

The authors undertook a review of measures available for assessing outcomes of early childhood services for children with disabilities and their families. With principles of family-centered practice mandating the inclusion of both family and child outcome measures in effective evaluation plans, the review examined measures with established…

Mannan, Hasheem; Summers, Jean Ann; Turnbull, Ann P.; Poston, Denise J.

2006-01-01

33

Generating Outcome Measurements: Economic and Societal. A Guide to Educational Outcomes Measurements and Their Uses. Seminar No. 4.  

ERIC Educational Resources Information Center

This guide is essentially designed as a teaching aid for those who would inform planners, officials of educational ministires, school administrators, principals, and teachers about educational outcome measurements. In outline and graphic form, the guide presents topics for discussion in a seminar dealing with generating outcome measurements:…

Mushkin, Selma J.; Billings, Bradley B.

34

Core Outcome Measures in Effectiveness Trials (COMET) initiative: protocol for an international Delphi study to achieve consensus on how to select outcome measurement instruments for outcomes included in a 'core outcome set'  

PubMed Central

Background The Core Outcome Measures in Effectiveness Trials (COMET) initiative aims to facilitate the development and application of ‘core outcome sets’ (COS). A COS is an agreed minimum set of outcomes that should be measured and reported in all clinical trials of a specific disease or trial population. The overall aim of the Core Outcome Measurement Instrument Selection (COMIS) project is to develop a guideline on how to select outcome measurement instruments for outcomes included in a COS. As part of this project, we describe our current efforts to achieve a consensus on the methods for selecting outcome measurement instruments for outcomes to be included in a COS. Methods/Design A Delphi study is being performed by a panel of international experts representing diverse stakeholders with the intention that this will result in a guideline for outcome measurement instrument selection. Informed by a literature review, a Delphi questionnaire was developed to identify potentially relevant tasks on instrument selection. The Delphi study takes place in a series of rounds. In the first round, panelists were asked to rate the importance of different tasks in the selection of outcome measurement instruments. They were encouraged to justify their choices and to add other relevant tasks. Consensus was reached if at least 70% of the panelists considered a task ‘highly recommended’ or ‘desirable’ and if no opposing arguments were provided. These tasks will be included in the guideline. Tasks that at least 50% of the panelists considered ‘not relevant’ will be excluded from the guideline. Tasks that were indeterminate will be taken to the second round. All responses of the first round are currently being aggregated and will be fed back to panelists in the second round. A third round will only be performed if the results of the second round require it. Discussion Since the Delphi method allows a large group of international experts to participate, we consider it to be the preferred consensus-based method for our study. Based upon this consultation process, a guideline will be developed on instrument selection for outcomes to be included in a COS. PMID:24962012

2014-01-01

35

A review of outcome measures used in cleft care.  

PubMed

This article provides a summary of the main outcome measures currently available and in use within modern cleft care. The fact that there are such a diverse range, including surgical, orthodontic, dental, speech and patient satisfaction measures, is a reflection of the complex, multidisciplinary and longitudinal nature of the care provided. The use of such measures of outcome is essential in the auditing and drive for continued improvements in the standards of care for patients affected with cleft lip and palate. PMID:24521752

Jones, Timothy; Al-Ghatam, Rana; Atack, Nikki; Deacon, Scott; Power, Rosie; Albery, Liz; Ireland, Tony; Sandy, Jonathan

2014-06-01

36

What Do They Measure? Comparing Three Learning Outcomes Assessments  

ERIC Educational Resources Information Center

Many postsecondary institutions currently administer standardized tests of general college outcomes; more than a quarter of Association of American Colleges and Universities (AAC&U) member institutions do so. Using standardized tests for accountability purposes has been contentious mainly because these tests do not measure every important outcome

Steedle, Jeffrey; Kugelmass, Heather; Nemeth, Alex

2010-01-01

37

A Binomial Test of Group Differences with Correlated Outcome Measures  

ERIC Educational Resources Information Center

Building on previous arguments for why educational researchers should not provide effect-size estimates in the face of statistically nonsignificant outcomes (Robinson & Levin, 1997), Onwuegbuzie and Levin (2005) proposed a 3-step statistical approach for assessing group differences when multiple outcome measures are individually analyzed within…

Onwuegbuzie, Anthony J.; Levin, Joel R.; Ferron, John M.

2011-01-01

38

Measuring Assistive Technology Outcomes in Schools Using Functional Assessment.  

ERIC Educational Resources Information Center

Activities of Project OATS (Outcomes of Assistive Technology in the Schools) are described, including identification and piloting of existing assessment instruments for use as an outcome measure, examining the validity of the School Function Assessment, and field testing the School Function Assessment-Assistive Technology Version, an adaptation of…

Silverman, Michelle Kaye; Stratman, Kristine Freiberg; Smith, Roger O.

2000-01-01

39

Measuring alternative learning outcomes: dispositions to study in higher education.  

PubMed

In this paper we describe the validation of two scales constructed to measure pre-university students' changing disposition (i) to enter Higher Education (HE) and (ii) to further study mathematically-demanding subjects. Items were selected drawing on interview data, and on a model of disposition as socially- as well as self- attributed. Rasch analyses showed that the two scales each produce robust one-dimensional measures on what we call a 'strength of commitment to enter HE' and 'disposition to study mathematically-demanding subjects further' respectively. However, the former scale was initially found to suffer psychometrically from a ceiling effect, which we 'corrected' by adding some harder items at a later data point, and revised the scale according to our interpretation of subsequent results. We finally discuss the potential significance of the constructed measures of learning outcomes, as variables in monitoring or even explaining students' progress into different subjects in HE. PMID:23816596

Pampaka, Maria; Williams, Julian; Hutcheson, Graeme; Black, Laura; Davis, Pauline; Hernandez-Martinez, Paul; Wake, Geoff

2013-01-01

40

Outcome measures and their everyday use in chiropractic practice  

PubMed Central

Objectives: To describe the extent to which chiropractors utilize standardized outcome and various clinical measures to systematically document patients’ baseline health status and responses to treatment, with particular consideration being given towards quantifiable outcome instruments. Study design: Cross-sectional mailed survey. Participants: Registered chiropractors in the province of Saskatchewan. Methods: A survey was mailed to all registrants of the Chiropractors’ Association of Saskatchewan. Respondents graded their frequency of using various standardized pencil-and-paper instruments and functional chiropractic, orthopaedic and neurological tests in the contexts of both the initial intake assessment (‘always,’ ‘commonly,’ ‘occasionally,’ or ‘never’) and the course of subsequent treatment (after ‘each visit,’ after ‘9–12 visits,’ ‘annually,’ when patient ‘not responding,’ on ‘dismissal/discharge,’ ‘never’ or for some ‘other’ reason). Data were tabulated for all item and response category combinations as frequencies and percentages using the total sample size as the denominator. Results: Of 164 registered chiropractors, 62 (38%) returned a completed questionnaire. A pain diagram was the most commonly used subjective outcome measure and was administered routinely (either “always” or “commonly”) by 75% of respondents, at either the initial consultation or during a subsequent visit. Numerical rating and visual analogue scales were less popular (routinely used by 59% and 42% respectively). The majority of respondents (80%) seldom (“occasionally” or “never”) used spine pain-specific disability indices such as the Low Back Revised Oswestry, Neck Disability Index or the Roland-Morris Questionnaire. As well, they did not use standardized psychosocial instruments such as the Beck Depression Index, or general health assessment measures such as the SF-36 or SF-12 questionnaire. Neurological testing was the most commonly used objective outcome measure. Most respondents (84% to 95%) indicated that they continually monitored neurological status through dermatomal, manual muscle strength and deep tendon reflex testing. Ranges of motion were routinely measured by 95% of respondents, usually visually (96%) rather than goniometrically or by some other specialized device (7%). Conclusions: Our findings suggest that the majority of chiropractors do not use psychosocial questionnaires or condition-specific disability indices to document baseline or subsequent changes in health status. Chiropractors are more likely to rely on medical history taking and pain drawings during an initial intake assessment, as well as neurological and visually estimated range of motion testing during both initial intake and subsequent treatment visits. PMID:20520756

Hinton, Paul M.; McLeod, Randall; Broker, Blaine; MacLellan, C. Elizabeth

2010-01-01

41

Can a Future Choice Affect a Past Measurement's Outcome?  

NASA Astrophysics Data System (ADS)

An EPR experiment is studied where each particle undergoes a few weak measurements along some pre-set spin orientations, whose outcomes are individually recorded. Then the particle undergoes a strong measurement along a spin orientation freely chosen at the last moment. Bell-inequality violation is expected between the two final strong measurements within each EPR pair. At the same time, agreement is expected between these measurements and the earlier weak ones within the pair. A contradiction thereby ensues: i) Bell's theorem forbids spin values to exist prior to the choice of the spin-orientation to be measured; ii) A weak measurement cannot determine the outcome of a successive strong one; and iii) Indeed no disentanglement is inflicted by the weak measurements; yet iv) The weak measurements' outcomes agree with those of the strong ones. The most reasonable resolution seems to be that of the Two-State-Vector Formalism, namely, that the experimenter's choice has been encrypted within the weak measurement's outcomes, even before the experimenter themselves knows what their choice will be. Causal loops are avoided by this anticipation remaining encrypted until the final outcomes enable to decipher it.

Aharonov, Y.; Cohen, E.; Grossman, D.; Elizutr, A. C.

2014-04-01

42

Measuring behavioral outcomes in cardiopulmonary rehabilitation: AN AACVPR STATEMENT.  

PubMed

Outcome measurement in cardiopulmonary rehabilitation is required for optimal assessment of program quality, effectiveness of treatments, and evaluation of patient progress. Recent position statements from the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR), American College of Cardiology, American Heart Association, American Thoracic Society, and American College of Chest Physicians have provided state-of-the-art information on the importance of assessing performance and outcome measures for optimal program effectiveness. Such measures are also required for AACVPR program certification. To meet current standards of practice, the AACVPR developed an Outcomes Matrix that includes 4 domains: Health, Clinical, Behavioral, and Service. Although the Clinical and Health domains have been most commonly used in outcome reporting (eg, 6-minute walk test, quality-of-life survey scores), behavioral measures have received less attention, primarily because they have been perceived as being more difficult to measure and quantify over time. This statement describes 5 common behavioral outcome measures: smoking cessation, medication use, supplemental oxygen use, exercise habits, and nutritional behaviors. Sample questions and calculations for each of these behavioral measures are also provided. By using these measures at program entry and completion, cardiac and pulmonary rehabilitation practitioners can effectively track and document behavioral changes over time for physicians, third-party insurance providers, or hospital administrators and thus demonstrate the effectiveness of exercise and educational interventions on patient overall health and well-being. PMID:19471140

Verrill, David; Graham, Helen; Vitcenda, Mark; Peno-Green, Laura; Kramer, Valerie; Corbisiero, Teresa

2009-01-01

43

Measuring success in the treatment of children in the emergency department setting: process versus outcomes?  

PubMed

The current best design practices for clinical studies require consideration of the assessment of end points that combine key processes and outcomes. Process assessment measures events in the pathway on which a more important intermediate or ultimate health outcome depends. Process assessment can be either formative or summative. Outcomes assessment relates to identifying the results related to a process, and is most often defined as the change in a patient's current or future health state. The development of process and outcomes measures for any study is difficult, and children and emergency department settings present unique sets of issues worth highlighting. This article presents an overview of issues relating to choice of process and outcomes measures in studies of pediatric emergency medicine. Asthma care is used to illustrate the complex issues surrounding the measurement of success in management in the emergency department setting. PMID:12135404

Weiss, Kevin B

2002-01-01

44

45 CFR 287.145 - What measures will be used to determine NEW Program outcomes?  

...NATIVE EMPLOYMENT WORKS (NEW) PROGRAM Program Design and Operations § 287.145 What measures will be used to determine NEW Program outcomes? Each grantee...results. A Tribe's program plan must identify planned...

2014-10-01

45

45 CFR 287.145 - What measures will be used to determine NEW Program outcomes?  

Code of Federal Regulations, 2011 CFR

...NATIVE EMPLOYMENT WORKS (NEW) PROGRAM Program Design and Operations § 287.145 What measures will be used to determine NEW Program outcomes? Each grantee...results. A Tribe's program plan must identify planned...

2011-10-01

46

45 CFR 287.145 - What measures will be used to determine NEW Program outcomes?  

Code of Federal Regulations, 2013 CFR

...NATIVE EMPLOYMENT WORKS (NEW) PROGRAM Program Design and Operations § 287.145 What measures will be used to determine NEW Program outcomes? Each grantee...results. A Tribe's program plan must identify planned...

2013-10-01

47

45 CFR 287.145 - What measures will be used to determine NEW Program outcomes?  

Code of Federal Regulations, 2010 CFR

...NATIVE EMPLOYMENT WORKS (NEW) PROGRAM Program Design and Operations § 287.145 What measures will be used to determine NEW Program outcomes? Each grantee...results. A Tribe's program plan must identify planned...

2010-10-01

48

45 CFR 287.145 - What measures will be used to determine NEW Program outcomes?  

Code of Federal Regulations, 2012 CFR

...NATIVE EMPLOYMENT WORKS (NEW) PROGRAM Program Design and Operations § 287.145 What measures will be used to determine NEW Program outcomes? Each grantee...results. A Tribe's program plan must identify planned...

2012-10-01

49

Measured Outcomes of Learning under Block Scheduling.  

ERIC Educational Resources Information Center

A study of 270 sophomores taught in either a block scheduling or traditional scheduling format showed significant results for English and biology. Block schedules significantly predicted pretest to posttest differences in Educational Testing Service subject scores over and above those of students following traditional schedules. (Contains 16…

Hess, Caryl; Wronkovich, Michael; Robinson, James

1999-01-01

50

Measuring Violence Risk and Outcomes among Mexican American Adolescent Females  

ERIC Educational Resources Information Center

Central to the development of culturally competent violence prevention programs for Hispanic youth is the development of psychometrically sound violence risk and outcome measures for this population. A study was conducted to determine the psychometric properties of two commonly used violence measures, in this case for Mexican American adolescent…

Cervantes, Richard C.; Duenas, Norma; Valdez, Avelardo; Kaplan, Charles

2006-01-01

51

OMERACT: An international initiative to improve outcome measurement in rheumatology  

Microsoft Academic Search

OMERACT is the acronym for an international, informally organized network initiated in 1992 aimed at improving outcome measurement in rheumatology. Chaired by an executive committee, it organizes consensus conferences in a 2-yearly cycle that circles the globe. Data driven recommendations are prepared and updated by expert working groups. Recommendations include core sets of measures for most of the major rheumatologic

Peter Tugwell; Maarten Boers; Peter Brooks; Lee Simon; Vibeke Strand; Leanne Idzerda

2007-01-01

52

Outcome measures in rheumatoid arthritis randomised trials over the last 50 years  

PubMed Central

Background The development and application of standardised sets of outcomes to be measured and reported in clinical trials have the potential to increase the efficiency and value of research. One of the most notable of the current outcome sets began nearly 20 years ago: the World Health Organization and International League of Associations for Rheumatology core set of outcomes for rheumatoid arthritis clinical trials, originating from the OMERACT (Outcome Measures in Rheumatology) Initiative. This study assesses the use of this core outcome set by randomised trials in rheumatology. Methods An observational review was carried out of 350 randomised trials for the treatment of rheumatoid arthritis identified through The Cochrane Library (up to and including September 2012 issue). Reports of these trials were evaluated to determine whether or not there were trends in the proportion of trials reporting on the full set of core outcomes over time. Researchers who conducted trials after the publication of the core set were contacted to assess their awareness of it and to collect reasons for non-inclusion of the full core set of outcomes in the study. Results Since the introduction of the core set of outcomes for rheumatoid arthritis, the consistency of measurement of the core set of outcomes has improved, although variation in the choice of measurement instrument remains. The majority of trialists who responded said that they would consider using the core outcome set in the design of a new trial. Conclusions This observational review suggests that a higher percentage of trialists conducting trials in rheumatoid arthritis are now measuring the rheumatoid arthritis core outcome set. Core outcome sets have the potential to improve the evidence base for health care, but consideration must be given to the methods for disseminating their availability amongst the relevant communities. PMID:24103529

2013-01-01

53

Clinical Practices and Outcomes in Elderly Hemodialysis Patients: Results from the Dialysis Outcomes and Practice Patterns Study (DOPPS)  

PubMed Central

Summary Background and objectives Demand for hemodialysis among elderly patients is increasing worldwide. Although clinical care of this high-risk group is complex and challenging, no guidelines exist to inform hemodialysis practices. The Dialysis Outcomes and Practice Patterns Study (DOPPS) provides a unique opportunity to assess dialysis practices and associated outcomes among elderly versus younger patients on chronic in-center hemodialysis in 12 countries. Design, setting, participants, & measurements Clinical characteristics, dialysis practices, and outcomes of elderly versus younger patients were compared among participants in four DOPPS regions in 2005 through 2007. Results Although participant mean age increased over time in all DOPPS countries, the percentage of elderly varied widely. Overall, comorbidities and malnutrition were more common in the elderly. Fistulae were used less frequently among elderly versus younger patients in Europe and North America but not in Australia, New Zealand, and Japan. No difference in treatment time was observed between elderly and younger patients after normalizing for body weight. In all regions, ultrafiltration rates were lower among elderly patients. Elderly patients reported poorer quality of life with respect to the physical but not mental component scores. Mortality risk was three- to sixfold higher in the elderly group, whereas causes of death overall were similar for elderly and younger patients. Conclusions Elderly patients represent a different proportion of DOPPS participants across countries, possibly reflecting differences in policies and clinical practices. In general, hemodialysis practices in the elderly reflected each region's clinical patterns, with some variation by age group depending upon the practice. PMID:21734085

Tong, Lin; Tentori, Francesca; Akiba, Takashi; Karaboyas, Angelo; Gillespie, Brenda; Akizawa, Tadao; Pisoni, Ronald L.; Bommer, Juergen; Port, Friedrich K.

2011-01-01

54

Psychometric properties of the Medical Outcomes Study Sleep measure  

Microsoft Academic Search

Background and purpose: Sleep is an active and highly organized biological process that is an important component of life. Self-report measures of sleep provide information that can be useful for characterizing the quality of sleep in subgroups of the population. A 12-item self-report sleep measure, the Medical Outcomes Study Sleep measure, was developed and evaluated previously in a sample of

Ron D. Hays; Susan A. Martin; Anne M. Sesti; Karen L. Spritzer

2005-01-01

55

Knowledge Retention as a Latent Outcome Measure in Distance Learning.  

ERIC Educational Resources Information Center

Describes two experiments that investigated the retention of knowledge as a latent measure of learning outcome in video teletraining courses, one for air traffic controllers and one for military training. Discusses the merits of knowledge retention as a construct for examining initial evidence of learning, especially for training related to the…

Wisher, Robert A.; Curnow, Christina K.; Seidel, Robert J.

2001-01-01

56

Measuring Educational Outcomes: Vocational Education and Training. Conference Paper  

ERIC Educational Resources Information Center

The vocational education and training (VET) sector has a long tradition of measuring and reporting outcomes. The public face of this is the "Annual National Report of the Australian Vocational Education and Training System" published (and tabled in the Commonwealth Parliament) since 1994. The reporting framework has undergone a number of changes…

Karmel, Tom

2009-01-01

57

Outcome measures in palliative care for advanced cancer patients: a review  

Microsoft Academic Search

Summary Information generated using outcome measures to measure the effectiveness of palliative care interventions is potentially invaluable. Depending on the measurement tool employed the results can be used to monitor clinical care, carry out comparative research, provide audit data or inform purchas- ing decisions. However, the data collected can only ever be as good as the method used to obtain

Julie Hearn; Irene J. Higginson

58

Inside Quality Reform: Early Results on Using Outcomes for Improvement  

ERIC Educational Resources Information Center

This article offers evidence on ways in which assessment of student learning outcomes made a difference for some academic institutions in the United States. It offers perspectives on the internal changes that took place, especially within academic programmes. Even after the capacity for assessment was developed, challenges remained in evaluating…

El-Khawas, Elaine

2014-01-01

59

Assessment Program Results 1996-1997. Focus on Assessing Outcomes.  

ERIC Educational Resources Information Center

The Des Moines (Iowa) Public Schools continually evaluate the process of teaching for learning in order to provide quality programming for its diverse student body. Different methods of student outcome assessment are used to identify areas for study and analysis. This report provides information about the achievement of district students on: (1)…

Deeter, Thomas; Prine, Don

60

Outcome Measurement in Clinical Genetics Services: A Systematic Review of Validated Measures  

Microsoft Academic Search

ObjectiveThis systematic review aimed to inform researchers and policymakers about what validated outcome measures are available to evaluate clinical genetics services (CGS) and the need for new measures.

Katherine Payne; Stuart Nicholls; Marion McAllister; Rhona MacLeod; Dian Donnai; Linda M. Davies

2008-01-01

61

A National Survey of Faculty Development Evaluation Outcome Measures and Procedures  

ERIC Educational Resources Information Center

This article presents the results of a national study of 39 higher education institutions that collected information about their evaluation procedures and outcome measures for faculty development for online teaching conducted during 2011-2012. The survey results found that over 90% of institutions used measures of the faculty person's…

Meyer, Katrina A.; Murrell, Vicki S.

2014-01-01

62

Medical specialty boards can help measure graduate medical education outcomes.  

PubMed

U.S. graduate medical education (GME) training institutions are under increasing scrutiny to measure program outcomes as a demonstration of accountability for the sizeable funding they receive from the federal government. The Accreditation Council for Graduate Medical Education (ACGME) is a potential agent of measuring GME accountability but has no interaction with physicians after residency training is completed. American Board of Medical Specialty (ABMS) member boards interact with physicians throughout their careers through maintenance of certification (MOC) and are a potential source of valuable data on physician competency and quality of care, both of which could be used to measure GME accountability.The authors propose that ABMS boards and the ACGME deepen their existing relationship to better assess residency training outcomes. ABMS boards have a wealth of data on physicians collected as a by-product of MOC and business operations. Further, many ABMS boards collect practice demographics and scope-of-practice information through MOC enrollment surveys or recertification examination questionnaires. These data are potentially valuable in helping residencies know what their graduates are doing in practice. Part 4 of MOC generally involves assessment of the quality of care delivered in practice, and ABMS boards could share these deidentified data with the ACGME and residency programs to provide direct feedback on the practice outcomes of graduates.ABMS member boards and the ACGME should broaden their long-standing relationship to further develop shared roles and data-sharing mechanisms to better inform residencies and the public about GME training outcomes. PMID:24871232

Peterson, Lars E; Carek, Peter; Holmboe, Eric S; Puffer, James C; Warm, Eric J; Phillips, Robert L

2014-06-01

63

PERFORMANCE METRICS: AN OVERVIEW OF ECOLOGICAL "OUTCOME" MEASUREMENT AT EPA  

EPA Science Inventory

The terms "Accountability" and "Outcome" are becoming ubiquitous in government agencies. The impetus for demonstrating results from government-sponsored research and regulation comes from Congress (e.g., statutes like the Government Performance Results Act of 1993 and reports fro...

64

Generating Outcome Measurements: Achievement and Attitudes. A Guide to Educational Outcome Measurements and Their Uses. Seminar No. 3.  

ERIC Educational Resources Information Center

This guide is essentially designed as a teaching aid for those who would inform planners, officials of educational ministries, school administrators, principals, and teachers about educational outcome measurements. In outline and graphic form, the guide presents topics for discussion in a seminar dealing with how to obtain information on…

Mushkin, Selma J.; Billings, Bradley B.

65

Understanding the outcomes measures used in Huntington disease pharmacologicaltrials: A systematic review  

PubMed Central

Background The identification of the gene mutation causing Huntington disease has raised hopes for new treatments to ease symptoms and slow functional decline. As such, there has been a push towards designing efficient pharmacological trials (i.e., drug trials), especially with regard to selecting outcomes measures that are both brief and sensitive to changes across the course of the disease, from subtle prodromal changes, to more severe end-stage changes. Objectives Recently, to aid in efficient development of new HD research studies, the National Institute of Neurological Disorders and Stroke (NINDS) published recommendations for measurement selection in HD. While these recommendations are helpful, many of the recommended measures have little published data in HD. As such, we conducted a systematic review of the literature to identify the most common outcomes measures used in HD clinical trials. Methods Major medical databases, including PubMed, Embase, CINAHL, and the Cochrane Central Register of Controlled Trials, were used to identify peer-reviewed journal articles in English from 2001 through April 2013; 151 pharmacological trials were identified. Results The majority of HD clinical trials employed clinician-reported outcomes measures (93%); patient reported outcome measures (11%) and observer reported outcome measures (3%) were used with much less frequency. Conclusions We provide a review of the most commonly used measures across these trials, compare these measures to the clinical recommendations made by the NINDS working groups, and provide recommendations for selecting measures for future clinical trials that meet the Food and Drug Administration standards. PMID:25300328

Carlozzi, Noelle E; Miciura, Angela; Migliore, Nicholas; Dayalu, Praveen

2014-01-01

66

Outcome measures in acute gout: a systematic literature review  

PubMed Central

Objective Five core domains have been endorsed by Outcomes Measures in Rheumatology (OMERACT) for acute gout: pain, joint swelling, joint tenderness, patient global assessment, and activity limitation. The aim of this work was to evaluate instruments for these domains according to the OMERACT filter: truth, feasibility, and discrimination. Methods A systematic search strategy for instruments used to measure the acute gout core domains was formulated. For each method, articles were assessed by two reviewers to summarise information according to the specific components of the OMERACT filter. Results Seventy-seven articles and abstracts met the inclusion criteria. Pain was most frequently reported (76 studies, 20 instruments). The pain instruments used most often were 100mm visual analog scale (VAS) and 5-point Likert scale. Both methods have high feasibility, face and content validity, within- and between-group discrimination. Four-point Likert scales assessing index joint swelling and tenderness have been used in numerous acute gout studies; these instruments are feasible, with high face and content validity, and show within- and between-group discrimination. Five-point patient global assessment of response to treatment (PGART) scales are feasible and valid, and show within- and between-group discrimination. Measures of activity limitations were infrequently reported, and insufficient data were available to make definite assessments of the instruments for this domain. Conclusion Many different instruments have been used to assess the acute gout core domains. Pain VAS and 5-point Likert scales, 4-point Likert scales of index joint swelling and tenderness and 5-point PGART instruments meet the criteria for the OMERACT filter. PMID:24334652

Dalbeth, Nicola; Zhong, Cathy S; Grainger, Rebecca; Khanna, Dinesh; Khanna, Puja P; Singh, Jasvinder A; McQueen, Fiona M; Taylor, William J

2014-01-01

67

Towards measurement of outcome for patients with varicose veins  

Microsoft Academic Search

OBJECTIVE--To develop a valid and reliable outcome measure for patients with varicose veins. DESIGN--Postal questionnaire survey of patients with varicose veins. SETTING--Surgical outpatient departments and training general practices in Grampian region. SUBJECTS--373 patients, 287 of whom had just been referred to hospital for their varicose veins and 86 who had just consulted a general practitioner for this condition and, for

A M Garratt; L M Macdonald; D A Ruta; I T Russell; J K Buckingham; Z H Krukowski

1993-01-01

68

Measuring mathematics self-efficacy as a learning outcome  

Microsoft Academic Search

We report the construction and validation of a self-report ‘Mathematics self-efficacy (MSE)’ instrument, designed to measure this construct as a learning outcome of students following post-compulsory mathematics programmes. The sample ranged across two programmes: a traditional preparation for university study in mathematical subjects (Advanced level) and an innovative ‘modelling’-based programme intended to widen participation in mathematics through use of technology

Maria Pampaka; Irene Kleanthous; Graeme D. Hutcheson; Geoff Wake

2011-01-01

69

On the unpredictability of individual quantum measurement outcomes  

E-print Network

We develop a general, non-probabilistic model of prediction which is suitable for assessing the (un)predictability of individual physical events. We use this model to provide, for the first time, a rigorous proof of the unpredictability of a class of individual quantum measurement outcomes, a well-known quantum attribute postulated or claimed for a long time. We prove that quantum indeterminism - formally modelled as value indefiniteness - is incompatible with the supposition of predictability: value indefinite observables are unpredictable. The proof makes essential use of a strengthened form of the Kochen-Specker theorem proven previously to identify value indefinite observables. As a result, quantum unpredictability, like the Kochen-Specker theorem, relies on three assumptions: compatibility with quantum mechanical predictions, non-contextuality, and the value definiteness of observables corresponding to the preparation basis of a quantum state. Finally, quantum unpredictability is used to prove that quantum randomness is "maximally incomputable", and to discuss a real model of hypercomputation whose computational power has yet to be determined. The paper ends with a further open problem.

Alastair A. Abbott; Cristian S. Calude; Karl Svozil

2014-03-11

70

Predicting treatment outcome on three measures for post-traumatic stress disorder.  

PubMed

The aim of the present study was to investigate predictors of treatment outcome for Posttraumatic Stress Disorder (PTSD) after treatment completion and at 15-months follow-up (n = 48), in a trial of Eye Movement Desensitisation and Reprocessing (EMDR) versus Imaginal Exposure and Cognitive Restructuring (E+CR). Factors associated with treatment outcome were investigated using regression analyses with the mean change scores in three assessor and self-rated PTSD symptomatology measures, including the Clinician-Administered PTSD Scale (CAPS), the Impact of Events Scale (IES) and the PTSD Symptom Checklist (PCL) from pre- to post-treatment and pre-treatment to follow-up as the dependent variables and demographics, trauma, clinical and personality measures as independent variables. Irrespective to outcome measures and assessment points it was found that four variables were able to predict significantly treatment outcome. These included baseline PTSD symptomatology, number of sessions, gender and therapy type. Overall, our results showed that it is difficult to use pre-treatment variables as a powerful and reliable tool for predicting treatment outcome, as significant predictors were found to be sample-specific and outcome measure-specific. Clinical relevance of the present results and directions for future research are discussed. PMID:16915361

Karatzias, Athanasios; Power, Kevin; McGoldrick, Theresa; Brown, Keith; Buchanan, Robin; Sharp, Donald; Swanson, Vivien

2007-02-01

71

Engaging the hearts and minds of clinicians in outcome measurement – the UK rehabilitation outcomes collaborative approach  

PubMed Central

Purpose This article explores the rationale for choosing the instruments included within the UK Rehabilitation Outcomes Collaborative (UKROC) data set. Using one specialist neuro-rehabilitation unit as an exemplar service, it describes an approach to engaging the hearts and minds of clinicians in recording the data. Key messages and implications Measures included within a national data set for rehabilitation should be psychometrically robust and feasible to use in routine clinical practice; they should also support clinical decision-making so that clinicians actually want to use them. Learning from other international casemix models and benchmarking data sets, the UKROC team has developed a cluster of measures to inform the development of effective and cost-efficient rehabilitation services. These include measures of (1) “needs” for rehabilitation (complexity), (2) inputs provided to meet those needs (nursing and therapy intervention), and (3) outcome, including the attainment of personal goals as well as gains in functional independence. Conclusions By integrating the use of the data set measures in everyday clinical practice, we have achieved a very high rate of compliance with data collection. However, staff training and ongoing commitment from senior staff and managers are critical to the maintenance of effort required to provide assurance of data quality in the longer term. PMID:22506959

2012-01-01

72

Stroboscopic Parameters Reported as Voice Outcome Measures in Patients Treated for Laryngeal Cancer: A Systematic Review  

PubMed Central

Background A systematic review of the use of stroboscopy as a treatment outcome measure of vocal fold function in patients treated for laryngeal cancer is presented. Methods Computerized literature searches were performed. Eligible articles were admitted when stroboscopy was used to measure vocal fold function before and after treatment in patients with laryngeal cancer. Data extracted included: tumor stage and location, treatment modality, stroboscopy parameters, parameter scale, number of raters, rater reliability, methodology, and level of evidence. Results Of 520 articles retrieved, 11 studies met inclusion criteria. A total of twenty-four parameters were reported. Rating scales and rater reliability varied. Discussion Major methodological differences exist in studies using stroboscopic findings as voice outcome measures in patients’ post-cancer treatment. These differences lead to equivocal findings when assessing the utility of stroboscopy as an outcome measure. Standardized, reliable scoring and reporting systems for laryngeal stroboscopic examinations are needed. PMID:25339842

Focht, Kendrea L.; Martin-Harris, Bonnie; Bonilha, Heather Shaw

2013-01-01

73

Patient-Reported Outcomes (PROs) and Patient-Reported Outcome Measures (PROMs)  

PubMed Central

In recent years, there has been an increased focus on placing patients at the center of health care research and evaluating clinical care in order to improve their experience and ensure that research is both robust and of maximum value for the use of medicinal products, therapy, or health services. This paper provides an overview of patients’ involvement in clinical research and service evaluation along with its benefits and limitations. We describe and discuss patient-reported outcomes (PROs) and patient-reported outcome measures (PROMs), including the trends in current research. Both the patient-reported experiences measures (PREMs) and patient and public involvement (PPI) initiative for including patients in the research processes are also outlined. PROs provide reports from patients about their own health, quality of life, or functional status associated with the health care or treatment they have received. PROMs are tools and/or instruments used to report PROs. Patient report experiences through the use of PREMs, such as satisfaction scales, providing insight into the patients’ experience with their care or a health service. There is increasing international attention regarding the use of PREMS as a quality indicator of patient care and safety. This reflects the ongoing health service commitment of involving patients and the public within the wider context of the development and evaluation of health care service delivery and quality improvement. PMID:25114561

Weldring, Theresa; Smith, Sheree M.S.

2013-01-01

74

Patient-Reported Outcomes (PROs) and Patient-Reported Outcome Measures (PROMs).  

PubMed

In recent years, there has been an increased focus on placing patients at the center of health care research and evaluating clinical care in order to improve their experience and ensure that research is both robust and of maximum value for the use of medicinal products, therapy, or health services. This paper provides an overview of patients' involvement in clinical research and service evaluation along with its benefits and limitations. We describe and discuss patient-reported outcomes (PROs) and patient-reported outcome measures (PROMs), including the trends in current research. Both the patient-reported experiences measures (PREMs) and patient and public involvement (PPI) initiative for including patients in the research processes are also outlined. PROs provide reports from patients about their own health, quality of life, or functional status associated with the health care or treatment they have received. PROMs are tools and/or instruments used to report PROs. Patient report experiences through the use of PREMs, such as satisfaction scales, providing insight into the patients' experience with their care or a health service. There is increasing international attention regarding the use of PREMS as a quality indicator of patient care and safety. This reflects the ongoing health service commitment of involving patients and the public within the wider context of the development and evaluation of health care service delivery and quality improvement. PMID:25114561

Weldring, Theresa; Smith, Sheree M S

2013-01-01

75

Pediatric stroke outcome measure: predictor of multiple impairments in childhood stroke.  

PubMed

The ability to anticipate deficits would help with implementation of interventions for children affected by stroke. The Pediatric Stroke Outcome Measure (Measure) measures neurological impairment after stroke, but there has been little research examining the relationship between the Measure and functional outcomes. We hypothesized the Measure correlates with cognitive and behavioral outcomes. Thirty-six children with stroke were assessed with the Measure, and tested for cognitive ability, problem behavior, adaptive behavior, and social participation. We examined the correlation between the total Measure and outcomes and determined how subscale scores associated with outcomes. Higher total Measure scores correlated with poorer outcomes in cognitive ability, problem behaviors, adaptive behaviors, and social participation. Specific subscale scores correlated with poorer outcomes in multiple domains. The total Measure can be used to anticipate poor outcomes in multiple domains after stroke and can help the clinician in the treatment of children as they recover. PMID:24163399

Lo, Warren; Gordon, Anne L; Hajek, Christine; Gomes, Alison; Greenham, Mardee; Anderson, Vicki; Yeates, Keith O; Mackay, Mark T

2014-11-01

76

Mathematics Placement Test: Typical Results with Unexpected Outcomes  

ERIC Educational Resources Information Center

Based on the results of a prior case-study analysis of mathematics placement at one university, the mathematics department developed and piloted a mathematics placement test. This article describes the implementation process for a mathematics placement test and further analyzes the test results for the pilot group. As an unexpected result, the…

Ingalls, Victoria

2011-01-01

77

Japanese haemodialysis anaemia management practices and outcomes (1999–2006): results from the DOPPS  

PubMed Central

Background. Japanese haemodialysis (HD) patients not only have a very low mortality and hospitalization risk but also low haemoglobin (Hb) levels. Internationally, anaemia is associated with mortality, hospitalization and health-related quality of life (QoL) measures of HD patients. Methods. Longitudinal data collected from 1999 to 2006 from 60 to 64 representative Japanese dialysis units participating in the Dialysis Outcomes and Practice Patterns Study (DOPPS) were used to describe anaemia management practices and outcomes for Japanese HD patients. Results. From 1999 to 2006, patient mean Hb increased from 9.7 g/dl to 10.4 g/dl, and the percentage of facilities with median Hb ?10 g/dl increased from 27% to 75%. Hb was measured in the supine position for 90% of patients, resulting in substantially lower reported Hb values than those seen in other countries. As of 2006, erythropoietin (Epo) was prescribed to 83% of HD patients; mean Epo dose was 5231 units/week; intravenous (IV) iron use was 33% and median IV iron dose was 160 mg/month. Many patient- and facility-level factors were significantly related to higher Hb. A consistent overall pattern of lower mortality risk with higher baseline Hb levels was seen (RR = 0.89 per 1 g/dl higher Hb, P = 0.003). Facilities with median Hb ?10.4 displayed a lower mortality risk (RR = 0.77, P = 0.03) versus facility median Hb <10.4 g/dl. Lower Hb levels were not significantly related to hospitalization risk, but were associated with lower QoL scores. Conclusions. These results provide detailed information on anaemia management practices in Japan and the relationships of anaemia control with outcomes, with implications of anaemia management worldwide. PMID:18577535

Akizawa, Tadao; Pisoni, Ronald L.; Akiba, Takashi; Saito, Akira; Fukuhara, Shunichi; Asano, Yasushi; Hasegawa, Takeshi; Port, Friedrich K.; Kurokawa, Kiyoshi

2008-01-01

78

Developing measures of community-relevant outcomes for violence prevention programs: a community-based participatory research approach to measurement.  

PubMed

Community-Based Participatory Research is a research paradigm that encourages community participation in designing and implementing evaluation research, though the actual outcome measures usually reflect the "external" academic researchers' view of program effect and the policy-makers' needs for decision-making. This paper describes a replicable process by which existing standardized psychometric scales commonly used in youth-related intervention programs were modified to measure indicators of program success defined by community partners. This study utilizes a secondary analysis of data gathered in the context of a community-based youth violence prevention program. Data were retooled into new measures developed using items from the Alabama Parenting Questionnaire, the Hare Area Specific Self-Esteem Scale, and the Youth Asset Survey. These measures evaluated two community-defined outcome indicators, "More Parental Involvement" and "Showing Kids Love." Results showed that existing scale items can be re-organized to create measures of community-defined outcomes that are psychometrically reliable and valid. Results also show that the community definitions of parent or parenting caregivers exemplified by the two indicators are similar to how these constructs have been defined in previous research, but they are not synonymous. There are nuanced differences that are important and worthy of better understanding, in part through better measurement. PMID:23846829

Hausman, Alice J; Baker, Courtney N; Komaroff, Eugene; Thomas, Nicole; Guerra, Terry; Hohl, Bernadette C; Leff, Stephen S

2013-12-01

79

Recommendations for the Use of Common Outcome Measures in Pediatric Traumatic Brain Injury Research  

E-print Network

characterizing course of recovery from TBI, prediction of later outcome, measurement of treatment effects, language and communication, neuropsycho- logical impairment, physical functioning, psychiatric; infants; outcome assessment, TBI 1 Departments of Physical Medicine and Rehabilitation, Neurology

O'Toole, Alice J.

80

Comparison of IKDC and SANE Outcome Measures Following Knee Injury in Active Female Patients  

PubMed Central

Background: Knee injury among young, active female patients remains a public health issue. Clinicians are called upon to pay greater attention to patient-oriented outcomes to evaluate the impact of these injuries. Little agreement exists on which outcome measures are best, and clinicians cite several barriers to their use. Single Assessment Numerical Evaluation (SANE) may provide meaningful outcome information while lessening the time burden associated with other patient-oriented measures. Hypothesis: The SANE and International Knee Documentation Committee (IKDC) scores would be strongly correlated in a cohort of young active female patients with knee injuries from preinjury through 1-year follow-up and that a minimal clinically important difference (MCID) could be calculated for the SANE score. Study Design: Observational prospective cohort. Methods: Two hundred sixty-three subjects completed SANE and IKDC at preinjury by recall, time of injury, and 3, 6, and 12 months postinjury. Pearson correlation coefficients were used to assess the association between SANE and IKDC. Repeated-measures analysis of variance was used to determine differences in SANE and IKDC over time. MCID was calculated for SANE using IKDC MCID as an anchor. Results: Moderate to strong correlations were seen between SANE and IKDC (0.65-0.83). SANE, on average, was 2.7 (95% confidence interval, 1.5-3.9; P < 0.00) units greater than IKDC over all time points. MCID for the SANE was calculated as 7 for a 6-month follow-up and 19 for a 12-month follow-up. Conclusion: SANE scores were moderately to strongly correlated to IKDC scores across all time points. Reported MCID values for the SANE should be utilized to measure meaningful changes over time for young, active female patients with knee injuries. Clinical Relevance: Providing clinicians with patient-oriented outcome measures that can be obtained with little clinician and patient burden may allow for greater acceptance and use of outcome measures in clinical settings. PMID:24427427

Winterstein, Andrew P.; McGuine, Timothy A.; Carr, Kathleen E.; Hetzel, Scott J.

2013-01-01

81

The Washington Circle Engagement Performance Measures' Association with Adolescent Treatment Outcomes  

PubMed Central

Background For adolescents, substance use disorder (SUD) treatment outcomes (e.g., abstinence, problematic behaviors) often cannot be measured soon enough to influence treatment trajectory. Although process measures (e.g., treatment engagement) can play an important role, it is essential to demonstrate their association with outcomes. This study explored the extent to which engagement in outpatient treatment was associated with outcomes and whether demographic/clinical characteristics moderated these relationships. Methods This is a prospective study of adolescents (N=1,491) who received outpatient treatment for SUDs at one of 28 treatment sites taking part in a national evidence-based practice implementation initiative. Information from the Global Appraisal of Individual Needs interviews at intake and six-month follow-up, as well as encounter data, were used. Adjusted hierarchical logistic models were used to estimate effects of engagement on six-month outcomes. Results Sixty-one percent of adolescents engaged in outpatient treatment. Adolescents engaging in treatment had significantly lower likelihoods of reporting any substance use (OR 0.60, 95% CI 0.41, 0.87), alcohol use (OR 0.63, 95% CI 0.45, 0.87), heavy alcohol use (OR 0.53, 95% CI 0.33, 0.86), and marijuana use (OR 0.64, 95% CI 0.45, 0.93). This association of engagement with abstinence outcomes was not limited to any particular group. Treatment engagement, however, was not associated with adolescents' self-report of illegal activity or trouble controlling behavior at follow-up. Conclusion At the individual level, the Washington Circle engagement measure was a predictor of some positive outcomes for adolescents in outpatient treatment. Efforts to better engage adolescents in treatment could improve quality of care. PMID:22364777

Garnick, Deborah W.; Lee, Margaret T.; O'Brien, Peggy L.; Panas, Lee; Ritter, Grant A.; Acevedo, Andrea; Garner, Bryan R.; Funk, Rodney R.; Godley, Mark D.

2013-01-01

82

An evaluation of the responsiveness of a comprehensive set of outcome measures for children and adolescents with traumatic brain injuries.  

PubMed

The relative responsiveness of nine outcome measure scales was evaluated with 33 children and adolescents (aged 4-18 years) who had sustained traumatic brain injuries. Scales were selected to evaluate outcomes from each of the World Health Organization (WHO) International Classification of Functioning, Disability and Health domains. The outcome measures were administered to all participants during their inpatient rehabilitation stay and again at a follow-up clinic visit. No single outcome measure captured the diversity of improvement in this sample. The measures agreed that improvement had occurred, but did not agree about which children were improving. This result suggests that the scales were measuring different skills and outcomes. Three of the measures used in combination, either the Child Health Questionnaire or the Functional Independence Measure for Children, the American Speech-Language-Hearing Association National Outcome Measures System (Birth to Kindergarten NOMS/School-aged Health Care) and the Gross Motor Function Measure, are sufficient to detect change in each of the children where change occurred. The Pediatric Evaluation of Disability Inventory and the MultiAttribute Health Status Classification were the least responsive of the nine measures used. PMID:16352501

Thomas-Stonell, N; Johnson, P; Rumney, P; Wright, V; Oddson, B

2006-01-01

83

Outcome measures for vulval skin conditions: a systematic review of randomized controlled trials.  

PubMed

Symptoms and signs of vulval skin disorders are common. These conditions can have a considerable impact on quality of life, restricting physical activities and causing difficulty in everyday activities and may also affect social, psychosexual and psychological well-being. There are no standardized measures routinely used to assess the impact of vulval disease on daily life. To report outcome measures used in clinically based randomized controlled trials (RCTs) investigating therapeutic interventions in vulval disease. The Medline, EMBASE and CENTRAL databases were searched to identify RCTs of vulval skin conditions written in English. Studies with laboratory tests or survival rates as the primary outcome, or those investigating menopausal symptoms or infections were excluded. Twenty-eight published RCTs were included. The vulval conditions represented were vulvodynia (n = 14), lichen sclerosus (n = 9), vulval intraepithelial neoplasia (n = 2), vulval pruritus (n = 2) and lichen planus (n = 1). The 28 RCTs measured 25 different outcomes, using 49 different scales. The method of outcome assessment was lacking on nine occasions. Only 21% (six of 28) of included trials had a clearly stated primary outcome. Patient-reported outcomes were more commonly reported than clinician-related outcome measures. The most commonly reported patient-rated outcome measure was a reduction in pain (measured 15 times) and an overall improvement in symptoms using a patient global assessment (measured 11 times). The most commonly reported clinician-rated outcome was an overall assessment of the appearance of affected sites (measured 13 times). There were no agreed standard scales used for the global assessments. Only nine of the recorded outcome measure tools were designed to assess vulval disease or sexual functioning, the remainder were general measures. There is heterogeneity in the outcome measures used when reporting therapeutic interventions in vulval disease. This field of dermatology would benefit from development of a vulval-specific outcome measure and the establishment of a core outcome measure set. PMID:23600623

Simpson, R C; Thomas, K S; Murphy, R

2013-09-01

84

Prediction of Treatment Outcome with Bioimpedance Measurements in Breast Cancer Related Lymphedema Patients  

PubMed Central

Objective To investigate the usefulness of bioimpedance measurement for predicting the treatment outcome in breast cancer related lymphedema (BCRL) patients. Method Unilateral BCRL patients who received complex decongestive therapy (CDT) for 2 weeks (5 days per week) were enrolled in this study. We measured the ratio of extracellular fluid (ECF) volume by using bioelectrical impedance spectroscopy (BIS), and single frequency bioimpedance analysis (SFBIA) at a 5 kHz frequency before treatment. Arm circumferences were measured at 10 cm above and below the elbow before and after treatment. We also investigated whether there is correlation between ECF ratio and SFBIA ratio with the change of arm circumference after CDT. Results A total of 73 patients were enrolled in this study. The higher ECF ratio was significantly correlated with higher reduction of arm circumference at both above and below the elbow after treatment, but the higher SFBIA ratio was correlated only with the higher reduction of arm circumference below the elbow. Conclusion These results show that ECF volume measurements and SFBIA before treatment are useful tools for predicting the outcome of patients with lymphedema. We concluded that ECF volume measure can be used as a screening tool for predicting treatment outcome of BCRL patients. PMID:22506192

Kim, Leesuk; Sung, In Young; Jeong, Soon Yong; Do, Jung Hwa; Kim, Hwa Jung

2011-01-01

85

Optimal functional outcome measures for assessing treatment for Dupuytren's disease: a systematic review and recommendations for future practice  

PubMed Central

Background Dupuytren's disease of the hand is a common condition affecting the palmar fascia, resulting in progressive flexion deformities of the digits and hence limitation of hand function. The optimal treatment remains unclear as outcomes studies have used a variety of measures for assessment. Methods A literature search was performed for all publications describing surgical treatment, percutaneous needle aponeurotomy or collagenase injection for primary or recurrent Dupuytren’s disease where outcomes had been monitored using functional measures. Results Ninety-one studies met the inclusion criteria. Twenty-two studies reported outcomes using patient reported outcome measures (PROMs) ranging from validated questionnaires to self-reported measures for return to work and self-rated disability. The Disability of Arm, Shoulder and Hand (DASH) score was the most utilised patient-reported function measure (n=11). Patient satisfaction was reported by eighteen studies but no single method was used consistently. Range of movement was the most frequent physical measure and was reported in all 91 studies. However, the methods of measurement and reporting varied, with seventeen different techniques being used. Other physical measures included grip and pinch strength and sensibility, again with variations in measurement protocols. The mean follow-up time ranged from 2 weeks to 17 years. Conclusions There is little consistency in the reporting of outcomes for interventions in patients with Dupuytren’s disease, making it impossible to compare the efficacy of different treatment modalities. Although there are limitations to the existing generic patient reported outcomes measures, a combination of these together with a disease-specific questionnaire, and physical measures of active and passive individual joint Range of movement (ROM), grip and sensibility using standardised protocols should be used for future outcomes studies. As Dupuytren’s disease tends to recur following treatment as well as extend to involve other areas of the hand, follow-up times should be standardised and designed to capture both short and long term outcomes. PMID:23575442

2013-01-01

86

The incremental value of self-reported mental health measures in predicting functional outcomes of veterans.  

