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Sample records for outcome measure results

  1. Outcome-Based Vocational Rehabilitation: Measuring Valuable Results

    ERIC Educational Resources Information Center

    Guerra, Ingrid

    2005-01-01

    This case study illustrates one of the many possible ways to implement Kaufman's Organizational Elements Model (1992, 2000) for identifying and aligning organizational results and the means to achieve them. The model was applied in the context of a needs assessment effort between the Florida State University's Office for Needs Assessment &…

  2. Action Research: Measuring Literacy Programme Participants' Learning Outcomes. Results of the Final Phase (2011-2014)

    ERIC Educational Resources Information Center

    Bolly, Madina; Jonas, Nicolas

    2015-01-01

    Action Research on Measuring Literacy Programme Participants' Learning Outcomes (RAMAA) aims to develop, implement and collaborate on the creation of a methodological approach to measure acquired learning and study the various factors that influence its development. This report examines how RAMAA I has been implemented over the past four years in…

  3. Measuring Course Learning Outcomes

    ERIC Educational Resources Information Center

    Keshavarz, Mohsen

    2011-01-01

    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…

  4. Why Measure Outcomes?

    PubMed

    Kuhn, John E

    2016-01-01

    The concept of measuring the outcomes of treatment in health care was promoted by Ernest Amory Codman in the early 1900s, but, until recently, his ideas were generally ignored. The forces that have advanced outcome measurement to the forefront of health care include the shift in payers for health care from the patient to large insurance companies or government agencies, the movement toward assessing the care of populations not individuals, and the effort to find value (or cost-effective treatments) amid rising healthcare costs. No ideal method exists to measure outcomes, and the information gathered depends on the reason the outcome information is required. Outcome measures used in research are best able to answer research questions. The methods for assessing physician and hospital performance include process measures, patient-experience measures, structure measures, and measures used to assess the outcomes of treatment. The methods used to assess performance should be validated, be reliable, and reflect a patient's perception of the treatment results. The healthcare industry must measure outcomes to identify which treatments are most effective and provide the most benefit to patients. PMID:27049223

  5. Physiotherapy treatment for atraumatic recurrent shoulder instability: early results of a specific exercise protocol using pathology-specific outcome measures

    PubMed Central

    Smith, Benjamin E; Osborne, Sally E; Wilkes, Sally R

    2015-01-01

    Background Recurrent shoulder instability is usually caused by a traumatic event resulting in structural pathology, although a small subgroup of patients experience symptomatic recurrent shoulder instability without trauma. These patients are usually treated non-operatively but limited evidence exists regarding effective conservative management. In particular, there is a lack of reproducible exercise regimes and none that have been tested with condition-specific outcome measures. Methods A service evaluation was conducted over a 15-month period to assess our current treatment protocol used in the management of patients with atraumatic recurrent shoulder instability. The regime is reproducible with target-led progression milestones. Oxford Instability Shoulder Scores (OISS) and Western Ontario Shoulder Index (WOSI) scores were compared between baseline and final follow-up. Results Eighteen consecutive patients were included with mean follow-up of 4.5 months (range 1.35 months to 11.77 months). A statistically significant improvement was seen in both outcome measures. Mean OISS improved by 16.67 points (confidence interval: 12.34 to 20.99; p < 0.001). Mean WOSI improved by 36.76% (confidence interval: 28.46 to 45.06; p < 0.001). Conclusions For this small group of patients with recurrent atraumatic shoulder instability, the Derby Shoulder Instability Programme produced significant improvements over the short term, with a high level of patient compliance. This is the first study to include pathology-specific patient-reported outcome measures to assess outcomes from a specific and reproducible exercise regime in this group of patients. The findings support further research to evaluate the exercise protocol in a larger group of patients over the longer term.

  6. A novel simple measure correlates to the outcome in 57 patients with intracerebellar hematomas. Results of a retrospective analysis

    PubMed Central

    Doukas, Alexandros; Maslehaty, Homajoun; Barth, Harald; Hedderich, Jürgen; Petridis, Athanasios K.; Mehdorn, H. Maximilian

    2015-01-01

    Background: The incidence of intracerebellar hemorrhages approaches 5–10% of all intracerebral hematomas. The clinical presentation varies from headaches and dizziness to rapid deterioration of consciousness to the point of coma in severe cases. In order to find some concrete criteria that could influence the prognosis of these patients, we performed this retrospective study. Methods: We retrospectively analyzed the factors influencing the outcome of 57 patients with intracerebellar hematomas treated in our clinic in the last 7 years. The Glasgow Coma Scale (GCS) on admission, as well as other parameters as hypertension, diabetes mellitus, presence of malign tumors in the medical history, or the intake of anticoagulants were assessed as independent factors influencing the outcome of the patients. On the other hand, various computed tomography parameters on admission were also correlated with the clinical outcome such as, tight posterior fossa (TPF), volume of the hematoma, hydrocephalus, compression of the fourth ventricle, intraventricular bleeding, as well as the ratio of the maximal width of the hematoma in comparison to the width of the PF were taken into consideration. Results: The results of the study showed that patients with poor GCS on admission had also a poor Glasgow Outcome Score. Interestingly there was a statistically significant correlation between the maximal width of the hematoma in comparison to the width of the PF and the outcome of the patients. It could be also shown that the patients with intraventricular hemorrhage, hydrocephalus, compression of the fourth ventricle over 50% of its maximal width and TPF, had a poor clinical outcome. Moreover, there was a statistically significant correlation of the volume of the hematoma and a poor clinical outcome. Conclusions: We introduced as a new factor that is, the cerebellar hemorrhage/PF ratio and found out that the value >35% was associated to an unfavorable outcome. PMID:26673852

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

    PubMed Central

    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

    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

  8. Asthma outcome measures.

    PubMed

    Watkins, K D

    1999-08-01

    Annually, asthma accounts for 10.4 million physician visits, 468,000 hospitalizations, 1.8 million emergency room visits, and 10 million missed school days. According to the Centers for Disease Control and Prevention, the number of asthma deaths has increased progressively since 1978 form 1,800 to 5,400 per year. It is an expensive disease, accounting for about 1% of all health expenditure in the United States in 1990. Asthma has a significant impact on the patient and the community at large and the assessment of the clinical, physiologic, humanistic and economic outcomes will be measured. PMID:10563275

  9. Cognitive Interviewing in the Evaluation of Fatigue Items: Results from the Patient-Reported Outcomes Measurement Information System (PROMIS)

    PubMed Central

    Christodoulou, Christopher; Junghaenel, Doerte U.; DeWalt, Darren A.; Rothrock, Nan; Stone, Arthur A.

    2010-01-01

    Objectives Cognitive Interviewing (CI) is a technique increasingly used to obtain respondent feedback on potential items during questionnaire development. No standard guidelines exist by which to incorporate CI feedback in deciding to retain, revise, or eliminate potential items. We used CI in developing fatigue items for the National Institutes of Health (NIH) Patient-Reported Outcomes Measurement Information System (PROMIS) Roadmap initiative. Our aims were to describe the CI process, formally evaluate the utility of decisions made on the basis of CI, and offer suggestions for future research. Methods Participants were 22 patients with a diverse range of chronic health conditions. During CI, each participant provided feedback on a series of items. We then reviewed the CI data and decided whether to retain, revise, or eliminate each potential item. Following this, we developed or adopted three quantitative methods to compare retained versus eliminated items. Results Retained items raised fewer serious concerns, were less likely to be viewed as non-applicable, and were less likely to display problems with clarity or to make incorrect assumptions about respondents. Conclusions CI was useful in developing the PROMIS fatigue items and the methods used to judge CI for the present item set may be useful for future investigations. PMID:18850327

  10. Routine outcome measures in Canada.

    PubMed

    Kisely, Steve; Adair, Carol E; Lin, Elizabeth; Marriott, Brian

    2015-01-01

    Canada is a federal country of 10 provinces and three territories. High level information on mental health conditions and service use has mostly been generated from administrative data collected by provinces and territories. These include four major types - hospital admissions and discharges, physician billings, ambulatory care services, and drug databases. At the national level, the Canadian Institute for Health Information brings together this information to produce indicators of outcome. Although these data provide information on patient and health system characteristics, they do not capture the full spectrum of formal and informal mental healthcare. These include changes in health status, functioning, community integration and quality of life. As a result, some jurisdictions have begun to implement more standardized measures of outcome such as the clinician-rated Health of the Nation Outcome Scales or the inpatient Resident Assessment Instrument - Mental Health. In this paper we provide an overview of mental-health-related data sources in Canada, highlight some of the more progressive practices beginning to emerge, and conclude with some thoughts about how the routine measurement and reporting of mental health outcomes in Canada might be advanced including efforts at engaging both clinicians and decision-makers. PMID:25738745

  11. Evaluating more naturalistic outcome measures

    PubMed Central

    Bove, Riley; White, Charles C.; Giovannoni, Gavin; Glanz, Bonnie; Golubchikov, Victor; Hujol, Johnny; Jennings, Charles; Langdon, Dawn; Lee, Michelle; Legedza, Anna; Paskavitz, James; Prasad, Sashank; Richert, John; Robbins, Allison; Roberts, Susan; Weiner, Howard; Ramachandran, Ravi; Botfield, Martyn

    2015-01-01

    Objective: In this cohort of individuals with and without multiple sclerosis (MS), we illustrate some of the novel approaches that smartphones provide to monitor patients with chronic neurologic disorders in their natural setting. Methods: Thirty-eight participant pairs (MS and cohabitant) aged 18–55 years participated in the study. Each participant received an Android HTC Sensation 4G smartphone containing a custom application suite of 19 tests capturing participant performance and patient-reported outcomes (PROs). Over 1 year, participants were prompted daily to complete one assigned test. Results: A total of 22 patients with MS and 17 cohabitants completed the entire study. Among patients with MS, low scores on PROs relating to mental and visual function were associated with dropout (p < 0.05). We illustrate several novel features of a smartphone platform. First, fluctuations in MS outcomes (e.g., fatigue) were assessed against an individual's ambient environment by linking responses to meteorological data. Second, both response accuracy and speed for the Ishihara color vision test were captured, highlighting the benefits of both active and passive data collection. Third, a new trait, a person-specific learning curve in neuropsychological testing, was identified using spline analysis. Finally, averaging repeated measures over the study yielded the most robust correlation matrix of the different outcome measures. Conclusions: We report the feasibility of, and barriers to, deploying a smartphone platform to gather useful passive and active performance data at high frequency in an unstructured manner in the field. A smartphone platform may therefore enable large-scale naturalistic studies of patients with MS or other neurologic diseases. PMID:26516627

  12. Measuring Inclusive Education Outcomes in Alberta, Canada

    ERIC Educational Resources Information Center

    Loreman, Tim

    2014-01-01

    This study details the results of a review of the academic and public sector literature on measuring inclusive education in large systems. It highlights some outcomes drawn from the international literature on inclusion that might be indicative of the presence and quality of inclusive education in an effort to develop a set of outcomes for…

  13. Physician outcome measurement: review and proposed model.

    PubMed

    Siha, S

    1998-01-01

    As health care moves from a free-for-service environment to a capitated arena, outcome measurements must change. ABC Children's Medical Center is challenged with developing comprehensive outcome measures for an employed physician group. An extensive literature review validates that physician outcomes must move beyond revenue production and measure all aspects of care delivery. The proposed measurement model for this physician group is a trilogy model. It includes measures of cost, quality, and service. While these measures can be examined separately, it is imperative to understand their integration in determining an organization's competitive advantage. The recommended measurements for the physician group must be consistent with the overall organizational goals. The long-term impact will be better utilization of resources. This will result in the most cost effective, quality care for the health care consumer. PMID:10339092

  14. Results of a two-year pilot study of clinical outcome measures in collagen VI- and laminin alpha2-related congenital muscular dystrophies.