PubMed

Research on patient-centered care supports use of patient/consumer self-report measures in monitoring health outcomes. This study examined the incremental value of self-report mental health measures relative to a clinician-rated measure in predicting functional outcomes among mental health service recipients. Participants (n?=?446) completed the Behavior and Symptom Identification Scale, the Brief Symptom Inventory, and the Veterans/Rand Short Form-36 at enrollment in the study (T1) and 3 months later (T2). Global Assessment of Functioning (GAF) ratings, mental health service utilization, and psychiatric diagnoses were obtained from administrative data files. Controlling for demographic and clinical variables, results indicated that improvement based on the self-report measures significantly predicted one or more functional outcomes (i.e., decreased likelihood of post-enrollment psychiatric hospitalization and increased likelihood of paid employment), above and beyond the predictive value of the GAF. Inclusion of self-report measures may be a useful addition to performance measurement efforts. PMID:21191819

Eisen, Susan V; Bottonari, Kathryn A; Glickman, Mark E; Spiro, Avron; Schultz, Mark R; Herz, Lawrence; Rosenheck, Robert; Rofman, Ethan S

2011-04-01

87

Interpretation of the dosimetric results of three uniformity regularization methods in terms of expected treatment outcome  

SciTech Connect

In IMRT treatment plan optimization there are various methods that try to regularize the variation of dose nonuniformity using purely dosimetric measures. However, although these methods can help in finding a good dose distribution, they do not provide any information regarding the expected treatment outcome. When a treatment plan optimization is performed using biological measures, the final goal should be some indication about the expected tumor control or normal tissue complications, which is the primary goal of treatment planning (the association of treatment configurations and dose prescription with the treatment outcome). In this study, this issue is analyzed distinguishing the dose-oriented treatment plan optimization from the response-oriented optimization. Three different dose distributions were obtained by using a dose-based optimization technique, an EUD-based optimization without applying any technique for regularizing the nonuniformity of the dose distribution, and an EUD-based optimization using a variational regularization technique, which controls dose nonuniformity. The clinical effectiveness of the three dose distributions was investigated by calculating the response probabilities of the tumors and organs-at-risk (OARs) involved in two head and neck and prostate cancer cases. The radiobiological models used are the linear-quadratic-Poisson and the Relative Seriality models. Furthermore, the complication-free tumor control probability and the biologically effective uniform dose (D-bar) were used for treatment plan evaluation and comparison. The radiobiological comparison shows that the EUD-based optimization using L-curve regularization gives better results than the EUD-based optimization without regularization and dose-based optimization in both clinical cases. Concluding, it appears that the applied dose nonuniformity regularization technique is expected to improve the effectiveness of the optimized IMRT dose distributions. However, more patient cases are needed to validate the statistical significance of the results and conclusions presented in this paper.

Mavroidis, Panayiotis; Komisopoulos, Georgios; Lind, Bengt K.; Papanikolaou, Nikos [Department of Medical Radiation Physics, Karolinska Institutet and Stockholm University, Sweden and Department of Medical Physics, Larissa University Hospital, Larissa (Greece); Department of Medical Physics, Larissa University Hospital, Larissa (Greece); Department of Medical Radiation Physics, Karolinska Institutet and Stockholm University, Stockholm (Sweden); Department of Medical Physics, Cancer Therapy and Research Center, San Antonio, Texas 78229 (United States)

2008-11-15

88

A view from health services research and outcomes measurement.  

PubMed

Depicted in this presentation is the relationship of the aims of the original articles in this issue--using theory in a substantive way; introducing a strong focus on the organization as a contributor to patient, provider, and system outcomes; accounting for organizational level; and moving the field toward a view of research utilization as an intermediate, not terminal, outcome--to outcomes research in health services generally and in nursing health services research more specifically. The insights and innovations described in this set of articles contribute significantly to the literature on research use in healthcare, specifically including the need to account more fully for organizational structure and hierarchy than has been the case to date in health services outcomes research, as well as a strong intimation that research use is not only an important intervening variable in the causal chain producing outcomes at the patient, provider, and system levels but also a latent or unobservable variable. PMID:17625476

Sales, Anne E

2007-01-01

89

Assessing patient reported outcome measures: A practical guide for gastroenterologists  

PubMed Central

Gastrointestinal illnesses cause physical, emotional and social impact on patients. Patient reported outcome measures (PROMs) are increasingly used in clinical decision-making, clinical research and approval of new therapies. In the last decade, there has been a rapid increase in the number of PROMs in gastroenterology and, therefore, the choice between which of these PROMs to use can be difficult. Not all PROM instruments currently used in research and clinical practice in gastroenterology have gone through a rigorous development methodology. New drugs and therapies will not have access to the market if the PROMs used in their clinical trials are not validated according to the guidelines of the international agencies. Therefore, it is important to know the required properties of PROMs when choosing or evaluating a drug or a clinical intervention. This paper reviews the current literature on how to assess the validity and reliability of PROMs. It summarises the required properties into a practical guide for gastroenterologists to use in assessing an instrument for use in clinical practice or research.

Hutchings, Hayley A; Williams, John G

2014-01-01

90

Comparing measures of multimorbidity to predict outcomes in primary care: a cross sectional study  

PubMed Central

Background. An increasing proportion of people are living with multiple health conditions, or ‘multimorbidity’. Measures of multimorbidity are useful in studies of interventions in primary care to take account of confounding due to differences in case-mix. Objectives. Assess the predictive validity of commonly used measures of multimorbidity in relation to a health outcome (mortality) and a measure of health service utilization (consultation rate). Methods. We included 95372 patients registered on 1 April 2005 at 174 English general practices included in the General Practice Research Database. Using regression models we compared the explanatory power of six measures of multimorbidity: count of chronic diseases from the Quality and Outcomes Framework (QOF); Charlson index; count of prescribed drugs; three measures from the John Hopkins ACG software [Expanded Diagnosis Clusters count (EDCs), Adjusted Clinical Groups (ACGs), Resource Utilisation Bands (RUBs)]. Results. A model containing demographics and GP practice alone explained 22% of the uncertainty in consultation rates. The number of prescribed drugs, ACG category, EDC count, RUB category, QOF disease count, or Charlson index increased this to 42%, 37%, 36%, 35%, 30%, and 26%, respectively. Measures of multimorbidity made little difference to the fit of a model predicting 3-year mortality. Nonetheless, Charlson index score was the best performing measure, followed by the number of prescribed drugs. Conclusion. The number of prescribed drugs is the most powerful measure for predicting future consultations and the second most powerful measure for predicting mortality. It may have potential as a simple proxy measure of multimorbidity in primary care. PMID:23045354

Salisbury, Chris

2013-01-01

91

Results.  

ERIC Educational Resources Information Center

Describes the Collegiate Results Instrument (CRI), which measures a range of collegiate outcomes for alumni 6 years after graduation. The CRI was designed to target alumni from institutions across market segments and assess their values, abilities, work skills, occupations, and pursuit of lifelong learning. (EV)

Zemsky, Robert; Shaman, Susan; Shapiro, Daniel B.

2001-01-01

92

Transforming Course Evaluations into a Meaningful Measure of Student Outcomes Achievement  

ERIC Educational Resources Information Center

Over the past few years, the author had the good fortune to engage many faculty and administrators in conversations about student outcomes assessment. The author has discovered that many faculty and administrators associate course valuations with student outcomes assessment measures. He also found that no items about student learning outcomes are…

McCullough, Christopher A.

2008-01-01

93

Reliability and Validity of Outcome Expectancy-Related Measures in Physical Education  

ERIC Educational Resources Information Center

The purpose of this study was to examine the reliability and validity of outcome likelihood, outcome value, and outcome expectancy using data collected from students in secondary school physical education classes. Dependent measures were examined for construct, concurrent, and predictive validity, as well as internal and temporal reliability. The…

Gao, Zan; Liu, Yuanlong; Lodewyk, Ken; Zhang, Tao; Kosma, Maria

2011-01-01

94

Development of a preliminary diabetes dietary satisfaction and outcomes measure for patients with type 2 diabetes  

Microsoft Academic Search

Adopting dietary lifestyle changes for diabetes management is often difficult for patients; yet the health-related quality of life (HRQOL) outcomes of dietary management for the patient are not extensively developed in the HRQOL assessments now widely used in diabetes research. This study developed a preliminary instrument, the diabetes dietary satisfaction and outcomes measure, to assess outcomes of individuals' experiences in

S. S. Ahlgren; J. A. Shultz; L. K. Massey; B. C. Hicks; C. Wysham

2004-01-01

95

The delay effect on outcome evaluation: results from an event-related potential study  

PubMed Central

Behavioral studies demonstrate that the timing of receiving gains or losses affects decision-making, a phenomenon known as temporal discounting, as participants are inclined to prefer immediate rewards over delayed ones and vice versa for losses. The present study used the event-related potential technique with a simple gambling task to investigate how delayed rewards and losses affected the brain activity in outcome evaluations made by 20 young adults. Statistical analysis revealed a larger feedback-related negativity (FRN) effect between loss and gain following immediate outcomes than following future outcomes. In addition, delay impacted FRN only in gain conditions, with delayed winning eliciting a more negative FRN than immediate winning. These results suggest that temporal discounting and sign effect could be encoded in the FRN in the early stage of outcome evaluation. PMID:24312036

Qu, Chen; Huang, Yunyun; Wang, Yuru; Huang, Yu-Xia

2013-01-01

96

A review of the psychometric properties of the Health of the Nation Outcome Scales (HoNOS) family of measures  

PubMed Central

Background The Health of the Nation Outcome Scales was developed to routinely measure outcomes for adults with mental illness. Comparable instruments were also developed for children and adolescents (the Health of the Nation Outcome Scales for Children and Adolescents) and older people (the Health of the Nation Outcome Scales 65+). All three are being widely used as outcome measures in the United Kingdom, Australia and New Zealand. There is, however, no comprehensive review of these instruments. This paper fills this gap by reviewing the psychometric properties of each. Method Articles and reports relating to the instruments were retrieved, and their findings synthesised to assess the instruments' validity (content, construct, concurrent, predictive), reliability (test-retest, inter-rater), sensitivity to change, and feasibility/utility. Results Mostly, the instruments perform adequately or better on most dimensions, although some of their psychometric properties warrant closer examination. Conclusion Collectively, the Health of the Nation Outcome Scales family of measures can assess outcomes for different groups on a range of mental health-related constructs, and can be regarded as appropriate for routinely monitoring outcomes. PMID:16313678

Pirkis, Jane E; Burgess, Philip M; Kirk, Pia K; Dodson, Sarity; Coombs, Tim J; Williamson, Michelle K

2005-01-01

97

The Australian Palliative Care Outcomes Collaboration (PCOC)--measuring the quality and outcomes of palliative care on a routine basis.  

PubMed

Australia is leading the way in establishing a national system (the Palliative Care Outcomes Collaboration - PCOC) to measure the outcomes and quality of specialist palliative care services and to benchmark services across the country. This article reports on analysis of data collected routinely at point-of-care on 5939 patients treated by the first fifty one services that voluntarily joined PCOC. By March 2009, 111 services have agreed to join PCOC, representing more than 70% of services and more than 80% of specialist palliative care patients nationally. All states and territories are involved in this unique process that has involved extensive consultation and infrastructure and close collaboration between health services and researchers. The challenges of dealing with wide variation in outcomes and practice and the progress achieved to date are described. PCOC is aiming to improve understanding of the reasons for variations in clinical outcomes between specialist palliative care patients and differences in service outcomes as a critical step in an ongoing process to improve both service quality and patient outcomes. PMID:20497731

Eagar, Kathy; Watters, Prue; Currow, David C; Aoun, Samar M; Yates, Patsy

2010-05-01

98

Physician empathy: Definition, outcome-relevance and its measurement in patient care and medical education  

PubMed Central

Objective: The present study gives a brief introduction into the definition of physician empathy (PE) and its influence on patients’ health outcomes. Furthermore we present assessment instruments to measure PE from the perspective of the patient and medical student. The latter topic will be explored in detail as we conducted a pilot study on the German versions of two self-assessment instruments of empathy, which are mostly used in medical education research, namely the “Jefferson Scale of Physician Empathy, Student Version” (JSPE-S) and the “Interpersonal Reactivity Index” (IRI). Methods: We first present an overview of the current empirical and theoretical literature on the definition and outcome-relevance of PE. Additionally, we conducted basic psychometric analyses of the German versions of the JSPE-S and the IRI. Data for this analyses is based on a cross-sectional pilot-survey in N=44 medical students and N=63 students of other disciplines from the University of Cologne. Results: PE includes the understanding of the patient as well as verbal and non-verbal communication, which should result in a helpful therapeutic action of the physician. Patients’ health outcomes in different healthcare settings can be improved considerably from a high quality empathic encounter with their clinician. Basic psychometric results of the German JSPE-S and IRI measures show first promising results. Conclusion: PE as an essential and outcome-relevant element in the patient-physician relationship requires more consideration in the education of medical students and, thus, in medical education research. The German versions of the JSPE-S and IRI measures seem to be promising means to evaluate these education aims and to conduct medical education research on empathy. PMID:22403596

Neumann, Melanie; Scheffer, Christian; Tauschel, Diethard; Lutz, Gabriele; Wirtz, Markus; Edelhauser, Friedrich

2012-01-01

99

Exploring Outcome Measures for Exercise Intervention in People with Parkinson's Disease  

PubMed Central

Background. It is widely believed that exercise improves mobility in people with Parkinson's disease (PD). However, it is difficult to determine whether a specific type of exercise is the most effective. The purpose of this study was to determine which outcome measures were sensitive to exercise intervention and to explore the effects of two different exercise programs for improving mobility in patients with PD. Methods. Participants were randomized into either the Agility Boot Camp (ABC) or treadmill training; 4x/week for 4 weeks. Outcome measures were grouped by the International Classification of Function/Disability (ICF). To determine the responsiveness to exercise, we calculated the standardized response means. t-tests were used to compare the relative benefits of each exercise program. Results. Four of five variables at the structure/function level changed after exercise: turn duration (P = 0.03), stride velocity (P = 0.001), peak arm speed (P = 0.001), and horizontal trunk ROM during gait (P = 0.02). Most measures improved similarly for both interventions. The only variable that detected a difference between groups was postural sway in ABC group (F = 4.95; P = 0.03). Conclusion. Outcome measures at ICF body structure/function level were most effective at detecting change after exercise and revealing differences in improvement between interventions. PMID:23738230

King, L. A.; Salarian, A.; Mancini, M.; Priest, K. C.; Nutt, J.; Serdar, A.; Wilhelm, J.; Schlimgen, J.; Smith, M.; Horak, F. B.

2013-01-01

100

Psychometric validation of patient-reported outcome measures assessing chronic constipation  

PubMed Central

Background Measures assessing treatment outcomes in previous CC clinical trials have not met the requirements described in the US Food and Drug Administration’s guidance on patient-reported outcomes. Aim Psychometric analyses using data from one Phase IIb study and two Phase III trials of linaclotide for the treatment of chronic constipation (CC) were conducted to document the measurement properties of patient-reported CC Symptom Severity Measures. Study methods Each study had a multicenter, randomized, double-blind, placebo-controlled, parallel-group design, comparing placebo to four doses of oral linaclotide taken once daily for 4 weeks in the Phase IIb dose-ranging study (n=307) and to two doses of linaclotide taken once daily for 12 weeks in the Phase III trials (n=1,272). The CC Symptom Severity Measures addressing bowel function (Bowel Movement Frequency, Stool Consistency, Straining) and abdominal symptoms (Bloating, Abdominal Discomfort, Abdominal Pain) were administered daily using interactive voice-response system technology. Intraclass correlations, Pearson correlations, factor analyses, F-tests, and effect sizes were computed. Results The CC Symptom Severity Measures demonstrated satisfactory test–retest reliability and construct validity. Factor analyses indicated one factor for abdominal symptoms and another for bowel symptoms. Known-groups F-tests substantiated the discriminating ability of the CC Symptom Severity Measures. Responsiveness statistics were moderate to strong, indicating that these measures are capable of detecting change. Conclusion In large studies of CC patients, linaclotide significantly improved abdominal and bowel symptoms. These psychometric analyses support the reliability, validity, discriminating ability, and responsiveness of the CC Symptom Severity Measures for evaluating treatment outcomes in the linaclotide clinical studies. PMID:25298737

Nelson, Lauren M; Williams, Valerie SL; Fehnel, Sheri E; Carson, Robyn T; MacDougall, James; Baird, Mollie J; Tourkodimitris, Stavros; Kurtz, Caroline B; Johnston, Jeffrey M

2014-01-01

101

Development of a New Patient-Reported Outcome Measure for Breast Surgery: The BREAST-Q  

Microsoft Academic Search

Background: Measuring patient-reported outcomes has become increasingly important in cosmetic and reconstructive breast surgery. The objective of this study was to develop a new patient-reported outcome measure to assess the unique outcomes of breast surgery patients. Methods: Patientinterviews,focusgroups,expertpanels,andaliteraturereview were used to develop a conceptual framework and a list of questionnaire items. Three procedure-specific questionnaires (augmentation, reduction, and recon- struction) were

Andrea L. Pusic; Anne F. Klassen; Amie M. Scott; Jennifer A. Klok; Peter G. Cordeiro; Stefan J. Cano

2009-01-01

102

Measuring outcomes of midwifery care: development of an instrument to assess optimality  

Microsoft Academic Search

Research on the outcomes of midwifery care is hampered by the lack of appropriate instruments that measure both process and outcomes of care in lower risk women. This article describes an effort to adapt an existing measurement instrument focused on the optimal outcomes of care (The Optimality Index—US) to reflect the contemporary style of U.S.-based nurse-midwifery practice. Evidence for content

Patricia Aikins Murphy; Judith T Fullerton

2001-01-01

103

Predictors of Poor Outcomes After Transcatheter Aortic Valve Replacement: Results from the PARTNER Trial  

PubMed Central

Background Transcatheter Aortic Valve Replacement (TAVR) has emerged as a less invasive option for valve replacement for high-risk patients with severe aortic stenosis. However, not all patients derive a mortality or quality of life (QoL) benefit from TAVR. As such, we sought to build and validate a prediction model to identify patients at high risk for a poor outcome after TAVR, using a novel definition of outcome that integrates QoL with mortality. Methods and Results We examined QoL and mortality outcomes among 2137 patients who underwent TAVR in the PARTNER randomized trial or the associated continued access registry. QoL was assessed using the Overall Summary Scale of the Kansas City Cardiomyopathy Questionnaire (KCCQ-OS, range 0-100; higher=better) at baseline and at 1, 6, and 12 months. A poor 6-month outcome—defined as death, KCCQ-OS <45, or a decrease in KCCQ-OS by ?10 points compared with baseline—occurred in 704 patients (33%). A multivariable model was constructed using a split-sample design to identify a parsimonious set of covariates to identify patients at high-risk for poor outcome. The resulting model demonstrated adequate discrimination (c-index=0.66) and good calibration with the observed data and performed similarly in the separate validation cohort. Based on pre-procedure characteristics alone, the model identified 211 patients (10% of the population) with a ?50% likelihood of a poor outcome after TAVR. These individuals were more likely to have low body weights, low mean aortic valve gradients, oxygen-dependent lung disease, and poor baseline functional and cognitive status. A second model that explored predictors of poor outcome at 1 year identified similar predictors as the original model and was able to identify 1102 patients (52%) with ?50% likelihood and 178 (8%) with ?70% likelihood of a poor 1-year outcome after TAVR Conclusions Using a large, multicenter cohort of patients undergoing TAVR, we have developed and validated predictive models that can identify patients at high-risk for a poor outcome after TAVR. These models may help guide treatment choices and offer patients realistic expectations of outcomes based on their presenting characteristics. PMID:24958751

Arnold, Suzanne V.; Reynolds, Matthew R.; Lei, Yang; Magnuson, Elizabeth A.; Kirtane, Ajay J.; Kodali, Susheel K.; Zajarias, Alan; Thourani, Vinod H.; Green, Philip; Rodes-Cabau, Josep; Beohar, Nirat; Mack, Michael J.; Leon, Martin B.; Cohen, David J.

2014-01-01

104

Typology of Learning Outcomes in Cognitive Domain: What Is Said vs. What Is Measured  

ERIC Educational Resources Information Center

Based on extensive literature review, this study reports the result of a meta analysis of learning outcome studies and presents an integrated typology of content types and learning outcomes. Examining the ERIC database for learning studies conducted from 1992 until 2006 shows that most empirical studies have assessed the learning outcome at lower…

Lim, Doo H.; Yoon, Seung Won; Son, Su Jin; Park, Sunyoung

2007-01-01

105

Measuring Outcomes of United Way-Funded Programs: Expectations and Reality  

ERIC Educational Resources Information Center

In 1996, United Way of America (UWA) developed and began disseminating the most widely used approach to program outcome measurement in the nonprofit sector. Today an estimated 450 local United Ways encourage approximately 19,000 local agencies they fund to measure outcomes. The authors first describe and then assess the strengths and limitations…

Hendricks, Michael; Plantz, Margaret C.; Pritchard, Kathleen J.

2008-01-01

106

RESNA Resource Guide for Assistive Technology Outcomes: Measurement Tools. Volume I.  

ERIC Educational Resources Information Center

This resource guide, the first of three volumes, lays out the fundamentals of outcome measurements for assistive technology. It includes the whys and hows of gathering data so that assistive technology practitioners can integrate outcomes measurement activities in their daily practice. Chapters include: (1) "Concepts and Rationale for…

RESNA: Association for the Advancement of Rehabilitation Technology, Arlington, VA.

107

Evaluating complementary and alternative medicine interventions: in search of appropriate patient-centered outcome measures  

Microsoft Academic Search

BACKGROUND: Central to the development of a sound evidence base for Complementary and Alternative Medicine (CAM) interventions is the need for valid, reliable and relevant outcome measures to assess whether the interventions work. We assessed the specific needs for a database that would cover a wide range of outcomes measures for CAM research and considered a framework for such a

Marja J Verhoef; Laura C Vanderheyden; Trish Dryden; Devon Mallory; Mark A Ware

2006-01-01

108

The Impact of a "Healthy Youth" Learning Community on Student Learning Outcome Measures  

ERIC Educational Resources Information Center

Learning communities are becoming increasingly popular in the quest for enhancing student learning. The purpose of this study is to examine the impact of the "Healthy Youth" Learning Community on student learning outcome measures. In this study, the authors compared student learning outcome measures of students enrolled in those sections of HED…

Butler, Karen L.; Dawkins, Phyllis Worthy

2008-01-01

109

Disability measurements: impact on research results  

Microsoft Academic Search

This article addresses the issue of whether the choice of operational definition of disability in survey research affects findings. Earlier studies have shown that different definitions cause substantial variation in prevalence rates, as well as limited agreement on the classification of subjects as disabled or not disabled. The article addresses whether this leads to differences in research outcomes. The study

Thomas Hugaas Molden; Jan Tøssebro

2011-01-01

110

Measuring Student Satisfaction from the Student Outcomes Survey. Technical Paper  

ERIC Educational Resources Information Center

The Student Outcomes Survey is an annual national survey of vocational education and training (VET) students. Since 1995, participants have been asked to rate their satisfaction with different aspects of their training, grouped under three main themes: teaching, assessment, and generic skills and learning experiences. While the composition of the…

Fieger, Peter

2012-01-01

111

Measuring Learning Outcomes in Higher Education: Motivation Matters  

ERIC Educational Resources Information Center

With the pressing need for accountability in higher education, standardized outcomes assessments have been widely used to evaluate learning and inform policy. However, the critical question on how scores are influenced by students' motivation has been insufficiently addressed. Using random assignment, we administered a multiple-choice test and an…

Liu, Ou Lydia; Bridgeman, Brent; Adler, Rachel M.

2012-01-01

112

Directly measured secondhand smoke exposure and COPD health outcomes  

Microsoft Academic Search

BACKGROUND: Although personal cigarette smoking is the most important cause and modulator of chronic obstructive pulmonary disease (COPD), secondhand smoke (SHS) exposure could influence the course of the disease. Despite the importance of this question, the impact of SHS exposure on COPD health outcomes remains unknown. METHODS: We used data from two waves of a population-based multiwave U.S. cohort study

Mark D Eisner; John Balmes; Edward H Yelin; Patricia P Katz; S Katherine Hammond; Neal Benowitz; Paul D Blanc

2006-01-01

113

Measuring intranodal pressure and lymph viscosity to elucidate mechanisms of arthritic flare and therapeutic outcomes  

PubMed Central

Rheumatoid arthritis (RA) is a chronic autoimmune disease with episodic flares in affected joints, whose etiology is largely unknown. Recent studies in mice demonstrated alterations in lymphatics from affected joints precede flares. Thus, we aimed to develop novel methods for measuring lymph node pressure and lymph viscosity in limbs of mice. Pressure measurements were performed by inserting a glass micropipette connected to a pressure transducer into popliteal lymph nodes (PLN) or axillary lymph nodes (ALN) of mice and determined that the lymphatic pressures were 9 and 12 cm of water, respectively. We are also developing methods for measuring lymph viscosity in lymphatic vessels afferent to PLN, which can be measured by multi-photon fluorescence recovery after photobleaching (MP-FRAP) of FITC-BSA injected into the hind footpad. These results demonstrate the potential of lymph node pressure and lymph viscosity measurements, and warrant future studies to test these outcomes as biomarkers of arthritic flare. PMID:22172039

Bouta, Echoe M.; Wood, Ronald W.; Perry, Seth W.; Brown, Edward; Ritchlin, Christopher T.; Xing, Lianping; Schwarz, Edward M.

2012-01-01

114

The association of self-reported measures with poor training outcomes among male and female U.S. Navy recruits.  

PubMed

This prospective study evaluated the association of self-reported health habits and behaviors in 2,930 Navy recruits with poor training outcomes, defined as graduating late or separating from training. Although 17% of the men and 21% of the women had a poor training outcome, results suggest that some self-reported measures were associated with poor training outcomes. Men who did not run or jog at least 1 month before basic training or had a previous lower limb injury without complete recovery and women reporting the same or less physical activity compared with their same-age counterparts were more likely to have a poor training outcome. An important first step in decreasing poor training outcomes is encouraging incoming recruits to participate in physical activity and taking steps to identify and rehabilitate recruits who are not completely healed from a lower limb musculoskeletal injury before reporting to basic training. PMID:23356118

Trone, Daniel W; Cipriani, Daniel J; Raman, Rema; Wingard, Deborah L; Shaffer, Richard A; Macera, Caroline A

2013-01-01

115

Research Paper: Communication Outcomes of Critical Imaging Results in a Computerized Notification System  

Microsoft Academic Search

ObjectiveCommunication of abnormal test results in the outpatient setting is prone to error. Using information technology can improve communication and improve patient safety. We standardized processes and procedures in a computerized test result notification system and examined their effectiveness to reduce errors in communication of abnormal imaging results.DesignWe prospectively analyzed outcomes of computerized notification of abnormal test results (alerts) that

Hardeep Singh; Harvinder S. Arora; Meena S. Vij; Raghuram Rao; Myrna M. Khan; Laura A. Petersen

2007-01-01

116

Identification of core educational goals and related outcome measures for development of assessment programs in selected schools of allied health.  

PubMed

The purpose of this study was to determine important core educational goals and valid, feasible outcome measures to assess the goals in schools of allied health in academic health centers. The study also attempted to identify potential problems associated with using these outcome measures. The population included all allied health deans in public academic health centers accredited by the Southern Association of Colleges and Schools. Questionnaires with Likert scales were designed to gather opinions utilizing the Delphi technique. Deans identified 13 important core educational goals and 84 outcome measures they perceived to be both valid and feasible to assess these goals. Outcome measures that require collection of highly objective data obtained from student or university records were considered most valid and feasible. Problems included inconsistency in definitions of outcomes, lack of appropriate methodology, and costs associated with developing instruments and collecting data. The results of this study indicate that there are a number of common educational goals and valid feasible outcome measures that schools can select to fit their unique needs, but potential problems must be addressed to ensure full and fair representation of the school's performance. PMID:7721648

McKenzie, S B

1994-01-01

117

Aquarius Third Stokes Parameter Measurements: Initial Results  

NASA Technical Reports Server (NTRS)

The Aquarius/SAC-D observatory was launched on June 10, 2011 and the Aquarius instrument has been collecting data continuously since late August. One of the unique features of the L-band radiometers comprising Aquarius is the presence of a polarimetric channel to measure the third Stokes parameter. The purpose is to provide a measure of Faraday rotation, which can be important for remote sensing at L-band, especially in the case of remote sensing of salinity which requires high precision. Initial results are presented here showing a reasonable agreement between retrieved and modeled Faraday rotation and also the "noisy" behavior at land-water boundaries and other mixed scenes predicted by theory.

Utku, Cuneyt; Vine, David M Le; Abraham, S.; Piepmeier, J.

2012-01-01

118

The ACT College Outcome Measurement Project: A New Tool for Summative Evaluation of Nontraditional Postsecondary Education Programs?  

ERIC Educational Resources Information Center

The American College Testing Program (ACT) developed tests as a result of the College Outcome Measures Project (COMP). These instruments were intended for evaluation of nontraditional and traditional postsecondary education programs. They measure skills rather than information. The study was designed to check on several aspects of use of the COMP…

Ward, Eric F.; Pringle, Robert A.

119

Female College Students' Media Use and Academic Outcomes: Results from a Longitudinal Cohort Study  

PubMed Central

This longitudinal study describes women’s media use during their first year of college and examines associations between media use and academic outcomes. Female students (N = 483, Mage = 18.1 years) reported on their use of 11 media forms and their grade point average, academic behaviors, academic confidence, and problems affecting schoolwork. Allowing for multi-tasking, women reported nearly 12 hours of media use per day; use of texting, music, the Internet, and social networking was heaviest. In general, media use was negatively associated with academic outcomes after controlling for prior academics and demographics. Exceptions were newspaper reading and music listening, which were positively associated with academic outcomes. There were significant indirect effects of magazine reading and social networking on GPA via academic behaviors, confidence, and problems. Results show that female college students are heavy users of new media, and that some forms of media use may adversely impact academic performance. PMID:24505554

Walsh, Jennifer L.; Fielder, Robyn L.; Carey, Kate B.; Carey, Michael P.

2013-01-01

120

Recommendations for the use of common outcome measures in pediatric traumatic brain injury research.  

PubMed

This article addresses the need for age-relevant outcome measures for traumatic brain injury (TBI) research and summarizes the recommendations by the inter-agency Pediatric TBI Outcomes Workgroup. The Pediatric Workgroup's recommendations address primary clinical research objectives including characterizing course of recovery from TBI, prediction of later outcome, measurement of treatment effects, and comparison of outcomes across studies. Consistent with other Common Data Elements (CDE) Workgroups, the Pediatric TBI Outcomes Workgroup adopted the standard three-tier system in its selection of measures. In the first tier, core measures included valid, robust, and widely applicable outcome measures with proven utility in pediatric TBI from each identified domain including academics, adaptive and daily living skills, family and environment, global outcome, health-related quality of life, infant and toddler measures, language and communication, neuropsychological impairment, physical functioning, psychiatric and psychological functioning, recovery of consciousness, social role participation and social competence, social cognition, and TBI-related symptoms. In the second tier, supplemental measures were recommended for consideration in TBI research focusing on specific topics or populations. In the third tier, emerging measures included important instruments currently under development, in the process of validation, or nearing the point of published findings that have significant potential to be superior to measures in the core and supplemental lists and may eventually replace them as evidence for their utility emerges. PMID:21644810

McCauley, Stephen R; Wilde, Elisabeth A; Anderson, Vicki A; Bedell, Gary; Beers, Sue R; Campbell, Thomas F; Chapman, Sandra B; Ewing-Cobbs, Linda; Gerring, Joan P; Gioia, Gerard A; Levin, Harvey S; Michaud, Linda J; Prasad, Mary R; Swaine, Bonnie R; Turkstra, Lyn S; Wade, Shari L; Yeates, Keith O

2012-03-01

121

Developing a Valid Patient-Reported Outcome Measure  

PubMed Central

Many aspects of patients’ experiences with illness, medication, and health care are best captured from patient-reported outcomes (PROs). In this article, we describe the process for constructing quality PRO instruments, from conceptual model development through instrument validation. We also discuss PROs as clinical trial end points and the potential of PRO data for aiding clinicians and patients in choosing from among multiple therapeutic options. Finally, we provide an overview of some existing PRO instruments. PMID:21975345

Rothrock, NE; Kaiser, KA; Cella, D

2013-01-01

122

Responsiveness of Health-Related Quality of Life Outcome Measures in Cardiac Rehabilitation: Comparison of Cardiac Rehabilitation Outcome Measures  

ERIC Educational Resources Information Center

Assessment instruments that are not responsive to change are unsuitable as outcome tools in cardiac rehabilitation because they underestimate the psychosocial benefits of program attendance. Nine questionnaires were assessed for responsiveness with the standardized response mean (SRM). Questionnaires were allocated into 3 batteries, and each…

Hevey, David; McGee, Hannah M.; Horgan, John

2004-01-01

123

Comparison of ASSESS neutralization module results with actual small force engagement outcomes  

SciTech Connect

The ASSESS Neutralization module (Neutralization) is part of the Analytic System and Software for Evaluation of Safeguards and Security (ASSESS), a vulnerability assessment tool. Neutralization models a fire fight between security inspectors (SIs) and adversaries. This paper reports that a comparison has been made between actual outcomes of police and small military engagements and the results predicted by the Neutralization module for similar scenarios. The results of this comparison show a surprising correlation between predicted outcomes (based on numbers of combatants, weapon types, and exposures, etc.) and the actual outcomes of the engagements analyzed. The importance of this analysis is that given the defenders have intelligence on actual adversary characteristics or are protecting against a design basis threat, defense capabilities can be evaluated before an engagement. Results could then be used to develop a favorable probability of a desired outcome. For example, law enforcement agencies are frequently able to compile the number of criminals, types of weaponry, willingness to use force, etc., from analysis of crime scenes.

Gardner, B.H.; Snell, M.K.; Paulus, W.K. (Sandia National Labs., Albuquerque, NM (United States))

1991-01-01

124

Quality of life measurement and outcome in aphasia  

PubMed Central

Background Quality of life (QL) can be defined as the individual’s perception of their own well-being. Aphasia is the most important potential consequence of stroke and has a profound effect on a patient’s life, causing emotional distress, depression, and social isolation, due to loss of language functions. Aims To draw up a QL questionnaire for aphasics (QLQA) focusing particularly on difficulties in interpersonal relationships and on the loss of independence as a result of language disorders. We reported the results of a psychometric evaluation of this measure. Moreover, we experimentally focused on the differences in QLQA between patients affected only by neurological motor impairment and hemiparetic patients with aphasia (PWA) in order to verify the specific role of aphasia on QL. We also explored if the QLQA is sensitive to the severity of aphasia and to the time elapsing from the stroke. Methods A total of 146 consecutive PWA and 37 control subjects were enrolled to evaluate the reliability (internal consistency and test–retest reliability) and validity of the QLQA, using standard psychometric methods. Patients were divided into acute (within 3 months since stroke) and chronic (beyond 3 months) groups, and into mild and severe according to the severity of aphasia. The experimental group of only acute PWA was compared to control subjects, with right hemispherical lesion and without aphasia in QLQA total and partial scores. Results The QLQA had good internal consistency and test–retest reliability. Acute and chronic PWA and mild and severe ones differed in QLQA total, communication, and autonomy subscales. No differences were found in psychological condition. Between aphasic and control patients, significant differences were found in all QLQA subscales. Conclusion The QLQA is a valid measure of QL in PWA, contributing to a better distinction between severe and mild aphasia, and it is sensitive also to the variations in QL depending on the time interval from stroke. PMID:24368886

Spaccavento, Simona; Craca, Angela; Del Prete, Marina; Falcone, Rosanna; Colucci, Antonia; Di Palma, Angela; Loverre, Anna

2014-01-01

125

Novel methods of measuring clinical outcomes from psoriasis and psoriatic arthritis clinical trials.  

PubMed

Numerous instruments exist that measure the clinical and health related quality of life impact of psoriasis and psoriatic arthritis (PsA) in clinical trials. However, many of these instruments are not typically used in economic evaluations to inform decision problems facing health care decision makers. This study reviews the current state of psoriasis and PsA health outcome measures and evaluates their limitations in cost-effectiveness analyses (CEAs). We highlight the health related quality of life and clinical outcome measures that are typically used in CEAs, with special focus on studies with quality adjusted life years as a primary outcome measure. Despite the high prevalence of psoriasis and PsA health outcome measures in clinical trials, only a few are used in CEAs. The methods by which utilities are estimated from these measures vary across cost-effectiveness studies. These differences should be considered when conducting cost-effectiveness research in psoriasis and PsA. PMID:24820676

Villacorta, Reginald; Hay, Joel W; Messali, Andrew

2014-08-01

126

Outcome-driven thresholds for home blood pressure measurement: international database of home blood pressure in relation to cardiovascular outcome.  

PubMed

The lack of outcome-driven operational thresholds limits the clinical application of home blood pressure (BP) measurement. Our objective was to determine an outcome-driven reference frame for home BP measurement. We measured home and clinic BP in 6470 participants (mean age, 59.3 years; 56.9% women; 22.4% on antihypertensive treatment) recruited in Ohasama, Japan (n=2520); Montevideo, Uruguay (n=399); Tsurugaya, Japan (n=811); Didima, Greece (n=665); and nationwide in Finland (n=2075). In multivariable-adjusted analyses of individual subject data, we determined home BP thresholds, which yielded 10-year cardiovascular risks similar to those associated with stages 1 (120/80 mm Hg) and 2 (130/85 mm Hg) prehypertension, and stages 1 (140/90 mm Hg) and 2 (160/100 mm Hg) hypertension on clinic measurement. During 8.3 years of follow-up (median), 716 cardiovascular end points, 294 cardiovascular deaths, 393 strokes, and 336 cardiac events occurred in the whole cohort; in untreated participants these numbers were 414, 158, 225, and 194, respectively. In the whole cohort, outcome-driven systolic/diastolic thresholds for the home BP corresponding with stages 1 and 2 prehypertension and stages 1 and 2 hypertension were 121.4/77.7, 127.4/79.9, 133.4/82.2, and 145.4/86.8 mm Hg; in 5018 untreated participants, these thresholds were 118.5/76.9, 125.2/79.7, 131.9/82.4, and 145.3/87.9 mm Hg, respectively. Rounded thresholds for stages 1 and 2 prehypertension and stages 1 and 2 hypertension amounted to 120/75, 125/80, 130/85, and 145/90 mm Hg, respectively. Population-based outcome-driven thresholds for home BP are slightly lower than those currently proposed in hypertension guidelines. Our current findings could inform guidelines and help clinicians in diagnosing and managing patients. PMID:23129700

Niiranen, Teemu J; Asayama, Kei; Thijs, Lutgarde; Johansson, Jouni K; Ohkubo, Takayoshi; Kikuya, Masahiro; Boggia, José; Hozawa, Atsushi; Sandoya, Edgardo; Stergiou, George S; Tsuji, Ichiro; Jula, Antti M; Imai, Yutaka; Staessen, Jan A

2013-01-01

127

Adult experience of mental health outcomes as a result of intimate partner violence victimisation: a systematic review  

PubMed Central

Background Intimate partner violence (IPV) has been known to adversely affect the mental health of victims. Research has tended to focus on the mental health impact of physical violence rather than considering other forms of violence. Objective To systematically review the literature in order to identify the impact of all types of IPV victimisation on various mental health outcomes. Method A systematic review of 11 electronic databases (2004–2014) was conducted. Fifty eight papers were identified and later described and reviewed in relation to the main objective. Results Main findings suggest that IPV can have increasing adverse effects on the mental health of victims in comparison with those who have never experienced IPV or those experiencing other traumatic events. The most significant outcomes were associations between IPV experiences with depression, posttraumatic stress disorder, and anxiety. Findings confirm previous observations that the severity and extent of IPV exposure can increase mental health symptoms. The effect of psychological violence on mental health is more prominent than originally thought. Individual differences such as gender and childhood experience of violence also increase IPV risk and affect mental health outcomes in diverse ways. Conclusions Psychological violence should be considered as a more serious form of IPV which can affect the mental health of victims. Experiencing more than one form of IPV can increase severity of outcomes. Researchers should look at IPV as a multi-dimensional experience. A uniformed definition and measure of IPV could help advance knowledge and understanding of this disparaging global issue. PMID:25279103

Lagdon, Susan; Armour, Cherie; Stringer, Maurice

2014-01-01

128

Measuring Outcome in Traumatic Brain Injury Treatment Trials: Recommendations From the Traumatic Brain Injury Clinical Trials Network  

PubMed Central

Background Traumatic brain injury (TBI) involves several aspects of a patient’s condition, including physical, mental, emotional, cognitive, social, and functional changes. Therefore, a clinical trial with individuals with TBI should consider outcome measures that reflect their global status. Methods We present the work of the National Institute of Child Health and Development–sponsored Traumatic Brain Injury Clinical Trials Network Outcome Measures subcommittee and its choice of outcome measures for a phase III clinical trial of patients with complicated mild to severe TBI. Results On the basis of theoretical and practical considerations, the subcommittee recommended the adoption of a core of 9 measures that cover 2 different areas of recovery: functional and cognitive. These measures are the Extended Glasgow Outcome Scale; the Controlled Oral Word Association Test; the Trail Making Test, Parts A and B; the California Verbal Learning Test–II; the Wechsler Adult Intelligence Scale–III Digit Span subtest; the Wechsler Adult Intelligence Scale–III Processing Speed Index; and the Stroop Color-Word Matching Test, Parts 1 and 2. Conclusions The statistical methods proposed to analyze these measures using a global test procedure, along with research and methodological and regulatory issues involved with the use of multiple outcomes in a clinical trial, are discussed. PMID:20216459

Bagiella, Emilia; Novack, Thomas A.; Ansel, Beth; Diaz-Arrastia, Ramon; Dikmen, Sureyya; Hart, Tessa; Temkin, Nancy

2010-01-01

129

The Effect of Donor Age on Corneal Transplantation Outcome: Results of the Cornea Donor Study  

PubMed Central

Objective To determine whether graft survival over a 5-year follow-up period using corneal tissue from donors older than 65 years of age is similar to graft survival using corneas from younger donors. Design Multi-center prospective, double-masked, controlled clinical trial Participants 1090 subjects undergoing corneal transplantation for a moderate risk condition (principally Fuchs’ dystrophy or pseudophakic corneal edema); 11 subjects with ineligible diagnoses were not included Methods 43 participating eye banks provided corneas from donors in the age range of 12 to 75 with endothelial cell densities of 2300 to 3300 cells/mm2, using a random approach without respect to recipient factors. The 105 participating surgeons at 80 sites were masked to information about the donor cornea including donor age. Surgery and post-operative care were performed according to the surgeons’ usual routines. Subjects were followed for five years. Main Outcome Measures Graft failure, defined as a regraft or a cloudy cornea that was sufficiently opaque as to compromise vision for a minimum of three consecutive months. Results The 5-year cumulative probability of graft survival was 86% in both the <66.0 donor age group and the ?66.0 donor age group (difference = 0%, upper limit of one-sided 95% confidence interval = 4%). In a statistical model with donor age as a continuous variable, there was not a significant relationship between donor age and outcome (P=0.11). Three graft failures were due to primary donor failure, 8 to uncorrectable refractive error, 48 to graft rejection, 46 to endothelial decompensation (23 of which had a prior, resolved episode of probable or definite graft rejection), and 30 to other causes. The distribution of the causes of graft failure did not differ between donor age groups. Conclusions Five-year graft survival for cornea transplants at moderate risk for failure is similar using corneas from donors ? 66.0 years and donors < 66.0 years. Surgeons and patients now have evidence that corneas comparable in quality to those used in this study from donors through age 75 years are suitable for transplantation. PMID:18387407

2009-01-01

130

Measuring communicative participation using the FOCUS©1: Focus on the Outcomes of Communication Under Six  

PubMed Central

Background The FOCUS© is a new outcome tool for use by both parents and clinicians that measures changes in the communicative participation skills of preschool children. Changes in communicative participation skills as measured by the FOCUS were compared across three groups of children: those with speech impairments only (SI), those with language impairments only (LI) and those with both speech and language impairments (S/LI). Methods Participating families (n = 112, 75 male children) were recruited through 13 Canadian organizations. Children ranged from 10 months to 6 years 0 months (mean = 2.11 years; SD = 1.18 years) and attended speech-language intervention. Parents completed the FOCUS at the start and end of treatment. There were 23 children in the SI group, 62 children in the LI group and 27 children in the S/LI group. The average amount of the children's therapy varied from 7 to 10 h. Results The FOCUS captures changes in communicative participation for children with a range of communication disorder types and severities. All three groups of children made clinically important improvements according to their FOCUS scores (MCID ? 16 points). The FOCUS captured improvements in intelligibility, independent communication, play and socialization. Conclusions The FOCUS measured positive changes in communicative participation skills for all three groups of children after 7–10 h of speech-language therapy. An outcome measure that targets only specific speech and language skills would miss many of the important social function changes associated with speech-language treatment. PMID:23763248

Thomas-Stonell, N; Washington, K; Oddson, B; Robertson, B; Rosenbaum, P

2013-01-01

131

Validity and reliability of Patient-Reported Outcomes Measurement Information System (PROMIS) Instruments in Osteoarthritis  

PubMed Central

Objective Evaluation of known group validity, ecological validity, and test-retest reliability of four domain instruments from the Patient Reported Outcomes Measurement System (PROMIS) in osteoarthritis (OA) patients. Methods Recruitment of an osteoarthritis sample and a comparison general population (GP) through an Internet survey panel. Pain intensity, pain interference, physical functioning, and fatigue were assessed for 4 consecutive weeks with PROMIS short forms on a daily basis and compared with same-domain Computer Adaptive Test (CAT) instruments that use a 7-day recall. Known group validity (comparison of OA and GP), ecological validity (comparison of aggregated daily measures with CATs), and test-retest reliability were evaluated. Results The recruited samples matched (age, sex, race, ethnicity) the demographic characteristics of the U.S. sample for arthritis and the 2009 Census for the GP. Compliance with repeated measurements was excellent: > 95%. Known group validity for CATs was demonstrated with large effect sizes (pain intensity: 1.42, pain interference: 1.25, and fatigue: .85). Ecological validity was also established through high correlations between aggregated daily measures and weekly CATs (? .86). Test-retest validity (7-day) was very good (? .80). Conclusion PROMIS CAT instruments demonstrated known group and ecological validity in a comparison of osteoarthritis patients with a general population sample. Adequate test-retest reliability was also observed. These data provide encouraging initial data on the utility of these PROMIS instruments for clinical and research outcomes in osteoarthritis patients. PMID:23592494

Broderick, Joan E.; Schneider, Stefan; Junghaenel, Doerte U.; Schwartz, Joseph E.; Stone, Arthur A.

2013-01-01

132

Multiple Measures of Outcome in Assessing a Prison-Based Drug Treatment Program  

ERIC Educational Resources Information Center

Evaluations of prison-based drug treatment programs typically focus on one or two dichotomous outcome variables related to recidivism. In contrast, this paper uses multiple measures of outcomes related to crime and drug use to examine the impact of prison treatment. Crime variables included self-report data of time to first illegal activity,…

Prendergast, Michael L.; Hall, Elizabeth A.; Wexler, Harry K.

2003-01-01

133

Longitudinal imaging studies in schizophrenia: the relationship between brain morphology and outcome measures.  