    PubMed

    Meilleur, Katherine G; Jain, Minal S; Hynan, Linda S; Shieh, Ching-Yi; Kim, Eunice; Waite, Melissa; McGuire, Michelle; Fiorini, Courtney; Glanzman, Allan M; Main, Marion; Rose, Kristy; Duong, Tina; Bendixen, Roxanna; Linton, Melody M; Arveson, Irene C; Nichols, Carmel; Yang, Kelly; Fischbeck, Kenneth H; Wagner, Kathryn R; North, Kathryn; Mankodi, Ami; Grunseich, Christopher; Hartnett, Elizabeth J; Smith, Michaele; Donkervoort, Sandra; Schindler, Alice; Kokkinis, Angela; Leach, Meganne; Foley, A Reghan; Collins, James; Muntoni, Francesco; Rutkowski, Anne; Bönnemann, Carsten G

    2015-01-01

    Potential therapies are currently under development for two congenital muscular dystrophy (CMD) subtypes: collagen VI-related muscular dystrophy (COL6-RD) and laminin alpha 2-related dystrophy (LAMA2-RD). However, appropriate clinical outcome measures to be used in clinical trials have not been validated in CMDs. We conducted a two-year pilot study to evaluate feasibility, reliability, and validity of various outcome measures, particularly the Motor Function Measure 32, in 33 subjects with COL6-RD and LAMA2-RD. In the first year, outcome measures tested included: Motor Function Measure 32 (MFM32), forced vital capacity (FVC) percent predicted sitting, myometry, goniometry, 10-meter walk, Egen Klassification 2, and PedsQL(TM) Generic and Neuromuscular Cores. In the second year, we added the North Star Ambulatory Assessment (NSAA), Hammersmith Functional Motor Scale (HFMS), timed functional tests, Measure of Activity Limitations (ACTIVLIM), Quality of Upper Extremity Skills Test (QUEST), and Patient-Reported Outcomes Measurement Information System (PROMIS) fatigue subscale. The MFM32 showed strong inter-rater (0.92) and internal consistency (0.96) reliabilities. Concurrent validity for the MFM32 was supported by large correlations (range 0.623-0.936) with the following: FVC, NSAA, HFMS, timed functional tests, ACTIVLIM, and QUEST. Significant correlations of the MFM32 were also found with select myometry measurements, mainly of the proximal extremities and domains of the PedsQL(TM) scales focusing on physical health and neuromuscular disease. Goniometry measurements were less reliable. The Motor Function Measure is reliable and valid in the two specific subtypes of CMD evaluated, COL6-RD and LAMA2-RD. The NSAA is useful as a complementary outcome measure in ambulatory individuals. Preliminary concurrent validity of several other clinical outcome measures was also demonstrated for these subtypes. PMID:25307854

  15. Routine outcome measurement in Australia.

    PubMed

    Burgess, Philip; Pirkis, Jane; Coombs, Tim

    2015-08-01

    Australia has been implementing routine outcome measurement in its specialized public sector mental health services for over a decade. It uses a range of clinician-rated and consumer-rated measures that are administered at set times during episodes of inpatient, ambulatory and community residential episodes of care. Routine outcome measurement is now embedded in service delivery, and data are made available in a variety of ways to different audiences. These data are used by policy-makers and planners to inform decisions about system-wide reforms, by service managers to monitor quality and effectiveness, and by clinicians to guide clinical decision-making and to promote dialogue with consumers. Consumers, carers and the general community can use these data to ensure that services are accountable for the care they deliver. This paper describes the status quo in Australia with respect to routine outcome measurement, discusses the factors that led to its successful implementation, and considers the steps that are necessary for its continued development. PMID:25768326

  16. Quality Markers in Cardiology. Main Markers to Measure Quality of Results (Outcomes) and Quality Measures Related to Better Results in Clinical Practice (Performance Metrics). INCARDIO (Indicadores de Calidad en Unidades Asistenciales del Área del Corazón): A SEC/SECTCV Consensus Position Paper.

    PubMed

    López-Sendón, José; González-Juanatey, José Ramón; Pinto, Fausto; Cuenca Castillo, José; Badimón, Lina; Dalmau, Regina; González Torrecilla, Esteban; López-Mínguez, José Ramón; Maceira, Alicia M; Pascual-Figal, Domingo; Pomar Moya-Prats, José Luis; Sionis, Alessandro; Zamorano, José Luis

    2015-11-01

    Cardiology practice requires complex organization that impacts overall outcomes and may differ substantially among hospitals and communities. The aim of this consensus document is to define quality markers in cardiology, including markers to measure the quality of results (outcomes metrics) and quality measures related to better results in clinical practice (performance metrics). The document is mainly intended for the Spanish health care system and may serve as a basis for similar documents in other countries. PMID:26315766

  17. Measurement outcomes from hip simulators.

    PubMed

    de Villiers, Danielle; Shelton, Julia C

    2016-05-01

    Simulation of wear in total hip replacements has been recognised as an important factor in determining the likelihood of clinical success. However, accurate measurement of wear can be problematic with factors such as number and morphology of wear particles produced as well as ion release proving more important in the biological response to hip replacements than wear volume or wear rate alone. In this study, hard-on-hard (CoCr alloy, AgCrN coating) and hard-on-soft (CoCr alloy and CrN coating on vitamin E blended highly cross-linked polyethylene) bearing combinations were tested in an orbital hip simulator under standard and some adverse conditions. Gravimetric wear rates were determined for all bearings, with cobalt and where applicable, silver release determined throughout testing. Isolation of wear particles from the lubricating fluid was used to determine the influence of different bearing combinations and wear conditions on particle morphology. It was found that cobalt and silver could be measured in the lubricating fluid even when volumetric wear was not detectable. In hard-on-hard bearings, Pearson's correlation of 0.98 was established between metal release into the lubricating fluid and wear volume. In hard-on-soft bearings, coating the head did not influence the polyethylene wear rates measured under standard conditions but did influence the cobalt release; the diameter influenced both polyethylene wear and cobalt release, and the introduction of adverse testing generated smaller polyethylene particles. While hip simulators can be useful to assess the wear performance of a new material or design, measurement of other outcomes may yield greater insight into the clinical behaviour of the bearings in vivo. PMID:26888886

  18. [Patient evaluation and outcome measures].

    PubMed

    Nieto Pol, Enrique

    2014-01-01

    Both the initial evaluation and follow-up of patients with osteoarthritis require systematic evaluation of the indicators that provide information on the degree of involvement of the disease and allow its quantification. Reliable measures of disease progression help decision-making by clinicians and provide valid information on treatment response and the effectiveness of the distinct therapeutic interventions. The instruments recommended in research, as outcome measures in osteoarthritis, are pain evaluation, assessment of physical function, and self-reported global evaluation. In studies lasting more than 1 year, structural changes are evaluated through simple X-ray. Self-reported quality of life assessment and physician global assessment are also recommended as options. These indicators should be incorporated into routine clinical practice for adequate evaluation and correct follow-up of patients with osteoarthritis. The recommended pain evaluation method for use in clinical practice is the visual analog scale (VAS). The best instrument to evaluate physical function in patients with hip or knee osteoarthritis is the WOMAC scale (Western Ontario and McMaster Universities Osteoarthritis Index). For patient-reported global assessment in routine practice, the recommended scales are VAS or the SF-12 (12-item short-form health survey). PMID:24467959

  19. Measuring Outcomes in Children's Services.

    ERIC Educational Resources Information Center

    Christner, Anne Marshall, Ed.

    Outcomes evaluation can provide program managers and clinical directors in child welfare, juvenile justice, child mental health, and child protective services the necessary tools for program quality assurance and accountability. This guide describes the outcomes evaluation process and provides a summary of articles and reports detailing current…

  20. Learning Outcomes across Disciplines and Professions: Measurement and Interpretation

    ERIC Educational Resources Information Center

    Caspersen, Joakim; Frølich, Nicoline; Karlsen, Hilde; Aamodt, Per Olaf

    2014-01-01

    Learning outcomes of higher education are a quality tool in a changing higher education landscape but cannot be seen as neutral measures across professions and disciplines. Survey results from graduates and recent graduates indicate that prevailing measures of learning outcomes yield the same result within and across disciplinary and professional…

  1. Patient reported outcome measures in septorhinoplasty surgery

    PubMed Central

    Fraser, LR; Ward, MJ; Sunkaraneni, VS; Harries, PG; Salib, RJ

    2015-01-01

    Introduction Surgical procedures incorporating a cosmetic element such as septorhinoplasty and otoplasty are currently under threat in the National Health Service (NHS) as they are deemed to be procedures of ‘limited clinical benefit’ by many primary care providers. Patient reported outcome measures (PROMs), which assess the quality of care delivered from the patients’ perspective, are becoming increasingly important in documenting the effectiveness of such procedures. Methods The Rhinoplasty Outcomes Evaluation (ROE) questionnaire, a validated PROM tool, was used to assess patient satisfaction in 141 patients undergoing septorhinoplasty surgery over a 90-month period at the University Hospital Southampton NHS Foundation Trust. Results Overall, 100 patients with a mean follow-up period of 36 months completed the study. The mean ROE score was 73.3%. In addition, 75% of patients questioned were happy with the final result of their operation and 83% would undergo the procedure again if required. These benefits occurred irrespective of age, sex and primary versus revision surgery, and were maintained for up to 71 months following surgery. Conclusions This study has shown that patients are generally satisfied with their functional and cosmetic outcomes following septorhinoplasty surgery. These results help support the case for septorhinoplasty surgery to continue being funded as an NHS procedure. PMID:25519270

  2. Sensitivity of Outcome Measures for Treatments of Generalized Social Phobia.

    ERIC Educational Resources Information Center

    Taylor, Steven; Woody, Sheila; McLean, Peter D.; Koch, William J.

    1997-01-01

    The sensitivity of five measures of outcomes of treatment for generalized social phobia was studied with 60 people diagnosed with generalized social phobia. Outcome measures were completed before and after treatment and three months later, and effect sizes were computed. Results support the usefulness of the Social Phobia and Anxiety Inventory (S.…

  3. Challenges in Measuring Outcomes Following Digital Replantation

    PubMed Central

    Sebastin, Sandeep J.; Chung, Kevin C.

    2013-01-01

    In the early period of replantation surgery, the emphasis was on digit survival. Subsequently, with better microsurgical techniques and instrumentation, the focus has shifted to function and in recent years to consideration of cost-effectiveness. Despite over 40 years of effort in refining digital replantation surgery, a rigorous evaluation of the outcomes of digital replantation has not been performed. This is because of the many confounding variables that influence outcome comparisons. These variables include the mechanism of injury (guillotine, crush, avulsion), the injury itself (total, near total, subtotal, partial amputation), and the surgical procedure (replantation, revascularization). In addition, the traditional outcome measures (two-point discrimination, range of motion, grip strength, or the ability to return to work) are reported inconsistently and vary widely among publications. All these factors make meaningful comparison of outcomes difficult. The recent emphasis on outcome research and cost-effectiveness necessitates a rethinking in the way we report outcomes of digital replantation. In this article, the authors summarize the challenges in assessing outcomes of digital replantation and explain the need to measure outcomes using rigorous clinical research designs that incorporate cost-effectiveness studies in the research protocol. PMID:24872766

  4. Patient reported outcome measures in neurogenic bladder

    PubMed Central

    Clark, Roderick

    2016-01-01

    Many interventions for neurogenic bladder patients are directed towards improving quality of life (QOL). Patient reported outcome measures (PROMs) are the primary method of evaluating QOL, and they provide an important quantification of symptoms which can’t be measured objectively. Our goal was to review general measurement principles, and identify and discuss PROMs relevant to neurogenic bladder patients. We identify two recent reviews of the state of the literature and updated the results with an additional Medline search up to September 1, 2015. Using the previous identified reviews, and our updated literature review, we identified 16 PROMs which are used for the assessment of QOL and symptoms in neurogenic bladder patients. Several are specifically designed for neurogenic bladder patients, such as the Qualiveen (for neurogenic bladder related QOL), and the Neurogenic Bladder Symptom Score (NBSS) (for neurogenic bladder symptoms). We also highlight general QOL measures for patients with multiple sclerosis (MS) and spinal cord injury (SCI) which include questions about bladder symptoms, and incontinence PROMs which are commonly used, but not specifically designed for neurogenic bladder patients. It is essential for clinicians and researchers with an interest in neurogenic bladder to be aware of the current PROMs, and to have a basic understanding of the principals of measurement in order to select the most appropriate one for their purpose. PMID:26904409

  5. Testing Multiple Outcomes in Repeated Measures Designs

    ERIC Educational Resources Information Center

    Lix, Lisa M.; Sajobi, Tolulope

    2010-01-01

    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…

  6. General Outcome Measures for Verbal Operants

    ERIC Educational Resources Information Center

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

    2009-01-01

    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…

  7. The Development of NOAA Education Common Outcome Performance Measures (Invited)

    NASA Astrophysics Data System (ADS)

    Baek, J.