PubMed

Imaging studies have tried to identify morphological outcome measures of schizophrenia in the last two decades. In particular, longitudinal studies have reported a correlation between larger ventricles, decreased prefrontal volumes and worse outcome. This would potentially allow to isolate subtypes of schizophrenia patients with a worse prognosis and more evident biological impairments, ultimately helping in designing specific rehabilitation interventions. PMID:21261215

Bellani, Marcella; Dusi, Nicola; Brambilla, Paolo

2010-01-01

134

The National Outcomes Measurement System for Pediatric Speech-Language Pathology  

ERIC Educational Resources Information Center

Purpose: The American Speech-Language-Hearing Association's (ASHA's) National Outcomes Measurement System (NOMS) was developed in the late 1990s. The primary purpose was to serve as a source of data for speech-language pathologists (SLPs) who found themselves called on to provide empirical evidence of the functional outcomes associated with their…

Mullen, Robert; Schooling, Tracy

2010-01-01

135

The Menopause Rating Scale (MRS) as outcome measure for hormone treatment? A validation study  

PubMed Central

Background The Menopause Rating Scale is a health-related Quality of Life scale developed in the early 1990s and step-by-step validated since then. No methodologically detailed work on the utility of the scale to assess health-related changes after treatment was published before. Method We analysed an open, uncontrolled post-marketing study with over 9000 women with pre- and post-treatment data of the MRS scale to critically evaluate the capacity of the scale to measure the health-related effects of hormone treatment independent from the severity of complaints at baseline. Results The improvement of complaints during treatment relative to the baseline score was 36% in average. Patients with little/no complaints before therapy improved by 11%, those with mild complaints at entry by 32%, with moderate by 44%, and with severe symptoms by 55% – compared with the baseline score. We showed that the distribution of complaints in women before therapy returned to norm values after 6 months of hormone treatment. We also provided weak evidence that the MRS results may well predict the assessment of the treating physician. Limitations of the study, however, may have lead to overestimating the utility of the MRS scale as outcome measure. Conclusion The MRS scale showed some evidence for its ability to measure treatment effects on quality of life across the full range of severity of complaints in aging women. This however needs confirmation in other and better-designed clinical/outcome studies. PMID:15555079

Heinemann, Lothar AJ; DoMinh, Thai; Strelow, Frank; Gerbsch, Silvia; Schnitker, Jörg; Schneider, Hermann PG

2004-01-01

136

Gender Disparities in HIV Treatment Outcomes Following Release From Jail: Results From a Multicenter Study  

PubMed Central

Objectives We assessed gender differences in longitudinal HIV treatment outcomes among HIV-infected jail detainees transitioning to the community. Methods Data were from the largest multisite prospective cohort study of HIV-infected released jail detainees (n = 1270)—the Enhancing Linkages to HIV Primary Care and Services in Jail Setting Initiative, January 2008 and March 2011, which had 10 sites in 9 states. We assessed baseline and 6-month HIV treatment outcomes, stratifying by gender. Results Of 867 evaluable participants, 277 (31.9%) were women. Compared with men, women were more likely to be younger, non-Hispanic White, married, homeless, and depressed, but were similar in recent alcohol and heroin use. By 6 months postrelease, women were significantly less likely than men to experience optimal HIV treatment outcomes, including (1) retention in care (50% vs 63%), (2) antiretroviral therapy prescription (39% vs 58%) or optimal antiretro-viral therapy adherence (28% vs 44%), and (3) viral suppression (18% vs 30%). In multiple logistic regression models, women were half as likely as men to achieve viral suppression. Conclusions HIV-infected women transitioning from jail experience greater comorbidity and worse HIV treatment outcomes than men. Future interventions that transition people from jail to community-based HIV clinical care should be gender-specific. PMID:24432878

Meyer, Jaimie P.; Zelenev, Alexei; Wickersham, Jeffrey A.; Williams, Chyvette T.; Teixeira, Paul A.; Altice, Frederick L.

2014-01-01

137

A 'learning platform' approach to outcome measurement in fragile X syndrome: a preliminary psychometric study  

PubMed Central

Background Clinical trials of medications to alleviate the cognitive and behavioural symptoms of individuals with fragile X syndrome (FXS) are now underway. However, there are few reliable, valid and/or sensitive outcome measures available that can be directly administered to individuals with FXS. The majority of assessments employed in clinical trials may be suboptimal for individuals with intellectual disability (ID) because they require face-to-face interaction with an examiner, taxing administration periods, and do not provide reinforcement and/or feedback during the test. We therefore examined the psychometric properties of a new computerised ‘learning platform’ approach to outcome measurement in FXS. Method A brief computerised test, incorporated into the Discrete Trial Trainer© – a commercially available software program designed for children with ID – was administered to 13 girls with FXS, 12 boys with FXS and 15 matched ID controls aged 10 to 23 years (mental age = 4 to 12 years). The software delivered automated contingent access to reinforcement, feedback, token delivery and prompting procedures (if necessary) on each trial to facilitate responding. The primary outcome measure was the participant’s learning rate, derived from the participant’s cumulative record of correct responses. Results All participants were able to complete the test and floor effects appeared to be minimal. Learning rates averaged approximately five correct responses per minute, ranging from one to eight correct responses per minute in each group. Test–retest reliability of the learning rates was 0.77 for girls with FXS, 0.90 for boys with FXS and 0.90 for matched ID controls. Concurrent validity with raw scores obtained on the Arithmetic subtest of the Wechsler Intelligence Scale for Children-III was 0.35 for girls with FXS, 0.80 for boys with FXS and 0.56 for matched ID controls. The learning rates were also highly sensitive to change, with effect sizes of 1.21, 0.89 and 1.47 in each group respectively following 15 to 20, 15-min sessions of intensive discrete trial training conducted over 1.5 days. Conclusions These results suggest that a learning platform approach to outcome measurement could provide investigators with a reliable, valid and highly sensitive measure to evaluate treatment efficacy, not only for individuals with FXS but also for individuals with other ID. PMID:22533667

Hall, S. S.; Hammond, J. L.; Hirt, M.; Reiss, A. L.

2012-01-01

138

A systematic review of ‘knowledge of dementia’ outcome measures  

Microsoft Academic Search

Knowledge of dementia measures are key to identifying areas of misinformation and establishing knowledge levels, thus guiding educational programmes and interventions.A three-step literature search was undertaken to identify measures of knowledge in dementia. An evaluation framework was employed articulating quality indicators for the psychometric properties of measures, based on their development and use within research studies.Five measures were identified: the

Aimee Spector; Martin Orrell; Astrid Schepers; Niamh Shanahan

139

Predictors of early poor aesthetic outcome after breast-conserving surgery in patients with breast cancer: Initial results of a prospective cohort study at a single institution.  

PubMed

Background and objectives The aim of this study was to explore features of patients reporting early poor aesthetic outcome after simple breast-conserving surgery. Methods We prospectively evaluated 709 patients shortly after breast-conserving surgery. Aesthetic outcome was measured by aesthetic status scores of the Breast Cancer Treatment Outcome Scale. Clinical, surgical, and pathologic variables were assessed to identify predictors of poor aesthetic outcome. Results Poor aesthetic outcome was reported by 46 (6.5%) patients, and 209 (29%) patients reported an intermediate aesthetic outcome. A single factor analysis of variance showed a negative impact of higher specimen weight (P?outcome: 12 o'clock positioning of tumor localization, a tumor behind the nipple areolar complex (NAC), fishmouth-shaped incision with resection of the NAC, quadrantectomy, central segmental resection, and pT stages 3 and 4. Multivariate logistic regression analysis indicated statistically independent associations between poor aesthetic outcome and tumor position in the inner half of the breast or behind the NAC, quadrantectomy, and pT stages 3 and 4. Conclusion Poor aesthetic outcome is relatively rare shortly after breast-conserving surgery, but predictable in specific situations. J. Surg. Oncol. 2014 110:801-806. © 2014 Wiley Periodicals, Inc. PMID:25132148

Foersterling, Eva; Golatta, Michael; Hennigs, Andre; Schulz, Sophie; Rauch, Geraldine; Schott, Sarah; Domschke, Christoph; Schuetz, Florian; Sohn, Christof; Heil, Joerg

2014-12-01

140

Psychometric investigation of a brief measure of outcomes in children's mental health.  

PubMed

The current investigation sought to provide reliability and validity evidence for the Child Outcomes Survey (COS), a brief measure designed with a dual purpose to measure functioning and therapeutic relationship and to serve as a clinician-caregiver communication tool. Exploratory (EFA) and confirmatory factor analyses (CFA) were performed using a sample of 774 responses collected from 15 provider sites throughout the state of Pennsylvania. Results of the EFA (n = 387) uncovered a three factor structure (family functioning, child functioning, and therapeutic relationship) which was confirmed in the CFA (n = 387). The internal consistency reliability of the three subscales ranged from ? = .76 to ? = .91. There was a significant relationship between the therapeutic relationship subscale and the use of the COS as a communication aid (r s = .50, p < .001). Findings support the COS as an accurate measure of functioning and therapeutic relationship and its utility as a communication aid between clinician and caregiver. PMID:23748555

Terhorst, Lauren; Hutchison, Shari L; Sorbero, Mark J; Mitchell, Ann M; Dogin, Judith W; Stein, Bradley D

2014-02-01

141

Outcome measures of behavioral weight loss programs in perimenopause.  

PubMed

Obesity and being overweight are associated with many comorbid conditions and are major contributing factors to cardiovascular disease. The increased proportion of overweight and obese people in Western societies has been attributed largely to behaviors that include sedentary lifestyle and dietary excess. Women are at particular risk during perimenopause, when hormones change and metabolism slows. The purpose of this review was to examine published studies of weight loss programs for perimenopausal women using behavioral change strategies of diet alone, regular physical activity alone, or both in combination to determine the range of potential outcomes and reduction of cardiovascular risks. Based on the findings from this review, practice applications and recommendations for future research are proposed. PMID:25084185

Zargarian, Naira; Lindquist, Ruth; Gross, Cynthia R; Treat-Jacobson, Diane

2014-08-01

142

Results and analysis of the GLONASS measurements  

NASA Astrophysics Data System (ADS)

With the purpose of improving the national geodetic reference frame an establishment of the new Fundamental Astro-Geodetic network (FAGN), based mainly on the combined use of GPS and GLONASS measurements, is now carried out in Russia. From the geodetic point of view, the advantages of combining both systems are numerous, especially in the urban, mountain and near polar areas. More than 30 permanent core sites of this network are provided with the dual GPS/GLONASS receivers. Several core sites of the FAGN network are collocated with the existing IERS stations, equipped with the SLR, VLBI and DORIS instruments. Now the constellation of the GLONASS consists of 24 satellites at three orbital planes, 8 satellites in each. Inclination of the orbit is 64.80, height 19100 km and revolution time 11h 15min. Analysis of the GLONASS data, obtained at the IGS sites, including most of the Russian sites, have been made with the use of GIPSY-OASIS 2 software. Results of estimation of GLONASS orbital parameters and station coordinates were compared with the GPS estimations at the collocated sites. Both solutions are related to the ITRF2005 coordinate system. Differences between solutions are in the limit of a few cm. The means of improvement of the GLONASS solution and adjustment of the GLONASS coordinate system with the ITRF are considered.

Suriya, Tatevyan

2012-07-01

143

Conservation Covenants on Private Land: Issues with Measuring and Achieving Biodiversity Outcomes in Australia  

NASA Astrophysics Data System (ADS)

Conservation covenants and easements have become essential tools to secure biodiversity outcomes on private land, and to assist in meeting international protection targets. In Australia, the number and spatial area of conservation covenants has grown significantly in the past decade. Yet there has been little research or detailed policy analysis of conservation covenanting in Australia. We sought to determine how conservation covenanting agencies were measuring the biodiversity conservation outcomes achieved on covenanted properties, and factors inhibiting or contributing to measuring these outcomes. In addition, we also investigated the drivers and constraints associated with actually delivering the biodiversity outcomes, drawing on detailed input from covenanting programs. Although all conservation covenanting programs had the broad aim of maintaining or improving biodiversity in their covenants in the long term, the specific stated objectives of conservation covenanting programs varied. Programs undertook monitoring and evaluation in different ways and at different spatial and temporal scales. Thus, it was difficult to determine the extent Australian conservation covenanting agencies were measuring the biodiversity conservation outcomes achieved on covenanted properties on a national scale. Lack of time available to covenantors to undertake management was one of the biggest impediments to achieving biodiversity conservation outcomes. A lack of financial resources and human capital to monitor, knowing what to monitor, inconsistent monitoring methodologies, a lack of benchmark data, and length of time to achieve outcomes were all considered potential barriers to monitoring the biodiversity conservation outcomes of conservation covenants.

Fitzsimons, James A.; Carr, C. Ben

2014-09-01

144

The difficulties of making 'CPD verifiability' a legitimate measure of learning outcomes.  

PubMed

This article offers further thoughts and raises wider issues in the continuing debate over the value of current CPD programmes and the way in which they are measured in terms of input rather than learning outcomes benefiting patients. PMID:23099689

Kelleher, M

2012-10-01

145

Results and Outcome Reporting In ClinicalTrials.gov, What Makes it Happen?  

PubMed Central

Background At the end of the past century there were multiple concerns regarding lack of transparency in the conduct of clinical trials as well as some ethical and scientific issues affecting the trials’ design and reporting. In 2000 ClinicalTrials.gov data repository was developed and deployed to serve public and scientific communities with valid data on clinical trials. Later in order to increase deposited data completeness and transparency of medical research a set of restrains had been imposed making the results deposition compulsory for multiple cases. Methods We investigated efficiency of the results deposition and outcome reporting as well as what factors make positive impact on providing information of interest and what makes it more difficult, whether efficiency depends on what kind of institution was a trial sponsor. Data from the ClinicalTrials.gov repository has been classified based on what kind of institution a trial sponsor was. The odds ratio was calculated for results and outcome reporting by different sponsors’ class. Results As of 01/01/2012 118,602 clinical trials data deposits were made to the depository. They came from 9068 different sources. 35344 (29.8%) of them are assigned as FDA regulated and 25151 (21.2%) as Section 801 controlled substances. Despite multiple regulatory requirements, only about 35% of trials had clinical study results deposited, the maximum 55.56% of trials with the results, was observed for trials completed in 2008. Conclusions The most positive impact on depositing results, the imposed restrains made for hospitals and clinics. Health care companies showed much higher efficiency than other investigated classes both in higher fraction of trials with results and in providing at least one outcome for their trials. They also more often than others deposit results when it is not strictly required, particularly, in the case of non-interventional studies. PMID:22719853

Kirillova, Olga

2012-01-01

146

Methodological issues in evaluating measures of health as outcomes for COPD.  

PubMed

The selection of an appropriate outcome measure depends on the aspect of the disease being addressed and the purpose of the study being conducted. The most fundamental property of any outcome is its ability to measure the biological variable under question. Other properties such as discriminative and evaluative abilities are also important. Specific outcomes measure a single biological variable, such as forced expiratory volume in one second or depression. The specificity of such measures is attractive but requires precise definition of what is being measured and why. Other, summative, outcomes are used to quantify the overall effect of a number of different biological processes. The simplest summative measures are global questions such as "How would you rate your health overall?" Others are complex with many items. If designed and used correctly, these questionnaires can provide an estimate of the overall impact of disease or response to therapy and an index of whether that response was clinically worthwhile. Standardisation of measurements is important to permit comparisons between patients and studies, which makes the measurement of an individual's "quality of life" difficult. The term "health-status measurement" may be better when referring to the use of standardised questionnaires. Utility-based measures help address concerns regarding clinical versus statistical improvement and place outcomes for chronic obstructive pulmonary disease treatment trials in the context of all healthcare treatments. PMID:12795327

Jones, P W; Kaplan, R M

2003-06-01

147

Surgical Outcomes after Breast Cancer Surgery: Measuring Acute Lymphedema  

Microsoft Academic Search

Background. Studies of lymphedema have used inconsistent measures and criteria. The purpose of this pilot study was to measure the onset and incidence of acute lymphedema in breast cancer survivors using strict criteria for limb evaluation.Materials and Methods. Eligible women were those undergoing breast cancer surgery that included axillary staging and\\/or radiation therapy of the breast. Arm volume, strength, and

Mary Ann Kosir; Christine Rymal; Prathima Koppolu; Lynn Hryniuk; Linda Darga; Wei Du; Virginia Rice; Darlene Mood; Shakeela Shakoor; Wenlian Wang; Jirair Bedoyan; Amr Aref; Laura Biernat; Laurel Northouse

2001-01-01

148

A European consensus on outcome measures for psychosocial intervention research in dementia care  

Microsoft Academic Search

Psychosocial intervention makes a vital contribution to dementia care. However, the lack of consensus about which outcome measures to use to evaluate effectiveness prevents meaningful comparisons between different studies and interventions. This study used an iterative collaborative, evidence-based approach to identify the best of currently available outcome measures for European psychosocial intervention research. This included consensus workshops, a web-based pan-European

E. Moniz-Cook; M. J. F. J. Vernooy-Dassen; R. Woods; F. Verhey; R. Chattat; M. DE Vugt; M. O’connell; J. Harrison; E. Vasse; R. M. Dröes

2008-01-01

149

Establishing outcome measures for shared care in the treatment of depression.  

PubMed

Collaborative care between general practitioners and mental health specialists has been shown to improve the care of patients with depression in primary care and may be an important development in mental health services. Outcome measures are becoming increasingly important in psychiatry as we attempt to alter and improve the structure of services. In this article we propose a series of outcome measures that can be used to measure the effectiveness of shared care for patients with depression including objective measures of improvement in psychopathology and subjective measures of patient and professional experience. PMID:23995196

Hopwood, Jenny; Agius, Mark

2013-09-01

150

Treatment of mental slowness: How to evaluate treatment effects. A systematic review of outcome measures  

Microsoft Academic Search

Brain-damaged patients with slow mental processes may be taught compensatory strategies that might enable them to minimise disabilities and participation problems in daily life. The effects of the application of compensatory strategies should be measured in these domains of functioning. We systematically reviewed existing outcome measures used to evaluate the consequences of mental slowness. We classified measures into four categories:

Ieke Winkens; Caroline M. Van Heugten; Luciano Fasotti; Derick T. Wade

2011-01-01

151

A Review of Selected Patient-Generated Outcome Measures and Their Application in Clinical Trials  

Microsoft Academic Search

BackgroundPatient-generated outcome measures have been developed in an effort to capture the individualistic nature of health-related quality of life (HRQoL). These measures differ from traditional HRQoL instruments in that they allow patients to individually define HRQoL domains or weights. Nevertheless, application of these measures may be challenging, particularly in a clinical trial setting.

Kavita K. Patel; David L. Veenstra; Donald L. Patrick

2003-01-01

152

Core outcome measures for opioid abuse liability laboratory assessment studies in humans: IMMPACT recommendations  

PubMed Central

A critical component in development of opioid analgesics is assessment of their abuse liability (AL). Standardization of approaches and measures used in assessing AL has the potential to facilitate comparisons across studies, research laboratories, and drugs. The goal of this report is to provide consensus recommendations regarding core outcome measures for assessing abuse potential of opioid medications in humans in a controlled laboratory setting. Although many of the recommended measures are appropriate for assessing the AL of medications from other drug classes, the focus here is on opioid medications because they present unique risks from both physiological (e.g., respiratory depression, physical dependence) and public health (e.g., individuals in pain) perspectives. A brief historical perspective on AL testing is provided and then those measures that can be considered primary and secondary outcomes and possible additional outcomes in AL assessment are discussed. These outcome measures include: (1) subjective effects (some of which comprise the primary outcome measures, including drug liking); (2) physiological responses; (3) drug self-administration behavior; and (4) cognitive and psychomotor performance. Prior to presenting recommendations for standardized approaches and measures to be used in AL assessments, the appropriateness of using these measures in clinical trials with patients in pain is discussed. PMID:22998781

Comer, Sandra D.; Zacny, James P.; Dworkin, Robert H.; Turk, Dennis C.; Bigelow, George E.; Foltin, Richard W.; Jasinski, Donald R.; Sellers, Edward M.; Adams, Edgar H.; Balster, Robert; Burke, Laurie B.; Cerny, Igor; Colucci, Robert D.; Cone, Edward; Cowan, Penney; Farrar, John T.; Haddox, J. David; Haythornthwaite, Jennifer A.; Hertz, Sharon; Jay, Gary W.; Johanson, Chris-Ellyn; Junor, Roderick; Katz, Nathaniel P.; Klein, Michael; Kopecky, Ernest A.; Leiderman, Deborah B.; McDermott, Michael P.; O'Brien, Charles; O'Connor, Alec B.; Palmer, Pamela P.; Raja, Srinivasa N.; Rappaport, Bob A.; Rauschkolb, Christine; Rowbotham, Michael C.; Sampaio, Cristina; Setnik, Beatrice; Sokolowska, Marta; Stauffer, Joseph W.; Walsh, Sharon L.

2012-01-01

153

RELATION OVER TIME BETWEEN FACIAL MEASUREMENTS AND COGNITIVE OUTCOMES IN FETAL ALCOHOL EXPOSED CHILDREN  

PubMed Central

Background The identification of individuals exposed prenatally to alcohol can be challenging, with only those having the characteristic pattern of facial features, CNS abnormality, and growth retardation receiving a clinical diagnosis of fetal alcohol syndrome (FAS). Methods 17 anthropometric measurements were obtained at 5 and 9 years from 125 Cape Town, South African children, studied since birth. The children were divided into 3 groups: FAS or partial FAS (PFAS), heavily exposed nonsyndromal (HE), and non-alcohol exposed controls (C). Anthropometric measurements were evaluated for mean group differences. Logistic regression models were used to identify the subset of anthropometric measures that best predicted group membership. Anthropometric measurements were examined at the two ages in relation to prenatal alcohol exposure obtained prospectively from the mothers during pregnancy. Correlation of these facial measurements with key neurobehavioral outcomes including WISC-IV IQ and eyeblink conditioning was used to assess their utility as indicators of alcohol-related central nervous system impairment. Results Significant group differences were found for the majority of the anthropometric measures, with means of these measures smaller in the FAS/PFAS compared with HE or C. Upper facial widths, ear length, lower facial depth, and eye widths were consistent predictors distinguishing those exposed to alcohol from those who were not. Using longitudinal data, unique measures were identified that predicted facial anomalies at one age but not the other, suggesting the face changes as the individual matures. 41% of the FAS/PFAS group met criteria for microtia at both ages. Three of the predictive anthropometric measures were negatively related to measures of prenatal alcohol consumption, and all were positively related to at least one neurobehavioral outcome. Conclusions The analysis of longitudinal data identified a common set of predictors, as well as some that are unique at each age. Prenatal alcohol exposure appears to have its primary effect on brain growth, reflected by smaller forehead widths, and may suppress neural crest migration to the branchial arches, reflected by deficits in ear length and mandibular dimensions. These results may improve diagnostic resolution and enhance our understanding of the relation between the face and the neuropsychological deficits that occur. PMID:22404085

Foroud, Tatiana; Wetherill, Leah; Vinci-Booher, Sophia; Moore, Elizabeth S.; Ward, Richard E.; Hoyme, H. Eugene; Robinson, Luther K.; Rogers, Jeffrey; Meintjes, Ernesta M.; Molteno, Christopher D.; Jacobson, Joseph L.; Jacobson, Sandra W.

2012-01-01

154

A transuranic aerosol measurement system: Preliminary results  

SciTech Connect

We have completed the design, fabrication, and assembly of a computer-based prototype system for the measurement of transuranic aerosols in the workplace and environment. This system (called WOTAMS for Workplace Transuranic Aerosol Measurement System) incorporates two detectors: (1) an in-line solid-state alpha detector that sends out an alarm the moment a transuranic release occurs, and (2) an in-vacuum detector that increases off-line-analysis sensitivity. The in-line sensitivity of the system is better than 5.0 MPC-h, and the in-vacuum sensitivity exceeds 0.5 MPC-h. 5 refs., 8 figs., 1 tab.

Prevo, C.T.; Kaifer, R.C.; Rueppel, D.W.; Delvasto, R.M.; Biermann, A.H.; Phelps, P.L.

1986-10-01

155

Evaluating Faculty Perceptions of Student Learning Outcomes: A Rasch Measurement Analysis  

ERIC Educational Resources Information Center

Background: The importance of assessing student learning outcomes has demanded attention from most everyone involved in the higher education enterprise, as accreditation and funding implications are often linked to the results. Faculty, however, are often critical of the assessment process because outcomes assessment is costly with regard to time,…

Royal, Kenneth D.

2010-01-01

156

Measuring Treatment Outcome in a Child and Adolescent Partial Hospitalization Program  

Microsoft Academic Search

Mental health practitioners are increasingly being called upon to evaluate the effectiveness of the treatment they provide. The partial hospitalization component of the mental health industry has also felt this call for outcome research. This article presents the results of assessments of treatment outcome at a child and adolescent partial hospitalization program. The research design was an effectiveness study, a

Darcy Haag Granello; Paul F. Granello; Fred Lee

2000-01-01

157

Measuring Social Capital as an Outcome of Service Learning  

ERIC Educational Resources Information Center

Service-learning has been put forth as one of the proposed solutions to increasing social capital. However, service-learning research has not significantly addressed the impact of service learning on social capital. Unlike most previous studies, this research used quantitative analysis to measure the effect of university service-learning programs…

D'Agostino, Maria J.

2010-01-01

158

Validation of the CMT Pediatric Scale as an outcome measure of disability  

PubMed Central

Objective Charcot-Marie-Tooth disease (CMT) is a common heritable peripheral neuropathy. There is no treatment for any form of CMT although clinical trials are increasingly occurring. Patients usually develop symptoms during the first two decades of life but there are no established outcome measures of disease severity or response to treatment. We identified a set of items that represent a range of impairment levels and conducted a series of validation studies to build a patient-centered multi-item rating scale of disability for children with CMT. Methods As part of the Inherited Neuropathies Consortium, patients aged 3–20 years with a variety of CMT types were recruited from the USA, UK, Italy and Australia. Initial development stages involved: definition of the construct, item pool generation, peer review and pilot testing. Based on data from 172 patients, a series of validation studies were conducted, including: item and factor analysis, reliability testing, Rasch modeling and sensitivity analysis. Results Seven areas for measurement were identified (strength, dexterity, sensation, gait, balance, power, endurance), and a psychometrically robust 11-item scale constructed (Charcot-Marie-Tooth disease Pediatric Scale: CMTPedS). Rasch analysis supported the viability of the CMTPedS as a unidimensional measure of disability in children with CMT. It showed good overall model fit, no evidence of misfitting items, no person misfit and it was well targeted for children with CMT. Interpretation The CMTPedS is a well-tolerated outcome measure that can be completed in 25-minutes. It is a reliable, valid and sensitive global measure of disability for children with CMT from the age of 3 years. PMID:22522479

Burns, Joshua; Ouvrier, Robert; Estilow, Tim; Shy, Rosemary; Laurá, Matilde; Pallant, Julie F.; Lek, Monkol; Muntoni, Francesco; Reilly, Mary M.; Pareyson, Davide; Acsadi, Gyula; Shy, Michael E.; Finkel, Richard S.

2012-01-01

159

Reliability of clinical outcome measures in Charcot-Marie-Tooth disease.  

PubMed

We assessed inter- and intra-rater reliability of outcome measures in Charcot-Marie-Tooth disease (CMT) patients. In 40 CMT patients, we assessed reliability of Overall Neuropathy Limitations Scale (ONLS), 10-m timed walk (T10MW), 9-hole-peg test (9-HPT), maximal voluntary isometric contraction (MVIC) of arm (elbow flexion, hand-grip, and three-point pinch) and leg (knee extension, foot dorsiflexion/plantar flexion). Reliability was substantial for ONLS, excellent for T10MW and 9-HPT. For MVIC, inter and intra-rater reliability was excellent for hand contractions; for leg contractions, intra-rater agreement was moderate to substantial, whereas inter-rater agreement was poor. An ad hoc device was produced to immobilize the foot and MVIC reliability was re-assessed in 26 CMT patients, resulting in excellent inter-rater and intra-rater reliability for foot dorsiflexion, and clear inter-rater improvement for foot plantar flexion. All outcome measures appear adequate for CMT assessment. Use of an immobilization device improves foot MVIC reliability, preventing biased findings in patients with greater strength. PMID:17964785

Solari, A; Laurà, M; Salsano, E; Radice, D; Pareyson, D

2008-01-01

160

An introduction to patient-reported outcome measures in ophthalmic research.  

PubMed

Clinical outcomes, such as quantifying the extent of visual field loss by automated perimetry, are valued highly by health professionals, but such measures do not capture the impact of the condition on a patient's life. Patient-reported outcomes describe any report or measure of health reported by the patient, without external interpretation by a clinician or researcher. In this review, we discuss the value of the measures that capture this information (patient-reported outcome measures; PROMs), and why they are important to both the clinician and the researcher. We also consider issues around developing or selecting a PROM for ophthalmic research, the emerging challenges around conducting and reporting PROMs in clinical trials and highlight best practice for their use. Search terms for this review comprised: (1) (patient-reported outcomes OR patient-reported outcome measures) AND (2) randomised controlled trials AND (3) limited to ophthalmic conditions. These terms were expanded as follows: ((('patients'(MeSH Terms) OR 'patients'(All Fields) OR 'patient'(All Fields)) AND ('research report'(MeSH Terms) OR ('research'(All Fields) AND 'report'(All Fields)) OR 'research report'(All Fields) OR 'reported'(All Fields)) AND outcomes(All Fields)) OR (('patients'(MeSH Terms) OR 'patients'(All Fields) OR 'patient'(All Fields)) AND ('research report'(MeSH Terms) OR ('research'(All Fields) AND 'report'(All Fields)) OR 'research report'(All Fields) OR 'reported'(All Fields) AND ('outcome assessment (health care)'(MeSH Terms) OR ('outcome'(All Fields) AND 'assessment'(All Fields) AND '(health'(All Fields) AND 'care)'(All Fields)) OR 'outcome assessment (health care)'(All Fields) OR ('outcome'(All Fields) AND 'measures'(All Fields)) OR 'outcome measures'(All Fields)))) AND ('randomized controlled trial'(Publication Type) OR 'randomized controlled trials as topic'(MeSH Terms) OR 'randomised controlled trials'(All Fields) OR 'randomized controlled trials'(All Fields)) AND (ophth*(All Fields)). The authors also utilised the extensive non-ophthalmic literature and online resources relating to PROs and PROMs to inform this review. PMID:24625379

Denniston, A K; Kyte, D; Calvert, M; Burr, J M

2014-06-01

161

Measuring Social Capital as an Outcome of Service Learning  

Microsoft Academic Search

Service-learning has been put forth as one of the proposed solutions to increasing social capital. However, service-learning\\u000a research has not significantly addressed the impact of service learning on social capital. Unlike most previous studies, this\\u000a research used quantitative analysis to measure the effect of university service-learning programs on social capital by examining\\u000a the question: What impact do service-learning programs have

Maria J. D’Agostino

2010-01-01

162

Outcome measurement in HEDIS: can risk adjustment save the low birth weight measure?  

PubMed Central

OBJECTIVE. To evaluate whether adjusting the Health Plan Employer Data and Information Set (HEDIS) low birth weight (LBW) measure for maternal risk factors is feasible and improves its validity as a quality indicator. DATA SOURCE: The Washington State Birth Event Record Data for calendar years 1989 and 1990, including birth certificate data matched with mothers' and infants' hospital discharge records, with 5,837 records of singlet on infants identified as LBW (< 2,500 g) and a 25 percent sample ( n = 31,570) of the normal-weight births ( measure, we assessed health plan readiness to produce a risk-adjusted measure. PRINCIPAL FINDINGS: An LBW indicator that is adjusted for maternal risks represents health plan performance better than the unadjusted rate. In the most parsimonious risk adjustment model LBW risk was higher for mothers with a history of prior preterm birth , LBW, or fet al death . Risk was also high er for primiparas or mothers with high parity, mothers less than 19 years of age, and primiparas over age 35. In a model adding race to these obstetric factors, black, Asian/Pacific Islander, or other non-white, non-Hispanic race were also significantly associated with higher LBW risk. While adjusting for maternal risk improved the LBW measure's validity, the rate adjustment magnitude was small (0.17 percentage points) for the most plausible model. Th is may not be mean in gf ul clinically or for measuring differences in quality. The costs and data collection requirements of risk adjustment could be substantial for health plans lacking access to State birth records data. CONCLUSIONS Selection of risk adjusters for quality measures depends on judgments of their effect, legitimacy, and feasibility. A comprehensive examination of validity and feasibility is needed to understand to what extent outcome measures represent quality and how their value compares to their cost of collection . PMID:16148953

Inkelas, M; Decristofaro, A H; McGlynn, E A; Keeler, E B

2000-01-01

163

Patient reported outcome measures for cardiac ablation procedures: a multicentre pilot to develop a new questionnaire  

PubMed Central

Aim To assess the feasibility of administering Patient Reported Outcomes Measures (PROMs) in patients treated with ablation for cardiac arrhythmias, and to conduct the first stage of development and testing of a new PROM tool. Methods and results A new tool was developed by a multidisciplinary team and tested alongside an adaptation of the patient perception of arrhythmia questionnaire (PPAQ) and EQ-5D-5L in a multicentre retrospective audit involving 791 consecutive cardiac arrhythmia patients treated with catheter ablation at three UK centres over 13 months. Data were recorded in the National Cardiac Rhythm Management Database, part of the National Institute for Cardiovascular Outcomes Research. The response rate was 71.9% (n = 569). Patients reported significant improvements across all outcomes and impacts, with reductions in symptoms of 51.7% (heart racing), 33.9% (fatigue) 31.8% (heart flutters), 43.5% (dizziness), 38.6% (breathlessness), 44.2% (chest pressure), 33.1% (trouble concentrating), 15.9% (headache), 28.3% (neck pressure), and 23.4% (fainting) (P < 0.001). The mean number of social days affected reduced by 7.49 days/month (P < 0.001); mean work/school days affected/month reduced by 6.26 (P < 0.001); mean GP/hospital visits reduced by 1.36 days/month (P < 0.001). The procedure met patient expectations in 72% of responders. Conclusions The high response rate suggests that the use of PROMs in this patient group is feasible, with rates equalling those of the National PROMs Programme. The results showed that patients experienced significant improvements in their quality of life following ablation, while feedback allowed the tools to be improved. Further work is required to validate these tools; however, the findings suggest that PROMs could be useful in the audit of ablation techniques. PMID:24627541

Withers, Kathleen L.; White, Judith; Carolan-Rees, Grace; Patrick, Hannah; O'Callaghan, Peter; Murray, Stephen; Cunningham, David; Wood, Kathryn A.; Lencioni, Mauro; Griffith, Michael

2014-01-01

164

Isolated fetal intracardiac hyperechogenic focus associated with neonatal outcome and triple test results  

Microsoft Academic Search

Objective  To investigate the relationship between isolated intracardiac hyperechogenic focus (IHF) in the mid trimester of pregnancy\\u000a with neonatal outcomes and triple test results.\\u000a \\u000a \\u000a \\u000a Materials and methods  The study included low-risk pregnant women who came for routine follow-up to our antenatal clinic between years 2000 and 2005.\\u000a A detailed structural survey by ultrasound (USG) of the fetal heart was performed on each

Sezer Arda; N. Cenk Say?n; Füsun G. Varol; Necdet Süt

2007-01-01

165

Implementation and outcomes of telephone disclosure of clinical BRCA1/2 test results?  

PubMed Central

Objectives: With an increasing demand for genetic services, effective and efficient delivery models for genetic testing are needed. Methods: In this prospective single-arm communication study, participants received clinical BRCA1/2 results by telephone with a genetic counselor and completed surveys at baseline, after telephone disclosure (TD) and after in-person clinical follow-up. Results: Sixty percent of women agreed to participate; 73% of decliners preferred in-person communication. Anxiety decreased from baseline to post-TD (p = 0.03) and satisfaction increased (p < 0.01). Knowledge did not change significantly from baseline to post-TD, but was higher post-clinical follow-up (p = 0.04). Cancer patients had greater declines in state anxiety and African-American participants reported less increase in satisfaction. 28% of participants did not return for in-person clinical follow-up, particularly those with less formal education, and higher post-disclosure anxiety and depression (p < 0.01). Conclusions: Telephone disclosure of BRCA1/2 test results may not be associated with negative cognitive and affective responses among willing patients, although some subgroups may experience less favorable responses. Some patients do not return for in-person clinical follow-up and longitudinal outcomes are unknown. Practice implications: Further evaluation of longitudinal outcomes of telephone disclosure and differences among subgroups can inform how to best incorporate telephone communication into delivery of genetic services. PMID:24075727

Patrick-Miller, Linda; Egleston, Brian L.; Daly, Mary; Stevens, Evelyn; Fetzer, Dominique; Forman, Andrea; Bealin, Lisa; Rybak, Christina; Peterson, Candace; Corbman, Melanie; Bradbury, Angela R.

2014-01-01

166

Relationship Between 1-Hour Glucose Challenge Test Results and Perinatal Outcomes  

PubMed Central

Objective To estimate the relationship between 1-hour 50 gm glucose challenge test (GCT) values and perinatal outcomes. Methods This was a secondary analysis of data from a multicenter treatment trial of mild gestational diabetes mellitus (GDM). Women with GCT 135199 mg/dL completed a 3-hour oral glucose tolerance test (OGTT). Mild GDM was defined as fasting glucose less than 95 mg/dL and two or more abnormal OGTT values: 1-hour 180 mg/dL or more; 2-hour 155 mg/dL or more; 3-hour 140 mg/dL or more. Our study included untreated women with GCT 135–139 mg/dL, GCT 140–199 mg/dL, and a comparison group with GCT less than 120 mg/dL. Primary outcomes included a perinatal composite (stillbirth, neonatal death, hypoglycemia, hyperbilirubinemia, neonatal hyperinsulinemia, and birth trauma), large for gestational age (LGA, birth weight above the 90th percentile based on gender and race specific norms) and macrosomia (greater than 4,000gm). Results There were 436 women with GCT less than120 mg/dL and 1,403 with GCT 135 mg/dL or more (GCT 135–139, n=135; 140–199, n=1,268). The composite perinatal outcome occurred in 25.6% of those with GCT less than 120 mg/dL compared with 21.1% for GCT 135–139 mg/dL, and 35.3% for GCT 140–199 mg/dL. Rates of LGA by group were 6.6%, 6.8% and 12.4%, respectively. Rates of macrosomia by group were 7.8%, 6.1% and 12.1%, respectively. Compared with GCT less than 120 mg/dL, the adjusted odds ratios (OR) (95% confidence intervals [CI]) for GCT values of 140–199 mg/dL were 1.48 (1.14–1.93) for the composite outcome, 1.97 (1.29–3.11) for LGA, and 1.61(1.07–2.49) for macrosomia. For GCT values 135–139 mg/dL, adjusted ORs and 95% CIs were 0.75 (0.45–1.21), 1.04 (0.44–2.24) and 0.75 (0.30–1.66), respectively. The subcategories with GCT values 140–144 mg/dL and 145–149 mg/dL were also associated with an increase in selected outcomes when compared with those with GCT less than 120 mg/dL. Conclusions Glucose challenge test values of 135–139 mg/dL were not associated with adverse outcomes compared with GCT less than 120 mg/dL; however, GCT values 140 mg/dL or more were associated with an increase in odds of the composite perinatal outcome, LGA and macrosomia. PMID:23812458

Figueroa, Dana; Landon, Mark B.; Mele, Lisa; Spong, Catherine Y.; Ramin, Susan M.; Casey, Brian; Wapner, Ronald J.; Varner, Michael W.; Thorp, John M.; Sciscione, Anthony; Catalano, Patrick; Harper, Margaret; Saade, George; Caritis, Steve N.; Sorokin, Yoram; Peaceman, Alan M.; Tolosa, Jorge E.

2014-01-01

167

Outcome measures in relapsing-remitting multiple sclerosis: capturing disability and disease progression in clinical trials.  

PubMed

Multiple sclerosis (MS) is a chronic inflammatory and neurodegenerative disease that manifests as acute relapses and progressive disability. As a primary endpoint for clinical trials in MS, disability is difficult to both characterize and measure. Furthermore, the recovery from relapses and the rate of disability vary considerably among patients. Given these challenges, investigators have developed and studied the performance of various outcome measures and surrogate endpoints in MS clinical trials. This review defines the outcome measures and surrogate endpoints used to date in MS clinical trials and presents challenges in the design of both adult and pediatric trials. PMID:24883205

Lavery, Amy M; Verhey, Leonard H; Waldman, Amy T

2014-01-01

168

Interpretation of Magnetotelluric Results Using Laboratory Measurements  

NASA Astrophysics Data System (ADS)

Magnetotelluric (MT) surveying is a remote sensing technique of the crust and mantle based on electrical conductivity that provides constraints to our knowledge of the structure and composition of the Earth's interior. This paper presents a review of electrical measurements in the laboratory applied to the understanding of MT profiles. In particular, the purpose of such a review is to make the laboratory technique accessible to geophysicists by pointing out the main caveats regarding a careful use of laboratory data to interpret electromagnetic profiles. First, this paper addresses the main issues of cross-spatial-scale comparisons. For brevity, these issues are restricted to reproducing in the laboratory the texture, structure of the sample as well as conditions prevailing in the Earth's interior (pressure, temperature, redox conditions, time). Second, some critical scientific questions that have motivated laboratory-based interpretation of electromagnetic profiles are presented. This section will focus on the characterization of the presence and distribution of hydrogen in the Earth's crust and mantle, the investigation of electrical anisotropy in the asthenosphere and the interpretation of highly conductive field anomalies. In a last section, the current and future challenges to improve quantitative interpretation of MT profiles are discussed. These challenges correspond to technical improvements in the laboratory and the field as well as the integration of other disciplines, such as petrology, rheology and seismology.

Pommier, Anne

2014-01-01

169

Interpretation of Magnetotelluric Results Using Laboratory Measurements  

NASA Astrophysics Data System (ADS)

Magnetotelluric (MT) surveying is a remote sensing technique of the crust and mantle based on electrical conductivity that provides constraints to our knowledge of the structure and composition of the Earth's interior. This paper presents a review of electrical measurements in the laboratory applied to the understanding of MT profiles. In particular, the purpose of such a review is to make the laboratory technique accessible to geophysicists by pointing out the main caveats regarding a careful use of laboratory data to interpret electromagnetic profiles. First, this paper addresses the main issues of cross-spatial-scale comparisons. For brevity, these issues are restricted to reproducing in the laboratory the texture, structure of the sample as well as conditions prevailing in the Earth's interior (pressure, temperature, redox conditions, time). Second, some critical scientific questions that have motivated laboratory-based interpretation of electromagnetic profiles are presented. This section will focus on the characterization of the presence and distribution of hydrogen in the Earth's crust and mantle, the investigation of electrical anisotropy in the asthenosphere and the interpretation of highly conductive field anomalies. In a last section, the current and future challenges to improve quantitative interpretation of MT profiles are discussed. These challenges correspond to technical improvements in the laboratory and the field as well as the integration of other disciplines, such as petrology, rheology and seismology.

Pommier, Anne

2013-04-01

170

Measuring health outcomes of adolescents: report from a pilot study.  

PubMed

There is a need to understand the practicality, validity and reliability of using utility measures with children and adolescents. We designed a pilot study in order to help guide the selection of an appropriate health-related quality-of-life (HRQoL) questionnaire for adolescents to be used in the context of a large randomised controlled trial (RCT) of family therapy versus standard treatment for adolescents aged 11-17 years. The pilot study was carried out on a school sample of adolescents in the same age range as the RCT. Adolescents were asked to fill in three HRQoL questionnaires: the standard EQ-5D, the licensed Health Utilities Index HUI, and the child-friendly version of the standard EQ-5D: the EQ-5D for youth (EQ-5D-Y). This report explores the problems with the language and concepts embodied within those HRQoL questionnaires and open discussion regarding how we can value the health of adolescents for cost-utility analysis in a larger study. PMID:21785871

Oluboyede, Yemi; Tubeuf, Sandy; McCabe, Chris

2013-02-01

171

A Systematic Review of Patient-Reported Outcome Instruments Measuring Sleep Dysfunction in Adults  

Microsoft Academic Search

Sleep dysfunction can manifest in several ways, ranging from insomnia to somnolence, and from disrupted sleep to lack of restful sleep. Measuring sleep dysfunction is an area of active research and there exist a number of patient-reported outcome instruments that measure various aspects of sleep dysfunction. However, these instruments have not been evaluated systematically. We used a conceptual model of

Emily Beth Devine; Zafar Hakim; Jesse Green

2005-01-01

172

Measuring and reporting quality of life outcomes in clinical trials in cystic fibrosis: a critical review  

Microsoft Academic Search

Good quality clinical trials are essential to inform the best cystic fibrosis (CF) management and care, by determining and comparing the effectiveness of new and existing therapies and drug delivery systems. The formal inclusion of quality of life (QoL) as an outcome measure in CF clinical trials is becoming more common. Both an appropriate QoL measure and sound methodology are

Janice Abbott; Anna Hart

2005-01-01

173

Outcome Classification of Preschool Children with Autism Spectrum Disorders Using Mri Brain Measures.  

ERIC Educational Resources Information Center

Objective: To test the hypothesis that a combination of magnetic resonance imaging (MRI) brain measures obtained during early childhood distinguish children with autism spectrum disorders (ASD) from typically developing children and is associated with functional outcome. Method: Quantitative MRI technology was used to measure gray and white matter…

Akshoomoff, Natacha; Lord, Catherine; Lincoln, Alan J.; Courchesne, Rachel Y.; Carper, Ruth A.; Townsend, Jeanne; Courchesne, Eric

2004-01-01

174

Composite Spirometric-Computed Tomography Outcome Measure in Early Cystic Fibrosis Lung Disease  

Microsoft Academic Search

With the advent of therapies aimed at young patients with cystic fibrosis, who have mildly reduced pulmonary function, the need for improved outcome measures that discriminate treatment effects has become important. Pulmonary function measurements or chest high-resolution computed tomography (HRCT) scores have been separately used to assess interventions. We evaluated these modal- ities separately and together during a treatment study

Terry E. Robinson; Ann N. Leung; William H. Northway; Francis G. Blankenberg; Frandics P. Chan; Daniel A. Bloch; Tyson H. Holmes; Richard B. Moss

2003-01-01

175

Validation of the Insomnia Severity Index as an outcome measure for insomnia research  

Microsoft Academic Search

Background: Insomnia is a prevalent health complaint that is often difficult to evaluate reliably. There is an important need for brief and valid assessment tools to assist practitioners in the clinical evaluation of insomnia complaints.Objective: This paper reports on the clinical validation of the Insomnia Severity Index (ISI) as a brief screening measure of insomnia and as an outcome measure

Célyne H Bastien; Annie Vallières; Charles M Morin

2001-01-01

176

Characterization of Potential Outcome Measures for Future Clinical Trials in Fragile X Syndrome  

ERIC Educational Resources Information Center

Clinical trials targeting recently elucidated synaptic defects in fragile X syndrome (FXS) will require outcome measures capable of assessing short-term changes in cognitive functioning. Potentially useful measures for FXS were evaluated here in a test-retest setting in males and females with FXS (N = 46). Good reproducibility, determined by an…

Berry-Kravis, Elizabeth; Sumis, Allison; Kim, Ok-Kyung; Lara, Rebecca; Wuu, Joanne

2008-01-01

177

Quantitative Liver Function Tests Improve the Prediction of Clinical Outcomes in Chronic Hepatitis C: Results from the HALT-C Trial  

PubMed Central

Risk for future clinical outcomes is proportional to the severity of liver disease in patients with chronic hepatitis C. We measured disease severity by quantitative liver function tests (QLFTs) to determine cutoffs for QLFTs that identified patients who were at low and high risk for a clinical outcome. Two hundred twenty seven participants in the Hepatitis C Antiviral Long-Term Treatment Against Cirrhosis (HALT-C) Trial underwent baseline QLFTs and were followed for a median of 5.5 years for clinical outcomes. QLFTs were repeated in 196 patients at month 24 and in 165 patients at month 48. Caffeine elimination rate (k), antipyrine (AP) clearance (Cl), MEGX concentration, methionine breath test (MBT), galactose elimination capacity (GEC), dual cholate (CA) clearances and shunt, and perfused hepatic mass (PHM) and liver and spleen volumes (SPECT) were measured. Baseline QLFTs were significantly worse (p=0.0017 to <0.0001) and spleen volumes larger (p<0.0001) in the 54 patients who subsequently experienced clinical outcomes. QLFT cutoffs that characterized patients as “low” and “high risk” for clinical outcome yielded hazard ratios ranging from 2.21 (95%CI 1.29–3.78) for GEC to 6.52 (95%CI 3.63–11.71) for CA Cloral. QLFTs independently predicted outcome in models with Ishak fibrosis score, platelet count, and standard laboratory tests. In serial studies, patients with “high risk” results for CA Cloral or PHM had a nearly 15-fold increase in risk for clinical outcome. Less than 5% of patients with “low risk” QLFTs experienced a clinical outcome. Conclusion QLFTs independently predict risk for future clinical outcomes. By improving risk assessment, QLFTs could enhance noninvasive monitoring, counseling, and management of patients with chronic hepatitis C. PMID:22030902

Everson, Gregory T.; Shiffman, Mitchell L.; Hoefs, John C.; Morgan, Timothy R.; Sterling, Richard K.; Wagner, David A.; Lauriski, Shannon; Curto, Teresa M.; Stoddard, Anne; Wright, Elizabeth C.

2011-01-01

178

Quality Improvement Measurement of Outcomes for People With Disabilities Closing the Quality Gap: Revisiting the State of the Science  

National Technical Information Service (NTIS)

We included all forms of disability except severe and persistent mental illness for all age groups in outpatient and community settings. We focused on outcomes, patient experience, and care coordination process measures. We looked for generic outcome meas...

M. Butler, M. Grove-Jeffery, R. L. Kane, S. Larson

2012-01-01

179

A Critical Review of Audiological Outcome Measures for Infants and Children  

PubMed Central

Outcome evaluation is an important stage in the pediatric hearing aid fitting process, however a systematic way of evaluating outcome in the pediatric audiology population is lacking. This is in part due to the need for an evidence-based outcome evaluation guideline for infants and children with hearing loss who wear hearing aids. As part of the development of a guideline, a critical review of the existing pediatric audiology outcome evaluation tools was conducted. Subjective outcome evaluation tools that measure auditory-related behaviors in children from birth to 6 years of age were critically appraised using a published grading system (Andresen, 2000). Of the tools that exist, 12 were appraised because they met initial criteria outlined by the Network of Pediatric Audiologists of Canada as being appropriate for children birth to 6 years of age who wear hearing aids. Tools that were considered for the guideline scored high in both statistical and feasibility criteria. The subjective outcome evaluation tools that were ultimately chosen to be included in the guideline were the LittlEARS Auditory Questionnaire (Tsiakpini et al., 2004) and the Parents’ Evaluation of Aural/Oral Performance of Children (PEACH) Rating Scale (Ching & Hill, 2005b) due to the high grades they received in the critical review and their target age ranges. Following this critical review of pediatric outcome evaluation tools, the next step was for the Network Clinicians to evaluate the guideline (Moodie et al., 2011b). PMID:21873343

Moodie, Sheila T.; Seewald, Richard C.; Bartlett, Doreen J.; Scollie, Susan D.

2011-01-01

180

Clinical Features and Treatment Outcomes of Vitiligo from the Patients’ Perspective: Results of a National Survey in Germany  

Microsoft Academic Search

Background: Vitiligo causes substantial disease burden and patient needs still remain underestimated. Objective: To assess the clinical features, treatment outcomes and satisfaction in patients with vitiligo. Methods: A nationwide, cross-sectional German postal survey was conducted. Clinical features and treatment outcomes of vitiligo (affected body surface, comorbidities, treatments applied, patient benefit index [PBI]) were evaluated using a standardized patient questionnaire. Results:

Marc A. Radtke; Ines Schäfer; Angelika I. Gajur; Matthias Augustin

2010-01-01

181

Microinvasive cervical adenocarcinoma (FIGO stage 1A tumors): results of surgical staging and outcome analysis.  

PubMed

Although studies suggest that microinvasive cervical adenocarcinoma has an excellent prognosis, none has reported treatment-related complications and many have lacked detailed measurement criteria. Our study looks at the rate of lymph node metastases and outcome, including complications, in patients with FIGO 1A1 and 1A2 adenocarcinomas of the cervix. Invasion was strictly defined, and the method of measurement was standardized. Villoglandular, papillary serous and clear cell carcinomas were excluded, as were tumors in which invasion exceeded 7 mm in width or 5 mm in thickness, with tumor thickness measured from the basement membrane of the overlying endocervical or ectocervical surface to the deepest focus of invasive tumor. A mean follow-up of 54 months (range, 5-159 months) was available for 31 of 32 (97%) patients. A total of 29 of 32 patients underwent hysterectomies, 2 patients had radical trachelectomies, and 1 patient was treated by cone biopsy. One patient received adjuvant radiotherapy. A total of 27 of 32 patients had bilateral pelvic lymph node dissections, and no lymph node metastases were identified. No recurrences have been reported to date. One patient died of metastatic ovarian carcinoma 82 months after her diagnosis of cervical carcinoma. Two of 27 (7%) patients have chronic leg edema secondary to lymph node dissection. Given the excellent prognosis of this tumor, the absence of lymph node metastases and a lymph node dissection complication rate of 7%, less radical surgery should be considered in this low-risk patient population. PMID:16538058

Ceballos, Katherine M; Shaw, Danielle; Daya, Dean

2006-03-01

182

Coronary revascularisation outcome questionnaire (CROQ): development and validation of a new, patient based measure of outcome in coronary bypass surgery and angioplasty  

Microsoft Academic Search

Objective: To describe the development and scientific validation of a new patient based measure, the coronary revascularisation outcome questionnaire (CROQ), to evaluate health outcomes and quality of life before and after coronary artery bypass grafting and percutaneous transluminal coronary angioplasty.Design and setting: Psychometric validation study conducted with patients from three hospitals in the UK.Patients: Two independent field tests were conducted

S Schroter; D L Lamping

2004-01-01

183

Evaluating the impact of California's full service partnership program using a multidimensional measure of outcomes.  

PubMed

This study evaluates the impact of California's full-service partnership (FSP) program using a multidimensional measure of outcomes. The FSP program is a key part of California's 2005 Mental Health Services Act. Secondary data were collected from the Consumer Perception Survey, the Client and Service Information System, and the Data Collection and Reporting System, all data systems which are maintained by the California Department of Mental Health. The analytic sample contained 39,681 observations of which 588 were FSP participants (seven repeated cross-sections from May 2005 to May 2008). We performed instrumental variables (IV) limited information maximum likelihood and IV Tobit analyses. The marginal monthly improvement in outcomes of services for FSP participants was approximately 3.5 % higher than those receiving usual care with the outcomes of the average individual in the program improving by 33.4 %. This shows that the FSP program is causally effective in improving outcomes among the seriously mentally ill. PMID:23456598

Brown, Timothy Tyler; Hong, Juliette S; Scheffler, Richard M

2014-05-01

184

Outcome measures for Charcot-Marie-Tooth disease: clinical and neurofunctional assessment in children.  

PubMed

Charcot-Marie-Tooth (CMT) disease is the most common inherited neuromuscular disorder, presenting with symptoms often occurring since childhood, and showing a progressive course. At present, there are no valid and reliable measures for evaluation of impairment and disability in the pediatric population. The aim of this study was to determine the usefulness of outcome measures, commonly used in adult patients, in CMT children. We report the results of a comprehensive evaluation of 21 children affected with CMT type 1A, including clinical examinations, measure of hand and foot muscle strength with a hand-held dynamometer, and the following scales: CMT Neuropathy Score or its clinical component CMT Examination Score, Overall Neuropathy Limitations Scale (ONLS), Walk-12 questionnaire, and nine-hole peg test (9-HPT). Hand grip, three-point pinch, and foot dorsiflexion strength were significantly lower than age/sex equivalent in almost all cases. 9-HPT was significantly abnormal in 62% of patients and CMT Examination Score was <10 points in all cases. ONLS showed presence of minor disability in the upper limbs in 57% and mild abnormalities of gait in 71% of patients. Overall, these scales demonstrated limited potential to measure disability and severity of the disease confirming that it is necessary to identify specific scales for children with CMT. PMID:22003938

Pagliano, Emanuela; Moroni, Isabella; Baranello, Giovanni; Magro, Anita; Marchi, Alessia; Bulgheroni, Sara; Ferrarin, Maurizio; Pareyson, Davide

2011-09-01

185

Outcome measures for Charcot-Marie-Tooth disease: clinical and neurofunctional assessment in children  

PubMed Central

Charcot-Marie-Tooth (CMT) disease is the most common inherited neuromuscular disorder, presenting with symptoms often occurring since childhood, and showing a progressive course. At present, there are no valid and reliable measures for evaluation of impairment and disability in the pediatric population. The aim of this study was to determine the usefulness of outcome measures, commonly used in adult patients, in CMT children. We report the results of a comprehensive evaluation of 21 children affected with CMT type 1A, including clinical examinations, measure of hand and foot muscle strength with a hand-held dynamometer, and the following scales: CMT Neuropathy Score or its clinical component CMT Examination Score, Overall Neuropathy Limitations Scale (ONLS), Walk-12 questionnaire, and nine-hole peg test (9-HPT). Hand grip, three-point pinch, and foot dorsiflexion strength were significantly lower than age/sex equivalent in almost all cases. 9-HPT was significantly abnormal in 62% of patients and CMT Examination Score was <10 points in all cases. ONLS showed presence of minor disability in the upper limbs in 57% and mild abnormalities of gait in 71% of patients. Overall, these scales demonstrated limited potential to measure disability and severity of the disease confirming that it is necessary to identify specific scales for children with CMT. PMID:22003938

Baranello, Giovanni; Magro, Anita; Marchi, Alessia; Bulgheroni, Sara; Ferrarin, Maurizio; Pareyson, Davide

2014-01-01

186

The importance of rating scales in measuring patient-reported outcomes  

PubMed Central

Background A critical component that influences the measurement properties of a patient-reported outcome (PRO) instrument is the rating scale. Yet, there is a lack of general consensus regarding optimal rating scale format, including aspects of question structure, the number and the labels of response categories. This study aims to explore the characteristics of rating scales that function well and those that do not, and thereby develop guidelines for formulating rating scales. Methods Seventeen existing PROs designed to measure vision-related quality of life dimensions were mailed for self-administration, in sets of 10, to patients who were on a waiting list for cataract extraction. These PROs included questions with ratings of difficulty, frequency, severity, and global ratings. Using Rasch analysis, performance of rating scales were assessed by examining hierarchical ordering (indicating categories are distinct from each other and follow a logical transition from lower to higher value), evenness (indicating relative utilization of categories), and range (indicating coverage of the attribute by the rating scale). Results The rating scales with complicated question format, a large number of response categories, or unlabelled categories, tended to be dysfunctional. Rating scales with five or fewer response categories tended to be functional. Most of the rating scales measuring difficulty performed well. The rating scales measuring frequency and severity demonstrated hierarchical ordering but the categories lacked even utilization. Conclusion Developers of PRO instruments should use a simple question format, fewer (four to five) and labelled response categories. PMID:22794788

2012-01-01

187

Incidence and Outcomes of Desmoplastic Small Round Cell Tumor: Results from the Surveillance, Epidemiology, and End Results Database  

PubMed Central

Desmoplastic small round cell tumor (DSRCT) is a rare but highly fatal malignancy. Due to the rarity of this neoplasm, no large population based studies exist. Procedure. This is a retrospective cohort analysis. Incidence rates were calculated based on sex and ethnicity and compared statistically. Gender-, ethnicity-, and treatment- based survival were calculated using the Kaplan-Meier method. Results. A total of 192 cases of DSRCT were identified. Peak incidence age was between 20 and 24 years. Age-adjusted incidence rate for blacks was 0.5 cases/million and for whites was 0.2 cases/million (P = 0.037). There was no statistically significant difference in survival based on gender or ethnicity. When adjusted for age, there was no statistically significant difference in survival amongst patients who received radiation therapy compared to those who did not (HRadj = 0.73; 95% CI 0.49, 1.11). There was a statistically significant survival advantage for patients who received radiation after surgery compared to those who did not (HR 0.49; 95% CI 0.30, 0.79). Conclusion. DSRCT is more common in males and in people of African-American descent. Although overall survival remains poor, radiation therapy following surgery seems to improve outcome in these patients.

Lettieri, Christina K.; Hingorani, Pooja

2014-01-01

188

Mid-term results of the Radial Artery Patency and Clinical Outcomes randomized trial  

PubMed Central

Background The radial artery (RA), as an alternative to the saphenous vein or the right internal thoracic artery (RITA) for coronary artery bypass grafting, has gained considerable interest over the years. A randomized controlled trial was undertaken to assess the suitability of the radial artery as a conduit. Method The Radial Artery Patency and Clinical Outcomes (RAPCO) trial is a double-armed randomized controlled trial comparing the RA with the free RITA in a younger cohort of patients undergoing elective coronary bypass surgery, and the RA with the saphenous vein in an older group. The trial conduit was grafted to the most important coronary target after the left anterior descending artery, which received the gold standard left internal thoracic artery. Clinical outcomes and angiographic patency up to 10 years was recorded during careful follow up, with annual clinical review and a program of randomly assigned, staggered angiography. The final trial results will be available in 2014. Results Mid-trial results have shown equivalent survival and event-free survival and graft patency in both arms at median follow up of approximately 6 years. The demographic and clinical data, pre- and postoperative angiographic findings of the trial database have led to a number of substudies focusing on the role of lipid exposure in patency and disease progression, the fate of moderate lesions when grafted or left alone, patterns of disease regression, and patient satisfaction with graft harvest sites. Conclusions While the final analysis of the primary trial end points is eagerly awaited, the additional insight into the natural history of grafted coronary artery disease with modern secondary prevention will be of considerable interest. PMID:23977623

Hayward, Philip A.

2013-01-01

189

Measuring Spatial Infiltration in Stormwater Control Measures: Results and Implications  

EPA Science Inventory

This presentation will provide background information on research conducted by EPA-ORD on the use of soil moisture sensors in bioretention/bioinfiltration technologies to evaluate infiltration mechanisms and compares monitoring results to simplified modeling assumptions. A serie...

190

Annals of Rehabilitation Medicine Prediction of Treatment Outcome with Bioimpedance Measurements in Breast Cancer Related Lymphedema Patients  

E-print Network

Objective To investigate the usefulness of bioimpedance measurement for predicting the treatment outcome in breast cancer related lymphedema (BCRL) patients. Method Unilateral BCRL patients who received complex decongestive therapy (CDT) for 2 weeks (5 days per week) were enrolled in this study. We measured the ratio of extracellular fluid (ECF) volume by using bioelectrical impedance spectroscopy (BIS), and single frequency bioimpedance analysis (SFBIA) at a 5 kHz frequency before treatment. Arm circumferences were measured at 10 cm above and below the elbow before and after treatment. We also investigated whether there is correlation between ECF ratio and SFBIA ratio with the change of arm circumference after CDT. Results A total of 73 patients were enrolled in this study. The higher ECF ratio was significantly correlated with higher reduction of arm circumference at both above and below the elbow after treatment, but the higher SFBIA ratio was correlated only with the higher reduction of arm circumference below the elbow. Conclusion These results show that ECF volume measurements and SFBIA before treatment are useful tools for predicting the outcome of patients with lymphedema. We concluded that ECF volume measure can be used as a screening tool for predicting treatment outcome of BCRL patients. Key Words Breast cancer related lymphedema, Bioelectrical impedance spectroscopy, Single frequency bioimpedance analysis

Leesuk Kim; Jae Yong Jeon; In Young Sung; Soon Yong Jeong; Jung Hwa Do; Hwa Jung Kim

2011-01-01

191

Methodology of Path Loss Calculation using Measurement Results  

Microsoft Academic Search

This paper deals with path loss calculation by using measurement results. This paper offers methodology for processing path loss measurement results. First part of the paper gives short introduction. Second part of the paper describes measurement results collection process. Third part of the paper offers methodology for processing measurement results. By using this methodology we can found real propagation model

Winton Afric; Branka Zovko-Cihlar; Sonja Grgic

2007-01-01

192

A Systematic Review of Measures of End-of-Life Care and Its Outcomes  

PubMed Central

Objective To identify psychometrically sound measures of outcomes in end-of-life care and to characterize their use in intervention studies. Data Sources English language articles from 1990 to November 2005 describing measures with published psychometric data and intervention studies of end-of-life care. Study Design Systematic review of end-of-life care literature. Extraction Methods Two reviewers organized identified measures into 10 major domains. Eight reviewers extracted and characterized measures from intervention studies. Principal Findings Of 24,423 citations, we extracted 200 articles that described 261 measures, accepting 99 measures. In addition to 35 measures recommended in a prior systematic review, we identified an additional 64 measures of the end-of-life experience. The most robust measures were in the areas of symptoms, quality of life, and satisfaction; significant gaps existed in continuity of care, advance care planning, spirituality, and caregiver well-being. We also reviewed 84 intervention studies in which 135 patient-centered outcomes were assessed by 97 separate measures. Of these, 80 were used only once and only eight measures were used in more than two studies. Conclusions In general, most measures have not undergone rigorous development and testing. Measure development in end-of-life care should focus on areas with identified gaps, and testing should be done to facilitate comparability across the care settings, populations, and clinical conditions. Intervention research should use robust measures that adhere to these standards. PMID:17850523

Mularski, Richard A; Dy, Sydney M; Shugarman, Lisa R; Wilkinson, Anne M; Lynn, Joanne; Shekelle, Paul G; Morton, Sally C; Sun, Virginia C; Hughes, Ronda G; Hilton, Lara K; Maglione, Margaret; Rhodes, Shannon L; Rolon, Cony; Lorenz, Karl A

2007-01-01

193

Measurement of religiosity/spirituality in adolescent health outcomes research: trends and recommendations.  

PubMed

The relationship between religious/spiritual (R/S) factors and adolescent health outcomes has been studied for decades; however, the R/S measurement tools used may not be developmentally relevant for adolescents. A systematic literature review was conducted to review and evaluate trends in measuring R/S in adolescent health outcomes research. In this review a total of 100 articles met criteria for inclusion. Relatively few (n = 15) included adolescent-specific R/S measures or items accounting for developmentally relevant issues such as parental religiosity or age-appropriate language. Future R/S and health research with adolescents would be strengthened by incorporating developmentally relevant R/S measurement tools, psychometrics, and multidimensional measures. PMID:20127172

Cotton, Sian; McGrady, Meghan E; Rosenthal, Susan L

2010-12-01

194

Measurement of Religiosity/Spirituality in Adolescent Health Outcomes Research: Trends and Recommendations  

PubMed Central

The relationship between religious/spiritual (R/S) factors and adolescent health outcomes has been studied for decades; however, the R/S measurement tools used may not be developmentally relevant for adolescents. A systematic literature review was conducted to review and evaluate trends in measuring R/S in adolescent health outcomes research. In this review a total of 100 articles met criteria for inclusion. Relatively few (n = 15) included adolescent-specific R/S measures or items accounting for developmentally relevant issues such as parental religiosity or age-appropriate language. Future R/S and health research with adolescents would be strengthened by incorporating developmentally relevant R/S measurement tools, psychometrics, and multidimensional measures. PMID:20127172

McGrady, Meghan E.; Rosenthal, Susan L.

2010-01-01

195

Deconstructing Therapy Outcome Measurement with Rasch Analysis of a Measure of General Clinical Distress: The Symptom Checklist-90-Revised  

ERIC Educational Resources Information Center

Rasch analysis was used to illustrate the usefulness of item-level analyses for evaluating a common therapy outcome measure of general clinical distress, the Symptom Checklist-90-Revised (SCL-90-R; Derogatis, 1994). Using complementary therapy research samples, the instrument's 5-point rating scale was found to exceed clients' ability to make…

Elliott, Robert; Fox, Christine M.; Beltyukova, Svetlana A.; Stone, Gregory E.; Gunderson, Jennifer; Zhang, Xi

2006-01-01

196

Universal health outcome measures for older persons with multiple chronic conditions  

PubMed Central

Older adults with multiple chronic conditions (MCC) require considerable health services and complex care. As health status is affected along multiple dimensions by the persistence and progression of diseases and courses of treatments, well-validated universal outcome measures across diseases are needed for research, clinical care and administrative purposes. An expert panel meeting held by the National Institute on Aging (NIA) in September 2011 recommends that older persons with MCC complete a brief initial composite measure that includes general health, pain, fatigue, and physical, mental health and social role function, along with gait speed measurement. Suitable composite measures include the Short-form 8 (SF-8) and 36 (SF-36) and the Patient Reported Outcomes Measurement Information System29-item Health Profile (PROMIS-29). Based on responses to items within the initial measure, short follow-on measures should be selectively targeted to the following areas: symptom burden, depression, anxiety and daily activities. Persons unable to walk a short distance for gait speed should be assessed using a physical function scale. Remaining gaps to be considered for measure development include disease burden, cognitive function and caregiver burden. Routine outcome assessment of MCC patients could facilitate system-based care improvement and clinical effectiveness research. PMID:23194184

2012-01-01

197

Pregnancy outcomes after living donor liver transplantation: results from a Japanese survey.  

PubMed

A national survey of pregnancy outcomes after living donor liver transplantation (LDLT) was performed in Japan. Thirty-eight pregnancies in 30 recipients resulted in 31 live births (25 recipients), 3 artificial abortions in the first trimester (3 recipients), 1 spontaneous abortion (1 recipient), and 3 fetal deaths (3 recipients). After the exclusion of the 3 artificial abortions, there were 35 pregnancies in 27 recipients: pregnancy-induced hypertension developed during 6 pregnancies (5 recipients), fetal growth restriction developed during 7 pregnancies (6 recipients), acute rejection developed during 2 pregnancies (2 recipients), and ileus developed during 1 pregnancy (1 recipient). Preterm delivery (<37 weeks) occurred for 10 pregnancies (10 recipients), and cesarean delivery was performed for 12 pregnancies (12 recipients). After delivery, acute rejection developed in 3 recipients. Twelve neonates were born with low birth weights (<2500 g), and 4 of these 12 neonates had extremely low birth weights (<1500 g). Two neonates had congenital malformations. The pregnancy outcomes after LDLT were similar to those reported for cadaveric liver transplantation (LT). The incidence of pregnancy-induced hypertension in recipients who were 33 years old or older at the diagnosis of pregnancy was significantly higher than the incidence in recipients who were less than 33 years old at the diagnosis of pregnancy. The incidences of fetal growth restriction, pregnancy-induced hypertension, and extremely low birth weight were significantly higher in the early group (<3 years after transplantation) versus the late group (?3 years after transplantation). In conclusion, it is necessary to pay careful attention to complications during pregnancy in recipients who become pregnant within 3 years of LT, particularly if the age at the diagnosis of pregnancy is ?33 years. PMID:24478123

Kubo, Shoji; Uemoto, Shinji; Furukawa, Hiroyuki; Umeshita, Koji; Tachibana, Daisuke

2014-05-01

198

Comparison of outcome measures for patients with chronic obstructive pulmonary disease (COPD) in an outpatient setting  

Microsoft Academic Search

BACKGROUND: To assist clinicians and researchers in choosing outcome measures for patients with chronic obstructive pulmonary disease attending routine outpatient clinics, a comparative assessment was undertaken of four questionnaires designed to reflect the patients' perception of their physical and emotional health in terms of their feasibility, validity, reliability, and responsiveness to health change. METHODS: Two condition specific questionnaires, the St

R. Harper; J. E. Brazier; J. C. Waterhouse; S. J. Walters; N. M. Jones; P. Howard

1997-01-01

199

Challenges of General Outcomes Measurement in the RTI Progress Monitoring of Linguistically Diverse Exceptional Learners  

ERIC Educational Resources Information Center

The assessment for accurate identification and appropriate instruction of English language learners (ELLs) with learning-related disabilities has remained a chronic source of concern. One source of concern that has gone relatively unchallenged is the use of general outcomes measurement (GOMs). The authors examine the problems and challenges of…

Barrera, Manuel; Liu, Kristin Kline

2010-01-01

200

A "Learning Platform" Approach to Outcome Measurement in Fragile X Syndrome: A Preliminary Psychometric Study  

ERIC Educational Resources Information Center

Background: Clinical trials of medications to alleviate the cognitive and behavioural symptoms of individuals with fragile X syndrome (FXS) are now underway. However, there are few reliable, valid and/or sensitive outcome measures available that can be directly administered to individuals with FXS. The majority of assessments employed in clinical…

Hall, S. S.; Hammond, J. L.; Hirt, M.; Reiss, A. L.

2012-01-01

201

Gender Equality Action Plan 2007-10 Action Outcome Measured by Lead Target date  

E-print Network

Appendix 1 Gender Equality Action Plan 2007-10 Action Outcome Measured by Lead Target date Compliance with the Equality Act 2006 Publication of Gender Equality Scheme (GES) GES and Action Plan appear level strategic commitment to equality and diversity Inclusion of equality and diversity commitments

Feigon, Brooke

202

National Outcome Measures for Early Childhood Development: Development of an Indicator-Based Reporting Framework  

ERIC Educational Resources Information Center

The Council of Australian Governments released the National Early Childhood Development Strategy, Investing in the Early Years in July 2009 (COAG 2009). One of the key reform priorities in the strategy is to build better information and a solid evidence base, and establishing national outcome measures for early childhood development has been…

Australian Institute of Health and Welfare, 2011

2011-01-01

203

Clinical Utility of the Modified Stroop Task as a Treatment Outcome Measure: Questions Raised  

ERIC Educational Resources Information Center

Data from an outpatient treatment trial for anorexia nervosa were examined to gain preliminary insights as to whether the modified Stroop colour-naming task might offer a useful measure of treatment outcome. It was hypothesised that interference for eating-, weight- and shape-related words on a modified version on the Stroop colour-naming task…

Ball, Jillian R.; Mitchell, Philip B.; Touyz, Stephen W.; Griffiths, Rosalyn A.; Beumont, Pierre J. V.

2004-01-01

204

Goal Attainment Scaling as an Outcome Measure in Randomized Controlled Trials of Psychosocial Interventions in Autism  

ERIC Educational Resources Information Center

Goal attainment scaling (GAS) holds promise as an idiographic approach for measuring outcomes of psychosocial interventions in community settings. GAS has been criticized for untested assumptions of scaling level (i.e., interval or ordinal), inter-individual equivalence and comparability, and reliability of coding across different behavioral…

Ruble, Lisa; McGrew, John H.; Toland, Michael D.

2012-01-01

205

The Cognitive Bias Questionnaire: An Outcome Measure in the Treatment of Depression.  

ERIC Educational Resources Information Center

The Cognitive Bias Questionnaire (CBQ) was assessed as an outcome measure in the treatment of depression in a study involving 20 depressed and 20 non-depressed female subjects. The role of depressive distortion in the maintenance or stabilization of depression was also examined. Subjects were randomly assigned to one of four groups:…

Suarez, Yolanda; And Others

206

Conceptualization and Measurement of Family Outcomes Associated with Families of Individuals with Intellectual Disabilities  

ERIC Educational Resources Information Center

The purpose of this review is to (a) document the current status of conceptualizing and measuring family outcomes related to having a member with an intellectual disability and (b) determine the extent to which family research focuses on internal family characteristics as contrasted to external family support. The reviewers collected 28 articles…

Turnbull, Ann P.; Summers, Jean Ann; Lee, Suk-Hyang; Kyzar, Kathleen

2007-01-01

207

Measuring Outcomes of Family-Centered Intervention: Development of the Life Participation for Parents (LPP)  

ERIC Educational Resources Information Center

Raising a child with disabilities impacts the ability of parents to participate in life situations. This paper describes the development of a new instrument, Life Participation for Parents, to measure outcomes of pediatric therapy on parental participation. Items were reviewed by six occupational therapists with experience in pediatrics and…

Fingerhut, Patricia E.

2009-01-01

208

Side Effects of Minocycline Treatment in Patients with Fragile X Syndrome and Exploration of Outcome Measures  

ERIC Educational Resources Information Center

Minocycline can rescue the dendritic spine and synaptic structural abnormalities in the fragile X knock-out mouse. This is a review and preliminary survey to document side effects and potential outcome measures for minocycline use in the treatment of individuals with fragile X syndrome. We surveyed 50 patients with fragile X syndrome who received…

Utari, Agustini; Chonchaiya, Weerasak; Rivera, Susan M.; Schneider, Andrea; Hagerman, Randi J.; Faradz, Sultana M. H.; Ethell, Iryna M.; Nguyen, Danh V.

2010-01-01

209

Outcome Measures for the New Hampshire Special Olympics Healthy Hearing Program  

E-print Network

of Audiology, 45(2), 83-90. gy Participants The subjects of this study were Special Olympic athletes fromOutcome Measures for the New Hampshire Special Olympics Healthy Hearing Program Lauren Hardies of follow-up. For the athletes that went for follow-up, 73.3% had cerumen removed, Reasons why follow

New Hampshire, University of

210

Reliability and validity of the cross-culturally adapted Italian version of the Core Outcome Measures Index  

Microsoft Academic Search

Patient-orientated outcome questionnaires are essential for the assessment of treatment success in spine care. Standardisation\\u000a of the instruments used is necessary for comparison across studies and in registries. The Core Outcome Measures Index (COMI)\\u000a is a short, multidimensional outcome instrument validated for patients with spinal disorders and is the recommended outcome\\u000a instrument in the Spine Society of Europe Spine Tango

A. F. Mannion; M. Boneschi; M. Teli; A. Luca; F. Zaina; S. Negrini; P. J. Schulz

211

Social and behavioral research in genomic sequencing: approaches from the Clinical Sequencing Exploratory Research Consortium Outcomes and Measures Working Group  

PubMed Central

The routine use of genomic sequencing in clinical medicine has the potential to dramatically alter patient care and medical outcomes. To fully understand the psychosocial and behavioral impact of sequencing integration into clinical practice, it is imperative that we identify the factors that influence sequencing-related decision making and patient outcomes. In an effort to develop a collaborative and conceptually grounded approach to studying sequencing adoption, members of the National Human Genome Research Institute's Clinical Sequencing Exploratory Research Consortium formed the Outcomes and Measures Working Group. Here we highlight the priority areas of investigation and psychosocial and behavioral outcomes identified by the Working Group. We also review some of the anticipated challenges to measurement in social and behavioral research related to genomic sequencing; opportunities for instrument development; and the importance of qualitative, quantitative, and mixed-method approaches. This work represents the early, shared efforts of multiple research teams as we strive to understand individuals' experiences with genomic sequencing. The resulting body of knowledge will guide recommendations for the optimal use of sequencing in clinical practice. PMID:24625446

Gray, Stacy W.; Martins, Yolanda; Feuerman, Lindsay Z.; Bernhardt, Barbara A.; Biesecker, Barbara B.; Christensen, Kurt D.; Joffe, Steven; Rini, Christine; Veenstra, David; McGuire, Amy L.

2014-01-01

212

Comparing frailty measures in their ability to predict adverse outcome among older residents of assisted living  

PubMed Central

Background Few studies have directly compared the competing approaches to identifying frailty in more vulnerable older populations. We examined the ability of two versions of a frailty index (43 vs. 83 items), the Cardiovascular Health Study (CHS) frailty criteria, and the CHESS scale to accurately predict the occurrence of three outcomes among Assisted Living (AL) residents followed over one year. Methods The three frailty measures and the CHESS scale were derived from assessment items completed among 1,066 AL residents (aged 65+) participating in the Alberta Continuing Care Epidemiological Studies (ACCES). Adjusted risks of one-year mortality, hospitalization and long-term care placement were estimated for those categorized as frail or pre-frail compared with non-frail (or at high/intermediate vs. low risk on CHESS). The area under the ROC curve (AUC) was calculated for select models to assess the predictive accuracy of the different frailty measures and CHESS scale in relation to the three outcomes examined. Results Frail subjects defined by the three approaches and those at high risk for decline on CHESS showed a statistically significant increased risk for death and long-term care placement compared with those categorized as either not frail or at low risk for decline. The risk estimates for hospitalization associated with the frailty measures and CHESS were generally weaker with one of the frailty indices (43 items) showing no significant association. For death and long-term care placement, the addition of frailty (however derived) or CHESS significantly improved on the AUC obtained with a model including only age, sex and co-morbidity, though the magnitude of improvement was sometimes small. The different frailty/risk models did not differ significantly from each other in predicting mortality or hospitalization; however, one of the frailty indices (83 items) showed significantly better performance over the other measures in predicting long-term care placement. Conclusions Using different approaches, varying degrees of frailty were detected within the AL population. The various approaches to defining frailty were generally more similar than dissimilar with regard to predictive accuracy with some exceptions. The clinical implications and opportunities of detecting frailty in more vulnerable older adults require further investigation. PMID:22978265

2012-01-01

213

Lupus-specific health outcome measure for US patients: the LupusQoL-US version  

Microsoft Academic Search

Background:Patient-reported outcomes are valuable for the management of chronic diseases like systematic lupus erythematosus (SLE), but no measures have been validated for use in US-based patients with SLE.Objectives:To adapt and assess the validity and reliability of an SLE-specific quality of life (QoL) measure developed in the United Kingdom, the LupusQoL, for use in US-based patients with SLE.Methods:Debriefing interviews of subjects

M Jolly; A S Pickard; C Wilke; R A Mikolaitis; L-S Teh; K McElhone; L Fogg; J Block

2010-01-01

214

Interventions designed to prevent adverse programming outcomes resulting from exposure to maternal obesity during development  

PubMed Central

Maternal obesity is a global epidemic affecting the developed and developing world. Human and animal studies indicate that maternal obesity programs development predisposing offspring to later-life chronic diseases. Several mechanisms act together to produce these adverse health problems. There is a need for effective interventions that prevent these outcomes and guide management in human pregnancy. We report here dietary and exercise intervention studies in both altricial and precocial species, rats and sheep, designed to prevent adverse offspring outcomes. Both interventions present exciting opportunities to at least in part prevent adverse metabolic and other outcomes in mother and offspring. PMID:24147928

Nathanielsz, PW; Ford, SP; Long, NM; Vega, CC; Reyes-Castro, LA; Zambrano, E

2013-01-01

215

Association Between a Quantitative CT Scan Measure of Brain Edema and Outcome After Cardiac Arrest  

PubMed Central

Background Cerebral edema is one physical change associated with brain injury and decreased survival after cardiac arrest. Edema appears on computed tomography (CT) scan of the brain as decreased x-ray attenuation by gray matter. This study tested whether the gray matter attenuation to white matter attenuation ratio (GWR) was associated with survival and functional recovery. Methods Subjects were patients hospitalized after cardiac arrest at a single institution between 1/1/2005 and 7/30/2010. Subjects were included if they had non-traumatic cardiac arrest and a non-contrast CT scan within 24 hours after cardiac arrest. Attenuation (Hounsfield Units) was measured in gray matter (caudate nucleus, putamen, thalamus, and cortex) and in white matter (internal capsule, corpus callosum and centrum semiovale). The GWR was calculated for basal ganglia and cerebrum. Outcomes included survival and functional status at hospital discharge. Results For 680 patients, 258 CT scans were available, but 18 were excluded because of hemorrhage (10), intravenous contrast (3) or technical artifact (5), leaving 240 CT scans for analysis. Lower GWR values were associated with lower initial Glasgow Coma Scale motor score. Overall survival was 36%, but decreased with decreasing GWR. The average of basal ganglia and cerebrum GWR provided the best discrimination. Only 2/58 subjects with average GWR<1.20 survived and both were treated with hypothermia. The association of GWR with functional outcome was completely explained by mortality when GWR<1.20. Conclusions Subjects with severe cerebral edema, defined by GWR<1.20, have very low survival with conventional care, including hypothermia. GWR estimates pre-treatment likelihood of survival after cardiac arrest. PMID:21592642

Metter, Robert B.; Rittenberger, Jon C.; Guyette, Francis X.; Callaway, Clifton W.

2011-01-01

216

Self-control in children: a multimethod examination of treatment outcome measures.  

PubMed

This investigation consisted of a multimethod evaluation of treatment outcome measures that have been developed to assess self-control in children. Subjects were 132 children from the fourth, fifth, and sixth grades. Each child's homeroom teacher and one other classroom teacher independently completed the Self-Control Rating Scale (SCRS), the Teacher's Self-Control Rating Scale (TSCRS), and the 10-item Conners Teacher Rating Scale (TRS). Parents of 41 children completed the Teacher's Self-Control Rating Scale and the Conners Teacher Rating Scale. Children completed the Children's Perceived Self-Control Scale (CPSC) and were administered the Matching Familiar Figure Test (MFF). Results showed high internal consistency reliability for the TSCRS, SCRS, TRS, and MFF latency scores. CPSCS and MFF error scores demonstrated low reliability (r alpha's = .58 and .61, respectively). Interrater reliability between teachers was considered acceptable for the TSCRS but not for the SCRS and TRS. Correlations between teacher and parent ratings on the TSCRS and TRS were low (r's = .37 to .50). Correlations between children's latency scores on the MFF and teachers and parent ratings were very low, r's = .01 to .19, as was the correlation with children's self-ratings on the CPSCS (r = .07). Correlations between rating scales and MFF error scores also were low. The findings suggest that considerable construct confusion does exist between measures designed to assess self-control and impulsivity in children. PMID:3950214

Reynolds, W M; Stark, K D

1986-03-01

217

Patient-Reported Shoulder Outcome Measures Utilized in Breast Cancer Survivors: A Systematic Review  

PubMed Central

Objective 1) To identify English Language published patient-reported upper extremity outcome measures used in breast cancer research and 2) To examine construct validity and responsiveness in patient-reported upper extremity outcome measures used in breast cancer research. Data Sources PubMed, CINAHL and ProQuest MEDLINE® databases were searched up to February 5, 2013. Study Selection Studies were included if a patient-reported upper extremity outcome measure was administered, the participants were diagnosed with breast cancer, and published in English. Data Extraction Eight hundred and sixty-five articles were screened. Fifty-nine full text articles were assessed for eligibility. A total of 46 articles met the initial eligibility criteria for aim 1. Eleven of these articles reported mean and standard deviations for the outcome scores, and included a comparison group analysis for aim 2. Data Synthesis Construct validity was evaluated by calculating effect sizes for known group differences in 6 studies using the Disabilities of Arm, Shoulder and Hand (DASH), Penn Shoulder Score, Shoulder Disability Questionnaire-Dutch, and 10 Questions by Wingate (Wingate). Responsiveness was analyzed comparing a treatment and control group by calculating the coefficient of responsiveness in 5 studies for the DASH and Wingate. Conclusions Eight different patient-reported upper extremity outcome measures have been reported in the peer-review literature for women with breast cancer, some (n=3) were specifically developed for breast cancer survivors and others that were not (n=5). Based on the current evidence we recommend administering the DASH to assess patient-reported upper extremity function in breast cancer survivors because the DASH had most consistently large effects sizes for construct validity and responsiveness. Future large studies are needed for more definitive recommendations. PMID:23932969

Harrington, Shana; Michener, Lori A; Kendig, Tiffany; Miale, Susan; George, Steven Z

2014-01-01

218

A tool for evaluating the potential for cost-effective outcomes measurement  

PubMed Central

Cost related to higher-level outcomes measurement is often very high. However, the cost burden is felt even more by smaller, less well-funded continuing medical education (CME) programs. It is possible to overcome financial and participant-related barriers to measuring Level 6 outcomes, which are patient health outcomes. The Temple University School of Medicine’s Office for Continuing Medical Education developed a sequential tool for attaining cost-effective outcomes measurement for determining the likelihood of a CME intervention to produce significant changes in physician performance. The appropriate selection of the CME topic and specific practice change indictors drive this tool. This tool walks providers through a simple YES or NO decision-making list that guides them toward an accurate prediction of potential programmatic outcomes. Factors considered during the decision-making process include whether: (a) the intended change(s) will have a substantial impact on current practice; (b) the intended practice change(s) are well supported by clinical data, specialty organization/government recommendations, expert opinion, etc; (c) the potential change(s) affects a large population; (d) external factors, such as system pressures, media pressures, financial pressures, patient pressures, safety pressures, etc, are driving this intended change in performance; (e) there is a strong motivation on the part of physicians to implement the intended change(s); and (f) the intended change(s) is relatively easy to implement within any system of practice. If each of these questions can be responded to positively, there is a higher likelihood that the intended practice-related change(s) will occur. Such change can be measured using a simpler and less costly methodology. PMID:22573943

Somasekhar, Melinda M; Bove, Alfred; Rausch, Chris; Degnan, James; King, Cathy T; Meyer, Arnold

2012-01-01

219

What Do Patients Consider to Be the Most Important Outcomes for Effectiveness Studies on Migraine Treatment? Results of a Delphi Study  

PubMed Central

Background The outcome measures most frequently used in studies on the effectiveness of migraine treatment are whether the patient is free of pain, nausea, and free of photophobia/phonophobia within two hours. However, no patient-centred outcome measures are available. Therefore, we performed an online Delphi procedure to compile a list of outcome measures deemed most important to migraine patients. Methods From a large database of migraine patients, we randomly selected 150 males and 150 females patients. We asked the open-ended question: ‘If a new medicine was developed for migraine attacks, what would you wish the effect of this medication to be?’ In the second and third rounds, we presented the answers of the first round and asked the patients to rate the importance of each item. Results The initial response rate was 56% (n?=?169). In the subsequent rounds the response rates were 90% (n?=?152), and 97% (n?=?147), respectively. Patients wanted their attack medication to treat the headache within 30 min, to prevent the attack from getting worse, to ensure they could function properly within 1 h, and prevent the recurrence of symptoms during the same day. Conclusions The currently used outcome measures in migraine research do not sufficiently reflect the wishes of patients. Patients want the medication to work faster, to take away pain at an earlier stage, to make them able to function properly quickly, and to prevent recurrence. These aspects should be considered in future evaluation of new attack medication for migraine. PMID:24932784

Smelt, Antonia F. H.; Louter, Mark A.; Kies, Dennis A.; Blom, Jeanet W.; Terwindt, Gisela M.; van der Heijden, Geert J. M. G.; De Gucht, Veronique; Ferrari, Michel D.; Assendelft, Willem J. J.

2014-01-01

220

The WHO-DAS II: Measuring Outcomes of Hearing Aid Intervention for Adults  

PubMed Central

The World Health Organization's Disability Assessment Scale II (WHO-DAS II) is a generic health-status instrument that provides six domain scores and a total, aggregate score. Two of the domain scores, communication and participation, and the total score, have good validity, internal-consistency reliability, and test-retest stability in individuals with adult-onset hearing loss. As such, these two domain scores and the total WHO-DAS II score may be useful as generic outcome measures to assess the effectiveness of hearing aid intervention for this population. Before the use of the WHO-DAS II in hearing aid clinical trials, however, the responsiveness of the instrument and the short- and long-term outcomes to hearing aid intervention had to be determined. Responsiveness and outcomes were assessed in 380 veterans (approximately half received hearing aids and half served as controls) by examining group differences, effect-size estimates, and individual differences as a function of hearing aid intervention. For comparison, data also were obtained on two disease-specific measures, the APHAB and the HHIE. The WHO-DAS II communication domain and total scores were sufficiently responsive to hearing aid intervention for use in future studies in which group differences are to be detected. The WHO-DAS II participation domain was not sufficiently responsive to hearing aid intervention. The APHAB and HHIE, both disease-specific measures, were more sensitive to hearing aid intervention than the generic measure. The short- and long-term outcomes of hearing aid intervention were also examined in the present study. Group outcomes for hearing aid intervention can be expected to be stable for at least 6 months when measured by WHO-DAS II total score and for at least 12 months when measured by the WHO-DAS II communication domain scores. Effect-size estimates and examination of the number of individuals exhibiting change scores exceeding 90% critical differences for true changes in scores indicate that for clinical applications, disease-specific instruments are more useful than the WHO-DAS II. The findings of this study support the use of the WHO-DAS II as a generic measure in hearing aid trials research so as to allow for comparisons of health-status outcomes across different diseases or disorders. PMID:16244759

McArdle, Rachel; Chisolm, Theresa H.; Abrams, Harvey B.; Wilson, Richard H.; Doyle, Patrick J.

2005-01-01

221

Improved Outcome Prediction Using CT Angiography in Addition to Standard Ischemic Stroke Assessment: Results from the STOPStroke Study  

PubMed Central

Purpose To improve ischemic stroke outcome prediction using imaging information from a prospective cohort who received admission CT angiography (CTA). Methods In a prospectively designed study, 649 stroke patients diagnosed with acute ischemic stroke had admission NIH stroke scale scores, noncontrast CT (NCCT), CTA, and 6-month outcome assessed using the modified Rankin scale (mRS) scores. Poor outcome was defined as mRS>2. Strokes were classified as “major” by the (1) Alberta Stroke Program Early CT Score (ASPECTS+) if NCCT ASPECTS was?7; (2) Boston Acute Stroke Imaging Scale (BASIS+) if they were ASPECTS+ or CTA showed occlusion of the distal internal carotid, proximal middle cerebral, or basilar arteries; and (3) NIHSS for scores>10. Results Of 649 patients, 253 (39.0%) had poor outcomes. NIHSS, BASIS, and age, but not ASPECTS, were independent predictors of outcome. BASIS and NIHSS had similar sensitivities, both superior to ASPECTS (p<0.0001). Combining NIHSS with BASIS was highly predictive: 77.6% (114/147) classified as NIHSS>10/BASIS+ had poor outcomes, versus 21.5% (77/358) with NIHSS?10/BASIS? (p<0.0001), regardless of treatment. The odds ratios for poor outcome is 12.6 (95% CI: 7.9 to 20.0) in patients who are NIHSS>10/BASIS+ compared to patients who are NIHSS?10/BASIS?; the odds ratio is 5.4 (95% CI: 3.5 to 8.5) when compared to patients who are only NIHSS>10 or BASIS+. Conclusions BASIS and NIHSS are independent outcome predictors. Their combination is stronger than either instrument alone in predicting outcomes. The findings suggest that CTA is a significant clinical tool in routine acute stroke assessment. PMID:22276182

Gonzalez, R. Gilberto; Lev, Michael H.; Goldmacher, Gregory V.; Smith, Wade S.; Payabvash, Seyedmehdi; Harris, Gordon J.; Halpern, Elkan F.; Koroshetz, Walter J.; Camargo, Erica C. S.; Dillon, William P.; Furie, Karen L.

2012-01-01

222

Use of an electronic patient-reported outcome measurement system to improve distress management in oncology  

PubMed Central

Objective Management of patient distress is a critical task in cancer nursing and cancer practice. Here we describe two examples of how an electronic patient-reported outcome (ePRO) measurement system implemented into routine oncology care can practically aid clinical and research tasks related to distress management. Methods Tablet personal computers were used to routinely complete a standardized ePRO review of systems surveys at point of care during every encounter in the Duke Oncology outpatient clinics. Two cases of use implementation are explored: (1) triaging distressed patients for optimal care, and (2) psychosocial program evaluation research. Results Between 2009 and 2011, the ePRO system was used to collect information during 17,338 Duke Oncology patient encounters. The system was used to monitor patients for psychosocial distress employing an electronic clinical decision support algorithm, with 1,952 (11.3%) referrals generated for supportive services. The system was utilized to examine the efficacy of a psychosocial care intervention documenting statistically significant improvements in distress, despair, fatigue, and quality of life (QOL) in 50 breast cancer patients. Significance of results ePRO solutions can guide best practice management of cancer patient distress. Nurses play a key role in implementation and utilization. PMID:24128592

Smith, Sophia K.; Rowe, Krista; Abernethy, Amy P.

2014-01-01

223

Assessing outcomes for cost-utility analysis in depression: comparison of five multi-attribute utility instruments with two depression-specific outcome measures.  

PubMed

Background Many mental health surveys and clinical studies do not include a multi-attribute utility instrument (MAUI) that produces quality-adjusted life-years (QALYs). There is also some question about the sensitivity of the existing utility instruments to mental health. Aims To compare the sensitivity of five commonly used MAUIs (Assessment of Quality of Life - Eight Dimension Scale (AQoL-8D), EuroQoL-five dimension (EQ-5D-5L), Short Form 6D (SF-6D), Health Utilities Index Mark 3 (HUI3), 15D) with that of disease-specific depression outcome measures (Depression Anxiety Stress Scales (DASS-21) and the Kessler Psychological Distress Scale (K10)) and develop 'crosswalk' transformation algorithms between the measures. Method Individual data from 917 people with self-report depression collected as part of the International Multi-Instrument Comparison Survey. Results All the MAUIs discriminated between the levels of severity measured by the K10 and the DASS-21. The AQoL-8D had the highest correlation with the disease-specific measures and the best goodness-of-fit transformation properties. Conclusions The algorithms developed in this study can be used to determine cost-effectiveness of services or interventions where utility measures are not collected. PMID:25257063

Mihalopoulos, Cathrine; Chen, Gang; Iezzi, Angelo; Khan, Munir A; Richardson, Jeffrey

2014-11-01

224

The case for an international patient-reported outcomes measurement information system (PROMIS®) initiative.  