    2013-12-01

    The National Oceanic and Atmospheric Administration (NOAA) Education Council has embarked on an ambitious Monitoring and Evaluation (M&E) project that will allow it to assess education program outcomes and impacts across the agency, line offices, and programs. The purpose of this internal effort is to link outcome measures to program efforts and to evaluate the success of the agency's education programs in meeting the strategic goals. Using an outcome-based evaluation approach, the NOAA Education Council is developing two sets of common outcome performance measures, environmental stewardship and professional development. This presentation will examine the benefits and tradeoffs of common outcome performance measures that collect program results across a portfolio of education programs focused on common outcomes. Common outcome performance measures have a few benefits to our agency and to the climate education field at large. The primary benefit is shared understanding, which comes from our process for writing common outcome performance measures. Without a shared and agreed upon set of definitions for the measure of an outcome, the reported results may not be measuring the same things and would incorrectly indicate levels of performance. Therefore, our writing process relies on a commitment to developing a shared set of definitions based on consensus. We hope that by taking the time to debate and coming to agreement across a diverse set of programs, the strength of our common measures can indicate real progress towards outcomes we care about. An additional benefit is that these common measures can be adopted and adapted by other agencies and organizations that share similar theories of change. The measures are not without their drawbacks, and we do make tradeoffs as part of our process in order to continue making progress. We know that any measure is necessarily a narrow slice of performance. A slice that may not best represent the unique and remarkable contribution

  8. Outcome measures in neuromuscular disease: is the world still flat?

    PubMed

    Lunn, Michael P; Van den Bergh, Peter Y K

    2015-09-01

    Valid, responsive, and meaningful outcome measures for the measurement of the impairment, activity limitations, and quality of life in patients with neuromuscular disease are crucial to identify the natural history of disease and benefits of therapy in clinical practice and trials. Although understanding of many aspects of neuromuscular diseases has advanced dramatically, the development of outcome measures has received less attention. The scales developed from Rasch theory by the PeriNomS Group represent the biggest significant shift in thought in neuromuscular outcome measures for decades. There remain problems with many of them, and further developments are required. However, incorporating them into our outcome sets for daily use and in clinical trials will lead to the more efficient capture of meaningful change and will result in better assessment of individuals and groups of patients in both clinical trials and neurological practice. PMID:26114965

  9. Biobehavioral Measures as Outcomes: A Cautionary Tale

    PubMed Central

    Kovach, Christine R.; Woods, Diana Lynn; Devine, Elizabeth C.; Logan, Brent R.; Raff, Hershel

    2013-01-01

    This article discusses the use of biobehavioral measures as outcomes for healthcare intervention studies. Effect size (ES) values for salivary cortisol, and observation-based measures of pain and agitation are examined. Effects pre to post treatment were assessed separately for nursing home (NH) residents with and without acute psychotic symptoms. This study revealed large positive effects on both pain and agitation measures in the group with acute psychotic symptoms and small-to-medium positive effects on these same measures in the group without acute psychotic symptoms. In both of these groups the ES values were not consistently positive on the cortisol measures. Prior to determining if a measure can be used to estimate minimum clinically important differences, it is essential to consider if the biomarker will be responsive to therapy in the populations and contexts being studied. PMID:24158972

  10. Clinical outcome measures for Cutaneous Lupus Erythematosus

    PubMed Central

    Albrecht, Joerg; Werth, Victoria P.

    2011-01-01

    Cutaneous lupus erythematosus is a clinically heterogeneous group of rare skin diseases that only rarely have been subjected to controlled clinical trials. This may be have been partly due to a lack of suitable validated outcome instruments. Recently the FDA mandated that organ specific trials for lupus erythematosus need to use a combination of different outcome measures. The patient’s condition needs to be assessed in terms of quality of life, the patient’s global response and organ specific instruments that measure activity of the disease as well as damage due to the disease. For the skin the only formally validated and published instrument is currently the Cutaneous Lupus Erythematosis Disease Area and Severity Index (CLASI). This paper discusses the background of the development of the CLASI as well as issues related to its use and interpretation in the context of clinical research of CLE. PMID:20693208

  11. Measuring Program Outcomes: Using Retrospective Pretest Methodology.

    ERIC Educational Resources Information Center

    Pratt, Clara C.; McGuigan, William M.; Katsev, Aphra R.

    2000-01-01

    Used longitudinal data from 307 mothers of firstborn infants participating in a home-visitation, child abuse prevention program in a retrospective pretest methodology. Results shows that when response shift bias was present, the retrospective pretest methodology produced a more legitimate assessment of program outcomes than did the traditional…

  12. Clinical outcomes of pars plicata anterior vitrectomy: 2-year results

    PubMed Central

    Narang, Priya; Agarwal, Amar

    2015-01-01

    Purpose: To demonstrate the safety and outcome of a surgical approach that uses pars plicata site for anterior vitrectomy during phacoemulsification procedure complicated by posterior capsule rupture and residual cortical matter. Design: Single center, retrospective, interventional, noncomparative study. Materials and Methods: Medical records of a consecutive series of 35 eyes of 35 patients who underwent pars plicata anterior vitrectomy (PPAV) were reviewed. The main outcome measures were corrected and uncorrected distance visual acuity (CDVA, UDVA), early and late postoperative complications and intraocular pressure (IOP). Ultrasound biomicroscopic (UBM) evaluation of sclerotomy site and spectral domain optical coherence tomography analysis for central macular thickness (CMT) was performed. The final visual outcome at 2 years was evaluated. Results: At 2 years follow-up, the mean postoperative UDVA (logarithm of the minimum angle of resolution [logMAR]) and CDVA (logMAR) was 0.49 ± 0.26 and 0.19 ± 0.14, respectively. There was no significant change in the IOP (P = 0.061) and the mean CMT at 2 years was 192.5 ± 5.54 μm. The postoperative UBM image of the sclerotomy site at 8 weeks demonstrated a clear wound without any vitreous adhesion or incarceration. Intraoperative hyphema was seen in 1 (2.8%) case and postoperative uveitis was seen in 2 (5.7%) cases, which resolved with medications. No case of an iatrogenic retinal break or retinal detachment was reported. Conclusions: PPAV enables a closed chamber approach, allows thorough cleanup of vitreous in the pupillary plane and anterior chamber and affords better access to the subincisional and retropupillary cortical remnant with a significant visual outcome and an acceptable complication rate. PMID:26632124

  13. [Patient-reported outcomes: definition and measurement].

    PubMed

    Botturi, Davide; Rodella, Stefania

    2014-06-01

    The concept of "patient-reported outcomes" have been proposed by the Food and Drug Administration in the year 2000, in order to describe one of the different and potential sources of information on the drug's safety and effectiveness. It represents an "umbrella" term, which covers a multiplicity of meanings and primarily identifies a conceptual approach and a methodology specifically oriented to the patients' point of view on outcomes, instead of the traditional clinical and professional perspective. The patient-reported outcomes measures are frequently self-completed questionnaires. The measures can be classified in general and specific. The first one, general, relates to the assessment of the quality of life or the health status, in the general population or in subgroups with particular health problems (eg. SF-36 Health Survey, EQ-5D). The second one, specific, mainly relates to the assessment of particular types of symptoms (eg. pain, anxiety, fear, depression) and functions (eg. daily living activities), in population's subgroups with definite health problems, undergoing or not to a healthcare procedure (eg. Adult Asthma Quality of Life Questionnaire, Kidney Disease Quality of Life Instrument, Oxford Hip Score, Oxford Knee Score). For the selection of an instrument a series of criteria needs to be taken into account, among which the psychometric properties, the expert judgement, the interpretability, the acceptability, and the feasibility of the entire process. PMID:25002284

  14. Outcome Measures for Artificial Pancreas Clinical Trials: A Consensus Report.

    PubMed

    Maahs, David M; Buckingham, Bruce A; Castle, Jessica R; Cinar, Ali; Damiano, Edward R; Dassau, Eyal; DeVries, J Hans; Doyle, Francis J; Griffen, Steven C; Haidar, Ahmad; Heinemann, Lutz; Hovorka, Roman; Jones, Timothy W; Kollman, Craig; Kovatchev, Boris; Levy, Brian L; Nimri, Revital; O'Neal, David N; Philip, Moshe; Renard, Eric; Russell, Steven J; Weinzimer, Stuart A; Zisser, Howard; Lum, John W

    2016-07-01

    Research on and commercial development of the artificial pancreas (AP) continue to progress rapidly, and the AP promises to become a part of clinical care. In this report, members of the JDRF Artificial Pancreas Project Consortium in collaboration with the wider AP community 1) advocate for the use of continuous glucose monitoring glucose metrics as outcome measures in AP trials, in addition to HbA1c, and 2) identify a short set of basic, easily interpreted outcome measures to be reported in AP studies whenever feasible. Consensus on a broader range of measures remains challenging; therefore, reporting of additional metrics is encouraged as appropriate for individual AP studies or study groups. Greater consistency in reporting of basic outcome measures may facilitate the interpretation of study results by investigators, regulatory bodies, health care providers, payers, and patients themselves, thereby accelerating the widespread adoption of AP technology to improve the lives of people with type 1 diabetes. PMID:27330126

  15. Interpreting and reporting results based on patient-reported outcomes.

    PubMed

    Revicki, Dennis A; Erickson, Pennifer A; Sloan, Jeff A; Dueck, Amylou; Guess, Harry; Santanello, Nancy C

    2007-01-01

    This article deals with the incorporation of patient-reported outcomes (PROs) into clinical trials and focuses on issues associated with the interpretation and reporting of PRO data. The primary focus and context of this information relates to the evidentiary support and reporting for a labeling or advertising claim of a PRO benefit for a new or approved pharmaceutical product. This manuscript focuses on issues associated with assessing clinical significance and common pitfalls to avoid in presenting results related to PROs. Specifically, the questions addressed by this manuscript involve: What are the best methods to assess clinical significance for PROs? How should investigators present PRO data most effectively in a Food and Drug Administration (FDA) application? In labeling or in a scientific publication? Guidelines for interpreting clinical significance of PROs and for comprehensively reporting on the methods, measures and results of clinical trials that incorporate PROs are important for clinicians, regulatory agencies, and most of all to patients. Clear specifications for considering a finding on a PRO measure, as clinically meaningful, need to be determined by instrument developers and psychometricians; they need to be reported for all clinical trials involving PRO end points. Clinical trial reports need to be comprehensive, clear, and sufficient to enable any reader to understand the methods, PRO measures, statistical analysis, and results. PMID:17995470

  16. The International Dermatology Outcome Measures Group: formation of patient-centered outcome measures in dermatology.

    PubMed

    Gottlieb, Alice B; Levin, Adriane A; Armstrong, April W; Abernethy, April; Duffin, Kristina Callis; Bhushan, Reva; Garg, Amit; Merola, Joseph F; Maccarone, Mara; Christensen, Robin

    2015-02-01

    As quality standards are increasingly in demand throughout medicine, dermatology needs to establish outcome measures to quantify the effectiveness of treatments and providers. The International Dermatology Outcome Measures Group was established to address this need. Beginning with psoriasis, the group aims to create a tool considerate of patients and providers using the input of all relevant stakeholders in assessment of disease severity and response to treatment. Herein, we delineate the procedures through which consensus is being reached and the future directions of the project. PMID:25486914

  17. Measurement Services Association Questionnaire Results.

    ERIC Educational Resources Information Center

    Wood, Lewis J.; Gillis, Rod

    This paper presents the results of a questionnaire sent to 211 Measurement Services Association members. Sixty-four centers responded. The main purpose of the questionnaire was to find out what hardware and software are used by testing centers throughout the country. Results indicate that 52 institutions use mainframe computers, 50 use…

  18. 42 CFR 410.146 - Diabetes outcome measurements.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Diabetes outcome measurements. 410.146 Section 410.146 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Training and Diabetes Outcome Measurements § 410.146 Diabetes outcome measurements. (a)...

  19. 42 CFR 410.146 - Diabetes outcome measurements.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Diabetes outcome measurements. 410.146 Section 410... MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Outpatient Diabetes Self-Management Training and Diabetes Outcome Measurements § 410.146 Diabetes outcome measurements. (a)...

  20. 42 CFR 410.146 - Diabetes outcome measurements.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Diabetes outcome measurements. 410.146 Section 410... MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Outpatient Diabetes Self-Management Training and Diabetes Outcome Measurements § 410.146 Diabetes outcome measurements. (a)...

  1. 42 CFR 410.146 - Diabetes outcome measurements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Diabetes outcome measurements. 410.146 Section 410... MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Outpatient Diabetes Self-Management Training and Diabetes Outcome Measurements § 410.146 Diabetes outcome measurements. (a)...

  2. 42 CFR 410.146 - Diabetes outcome measurements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Diabetes outcome measurements. 410.146 Section 410... MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Outpatient Diabetes Self-Management Training and Diabetes Outcome Measurements § 410.146 Diabetes outcome measurements. (a)...

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

    ERIC Educational Resources Information Center

    Glaser, Ezra

    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…

  4. General Outcome Measures for Verbal Operants

    PubMed Central

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

    2009-01-01

    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

  5. 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

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

    2013-01-01

    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

  6. Child Outcome Measures in the Study of Child Care Quality

    ERIC Educational Resources Information Center

    Zaslow, Martha; Halle, Tamara; Martin, Laurie; Cabrera, Natasha; Calkins, Julia; Pitzer, Lindsay; Margie, Nancy Geyelin

    2006-01-01

    This article assesses whether there are methodological problems with child outcome measures that may contribute to the small associations between child care quality and child outcomes found in the literature. Outcome measures used in 65 studies of child care quality published between 1979 and December 2005 were examined, taking the previous review…

  7. 42 CFR 486.318 - Condition: Outcome measures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... SUPPLIERS Requirements for Certification and Designation and Conditions for Coverage: Organ Procurement Organizations Organ Procurement Organization Outcome Requirements § 486.318 Condition: Outcome measures. (a... of organs transplanted per standard criteria donor, including pancreata used for islet...