PubMed

Patient-reported outcomes (PROs) play an increasingly important role in clinical practice and research. Modern psychometric methods such as item response theory (IRT) enable the creation of item banks that support fixed-length forms as well as computerized adaptive testing (CAT), often resulting in improved measurement precision and responsiveness. Here we describe and discuss the case for developing an international core set of PROs building from the US PROMIS® network.PROMIS is a U.S.-based cooperative group of research sites and centers of excellence convened to develop and standardize PRO measures across studies and settings. If extended to a global collaboration, PROMIS has the potential to transform PRO measurement by creating a shared, unifying terminology and metric for reporting of common symptoms and functional life domains. Extending a common set of standardized PRO measures to the international community offers great potential for improving patient-centered research, clinical trials reporting, population monitoring, and health care worldwide. Benefits of such standardization include the possibility of: international syntheses (such as meta-analyses) of research findings; international population monitoring and policy development; health services administrators and planners access to relevant information on the populations they serve; better assessment and monitoring of patients by providers; and improved shared decision making.The goal of the current PROMIS International initiative is to ensure that item banks are translated and culturally adapted for use in adults and children in as many countries as possible. The process includes 3 key steps: translation/cultural adaptation, calibration, and validation. A universal translation, an approach focusing on commonalities, rather than differences across versions developed in regions or countries speaking the same language, is proposed to ensure conceptual equivalence for all items. International item calibration using nationally representative samples of adults and children within countries is essential to demonstrate that all items possess expected strong measurement properties. Finally, it is important to demonstrate that the PROMIS measures are valid, reliable and responsive to change when used in an international context.IRT item banking will allow for tailoring within countries and facilitate growth and evolution of PROs through contributions from the international measurement community. A number of opportunities and challenges of international development of PROs item banks are discussed. PMID:24359143

Alonso, Jordi; Bartlett, Susan J; Rose, Matthias; Aaronson, Neil K; Chaplin, John E; Efficace, Fabio; Leplège, Alain; Lu, Aiping; Tulsky, David S; Raat, Hein; Ravens-Sieberer, Ulrike; Revicki, Dennis; Terwee, Caroline B; Valderas, Jose M; Cella, David; Forrest, Christopher B

2013-01-01

225

The case for an international patient-reported outcomes measurement information system (PROMIS®) initiative  

PubMed Central

Patient-reported outcomes (PROs) play an increasingly important role in clinical practice and research. Modern psychometric methods such as item response theory (IRT) enable the creation of item banks that support fixed-length forms as well as computerized adaptive testing (CAT), often resulting in improved measurement precision and responsiveness. Here we describe and discuss the case for developing an international core set of PROs building from the US PROMIS® network. PROMIS is a U.S.-based cooperative group of research sites and centers of excellence convened to develop and standardize PRO measures across studies and settings. If extended to a global collaboration, PROMIS has the potential to transform PRO measurement by creating a shared, unifying terminology and metric for reporting of common symptoms and functional life domains. Extending a common set of standardized PRO measures to the international community offers great potential for improving patient-centered research, clinical trials reporting, population monitoring, and health care worldwide. Benefits of such standardization include the possibility of: international syntheses (such as meta-analyses) of research findings; international population monitoring and policy development; health services administrators and planners access to relevant information on the populations they serve; better assessment and monitoring of patients by providers; and improved shared decision making. The goal of the current PROMIS International initiative is to ensure that item banks are translated and culturally adapted for use in adults and children in as many countries as possible. The process includes 3 key steps: translation/cultural adaptation, calibration, and validation. A universal translation, an approach focusing on commonalities, rather than differences across versions developed in regions or countries speaking the same language, is proposed to ensure conceptual equivalence for all items. International item calibration using nationally representative samples of adults and children within countries is essential to demonstrate that all items possess expected strong measurement properties. Finally, it is important to demonstrate that the PROMIS measures are valid, reliable and responsive to change when used in an international context. IRT item banking will allow for tailoring within countries and facilitate growth and evolution of PROs through contributions from the international measurement community. A number of opportunities and challenges of international development of PROs item banks are discussed. PMID:24359143

2013-01-01

226

Do intervention fidelity and dose influence outcomes? Results from the Move to Improve worksite physical activity program  

Microsoft Academic Search

The purpose of this paper is to evaluate the implementation of the Move to Improve worksite physical activity program using a four step framework that includes the following: (i) de- fining the active ingredients, (ii) using good methods to measure implementation, (iii) mon- itoring implementation and (iv) relating imple- mentation to outcomes. The intervention active ingredients consisted of a goal

Mark G. Wilson; Tania B. Basta; Bethany H. Bynum; David M. DeJoy; Robert J. Vandenberg; Rod K. Dishman

2009-01-01

227

Pilot Study to Evaluate Hearing Aid Service Delivery Model and Measure Benefit Using Self-Report Outcome Measures Using Community Hearing Workers in a Developing Country  

PubMed Central

Hearing loss is a major handicap in developing countries with paucity of trained audiologists and limited resources. In this pilot study trained community health workers were used to provide comprehensive hearing aid services in the community. One hundred and eleven patients were fitted with semi-digital hearing aid and were evaluated over a period of six months. They were assessed using self-report outcome measure APHAB. Results show that trained CHWs are effective in detecting disabling hearing loss and in providing HAs. APHAB can identify and pick up significant improvements in communication in daily activities and provides a realistic expectation of the benefits of a hearing aid. The model of using trained CHWs to provide rehabilitative services in audiology along with self-report outcome measures can be replicated in other developing countries. PMID:23724277

Emerson, Lingamdenne Paul; Job, Anand; Abraham, Vinod

2013-01-01

228

Risk-adjusted infection rates in surgery: a model for outcome measurement in hospitals developing new quality improvement programmes  

Microsoft Academic Search

Assessment of healthcare quality is a major challenge in countries such as Hungary where there is limited experience with measurement of patient outcomes. We sought to develop the capacity for valid outcome measurement in Hungarian hospitals using surgical site infection (SSI) surveillance as a model and to identify areas for improvement by comparing SSI rates in Hungarian hospitals to benchmarks

L Gulácsi; Zs. Tatár Kiss; D. A Goldmann; W. C Huskins

2000-01-01

229

The Ohio Scales Youth Form: Expansion and Validation of a Self-Report Outcome Measure for Young Children  

ERIC Educational Resources Information Center

We examined the validity and reliability of a self-report outcome measure for children between the ages of 8 and 11. The Ohio Scales Problem Severity scale is a brief, practical outcome measure available in three parallel forms: Parent, Youth, and Agency Worker. The Youth Self-Report form is currently validated for children ages 12 and older. The…

Dowell, Kathy A.; Ogles, Benjamin M.

2008-01-01

230

Development and Validation of a Multifactorial Treatment Outcome Measure for Eating Disorders.  

ERIC Educational Resources Information Center

Developed a brief self-report inventory to evaluate treatment outcome for anorexia and bulimia nervosa, the Multifactorial Assessment of Eating Disorders, and evaluated the instrument in a series of studies involving 1,054 women. Results support a stable factor structure and satisfactory reliability and validity, and establish normative data. (SLD)

Anderson, Drew A.; Williamson, Donald A.; Duchmann, Erich G.; Gleaves, David H.; Barbin, Jane M.

1999-01-01

231

Dissociation between Judgments and Outcome-Expectancy Measures in Covariation Learning: A Signal Detection Theory Approach  

ERIC Educational Resources Information Center

A number of studies using trial-by-trial learning tasks have shown that judgments of covariation between a cue c and an outcome o deviate from normative metrics. Parameters based on trial-by-trial predictions were estimated from signal detection theory (SDT) in a standard causal learning task. Results showed that manipulations of P(c) when…

Perales, Jose C.; Catena, Andres; Shanks, David R.; Gonzalez, Jose A.

2005-01-01

232

Systematic review of treatment effectiveness and outcome measures for enthesitis in psoriatic arthritis.  

PubMed

Enthesitis is a characteristic feature of psoriatic arthritis (PsA) and is important in disease pathogenesis and classification. Use of clinical outcome measures for enthesitis is heterogeneous, and only 1 measure has been specifically developed and validated in PsA. Ultrasound and magnetic resonance imaging assessments of enthesitis may have advantages over clinical examination but are insufficiently studied. As part of an update of treatment recommendations by the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA), we performed a systematic literature review and identified randomized controlled trials with enthesitis outcomes in PsA. For each treatment agent we calculated treatment effect sizes (where applicable) and graded the level of evidence. PMID:25362713

Orbai, Ana-Maria; Weitz, Joshua; Siegel, Evan L; Siebert, Stefan; Savage, Laura J; Aydin, Sibel Z; Luime, Jolanda J; Elkayam, Ori; Neerinckx, Barbara; Urbancek, Slavo; de Vlam, Kurt; Ritchlin, Christopher T

2014-11-01

233

The relationship between safety culture and patient outcomes: results from pilot meta-analyses.  

PubMed

Patient safety continues to be a serious health concern in acute-care hospitals. Safety culture has been a frequent target for patient safety improvement over the past decade, based on recommendations from the Institute of Medicine and its use in industry. However, the relationship between safety culture and patient safety in acute-care hospitals has yet to be systematically examined. Thus, a meta-analysis was devised to examine the relationship between patient safety outcomes and safety culture in that setting. Due to the limited empirical research reports available, five small pilot meta-analyses were conducted, examining the relationship between safety culture and each of the following: pressure ulcers, falls, medication errors, nurse-sensitive outcomes, and post-operative outcomes. No significant relationships of any size were identified. An assessment of the relevant literature is presented, offering potential explanations for this surprising finding and an agenda for future research. PMID:23743508

Groves, Patricia S

2014-01-01

234

Self-control in children: A multimethod examination of treatment outcome measures  

Microsoft Academic Search

This investigation consisted of a multimethod evaluation of treatment outcome measures that have been developed to assess self-control in children. Subjects were 132 children from the fourth, fifth, and sixth grades. Each child's homeroom teacher and one other classroom teacher independently completed the Self-Control Rating Scale (SCRS), the Teacher's Self-Control Rating Scale (TSCRS), and the 10-item Conners Teacher Rating Scale

William M. Reynolds; Kevin D. Stark

1986-01-01

235

Reliability of clinical outcome measures in Charcot-Marie-Tooth disease  

Microsoft Academic Search

We assessed inter- and intra-rater reliability of outcome measures in Charcot-Marie-Tooth disease (CMT) patients. In 40 CMT patients, we assessed reliability of Overall Neuropathy Limitations Scale (ONLS), 10-m timed walk (T10MW), 9-hole-peg test (9-HPT), maximal voluntary isometric contraction (MVIC) of arm (elbow flexion, hand-grip, and three-point pinch) and leg (knee extension, foot dorsiflexion\\/plantar flexion). Reliability was substantial for ONLS, excellent

A. Solari; M. Laurà; E. Salsano; D. Radice; D. Pareyson

2008-01-01

236

Statistical approaches to assessing single and multiple outcome measures in dry eye therapy and diagnosis.  

PubMed

Dry eye is a multifactorial disease which would require a broad spectrum of test measures in the monitoring of its treatment and diagnosis. However, studies have typically reported improvements in individual measures with treatment. Alternative approaches involve multiple, combined outcomes being assessed by different statistical analyses. In order to assess the effect of various statistical approaches to the use of single and combined test measures in dry eye, this review reanalyzed measures from two previous studies (osmolarity, evaporation, tear turnover rate, and lipid film quality). These analyses assessed the measures as single variables within groups, pre- and post-intervention with a lubricant supplement, by creating combinations of these variables and by validating these combinations with the combined sample of data from all groups of dry eye subjects. The effectiveness of single measures and combinations in diagnosis of dry eye was also considered. PMID:24112230

Tomlinson, Alan; Hair, Mario; McFadyen, Angus

2013-10-01

237

From Radical Mastectomy to Breast-Conserving Therapy and Oncoplastic Breast Surgery: A Narrative Review Comparing Oncological Result, Cosmetic Outcome, Quality of Life, and Health Economy  

PubMed Central

Surgical management of breast cancer has evolved considerably over the last two decades. There has been a major shift toward less-invasive local treatments, from radical mastectomy to breast-conserving therapy (BCT) and oncoplastic breast surgery (OBS). In order to investigate the efficacy of each of the three abovementioned methods, a literature review was conducted for measurable outcomes including local recurrence, survival, cosmetic outcome, quality of life (QOL), and health economy. From the point of view of oncological result, there is no difference between mastectomy and BCT in local recurrence rate and survival. Long-term results for OBS are not available. The items assessed in the QOL sound a better score for OBS in comparison with mastectomy or BCT. OBS is also associated with a better cosmetic outcome. Although having low income seems to be associated with lower BCT and OBS utilization, prognosis of breast cancer is worse in these women as well. Thus, health economy is the matter that should be studied seriously. OBS is an innovative, progressive, and complicated subspeciality that lacks published randomized clinical trials comparing surgical techniques and objective measures of outcome, especially from oncologic and health economy points of view. PMID:24167743

Kaviani, Ahmad; Sodagari, Nassim; Sheikhbahaei, Sara; Eslami, Vahid; Hafezi-Nejad, Nima; Safavi, Amin; Noparast, Maryam; Fitoussi, Alfred

2013-01-01

238

From radical mastectomy to breast-conserving therapy and oncoplastic breast surgery: a narrative review comparing oncological result, cosmetic outcome, quality of life, and health economy.  

PubMed

Surgical management of breast cancer has evolved considerably over the last two decades. There has been a major shift toward less-invasive local treatments, from radical mastectomy to breast-conserving therapy (BCT) and oncoplastic breast surgery (OBS). In order to investigate the efficacy of each of the three abovementioned methods, a literature review was conducted for measurable outcomes including local recurrence, survival, cosmetic outcome, quality of life (QOL), and health economy. From the point of view of oncological result, there is no difference between mastectomy and BCT in local recurrence rate and survival. Long-term results for OBS are not available. The items assessed in the QOL sound a better score for OBS in comparison with mastectomy or BCT. OBS is also associated with a better cosmetic outcome. Although having low income seems to be associated with lower BCT and OBS utilization, prognosis of breast cancer is worse in these women as well. Thus, health economy is the matter that should be studied seriously. OBS is an innovative, progressive, and complicated subspeciality that lacks published randomized clinical trials comparing surgical techniques and objective measures of outcome, especially from oncologic and health economy points of view. PMID:24167743

Kaviani, Ahmad; Sodagari, Nassim; Sheikhbahaei, Sara; Eslami, Vahid; Hafezi-Nejad, Nima; Safavi, Amin; Noparast, Maryam; Fitoussi, Alfred

2013-01-01

239

Worker productivity outcome measures: OMERACT filter evidence and agenda for future research.  

PubMed

The objective of the Outcome Measures in Rheumatology (OMERACT) Worker Productivity working group is to identify worker productivity outcome measures that meet the requirements of the OMERACT filter. At the OMERACT 11 Workshop, we focused on the at-work limitations/productivity component of worker productivity (i.e., presenteeism) - an area with diverse conceptualization and instrumentation approaches. Various approaches to quantify at-work limitations/productivity (e.g., single-item global and multi-item measures) were examined, and available evidence pertaining to OMERACT truth, discrimination, and feasibility were presented to conference participants. Four candidate global measures of presenteeism were put forth for a plenary vote to determine whether current evidence meets the OMERACT filter requirements. Presenteeism globals from the Work Productivity and Activity Impairment Questionnaire (72% support) and Rheumatoid Arthritis-specific Work Productivity Survey (71% support) were endorsed by conference participants; however, neither the presenteeism global item from the Health and Work Performance Questionnaire nor the Quantity and Quality method achieved the level of support required for endorsement at the present time. The plenary was also asked whether the central item from the Work Ability Index should also be considered as a candidate measure for potential endorsement in the future. Of participants at the plenary, 70% supported this presenteeism global measure. Progress was also made in other areas through discussions at individual breakout sessions. Topics examined include the merits of various multi-item measures of at-work limitations/productivity, methodological issues related to interpretability of outcome scores, and approaches to appraise and classify contextual factors of worker productivity. Feedback gathered from conference participants will inform the future research agenda of the working group. PMID:24128774

Tang, Kenneth; Boonen, Annelies; Verstappen, Suzanne M M; Escorpizo, Reuben; Luime, Jolanda J; Lacaille, Diane; Fautrel, Bruno; Bosworth, Ailsa; Cifaldi, Mary; Gignac, Monique A M; Hofstetter, Cathy; Leong, Amye; Montie, Pam; Petersson, Ingemar F; Purcaru, Oana; Bombardier, Claire; Tugwell, Peter S; Beaton, Dorcas E

2014-01-01

240

Faculty clinical quality goals drive improvement in University HealthSystem Consortium outcome measures.  

PubMed

Mortality, length of stay (LOS), patient safety indicators (PSIs), and hospital-acquired conditions (HACs) are routinely reported by the University HealthSystem Consortium (UHC) to measure quality at academic health centers. We hypothesized that a clinical quality measurable goal assigned to individual faculty members would decrease UHC measures of mortality, LOS, PSIs, and HACs. For academic year (AY) 2010-2011, faculty members received a clinical quality goal related to mortality, LOS, PSIs, and HACs. The quality metric constituted 25 per cent of each faculty member's annual evaluation clinical score, which is tied to compensation. The outcomes were compared before and after goal assignment. Outcome data on 6212 patients from AY 2009-2010 were compared with 6094 patients from AY 2010-2011. The mortality index (0.89 vs 0.93; P = 0.73) was not markedly different. However, the LOS index decreased from 1.01 to 0.97 (P = 0.011), and department-wide PSIs decreased significantly from 285 to 162 (P = 0.011). Likewise, HACs decreased from 54 to 18 (P = 0.0013). Seven (17.9%) of 39 faculty had quality grades that were average or below. Quality goals assigned to individual faculty members are associated with decreased average LOS index, PSIs, and HACs. Focused, relevant quality assignments that are tied to compensation improve patient safety and outcomes. PMID:22748532

Behrns, Kevin E; Ang, Darwin; Liu, Huazi; Hughes, Steven J; Creel, Holly; Russin, Millie; Flynn, Timothy C

2012-07-01

241

Defining the effect and mediators of two knowledge translation strategies designed to alter knowledge, intent and clinical utilization of rehabilitation outcome measures: a study protocol [NCT00298727  

Microsoft Academic Search

BACKGROUND: A substantial number of valid outcome measures have been developed to measure health in adult musculoskeletal and childhood disability. Regrettably, national initiatives have merely resulted in changes in attitude, while utilization remains unacceptably low. This study will compare the effectiveness and mediators of two different knowledge transfer (KT) interventions in terms of their impact on changing knowledge and behavior

Joy C MacDermid; Patty Solomon; Mary Law; Dianne Russell; Paul Stratford

2006-01-01

242

Using discrete choice experiments to estimate a preference-based measure of outcome—An application to social care for older people  

Microsoft Academic Search

This paper reports the results of a study that used discrete choice experiment (DCE) methodology to estimate quality weights for a of social care outcome measure. To reflect different states of need, a five-dimensional profile measure was developed. Experimental design techniques were used to derive a sample of states for which preferences were elicited. The DCE approach was employed to

Mandy Ryan; Ann Netten; Diane Skåtun; Paul Smith

2006-01-01

243

Ongoing pregnancy qualifies best as the primary outcome measure of choice in trials in reproductive medicine: an opinion paper.  

PubMed

The most appropriate primary outcome measure for reproductive medicine has been discussed frequently. In 2003 the European Society for Human Reproduction and Embryology recommended that the outcome measure of assisted reproductive technology (ART) and non-ART should be singleton live birth. Although live birth is indeed the aim of clinical practice, and there is no discussion that it should be reported in infertility trials, we hereby provide arguments that plead for using ongoing pregnancy as the primary outcome in such trials. We feel that ongoing pregnancy best serves the many purposes of a primary outcome and best reflects the effectiveness of a treatment. PMID:24786739

Braakhekke, Miriam; Kamphuis, Esme I; Dancet, Eline A; Mol, Femke; van der Veen, Fulco; Mol, Ben W

2014-05-01

244

Getting Results: Outcomes Management and the Annie E. Casey Foundations Jobs Initiative.  

ERIC Educational Resources Information Center

The Anne E. Casey Foundation (AECF) funded replications of effective jobs projects to achieve better job placement and retention for low-income, young adults. The six projects funded, collectively called the Jobs Initiative (JI), in Denver, Milwaukee, New Orleans, Philadelphia, Seattle, and St. Louis, used an outcomes framework developed by The…

Giloth, Robert; Phillips, William

245

PBL-GIS in Secondary Geography Education: Does It Result in Higher-Order Learning Outcomes?  

ERIC Educational Resources Information Center

This article presents research on evaluating problem-based learning using GIS technology in a Singapore secondary school. A quasi-experimental research design was carried to test the PBL pedagogy (PBL-GIS) with an experimental group of students and compare their learning outcomes with a control group who were exposed to PBL but not GIS. The…

Liu, Yan; Bui, Elisabeth N.; Chang, Chew-Hung; Lossman, Hans G.

2010-01-01

246

Goals, Motivation for, and Outcomes of Personal Learning through Networks: Results of a Tweetstorm  

ERIC Educational Resources Information Center

Recent developments in the use of social media for learning have posed serious challenges for learners. The information overload that these online social tools create has changed the way learners learn and from whom they learn. An investigation of learners' goals, motivations and expected outcomes when using a personal learning network is…

Sie, Rory L. L.; Pataraia, Nino; Boursinou, Eleni; Rajagopal, Kamakshi; Margaryan, Anoush; Falconer, Isobel; Bitter-Rijpkema, Marlies; Littlejohn, Allison; Sloep, Peter B.

2013-01-01

247

Examining Student Spiritual Outcomes as a Result of a General Education Religion Course  

ERIC Educational Resources Information Center

In an era in which part-time faculty are becoming a higher proportion of the teaching faculty on most campuses, this study addressed the question of whether student learning outcomes in religious education courses are significantly influenced by whether the instructor teaches in a full- or part-time capacity in the Department of Religion. We…

Hilton, John, III; Plummer, Kenneth

2013-01-01

248

Long-term results and outcomes of crossover axilloaxillary bypass grafting: A 24-year experience  

Microsoft Academic Search

Objective: The outcome of crossover axilloaxillary bypass grafting in patients with stenosis or occlusion of the innominate or subclavian arteries was investigated. Methods: The study was designed as a retrospective clinical study in a university hospital setting with 61 patients as the basis of the study. Fifty-eight patients (95.1%) had at least two risk factors or associated medical illnesses for

Andrea Mingoli; Paolo Sapienza; Richard J. Feldhaus; Stefano Bartoli; Maurizio Palombi; Luca di Marzo; Antonino Cavallaro

1999-01-01

249

Neonatal Ultrasound Results Following Very Preterm Birth Predict Adolescent Behavioral and Cognitive Outcome  

Microsoft Academic Search

This study investigated the association between different neonatal ultrasonographic classifications and adolescent cognitive, educational, and behavioral outcomes following very preterm birth. Participants included a group of 120 adolescents who were born very preterm (<33 weeks of gestation), subdivided into three groups according to their neonatal cerebral ultrasound (US) classifications: (a) normal (N = 69), (b) periventricular hemorrhage (PVH, N =

C. Nosarti; M. Walshe; T. M. Rushe; L. Rifkin; J. Wyatt; R. M. Murray; M. P. Allin

2011-01-01

250

Cardiovascular outcome associations among cardiovascular magnetic resonance measures of arterial stiffness: the Dallas heart study  

PubMed Central

Background Cardiovascular magnetic resonance (CMR) has been validated for the noninvasive assessment of total arterial compliance and aortic stiffness, but their associations with cardiovascular outcomes is unknown. The purpose of this study was to evaluate associations of CMR measures of total arterial compliance and two CMR measures of aortic stiffness with respect to future cardiovascular events. Methods The study consisted of 2122 Dallas Heart Study participants without cardiovascular disease who underwent CMR at 1.5 Tesla. Aortic stiffness was measured by CMR-derived ascending aortic distensibility and aortic arch pulse wave velocity. Total arterial compliance was calculated by dividing left ventricular stroke volume by pulse pressure. Participants were monitored for cardiovascular death, non-fatal cardiac events, and non-fatal extra-cardiac vascular events over 7.8?±?1.5 years. Cox proportional hazards regression was used to assess for associations between CMR measures and cardiovascular events. Results Age, systolic blood pressure, and resting heart rate were independently associated with changes in ascending aortic distensibility, arch pulse wave velocity, and total arterial compliance (all p?measures of arterial stiffness are associated with future cardiovascular events. Total arterial compliance and aortic distensibility may be stronger predictors of nonfatal cardiac events, while pulse wave velocity may be a stronger predictor of nonfatal extra-cardiac vascular events. PMID:24886531

2014-01-01

251

Surgeon's experiences of receiving peer benchmarked feedback using patient-reported outcome measures: a qualitative study  

PubMed Central

Background The use of patient-reported outcome measures (PROMs) to provide healthcare professionals with peer benchmarked feedback is growing. However, there is little evidence on the opinions of professionals on the value of this information in practice. The purpose of this research is to explore surgeon’s experiences of receiving peer benchmarked PROMs feedback and to examine whether this information led to changes in their practice. Methods This qualitative research employed a Framework approach. Semi-structured interviews were undertaken with surgeons who received peer benchmarked PROMs feedback. The participants included eleven consultant orthopaedic surgeons in the Republic of Ireland. Results Five themes were identified: conceptual, methodological, practical, attitudinal, and impact. A typology was developed based on the attitudinal and impact themes from which three distinct groups emerged. ‘Advocates’ had positive attitudes towards PROMs and confirmed that the information promoted a self-reflective process. ‘Converts’ were uncertain about the value of PROMs, which reduced their inclination to use the data. ‘Sceptics’ had negative attitudes towards PROMs and claimed that the information had no impact on their behaviour. The conceptual, methodological and practical factors were linked to the typology. Conclusion Surgeons had mixed opinions on the value of peer benchmarked PROMs data. Many appreciated the feedback as it reassured them that their practice was similar to their peers. However, PROMs information alone was considered insufficient to help identify opportunities for quality improvements. The reasons for the observed reluctance of participants to embrace PROMs can be categorised into conceptual, methodological, and practical factors. Policy makers and researchers need to increase professionals’ awareness of the numerous purposes and benefits of using PROMs, challenge the current methods to measure performance using PROMs, and reduce the burden of data collection and information dissemination on routine practice. PMID:24972784

2014-01-01

252

Monitoring the change: current trends in outcome measure usage in physiotherapy.  

PubMed

Physiotherapists have traditionally relied on impairment measures such as range of motion and muscle strength to monitor patient progress. The impact of treatment on patients' daily activities can be assessed with valid and reliable questionnaires, but the use of standardized questionnaires by physiotherapists appeared to be limited. A range of strategies were implemented that aimed to increase physiotherapists' use of standardized measures of functional activities. A simple random sample of 300 was drawn from a database of physiotherapy providers to a transport accident scheme, and was surveyed in March and September 2003, with response rates of 51% and 55%, respectively. There was a statistically significant (P<.05) increase in reported use of seven questionnaires and a significant reduction in the perception of barriers that were targeted by the interventions The most frequently utilized tests were a pain rating scale and questionnaires for lumbar and cervical problems. Physiotherapists' attitudes to outcome measurement were generally positive although there was a small but statistically significant (P=.02) reduction in mean attitude score over the re-test period. Physiotherapists in the population sampled significantly increased their reported use of a range of standardized outcome measures over the re-test period. The trend towards greater objectivity in measuring the progress of rehabilitation can enable physiotherapists to develop improved treatment plans with the patients' needs at the centre of the equation. PMID:15886046

Abrams, Daniel; Davidson, Megan; Harrick, Julie; Harcourt, Peter; Zylinski, Maria; Clancy, Jo

2006-02-01

253

The Autism Impact Measure (AIM): Initial Development of a New Tool for Treatment Outcome Measurement  

ERIC Educational Resources Information Center

The current study describes the development and psychometric properties of a new measure targeting sensitivity to change of core autism spectrum disorder (ASD) symptoms, the Autism Impact Measure (AIM). The AIM uses a 2-week recall period with items rated on two corresponding 5-point scales (frequency and impact). Psychometric properties were…

Kanne, Stephen M.; Mazurek, Micah O.; Sikora, Darryn; Bellando, Jayne; Branum-Martin, Lee; Handen, Benjamin; Katz, Terry; Freedman, Brian; Powell, Mary Paige; Warren, Zachary

2014-01-01

254

THE MISMATCH BETWEEN INCOME MEASURES AND DIRECT OUTCOME MEASURES OF POVERTY  

Microsoft Academic Search

A key finding of recent poverty research is that there is a significant mismatch between poverty measured using an income approach and poverty measured directly in terms of observed deprivation or other indicators of unacceptably low living standards. The mismatch is substantial and is typically in the range of 50% to 60%. This paper takes this mismatch as a springboard

Bryan Perry

2002-01-01

255

Survey and online discussion groups to develop a patient-rated outcome measure on acceptability of treatment response in vitiligo  

PubMed Central

Background Vitiligo is a chronic depigmenting skin disorder which affects around 0.5-1% of the world’s population. The outcome measures used most commonly in trials to judge treatment success focus on repigmentation. Patient-reported outcome measures of treatment success are rarely used, although recommendations have been made for their inclusion in vitiligo trials. This study aimed to evaluate the face validity of a new patient-reported outcome measure of treatment response, for use in future trials and clinical practice. Method An online survey to gather initial views on what constitutes treatment success for people with vitiligo or their parents/carers, followed by online discussion groups with patients to reach consensus on what constitutes treatment success for individuals with vitiligo, and how this can be assessed in the context of trials. Participants were recruited from an existing database of vitiligo patients and through posts on the social network sites Facebook and Twitter. Results A total of 202 survey responses were received, of which 37 were excluded and 165 analysed. Three main themes emerged as important in assessing treatment response: a) the match between vitiligo and normal skin (how well it blends in); b) how noticeable the vitiligo is and c) a reduction in the size of the white patches. The majority of respondents said they would consider 80% or more repigmentation to be a worthwhile treatment response after 9 months of treatment. Three online discussion groups involving 12 participants led to consensus that treatment success is best measured by asking patients how noticeable their vitiligo is after treatment. This was judged to be best answered using a 5-point Likert scale, on which a score of 4 or 5 represents treatment success. Conclusions This study represents the first step in developing a patient reported measure of treatment success in vitiligo trials. Further work is now needed to assess its construct validity and responsiveness to change. PMID:24929563

2014-01-01

256

Management Strategies and Determinants of Outcome in Acute Major Pulmonary Embolism: Results of a Multicenter Registry  

Microsoft Academic Search

Objectives. The present study investigated current management strategies as well as the clinical course of acute major pulmonary embolism.Background. The clinical outcome of patients with acute pulmonary embolism who present with overt or impending right heart failure has not yet been adequately elucidated.Methods. The 204 participating centers enrolled a total of 1,001 consecutive patients. The inclusion criteria were based on

Wolfgang Kasper; Stavros Konstantinides; Annette Geibel; Manfred Olschewski; Fritz Heinrich; Klaus D Grosser; Klaus Rauber; Stein Iversen; Matthias Redecker; Joachim Kienast

1997-01-01

257

Results of POCAT, Spring '06 The Program Outcomes Achievement Test (POCAT) is a direct assessment tool for assessing the degree of  

E-print Network

Outcomes: The questions on POCAT help assess the degree of achievement of EAC Outcomes 3.a, 3.b, 3.c, 3.eResults of POCAT, Spring '06 The Program Outcomes Achievement Test (POCAT) is a direct assessment eight students took the test in the Spring '06 quarter. The results appear in the table on the next page

Xuan, Dong

258

Dynamic patient data bases: the foundation of an integrated approach to outcome measures for the healthcare professionals.  

PubMed

In recent years there has been a tremendous need among healthcare professionals to assess the effectiveness, efficiency, and appropriateness of the patient care services being provided through criteria-based outcome and program evaluation. Although the need for a tool which could evaluate the effectiveness of patient care is widely recognized, such an undertaking has been severely limited due to the lack of any automated means to collect and analyze patient data on a routine, continuous basis within a clinical setting. We have developed and implemented at Mineral Springs Hospital, Banff, Alberta an integrated and automated hospital information system that not only continuously collects administrative, financial, and patient data, but also contains an intelligent component for automated outcome measure and program evaluation. The system collects various non-duplicated data elements from each routine work process within the facility on a continuous basis. Through the creation of a dynamic patient database, data is transformed into information--a powerful decision support tool. The system provides flexible user-defined reports in patient-specific resource utilization, direct and/or indirect specific financial costs, result reporting of each intervention, service provided and user-defined criteria-based outcome, and program evaluation. The system design incorporates expert rules, dynamic data entry forms, quantitative models, and user-defined access control. Using information derived from the dynamic common database, managers and front-line clinicians can easily evaluate and modify management decisions or careplans on a macro or micro level. An external review is planned to evaluate whether the system has helped the assessment of effectiveness, efficiency and appropriateness of healthcare services being provided at the hospital. The fundamental concept behind the system design is that the patient is the center of activity for data collection. The system provides the answers to the 5 W's (who, what, where, when, and why) together with intervention and service result reports. A dynamic common patient database is the center of the system and is accessible to all with proper authorization. Common data elements are collected from routine work flow without extra data entry and this information is subsequently shared. Data collection is a continuous process. We believe that every process is the outcome of another sub-process or event. The design of the dynamic patient database incorporates patient-specific costing and outcome evaluation, user-defined flexible data entry forms, user-defined access control, outcome evaluation rules and information semantic rules. Such a patient database would provide the flexibility needed to accommodate diverse methodologies to evaluate outcomes whether it they be medical, cost, access and/or other combination of measures. The system was developed on a PC-based Network technology, using FOXPRO (XBase) as the database development tool incorporating advanced technology such as distributed processing and fault tolerant computing. We chose PC-based technology because it is economical, having relatively low maintenance costs and requires no major dependency on vendors. The developed system produces patient-specific reports with many dimensions. The reports are user-defined. The system reports general data, CMG, RGN, LOS, Expected LOS, and other user-defined demographic data. Resource utilization, financial costs, and result reportings are produced together with rule-based outcome assessments of any type of measures, including, but not limited to, pre-set functional/health goals, user satisfaction, clinicianUs text or codified comments etc. It provides the framework for continually capturing data at a practical, work-flow level. The incorporation of a dynamic patient database as the driving forece of an integrated, rule-based administration, financial and patient data system will provdie the tools for healthcar PMID:8591238

Kwok, H K; Stevens, N

1995-01-01

259

Measuring Outcomes in Mental Health Services for Older People: An Evaluation of the Health of the Nation Outcome Scales for Elderly People (HoNOS65+)  

ERIC Educational Resources Information Center

The Health of the Nation Outcome Scales (HoNOS) family of measures is routinely used in mental health services in the New Zealand, Australia, and the United Kingdom. However, the psychometric properties of the HoNOS65+ for elderly people have not been extensively evaluated. The aim of the present study was to examine the validity, reliability, and…

Gee, Susan B.; Croucher, Matthew J.; Beveridge, John

2010-01-01

260

Patient and visit characteristics related to physicians' participatory decision-making style. Results from the Medical Outcomes Study  

Microsoft Academic Search

This article identifies the characteristics of patients and office visits associated with decreased mutual decision-making between physicians and patients. In the baseline cross-sectional survey of the Medical Outcomes Study we measured specific patient characteristics hypothesized to influence participatory decision-making (PDM) styles of physicians. We related these characteristics to the PDM style scores for their physicians. The study was conducted in

Sherrie H. Kaplan; Barbara Gandek; Sheldon Greenfield; William H. Rogers; Ware John E. Jr

1995-01-01

261

Reduced Sexual Risk Behaviors Among People Living with HIV: Results from the Healthy Relationships Outcome Monitoring Project  

Microsoft Academic Search

In 2006, the Centers for Disease Control and Prevention funded seven community-based organizations (CBOs) to conduct outcome\\u000a monitoring of Healthy Relationships. Healthy Relationships is an evidence-based behavioral intervention for people living\\u000a with HIV. Demographic and sexual risk behaviors recalled by participants with a time referent of the past 90 days were collected\\u000a over a 17-month project period using a repeated measures

Janet L. HeitgerdElizabeth; Elizabeth J. Kalayil; Alpa Patel-Larson; Gary Uhl; Weston O. Williams; Tanesha Griffin; Bryce D. Smith

262

Mediation analysis when a continuous mediator is measured with error and the outcome follows a generalized linear model.  

PubMed

Mediation analysis is a popular approach to examine the extent to which the effect of an exposure on an outcome is through an intermediate variable (mediator) and the extent to which the effect is direct. When the mediator is mis-measured, the validity of mediation analysis can be severely undermined. In this paper, we first study the bias of classical, non-differential measurement error on a continuous mediator in the estimation of direct and indirect causal effects in generalized linear models when the outcome is either continuous or discrete and exposure-mediator interaction may be present. Our theoretical results as well as a numerical study demonstrate that in the presence of non-linearities, the bias of naive estimators for direct and indirect effects that ignore measurement error can take unintuitive directions. We then develop methods to correct for measurement error. Three correction approaches using method of moments, regression calibration, and SIMEX are compared. We apply the proposed method to the Massachusetts General Hospital lung cancer study to evaluate the effect of genetic variants mediated through smoking on lung cancer risk. Copyright © 2014 John Wiley & Sons, Ltd. PMID:25220625

Valeri, Linda; Lin, Xihong; VanderWeele, Tyler J

2014-12-10

263

The impact of surgery for oral cancer on quality of life as measured by the Medical Outcomes Short Form 36  

Microsoft Academic Search

Quality of life evaluation is an important measure of outcome following the treatment of head and neck cancer. The aim of this study was to evaluate the quality of life of patients undergoing primary surgery for oral and oropharyngeal squamous cell carcinoma. 50 consecutive patients with previously untreated oral cancer were assessed using using two questionnaires, the Medical Outcomes Short

S. N Rogers; G Humphris; D Lowe; J. S Brown; E. D Vaughan

1998-01-01

264

Bluetooth radio network performance: measurement results and simulation models  

Microsoft Academic Search

When designing new communication systems, results from simulations determine a large part of the system parameters. As simulations simplify reality according to the investigated aspects, the results obtained strongly depend on the assumptions made for the simplifications. This paper now presents real-life measurement results obtained in a Bluetooth radio network testbed and compares these results with models used in radio

Kirsten Matheus; Sverker Magnusson

2004-01-01

265

Insomnia and Objectively Measured Sleep Disturbances Predict Treatment Outcome in Depressed Patients Treated with Psychotherapy or Psychotherapy-Pharmacotherapy Combinations  

PubMed Central

Objective Insomnia and objectively measured sleep disturbances predict poor treatment outcomes in patients with major depressive disorder (MDD). However, prior research has utilized individual clinical trials with relatively small sample sizes and has focused on insomnia symptoms or objective measures, but not both. The present study is a secondary analysis that examines the degree to which insomnia, objective sleep disturbances, or their combination, predicts depression remission following pharmacotherapy and/or psychotherapy treatment. Methods Participants were 711 depressed patients drawn from six clinical trials. Remission status, defined as a score of ? 7 on the Hamilton Rating Scale for Depression (HDRS) over two consecutive months, served as the primary outcome. Insomnia was assessed via the 3 sleep items on the HDRS. Objectively measured short sleep duration (total sleep time < = 6 hours), and prolonged sleep latency (SL >30 minutes) or wakefulness after sleep onset (WASO>30) were derived from in-laboratory polysomnographic (PSG) sleep studies. Logistic regression predicted the odds of non-remission according to insomnia, each of the objective sleep disturbances, or their combination, after adjusting for age, sex, treatment modality, and baseline depressive symptoms. Results Prolonged sleep latency alone (OR = 1.82; CI: 1.23, 2.70) or in combination with insomnia (OR = 2.03; CI: 1.13, 3.95) predicted increased risk of non-remission. In addition, insomnia and sleep duration individually and in combination were each associated with a significantly increased risk of non-remission (p’s < .05). Conclusion Findings suggest that objectively measured prolonged sleep latency and short sleep duration independently, or in conjunction with insomnia are risk factors for poor depression treatment outcome. PMID:22152403

Troxel, W.M.; Kupfer, D.J.; Reynolds, C.F.; Frank, E.; Thase, M.; Miewald, J.; Buysse, D.J.

2011-01-01

266

A Combined Measure of Procedural Volume and Outcome to Assess Hospital Quality of Colorectal Cancer Surgery, a Secondary Analysis of Clinical Audit Data  

PubMed Central

Objective To identify, on the basis of past performance, those hospitals that demonstrate good outcomes in sufficient numbers to make it likely that they will provide adequate quality of care in the future, using a combined measure of volume and outcome (CM-V&O). To compare this CM-V&O with measures using outcome-only (O-O) or volume-only (V-O), and verify 2010-quality of care assessment on 2011 data. Design Secondary analysis of clinical audit data. Setting The Dutch Surgical Colorectal Audit database of 2010 and 2011, the Netherlands. Participants 8911 patients (test population, treated in 2010) and 9212 patients (verification population, treated in 2011) who underwent a resection of primary colorectal cancer in 89 Dutch hospitals. Main Outcome Measures Outcome was measured by Observed/Expected (O/E) postoperative mortality and morbidity. CM-V&O states 2 criteria; 1) outcome is not significantly worse than average, and 2) outcome is significantly better than substandard, with ‘substandard care’ being defined as an unacceptably high O/E threshold for mortality and/or morbidity (which we set at 2 and 1.5 respectively). Results Average mortality and morbidity in 2010 were 4.1 and 24.3% respectively. 84 (94%) hospitals performed ‘not worse than average’ for mortality, but only 21 (24%) of those were able to prove they were also ‘better than substandard’ (O/E<2). For morbidity, 42 hospitals (47%) met the CM-V&O. Morbidity in 2011 was significantly lower in these hospitals (19.8 vs. 22.8% p<0.01). No relationship was found between hospitals' 2010 performance on O-O en V-O, and the quality of their care in 2011. Conclusion CM-V&O for morbidity can be used to identify hospitals that provide adequate quality and is associated with better outcomes in the subsequent year. PMID:24558418

Kolfschoten, Nikki E.; Marang-van de Mheen, Perla J.; Wouters, Michel W. J. M.; Eddes, Eric-Hans; Tollenaar, Rob A. E. M.; Stijnen, Theo; Kievit, Job

2014-01-01

267

A repeated measures model for analysis of continuous outcomes in sequential parallel comparison design studies.  

PubMed

Previous authors have proposed the sequential parallel comparison design (SPCD) to address the issue of high placebo response rate in clinical trials. The original use of SPCD focused on binary outcomes, but recent use has since been extended to continuous outcomes that arise more naturally in many fields, including psychiatry. Analytic methods proposed to date for analysis of SPCD trial continuous data included methods based on seemingly unrelated regression and ordinary least squares. Here, we propose a repeated measures linear model that uses all outcome data collected in the trial and accounts for data that are missing at random. An appropriate contrast formulated after the model has been fit can be used to test the primary hypothesis of no difference in treatment effects between study arms. Our extensive simulations show that when compared with the other methods, our approach preserves the type I error even for small sample sizes and offers adequate power and the smallest mean squared error under a wide variety of assumptions. We recommend consideration of our approach for analysis of data coming from SPCD trials. PMID:23355369

Doros, Gheorghe; Pencina, Michael; Rybin, Denis; Meisner, Allison; Fava, Maurizio

2013-07-20

268

Multivariate t linear mixed models for irregularly observed multiple repeated measures with missing outcomes.  

PubMed

Missing outcomes or irregularly timed multivariate longitudinal data frequently occur in clinical trials or biomedical studies. The multivariate t linear mixed model (MtLMM) has been shown to be a robust approach to modeling multioutcome continuous repeated measures in the presence of outliers or heavy-tailed noises. This paper presents a framework for fitting the MtLMM with an arbitrary missing data pattern embodied within multiple outcome variables recorded at irregular occasions. To address the serial correlation among the within-subject errors, a damped exponential correlation structure is considered in the model. Under the missing at random mechanism, an efficient alternating expectation-conditional maximization (AECM) algorithm is used to carry out estimation of parameters and imputation of missing values. The techniques for the estimation of random effects and the prediction of future responses are also investigated. Applications to an HIV-AIDS study and a pregnancy study involving analysis of multivariate longitudinal data with missing outcomes as well as a simulation study have highlighted the superiority of MtLMMs on the provision of more adequate estimation, imputation and prediction performances. PMID:23740830

Wang, Wan-Lun

2013-07-01

269

Planned versus actual outcomes as a result of animal feeding operation decisions for managing phosphorus.  

PubMed

The paper explores how decisions made on animal feeding operations (AFOs) influence the management of manure and phosphorus. Variability among these decisions from operation to operation and from field to field can influence the validity of nutrient loss risk assessments. These assessments are based on assumptions that the decision outcomes regarding manure distribution will occur as they are planned. The discrepancy between planned versus actual outcomes in phosphorus management was explored on nine AFOs managing a contiguous set of 210 fields in south-central Wisconsin. A total of 2611 soil samples were collected and multiple interviews conducted to assign phosphorus index (PI) ratings to the fields. Spearman's rank correlation coefficients (r(S)) indicated that PI ratings were less sensitive to soil test phosphorus (STP) levels (r(S) = 0.378), universal soil loss equation (USLE) (r(S) = 0.261), ratings for chemical fertilizer application (r(S) = 0.185), and runoff class (r(S) = -0.089), and more sensitive to ratings for manure application (r(S) = 0.854). One-way ANOVA indicated that mean field STP levels were more homogenous than field PI ratings between AFOs. Kolmogorov-Smirnov (K-S) tests displayed several nonsignificant comparisons for cumulative distribution functions, S(x), of mean STP levels on AFO fields. On the other hand, the K-S tests of S(x) for PI ratings indicated that the majority of these S(x) functions were significantly different between AFOs at or greater than the 0.05 significance level. Interviews suggested multiple reasons for divergence between planned and actual outcomes in managing phosphorus, and that this divergence arises at the strategic, tactical, and operational levels of decision-making. PMID:15843639

Cabot, Perry E; Nowak, Pete

2005-01-01

270

Burns as a result of assault: associated risk factors, injury characteristics, and outcomes.  

PubMed

The purpose of this study was to identify specific premorbid factors and injury characteristics associated with intentional burn injuries and to compare outcomes for individuals injured by assault and those with unintentional injuries. Participants sustaining major burns from May 1994 to August 2005 and consenting to a multisite, prospective, longitudinal outcome study were included. Etiology of the injury was classified as intentional (i.e., assault) or unintentional. Subjects <18 years old or with self-inflicted burns were excluded. Statistical analysis was performed with t-tests, chi2 tests, and analysis of variance. Eighty patients sustained intentional burn injuries and 1982 subjects sustained nonintentional burn injuries. Compared to patients with nonintentional burns, those with burns related to assault were more likely to be female, black, and unemployed and to have higher rates of premorbid substance use. Between the groups, there were no significant differences in preinjury living situation, education level, history of psychiatric treatment, or hospital length of stay. The intentional-burn group had larger burns and a greater in-hospital mortality rate, and these patients were less likely to be discharged to home. They also demonstrated significantly greater levels of psychological distress during the acute hospitalization but not at follow-up. Understanding the unique characteristics and needs of patients with intentional burn injuries is important because these individuals are less likely to have a steady income and more likely to rely on community social services. Affordable and accessible community-based health services are necessary in order to improve their outcomes. PMID:17211196

Kaufman, Marla S; Graham, Christina C; Lezotte, Dennis; Fauerbach, James A; Gabriel, Vincent; Engrav, Loren H; Esselman, Peter

2007-01-01

271

Selecting outcome measures in sports medicine: a guide for practitioners using the example of anterior cruciate ligament rehabilitation  

Microsoft Academic Search

Using examples from the field of anterior cruciate ligament rehabilitation, this review provides sports and health practitioners with a comprehensive, user-friendly, guide to selecting outcome measures for use with active populations. A series of questions are presented for consideration when selecting a measure: is the measure appropriate for the intended use? (appropriateness); is the measure acceptable to patients? (acceptability); is

N P Bent; C C Wright; A B Rushton; M E Batt

2009-01-01

272

An overview of animal models of pain: disease models and outcome measures  

PubMed Central

Pain is ultimately a perceptual phenomenon. It is built from information gathered by specialized pain receptors in tissue, modified by spinal and supraspinal mechanisms, and integrated into a discrete sensory experience with an emotional valence in the brain. Because of this, studying intact animals allows the multidimensional nature of pain to be examined. A number of animal models have been developed, reflecting observations that pain phenotypes are mediated by distinct mechanisms. Animal models of pain are designed to mimic distinct clinical diseases to better evaluate underlying mechanisms and potential treatments. Outcome measures are designed to measure multiple parts of the pain experience including reflexive hyperalgesia measures, sensory and affective dimensions of pain and impact of pain on function and quality of life. In this review we discuss the common methods used for inducing each of the pain phenotypes related to clinical pain syndromes, as well as the main behavioral tests for assessing pain in each model. PMID:24035349

Gregory, N; Harris, AL; Robinson, CR; Dougherty, PM; Fuchs, PN; Sluka, KA

2013-01-01

273

Measuring service learning outcomes: test-retest reliability of four scales.  