  8. 42 CFR 486.318 - Condition: Outcome measures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... SUPPLIERS Requirements for Certification and Designation and Conditions for Coverage: Organ Procurement Organizations Organ Procurement Organization Outcome Requirements § 486.318 Condition: Outcome measures. (a... of organs transplanted per standard criteria donor, including pancreata used for islet...

  9. 42 CFR 486.318 - Condition: Outcome measures.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... SUPPLIERS Requirements for Certification and Designation and Conditions for Coverage: Organ Procurement Organizations Organ Procurement Organization Outcome Requirements § 486.318 Condition: Outcome measures. (a... transplantation; (ii) The number of organs transplanted per expanded criteria donor, including pancreata used...

  10. 42 CFR 486.318 - Condition: Outcome measures.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... SUPPLIERS Requirements for Certification and Designation and Conditions for Coverage: Organ Procurement Organizations Organ Procurement Organization Outcome Requirements § 486.318 Condition: Outcome measures. (a... transplantation; (ii) The number of organs transplanted per expanded criteria donor, including pancreata used...

  11. Psychometric properties of the Spanish version of the Clinical Outcomes in Routine Evaluation – Outcome Measure

    PubMed Central

    Trujillo, Adriana; Feixas, Guillem; Bados, Arturo; García-Grau, Eugeni; Salla, Marta; Medina, Joan Carles; Montesano, Adrián; Soriano, José; Medeiros-Ferreira, Leticia; Cañete, Josep; Corbella, Sergi; Grau, Antoni; Lana, Fernando; Evans, Chris

    2016-01-01

    Objective The objective of this paper is to assess the reliability and validity of the Spanish translation of the Clinical Outcomes in Routine Evaluation – Outcome Measure, a 34-item self-report questionnaire that measures the client’s status in the domains of Subjective well-being, Problems/Symptoms, Life functioning, and Risk. Method Six hundred and forty-four adult participants were included in two samples: the clinical sample (n=192) from different mental health and primary care centers; and the nonclinical sample (n=452), which included a student and a community sample. Results The questionnaire showed good acceptability and internal consistency, appropriate test–retest reliability, and acceptable convergent validity. Strong differentiation between clinical and nonclinical samples was found. As expected, the Risk domain had different characteristics than other domains, but all findings were comparable with the UK referential data. Cutoff scores were calculated for clinical significant change assessment. Conclusion The Spanish version of the Clinical Outcomes in Routine Evaluation – Outcome Measure showed acceptable psychometric properties, providing support for using the questionnaire for monitoring the progress of Spanish-speaking psychotherapy clients. PMID:27382288

  12. RASCH ANALYSIS OF CLINICAL OUTCOME MEASURES IN SPINAL MUSCULAR ATROPHY

    PubMed Central

    CANO, STEFAN J.; MAYHEW, ANNA; GLANZMAN, ALLAN M.; KROSSCHELL, KRISTIN J.; SWOBODA, KATHRYN J.; MAIN, MARION; STEFFENSEN, BIRGIT F.; BÉRARD, CAROLE; GIRARDOT, FRANÇOISE; PAYAN, CHRISTINE A.M.; MERCURI, EUGENIO; MAZZONE, ELENA; ELSHEIKH, BAKRI; FLORENCE, JULAINE; HYNAN, LINDA S.; IANNACCONE, SUSAN T.; NELSON, LESLIE L.; PANDYA, SHREE; ROSE, MICHAEL; SCOTT, CHARLES; SADJADI, REZA; YORE, MACKENSIE A.; JOYCE, CYNTHIA; KISSEL, JOHN T.

    2015-01-01

    Introduction Trial design for SMA depends on meaningful rating scales to assess outcomes. In this study Rasch methodology was applied to 9 motor scales in spinal muscular atrophy (SMA). Methods Data from all 3 SMA types were provided by research groups for 9 commonly used scales. Rasch methodology assessed the ordering of response option thresholds, tests of fit, spread of item locations, residual correlations, and person separation index. Results Each scale had good reliability. However, several issues impacting scale validity were identified, including the extent that items defined clinically meaningful constructs and how well each scale measured performance across the SMA spectrum. Conclusions The sensitivity and potential utility of each SMA scale as outcome measures for trials could be improved by establishing clear definitions of what is measured, reconsidering items that misfit and items whose response categories have reversed thresholds, and adding new items at the extremes of scale ranges. PMID:23836324

  13. Breast Cancer EDGE Task Force Outcomes: Clinical Measures of Pain

    PubMed Central

    Harrington, Shana; Gilchrist, Laura; Sander, Antoinette

    2014-01-01

    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. PMID:25346950

  14. Comparison of Physician-Predicted to Measured Low Vision Outcomes

    PubMed Central

    Chan, Tiffany L.; Goldstein, Judith E.; Massof, Robert W.

    2013-01-01

    Purpose To compare low vision rehabilitation (LVR) physicians’ predictions of the probability of success of LVR to patients’ self-reported outcomes after provision of usual outpatient LVR services; and to determine if patients’ traits influence physician ratings. Methods The Activity Inventory (AI), a self-report visual function questionnaire, was administered pre and post-LVR to 316 low vision patients served by 28 LVR centers that participated in a collaborative observational study. The physical component of the Short Form-36, Geriatric Depression Scale, and Telephone Interview for Cognitive Status were also administered pre-LVR to measure physical capability, depression and cognitive status. Following patient evaluation, 38 LVR physicians estimated the probability of outcome success (POS), using their own criteria. The POS ratings and change in functional ability were used to assess the effects of patients’ baseline traits on predicted outcomes. Results A regression analysis with a hierarchical random effects model showed no relationship between LVR physician POS estimates and AI-based outcomes. In another analysis, Kappa statistics were calculated to determine the probability of agreement between POS and AI-based outcomes for different outcome criteria. Across all comparisons, none of the kappa values were significantly different from 0, which indicates the rate of agreement is equivalent to chance. In an exploratory analysis, hierarchical mixed effects regression models show that POS ratings are associated with information about the patient’s cognitive functioning and the combination of visual acuity and functional ability, as opposed to visual acuity or functional ability alone. Conclusions Physicians’ predictions of LVR outcomes appear to be influenced by knowledge of patients’ cognitive functioning and the combination of visual acuity and functional ability - information physicians acquire from the patient’s history and examination. However

  15. Systematic Review of Outcome Measures Reported in Clinical Canine Osteoarthritis Research

    PubMed Central

    Asher, Lucy; Dean, Rachel S.

    2016-01-01

    Objective To record and categorize the outcome measures used in dogs with naturally occurring osteoarthritis (OA) by systematically reviewing the peer reviewed publications on OA in dogs. Study Design Systematic literature review. Study Population Peer reviewed literature on canine OA. Methods A computer‐based bibliographic search was performed on PubMed and CAB Abstracts in August 2013 to find peer reviewed publications relevant to canine OA. Inclusion and exclusion criteria were applied. The outcome measures reported within each publication were recorded and categorized for comparison. Adequately described outcome measures were assessed for uniqueness and evidence of prior validation. Results Of 3,697 publications identified and screened, 117 were deemed eligible for inclusion. Within eligible publications, outcome measures were used 618 times (median of 4 outcome measures per publication). Outcomes measured were divided into 5 groups containing 65 categories. The most frequently assessed outcomes were lameness assessment with no stated gait/mixed gaits (66 outcomes), radiography (58), and lameness single gait/lateral motion (55). Of 618 outcome measures reported, 491 were assessed for uniqueness and 348 (71%) were unique to a single publication. Ten outcome measures were reported to have been validated. Conclusion Many outcome measures have been used to assess canine OA. There is no consensus on which are the most useful outcomes or by which method they should be assessed. There is a pressing need for agreement on outcomes reporting in canine OA and for validation of outcome measures used for these assessments. Until consensus is reached, we recommend at least one validated outcome measure be used in every clinical study. PMID:27120270

  16. Patient-Reported Outcome Measures in Systemic Sclerosis (Scleroderma).

    PubMed

    Pellar, Russell E; Tingey, Theresa M; Pope, Janet Elizabeth

    2016-05-01

    Scleroderma (systemic sclerosis) is a rare autoimmune connective tissue disease that can damage multiple organs and reduce quality of life. Patient-reported outcome measures capture the patient's perspective. Some measures are specific to systemic sclerosis and others are general. Patient-reported outcomes in systemic sclerosis are important to aid in understanding the impact of systemic sclerosis on patients. PMID:27133491

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

    PubMed Central

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

    2003-01-01

    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 the patient reported outcome measures that were used in the trials – the Dermatology Life Quality Index (DLQI), the Psoriasis Symptom Assessment (PSA) Scale, and two itch measures, a Visual Analog Scale (VAS) and the National Psoriasis Foundation (NPF) itch measure. Methods Subjects aged 18 to 70 years with moderate to severe psoriasis for at least 6 months were recruited into the two clinical trials (n = 1095). Internal consistency reliability was evaluated for all patient reported outcomes at baseline and at 12 weeks. Construct validity was evaluated by relations among the different patient reported outcomes and between the patient reported outcomes and the clinical assessments (Psoriasis Area and Severity Index; Overall Lesion Severity Scale; Physician's Global Assessment of Change) assessed at baseline and at 12 weeks, as was the change over the course of the 12 week portion of the trial. Results Internal consistency reliability ranged from 0.86 to 0.95 for the patient reported outcome measures. The patient reported outcome measures were all shown to have significant construct validity with respect to each other and with respect to the clinical assessments. The four measures also demonstrated significant responsiveness to change in underlying clinical status of the patients over the course of the trial, as measured by the independently assessed clinical outcomes. Conclusions The DLQI, the PSA, VAS, and the NPF are considered useful tools for the measurement of dermatology-related limitations of functional

  18. Outcome as a Measure of Quality of Care in Oncology

    PubMed Central

    Burney, Ikram A; Al Moundhri, Mansour S; Rizvi, Azhar J; Ganguly, Shyam S; Al Abri, Rashid; Ashrafi, Rafi A

    2008-01-01

    Objectives: Measurement of outcomes is increasingly employed as an indicator of the quality of clinical care. The most commonly measured outcome in many clinical studies, especially in oncology, still remains the overall survival rate. Sultan Qaboos University Hospital (SQUH), Oman, is striving for excellence through quality management. In seeking continual improvement, quality measurement exercises have been initiated throughout the Hospital. We present the overall survival rate of four of the ten most common cancers diagnosed in Oman. Methods: The cancers included non-Hodgkin’s lymphoma (NHL), Hodgkin’s lymphoma (HL), breast cancer, and stomach cancer. The studies were all retrospective and had been conducted previously. For present purposes, only the overall survival was compared with studies both from the region, and with bench-mark studies. Results: For NHL, with a median follow-up of 8 months, the 2-year overall survival rate was 64%; 90% for low risk, 55% for intermediate risk, and 15% for high risk groups. For HL, the 5-year overall survival rate was 64%; 76% for low risk and 42% for high risk. For breast cancer, the 5-year survival rate was 67%; percentages were 88%, 75% and 59% for Groups I, II, and III respectively. For gastric cancer, the 5-year survival rate was 16.5 %; 24% for the non-metastatic group. Conclusion: The outcome of patients with early stages and fewer adverse prognostic factors is comparable to what has been reported in the international literature; however, the outcome is inferior for patients presenting with advanced stage disease and several adverse prognostic factors. PMID:21654954

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

    ERIC Educational Resources Information Center

    Mushkin, Selma J.; Billings, Bradley B.

    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:…

  20. Measuring Outcome in the Treatment of Cocaine Dependence

    PubMed Central

    Crits-Christoph, Paul; Gallop, Robert; Gibbons, Mary Beth Connolly; Sadicario, Jaclyn S.; Woody, George

    2015-01-01

    Background Little in known about the extent to which outcome measures used in studies of the treatment of cocaine dependence are associated with longer-term use and with broader measures of clinical improvement. The current study examined reductions in use, and abstinence-oriented measures, in relation to functioning and longer-term clinical benefits in the treatment of cocaine dependence. Methods Overall drug use, cocaine use, and functioning in a number of addiction-related domains for 487 patients diagnosed with DSM-IV cocaine dependence and treated with one of four psychosocial interventions in the NIDA Cocaine Collaborative Treatment Study were assessed monthly during 6 months of treatment and at 9, 12, 15, and 18 month follow-up. Results Measures of during-treatment reduction in use were moderately correlated with drug and cocaine use measures 12 months, but showed non-significant or small correlations with measures of functioning at 12 months. Highest correlations were evident for abstinence measures (maximum consecutive days abstinence and completely abstinent) during treatment in relation to sustained (3 month) abstinence at 12 months. Latent class analysis of patterns of change over time revealed that most patients initially (months 1 to 4 of treatment) either became abstinent immediately or continued to use every month. Over the couse of follow-up, patients either maintained abstinence or used regularly – intermittent use was less common. Conclusions There were generally small associations between various measures of cocaine use and longer-term clinical benefits, other than abstinence was associated with continued abstinence. No one method of measuring outcome of treatment of cocaine dependence appears superior to others. PMID:26366427

  1. Measuring the results of faith.

    PubMed

    Hudson, T

    1996-09-20

    Guiding patients to health takes more than technological wizardry, wonder drugs, and pleasantly decorated surroundings. In fact, to an increasing number of institutions, faith is the missing ingredient. Faith in a higher power. Faith in oneself. Faith in the possibilities for recovery. Welcome, then, to the new high-tech, high-touch world, where pastoral care meets managed care. The results may startle you. PMID:8924945

  2. The Harmonizing Outcome Measures for Eczema (HOME) roadmap: a methodological framework to develop core sets of outcome measurements in dermatology.

    PubMed

    Schmitt, Jochen; Apfelbacher, Christian; Spuls, Phyllis I; Thomas, Kim S; Simpson, Eric L; Furue, Masutaka; Chalmers, Joanne; Williams, Hywel C

    2015-01-01

    Core outcome sets (COSs) are consensus-derived minimum sets of outcomes to be assessed in a specific situation. COSs are being increasingly developed to limit outcome-reporting bias, allow comparisons across trials, and strengthen clinical decision making. Despite the increasing interest in outcomes research, methods to develop COSs have not yet been standardized. The aim of this paper is to present the Harmonizing Outcomes Measures for Eczema (HOME) roadmap for the development and implementation of COSs, which was developed on the basis of our experience in the standardization of outcome measurements for atopic eczema. Following the establishment of a panel representing all relevant stakeholders and a research team experienced in outcomes research, the scope and setting of the core set should be defined. The next steps are the definition of a core set of outcome domains such as symptoms or quality of life, followed by the identification or development and validation of appropriate outcome measurement instruments to measure these core domains. Finally, the consented COS needs to be disseminated, implemented, and reviewed. We believe that the HOME roadmap is a useful methodological framework to develop COSs in dermatology, with the ultimate goal of better decision making and promoting patient-centered health care. PMID:25186228

  3. Using Learning Outcome Measures to assess Doctoral Nursing Education

    PubMed Central

    Raup, Glenn H.; King, Jeff; Hughes, Romana J.; Faidley, Natasha

    2010-01-01

    Education programs at all levels must be able to demonstrate successful program outcomes. Grades alone do not represent a comprehensive measurement methodology for assessing student learning outcomes at either the course or program level. The development and application of assessment rubrics provides an unequivocal measurement methodology to ensure a quality learning experience by providing a foundation for improvement based on qualitative and quantitatively measurable, aggregate course and program outcomes. Learning outcomes are the embodiment of the total learning experience and should incorporate assessment of both qualitative and quantitative program outcomes. The assessment of qualitative measures represents a challenge for educators in any level of a learning program. Nursing provides a unique challenge and opportunity as it is the application of science through the art of caring. Quantification of desired student learning outcomes may be enhanced through the development of assessment rubrics designed to measure quantitative and qualitative aspects of the nursing education and learning process. They provide a mechanism for uniform assessment by nursing faculty of concepts and constructs that are otherwise difficult to describe and measure. A protocol is presented and applied to a doctoral nursing education program with recommendations for application and transformation of the assessment rubric to other education programs. Through application of these specially designed rubrics, all aspects of an education program can be adequately assessed to provide information for program assessment that facilitates the closure of the gap between desired and actual student learning outcomes for any desired educational competency. PMID:20567217

  4. Measuring Outcomes for Children Late Placed for Adoption.

    ERIC Educational Resources Information Center

    Rushton, Alan

    1998-01-01

    Describes the selection of outcome measures used by the Maudsley Family Research team to assess outcomes--across a broad range of developmental dimensions--of permanent placement for children and adolescents. Developed a package of instruments to examine child emotional, cognitive, social, and academic development; attachment; and self-esteem, for…

  5. Measuring Assistive Technology Outcomes in Schools Using Functional Assessment.

    ERIC Educational Resources Information Center

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

    2000-01-01

    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…

  6. Outcome Measures in Quality of Life.

    PubMed

    Tate, D G; Dijkers, M; Johnson-Greene, L

    1996-01-01

    The concept of quality of life (QOL) represents a new paradigm in rehabilitation research and cSinical care. Three measurement approaches have been used to investigate QOL of individuals: (1) evaluative or subjective, (2) objective, and (3) quality adjusted life year (QALY). QALYs represent the utility approach to measurement with emphasis on value of, desirability of, or preference for conditions or status. When the condition in question isdefined as health, health-related quality of life (HQOL) measures are employed. Very few studies are found in the literature addressing QOL of stroke patients. Among studies reviewed, HQOL measures are often used. A summary of these studies and discussion of limitations associated with QOL measures utilized are provided. PMID:27620148

  7. Process versus outcome in hypertension: a positive result.

    PubMed

    Haynes, R B; Gibson, E S; Taylor, D W; Bernholz, C D; Sackett, D L

    1982-01-01

    We studied the association between the outcome of antihypertensive care and three items of that care among 230 hypertensive steelworkers who were referred to 83 physicians. The first item was the decision to treat some patients but not others: 63% of the patients were prescribed antihypertensive drugs and the mean decrease in their diastolic blood pressure (DBP) was greater than that among untreated patients (12.2 +/- 0.84 vs 7.8 +/- 0.83 mm Hg [+/- SEM], p less than 0.001). The second item was the vigor of prescribed medication: Patients prescribed more vigorous treatments had lower DBP (p less than 0.005). Third, patient compliance was related to achieving a goal DBP of less than 90 mm Hg (p less than 0.05) and the product of prescribed vigor and compliance was highly associated with DBP response (p less than 0.0001). These results stand in contrast to those of previous studies that failed to detect associations between various other items of the care process and the outcome of antihypertensive care. PMID:7053286

  8. Palliative care outcome measures in COPD patients: a conceptual review.

    PubMed

    Antoniu, Sabina Antonela; Boiculese, Lucian Vasile

    2016-04-01

    In chronic obstructive pulmonary disease (COPD), palliative care is appropriate in very advanced stages based on recognition of its need when conventional therapy is no longer able to control symptoms, disease morbidity, or to improve/maintain an acceptable quality of life. Palliative care aims to improve quality of life, or, if applied specifically at the end-of-life, to ensure comfortable care. In COPD palliative care effectiveness of interventions should be quantified with outcome measures able to better capture the holistic nature of approaches and not only the specific features of disease. These should include: physical outcomes, psychological outcomes, social outcomes, spiritual outcomes. Such measures are discussed in this review along with arguments supporting their use. PMID:26967768

  9. Measuring outcomes in craniofacial and pediatric plastic surgery.

    PubMed

    Wong, Karen W Y; Forrest, Christopher R; Goodacre, Tim E E; Klassen, Anne F

    2013-04-01

    This article discusses the measurement of outcomes in craniofacial and pediatric plastic surgery, using examples of craniosynostosis and cleft lip and/or palate (CLP). The challenges in measuring the standard outcomes of function, aesthetics, and health-related quality of life are discussed, along with the importance of developing evidence and studying quality improvement in this specialty. The need to define specific and comprehensive goals is discussed with a focus on patient-reported outcomes (PROs). Examples from the development of the CLEFT-Q, a PRO instrument for patients with CLP, are provided to support the need to seek the patient perspective. PMID:23506771

  10. US Valuation of Health Outcomes Measured Using the PROMIS-29

    PubMed Central

    Craig, Benjamin M.; Reeve, Bryce B.; Brown, Paul M.; Cella, David; Hays, Ron D.; Lipscomb, Joseph; Pickard, A. Simon; Revicki, Dennis A.

    2015-01-01

    Objectives Health valuation studies enhance economic evaluations of treatments by estimating the value of health-related quality of life (HRQoL). The Patient-Reported Outcomes Measurement Information System® (PROMIS) includes a 29-item short-form HRQOL measure, the PROMIS-29. Methods To value PROMIS-29 responses on a quality-adjusted life year (QALY) scale, we conducted a national survey (N=7557) using quota sampling based on the US 2010 Census. Based on 541 paired comparisons with over 350 responses each, pair-specific probabilities were incorporated into a weighted least-squared estimator. Results All losses in HRQoL influenced choice; however, respondents valued losses in physical function, anxiety, depression, sleep, and pain more than those in fatigue and social functioning. Conclusions This paper introduces a novel approach to valuing HRQoL for economic evaluations using paired comparisons and provides a tool to translate PROMIS-29 responses into QALYs. PMID:25498780

  11. Current Status of Outcome Measure Development in Vasculitis

    PubMed Central

    Merkel, Peter A.; Aydin, Sibel Z.; Boers, Maarten; Cornell, Christina; Direskeneli, Haner; Gebhart, Don; Hatemi, Gulen; Luqmani, Raashid; Matteson, Eric L.; Milman, Nataliya; Robson, Joanna; Seo, Philip; Tomasson, Gunnar

    2015-01-01

    The conduct of randomized controlled trials for vasculitis, especially for the antineutrophil cytoplasmic antibody-associated vasculitides [AAV, granulomatosis with polyangiitis (Wegener’s) and microscopic polyangiitis], has been greatly advanced by the development, use, and acceptance of validated outcome measures. Trials have subsequently provided the opportunity to validate and refine reliable, valid outcome measures for these multisystemic and relapsing rare diseases. The Outcome Measures in Rheumatology (OMERACT) Vasculitis Working Group was formed in 2004 to foster development of validated and widely accepted outcomes in vasculitis using data-driven analyses, a dedication to building consensus, and adherence to, and guidance by, the principles of the OMERACT approach. This work led to the endorsement by OMERACT of the core set of domains and associated outcome measures for AAV. Next steps for the study of existing outcome tools in AAV include better definition of response criteria through development of more data-driven weighting of the elements of activity and damage assessment. The Working Group is now also embarking on a series of linked projects to develop validated patient-reported outcomes for use in clinical research in vasculitis. Additionally, the Working Group is studying how current methods of disease assessment and plans for new outcomes can be informed by the conceptual framework of the International Classification of Function of the World Health Organization. The success of the Group’s work in AAV has also led to a formal process for developing outcomes for the large vessel vasculitides (Takayasu arteritis and giant cell arteritis) and Behçet disease. PMID:24429177

  12. Advances in Patient-Reported Outcomes: The NIH PROMIS® Measures

    PubMed Central

    Broderick, Joan E.; DeWitt, Esi Morgan; Rothrock, Nan; Crane, Paul K.; Forrest, Christopher B.

    2013-01-01

    Patient-reported outcomes (PRO) are questionnaire measures of patients’ symptoms, functioning, and health-related quality of life. They are designed to provide important clinical information that generally cannot be captured with objective medical testing. In 2004, the National Institutes of Health launched a research initiative to improve the clinical research enterprise by developing state-of-the-art PROs. The NIH Patient-Reported Outcomes Measurement System (PROMIS) and Assessment Center are the products of that initiative. Adult, pediatric, and parent-proxy item banks have been developed by using contemporary psychometric methods, yielding rapid, accurate measurements. PROMIS currently provides tools for assessing physical, mental, and social health using short-form and computer-adaptive testing methods. The PROMIS tools are being adopted for use in clinical trials and translational research. They are also being introduced in clinical medicine to assess a broad range of disease outcomes. Recent legislative developments in the United States support greater efforts to include patients’ reports of health experience in order to evaluate treatment outcomes, engage in shared decision-making, and prioritize the focus of treatment. PROs have garnered increased attention by the Food and Drug Administration (FDA) for evaluating drugs and medical devices. Recent calls for comparative effectiveness research favor inclusion of PROs. PROs could also potentially improve quality of care and disease outcomes, provide patient-centered assessment for comparative effectiveness research, and enable a common metric for tracking outcomes across providers and medical systems. PMID:25848562

  13. Outcome Measures Used in Clinical Trials for Behçet Syndrome: A Systematic Review

    PubMed Central

    Hatemi, Gulen; Merkel, Peter A.; Hamuryudan, Vedat; Boers, Maarten; Direskeneli, Haner; Aydin, Sibel Z.; Yazici, Hasan

    2015-01-01

    Behçet syndrome (BS) is a multisystem vasculitis that is most active during young adulthood, causing serious disability and significant impairment in quality of life. Differences in the disease course, severity, and organ involvement between patients, depending on the age at presentation and sex, makes it impossible to determine a single management strategy. The diversity and variability in the outcome measures used in clinical trials in BS makes it difficult to compare the results or inform physicians about the best management strategy for individual patients. There is a large unmet need to determine or develop validated outcome measures for use in clinical trials in BS that are acceptable to researchers and regulatory agencies. We conducted a systematic review to describe the outcomes and outcome measures that have been used in clinical trials in BS. This review revealed the diversity and variability in the outcomes and outcome measures and the lack of standard definitions for most outcomes and rarity of validated outcome tools for disease assessment in BS. This systematic literature review will identify domains and candidate instruments for use in a Delphi exercise, the next step in the development of a core set of outcome measures that are properly validated and widely accepted by the collaboration of researchers from many different regions of the world and from different specialties, including rheumatology, ophthalmology, dermatology, gastroenterology, and neurology. PMID:24488418

  14. Conceptual and methodological advances in child-reported outcomes measurement

    PubMed Central

    Bevans, Katherine B; Riley, Anne W; Moon, JeanHee; Forrest, Christopher B

    2011-01-01

    Increasingly, clinical, pharmaceutical and translational research studies use patient-reported outcomes as primary and secondary end points. Obtaining this type of information from children themselves is now possible, but effective assessment requires developmentally sensitive conceptual models of child health and an appreciation for the rapid change in children’s cognitive capacities. To overcome these barriers, outcomes researchers have capitalized on innovations in modern measurement theory, qualitative methods for instrument development and new computerized technologies to create reliable and valid methods for obtaining self-reported health data among 8–17-year-old children. This article provides a developmentally focused framework for selecting child-report health assessment instruments. Several generic health-related quality of life instruments and the assessment tools developed by the NIH-sponsored Patient-Reported Outcome Measurement Information System network are discussed to exemplify advances in the measurement of children’s self-reported health, illness, wellbeing and quality of life. PMID:20715916

  15. Comparing and ranking hospitals based on outcome: results from The Netherlands Stroke Survey

    PubMed Central

    Steyerberg, E.W.; Eijkemans, M.J.C.; Dippel, D.W.J.; Scholte Op Reimer, W.J.M.; Van Houwelingen, H.C.