PubMed

Previous research efforts have developed and validated various scales potentially useful in evaluating service learning outcomes. The developmental efforts reported for the four scales examined in this study did not include the test-retest reliabilities that would provide assurance to service learning researchers of the long-term stability and therefore usefulness of these measures. Summary estimates of 13-wk. test-retest reliabilities for the scales Civic Participation, Self-efficacy Toward Service, Attitude Toward Helping Others, and College Education's Role in Addressing Social Issues provide service learning researchers with evidence of stability of the scales over the typical duration of service learning courses. PMID:21117490

Weber, James E; Weber, Paula S; Young, Margaret A

2010-10-01

274

Physical activity level as an outcome measure for use in cancer cachexia trials: a feasibility study  

Microsoft Academic Search

Purpose  Cancer cachexia impacts on treatment options, quality of life and survival. New treatments are emerging but need to be assessed\\u000a using outcomes which patients find meaningful. One approach is the measurement of physical activity levels by small lightweight\\u000a monitors, but experience is limited in cancer patients.\\u000a \\u000a \\u000a \\u000a \\u000a Materials and methods  This study formally assessed the acceptability of wearing an ActivPAL™ monitor for

Matthew Maddocks; Anthony Byrne; Colin D. Johnson; Richard H. Wilson; Kenneth C. H. Fearon; Andrew Wilcock

2010-01-01

275

Spectral measurements in critical assemblies: MCNP specifications and calculated results  

SciTech Connect

Recently, a suite of 86 criticality benchmarks for the Monte Carlo N-Particle (MCNP) transport code was developed, and the results of testing the ENDF/B-V and ENDF/B-VI data (through Release 2) were published. In addition to the standard k{sub eff} measurements, other experimental measurements were performed on a number of these benchmark assemblies. In particular, the Cross Section Evaluation Working Group (CSEWG) specifications contain experimental data for neutron leakage and central-flux measurements, central-fission ratio measurements, and activation ratio measurements. Additionally, there exists another set of fission reaction-rate measurements performed at the National Institute of Standards and Technology (NIST) utilizing a {sup 252}Cf source. This report will describe the leakage and central-flux measurements and show a comparison of experimental data to MCNP simulations performed using the ENDF/B-V and B-VI (Release 2) data libraries. Central-fission and activation reaction-rate measurements will be described, and the comparison of experimental data to MCNP simulations using available data libraries for each reaction of interest will be presented. Finally, the NIST fission reaction-rate measurements will be described. A comparison of MCNP results published previously with the current MCNP simulations will be presented for the NIST measurements, and a comparison of the current MCNP simulations to the experimental measurements will be presented.

Stephanie C. Frankle; Judith F. Briesmeister

1999-12-01

276

An outcome measure of functionality in patients with lumber spinal stenosis: a validation study of the Iranian version of Neurogenic Claudication Outcome Score (NCOS)  

PubMed Central

Background Neurogenic claudication (NC) is a common symptom in patients with lumbar spinal stenosis (LSS). The Neurogenic Claudication Outcome Score (NCOS) is a very short instrument for measuring functional status in these patients. This study aimed to translate and validate the NCOS in Iran. Methods This was a prospective clinical validation study. The 'forward-backward' procedure was applied to translate the NCOS from English into Persian (Iranian language). A total of 84 patients with NC were asked to respond to the questionnaire at two points in time: at preoperative and at postoperative (6 months follow-up) assessments. The Oswestry Disabiltiy Index (ODI) also was completed for patients. To test reliability, the internal consistency was assessed by Cronbach's alpha coefficient. Validity was evaluated using known groups comparison and criterion validity (convergent validity). Internal responsiveness of the NCOS to the clinical intervention (surgery) also was assessed comparing patients’ pre- and postoperative scores. Results The Cronbach’s alpha coefficients for the NCOS at preoperative and postoperative assessments were 0.77 and 0.91, respectively. Known groups analysis showed satisfactory results. The instrument discriminated well between sub-groups of patients who differed in claudication distance as measured by the Self-Paced Walking Test (SPWT). The change in the ODI after surgery was strongly correlated with change in the NCOS, lending support to its good convergent validity (r?=?0.81; P?measure of functionality in patients with lumbar spinal stenosis who are suffering from neurogenic claudication. PMID:23006983

2012-01-01

277

A Guide to Strategically Planning Training and Measuring Results.  

ERIC Educational Resources Information Center

A four-step approach to implementing a training program and measuring results for government agencies was developed in response to an executive order to federal agencies to provide effective training and performance measures in their annual budgets. Step one is the analysis of established goals to identify training requirements. Suggested…

Office of Personnel Management, Washington, DC.

278

Original Method for Non-Invasive Glucose Measurement: Preliminary Results.  

National Technical Information Service (NTIS)

This paper presents first results obtained using a novel approach for non-invasive measurement of glucose content We use a network analyzer, which is used to measure T/R, the modulus of the Transmission to the Reference signal. The under-test solution is ...

S. M. Alavi, M. Gourzi, A. Rouane, M. Nadi

2001-01-01

279

Wind velocity measurements using a pulsed LIDAR system: first results  

E-print Network

Wind velocity measurements using a pulsed LIDAR system: first results M W¨achter1, A Rettenmeier2. Wind velocity measurements were taken using a Leosphere Windcube LIDAR system, which operates relevance for wind energy utilization. Different technologies are in use in this field, among them LIDAR

Peinke, Joachim

280

26 CFR 801.6 - Business results measures.  

Code of Federal Regulations, 2010 CFR

...PRACTICE BALANCED SYSTEM FOR MEASURING...Automated Collection System Units (ACS...and account information. (3) Other...results are data, statistics, compilations of information or other numerical...planning, resource management, and...

2010-04-01

281

Heart rate variability measured early in patients with evolving acute coronary syndrome and 1-year outcomes of rehospitalization and mortality  

PubMed Central

Objective This study sought to examine the prognostic value of heart rate variability (HRV) measurement initiated immediately after emergency department presentation for patients with acute coronary syndrome (ACS). Background Altered HRV has been associated with adverse outcomes in heart disease, but the value of HRV measured during the earliest phases of ACS related to risk of 1-year rehospitalization and death has not been established. Methods Twenty-four-hour Holter recordings of 279 patients with ACS were initiated within 45 minutes of emergency department arrival; recordings with ?18 hours of sinus rhythm were selected for HRV analysis (number [N] =193). Time domain, frequency domain, and nonlinear HRV were examined. Survival analysis was performed. Results During the 1-year follow-up, 94 patients were event-free, 82 were readmitted, and 17 died. HRV was altered in relation to outcomes. Predictors of rehospitalization included increased normalized high frequency power, decreased normalized low frequency power, and decreased low/high frequency ratio. Normalized high frequency >42 ms2 predicted rehospitalization while controlling for clinical variables (hazard ratio [HR] =2.3; 95% confidence interval [CI] =1.4–3.8, P=0.001). Variables significantly associated with death included natural logs of total power and ultra low frequency power. A model with ultra low frequency power <8 ms2 (HR =3.8; 95% CI =1.5–10.1; P=0.007) and troponin >0.3 ng/mL (HR =4.0; 95% CI =1.3–12.1; P=0.016) revealed that each contributed independently in predicting mortality. Nonlinear HRV variables were significant predictors of both outcomes. Conclusion HRV measured close to the ACS onset may assist in risk stratification. HRV cut-points may provide additional, incremental prognostic information to established assessment guidelines, and may be worthy of additional study. PMID:25143740

Harris, Patricia R E; Stein, Phyllis K; Fung, Gordon L; Drew, Barbara J

2014-01-01

282

Day-to-day measurement of patient-reported outcomes in exacerbations of chronic obstructive pulmonary disease  

PubMed Central

Background Exacerbations of chronic obstructive pulmonary disease (COPD) are a major burden to patients and to society. Little is known about the possible role of day-to-day patient-reported outcomes during an exacerbation. This study aims to describe the day-to-day course of patient-reported health status during exacerbations of COPD and to assess its value in predicting clinical outcomes. Methods Data from two randomized controlled COPD exacerbation trials (n = 210 and n = 45 patients) were used to describe both the feasibility of daily collection of and the day-to-day course of patient-reported outcomes during outpatient treatment or admission to hospital. In addition to clinical parameters, the BORG dyspnea score, the Clinical COPD Questionnaire (CCQ), and the St George’s Respiratory Questionnaire were used in Cox regression models to predict treatment failure, time to next exacerbation, and mortality in the hospital study. Results All patient-reported outcomes showed a distinct pattern of improvement. In the multivariate models, absence of improvement in CCQ symptom score and impaired lung function were independent predictors of treatment failure. Health status and gender predicted time to next exacerbation. Five-year mortality was predicted by age, forced expiratory flow in one second % predicted, smoking status, and CCQ score. In outpatient management of exacerbations, health status was found to be less impaired than in hospitalized patients, while the rate and pattern of recovery was remarkably similar. Conclusion Daily health status measurements were found to predict treatment failure, which could help decision-making for patients hospitalized due to an exacerbation of COPD. PMID:23766644

Kocks, Jan Willem H; van den Berg, Jan Willem K; Kerstjens, Huib AM; Uil, Steven M; Vonk, Judith M; de Jong, Ynze P; Tsiligianni, Ioanna G; van der Molen, Thys

2013-01-01

283

Rates, management, and outcome of rivaroxaban bleeding in daily care: results from the Dresden NOAC registry.  

PubMed

Worldwide, rivaroxaban is increasingly used for stroke prevention in atrial fibrillation and treatment of venous thromboembolism, but little is known about rivaroxaban-related bleeding complications in daily care. Using data from a prospective, noninterventional oral anticoagulation registry of daily care patients (Dresden NOAC registry), we analyzed rates, management, and outcome of rivaroxaban-related bleeding. Between October 1, 2011, and December 31, 2013, 1776 rivaroxaban patients were enrolled. So far, 762 patients (42.9%) reported 1082 bleeding events during/within 3 days after last intake of rivaroxaban (58.9% minor, 35.0% of nonmajor clinically relevant, and 6.1% major bleeding according to International Society on Thrombosis and Haemostasis definition). In case of major bleeding, surgical or interventional treatment was needed in 37.8% and prothrombin complex concentrate in 9.1%. In the time-to-first-event analysis, 100-patient-year rates of major bleeding were 3.1 (95% confidence interval 2.2-4.3) for stroke prevention in atrial fibrillation and 4.1 (95% confidence interval 2.5-6.4) for venous thromboembolism patients, respectively. In the as-treated analysis, case fatality rates of bleeding leading to hospitalizations were 5.1% and 6.3% at days 30 and 90 after bleeding, respectively. Our data indicate that, in real life, rates of rivaroxaban-related major bleeding may be lower and that the outcome may at least not be worse than that of major vitamin K antagonist bleeding, and probably better. This trial was registered at www.clinicaltrials.gov as identifier #NCT01588119. PMID:24859362

Beyer-Westendorf, Jan; Förster, Kati; Pannach, Sven; Ebertz, Franziska; Gelbricht, Vera; Thieme, Christoph; Michalski, Franziska; Köhler, Christina; Werth, Sebastian; Sahin, Kurtulus; Tittl, Luise; Hänsel, Ulrike; Weiss, Norbert

2014-08-01

284

Symptoms and Association with Health Outcomes in Relapsing-Remitting Multiple Sclerosis: Results of a US Patient Survey  

PubMed Central

Background. A variety of symptoms have been reported, but the prevalence of specific symptoms in relapsing-remitting multiple sclerosis (RRMS), how they are related to one another, and their impact on patient reported outcomes is not well understood. Objective. To describe how symptoms of RRMS cooccur and their impact on patient-reported outcomes. Methods. Individuals who reported a physician diagnosis of RRMS in a large general health survey in the United States indicated the symptoms they experience because of RRMS and completed validated scales, including the work productivity and activity impairment questionnaire and either the SF-12v2 or SF-36v2. Symptom clusters were identified through hierarchical cluster analysis, and the relationship between clusters and outcomes was assessed through regression. Results. Fatigue, difficulty walking, and numbness were the most commonly reported symptoms. Seven symptom clusters were identified, and several were significantly related to patient reported outcomes. Pain, muscle spasms, and stiffness formed a cluster strongly related to physical quality of life; depression was strongly related to mental quality of life and cognitive difficulty was associated with work impairment. Conclusions. Symptoms in RRMS show a strong relationship with quality of life and should be taken into consideration in treatment decisions and evaluation of treatment success. PMID:25328704

Williams, Angela E.; Vietri, Jeffrey T.

2014-01-01

285

Cerebellar Alterations and Gait Defects as Therapeutic Outcome Measures for Enzyme Replacement Therapy in ?-Mannosidosis  

PubMed Central

?-Mannosidosis is a rare lysosomal storage disease with accumulation of undegraded mannosyl-linked oligosaccharides in cells throughout the body, most notably in the CNS. This leads to a broad spectrum of neurological manifestations, including progressive intellectual impairment, disturbed motor functions and cerebellar atrophy. To develop therapeutic outcome measures for enzyme replacement therapy (ERT) that could be used for human patients, a gene knockout model of ?-mannosidosis in mice was analyzed for CNS pathology and motor deficits. In the cerebellar molecular layer, ?-mannosidosis mice display clusters of activated Bergman glia, infiltration of phagocytic macrophages and accumulation of free cholesterol and gangliosides (GM1), notably in regions lacking Purkinje cells. ?-mannosidosis brain lysates also displayed increased expression of Lamp1 and hyperglycosylation of the cholesterol binding protein NPC2. Detailed assessment of motor function revealed age-dependent gait defects in the mice that resemble the disturbed motor function in human patients. Short-term ERT partially reversed the observed cerebellar pathology with fewer activated macrophages and astrocytes but unchanged levels of hyperglycosylated NPC2, gangliosides and cholesterol. The present study demonstrates cerebellar alterations in ?-mannosidosis mice that relate to the motor deficits and pathological changes seen in human patients and can be used as therapeutic outcome measures. PMID:21157375

Damme, Markus; Stroobants, Stijn; Walkley, Steven U.; Lullmann-Rauch, Renate; D`Hooge, Rudi; Fogh, Jens; Saftig, Paul; Lubke, Torben; Blanz, Judith

2011-01-01

286

Evidence for the validity of grouped self-assessments in measuring the outcomes of educational programs.  

PubMed

There is compelling empirical evidence in support of the use of grouped self-assessment data to measure program outcomes. However, other credible research has clearly shown that self-assessments are poor predictors of individual achievement such that the validity of self-assessments has been called into question. Based on the reanalysis of two previously published studies and an analysis of two original studies, we show that grouped self-assessments may be good predictors of and hence valid measures of performance at the group level, an outcome commonly used in program evaluation studies. We found statistically significant correlation coefficients (between 0.56 and 0.87), when comparing across performance items using the group means of self-assessments with the group means of individual achievement on criterion tests. We call for further research into the conditions and circumstances in which grouped self-assessments are used, so that they can be employed more effectively and confidently by program evaluators, decision makers, and researchers. PMID:23396128

D'Eon, Marcel F; Trinder, Krista

2014-12-01

287

Content Validation of the Patient-Reported Outcomes Measurement Information System (PROMIS) Framework in Women With Urinary Incontinence  

PubMed Central

Aims To assess whether the existing National Institutes of Health (NIH) Patient Reported Outcomes Measurement Information System (PROMIS) conceptual framework and item banks sufficiently capture the concerns of women with urinary incontinence (UI). Methods Thirty-five women with UI were recruited between February-April 2009 for 4 structured focus groups to develop and assess the content validity of a conceptual framework for the impact of UI. This framework included domains from the NIH PROMIS framework and item banks including broad domains of physical and social function and mental health. All sessions were transcribed, coded, and qualitatively and quantitatively analyzed using analytic induction and deductive analysis to identify new themes and domains relevant to women with UI. Results The focus groups provided information that confirmed the relevance of existing PROMIS domains and identified new outcome domains that are important to this patient population. The groups confirmed the relevance of the physical and social functioning, and mental health domains. Additional themes that emerged included the distinction between ability versus participation and satisfaction, role functioning, external mediators, re-calibration/coping, cognitive function and new possibilities. Participants also felt strongly that not all domains and items apply to all women with UI and an option to tailor questionnaires and skip non-relevant items was important. Conclusions The PROMIS framework domains are relevant to women with UI, but additional patient-important themes are identified that may improve the comprehensiveness of this assessment framework for measuring outcomes important to women with UI. These results will inform future item content development for UI. PMID:21400574

Sung, Vivian W.; Marques, Felisha; Rogers, Rebecca R.; Williams, David A.; Myers, Deborah L.; Clark, Melissa A.

2014-01-01

288

Does duration of untreated psychosis predict very long term outcome of schizophrenic disorders? results of a retrospective study  

PubMed Central

Background Studies performed to assess the relevance of duration of untreated psychosis (DUP) as a predictor of long-term outcome (i.e. follow-ups of ten years or more) are somewhat limited. The aim of this study was to evaluate the potential association between DUP and very long-term outcome (16-33 yrs) of schizophrenia by means of a retrospective design. Methods Retrospective data obtained from clinical records were collected regarding DUP and outcome variables (number of hospitalizations; number of attempted suicides; course of illness; GAF scores at last observation) for a cohort of 80 outpatients (52 Males, 28 Females, mean age 51.0+/-11.58 years) affected by schizophrenia according to DSMIVTR attending a university community mental health centre. Results Mean duration of follow up was 25.2 +/- 8.68 years; mean duration of untreated psychosis was 49.00 months (range 1-312 mo), with no significant difference according to gender. Patients with a shorter DUP (=/< 1 year) displayed more frequent “favourable” courses of illness (28.9% vs 8.6%) (p?=?0.025), more frequent cases with limited (=/< 3) number of hospital admissions (85.7% vs 62.1%) (p?=?0.047) and a better functioning (mean GAF score?=?50.32+/-16.49 vs 40.26+/-9.60, p?=?0.002); regression analyses confirmed that shorter DUP independently predicted a more positive outcome in terms of number of hospital admissions, course of illness, functioning (GAF scores). Conclusion A shorter DUP appears to act as a significant predictor of better outcome in schizophrenia even in the very long-term. PMID:22856624

2012-01-01

289

Construct validity of the FOCUS© (Focus on the Outcomes of Communication Under Six): a communicative participation outcome measure for preschool children  

PubMed Central

Objective The aim of this study was to establish the construct validity of the Focus on the Outcomes of Communication Under Six (FOCUS©). This measure is reflective of concepts in the International Classification of Functioning Disability and Health – Children and Youth framework. It was developed to capture ‘real-world’ changes (e.g. communicative participation) in preschoolers' communication following speech-language intervention. Method A pre–post design was used. Fifty-two parents of 3- to 6-year-old preschoolers attending speech-language therapy were included as participants. Speech-language therapists provided individual and/or group intervention to preschoolers. Intervention targeted: articulation/phonology, voice/resonance, expressive/receptive language, play, and use of augmentative devices. Construct validity for communicative participation was assessed using pre-intervention and post-intervention parent interviews using the FOCUS© and the communication and socialization domains of the Vineland Adaptive Behavior Scales-II (VABS-II). Results Significant associations were found between the FOCUS©, measuring communicative participation, and the VABS-II domains for: (i) pre-intervention scores in communication (r = 0.53, P < 0.001; 95% CI 0.30–0.70) and socialization (r = 0.67, P < 0.001; 95% CI 0.48–0.80); (ii) change scores over-time in communication (r = 0.45, P < 0.001; 95% CI 0.201–0.65) and socialization (r = 0.39, P = 0.002; 95% CI 0.13–0.60); and (iii) scores at post-intervention for communication (r = 0.53, P < 0.001; 95% CI 0.30–0.70) and for socialization (r = 0.37, P = 0.003; 95% CI 0.11–0.50). Conclusions The study provided evidence on construct validity of the FOCUS© for evaluating real-world changes in communication. We believe that the FOCUS© is a useful measure of communicative participation. PMID:23763249

Washington, K; Thomas-Stonell, N; Oddson, B; McLeod, S; Warr-Leeper, G; Robertson, B; Rosenbaum, P

2013-01-01

290

Validation of a Measure of College Students' Intoxicated Behaviors: Associations With Alcohol Outcome Expectancies, Drinking Motives, and Personality  

Microsoft Academic Search

Objective: The authors aimed to develop a measure of college students' intoxicated behaviors and to validate the measure using scales assessing alcohol outcome expectancies, motives for drinking, and personality traits. Participants and Method Summary: The authors administered these measures and an inventory describing 50 intoxicated behaviors to 198 college students and conducted factor analysis on intoxicated behaviors. Logistic regression models

Johann Westmaas; Scott Moeller; Patricia Butler Woicik

2007-01-01

291

Assessing stability and change of four performance measures: a longitudinal study evaluating outcome following total hip and knee arthroplasty  

Microsoft Academic Search

BACKGROUND: Physical performance measures play an important role in the measurement of outcome in patients undergoing hip and knee arthroplasty. However, many of the commonly used measures lack information on their psychometric properties in this population. The purposes of this study were to examine the reliability and sensitivity to change of the six minute walk test (6MWT), timed up and

Deborah M Kennedy; Paul W Stratford; Jean Wessel; Jeffrey D Gollish; Dianne Penney

2005-01-01

292

Pregnancy Outcome in Systemic Lupus Erythematosus (SLE) is Improving: Results from a Case Control Study and Literature Review  

PubMed Central

Objectives For women who suffer from systemic lupus erythematosus (SLE), pregnancy can be a concern, placing the mother and fetus at risk. Our objectives were to assess the risk of adverse pregnancy outcome, disease flares, fertility rate, and co-morbidities in SLE women compared to healthy controls. We also systematically reviewed the literature available on pregnancy outcome in SLE to compare our results to other published data. Our hypothesis was that pregnancy outcome in SLE is improving over time. Methods A case-control study comparing self-report of the above-mentioned parameters in SLE (N=108) vs healthy controls or patients with non-inflammatory musculoskeletal (MSK) disorders (N=134) was performed. Data were collected using a self-administered questionnaire. Proportions, means and odds ratios were calculated. We searched and quantified the literature on pregnancy outcome, lupus reactivation and fertility rate. Data were summarized and presented in mean % ± SEM and median % with interquartile range (IQR). Results Gynecological history, fertility rate and age at first pregnancy in SLE patients were comparable to controls. Eighteen percent of SLE patients reported a flare and 18% reported an improvement of symptoms during pregnancy. Twenty-four percent of lupus patients had at least one preterm delivery vs 5% in controls (OR =8.32, p = 0.0008), however other pregnancy outcomes (miscarriage, therapeutic abortion, stillbirth and neonatal death rate) did not differ between the groups. Thyroid problems were reported to be more likely in SLE patients (p = 0.02), but the prevalence of other co-morbidities was similar to controls. A literature review demonstrated that fertility was not affected in SLE patients. Lupus reactivations are common during pregnancy (36.5% ± SEM 3.3%). Most agreed that SLE pregnancies had more fetal loss (19.5% ± SEM 1.6%) and preterm births (25.5% ± SEM 2.2%) when compared to the general population. Over time, the rate of SLE peripartum flares has improved (p = 0.002) and the proportion of pregnancies resulting in live birth has increased (p = 0.024). The frequency of fetal death has not significantly changed. Our findings from the case-control study were, in general, consistent with the literature including the frequency of fetal death, neonatal death, live births and pregnancy rate. Conclusion Prematurity (25.5% ± SEM 2.2%) and fetal death (19.5% ± SEM 1.6%) in SLE pregnancy are still a concern. However, new strategies with respect to pregnancy timing and multidisciplinary care have improved maternal and fetal outcome in SLE. PMID:19156224

Yan Yuen, Sai; Krizova, Adriana; Ouimet, Janine M; Pope, Janet E

2008-01-01

293

Depression symptom clusters and their predictive value for treatment outcomes: results from an individual patient data meta-analysis of duloxetine trials.  

PubMed

We evaluated individual patient data from phase II to IV clinical trials of duloxetine in major depressive disorder (MDD) (34 studies, 13,887 patients). Our goal was to identify clusters of patients with similar depressive symptom patterns at baseline, as measured by the 17-item Hamilton Depression Rating Scale (HAMD-17), and to investigate their respective predictive value of outcomes as measured by the HAMD-17 total score. Five clusters were identified at baseline: 1) "Lack of insight"; 2) "Sleep/sexual/somatic"; 3) "Typical MDD"; 4) "Gastrointestinal/weight loss"; and 5) "Mild MDD". However, it should be noted that cluster descriptors are not mutually exclusive. Analyses of the HAMD-17 total score results over time were performed using the 18 randomized placebo and/or actively controlled studies representing 6723 patients. At the end of acute treatment (ranging from 4 to 36 weeks), different levels of effect sizes for active therapy (64.5% duloxetine) vs. placebo were detected by cluster. In 3 out of 5 clusters (representing about 80% of the patients), the effect size was significantly different from 0, in favor of active therapy. The effect size was largest in those clusters with severe somatic symptoms ("Sleep/sexual/somatic" cluster [-0.4170], and "Gastrointestinal/weight loss" cluster [-0.338]). In conclusion, our cluster analysis identified 5 clinically relevant MDD patient clusters with specific mean treatment outcomes. Identification of MDD clusters may help to improve outcomes by adapting MDD treatment to particular clinical profiles. PMID:24572681

Schacht, Alexander; Gorwood, Philip; Boyce, Philip; Schaffer, Ayal; Picard, Hernan

2014-06-01

294

Reduced sexual risk behaviors among people living with HIV: Results from the Healthy Relationships Outcome Monitoring Project.  

PubMed

In 2006, the Centers for Disease Control and Prevention funded seven community-based organizations (CBOs) to conduct outcome monitoring of Healthy Relationships. Healthy Relationships is an evidence-based behavioral intervention for people living with HIV. Demographic and sexual risk behaviors recalled by participants with a time referent of the past 90 days were collected over a 17-month project period using a repeated measures design. Data were collected at baseline, and at 3 and 6 months after the intervention. Generalized estimating equations were used to assess the changes in sexual risk behaviors after participation in Healthy Relationships. Our findings show that participants (n = 474) in the outcome monitoring project reported decreased sexual risk behaviors over time, such as fewer number of partners (RR = 0.55; 95% CI 0.41-0.73, P < 0.001) and any unprotected sex events (OR = 0.44; 95% CI 0.36-0.54, P < 0.001) at 6 months after the intervention. Additionally, this project demonstrates that CBOs can successfully collect and report longitudinal outcome monitoring data. PMID:21390538

Heitgerd, Janet L; Kalayil, Elizabeth J; Patel-Larson, Alpa; Uhl, Gary; Williams, Weston O; Griffin, Tanesha; Smith, Bryce D

2011-11-01

295

Clinical outcome after 1 year of cardiac resynchronisation therapy: national results from the European CRT survey.  

PubMed

Cardiac resynchronisation therapy (CRT) is an established treatment option for heart failure patients with electromechanical dyssynchrony. Between 2008 and 2010, the Heart Failure Association (HFA) and the European Heart Rhythm Association (EHRA) of the European Society of Cardiology (ESC) initiated the European CRT survey to describe the current practice and short-term clinical outcome associated with CRT implantations in 13 countries. One year follow-up data from 150 patients collected in 10 Austrian centres are presented in comparison to the total 1,969 patients enrolled throughout Europe. In most cases (n = 120), CRT-D devices were implanted, while CRT-P devices were used in only 23 %. After 12 ± 3 months, mortality and hospitalisation rates reached 10 and 37 %, respectively. New York Heart Association (NYHA) functional classes improved significantly: NYHA I/II/III/IV were found before implantation in 2/20/71/7 % and after 1 year follow-up in 35/51/9/5 % of the patients, respectively. Left ventricular ejection fraction improved from 27 ± 8 % to 35 ± 10 %, left ventricular end-diastolic diameters were reduced from 65 ± 10 mm to 59 ± 5 mm. Median NT-proBNP was reduced from 1,886 to 997 pg/ml, QRS duration diminished from 158 ± 34 to 147 ± 27 ms. In conclusion, the Austrian data from the CRT survey confirms the efficacy of CRT in heart failure patients, but outlines that these patients still suffer from a high mortality and cardiovascular (CV) hospitalisation rate. PMID:24146326

Dichtl, Wolfgang; Strohmer, Bernhard; Fruhwald, Friedrich

2013-12-01

296

Outcomes after methadone maintenance and methadone reduction treatments: two-year follow-up results from the National Treatment Outcome Research Study  

Microsoft Academic Search

This paper provides a detailed analysis of the 2-year outcomes for 351 drug misusers allocated on an intention-to-treat basis to methadone maintenance or methadone reduction treatments. Both groups showed substantial reductions in their use of illicit drugs and in other outcome areas. However, whereas most methadone maintenance patients received maintenance, only about one third of those allocated to methadone reduction

Michael Gossop; John Marsden; Duncan Stewart; Samantha Treacy

2001-01-01

297

Processes and Outcomes of Care for Patients With Community-Acquired Pneumonia Results From the Pneumonia Patient Outcomes Research Team (PORT) Cohort Study  

Microsoft Academic Search

Background: Although understanding the processes of care and medical outcomes for patients with community- acquired pneumonia is instrumental to improving the quality and cost-effectiveness of care for this illness, lim- ited information is available on how physicians manage patients with this illness or on medical outcomes other than short-term mortality. Objectives: To describe the processes of care and to as-

Michael J. Fine; Roslyn A. Stone; Daniel E. Singer; Christopher M. Coley; Thomas J. Marrie; Judith R. Lave; Linda J. Hough; D. Scott Obrosky; Richard Schulz; Edmund M. Ricci; Joan C. Rogers; Wishwa N. Kapoor

298

Application of the National Institutes of Health Patient-Reported Outcomes Measurement Information System (PROMIS(R)) to Mental Health Research  

PubMed Central

Background The Patient-Reported Outcomes Measurement Information System (PROMIS) is a National Institutes of Health initiative to develop item banks measuring patient-reported outcomes (PROs) and to create and make available a computerized adaptive testing system (CAT) that allows for efficient and precise assessment of PROs in clinical research and practice. Aims of the Study Based on the presentation from a symposium on “Evidence-based Outcomes in Psychiatry: Updates on Measurement Using Patient-Reported Outcomes (PRO)” at the 2011 American Psychiatry Association Convention, this paper provides an overview of PROMIS and its application to mental health research. Methods The PROMIS methodology for item bank development and testing is described, with a focus on the implications of this work for mental health research. Results Utilizing qualitative item review and state-of-the-art applications of item response theory (IRT), PROMIS investigators have developed, tested, and released item banks measuring physical, mental, and social health components. Ongoing efforts continue to add new item banks and further validate existing banks. Discussion PROMIS provides item banks measuring several domains of interest to mental health researchers including emotional distress, social function, and sleep. PROMIS methodology also provides a rigorous standard for the development of new mental health measures. Implications for Health Care Provision Web-based CAT or administration of short forms derived from PROMIS item banks provide efficient and precise dimensional estimates of clinical outcomes that can be utilized to monitor patient progress and assess quality improvement. Implications for Future Research Use of the dimensional PROMIS metrics (and co-calibration of the PROMIS item banks with existing PROs) will allow comparisons of mental health and related health outcomes across disorders and studies. PMID:22345362

Riley, William T.; Pilkonis, Paul; Cella, David

2013-01-01

299

Left Ventricular Mass in Dialysis Patients, Determinants and Relation with Outcome. Results from the COnvective TRansport STudy (CONTRAST)  

PubMed Central

Background and Objectives Left ventricular mass (LVM) is known to be related to overall and cardiovascular mortality in end stage kidney disease (ESKD) patients. The aims of the present study are 1) to determine whether LVM is associated with mortality and various cardiovascular events and 2) to identify determinants of LVM including biomarkers of inflammation and fibrosis. Design, Setting, Participants, & Measurements Analysis was performed with data of 327 ESKD patients, a subset from the CONvective TRAnsport STudy (CONTRAST). Echocardiography was performed at baseline. Cox regression analysis was used to assess the relation of LVM tertiles with clinical events. Multivariable linear regression models were used to identify factors associated with LVM. Results Median age was 65 (IQR: 54–73) years, 203 (61%) were male and median LVM was 227 (IQR: 183–279) grams. The risk of all-cause mortality (hazard ratio (HR)?=?1.73, 95% CI: 1.11–2.99), cardiovascular death (HR?=?3.66, 95% CI: 1.35–10.05) and sudden death (HR?=?13.06; 95% CI: 6.60–107) was increased in the highest tertile (>260grams) of LVM. In the multivariable analysis positive relations with LVM were found for male gender (B?=?38.8±10.3), residual renal function (B?=?17.9±8.0), phosphate binder therapy (B?=?16.9±8.5), and an inverse relation for a previous kidney transplantation (B?=??41.1±7.6) and albumin (B?=??2.9±1.1). Interleukin-6 (Il-6), high-sensitivity C-reactive protein (hsCRP), hepcidin-25 and connective tissue growth factor (CTGF) were not related to LVM. Conclusion We confirm the relation between a high LVM and outcome and expand the evidence for increased risk of sudden death. No relationship was found between LVM and markers of inflammation and fibrosis. Trial Registration Controlled-Trials.com ISRCTN38365125 PMID:24505249

Mostovaya, Ira M.; Bots, Michiel L.; van den Dorpel, Marinus A.; Goldschmeding, Roel; den Hoedt, Claire H.; Kamp, Otto; Levesque, Renee; Mazairac, Albert H. A.; Penne, E. Lars; Swinkels, Dorine W.; van der Weerd, Neelke C.; ter Wee, Piet M.; Nube, Menso J.; Blankestijn, Peter J.; Grooteman, Muriel P. C.

2014-01-01

300

Uniqueness of Quantum States Compatible with Given Measurement Results  

E-print Network

We discuss the uniqueness of quantum states compatible with given results for measuring a set of observables. For a given pure state, we consider two different types of uniqueness: (1) no other pure state is compatible with the same measurement results and (2) no other state, pure or mixed, is compatible with the same measurement results. For case (1), it is known that for a d-dimensional Hilbert space, there exists a set of 4d-5 observables that uniquely determines any pure state. We show that for case (2), 5d-7 observables suffice to uniquely determine any pure state. Thus there is a gap between the results for (1) and (2), and we give some examples to illustrate this. The case of observables corresponding to reduced density matrices (RDMs) of a multipartite system is also discussed, where we improve known bounds on local dimensions for case (2) in which almost all pure states are uniquely determined by their RDMs. We further discuss circumstances where (1) can imply (2). We use convexity of the numerical range of operators to show that when only two observables are measured, (1) always implies (2). More generally, if there is a compact group of symmetries of the state space which has the span of the observables measured as the set of fixed points, then (1) implies (2). We analyze the possible dimensions for the span of such observables. Our results extend naturally to the case of low rank quantum states.

Jianxin Chen; Hillary Dawkins; Zhengfeng Ji; Nathaniel Johnston; David Kribs; Frederic Shultz; Bei Zeng

2012-12-14

301

Comparability and recognition of chemical measurement results – an international goal  

Microsoft Academic Search

As a consequence of the globalisation of trade and industry and other human activities, reliability of and confidence in\\u000a measurement results is increasingly required, also in the field of chemical analysis, so that measurements made in one country\\u000a will be accepted in other countries without the necessity to repeat them. The prerequisite for confidence is comparability\\u000a on the basis of

Wolfgang Richter

1999-01-01

302

Effects of a multidisciplinary family treatment drug court on child and family outcomes: results of a quasi-experimental study.  

PubMed

Family treatment drug courts (FTDCs) are an increasingly common approach for serving families involved in child welfare due to parental substance abuse; however, the evidence base for FTDCs remains emergent. This quasi-experimental study replicates previous research on FTDCs by comparing parental substance abuse treatment and child welfare outcomes for 76 FTDC participants to outcomes for 76 parents in the same system who did not participate in the FTDC, using propensity score matching. Data were obtained from the Superior court, FTDC, child welfare, and public substance use treatment service administrative databases. The follow-up window for participants ranged from 1 to 3 years. Results showed FTDC parents had significantly more review and motion hearings, were significantly more likely to enter treatment, entered treatment faster, received more treatment, and were more likely to successfully complete treatment. FTDC children spent significantly less time placed out of home, ended child welfare system involvement sooner, were more likely to be permanently placed and discharged from child welfare, and were more likely to return to parental care. Results demonstrate that FTDCs promote positive treatment and child welfare outcomes without deepening participants' involvement in justice systems. PMID:22887954

Bruns, Eric J; Pullmann, Michael D; Weathers, Ericka S; Wirschem, Mark L; Murphy, Jill K

2012-08-01

303

Evaluating outcomes of palliative photodynamic therapy: instrument development and preliminary results  

Microsoft Academic Search

Background: Subjective measures are considered the gold standard in palliative care evaluation, but no studies have evaluated palliative photodynamic therapy (PDT) subjectively. If PDT is to be accepted as a palliative therapy for later-stage obstructing esophageal and lung cancer, evidence of its effectiveness and acceptability to patients must be made known. Study Design\\/Materials and Methods: This ongoing study's major aim

Teresa T. Goodell; Paulo R. Bargo; Steven L. Jacques

2002-01-01

304

Preliminary results of ground reflectivity measurements using noise radar  

NASA Astrophysics Data System (ADS)

The paper describes experimental L-band ground reflectivity measurement using noise radar demonstrator working as a scatterometer. The radar ground return is usually described with a scattering coefficient, a quantity that is independent from the scatterometer system. To calculate the coefficient in a function of incidence angle, range profile values obtained after range compression were used. In order to improve dynamic range of the measurement, antenna cross-path interference was removed using lattice filter. The ground return was measured at L band both for HH and VV polarizations of radar wave as well as for HV and VH crosspolarizations using log-periodic antennas placed at a 10 m high mast directed towards a meadow surface. In the paper the theoretical considerations, noise radar setup, measurement campaign and the results are described.

Ma?likowski, ?ukasz; Krysik, Piotr; D?browska-Zieli?ska, Katarzyna; Kowalik, Wanda; Bartold, Maciej

2011-10-01

305

Development and Validation of Patient-Reported Outcome Measures for Sleep Disturbance and Sleep-Related Impairments  

PubMed Central

Study Objectives: To develop an archive of self-report questions assessing sleep disturbance and sleep-related impairments (SRI), to develop item banks from this archive, and to validate and calibrate the item banks using classic validation techniques and item response theory analyses in a sample of clinical and community participants. Design: Cross-sectional self-report study. Setting: Academic medical center and participant homes. Participants: One thousand nine hundred ninety-three adults recruited from an Internet polling sample and 259 adults recruited from medical, psychiatric, and sleep clinics. Interventions: None. Measurements and Results: This study was part of PROMIS (Patient-Reported Outcomes Information System), a National Institutes of Health Roadmap initiative. Self-report item banks were developed through an iterative process of literature searches, collecting and sorting items, expert content review, qualitative patient research, and pilot testing. Internal consistency, convergent validity, and exploratory and confirmatory factor analysis were examined in the resulting item banks. Factor analyses identified 2 preliminary item banks, sleep disturbance and SRI. Item response theory analyses and expert content review narrowed the item banks to 27 and 16 items, respectively. Validity of the item banks was supported by moderate to high correlations with existing scales and by significant differences in sleep disturbance and SRI scores between participants with and without sleep disorders. Conclusions: The PROMIS sleep disturbance and SRI item banks have excellent measurement properties and may prove to be useful for assessing general aspects of sleep and SRI with various groups of patients and interventions. Citation: Buysse DJ; Yu L; Moul DE; Germain A; Stover A; Dodds NE; Johnston KL; Shablesky-Cade MA; Pilkonis PA. Development and validation of patient-reported outcome measures for sleep disturbance and sleep-related impairments. SLEEP 2010;33(6):781-792. PMID:20550019

Buysse, Daniel J.; Yu, Lan; Moul, Douglas E.; Germain, Anne; Stover, Angela; Dodds, Nathan E.; Johnston, Kelly L.; Shablesky-Cade, Melissa A.; Pilkonis, Paul A.

2010-01-01

306

Validity and reliability of patient reported outcomes used in Psoriasis: results from two randomized clinical trials  

Microsoft Academic Search

BACKGROUND: Two Phase III randomized controlled clinical trials were conducted to assess the efficacy, safety, and tolerability of weekly subcutaneous administration of efalizumab for the treatment of psoriasis. Patient reported measures of psoriasis-related functionality and health-related quality of life and of psoriasis-related symptom assessments were included as part of the trials. OBJECTIVE: To assess the reliability, validity, and responsiveness of

Richard Shikiar; Brian W Bresnahan; Stephen P Stone; Christine Thompson; John Koo; Dennis A Revicki

2003-01-01

307

The 'Global Outcomes Score': a quality measure, based on health outcomes, that compares current care to a target level of care.  

PubMed

The quality of health care is measured today using performance measures that calculate the percentage of people whose health conditions are managed according to specified processes or who meet specified treatment goals. This approach has several limitations. For instance, each measure looks at a particular process, risk factor, or biomarker one by one, and each uses sharp thresholds for defining "success" versus "failure." We describe a new measure of quality called the Global Outcomes Score (GO Score), which represents the proportion of adverse outcomes expected to be prevented in a population under current levels of care compared to a target level of care, such as 100 percent performance on certain clinical guidelines. We illustrate the use of the GO Score to measure blood pressure and cholesterol care in a longitudinal study of people at risk of atherosclerotic diseases, or hardening of the arteries. In that population the baseline GO Score was 40 percent, which indicates that the care being delivered was 40 percent as effective in preventing myocardial infarctions and strokes as our target level of care. The GO Score can be used to assess the potential effectiveness of different interventions such as prevention activities, tests, and treatments. PMID:23129674

Eddy, David M; Adler, Joshua; Morris, Macdonald

2012-11-01

308

Three Measures of Forest Fire Smoke Exposure and Their Associations with Respiratory and Cardiovascular Health Outcomes in a Population-Based Cohort  

PubMed Central

Background: During the summer of 2003 numerous fires burned in British Columbia, Canada. Objectives: We examined the associations between respiratory and cardiovascular physician visits and hospital admissions, and three measures of smoke exposure over a 92-day study period (1 July to 30 September 2003). Methods: A population-based cohort of 281,711 residents was identified from administrative data. Spatially specific daily exposure estimates were assigned to each subject based on total measurements of particulate matter (PM) ? 10 ?m in aerodynamic diameter (PM10) from six regulatory tapered element oscillating microbalance (TEOM) air quality monitors, smoke-related PM10 from a CALPUFF dispersion model run for the study, and a SMOKE exposure metric for plumes visible in satellite images. Logistic regression with repeated measures was used to estimate associations with each outcome. Results: The mean (± SD) exposure based on TEOM-measured PM10 was 29 ± 31 ?g/m3, with an interquartile range of 14–31 ?g/m3. Correlations between the TEOM, smoke, and CALPUFF metrics were moderate (0.37–0.76). Odds ratios (ORs) for a 30-?g/m3 increase in TEOM-based PM10 were 1.05 [95% confidence interval (CI), 1.03–1.06] for all respiratory physician visits, 1.16 (95% CI, 1.09–1.23) for asthma-specific visits, and 1.15 (95% CI, 1.00–1.29) for respiratory hospital admissions. Associations with cardiovascular outcomes were largely null. Conclusions: Overall we found that increases in TEOM-measured PM10 were associated with increased odds of respiratory physician visits and hospital admissions, but not with cardiovascular health outcomes. Results indicating effects of fire smoke on respiratory outcomes are consistent with previous studies, as are the null results for cardiovascular outcomes. Some agreement between TEOM and the other metrics suggests that exposure assessment tools that are independent of air quality monitoring may be useful with further refinement. PMID:21659039

Brauer, Michael; MacNab, Ying C.; Kennedy, Susan M.

2011-01-01

309

Development of a self-assessed consumer recovery outcome measure: my voice, my life.  

PubMed

We report the development of a self-assessed consumer recovery outcome measure by way of a consumer led and focused iterative process, informed by exploratory and confirmatory factor analysis. The process began with a deliberately over-inclusive preliminary measure of 127 items, based on 12 presumptive domains derived from the recovery literature and consumer consultation, being piloted with over 500 mental health consumers. The full 504 participant data set was randomly split into two discrete sets of 300 and 204 to provide one for the initial exploratory factor analysis and another (of independence) for the subsequent confirmatory factor analysis and reliability estimation. Analyses identified and confirmed (using the separate data sets) a robust factor structure, with 11 distinct and relatively independent factors (relationships; day-to-day life; culture; physical health; quality of life; mental health; recovery; hope and empowerment; spirituality; resources; and satisfaction with services) underlying one substantial principal construct (that we refer to as consumer recovery). The measure was refined to 65 items, between three and ten items for each of the 11 domains, the reliabilities for which are uniformly high. PMID:22426650

Gordon, Sarah E; Ellis, Pete M; Siegert, Richard J; Walkey, Frank H

2013-05-01

310

The economics of mitigation and remediation measures - preliminary results  

NASA Astrophysics Data System (ADS)

Today there exists a high spatial density of orbital debris objects at about 800 km altitude. The control of the debris population in this region is important for the long-term evolution of the debris environment. The future debris population is investigated by simulations using the software tool LUCA (Long-Term Orbit Utilization Collision Analysis). It is likely that in the future there will occur more catastrophic collisions. Debris objects generated during such events may again trigger further catastrophic collisions. Current simulations have revealed that the number of debris objects will increase in the future. In a long-term perspective, catastrophic collisions may become the dominating mechanism in generating orbital debris. In this study it is investigated, when the situation will become unstable. To prevent this instability it is necessary to implement mitigation and maybe even remediation measures. It is investigated how these measures affect the future debris environment. It is simulated if the growth of the number of debris objects can be interrupted and how much this may cost. Different mitigation scenarios are considered. Furthermore also one remediation measure, the active removal of high-risk objects, is simulated. Cost drivers for the different measures are identified. It is investigated how selected measures are associated with costs. The goal is to find out which economic benefits may result from mitigation or remediation. First results of a cost benefit analyses are presented.

Wiedemann, Carsten; Flegel, Sven Kevin; Vörsmann, Peter; Gelhaus, Johannes; Moeckel, Marek; Braun, Vitali; Kebschull, Christopher; Metz, Manuel

2012-07-01

311

DWPF STARTUP FRIT VISCOSITY MEASUREMENT ROUND ROBIN RESULTS  

SciTech Connect

A viscosity standard is needed to replace the National Institute of Standards and Technology (NIST) glasses currently being used to calibrate viscosity measurement equipment. The current NIST glasses are either unavailable or less than ideal for calibrating equipment to measure the viscosity of high-level waste glasses. This report documents the results of a viscosity round robin study conducted on the Defense Waste Processing Facility (DWPF) startup frit. DWPF startup frit was selected because its viscosity-temperature relationship is similar to most DWPF and Hanford high-level waste glass compositions. The glass underwent grinding and blending to homogenize the large (100 lb) batch. Portions of the batch were supplied to the laboratories (named A through H) for viscosity measurements following a specified temperature schedule with a temperature range of 1150 C to 950 C and with an option to measure viscosity at lower temperatures if their equipment was capable of measuring at the higher viscosities. Results were used to fit the Vogel-Tamman-Fulcher and Arrhenius equations to viscosity as a function of temperature for the entire temperature range of 460 C through 1250 C as well as the limited temperature interval of approximately 950 C through 1250 C. The standard errors for confidence and prediction were determined for the fitted models.

Crum, Jarrod V.; Edwards, Tommy B.; Russell, Renee L.; Workman, Phyllis J.; Schweiger, Michael J.; Schumacher, Ray F.; Smith, Donald E.; Peeler, David K.; Vienna, John D.

2012-07-31

312

A Comparison of the College Outcome Measures Program (COMP) and the Collegiate Assessment of Academic Proficiency (CAAP) Exams.  

ERIC Educational Resources Information Center

The College Outcome Measures Program (COMP) and the Collegiate Assessment of Academic Proficiency (CAAP) examinations were evaluated as measures of the effectiveness of the general education program of the University of Tennessee (Knoxville). The criteria used to evaluate these examinations focused on their construct validity. The data were…

Pike, Gary R.