    2010-01-01

    Background: Measuring quality of care and ranking hospitals with outcome measures poses two major methodological challenges: case-mix adjustment and variation that exists by chance. Aim: To compare methods for comparing and ranking hospitals that considers these. Methods: The Netherlands Stroke Survey was conducted in 10 hospitals in the Netherlands, between October 2002 and May 2003, with prospective and consecutive enrolment of patients with acute brain ischaemia. Poor outcome was defined as death or disability after 1 year (modified Rankin scale of ⩾3). We calculated fixed and random hospital effects on poor outcome, unadjusted and adjusted for patient characteristics. We compared the hospitals using the expected rank, a novel statistical measure incorporating the magnitude and the uncertainty of differences in outcome. Results: At 1 year after stroke, 268 of the total 505 patients (53%) had a poor outcome. There were substantial differences in outcome between hospitals in unadjusted analysis (χ2 = 48, 9 df, P < 0.0001). Adjustment for 12 confounders led to halving of the χ2 (χ2 = 24). The same pattern was observed in random effects analysis. Estimated performance of individual hospitals changed considerably between unadjusted and adjusted analysis. Further changes were seen with random effect estimation, especially for smaller hospitals. Ordering by expected rank led to shrinkage of the original ranks of 1–10 towards the median rank of 5.5 and to a different order of the hospitals, compared to ranking based on fixed effects. Conclusion: In comparing and ranking hospitals, case-mix-adjusted random effect estimates and the expected ranks are more robust alternatives to traditional fixed effect estimates and simple rankings. PMID:20008321

  16. Children's Program Outcome Review Team: 2002 Evaluation Results.

    ERIC Educational Resources Information Center

    Wade, Patricia C.

    The Children's Program Outcome Review Team (CPORT), under the direction of the Tennessee Commission on Children and Youth, collects and analyzes data to improve service delivery to children and families involved in state custody. Using the Quality Service Review methodology, the Commission conducted 282 intensive case reviews on a random sample of…

  17. Undergraduate Time Use and Academic Outcomes: Results from UCUES 2006

    ERIC Educational Resources Information Center

    Brint, Steven; Cantwell, Allison M.

    2008-01-01

    Class attendance and out-of-class study time are known to be strongly associated with academic engagement and college GPA. The paper examines two other uses of time as influences on academic outcomes: those devoted to active engagements with friends and community as opposed to passive entertainments, and those that connect students to campus life…

  18. Inside Quality Reform: Early Results on Using Outcomes for Improvement

    ERIC Educational Resources Information Center

    El-Khawas, Elaine

    2014-01-01

    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…

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

    ERIC Educational Resources Information Center

    Deeter, Thomas; Prine, Don

    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)…

  20. Predicting Outcome in Behavioral Parent Training: Expected and Unexpected Results

    ERIC Educational Resources Information Center

    MacKenzie, Elizabeth P.; Fite, Paula J.; Bates, John E.

    2004-01-01

    This study examined the relationships among clinical utility and treatment outcome variables in Behavioral Parent Training (BPT). The sample included 21 mothers with 3-8 year-old children with significant externalizing behavior problems who received treatment for Oppositional Defiant Disorder. The primary aim was to relate two treatment…

  1. Children's Program Outcome Review Team: 2000 Evaluation Results.

    ERIC Educational Resources Information Center

    Wade, Patricia C.

    In its seventh year of evaluating children's services, the Children's Program Outcome Review Team (CPORT), under the direction of the Tennessee Commission on Children and Youth, continued to collect and analyze data to improve service delivery to children and families involved in state custody. The CPORT evaluation for 2000 collected and organized…

  2. Outcome Measures for Clinical Trials in Interstitial Lung Diseases

    PubMed Central

    Lammi, Matthew R.; Baughman, Robert P.; Birring, Surinder S.; Russell, Anne-Marie; Ryu, Jay H.; Scholand, Marybeth; Distler, Oliver; LeSage, Daphne; Sarver, Catherine; Antoniou, Katerina; Highland, Kristin B.; Kowal-Bielecka, Otylia; Lasky, Joseph A.; Wells, Athol U.; Saketkoo, Lesley Ann

    2015-01-01

    The chronic fibrosing idiopathic interstitial pneumonias (IIPs) are a group of heterogeneous pulmonary parenchymal disorders described by radiologic and histological patterns termed usual interstitial pneumonia (UIP) and non-specific interstitial pneumonia (NSIP). These include idiopathic pulmonary fibrosis (IPF) and those related to connective tissue disease (CTD) and are associated with substantial morbidity and mortality. Beyond the importance of establishing an appropriate diagnosis, designing optimal clinical trials for IIPs has been fraught with difficulties in consistency of clinical endpoints making power analyses, and the establishment of efficacy and interpretation of results across trials challenging. Preliminary recommendations, developed by rigorous consensus methods, proposed a minimum set of outcome measures, a ‘core set’, to be incorporated into future clinical trials (Saketkoo et al, THORAX. 2014.). This paper sets out to examine the candidate instruments for each domain (Dyspnea, Cough, Health Related Quality of Life, Imaging, Lung Physiology and Function, Mortality). Candidate measures that were not selected as well as measures that were not available for examination at the time of the consensus process will also be discussed. PMID:27019654

  3. Experimental evaluation of nonclassical correlations between measurement outcomes and target observable in a quantum measurement

    NASA Astrophysics Data System (ADS)

    Iinuma, Masataka; Suzuki, Yutaro; Nii, Taiki; Kinoshita, Ryuji; Hofmann, Holger F.

    2016-03-01

    In general, it is difficult to evaluate measurement errors when the initial and final conditions of the measurement make it impossible to identify the correct value of the target observable. Ozawa proposed a solution based on the operator algebra of observables which has recently been used in experiments investigating the error-disturbance trade-off of quantum measurements. Importantly, this solution makes surprisingly detailed statements about the relations between measurement outcomes and the unknown target observable. In the present paper, we investigate this relation by performing a sequence of two measurements on the polarization of a photon, so that the first measurement commutes with the target observable and the second measurement is sensitive to a complementary observable. While the initial measurement can be evaluated using classical statistics, the second measurement introduces the effects of quantum correlations between the noncommuting physical properties. By varying the resolution of the initial measurement, we can change the relative contribution of the nonclassical correlations and identify their role in the evaluation of the quantum measurement. It is shown that the most striking deviation from classical expectations is obtained at the transition between weak and strong measurements, where the competition between different statistical effects results in measurement values well outside the range of possible eigenvalues.

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

    NASA Astrophysics Data System (ADS)

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

    2002-06-01

    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 is to evaluate subjective outcomes of PDT in patients with obstructing esophageal and lung cancer. Existing measures of health status, dysphagia and performance status were supplemented with an instrument developed to evaluate PDT symptom relief and side effect burden, the PDT Side Effects Survey (PSES). Results: PDT patients treated with porfimer sodium (Photofrin) and 630-nm light experienced reduced dysphagia grade and stable performance status for at least one month after PDT (N= 10-17), but these effects did not necessarily persist at three months. Fatigue, appetite and quality of life may be the most burdensome issues for these patients. Conclusions: Preliminary data suggest that the PSES is an acceptable and valid tool for measuring subjective outcomes of palliative PDT. This study is the first attempt to systematically evaluate subjective outcomes of palliative PDT. Multi-center outcomes research is needed to draw generalizable conclusions that will establish PDT's effectiveness in actual clinical practice and enhance the wider adoption of PDT as a cancer symptom relief modality.

  5. International Dermatology Outcome Measures Initiative as Applied to Psoriatic Disease Outcomes: An Update.

    PubMed

    Merola, Joseph F; Armstrong, April W; Saraiya, Ami; Latella, John; Garg, Amit; Callis Duffin, Kristina; Gottlieb, Alice B

    2016-05-01

    Previous publications have described the International Dermatology Outcome Measures (IDEOM) group, comprising patients, physicians, health economists, participating pharmaceutical industry partners, payers, and regulatory agencies. The goal of IDEOM is to create patient-centered, validated measures of dermatologic disease progression and treatment efficacy for use in both clinical trials and clinical practice. We provide an update of IDEOM activities as of our 2015 IDEOM meeting in Washington, DC, USA. PMID:27134269

  6. Quantifying prosthetic gait deviation using simple outcome measures

    PubMed Central

    Kark, Lauren; Odell, Ross; McIntosh, Andrew S; Simmons, Anne

    2016-01-01

    AIM: To develop a subset of simple outcome measures to quantify prosthetic gait deviation without needing three-dimensional gait analysis (3DGA). METHODS: Eight unilateral, transfemoral amputees and 12 unilateral, transtibial amputees were recruited. Twenty-eight able-bodied controls were recruited. All participants underwent 3DGA, the timed-up-and-go test and the six-minute walk test (6MWT). The lower-limb amputees also completed the Prosthesis Evaluation Questionnaire. Results from 3DGA were summarised using the gait deviation index (GDI), which was subsequently regressed, using stepwise regression, against the other measures. RESULTS: Step-length (SL), self-selected walking speed (SSWS) and the distance walked during the 6MWT (6MWD) were significantly correlated with GDI. The 6MWD was the strongest, single predictor of the GDI, followed by SL and SSWS. The predictive ability of the regression equations were improved following inclusion of self-report data related to mobility and prosthetic utility. CONCLUSION: This study offers a practicable alternative to quantifying kinematic deviation without the need to conduct complete 3DGA. PMID:27335814

  7. Measuring Student Learning Outcomes Using the SALG Instrument

    ERIC Educational Resources Information Center

    Scholl, Kathleen; Olsen, Heather M.

    2014-01-01

    U.S. higher education institutions are being called to question their central nature, priorities, and functions, with prominent and unprecedented attention being given to accountability and the measurement of student learning outcomes. As higher education evolves in how it assesses student learning and leisure studies and recreation departments…

  8. What Do They Measure? Comparing Three Learning Outcomes Assessments

    ERIC Educational Resources Information Center

    Steedle, Jeffrey; Kugelmass, Heather; Nemeth, Alex

    2010-01-01

    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…

  9. Conceptualizing Outcome and Impact Measures for Intelligence Services

    ERIC Educational Resources Information Center

    Gainor, Rhiannon; Bouthillier, France

    2014-01-01

    Introduction: The purpose of this qualitative, exploratory study is to clarify ambiguous concepts in intelligence services literature specifically related to measurement of intelligence outcomes and impact. Method: Face to face interviews were held with five subject experts from various intelligence fields and countries regarding their…

  10. Use of Outcome Measurement by Paediatric AHPs in Northern Ireland

    ERIC Educational Resources Information Center

    Harron, Anita; Titterington, Jill

    2016-01-01

    Background: Professional standards advocate routine use of outcome measurement (OM) in the practice of allied health professionals (AHPs). Historically, OM has focused on impairment and its immediate constraints on activity, while current policy encourages the development and addition of impact-based OM. There appears to be an assumption at this…

  11. Measuring Educational Outcomes: Vocational Education and Training. Conference Paper

    ERIC Educational Resources Information Center

    Karmel, Tom

    2009-01-01

    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…

  12. Item response theory modeling in health outcomes measurement.

    PubMed

    Reeve, Bryce B

    2003-04-01

    There is a great need in health outcomes research to develop instruments that accurately measure a person's health status with minimal response burden. This need for psychometrically sound and clinically meaningful measures calls for better analytical tools beyond the methods available from traditional measurement theory. Applications of item response theory (IRT) modeling have increased considerably because of its utility for instrument development and evaluation, scale scoring, assessment of cultural equivalence, instrument linking and computerized adaptive testing. IRT models the relationship between a person's response to a survey question and their standing on a health construct, such as fatigue or depression. This review will discuss the theory and basics of IRT models and applications of these models to health outcomes measurement. PMID:19807361

  13. Upper Limb Outcome Measures Used in Stroke Rehabilitation Studies: A Systematic Literature Review

    PubMed Central

    Santisteban, Leire; Térémetz, Maxime; Bleton, Jean-Pierre; Baron, Jean-Claude; Maier, Marc A.; Lindberg, Påvel G.

    2016-01-01

    Background Establishing which upper limb outcome measures are most commonly used in stroke studies may help in improving consensus among scientists and clinicians. Objective In this study we aimed to identify the most commonly used upper limb outcome measures in intervention studies after stroke and to describe domains covered according to ICF, how measures are combined, and how their use varies geographically and over time. Methods Pubmed, CinHAL, and PeDRO databases were searched for upper limb intervention studies in stroke according to PRISMA guidelines and477 studies were included. Results In studies 48different outcome measures were found. Only 15 of these outcome measures were used in more than 5% of the studies. The Fugl-Meyer Test (FMT)was the most commonly used measure (in 36% of studies). Commonly used measures covered ICF domains of body function and activity to varying extents. Most studies (72%) combined multiple outcome measures: the FMT was often combined with the Motor Activity Log (MAL), the Wolf Motor Function Test and the Action Research Arm Test, but infrequently combined with the Motor Assessment Scale or the Nine Hole Peg Test. Key components of manual dexterity such as selective finger movements were rarely measured. Frequency of use increased over a twelve-year period for the FMT and for assessments of kinematics, whereas other measures, such as the MAL and the Jebsen Taylor Hand Test showed decreased use over time. Use varied largely between countries showing low international consensus. Conclusions The results showed a large diversity of outcome measures used across studies. However, a growing number of studies used the FMT, a neurological test with good psychometric properties. For thorough assessment the FMT needs to be combined with functional measures. These findings illustrate the need for strategies to build international consensus on appropriate outcome measures for upper limb function after stroke. PMID:27152853

  14. Intelligent outcome measures in liaison psychiatry: essential even if not desirable: Commentary on … a multidimensional Framework for Routine Outcome Measurement in Liaison Psychiatry (FROM-LP).

    PubMed

    Tadros, George

    2016-08-01

    Service development is guided by outcome measures that inform service commissioners and providers. Those in liaison psychiatry should be encouraged to develop a positive approach that integrates the collection of outcome measures into everyday clinical practice. The Framework for Routine Outcome Measurement in Liaison Psychiatry (FROM-LP) is a very useful tool to measure service quality and clinical effectiveness, using a combination of clinician-rated and patient-rated outcome measures and patient-rated experience measures. However, it does not include measures of cost-effectiveness or training activities. The FROM-LP is a significant step towards developing nationally unified outcome measures. PMID:27512588

  15. Development of a Change-Sensitive Outcome Measure for Children Receiving Counseling

    ERIC Educational Resources Information Center

    Meier, Scott T.; McDougal, James L.; Bardos, Achilles

    2008-01-01

    Contemporary testing standards place test purpose as the central focus during test development and subsequent use. This study describes the development of a measure for children designed explicitly to measure change resulting from psychosocial interventions. Parents completed the outcome measure for 896 elementary school-age children receiving…

  16. Treatment Outcome Package: Measuring and facilitating multidimensional change.

    PubMed

    Boswell, James F; Kraus, David R; Castonguay, Louis G; Youn, Soo Jeong

    2015-12-01

    The Treatment Outcome Package (TOP; D. R. Kraus, Seligman, & Jordan, 2005) is a multidimensional routine progress and outcome measure developed for use in diverse naturalistic practice settings. In this article, we (a) provide a brief review and summary of the extant psychometric and research support for the TOP, (b) provide examples of the TOP's use in clinical training and practice, and (c) discuss the implications of the TOP for future psychotherapy training, research, and practice. In particular, we focus on the implications of risk-adjusted progress monitoring for systems of care and mental health care decision making. PMID:26641372

  17. Measurement of Outcomes of Upper Limb Reconstructive Surgery for Tetraplegia.

    PubMed

    Sinnott, K Anne; Dunn, Jennifer A; Wangdell, Johanna; Johanson, M Elise; Hall, Andrew S; Post, Marcel W

    2016-06-01

    Reconstructive arm/hand surgery for tetraplegia is performed to improve arm/hand function and therefore personal well-being for individuals who accept such elective surgeries. However, changes at an impairment level do not always translate into functional or quality of life changes. Therefore, multiple outcome tools should be used that incorporate sufficient responsiveness to detect changes in arm/hand function, activity and participation, and quality of life of the individuals involved. This narrative review aims to assist clinicians to choose the most appropriate tools to assess the need for reconstructive surgery and to evaluate its outcomes. Our specific objectives are (1) to describe aspects to consider when choosing a measure and (2) to describe the measures advised by an international therapist consensus group established in 2007. All advised measures are appraised in terms of the underlying construct, administration, and clinical relevance to arm/hand reconstructions. Essentially there are currently no criterion standard measures to evaluate the consequences of reconstructive arm/hand surgery. However, with judicious use of available measures it is possible to ensure the questions asked or tasks completed are relevant to the surgical reconstruction(s) undertaken. Further work in this field is required. This would be best met by immediate collaboration between 2 outcome's tool developers and by analysis of pre- and postoperative data already held in various international sites, which would allow further evaluation of the measures already in use, or components thereof. PMID:27233592

  18. Novel mechanisms, treatments, and outcome measures in childhood sleep.

    PubMed

    Colonna, Annalisa; Smith, Anna B; Pal, Deb K; Gringras, Paul

    2015-01-01

    Sleep disorders and sleep of insufficient duration and quality are on the increase due to changes in our lifestyle, particularly in children and adolescents. Sleep disruption is also more common in children with medical conditions, compounding their difficulties. Recent studies have focused on new mechanisms that explain how learning and cognitive performance depend on a good night's sleep. Growing alongside this latest understanding is an innovative new field of non-drug interventions that improve sleep architecture, with resulting cognitive improvements. However, we need to rigorously evaluate such potentially popular and self-administered sleep interventions with equally state-of-the-art outcome measurement tools. Animated hand-held games, that incorporate embedded sleep-dependent learning tasks, promise to offer new robust methods of measuring changes in overnight learning. Portable computing technology has the potential to offer practical, inexpensive and reliable tools to indirectly assess the quality of sleep. They may be adopted in both clinical and educational settings, providing a unique way of monitoring the effect of sleep disruption on learning, leading also to a radical rethink of how we manage chronic diseases. PMID:26029140

  19. Medical specialty boards can help measure graduate medical education outcomes.

    PubMed

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

    2014-06-01

    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

  20. Outcome measures for primary Sjögren's syndrome.

    PubMed

    Seror, Raphaèle; Bootsma, Hendrika; Bowman, Simon J; Dörner, Thomas; Gottenberg, Jacques-Eric; Mariette, Xavier; Ramos-Casals, Manel; Ravaud, Philippe; Theander, Elke; Tzioufas, Athanasios; Vitali, Claudio

    2012-08-01

    Lymphocytic infiltration of different exocrine and non-exocrine epithelia is the pathological hallmark of primary Sjögren's syndrome, whereas involvement of salivary and lachrymal glands with the clinical counterpart of dry eye and dry mouth are the predominant features of the disease, together with fatigue and musculoskeletal pain. In addition, systemic manifestations, like arthritis, skin vasculitis, peripheral neuropathy, glomerulonephritis, may also be present in a consistent number of patients. As result, clinical features in SS can be divided into two facets: the benign subjective but disabling manifestations such as dryness, pain and fatigue, and the systemic manifestations. In the past decades, a core set of domains, which included sicca symptoms, objective measurements of tear and saliva production, fatigue, quality of life, disease activity and damage was indicated as essential for outcome assessment in this disorder. Afterwards, great efforts have been made to develop valid tools for the assessment of different domains. Specific questionnaires such as the Profile of Fatigue and Discomfort (PROFAD) and Sicca Symptoms Inventory (SSI) have been proposed as dedicated tools for the evaluation of patients symptoms, whereas different composite indexes have been suggested for the assessment of disease activity and damage. Some of these preliminary studies served as bases of an international project supported by EULAR, aimed at developing two consensus disease activity indexes: the EULAR Sjögren's Syndrome Patients Reported Index (ESSPRI), and the EULAR Sjögren's Syndrome Disease Activity Index (ESSDAI), a systemic activity index to assess systemic manifestations. A detailed and critical review of all these indexes is provided in this article. Both EULAR indexes showed, in recent studies, to be feasible, valid, and reliable instruments. After their final validation, which is currently in process, they could be used as consensus outcome criteria in therapeutic

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

    ERIC Educational Resources Information Center

    Mushkin, Selma J.; Billings, Bradley B.

    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…

  2. 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...

  3. A National Survey of Faculty Development Evaluation Outcome Measures and Procedures

    ERIC Educational Resources Information Center

    Meyer, Katrina A.; Murrell, Vicki S.

    2014-01-01

    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…

  4. Using Patient Reported Outcome Measures to Improve Service Effectiveness (UPROMISE): Training clinicians to Use Outcome Measures in Child Mental Health.

    PubMed

    Edbrooke-Childs, Julian; Wolpert, Miranda; Deighton, Jessica

    2016-05-01

    Patient reported outcome measures (PROMs) are prevalent in child mental health services. In this point of view, we discuss our experience of training clinicians to use PROMs and to interpret and discuss feedback from measures. Findings from pre-post observational data from clinicians who attended either a 1- or 3-day training course showed that clinicians in both courses had more positive attitudes and higher levels of self-efficacy regarding administering measures and using feedback after training. We hope that this special issue will lead the way for future research on training clinicians to use outcome measures so that PROMs may be a source of clinically useful practice based evidence. PMID:25331446

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

    PubMed Central

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

    2014-01-01

    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

  6. Outcome measures for palliative oxygen therapy: relevance and practical utility.

    PubMed

    Antoniu, Sabina; Mihaltan, Florin

    2014-06-01

    Dyspnea is a common symptom in many advanced malignant and non-malignant diseases and often is refractory to the usual therapies. In such circumstances palliative care approaches are necessary and among them palliative care oxygen therapy can be applied although currently its effectiveness is rather uncertain. Palliative oxygen therapy can be given on either continuous basis or on demand. Often the continuous palliative oxygen therapy is seen as long-term oxygen therapy although their aims are rather different. Palliative oxygen therapy was evaluated in populations with mixed underlying diseases, with outcome measures not only the most appropriate for the setting and therefore these limitations might have influenced the overall perceived therapeutic benefit. Therefore an evaluation of this method in subsets defined based on the etiology and pathogenic mechanisms and with appropriate outcome measures would help to better define the criteria for its indication and would increase its acceptability. PMID:24741999

  7. Novel Outcome Measures for Clinical Trials in Cystic Fibrosis

    PubMed Central

    Tiddens, Harm AWM; Puderbach, Michael; Venegas, Jose G; Ratjen, Felix; Donaldson, Scott H; Davis, Stephanie D; Rowe, Steven M; Sagel, Scott D; Higgins, Mark; Waltz, David A

    2015-01-01

    Cystic fibrosis (CF) is a common inherited condition caused by mutations in the gene encoding the CF transmembrane regulator protein. With increased understanding of the molecular mechanisms underlying CF and the development of new therapies there comes the need to develop new outcome measures to assess the disease, its progression and response to treatment. As there are limitations to the current endpoints accepted for regulatory purposes, a workshop to discuss novel endpoints for clinical trials in CF was held in Anaheim, California in November 2011. The pros and cons of novel outcome measures with potential utility for evaluation of novel treatments in CF were critically evaluated. The highlights of the 2011 workshop and subsequent advances in technologies and techniques that could be used to inform the development of clinical trial endpoints are summarized in this review. Pediatr Pulmonol. © 2014 The Authors. Pediatric Pulmonology published by Wiley Periodicals, Inc. PMID:25641878