313

Core Outcome Domains and Measures for Pediatric Acute and Chronic\\/Recurrent Pain Clinical Trials: PedIMMPACT Recommendations  

Microsoft Academic Search

Under the auspices of the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT), 26 professionals from academia, governmental agencies, and the pharmaceutical industry participated in a 2-stage Delphi poll and a consensus meeting that identified core outcome domains and measures that should be considered in clinical trials of treatments for acute and chronic pain in children and

Patrick J. McGrath; Gary A. Walco; Dennis C. Turk; Robert H. Dworkin; Mark T. Brown; Karina Davidson; Christopher Eccleston; G. Allen Finley; Kenneth Goldschneider; Lynne Haverkos; Sharon H. Hertz; Gustaf Ljungman; Tonya Palermo; Bob A. Rappaport; Thomas Rhodes; Neil Schechter; Jane Scott; Navil Sethna; Ola K. Svensson; Jennifer Stinson; Carl L. von Baeyer; Lynn Walker; Steven Weisman; Richard E. White; Anne Zajicek; Lonnie Zeltzer

2008-01-01

314

The Relationship between Content Area General Outcome Measurement and Statewide Testing in Sixth-Grade World History  

ERIC Educational Resources Information Center

The purpose of the present study was to extend validity research on a content area general outcome measurement tool known as vocabulary matching. Previous research has reported moderately strong to strong correlations between the group-administered vocabulary-matching measure and a standardized assessment instrument. The present study extended the…

Mooney, Paul; McCarter, Kevin S.; Schraven, Jodie; Haydel, Beth

2010-01-01

315

Unintended Policy Impacts of Outcome-Based Measures in a New Era of Service Delivery: Examples from Preschool Immunization  

Microsoft Academic Search

As public programs move to block grants and other more decentralized forms of government intervention, one of the most vexing problems is accountability. A commonly suggested solution is to develop an outcome-based approach to measuring program success. One measure that is already widely used to assess the quality of children's health care is immunization rates among preschool children. This paper

Lynn Olson; Andrew Gordon

316

Unraveling the Differential Effects of Motivational and Skills, Social, and Self-Management Measures from Traditional Predictors of College Outcomes  

ERIC Educational Resources Information Center

The authors report on a large-scale study examining the effects of self-reported psychosocial factors on 1st-year college outcomes. Using a sample of 14,464 students from 48 institutions, the authors constructed hierarchical regression models to measure the predictive validity of the Student Readiness Inventory, a measure of psychosocial factors.…

Robbins, Steven B.; Allen, Jeff; Casillas, Alex; Peterson, Christina Hamme; Le, Huy

2006-01-01

317

Capability Deprivation and Income Poverty in the United States, 1994 and 2004: Measurement Outcomes and Demographic Profiles  

ERIC Educational Resources Information Center

Shifting focus from income to capability signifies an important milestone toward accurately measuring poverty and deprivation. This paper operationalizes capability deprivation in the United States and compares measurement outcomes among various capability approaches and between capability and income spaces. Of the three capability approaches…

Wagle, Udaya R.

2009-01-01

318

The Effect of Ethical Signals on Recruitment Outcomes: Two Studies with Convergent Results  

E-print Network

of the organization as ethical. Additionally, two important moderators, self-importance of moral identity and cognitive moral development, were examined. Using a study in the field as well as a rigorous laboratory study, this research found results generally...

Degrassi, Sandra W.

2010-10-12

319

Intracoronary Stenting and Angiographic Results Strut Thickness Effect on Restenosis Outcome (ISAR-STEREO) Trial  

Microsoft Academic Search

Background—Increased thrombogenicity and smooth muscle cell proliferative response induced by the metal struts compromise the advantages of coronary stenting. The objective of this randomized, multicenter study was to assess whether a reduced strut thickness of coronary stents is associated with improved follow-up angiographic and clinical results. Methods and Results—A total of 651 patients with coronary lesions situated in native vessels

Adnan Kastrati; Julinda Mehilli; Josef Dirschinger; Franz Dotzer; Helmut Schühlen; Franz-Josef Neumann; Martin Fleckenstein; Conrad Pfafferott; Melchior Seyfarth; Albert Schömig

320

Results of ionospheric measurements, got on micro satellite "Compass-2"  

NASA Astrophysics Data System (ADS)

Results of measurements, executed by complex of scientific instruments of micro satellite Compass-2 in the period of 2006-2007, are presented. The project was aimed on registration and study of ionospheric effects, related to the natural and anthropogenic anomalous phenomena. The effects of interaction of solar wind with magnetosphere in the period of flare activity of the Sun and anomalous low frequency radiations, happened one day before the earthquake with magnitude 4.2, are registered. The data was got on measurements of corpuscular radiation, wide band radiations and low frequency waves along the orbit of satellite.

Dokukin, Vladimir; Kuznetsov, V. D.; Garipov, G. K.; Kapustina, O.; Mikhailov, Yu. M.; Mikhailova, G. A.; Ruzhin, Yu. Ya.; Sinelnikov, V. M.; Shirokov, A. V.; Yashin, I. V.; Danilkin, V. A.; Degtyar, V. G.

321

Preliminary results of linear polarization measurements at 99 GHz  

NASA Technical Reports Server (NTRS)

The results of the first linear polarization measurements of extrasolar radio sources at a frequency above 35 GHz are presented. For the quasars 3C 273 and 3C 345, the observed position angles are in accord with the predictions of Inoue, and the measurements are consistent with the suggestion that the compact components responsible for the high-frequency emission are affected by high degrees of internal Faraday depolarization. For the radio galaxy 3C 274 (Virgo A) the observed position angle and degree of polarization are consistent with the model of Hobbs and Waak.

Hobbs, R. W.; Maran, S. P.; Brown, L. W.

1978-01-01

322

The Cloud Physics Lidar: Instrument Description and Initial Measurement Results  

NASA Technical Reports Server (NTRS)

The new Cloud Physics Lidar (CPL) has been built for use on the NASA ER-2 high altitude aircraft. The purpose of the CPL is to provide multi-wavelength measurements of cirrus, subvisual cirrus, and aerosols with high temporal and spatial resolution. The CPL utilizes state-of-the-art technology with a high repetition rate, a low pulse energy laser, and photon-counting detection. The first deployment for the CPL was the SAFARI-2000 field campaign during August-September 2000. We provide here an overview of the instrument and initial data results to illustrate the measurement capability of the CPL.

McGill, Matthew; Hlavka, Dennis; Hart, William; Spinhirne, James; Scott, V. Stanley; Starr, David OC. (Technical Monitor)

2001-01-01

323

Cloud Physics Lidar: Instrument Description and Initial Measurement Results  

NASA Technical Reports Server (NTRS)

The Cloud Physics Lidar (CPL) is a new custom-built instrument for the NASA ER-2 high-altitude aircraft. The CPL can provide multiwavelength measurements of cirrus, subvisual cirrus, and aerosols with high temporal and spatial resolution. Its state-of-the-art technology gives it a high repetition rate, and photon-counting detection, and includes a low-pulse-energy laser. The CPL was first deployed at the Southern African Regional Science Initiative's 2000 field campaign during August and September 2000. This paper provides an overview of the instrument and initial data results to illustrate the measurement capability of the CPL.

McGill, Matthew; Hlavka, Dennis; Hart, William; Scott, V. Stanley; Spinhirne, James; Schmid, Beat

2002-01-01

324

[The relationship between therapist's competence and adherence to outcome in cognitive-behavioural therapy - results of a metaanalysis].  

PubMed

By now psychotherapy research has provided sufficient evidence in favour of the efficacy of psychotherapy, especially of the cognitive behaviour therapy (CBT). Hence one can argue that psychotherapy truly "works". Nevertheless, the rationale for the efficacy and the underlying mechanisms have not yet been explored. Resolving this ambiguity by focusing on the active ingredients in CBT is the aim of our review. More precisely we have explored whether the therapist's competence or his/her adherence to the CBT protocol is responsible for the therapeutic improvement that many patients sustain subsequent to psychotherapy. By means of a broad literature search we identified a total of n?=?13 studies, whereby n?=?7 referred to the impact of therapist's competence and n?=?7 to the impact of adherence on post-treatment outcome, respectively, and one of these studies referred to both. The meta-analytical evaluation yielded a small significant total effect (r?=?0.24) for the therapist's competence on therapeutic improvement of patients with diverse disorders and a moderate total effect (r?=?0.38) regarding patients with major depression. In contrast, for the case of an influence of adherence to protocol on post-treatment outcome we did not achieve significant results. Therefore a competent performance of cognitive-behaviour techniques on the part of the therapist seems to contribute thoroughly to the therapeutic improvement subsequent to treatment. However, solely a manual-guided implementation of CBT seems not to have a significant impact on patients impromvement. Furthermore, our results indicate that the therapeutic change constitutes an extensive process that has consequently to be understood in future process-outcome research. Finally the implications of our results as well as potentials for future research are discussed. PMID:25177902

Zarafonitis-Müller, S; Kuhr, K; Bechdolf, A

2014-09-01

325

Relationships of objectively measured physical activity and sleep with BMI and academic outcomes in 8-year-old children.  

PubMed

Current guidelines in place for sleep and physical activity in childhood are the result of data collected in the form of self-reports. Exact measurement of activity dimensions and sleep characteristics are essential. The purpose of clearly established parameters is for the intent of verifying health outcomes and evaluating interventions. The purpose of this research was to determine the relationships between the objective dimensions of physical activity, sleep, weight status, academic achievement, and academic behavior. This cross-sectional correlational descriptive design examined the activity and sleep patterns continuously for 24 hours/7 days with triaxial accelerometers in a low income African American sample of 8-year-olds. A qualitative component gathered additional identifiers. This sample was overweight/obese, inactive, and sleep-deprived. Moderate-vigorous activity was correlated with reading scores. Confirmed in this research was the association between sleep duration, physical activity intensities, and academics. Positive health outcomes in children are endorsed by an energy balance. PMID:23583266

Harrington, Susan Ann

2013-05-01

326

The Effectiveness of Substance Abuse Treatment in Illinois: Results of the Illinois Statewide Treatment Outcomes Project  

E-print Network

The Effectiveness of Substance Abuse Treatment in Illinois: Results of the Illinois Statewide Department of Human Services Office of Alcoholism and Substance Abuse (OASA), Melanie Whitter, Associate by the Substance Abuse Prevention and Treatment federal block grant. #12;ACKNOWLEDGMENTS The Illinois Department

Illinois at Chicago, University of

327

Student Learning Outcomes Committee 2009 (revised 12-29-09) Department/Program Assessment Results Report  

E-print Network

Report Department/Program__Management______ Degree/Program__BSBA in Management, Human Resource Management in response to last year's results. The Human Resource Management (HRM) specialization started as a new IN MANAGEMENT - HUMAN RESOURCE MANAGEMENT SPECIALIZATION ASSESSMENT PLAN (REV. 2/27/10) Mission/Vision Statement

Gallo, Linda C.

328

Second year treatment outcome of alcoholics treated by individualized behavior therapy: Results  

Microsoft Academic Search

who. while hospitalized at Patton State Hospital. served as subjects in an experiment evaluating 'Individualized Behavior Therapy (IBT)' techniques. Subjects were initially assigned to either a controlled drinking or non-drinking (abstinence) treatment goal. and were then randomly assigned to either an experimental group receiving IBT or a control group receiving conventional state hospital treatment oriented towards abstinence. Previously reported results

MARK B. SOBELL; LINDA C. SOBELL

1976-01-01

329

Outcomes of Treatment for Alcohol Problems: Current Methods, Problems, and Results.  

ERIC Educational Resources Information Center

Discusses current methods, problems, and results of psychological treatment for alcohol abuse, including alcoholism. Addresses external and internal validity problems specific to issues regarding who is treated for alcohol problems, and treatment and patient factors that predict response to alcoholism treatment. Reviews current data on…

Nathan, Peter E.; Skinstad, Anne-Helene

1987-01-01

330

Using patient-reported outcome measures to estimate cost-effectiveness of hip replacements in English hospitals  

PubMed Central

Objective To estimate the average cost per quality adjusted life year (QALY) gained from hip surgery, and to examine the variation in that between hospitals. Design The transformation of patient-reported outcome measures (EQ-5D data) into QALYs, covering 25,463 NHS patient episodes between April 2009 and August 2010 from hospitals in England, using a model of future health change arising from a hip operation compared to a counterfactual of no operation. Hospital-level costs for hip procedures from the National Reference Costs data-set was used to calculate the hospitals' cost per QALY. Setting English hospitals treating NHS-funded patients undergoing hip replacement. Participants NHS-funded patients undergoing primary hip replacement. Main outcome measure Cost per QALY. Results Assuming some degradation in patients’ health over the lifetime of the hip prosthesis, average health gain arising from a hip operation was 2.77 QALYs. For procedures paid for by the NHS but carried out in the independent sector the average gain was 2.97 QALYs. Average NHS hospital hip procedure costs were estimated to be £5844. The unweighted average cost per QALY for NHS hospitals was £2128. There were significant variations in cost per QALY between hospitals; most of this variation appears to be driven by variations in cost, not QALYs. Conclusions Using the new patient-assessed health-related quality of life data combined with routine hospital-level cost data it is possible to estimate a procedure-based measure of efficiency for hospitals. The fact that variations in cost per QALY are strongly driven by variations in cost suggests that further work is needed to investigate the causes of cost variations per se – especially the quality of routine NHS cost data. PMID:23759892

Appleby, John; Poteliakhoff, Emmi; Shah, Koonal; Devlin, Nancy

2013-01-01

331

Measurement results of DIPIX pixel sensor developed in SOI technology  

NASA Astrophysics Data System (ADS)

The development of integration type pixel detectors presents interest for physics communities because it brings optimization of design, simplicity of production-which means smaller cost, and reduction of detector material budget. During the last decade a lot of research and development activities took place in the field of CMOS Silicon-On-Insulator (SOI) technology resulting in improvement in wafer size, wafer resistivity and MIM capacitance. Several ideas have been tested successfully and are gradually entering into the application phase. Some of the novel concepts exploring SOI technology are pursued at KEK; several prototypes of dual mode integration type pixel (DIPIX) have been recently produced and described. This report presents initial test results of some of the prototypes including tests obtained with the infrared laser beams and Americium (Am-241) source. The Equivalent Noise Charge (ENC) of 86 e - has been measured. The measured performance demonstrates that SOI technology is a feasible choice for future applications.

Ahmed, Mohammed Imran; Arai, Yasuo; Idzik, Marek; Kapusta, Piotr; Miyoshi, Toshinobu; Turala, Michal

2013-08-01

332

Allergy-related outcomes in relation to serum IgE: Results from the National Health and Nutrition Examination Survey 2005-2006  

PubMed Central

Background The National Health and Nutrition Examination Survey (NHANES) 2005–2006 was the first population-based study to investigate levels of serum total and allergen-specific immunoglobulin E (IgE) in the general US population. Objective We estimated prevalence of allergy-related outcomes and examined relationships between serum IgE levels and these outcomes in a representative sample of the US population. Methods Data for this cross-sectional analysis were obtained from the NHANES 2005–2006. Study subjects aged 6 years and older (N=8086) had blood taken for measurement of total IgE and 19 specific IgEs against common aeroallergens, including Alternaria alternata, Aspergillus fumigatus, Bermuda grass, birch, oak, ragweed, Russian thistle, rye grass, cat dander, cockroach, dog dander, dust mite (Dermatophagoides farinae and D. pteronyssinus), mouse and rat urine proteins; and selected foods (egg white, cow’s milk, peanut, and shrimp). Serum samples were analyzed for total and allergen-specific IgEs using the Pharmacia CAP System. Information on allergy-related outcomes and demographics was collected by questionnaire. Results In the NHANES 2005–2006, 6.6% reported current hay fever and 23.5% suffered from current allergies. Allergy-related outcomes increased with increasing total IgE (adjusted ORs for a 10-fold increase in total IgE =1.86, 95% CI:1.44–2.41 for hay fever and 1.64, 95% CI: 1.41–1.91 for allergies). Elevated levels of plant-, pet-, and mold-specific IgEs contributed independently to allergy-related symptoms. The greatest increase in odds was observed for hay fever and plant-specific IgEs (adjusted OR=4.75, 95% CI:3.83–5.88). Conclusion In the US population, self-reported allergy symptoms are most consistently associated with elevated levels of plant-, pet-, and mold-specific IgEs. PMID:21320720

Salo, Paivi M.; Calatroni, Agustin; Gergen, Peter J.; Hoppin, Jane A.; Sever, Michelle L.; Jaramillo, Renee; Arbes, Samuel J.; Zeldin, Darryl C.

2011-01-01

333

Measuring mental health and wellbeing outcomes for children and adolescents to inform practice and policy: a review of child self-report measures  

PubMed Central

There is a growing appetite for mental health and wellbeing outcome measures that can inform clinical practice at individual and service levels, including use for local and national benchmarking. Despite a varied literature on child mental health and wellbeing outcome measures that focus on psychometric properties alone, no reviews exist that appraise the availability of psychometric evidence and suitability for use in routine practice in child and adolescent mental health services (CAMHS) including key implementation issues. This paper aimed to present the findings of the first review that evaluates existing broadband measures of mental health and wellbeing outcomes in terms of these criteria. The following steps were implemented in order to select measures suitable for use in routine practice: literature database searches, consultation with stakeholders, application of inclusion and exclusion criteria, secondary searches and filtering. Subsequently, detailed reviews of the retained measures’ psychometric properties and implementation features were carried out. 11 measures were identified as having potential for use in routine practice and meeting most of the key criteria: 1) Achenbach System of Empirically Based Assessment, 2) Beck Youth Inventories, 3) Behavior Assessment System for Children, 4) Behavioral and Emotional Rating Scale, 5) Child Health Questionnaire, 6) Child Symptom Inventories, 7) Health of the National Outcome Scale for Children and Adolescents, 8) Kidscreen, 9) Pediatric Symptom Checklist, 10) Strengths and Difficulties Questionnaire, 11) Youth Outcome Questionnaire. However, all existing measures identified had limitations as well as strengths. Furthermore, none had sufficient psychometric evidence available to demonstrate that they could reliably measure both severity and change over time in key groups. The review suggests a way of rigorously evaluating the growing number of broadband self-report mental health outcome measures against standards of feasibility and psychometric credibility in relation to use for practice and policy. PMID:24834111

2014-01-01

334

"Kissing-balloon" technique for abdominal aorta angioplasty. Initial results and long term outcome.  

PubMed

We evaluated results after angioplasty of the distal abdominal aorta using "kissing-balloon" technique. MATERIALS AND METHODS. From 1981 through 1993, 14 patients (12 women and 2 men, average age 52.4 years), underwent balloon angioplasty of the distal segment of the abdominal aorta. In 8 patients stenosis involved one or both iliac arteries as well. In all cases double balloon technique was used. Follow-up was based on clinical, angiographical and duplex scanning examinations. RESULTS. The initial success rate was 85% (12/14). In one case there was residual stenosis of 20% (redilated successfully 1 month later), and in one case there was acute thrombosis of the right iliac artery (successfully relieved surgically). Long-term follow-up (6-143 months) showed good patency of the dilated segment in all patients (including patients that initially failed). At follow-up, all patients were asymptomatic. CONCLUSION. Dilatation of the distal abdominal aorta using "kissing-balloon" technique is a safe and efficient modality of treatment, with acceptable initial and excellent long-term results. PMID:8708428

Sagic, D; Grujicic, S; Peric, M; Popovic, Z; Radevic, B; Bojic, M

1995-12-01

335

Risk constraint measures developed for the outcome-based strategy for tank waste management  

SciTech Connect

This report is one of a series of supporting documents for the outcome-based characterization strategy developed by PNNL. This report presents a set of proposed risk measures with risk constraint (acceptance) levels for use in the Value of Information process used in the NCS. The characterization strategy has developed a risk-based Value of Information (VOI) approach for comparing the cost-effectiveness of characterizing versus mitigating particular waste tanks or tank clusters. The preference between characterizing or mitigating in order to prevent an accident depends on the cost of those activities relative to the cost of the consequences of the accident. The consequences are defined as adverse impacts measured across a broad set of risk categories such as worker dose, public cancers, ecological harm, and sociocultural impacts. Within each risk measure, various {open_quotes}constraint levels{close_quotes} have been identified that reflect regulatory standards or conventionally negotiated thresholds of harm to Hanford resources and values. The cost of consequences includes the {open_quotes}costs{close_quote} of exceeding those constraint levels as well as a strictly linear costing per unit of impact within each of the risk measures. In actual application, VOI based-decision making is an iterative process, with a preliminary low-precision screen of potential technical options against the major risk constraints, followed by VOI analysis to determine the cost-effectiveness of gathering additional information and to select a preferred technical option, and finally a posterior screen to determine whether the preferred option meets all relevant risk constraints and acceptability criteria.

Harper, B.L.; Gajewski, S.J.; Glantz, C.L. [and others

1996-09-01

336

Quantifying handicap: a new measure of long-term rehabilitation outcomes.  

PubMed

According to the World Health Organization (WHO), handicaps exist when individuals are unable to fulfill expected social roles. Although ameliorating handicaps is one of the prime goals of rehabilitation, its effectiveness in this area is poorly measured and has not been documented empirically. Therefore, the Craig Handicap Assessment and Reporting Technique (CHART) was designed to quantify the extent of handicap in individuals. Using dimensions of handicap identified and described by the WHO, CHART uses measurable, behavioral terms to compare such individuals with the norms of able-bodied members of society. Test-retest, proxies, and independent raters have established the validity and reliability of CHART. Rasch analysis has verified the CHART scaling and scoring procedures. In addition, an initial application of CHART, with a group of 342 spinal cord injured individuals, is described. Beyond demonstrating the instrument's effectiveness in assessing the extent of handicap or social disadvantage, this application, by documenting rehabilitation outcomes, demonstrates the potential usefulness of CHART for program evaluation. PMID:1622299

Whiteneck, G G; Charlifue, S W; Gerhart, K A; Overholser, J D; Richardson, G N

1992-06-01

337

Bone Marrow Stem Cells Added to a Hydroxyapatite Scaffold Result in Better Outcomes after Surgical Treatment of Intertrochanteric Hip Fractures  

PubMed Central

Introduction. Intertrochanteric hip fractures occur in the proximal femur. They are very common in the elderly and are responsible for high rates of morbidity and mortality. The authors hypothesized that adding an autologous bone marrow stem cells concentrate (ABMC) to a hydroxyapatite scaffold and placing it in the fracture site would improve the outcome after surgical fixation of intertrochanteric hip fractures. Material and Methods. 30 patients were randomly selected and divided into 2 groups of 15 patients, to receive either the scaffold enriched with the ABMC (Group A) during the surgical procedure, or fracture fixation alone (Group B). Results. There was a statistically significant difference in favor of group A at days 30, 60, and 90 for Harris Hip Scores (HHS), at days 30 and 60 for VAS pain scales, for bedridden period and time taken to start partial and total weight bearing (P < 0.05). Discussion. These results show a significant benefit of adding a bone marrow enriched scaffold to surgical fixation in intertrochanteric hip fractures, which can significantly reduce the associated morbidity and mortality rates. Conclusion. Bone marrow stem cells added to a hydroxyapatite scaffold result in better outcomes after surgical treatment of intertrochanteric hip fractures. PMID:24955356

Gutierres, Manuel; Lopes, M. Ascencao; Santos, J. Domingos; Cabral, A. T.; Pinto, R.

2014-01-01

338

Can MR Measurement of Renal Artery Flow and Renal Volume Predict the Outcome of Percutaneous Transluminal Renal Angioplasty?  

SciTech Connect

Purpose: Predicting therapeutic benefit from percutaneous transluminal renal angioplasty (PTRA) in patients with renal artery stenosis (RAS) remains difficult. This study investigates whether magnetic resonance (MR)-based renal artery flow measurements relative to renal parenchymal volume can predict clinical outcome following PTRA.Methods: The data on 23 patients (13 men, 10 women; age range 47-82 years, mean age 64 years) were analyzed. The indication for treatment was hypertension (n = 18) or renal insufficiency (n = 5). Thirty-four cases of RAS were identified: bilateral disease was manifest in 11 and unilateral disease in 12 patients. The MR imaging protocol included a breath-hold, cardiac-gated cine phase-contrast sequence for renal flow measurement and a fast multiplanar spoiled gradient-echo sequence for renal volume measurement. MR measurements were performed on the day prior to and the day following PTRA. Clinical success was defined as (a) a reduction in diastolic blood pressure > 15% or (b) a reduction in serum creatinine > 20%. Kidneys were categorized as normal volume or low volume. A renal flow index (RFI) was calculated by dividing the renal flow (ml/min) by the renal volume (cm{sup 3}).Results: Clinical success was observed in 11 patients. Twelve patients did not benefit from angioplasty. Normal kidney volume was seen in 10 of 11 responders and in 8 of 12 nonresponders, resulting in a sensitivity of 91%, specificity of 33%, a positive predictive value (PPV) of 56% and a negative predictive value (NPV) of 80%. A RFI below a threshold of 1.5 ml/min/cm{sup 3} predicted successful outcome with 100% sensitivity, 33% specificity, 58% PPV, and 100% NPV. The combination of normal renal volume and a RFI below 1.5 ml/min/cm{sup 3} identified PTRA responders with a sensitivity of 91%, a specificity of 67%, a PPV of 71%, and a NPV of 89%. PTRA resulted in a greater increase in renal flow in responders compared with nonresponders (p < 0.001).Conclusion: A combination of cine phase-contrast MR renal flow and parenchymal volume measurements enables identification of patients benefiting from PTRA with a high sensitivity and NPV, but only moderate specificity and PPV.

Binkert, Christoph A.; Debatin, Jorg F. [Department of Radiology, University Hospital Zurich, Raemistrasse 100, CH-8091 Zuerich (Switzerland); Schneider, Ernst [Department of Internal Medicine, Angiology Division, University Hospital Zurich, Raemistrasse 100, CH-8091 Zuerich (Switzerland); Hodler, Juerg [Department of Radiology, University Hospital Balgrist, Forchstrasse 340, CH-8008 Zuerich (Switzerland); Ruehm, Stefan G. [Department of Radiology, University Hospital Essen, Hufelandstrasse 55, D-45122 Essen (Germany); Schmidt, Michaela [Department of Radiology, University Hospital Zurich, Raemistrasse 100, CH-8091 Zuerich (Switzerland); Hoffmann, Ulrich [Department of Internal Medicine, Angiology Division, University Hospital Zurich, Raemistrasse 100, CH-8091 Zuerich (Switzerland)

2001-07-15

339

Developing Tools to Measure Quality in Congenital Catheterization and Interventions: The Congenital Cardiac Catheterization Project on Outcomes (C3PO)  

PubMed Central

The broad range of relatively rare procedures performed in pediatric cardiac catheterization laboratories has made the standardization of care and risk assessment in the field statistically quite problematic. However, with the growing number of patients who undergo cardiac catheterization, it has become imperative that the cardiology community overcomes these challenges to study patient outcomes. The Congenital Cardiac Catheterization Project on Outcomes was able to develop benchmarks, tools for measurement, and risk adjustment methods while exploring procedural efficacy. Based on the success of these efforts, the collaborative is pursuing a follow-up project, the Congenital Cardiac Catheterization Project on Outcomes—Quality Improvement, aimed at improving the outcomes for all patients undergoing catheterization for congenital heart disease by reducing radiation exposure. PMID:25114756

2014-01-01

340

Aerodynamics of Dragonfly in Hover: Force measurements and PIV results  

NASA Astrophysics Data System (ADS)

We useda pair of dynamically scaled robotic dragonfly model wings to investigate the aerodynamic effects of wing-wing interaction in dragonflies. We follow the wing kinematics of real dragonflies in hover, while systematically varied the phase difference between the forewing and hindwing. Instantaneous aerodynamic forces and torques were measured on both wings, while flow visualization and PIV results were obtained. The results show that, in hovering flight, wing-wing interaction causes force reduction for both wings at most of the phase angle differences except around 0 degree (when the wings are beating in-phase).

Deng, Xinyan; Hu, Zheng

2009-11-01

341

Absolute gravity and GPS measurements in Chile : preliminary results  

NASA Astrophysics Data System (ADS)

High precision gravity combined with GPS geodesy offers increasing potentialities for the study of time variations of the earth gravity field and crustal deformations related with geodynamic, tectonic or volcanic processes. The continental margin of Chile, resulting from the subduction of Nazca and Antarctic plates under the South American plate, belongs to the most active zones in the world where such processes can be observed. During summer 2002, we carried out a first experience of simultaneous absolute gravity and GPS measurements in north and central Chile with the aim to set up a repetition network of precise reference stations. The objectives are : (i) to attempt an estimation of the present-day vertical crustal motions along the andean margin ; (ii) to better constraints the vertical displacements associated with large earthquakes ; (iii) to establish precise calibration lines for relative gravity meters. The measurements have been performed with the FG5 absolute gravity meter (n°206). The sites were selected to ensure precise and safe data acquisition and mid to long-term stability of the stations. Special care was attempted to get measurements on existing sites where other geodetic/gravity observations are available (permanent GPS, DORIS, VLBI, SLR absolute or superconducting gravity). For other sites, differential GPS observations have been realized simultaneously with the gravity measurements. Scintrex CG-3M relative gravity measurements have been taken for earth-tide recording and vertical gravity gradient determinations. A total number of 11 absolute gravity stations have been established in north and central/south Chile. A preliminary processing, confirms that an accuracy of 1 to 3 µGal is achieved for these absolute gravity networks. We present here the first results of this survey and discuss their implications for future monitoring of gravity changes along the south-american plate boundary.

Bonvalot, S.; Comte, D.; Dorbath, L.; Hinderer, J.; Gabalda, G.; Luck, B.; Ruegg, J. C.

2003-04-01

342

School Context and Educational Outcomes: Results from a Quasi-Experimental Study  

PubMed Central

In this study we draw on data from a quasi-experimental study to test whether moving into a subsidized housing development in an affluent suburb yields educational benefits to the children of residents, compared to the educations they would have received had they not moved into the development. Results suggest that resident children experienced a significant improvement in school quality compared with a comparison group of students whose parents also had applied for residence. Parents who were residents of the development also displayed higher levels of school involvement compared with the comparison group of non-resident parents, and their children were exposed to significantly lower levels of school disorder and violence within school and spent more time reading outside of school. Living in the development did not influence GPA directly, but did indirectly increase GPA by increasing the time residents spent reading outside of school. PMID:25342878

Casciano, Rebecca; Massey, Douglas S.

2013-01-01

343

Entanglement, weak values, and the precise inference of joint measurement outcomes for non-commuting observable pairs  

NASA Astrophysics Data System (ADS)

The problem of inferring the outcome of a simultaneous measurement of two non-commuting observables is addressed. We show that for certain pairs with dense spectra, precise inferences of the measurement outcomes are possible in pre- and postselected ensembles, and if the selections involve entangled states with some other system. We show that the problem is related to the problem of assigning weak values to a continuous family of operators, and give explicit examples where this problem is solvable. A quantum-optical experiment is suggested and some foundational implications are briefly discussed.

Botero, Alonso

2010-01-01

344

Application of the OMERACT filter to measures of core outcome domains in recent clinical studies of acute gout  

PubMed Central

Objective To determine the extent to which instruments that measure core outcome domains in acute gout fulfil the OMERACT filter requirements of truth, discrimination and feasibility. Methods Patient-level data from four randomised controlled trials of agents designed to treat acute gout and one observational study of acute gout were analysed. For each available measure construct validity, test-retest reliability, within-group change using effect size, between-group change using the Kruskall-Wallis statistic and repeated measures generalised estimating equations were assessed. Floor and ceiling effects were also assessed and MCID was estimated. These analyses were presented to participants at OMERACT 11 to help inform voting for possible endorsement. Results There was evidence for construct validity and discriminative ability for 3 measures of pain (0 to 4 Likert, 0 to 10 numeric rating scale, 0 to 100 mm visual analogue scale). Likewise, there appears to be sufficient evidence for a 4-point Likert scale to possess construct validity and discriminative ability for physician assessment of joint swelling and joint tenderness. There was some evidence for construct validity and within-group discriminative ability for the Health Assessment Questionnaire as a measure of activity limitations, but not for discrimination between groups allocated to different treatment. Conclusions There is sufficient evidence to support measures of pain (using Likert, numeric rating scale or visual analogue scales), joint tenderness and swelling (using Likert scale) as fulfilling the requirements of the OMERACT filter. Further research on a measure of activity limitations in acute gout clinical trials is required. PMID:24429178

Taylor, William J; Redden, David; Dalbeth, Nicola; Schumacher, H Ralph; Edwards, N Lawrence; Simon, Lee S; John, Markus R; Essex, Margaret N; Watson, Douglas J; Evans, Robert; Rome, Keith; Singh, Jasvinder A

2014-01-01

345

Assessing severity of illness and outcomes of treatment in children with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME): a systematic review of patient-reported outcome measures (PROMs).  

PubMed

Chronic Fatigue Syndrome or Myalgic Encephalomyelitis (CFS/ME) in children is characterized by persistent or recurrent debilitating fatigue which results in a substantial reduction in activity. There is a growing interest in the use of questionnaires, or patient-reported outcome measures (PROMs), to assess how patients function and feel in relation to their health and associated healthcare. However, guidance for PROM selection for children with CFS/ME does not exist. We reviewed the quality and acceptability of PROMs used with children with CFS/ME to inform recommendations for practice. We conducted a systematic review of PROMs completed by children with CFS/ME. The quality of the evaluative studies and the reviewed measures were assessed against recommended criteria using an appraisal framework and the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. We sought evidence of measurement (reliability, validity, responsiveness, interpretability, data quality) and practical properties (acceptability, relevance, feasibility). Sixteen articles were included in the review, providing evidence of reliability and/or validity for 13 PROMs. Of these, five were child-specific (one health-related quality-of-life; four emotional well-being) and eight were not (four emotional well-being, three fatigue-specific; and one generic). All measures had limited evidence of measurement properties and no evidence of practical properties. Recommendations for patient-reported assessment are difficult to make because of limited evidence of the quality and acceptability of PROMs for children with CFS/ME. The appraisal method highlighted significant methodological and quality issues which must be addressed in future research. There is a lack of qualitative evidence describing the outcomes of healthcare that are important to children with CFS/ME, and the relevance or appropriateness of available measures. Future PROM development and evaluation in this group must seek to involve children collaboratively to ensure that the outcomes that children care about are assessed in an acceptable way. PMID:24661148

Haywood, K L; Collin, S M; Crawley, E

2014-11-01

346

[Treatment and outcome of Crohn's disease without initial complications. Results of a retrospective, multicenter Tunisian study].  

PubMed

The purpose of this study was to estimate and achieve the factors that have an influence on the evolution of the Chron's disease. This study was done in 124 patients reaching the diagnosis of Chron's disease between 1988 and 1997. The evolution of this disease was achieved in 87 patients. The Chron's disease was inactive among 31 patients (35-6%)--with discontinous evolution in 42 patients (48.3%) and active chronic in 14 patients (16-1%). The active chronic form of Chron's disease was twice more frequent among the smokers and the patients with age above 40 years--but this difference has no statistical significance. The indication of surgical treatment was realised in 21 patients and it takes place as result of failure of medical treatment in 16 patients (76-2%)--an abcess in 2 patents (9-5%) and iatrogenic perforation in 1 patient (4-8%). The age-sexe-smoke--the intensity of the initial attack and the nature of the treatment had no influence in the need of the surgical interfference. The Chron's disease showed the less severe evolution in this study--the age above 40 years and the consumption of smoke increased the frequency of active chronic form. PMID:12416354

Cheikh, Imed; Ben Ammar, Ahmed; Essid, Mejda; Azzouz, Messadak; Ettahri, Nabil; Krichene, Mohamed; Bouzaidi, Slim; Ennajar, Taoufik

2002-04-01

347

Newborn calf vitality: risk factors, characteristics, assessment, resulting outcomes and strategies for improvement.  

PubMed

Dystocia is a stressful and traumatic event for both the cow and calf. As the prevalence of dystocia has increased over time, attention has been focused on maintaining the health and longevity of the cow. Lack of vitality in the newborn calf may go unnoticed and result in short or long-term implications for calf health and performance. A prolonged or assisted delivery may increase birth stress in calves causing a variety of effects including injury, inflammation, hypoxia, acidosis, pain and an inability to maintain homeostasis. Each of these effects can further contribute to a reduced state of vitality in the newborn calf. Newborn vitality is essential to the health, survival and welfare of the calf. If the calf is not vital at birth, it may be unwilling or unable to get up and suckle colostrum in a timely manner. Early colostrum intake improves passive transfer of immunoglobulins, energy uptake and thermoregulation. Intervention may be required to assist these calves such as respiratory and thermal support, manual feeding of colostrum or the administration of non-steroidal anti-inflammatory drugs to aid health and long-term survival. However, more research is needed to determine ways in which newborn calf vitality can be assessed and improved in order to reduce the increased risk of morbidity and mortality and long-term effects on performance. PMID:23932652

Murray, Christine F; Leslie, Ken E

2013-11-01

348

Radiographic scoring methods as outcome measures in rheumatoid arthritis: properties and advantages  

PubMed Central

BACKGROUND—Use of scored radiographs as an outcome measure can help estimate the progression of rheumatoid arthritis (RA). Radiographs not only provide permanent records with which to evaluate RA serially, but can also be randomised and blinded, a major advantage in clinical trials.?OBJECTIVES AND METHOD—Medline was searched for information about the principal methods of assessing joints affected by RA. Each technique was evaluated for its measurement properties, advantages, and limitations.?MAIN FINDINGS—The most commonly used methods are those devised by Sharp, Larsen, and van der Heijde/Sharp, and their variants. Methods based on the Sharp technique provide separate scores for erosion and for joint space narrowing. Larsen and variants, together with the Simple Erosion Narrowing Score (SENS) method, provide an overall score. Each method's measurement properties (feasibility, time consumption, etc) depend on the degree of detail it considers. Authors consistently recommend taking a posteroanterior view of hand and foot radiographs, and the use of trained raters. Intra- and interrater reliability values are generally higher than 0.70 (less often assessed by the intraclass correlation coefficient than the correlation coefficient). Sensitivity to change is calculated by several techniques (standardised response mean (SRM), adjusted SRM, minimal detectable change, smallest detectable difference). Most methods assessed with SRM reach a value of 0.80 or more.?CONCLUSION—Standardised procedures are available for performing and reading radiographs in RA. The choice of scoring method depends on the time and staff available, and the required degree of reliability and sensitivity to change.?? PMID:11502606

Boini, S; Guillemin, F

2001-01-01

349

Augmented Therapy Improves Outcome For Pediatric High Risk Acute Lymphocytic Leukemia: Results Of Children's Oncology Group Trial P9906  

PubMed Central

Background The augmented BFM regimen improves outcome for children with NCI high acute lymphoblastic leukemia (ALL). Patient age, sex, and presenting white blood cell count (WBC) can be used to identify a subset of approximately 12% of children with B-precursor ALL that had a 5-year continuous complete remission (CCR) rate of only about 50% on earlier Pediatric Oncology Group (POG) trials. Procedures Children’s Oncology Group trial P9906 evaluated a modified augmented BFM regimen in 267 patients with particularly high risk B-precursor ALL. Minimal residual disease (MRD) was assessed in blood at day 8 and in marrow at day 29 of Induction and correlated with outcome. Results The 5-year CCR probability for patients in P9906 was significantly better than that observed for similar patients on POG trials 8602/9006 (62.2 ±3.7% versus 50.6 ±2.4%; p=0.0007) but similar to POG 9406 (63.5±2.4%; p=0.81). Interim analysis showed poor central nervous system (CNS) control, especially in patients with initial WBC ?100,000/microliter. Day 29 marrow MRD positive (>=0.01%) vs. negative patients had 5 year CCR rates of 37.1±7.4% vs. 72.6±4.3%; day 8 blood MRD positive vs. negative patients had 5 year CCR rates of 57.1 ±4.6 % vs.83.6±6.3%. End induction marrow MRD predicted marrow but not CNS relapse. In multivariate analysis, day 29 MRD>0.01%, initial WBC?100,000/µl, male gender, and day 8 blood MRD>0.01% were significant prognostic factors. Conclusions Augmented BFM therapy improved outcome for children with higher risk ALL. Day 8 blood and day 29 marrow MRD were strong prognostic factors in these patients. PMID:21360654

Bowman, W. Paul; Larsen, Eric L; Devidas, Meenakshi; Linda, Stephen B.; Blach, Laurie; Carroll, Andrew J; Carroll, William L; Pullen, D. Jeanette; Shuster, Jonathan; Willman, Cheryl L; Winick, Naomi; Camitta, Bruce M; Hunger, Stephen P; Borowitz, Michael J

2011-01-01

350

Assessment of root canal treatment outcomes performed by Turkish dental students: results after two years.  

PubMed

The aim of this study was to evaluate radiographically the periapical status and technical standard of root canal therapies performed by a group of undergraduate dental students in Turkey two years following completion of the treatments. A random sample of 264 patients who received root canal treatment from undergraduate students at the Yeditepe University Faculty of Dentistry in 2009 were recalled after two years. The study sample consisted of 319 root-filled teeth in 158 dental patients (females=97, males=61) who presented to the student clinics during that time frame. For each root-filled tooth, two periapical radiographs were examined to identify the periapical status, one showing pre-treatment and the other showing post-treatment status. The quality of endodontic treatment was examined according to the distance between the end of root filling and radiographic apex and the density of the obturation according to presence of voids within the root filling material. This examination found that 54.2 percent of roots had fillings of acceptable length, while 37.3 percent were short, 7.8 percent were overfilled, and 0.6 percent was unfilled; 2.5 percent of the teeth were observed with broken root canal instruments. After two years, PAI scores of teeth with acceptable length of root canal filling (0-2 mm from the radiographic apex) were found to be lower than those of the overfilling and short filling cases (>2mm) (p<0.01). Moreover, voids were detected in the root canal fillings of 52.7 percent of endodontically treated teeth. The PAI scores of root fillings with inadequate density were significantly higher than adequate ones (p<0.01). Although endodontic treatments performed by undergraduate students do not appear to be unqualified compared to those performed by general practitioners, more emphasis must be placed on the technical quality of endodontic treatment to obtain better results. PMID:23576596

Ilgüy, Dilhan; Ilgüy, Mehmet; Fisekçioglu, Erdogan; Ersan, Nilüfer; Tanalp, Jale; Dölekoglu, Semanur

2013-04-01

351

Cervical spine injuries resulting from diving accidents in swimming pools: outcome of 34 patients  

PubMed Central

Cervical spine injuries after diving into private swimming pools can lead to dramatic consequences. We reviewed 34 patients hospitalized in our center between 1996 and 2006. Data was collected from their initial admission and from follow-up appointments. The injuries were sustained by young men in 97% (mean age 27) and the majority happened during the summer (88%). Fractures were at C5–C7 in 70%. American Spinal Injury Association class (ASIA) on admission was A for 8 patients, B for 4, C for 4, D for 1, and E for 17. There were 23 surgical spine stabilizations. Final ASIA class was A for 6 patients, B for 1, C for 3, D for 5, and E for 18. The mean duration of hospitalization was 21.3 days in our neurosurgical center (mean overall cost: 36,000 Euros/patient) plus 10.6 months in rehabilitation center for the 15 patients admitted who had an ASIA class A to C. Mean overall direct cost for a patient with class A is almost 300,000 Euros, compared to around 10,000 Euros for patients with class D and E. In addition, a profound impact on personal and professional life was seen in many cases including 11 divorces and 7 job losses. Dangerous diving into swimming pools can result in spinal injuries with drastic consequences, including permanent physical disability and a profound impact on socio-professional status. Moreover, there are significant financial costs to society. Better prevention strategies should be implemented to reduce the impact of this public health problem. PMID:19956985

Gouader, Ismail; Bousquet, Philippe; Draper, Louisa; Roux, Franck-Emmanuel

2009-01-01

352

AutoDensity: an automated method to measure mammographic breast density that predicts breast cancer risk and screening outcomes  

PubMed Central

Introduction While Cumulus – a semi-automated method for measuring breast density – is utilised extensively in research, it is labour-intensive and unsuitable for screening programmes that require an efficient and valid measure on which to base screening recommendations. We develop an automated method to measure breast density (AutoDensity) and compare it to Cumulus in terms of association with breast cancer risk and breast cancer screening outcomes. Methods AutoDensity automatically identifies the breast area in the mammogram and classifies breast density in a similar way to Cumulus, through a fast, stand-alone Windows or Linux program. Our sample comprised 985 women with screen-detected cancers, 367 women with interval cancers and 4,975 controls (women who did not have cancer), sampled from first and subsequent screening rounds of a film mammography screening programme. To test the validity of AutoDensity, we compared the effect estimates using AutoDensity with those using Cumulus from logistic regression models that tested the association between breast density and breast cancer risk, risk of small and large screen-detected cancers and interval cancers, and screening programme sensitivity (the proportion of cancers that are screen-detected). As a secondary analysis, we report on correlation between AutoDensity and Cumulus measures. Results AutoDensity performed similarly to Cumulus in all associations tested. For example, using AutoDensity, the odds ratios for women in the highest decile of breast density compared to women in the lowest quintile for invasive breast cancer, interval cancers, large and small screen-detected cancers were 3.2 (95% CI 2.5 to 4.1), 4.7 (95% CI 3.0 to 7.4), 6.4 (95% CI 3.7 to 11.1) and 2.2 (95% CI 1.6 to 3.0) respectively. For Cumulus the corresponding odds ratios were: 2.4 (95% CI 1.9 to 3.1), 4.1 (95% CI 2.6 to 6.3), 6.6 (95% CI 3.7 to 11.7) and 1.3 (95% CI 0.9 to 1.8). Correlation between Cumulus and AutoDensity measures was 0.63 (P < 0.001). Conclusions Based on the similarity of the effect estimates for AutoDensity and Cumulus in models of breast density and breast cancer risk and screening outcomes, we conclude that AutoDensity is a valid automated method for measuring breast density from digitised film mammograms. PMID:24020331

2013-01-01

353

Bristol Girls Dance Project Feasibility Trial: outcome and process evaluation results  

PubMed Central

Background Many adolescent girls do not engage in sufficient physical activity (PA). This study examined the feasibility of conducting a cluster randomized controlled trial (RCT) to evaluate an after-school dance program to increase PA among 11–12?year old girls in Bristol, UK. Methods Three-arm, cluster RCT. Three secondary schools were assigned to intervention arm. Intervention participants received a 9-week dance program with 2, 90-minute dance classes per week. Participants at 2 control schools received incentives for data collection. Participants at 2 additional control schools received incentives and a delayed dance workshop. Accelerometer data were collected at baseline (time 0), during the last week of the dance program (time 1) and 20?weeks after the start of the study (time 2). Weekly attendance, enjoyment and perceived exertion were assessed in intervention participants. Post-study qualitative work was conducted with intervention participants and personnel. Results 40.1% of girls provided consent to be in the study. The mean number of girls attending at least one dance session per week ranged from 15.4 to 25.9. There was greater number of participants for whom accelerometer data were collected in control arms. The mean attendance was 13.3 sessions (maximum?=?18). Perceived exertion ratings indicated that the girls did not find the sessions challenging. The dance teachers reported that the program content would benefit from revisions including less creative task time, a broader range of dance genres and improved behavioral management policies. At time 2, the 95% confidence intervals suggest between 5 and 12 minutes more weekday MVPA in the intervention group compared with the control incentives only group, and between 6 minutes fewer and 1 minute more compared with the control incentives plus workshop group. Between 14 and 24 schools would be required to detect a difference of 10 minutes in mean weekday MVPA between intervention and control groups. Conclusions It is possible to recruit 11–12?year old girls to participate in an after-school dance study. An after-school dance intervention has potential to positively affect the PA levels of 11–12?year old girls but an adequately powered RCT is required to test this intervention approach. PMID:22747608

2012-01-01

354

Employment and Educational Equivalence Outcomes as Measures of Employment and Career Counselling  

ERIC Educational Resources Information Center

In Canada, government departments and other funders of services tend to view change in employment status as the primary indicator of success in career and employment counselling. If a client becomes employed, the counselling is viewed as successful, while all other outcomes are viewed as failures. We advance the idea that many other outcomes, such…

Conger, Stuart; Hiebert, Bryan

2007-01-01

355

Measuring Outcomes of Living-Learning Programs: Examining College Environments and Student Learning and Development  

ERIC Educational Resources Information Center

The National Study of Living-Learning Programs (NSLLP) survey instrument was designed to assess college environments and student learning and development outcomes associated with participation in living-learning programs. Data from the NSLLP show that students in living-learning programs demonstrate higher self-reported engagement and outcomes

Inkelas, Karen Kurotsuchi; Vogt, Kristen E.; Longerbeam, Susan D.; Owen, Julie; Johnson, Dawn

2006-01-01

356

Discrimination measures for survival outcomes: connection between the AUC and the predictiveness curve  

E-print Network

(t). This relation confirms that the predictiveness curve is the key concept for evaluating calibration were originally defined for diagnostic tests and rely on the observation of a binary outcome of diagnostic models. Originally, the ROC curve was designed for a continuous (bio)marker X and a binary outcome

Paris-Sud XI, Université de

357

Modeling Data with Excess Zeros and Measurement Error: Application to Evaluating Relationships between Episodically Consumed Foods and Health Outcomes  

PubMed Central

Summary Dietary assessment of episodically consumed foods gives rise to nonnegative data that have excess zeros and measurement error. Tooze et al. (2006, Journal of the American Dietetic Association 106, 1575–1587) describe a general statistical approach (National Cancer Institute method) for modeling such food intakes reported on two or more 24-hour recalls (24HRs) and demonstrate its use to estimate the distribution of the food’s usual intake in the general population. In this article, we propose an extension of this method to predict individual usual intake of such foods and to evaluate the relationships of usual intakes with health outcomes. Following the regression calibration approach for measurement error correction, individual usual intake is generally predicted as the conditional mean intake given 24HR-reported intake and other covariates in the health model. One feature of the proposed method is that additional covariates potentially related to usual intake may be used to increase the precision of estimates of usual intake and of diet-health outcome associations. Applying the method to data from the Eating at America’s Table Study, we quantify the increased precision obtained from including reported frequency of intake on a food frequency questionnaire (FFQ) as a covariate in the calibration model. We then demonstrate the method in evaluating the linear relationship between log blood mercury levels and fish intake in women by using data from the National Health and Nutrition Examination Survey, and show increased precision when including the FFQ information. Finally, we present simulation results evaluating the performance of the proposed method in this context. PMID:19302405

Kipnis, Victor; Midthune, Douglas; Buckman, Dennis W.; Dodd, Kevin W.; Guenther, Patricia M.; Krebs-Smith, Susan M.; Subar, Amy F.; Tooze, Janet A.; Carroll, Raymond J.; Freedman, Laurence S.

2010-01-01

358

The Harmonising Outcome Measures for Eczema (HOME) statement to assess clinical signs of atopic eczema in trials.  

PubMed

The lack of core outcome sets for atopic eczema (AE) is a major obstacle for advancing evidence-based treatment. The global Harmonising Outcome Measures for Eczema (HOME) initiative has already defined clinical signs, symptoms, quality of life, and long-term control of flares as core outcome domains for AE trials. This article deals with the standardization of measurement instruments to assess clinical signs of AE. To resolve the current lack of standardization of the assessment of clinical signs of AE, we followed a structured process of systematic reviews and international consensus sessions to identify 1 core outcome measurement instrument for assessment of clinical signs in all future AE trials. Systematic reviews indicated that from 16 different instruments identified to assess clinical signs of AE, only the Eczema Area and Severity Index (EASI) and the objective Scoring Atopic Dermatitis (SCORAD) index were identified as extensively validated. The EASI has adequate validity, responsiveness, internal consistency, and intraobserver reliability. The objective SCORAD index has adequate validity, responsiveness, and interobserver reliability but unclear intraobserver reliability to measure clinical signs of AE. In an international consensus study, patients, physicians, nurses, methodologists, and pharmaceutical industry representatives agreed that the EASI is the preferred core instrument to measure clinical signs in all future AE trials. All stakeholders involved in designing, reporting, and using clinical trials on AE are asked to comply with this consensus to enable better evidence-based decision making, clearer scientific communication, and improved patient care. PMID:25282560

Schmitt, Jochen; Spuls, Phyllis I; Thomas, Kim S; Simpson, Eric; Furue, Masutaka; Deckert, Stefanie; Dohil, Magdalene; Apfelbacher, Christian; Singh, Jasvinder A; Chalmers, Joanne; Williams, Hywel C

2014-10-01

359

The role of therapist adherence, therapist competence, and alliance in predicting outcome of individual drug counseling: Results from the National Institute Drug Abuse Collaborative Cocaine Treatment Study  

Microsoft Academic Search

This study tested hypotheses related to linear and curvilinear relations among adherence, competence, and outcome and interactions of these effects with the quality of the therapeutic alliance among patients (N=95) who received individual drug counseling as part of the National Institute on Drug Abuse Collaborative Cocaine Treatment Study. Results support a hypothesized curvilinear relation between adherence and outcome as well

Jacques P. Barber; Robert Gallop; Paul Crits-Christoph; Arlene Frank; Michael E. Thase; Roger D. Weiss; Mary Beth Connolly Gibbons

2006-01-01

360

State Reduction by Measurements with a Null Result  

NASA Astrophysics Data System (ADS)

We review two topics of quantum optics that shed new light on the effect of state reduction by a quantum measurement. One topic is the observation of quantum jumps switching on and off the fluorescence of a trapped atomic ion. The other one is the spontaneous decay of a single atom, described by the method of quantum trajectories. This method is based on the decomposition of the density matrix of an open system into an ensemble of time-dependent pure state vectors. Here we consider single histories of the spontaneously emitting atom. It is shown that in both cases the evolution is affected by a detection with a null result.

Nienhuis, G.

2007-09-01

361

Accuracy of the DIBELS oral reading fluency measure for predicting third grade reading comprehension outcomes.  

PubMed

We evaluated the validity of DIBELS (Dynamic Indicators of Basic Early Literacy Skills) ORF (Oral Reading Fluency) for predicting performance on the Florida Comprehensive Assessment Test (FCAT-SSS) and Stanford Achievement Test (SAT-10) reading comprehension measures. The usefulness of previously established ORF risk-level cutoffs [Good, R.H., Simmons, D.C., and Kame'enui, E.J. (2001). The importance and decision-making utility of a continuum of fluency-based indicators of foundational reading skills for third-grade high-stakes outcomes. Scientific Studies of Reading, 5, 257-288.] for third grade students were evaluated on calibration (n(S1)=16,539) and cross-validation (n(S2)=16,908) samples representative of Florida's Reading First population. The strongest correlations were the third (February/March) administration of ORF with both FCAT-SSS and SAT-10 (r(S)=.70-.71), when the three tests were administered concurrently. Recalibrated ORF risk-level cut scores derived from ROC (receiver-operating characteristic) curve analyses produced more accurate identification of true positives than previously established benchmarks. The recalibrated risk-level cut scores predict performance on the FCAT-SSS equally well for students from different socio-economic, language, and race/ethnicity categories. PMID:19083363

Roehrig, Alysia D; Petscher, Yaacov; Nettles, Stephen M; Hudson, Roxanne F; Torgesen, Joseph K

2008-06-01

362

Results of flexible ranibizumab treatment in age-related macular degeneration and search for parameters with impact on outcome  

Microsoft Academic Search

Background  The aim of this study was to analyse functional results of flexible ranibizumab treatment in exudative age-related macular\\u000a degeneration (AMD), and to search for parameters with impact on outcome.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Analysis of a retrospective institutional case series (104 eyes) with a low-threshold re-treatment algorithm and monthly follow-up\\u000a for 12 months.\\u000a \\u000a \\u000a \\u000a \\u000a Results  Visual acuity (VA) improved at month 3 by +6.7 letters and declined

Heinrich Gerding; Vlassios Loukopoulos; Juliane Riese; Lars Hefner; Melanie Timmermann

2011-01-01

363

A Prospective Cohort Study of the Effects of Lower Extremity Orthopaedic Surgery on Outcome Measures in Ambulatory Children With Cerebral Palsy  

PubMed Central

Background Lower-extremity musculotendinous surgery is standard treatment for ambulatory children with deformities such as joint contractures and bony torsions resulting from cerebral palsy (CP). However, evidence of efficacy is limited to retrospective, uncontrolled studies with small sample sizes focusing on gait variables and clinical examination measures. The aim of this study was to prospectively examine whether lower-extremity musculotendinous surgery in ambulatory children with CP improves impairments and function measured by gait and clinical outcome tools beyond changes found in a concurrent matched control group. Methods Seventy-five children with spastic CP (Gross Motor Function Classification System levels I to III, age 4 to 18 y) that underwent surgery to improve gait were individually matched on the basis of sex, Gross Motor Function Classification System level, and CP subtype to a nonsurgical cohort, minimizing differences in age and Gross Motor Function Measure Dimension E. At baseline and at least 12 months after baseline or surgery, participants completed gait analysis and Gross Motor Function Measure, and parents completed outcome questionnaires. Mean changes at follow-up were compared using analysis of covariance adjusted for baseline differences. Results Surgery ranged from single-level soft tissue release to multilevel bony and/or soft tissue procedures. At follow-up, after correcting for baseline differences, Gillette Gait Index, Pediatric Outcomes Data Collection Instrument Expectations, and Pediatric Quality of Life Inventory (PedsQL) Physical Functioning improved significantly for the surgical group compared with the nonsurgical group, which showed minimal change. Conclusions On the basis of a matched concurrent data set, there was significant improvement in function after 1 year for a surgical group compared with a nonsurgical group as measured by the Gillette Gait Index, with few significant changes noted in outcome measures. Changes over 1 year are minimal in the nonsurgical group, supporting the possibility of ethically performing a randomized controlled trial using nonsurgical controls. Level of Evidence Therapeutic level 2. Prospective comparative study. PMID:19934707

Gorton, George Edwin; Abel, Mark F.; Oeffinger, Donna J.; Bagley, Anita; Rogers, Sarah P.; Damiano, Diane; Romness, Mark; Tylkowski, Chester

2010-01-01

364

The Amsterdam Pain Management Index compared to eight frequently used outcome measures to evaluate the adequacy of pain treatment in cancer patients with chronic pain.  

PubMed

There is no 'gold standard' to assess the adequacy of pain treatment in cancer patients. The purpose of the study is to explore the Amsterdam Pain Management Index, a newly designed measure to evaluate the adequacy of cancer pain treatment, and to compare it with eight frequently used outcome measures. The Amsterdam Pain Management Index compares patients' Present Pain Intensity, Average Pain Intensity, and Worst Pain Intensity with a composite score of analgesics used, while correcting for what a patient considers as a tolerable level of pain. The eight frequently used outcome measure consisted of three Pain Intensity Markers, the Pain Relief Scale, the Patient Satisfaction Scale, and three Pain Management Indexes. In a randomized controlled trial, 313 cancer patients with a pain duration of at least 1 month were included and followed-up three times until 2 months postdischarge at home. The experimental group received a Pain Education Program, consisting of tailored pain information and instruction. Results showed that, except for the three Pain Management Indexes, the agreement between the measures was very low to moderate. The test of known-groups comparisons and equivalence between groups indicated that the Amsterdam Pain Management Index showed promising results. The Pain Intensity Markers and the Pain Relief Scale were limited in discriminating between groups, while the Patient Satisfaction Scale showed no differences between patient groups. Although it was possible for the Pain Management Indexes to distinguish between patient groups, the differences were not in the expected direction. The ability of the outcome measures to detect changes over time was clearly demonstrated by all outcome measures. Effects of the intervention were only found for the Amsterdam Pain Management Index and patients' Substantial Worst Pain score. Although support was provided for the use of the Amsterdam Pain Management Index, more research is warranted. PMID:11275392

de Wit, R; van Dam, F; Loonstra, S; Zandbelt, L; van Buuren, A; van der Heijden, K; Leenhouts, G; Huijer Abu-Saad, H

2001-04-01

365

Application of terahertz radiation to soil measurements: initial results.  

PubMed

Developing soil sensors with the possibility of continuous online measurement is a major challenge in soil science. Terahertz (THz) electromagnetic radiation may provide the opportunity for the measurement of organic material density, water content and other soil parameters at different soil depths. Penetration depth and information content is important for a functional soil sensor. Therefore, we present initial research on the analysis of absorption coefficients of four different soil samples by means of THz transmission measurements. An optimized soil sample holder to determine absorption coefficients was used. This setup improves data acquisition because interface reflections can be neglected. Frequencies of 340 GHz to 360 GHz and 1.627 THz to 2.523 THz provided information about an existing frequency dependency. The results demonstrate the potential of this THz approach for both soil analysis and imaging of buried objects. Therefore, the THz approach allows different soil samples to be distinguished according to their different absorption properties so that relations among soil parameters may be established in future. PMID:22163737

Dworak, Volker; Augustin, Sven; Gebbers, Robin

2011-01-01

366

Results from the first Waste and Residue NDA Measurements School  

SciTech Connect

The first Waste and Residue Nondestructive Assay (NDA) Measurements School was given at Los Alamos on June 3--7, 1996. This school is a new part of the DOE Office of Safeguards and Security, Safeguards Training Program, with additional instructor support from the National Transuranic Waste Program, Idaho National Engineering Laboratory, Oak Ridge National Laboratory, Portsmouth Gaseous Diffusion Plant, Westinghouse savannah River Company, Pajarito Scientific Corporation, and Canberra Industries. The school was attended by 22 safeguards and waste measurement personnel from DOE facilities, and included lectures on waste characterization requirements, the WIPP Performance Demonstration Program, waste and residue NDA techniques, and a workshop discussion on waste assay issues. Hands-on training modules with 55-gallon-drum waste assay systems were held using a Segmented Gamma-ray Scanner, a Tomographic Gamma-ray Scanner, two Add-a-Source Waste-Drum Assay Systems, a Californium Shuffler, and a Differential Die-away system that included Combined Thermal-Epithermal Neutron Interrogation (CTEN). This paper will describe the new school and report on the measurement results obtained during the school with the above-mentioned waste-drum assay systems.

Ensslin, N.; Abhold, M.; Coop, K.; Prettyman, T.; Rinard, P.; Sheppard, G.; Smith, H.A.

1996-09-01

367

Application of patient-reported outcome measures (PROMs) data to estimate cost-effectiveness of hernia surgery in England  

PubMed Central

Objectives To demonstrate potential uses of nationally collected patient-reported outcome measures (PROMs) data to estimate cost-effectiveness of hernia surgery. Design Cost-utility model populated with national PROMs, National Reference Cost and Hospital Episodes Statistics data. Setting Hospitals in England that provided elective inguinal hernia repair surgery for NHS patients between 1 April 2009 and 31 March 2010. Participants Patients >18 years undergoing NHS-funded elective hernia surgery in English hospitals who completed PROMs questionnaires. Main outcome measures Change in quality-adjusted life year (QALY) following surgery; cost per QALY of surgery by acute provider hospital; health gain and cost per QALY by surgery type received (laparoscopic or open hernia repair). Results The casemix-adjusted, discounted (at 3.5%) and degraded (over 25 years) mean change in QALYs following elective hernia repair surgery is 0.826 (95% CI, 0.793–0.859) compared to a counterfactual of no treatment. Patients undergoing laparoscopic surgery show a significantly greater gain in health-related quality of life (EQ-5D index change, 0.0915; 95% CI, 0.0850–0.0979) with an estimated gain of 0.923 QALYS (95% CI, 0.859–0.988) compared to those having open repair (EQ-5D index change, 0.0806; 95% CI, 0.0771–0.0841) at 0.817 QALYS (95% CI, 0.782–0.852). The average cost of hernia surgery in England is £1554, representing a mean cost per QALY of £1881. The mean cost of laparoscopic and open hernia surgery is equivocal (£1421 vs. £1426 respectively) but laparoscopies appear to offer higher cost-utility at £1540 per QALY, compared to £1746 per QALY for open surgery. Conclusions Routine PROMs data derived from NHS patients could be usefully analyzed to estimate health outcomes and cost-effectiveness of interventions to inform decision-making. This analysis suggests elective hernia surgery offers value-for-money, and laparoscopic repair is more clinically effective and generates higher cost-utility than open surgery. PMID:23759893

Coronini-Cronberg, Sophie; Appleby, John; Thompson, James

2013-01-01

368

Recent Results of TMD Measurements from Jefferson Lab Hall A  

SciTech Connect

This slide-show presents results on transverse momentum distributions. The presentation covers: target single-spin asymmetry (SSA) (in parity conserving interactions); • Results of JLab Hall A polarized {sup 3}He target TMD measurement; • Semi-­?inclusive deep-inelastic scattering channels (E06-010); • Target single-spin asymmetry A{sub UT}, Collins and Sivers SSA on neutron; • Double-spin asymmetry A{sub LT}, extract TMD g{sub 1T} on neutron; • Inclusive channels SSA (E06-010, E05-015, E07-013) • Target SSA: inclusive {sup 3}He(e,e’) quasi-elastic scattering; • Target SSA: inclusive {sup 3}He(e,e’) deep inelastic-elastic scattering; • New SIDIS experiments planned in Hall-A for JLab-12 GeV.

Jiang, Xiaodong [LANL

2013-10-01

369

Fan Noise Source Diagnostic Test: LDV Measured Flow Field Results  

NASA Technical Reports Server (NTRS)

Results are presented of an experiment conducted to investigate potential sources of noise in the flow developed by two 22-in. diameter turbofan models. The R4 and M5 rotors that were tested were designed to operate at nominal take-off speeds of 12,657 and 14,064 RPMC, respectively. Both fans were tested with a common set of swept stators installed downstream of the rotors. Detailed measurements of the flows generated by the two were made using a laser Doppler velocimeter system. The wake flows generated by the two rotors are illustrated through a series of contour plots. These show that the two wake flows are quite different, especially in the tip region. These data are used to explain some of the differences in the rotor/stator interaction noise generated by the two fan stages. In addition to these wake data, measurements were also made in the R4 rotor blade passages. These results illustrate the tip flow development within the blade passages, its migration downstream, and (at high rotor speeds) its merging with the blade wake of the adjacent (following) blade. Data also depict the variation of this tip flow with tip clearance. Data obtained within the rotor blade passages at high rotational speeds illustrate the variation of the mean shock position across the different blade passages.

Podboy, Gary C.; Krupar, Martin J.; Hughes, Christopher E.; Woodward, Richard P.

2003-01-01

370

What is the optimal time point to assess patient-reported recovery after hip and knee replacement? a systematic review and analysis of routinely reported outcome data from the English patient-reported outcome measures programme  

PubMed Central

Background It is unclear if there is a clinically important improvement in the six to 12-month recovery period after hip and knee replacement. This is an obvious gap in the evidence required by patients undergoing these procedures. It is also an issue for the English PROMs (Patient-Reported Outcome Measures) Programme which uses 6-month outcome data to compare the results of hospitals that perform hip and knee replacements. Methods A systematic review of studies reporting the Oxford Hip Score (OHS) or Oxford Knee Score (OKS) at 12 months after surgery was performed. This was compared with six-month outcome data collected for 60, 160 patients within the English PROMs programme. A minimally important difference of one standard error of the measurement, equivalent to 2.7 for the OHS and 2.1 for the OKS, was adopted. Results and discussion Six studies reported OHS data for 10 different groups containing 8,308 patients in total. In eight groups the change scores reported were at least 2.7 points higher than the six-month change observed in the PROMs programme (20.2 points). Nine studies reported OKS data for 13 different groups containing 4,369 patients in total. In eight groups the change scores reported were at least 2.1 points higher than the six-month change observed in the PROMs programme (15.0 points). Conclusions There is some evidence from this systematic review that clinically important improvement in the Oxford hip and knee scores occurs in the six to 12 month recovery period. This trend is more apparent for hip than knee replacement. Therefore we recommend that the English Department of Health study the impact on hospital comparisons of using 12- rather than six-month outcome data. PMID:23895227

2013-01-01

371

Designing Reading Comprehension Assessments for Reading Interventions: How a Theoretically Motivated Assessment Can Serve as an Outcome Measure  

ERIC Educational Resources Information Center

When designing a reading intervention, researchers and educators face a number of challenges related to the focus, intensity, and duration of the intervention. In this paper, we argue there is another fundamental challenge--the nature of the reading outcome measures used to evaluate the intervention. Many interventions fail to demonstrate…

O'Reilly, Tenaha; Weeks, Jonathan; Sabatini, John; Halderman, Laura; Steinberg, Jonathan

2014-01-01

372

Feedback Consequences and Steps Toward Implementation: A Guide to Educational Outcome Measurements and Their Uses. Seminar No. 6.  

ERIC Educational Resources Information Center

This guide is essentially designed as a teaching aid for those who would inform planners, officials of educational ministries, school administrators, principals, and teachers about educational outcome measurements. In outline and graphic form, the guide presents topics for discussion in a seminar dealing with feedback consequences and steps toward…

Mushkin, Selma J.; Billings, Bradley B.

373

Intelligibility as a Clinical Outcome Measure Following Intervention with Children with Phonologically Based Speech-Sound Disorders  

ERIC Educational Resources Information Center

Background: The effectiveness of two treatment approaches (phonological therapy and articulation therapy) for treatment of 14 children, aged 4;0-6;7 years, with phonologically based speech-sound disorder (SSD) has been previously analysed with severity outcome measures (percentage of consonants correct score, percentage occurrence of phonological…

Lousada, M.; Jesus, Luis M. T.; Hall, A.; Joffe, V.

2014-01-01

374

Outcome Measurement Using Naturalistic Language Samples: A Feasibility Pilot Study Using Language Transcription Software and Speech and Language Therapy Assistants  

ERIC Educational Resources Information Center

The ultimate aim of intervention for children with language impairment is an improvement in their functional language skills. Baseline and outcome measurement of this is often problematic however and practitioners commonly resort to using formal assessments that may not adequately reflect the child's competence. Language sampling,…

Overton, Sarah; Wren, Yvonne

2014-01-01

375

Electrical axes of TESLA-type cavities (Theoretical background, development of measurement equipment, measurement results)  

E-print Network

- 1 - Electrical axes of TESLA-type cavities (Theoretical background, development of measurement equipment, measurement results) Anton Labanc, MHF-SL, DESY, January 2008 Abstract Cells in TESLA cavities. A short overview was already published at the TESLA Report 2007-01. This paper brings more details about

376

A qualitative process evaluation of electronic session-by-session outcome measurement in child and adolescent mental health services  

PubMed Central

Background Regular monitoring of patient progress is important to assess the clinical effectiveness of an intervention. Recently, initiatives within UK child and adolescent mental health services (CAMHS) have advocated the use of session-by-session monitoring to continually evaluate the patient’s outcome throughout the course of the intervention. However, the feasibility and acceptability of such regular monitoring is unknown. Method Semi-structured qualitative interviews were conducted with clinicians (n?=?10), administrative staff (n?=?8) and families (n?=?15) who participated in a feasibility study of an electronic session-by-session outcome monitoring tool, (SxS), which is based on the Strengths and Difficulties Questionnaire (SDQ). This study took place in three CAMHS clinics in Nottinghamshire. The interview transcripts were thematically analysed. Results We found clinicians accepted the need to complete outcome measures, particularly valuing those completed by the patient. However, there were some difficulties with engaging clinicians in this practice and in the training offered. Generally, patients were supportive of completing SxS in the waiting room prior to the clinic session and assistance with the process from administrative staff was seen to be a key factor. Clinicians and families found the feedback reports created from SxS to be helpful for tracking progress, facilitating communication and engagement, and as a point of reflection. The use of technology was considered positively, although some technological difficulties hindered the completion of SxS. Clinicians and families appreciated the brevity of SxS, but some were concerned that a short questionnaire could not adequately encapsulate the complexity of the patient’s issues. Conclusions The findings show the need for appropriate infrastructure, mandatory training, and support to enable an effective system of session-by-session monitoring. Our findings indicate that clinicians, administrative staff and young people and their parents/carers would support regular monitoring if the system is easy to implement, with a standard ‘clinic-wide’ adoption of the procedure, and the resulting data are clinically useful. PMID:24731701

2014-01-01

377

Enhancing measurement in health outcomes research supported by Agencies within the US Department of Health and Human Services.  

PubMed

Many of the Institutes, Agencies and Centers that make up the US Department of Health and Human Services (DHHS) have recognized the need for better instrumentation in health outcomes research, and provide support, both internally and externally, for research utilizing advances in measurement theory and computer technology (informatics). In this paper, representatives from several DHHS agencies and institutes will discuss their need for better instruments within their discipline and describe current or future initiatives for exploring the benefits of these technologies. Together, the perspectives underscore the importance of developing valid, precise, and efficient measures to capture the full burden of disease and treatment on patients. Initiatives, like the Patient-Reported Outcomes Measurement Information System (PROMIS) to create health-related quality of life item banks, represent a trans-DHHS effort to develop a standard set of measures for informing decision making in clinical research, practice, and health policy. PMID:17530449

Reeve, Bryce B; Burke, Laurie B; Chiang, Yen-pin; Clauser, Steven B; Colpe, Lisa J; Elias, Jeffrey W; Fleishman, John; Hohmann, Ann A; Johnson-Taylor, Wendy L; Lawrence, William; Moy, Claudia S; Quatrano, Louis A; Riley, William T; Smothers, Barbara A; Werner, Ellen M

2007-01-01

378

Effects of Cognitive Enhancement Therapy on Employment Outcomes in Early Schizophrenia: Results From a Two-Year Randomized Trial  

PubMed Central

Objective To examine the effects of psychosocial cognitive rehabilitation on employment outcomes in a randomized controlled trial for individuals with early course schizophrenia. Method Early course schizophrenia outpatients (N = 58) were randomly assigned to Cognitive Enhancement Therapy (CET) or an Enriched Supportive Therapy (EST) control and treated for two years. Comprehensive data on cognition and employment were collected annually. Results Individuals treated with CET were significantly more likely to be competitively employed, had greater earnings from employment, and were more satisfied with their employment status by the end of treatment compared to EST recipients. Mediator analyses revealed that improvements in both social and non-social cognition mediated the CET effects on employment. Conclusion CET can help facilitate employment in early schizophrenia, by addressing the cognitive impairments that limit functioning in the disorder. Inclusion of cognitive rehabilitation in social work practice can support more optimal functional recovery from schizophrenia. PMID:23885163

Eack, Shaun M.; Hogarty, Gerard E.; Greenwald, Deborah P.; Hogarty, Susan S.; Keshavan, Matcheri S.

2013-01-01

379

Measuring clinical progression in MCI and pre-MCI populations: enrichment and optimizing clinical outcomes over time  

PubMed Central

Recent biomarker research has improved the identification of individuals with very early stages of Alzheimer's disease (AD) and has demonstrated that biomarkers are sensitive for measuring progression in the pre-dementia or mild cognitive impairment (MCI) stage and even pre-symptomatic or pre-MCI stage of AD. Because there are no validated biomarkers in AD, it is important to seek out clinical outcomes that are also sensitive for measuring progression in these very early stages of disease. Clinical outcomes are more subjective and more affected by measurement error than biomarkers but represent the core aspects of the disease and are critical for validation of biomarkers and for evaluation of clinical relevance. Identification of individuals with pre-MCI stages of AD will need to continue to rely on biomarkers, but the identification of individuals with MCI who will progress to AD can be achieved with biomarkers or clinical criteria. Although standard clinical outcomes have been shown to be less sensitive to progression than biomarker outcomes in MCI and pre-MCI populations, non-standard scoring has improved the performance of the Alzheimer's Disease Assessment Scale cognitive subscale, making it more sensitive to progression. Neuropsychological cognitive testing items are optimal for measuring progression in pre-MCI populations, and current research is exploring the best ways to combine these items into a composite cognitive score with maximum responsiveness. In an MCI stage, cognitive, functional, and global items all change, and the best single composite score for measuring progression may involve all of these aspects of the disease. The best chance of success in demonstrating treatment effects in clinical trials will be achieved in a well-defined pre-MCI or MCI population and with an outcome that tracks well with clinical progression over time and with time. A partial least squares model can be used to identify these optimal weighted combinations. PMID:22805433

2012-01-01

380

If patient-reported outcome measures are considered key health-care quality indicators, who is excluded from participation?  

PubMed

Patient-reported outcome measures have received increasing attention with regard to ensuring quality improvement across the health service. However, there is a risk that people with disabilities and low literacy are systematically excluded from the development of these measures as well as their application in clinical practice. This editorial highlights some of these risks and the potential consequences of exclusion for these groups. PMID:22512658

Kroll, Thilo; Wyke, Sally; Jahagirdar, Deepa; Ritchie, Karen

2014-10-01

381

Capability Deprivation and Income Poverty in the United States, 1994 and 2004: Measurement Outcomes and Demographic Profiles  

Microsoft Academic Search

Shifting focus from income to capability signifies an important milestone toward accurately measuring poverty and deprivation.\\u000a This paper operationalizes capability deprivation in the United States and compares measurement outcomes among various capability\\u000a approaches and between capability and income spaces. Of the three capability approaches examined, the factor score absolute\\u000a approach suggests a greater extent of deprivation and more comprehensive demographic

Udaya R. Wagle

2009-01-01

382

A REVIEW OF COMMUNITY BASED REHABILITATION EVALUATIONS: QUALITY OF LIFE AS AN OUTCOME MEASURE FOR FUTURE EVALUATIONS  

Microsoft Academic Search

This review examines key articles in evaluation of community-based rehabilitation carried out in developing countries and proposes family quality of life as an outcome measure of community-based rehabilitation. The concept of community-based rehabilitation is reviewed, quality of life and family quality of life measurement scale is presented. It presents a practical approach to future evaluations of community-based rehabilitation programmes. This

Hasheem Mannan; Ann P. Turnbull

383

Methods and preliminary measurement results of liquid Li wettability.  

PubMed

A test of lithium wettability was performed in high vacuum (< 3 × 10(-4) Pa). High magnification images of Li droplets on stainless steel substrates were produced and processed using the MATLAB(®) program to obtain clear image edge points. In contrast to the more standard "?/2" or polynomial fitting methods, ellipse fitting of the complete Li droplet shape resulted in reliable contact angle measurements over a wide range of contact angles. Using the ellipse fitting method, it was observed that the contact angle of a liquid Li droplet on a stainless steel substrate gradually decreased with increasing substrate temperature. The critical wetting temperature of liquid Li on stainless steel was observed to be about 290?°C. PMID:24593360

Zuo, G Z; Hu, J S; Ren, J; Sun, Z; Yang, Q X; Li, J G; Zakharov, L E; Mansfield, D K

2014-02-01

384

Tunka-Rex: Status and results of the first measurements  

NASA Astrophysics Data System (ADS)

Tunka-Rex is the new radio extension of Tunka-133 located in Siberia close to Lake Baikal. The latter is a photomultiplier array registering air-Cherenkov light from air showers induced by cosmic-ray particles with initial energies of approximately 1016-1018 eV. Tunka-Rex extends this detector with 25 antennas spread over an area of 1 km2. It is triggered externally by Tunka-133, and detects the radio emission of the same air showers. The combination of an air-Cherenkov and a radio detector provides a facility for hybrid measurements and cross-calibration between the two techniques. The main goal of Tunka-Rex is to determine the precision of the reconstruction of air-shower parameters using the radio detection technique. It started operation in autumn 2012. We present the overall concept of Tunka-Rex, the current status of the array and first analysis results.

Kostunin, D.; Budnev, N. M.; Gress, O. A.; Haungs, A.; Hiller, R.; Huege, T.; Kazarina, Y.; Kleifges, M.; Konstantinov, A.; Konstantinov, E. N.; Korosteleva, E. E.; Krömer, O.; Kuzmichev, L. A.; Mirgazov, R. R.; Pankov, L.; Prosin, V. V.; Rubtsov, G. I.; Rühle, C.; Schröder, F. G.; Svetnitsky, E.; Wischnewski, R.; Zagorodnikov, A.

2014-04-01

385

Use of Local {sup 111}In-Capromab Pendetide Scan Results to Predict Outcome After Salvage Radiotherapy for Prostate Cancer  

SciTech Connect

Purpose: The {sup 111}In-capromab pendetide scan (ProstaScint; Cytogen Corp., Princeton NJ) is approved by the Food and Drug Administration to evaluate increasing prostate-specific antigen (PSA) levels after radical prostatectomy. This study evaluated the role of prostate bed {sup 111}In-capromab pendetide scan findings to predict response to salvage radiotherapy (RT). Methods and Materials: Forty patients who had PSA recurrence after radical prostatectomy and a {sup 111}In-capromab pendetide scan immediately before salvage prostate bed RT (median, 66 Gy) were identified from the Duke Prostate Center database. Patients with distant uptake of capromab pendetide or long-term androgen deprivation therapy were excluded. Median follow-up after salvage RT was 2.7 years. Patient demographic, clinical, and pathologic characteristics; PSA values; and {sup 111}In-capromab pendetide scan results were retrospectively analyzed. A PSA failure after salvage RT was defined as PSA level greater than 0.2 ng/ml. Data were combined with other published results in a secondary pooled analysis of 106 patients. Results: {sup 111}In-Capromab pendetide findings included 20 patients with negative scan results and 20 with locally positive scan results. Two-year progression-free survival rates were 60% for patients with a negative scan result and 74% for those with a locally positive scan result (p = 0.49). Combined analysis did not show a difference in outcome based on local {sup 111}In-capromab pendetide scan result. Conclusion: For patients without distant signal detected by using {sup 111}In-capromab pendetide scan, patients with locally positive scan findings did not have statistically different progression-free survival than those with a negative scan result, suggesting that salvage RT may be successful in patients with either a locally positive or negative {sup 111}In-capromab pendetide scan result.

Koontz, Bridget F. [Department of Radiation Oncology, Duke University Medical Center, Durham, NC (United States); Duke Prostate Center, Duke University Medical Center, Durham, NC (United States)], E-mail: koont005@mc.duke.edu; Mouraviev, Vladimir [Duke Prostate Center, Duke University Medical Center, Durham, NC (United States); Department of Surgery, Division of Urologic Surgery, Duke University Medical Center, Durham, NC (United States); Johnson, Jeffrey L. [Duke Cancer Center Biostatistics, Duke University Medical Center, Durham, NC (United States); Mayes, Janice; Chen, Stephanie H. [Department of Surgery, Division of Urologic Surgery, Duke University Medical Center, Durham, NC (United States); Wong, Terence Z. [Department of Radiology, Duke University Medical Center, Durham, NC (United States); Anscher, Mitchell S. [Department of Radiation Oncology, Virginia Commonwealth University School of Medicine, Richmond, VA (United States); Sun, Leon; Moul, Judd; Polascik, Thomas J. [Duke Prostate Center, Duke University Medical Center, Durham, NC (United States); Department of Surgery, Division of Urologic Surgery, Duke University Medical Center, Durham, NC (United States)

2008-06-01

386

Intensive-Phase Treatment Outcomes among Hospitalized Multidrug-Resistant Tuberculosis Patients: Results from a Nationwide Cohort in Nigeria  

PubMed Central

Background Nigeria is faced with a high burden of Human Immunodeficiency Virus (HIV) infection and multidrug-resistant tuberculosis (MDR-TB). Treatment outcomes among MDR-TB patients registered across the globe have been poor, partly due to high loss-to-follow-up. To address this challenge, MDR-TB patients in Nigeria are hospitalized during the intensive-phase(IP) of treatment (first 6–8 months) and are provided with a package of care including standardized MDR-TB treatment regimen, antiretroviral therapy (ART) and cotrimoxazole prophylaxis (CPT) for HIV-infected patients, nutritional and psychosocial support. In this study, we report the end-IP treatment outcomes among them. Methods In this retrospective cohort study, we reviewed the patient records of all bacteriologically-confirmed MDR-TB patients admitted for treatment between July 2010 and October 2012. Results Of 162 patients, 105(65%) were male, median age was 34 years and 28(17%) were HIV-infected; all 28 received ART and CPT. Overall, 138(85%) were alive and culture negative at the end of IP, 24(15%) died and there was no loss-to-follow-up. Mortality was related to low CD4-counts at baseline among HIV-positive patients. The median increase in body mass index among those documented to be underweight was 2.6 kg/m2 (p<0.01) and CD4-counts improved by a median of 52 cells/microL among the HIV-infected patients (p<0.01). Conclusions End-IP treatment outcomes were exceptional compared to previously published data from international cohorts, thus confirming the usefulness of a hospitalized model of care. However, less than five percent of all estimated 3600 MDR-TB patients in Nigeria were initiated on treatment during the study period. Given the expected scale-up of MDR-TB care, the hospitalized model is challenging to sustain and the national TB programme is contemplating to move to ambulatory care. Hence, we recommend using both ambulatory and hospitalized approaches, with the latter being reserved for selected high-risk groups. PMID:24722139

Oladimeji, Olanrewaju; Isaakidis, Petros; Obasanya, Olusegun J.; Eltayeb, Osman; Khogali, Mohammed; Van den Bergh, Rafael; Kumar, Ajay M. V.; Hinderaker, Sven Gudmund; Abdurrahman, Saddiq T.; Lawson, Lovett; Cuevas, Luis E.

2014-01-01

387

Impact of an Abdominal Binder on Speech Outcomes in People With Tetraplegic Spinal Cord Injury: Perceptual and Acoustic Measures  

PubMed Central

Background: An abdominal binder (AB) is routinely used for patients who have suffered a spinal cord injury (SCI) resulting in tetraplegia. It is thought to restore abdominal pressure and consequently improve breathing capacity and reduce postural hypotension in patients who do not have functioning abdominal muscles. Objective: To examine the early effects of an AB on respiratory and speech outcomes. Methods: Thirteen individuals who sustained an acute motor complete SCI between C3 and T1 were assessed after a 6-week trial of using an elasticized AB from the time of first mobilizing in an upright wheelchair. Assessments were made using spirometry and perceptual and acoustics speech measures based on sustained phonation, sentence recitation, and passage reading. Results: Significant improvements were found in the AB-on condition for 3 of 5 respiratory parameters (vital capacity, forced vital capacity, and forced expiratory volume in 1 second). Predominantly mild voice and speech dysfunction were noted in participants. No significant difference was found for any of the acoustic and perceptual speech parameters (maximum phonation time, vocal intensity for sentence recitation, perceptual speech characteristics, or vocal quality) between the AB conditions. Conclusions: Despite the finding that an AB results in significant improvements in respiratory function for individuals with tetraplegic SCI, the current study did not provide evidence that an AB improves speech production. PMID:24574822

Cornwell, Petrea L.

2014-01-01

388

Responsiveness of walking-based outcome measures after multiple sclerosis relapses following steroid pulses  

PubMed Central

Summary Background The aim of this study was to examine the impact of intravenous methylprednisolone therapy (IVMP) on the recovery of walking ability in patients experiencing multiple sclerosis (MS) relapses, to compare the responsiveness of walking-based measures, and to estimate the impact of different walking-based measures responsiveness on clinical trials. Material/Methods The study included 49 consecutive patients with relapsing-remitting MS who received Solu-Medrol 1000 mg/day over 3 days for relapse with difficulties in walking. The following walking-based measures were administered before and a month after IVMP: the Multiple Sclerosis Walking Scale-12 (MSWS-12), the Expanded Disability Status Scale (EDSS), the 2-minute timed walk (2-minTW), the 25-foot walk test (25FWT), the Six Spot Step Test (SSST). All patients had worn the step activity monitor accelerometer (SAM) 1 week prior to IVMP was applied and wore it again the fourth week upon the corticosteroid therapy was completed. The SAM analysis utilized the average daily step count and data regarding frequency and intensity of walking over a continuous time interval. We examined: (1) the impact of IVMP on the recovery of walking ability; (2) the responsiveness of each walking-based measure; (3) the relative responsiveness of competing walking-based measures; and (4) the impact of different walking-based measures responsiveness on clinical trials. Results All walking-based measures showed significant improvement of walking ability 1 month after the IVMP. The most responsive were MSWS-12 and EDSS. Different responsiveness implied a greater than 6-fold impact on sample size estimates. Conclusions All applied walking-based measures showed significant improvement of walking ability 1 month after the IVMP. Responsiveness of various walking-based measures notably differ, thus affecting sample size calculations. PMID:22129902

Grcic, Petar Filipovic; Matijaca, Meri; Lusic, Ivo; Capkun, Vesna

2011-01-01

389

Among health care professionals effective communication is vital to achieve the best patient outcomes possible. Improving communication and other teamwork skills will result in improved  

E-print Network

outcomes possible. Improving communication and other teamwork skills will result in improved performance Among health care professionals effective communication is vital to achieve the best patient. During emergencies and critical situations, communication among all health care team members

390

Racism, health status, and birth outcomes: results of a participatory community-based intervention and health survey.  

PubMed

Many community-based participatory research (CBPR) partnerships address social determinants of health as a central consideration. However, research studies that explicitly address racism are scarce in the CBPR literature, and there is a dearth of available community-generated data to empirically examine how racism influences health disparities at the local level. In this paper, we provide results of a cross-sectional, population-based health survey conducted in the urban areas of Genesee and Saginaw Counties in Michigan to assess how a sustained community intervention to reduce racism and infant mortality influenced knowledge, beliefs, and experiences of racism and to explore how perceived racism is associated with self-rated health and birth outcomes. We used ANOVA and regression models to compare the responses of intervention participants and non-participants as well as African Americans and European Americans (N = 629). We found that intervention participants reported greater acknowledgment of the enduring and differential impact of racism in comparison to the non-intervention participants. Moreover, survey analyses revealed that racism was associated with health in the following ways: (1) experiences of racial discrimination predicted self-rated physical health, mental health, and smoking status; (2) perceived racism against one's racial group predicted lower self-rated physical health; and (3) emotional responses to racism-related experiences were marginally associated with lower birth-weight births in the study sample. Our study bolsters the published findings on perceived racism and health outcomes and highlights the usefulness of CBPR and community surveys to empirically investigate racism as a social determinant of health. PMID:21271359

Carty, Denise C; Kruger, Daniel J; Turner, Tonya M; Campbell, Bettina; DeLoney, E Hill; Lewis, E Yvonne

2011-02-01

391

Construction of a traditional Chinese medicine syndrome-specific outcome measure: the Kidney Deficiency Syndrome questionnaire (KDSQ)  

PubMed Central

Background Development of Traditional Chinese Medicine (TCM) syndrome-specific outcome measures is needed for the evaluation of TCM syndrome-specific therapies. We constructed a Kidney Deficiency Syndrome Questionnaire (KDSQ) for the evaluation of the common TCM syndromes Kidney-Yin Deficiency Syndrome (KDS-Yin) and Kidney-Yang Deficiency Syndrome (KDS-Yang) in middle-aged women with menopausal symptoms. Methods KDS-Yin and KDS-Yang were traditionally defined by expert opinion were validated by exploratory factor analysis (EFA) and structural equation modeling (SEM). Content validity was tested by EFA on a sample of 236 women from a seminar and SEM on another sample of 321 women from a postal survey. Other psychometric properties were tested on 292 women from the seminar at baseline and two systematically selected sub-samples: 54 who reported no changes in discomforts 11–12?days after the baseline and 31 who reported changes in discomforts 67–74?days after the baseline. All participants completed the KDSQ, the Greene Climacteric Scale and the standard 12-item Short Form Health Survey. Results The EFA and SEM established the measurement models of KDS-Yin and KDS-Yang supporting content validity of the KDSQ. Internal consistency was good (Cronbach’s Alpha >0.70). Construct validity was supported by theoretically-derived levels of correlation with the established external measures. Test–retest reliability was strong (ICCagreement: KDS-Yin, 0.94; KDS-Yang, 0.93). The KDSQ was responsive to changes over time as tested by effect size and longitudinal validity. Conclusions The KDSQ was a valid and reliable measure for KDS-Yin and KDS-Yang in Hong Kong Chinese middle-aged women with menopausal symptoms. PMID:22672362

2012-01-01

392

Maladaptive Eating Patterns, Quality of Life, and Weight Outcomes Following Gastric Bypass: Results of an Internet Survey  

Microsoft Academic Search

Bariatric surgery is the most effective treatment for severe obesity. However, evidence suggests that maladaptive eating behaviors such as binge eating, grazing, and a loss of control when eating may impact postsurgical weight outcomes. The current study sought to characterize the weight outcomes, eating patterns, and perceived health-related quality of life of individuals 3–10 years following gastric bypass (GBP) surgery

Michele D. Kofman; Michelle R. Lent; Charles Swencionis

2010-01-01

393

Differences between Women and Men in Objectively Measured Outcomes, and the Factors That Influence Those Outcomes, in the First Three Years of College.  

ERIC Educational Resources Information Center

We examined the correlation between sex and cognitive outcomes of a national sample of students at four-year institutions. Outcomes data included objective tests and self-reported gains. In the presence of controls for a wide variety of potentially confounding variables, significant differences were found between women and men in outcomes and in…

Whitt, Elizabeth J.; Pascarella, Ernest T.; Nesheim, Becki S. Elkins; Marth, Brian P.; Pierson, Christopher T.

2003-01-01

394

Developing a patient-centered outcome measure for complementary and alternative medicine therapies II: Refining content validity through cognitive interviews  

PubMed Central

Background Available measures of patient-reported outcomes for complementary and alternative medicine (CAM) inadequately capture the range of patient-reported treatment effects. The Self-Assessment of Change questionnaire was developed to measure multi-dimensional shifts in well-being for CAM users. With content derived from patient narratives, items were subsequently focused through interviews on a new cohort of participants. Here we present the development of the final version in which the content and format is refined through cognitive interviews. Methods We conducted cognitive interviews across five iterations of questionnaire refinement with a culturally diverse sample of 28 CAM users. In each iteration, participant critiques were used to revise the questionnaire, which was then re-tested in subsequent rounds of cognitive interviews. Following all five iterations, transcripts of cognitive interviews were systematically coded and analyzed to examine participants' understanding of the format and content of the final questionnaire. Based on this data, we established summary descriptions and selected exemplar quotations for each word pair on the final questionnaire. Results The final version of the Self-Assessment of Change questionnaire (SAC) includes 16 word pairs, nine of which remained unchanged from the original draft. Participants consistently said that these stable word pairs represented opposite ends of the same domain of experience and the meanings of these terms were stable across the participant pool. Five pairs underwent revision and two word pairs were added. Four word pairs were eliminated for redundancy or because participants did not agree on the meaning of the terms. Cognitive interviews indicate that participants understood the format of the questionnaire and considered each word pair to represent opposite poles of a shared domain of experience. Conclusions We have placed lay language and direct experience at the center of questionnaire revision and refinement. In so doing, we provide an innovative model for the development of truly patient-centered outcome measures. Although this instrument was designed and tested in a CAM-specific population, it may be useful in assessing multi-dimensional shifts in well-being across a broader patient population. PMID:22206409

2011-01-01

395

The effect of measurement location on tibia lead XRF measurement results and uncertainty.  

PubMed

The aims of this study were to determine whether the location on the tibia measured by 109Cd-based K-shell x-ray fluorescence (XRF) affected the measurement result and its uncertainty, and whether higher tibia lead levels at the extremities of the tibia and/or inhomogeneity in the distribution of lead in the tibia could be inferred therefrom. Replicate XRF measurements were performed at multiple locations on ten adult cadaver intact legs and on nine bare tibiae dissected from them. Mean lead levels in the bare tibiae ranged from 16 to 48 microg Pb per g of bone mineral. Bare tibia measurements showed that both the XRF result and its uncertainty increased towards the proximal and distal ends of the tibia. The XRF result decreased away from the medial-lateral mid-point of the tibia, but XRF uncertainty was not significantly affected. Intact leg measurements showed no effect of proximal distal location on XRF result but did show an effect on XRF uncertainty. We conclude that the XRF method used can determine the differences in bone lead level resulting from the more trabecular composition at the ends of the tibia, and we present limited evidence for localized regions of low tibia lead level. PMID:11197677

Todd, A C; Carroll, S; Godbold, J H; Moshier, E L; Khan, F A

2001-01-01

396

Prospective study comparing functional outcomes and revision rates between hip resurfacing and total hip arthroplasty: preliminary results for 2 years.  

PubMed

There is a need of independent prospective studies about modern generation of hip resurfacing implants. The aim of this propective observational study was to compare the functional outcomes and revision rates with hip resurfacing arthroplasty and total hip arthroplasty and to present the preliminary results at 2 years. Patients included were recruited prospectively in the Partial Pelvic Replacement Hip Project by a single surgeon between January 2007 and January 2010. Patients were assessed with the Harris Hip Score (HHS) and Postel-Merle d'Aubigné (MDA) score and Devane Score. The end point of the study was reoperation for any cause related to the prosthesis. At a mean follow up of 38.6 months there were a total of 142 patients with hip resurfacing (group 1) [100 Durom(®) (Zimmer Inc., Warsaw, IN, USA) and 42 Birmingham Hip Resurfacing(®) (Smith & Nephew, Memphis, TN, USA)]