  8. Outcome Measures in Total Joint Arthroplasty: Current Status, Challenges, and Future Directions.

    PubMed

    Halawi, Mohamad J

    2015-08-01

    Total joint arthroplasty (TJA) is the most commonly performed surgical procedure for the treatment of advanced degenerative joint diseases. Numerous outcome measures for TJA have been developed, which can be reported by physicians, patients, or both. Although outcome tools were traditionally centered on morbidity, mortality, and implant survival, the focus has evolved over recent years to joint-specific, disease-specific, activity-specific, general well-being, and quality of life assessments. However, despite the importance of outcome measures in a time of growing demand for TJA and increased government scrutiny fueled by high implant costs, there remains no "gold standard" method to assess the impact of TJA. The aim of this review is to evaluate the currently available literature on outcome measures in joint arthroplasty, highlighting the strengths and limitations of commonly used instruments. Because outcomes are influenced by a multitude of intangible factors, there is an increasing role for assessing patient satisfaction as a simple way to account for the complex aspects of care. Strategies including proper patient selection and establishing realistic expectations preoperatively are critical to optimizing outcomes. In an era of increasing public scrutiny, the current state of conflicting results and variable correlations among outcome measures implores the need for a standardized system that should incorporate a metric for patient satisfaction adjusted for preoperative expectations. PMID:26270754

  9. Do clinical outcome measures assess consumer-defined recovery?

    PubMed

    Andresen, Retta; Caputi, Peter; Oades, Lindsay G

    2010-05-30

    There is an international call for mental health services to become recovery-oriented, and also to use evidence-based practices. Addressing this call requires recovery-oriented measurement of outcomes and service evaluation. Mental health consumers view recovery as leading as meaningful life, and have criticised traditional clinical measures for being too disability-oriented. This study compares three measures of consumer-defined recovery from enduring mental illness: the Recovery Assessment Scale, the Mental Health Recovery Measure and the Self-Identified Stage of Recovery, with four conventional clinical measures. Correlational analyses supported the convergent validity of the recovery measures, although certain subscales were unrelated to each other. More importantly, little relationship was found between consumer-defined recovery and the clinical measures. Analyses of variance revealed that scores on the recovery measures increased across self-identified stage of recovery, but scores on most clinical measures did not improve consistently across stage of recovery. The findings demonstrate the qualitative difference between the two types of measures, supporting the claim by consumers that clinical measures do not assess important aspects of recovery. There is a need for further research and refinement of recovery measurement, including assessment of stages of recovery, with the aim of including such measures as an adjunct in routine clinical assessment, service evaluation and research. PMID:20227768

  10. Reported Outcome Measures in Degenerative Cervical Myelopathy: A Systematic Review

    PubMed Central

    McHugh, Maire; Elgheriani, Ali; Kolias, Angelos G.; Tetreault, Lindsay A.; Hutchinson, Peter J. A.; Fehlings, Michael G.; Kotter, Mark R. N.

    2016-01-01

    Objective Degenerative cervical myelopathy [DCM] is a disabling and increasingly prevalent group of diseases. Heterogeneous reporting of trial outcomes limits effective inter-study comparison and optimisation of treatment. This is recognised in many fields of healthcare research. The present study aims to assess the heterogeneity of outcome reporting in DCM as the premise for the development of a standardised reporting set. Methods A systematic review of MEDLINE and EMBASE databases, registered with PROSPERO (CRD42015025497) was conducted in accordance with PRISMA guidelines. Full text articles in English, with >50 patients (prospective) or >200 patients (retrospective), reporting outcomes of DCM were eligible. Results 108 studies, assessing 23,876 patients, conducted world-wide, were identified. Reported outcome themes included function (reported by 97, 90% of studies), complications (reported by 56, 52% of studies), quality of life (reported by 31, 29% of studies), pain (reported by 29, 27% of studies) and imaging (reported by 59, 55% of studies). Only 7 (6%) studies considered all of domains in a single publication. All domains showed variability in reporting. Conclusions Significant heterogeneity exists in the reporting of outcomes in DCM. The development of a consensus minimum dataset will facilitate future research synthesis. PMID:27482710

  11. Outcome-Driven Thresholds for Home Blood Pressure Measurement

    PubMed Central

    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

    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

  12. A Preliminary Examination of a General Social Outcome Measure

    ERIC Educational Resources Information Center

    Stichter, Janine Peck; Herzog, Melissa J.; O'Connor, Karen V.; Schmidt, Carla

    2012-01-01

    Individuals with Pervasive Developmental Disorders (PDD) have social competence impairments that can result in negative adult outcomes. Despite considerable research on social skills training, little is available to evaluate these programs. This study describes the development, administration, and utility of a progress-monitoring tool for…

  13. Creating an Assistive Technology Outcomes Measurement System: Validating the Components

    ERIC Educational Resources Information Center

    Edyburn, Dave L.; Smith, Roger O.

    2004-01-01

    The topic of assistive technology (AT) outcomes has only recently received attention in the professional literature. As a result, there is a considerable void in the profession's ability to address contemporary questions about the value and use of AT. The purpose of this article is to highlight the theory, development, and research efforts of the…

  14. Outcome Measures of Triple Board Graduates, 1991-2003

    ERIC Educational Resources Information Center

    Warren, Marla J.; Dunn, David W.; Rushton, Jerry

    2006-01-01

    Objective: To describe program outcomes for the Combined Training Program in Child and Adolescent Psychiatry, Pediatrics, and Psychiatry (Triple Board Program). Method: All Triple Board Program graduates to date (1991-2003) were asked to participate in a 37-item written survey from February to April 2004. Results: The response rate was 80.7%. Most…

  15. Direct anterior total hip arthroplasty: Comparative outcomes and contemporary results

    PubMed Central

    Connolly, Keith P; Kamath, Atul F

    2016-01-01

    Direct anterior total hip arthroplasty has become increasingly more popular among arthroplasty surgeons, in large part due to the use of an intramuscular interval and desire to reduce soft tissue damage. Several studies have now been published comparing the anterior intramuscular to other commonly used approaches, and many studies have published complication rates on large series of patients. Review of comparative studies indicates direct anterior hips tend towards shorter hospital stays and high rates of patients discharged to home. Although some studies show evidence of early benefit in functional outcomes, there is no strong evidence that the anterior approach provides any long term functional improvements compared to other approaches. Additionally, evidence to support reduced damage to soft tissue may not translate to certain clinical significance. Rates of intra-operative femur fracture, operative time and blood loss rates are notably higher for those developing familiarity with this approach. However, when surgeons have performed a modest number of procedures, the complication rates tend to markedly decrease in most studies to levels comparable to other approaches. Accuracy of component positioning also favors the anterior approach in some studies. This review summarizes the available literature comparing the direct anterior to other approaches for total hip arthroplasty and provides a comprehensive summary of common complications. PMID:26925380

  16. Recent results from COMPASS muon scattering measurements

    SciTech Connect

    Capozza, Luigi [Irfu Collaboration: COMPASS Collaboration

    2012-10-23

    A sample of recent results in muon scattering measurements from the COMPASS experiment at CERN will be reviewed. These include high energy processes with longitudinally polarised proton and deuteron targets. High energy polarised measurements provide important constraints for studying the nucleon spin structure and thus permit to test the applicability of the theoretical framework of factorisation theorems and perturbative QCD. Specifically, latest results on longitudinal quark polarisation, quark helicity densities and gluon polarisation will be reviewed.

  17. Streptococcus Endophthalmitis Outbreak after Intravitreal Injection of Bevacizumab: One-year Outcomes and Investigative Results

    PubMed Central

    Goldberg, Roger A.; Flynn, Harry W.; Miller, Darlene; Gonzalez, Serafin; Isom, Ryan F.

    2013-01-01

    Purpose To report the one-year clinical outcomes of an outbreak of Streptococcus endophthalmitis after intravitreal injection of bevacizumab, including visual acuity outcomes, microbiological testing and compound pharmacy investigations by the Food and Drug Administration (FDA). Design Retrospective consecutive case series. Participants 12 eyes of 12 patients who developed endophthalmitis after receiving intravitreal bevacizumab prepared by a single compounding pharmacy. Methods Medical records of patients were reviewed; phenotypic and DNA analyses were performed on microbes cultured from patients and from unused syringes. An inspection report by the FDA based on site-visits to the pharmacy that prepared the bevacizumab syringes was summarized. Main Outcome Measures Visual acuity, interventions received, time-to-intervention; microbiological consistency; FDA inspection findings. Results Between July 5 and July 8, 2011, 12 patients developed endophthalmitis after intravitreal bevacizumab from syringes prepared by a single compounding pharmacy. All patients received initial vitreous tap and injection, and eight (67%) subsequently underwent pars plana vitrectomy (PPV). After twelve months follow-up, outcomes have been poor: 7 patients (58%) required evisceration or enucleation, and only one patient regained pre-injection visual acuity. Molecular testing using real time polymerase chain reaction, partial sequencing of the groEL gene, and multilocus sequencing of 7 housekeeping genes confirmed the presence of a common strain of Streptococcus mitis/oralis in vitreous specimens and seven unused syringes prepared by the compounding pharmacy at the same time. An FDA investigation of the compounding pharmacy noted deviations from standard sterile technique, inconsistent documentation, and inadequate testing of equipment required for safe preparation of medications. Conclusions In this outbreak of endophthalmitis, outcomes have been generally poor and PPV did not improve

  18. Postsecondary Education Outcome Measures and Procedures: A Sourcebook for Administrative Research.

    ERIC Educational Resources Information Center

    Lenning, Oscar T.; And Others

    A guide to acquiring information needed about postsecondary education outcomes is presented for campus and state-level officials. Attention is directed to: over 200 outcome measures or indicators; standard definitions of each outcome measure; data sources and procedures to acquire data for each outcome measure; and suggestions concerning the…

  19. Mathematics Placement Test: Typical Results with Unexpected Outcomes

    ERIC Educational Resources Information Center

    Ingalls, Victoria

    2011-01-01

    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…

  20. Cognitive and academic outcomes after pediatric liver transplantation: Functional Outcomes Group (FOG) results.

    PubMed

    Sorensen, L G; Neighbors, K; Martz, K; Zelko, F; Bucuvalas, J C; Alonso, E M

    2011-02-01

    This multicenter study examined prevalence of cognitive and academic delays in children following liver transplant (LT). One hundred and forty-four patients ages 5-7 and 2 years post-LT were recruited through the SPLIT consortium and administered the Wechsler Preschool and Primary Scale of Intelligence, 3rd Edition (WPPSI-III), the Bracken Basic Concept Scale, Revised (BBCS-R), and the Wide Range Achievement Test, 4th edition (WRAT-4). Parents and teachers completed the Behavior Rating Inventory of Executive Function (BRIEF). Participants performed significantly below test norms on intelligence quotient (IQ) and achievement measures (Mean WPPSI-III Full Scale IQ = 94.7 ± 13.5; WRAT-4 Reading = 92.7 ± 17.2; WRAT-4 Math = 93.1 ± 15.4; p < 0001). Twenty-six percent of patients (14% expected) had 'mild to moderate' IQ delays (Full Scale IQ = 71-85) and 4% (2% expected) had 'serious' delays (Full Scale IQ ≤ 70; p < 0.0001). Reading and/or math scores were weaker than IQ in 25%, suggesting learning disability, compared to 7% expected by CDC statistics (p < 0.0001). Executive deficits were noted on the BRIEF, especially by teacher report (Global Executive Composite = 58; p < 0.001). Results suggest a higher prevalence of cognitive and academic delays and learning problems in pediatric LT recipients compared to the normal population. PMID:21272236

  1. Cognitive and Academic Outcomes after Pediatric Liver Transplantation: Functional Outcomes Group (FOG) Results

    PubMed Central

    Sorensen, L.G.; Neighbors, K.; Martz, K.; Zelko, F.; Bucuvalas, J.C.; Alonso, E.M.

    2010-01-01

    This multi-center study examined prevalence of cognitive and academic delays in children following liver transplant (LT). 144 patients ages 5–7 and 2 years post-LT were recruited through the SPLIT consortium and administered the Wechsler Preschool and Primary Scale of Intelligence, 3rd Edition (WPPSI-III), the Bracken Basic Concept Scale, Revised (BBCS-R), and the Wide Range Achievement Test, 4th edition (WRAT-4). Parents and teachers completed the Behavior Rating Inventory of Executive Function (BRIEF). Participants performed significantly below test norms on intelligence quotient (IQ) and achievement measures (Mean WPPSI-III Full Scale IQ = 94.7± 13.5; WRAT-4 Reading = 92.7± 17.2; WRAT-4 Math = 93.1± 15.4; p<0001). 26% of patients (14% expected) had “mild to moderate” IQ delays (Full Scale IQ=71–85) and 4% (2% expected) had “serious” delays (Full Scale IQ ≤70; p<0.0001). Reading and/or math scores were weaker than IQ in 25%, suggesting learning disability, compared to 7% expected by CDC(1) statistics (p<0.0001). Executive deficits were noted on the BRIEF, especially by teacher report (Global Executive Composite = 58; p<0.001). Results suggest a higher prevalence of cognitive and academic delays and learning problems in pediatric LT recipients compared to the normal population. PMID:21272236

  2. Unconditionally secure bit commitment by transmitting measurement outcomes.

    PubMed

    Kent, Adrian

    2012-09-28

    We propose a new unconditionally secure bit commitment scheme based on Minkowski causality and the properties of quantum information. The receiving party sends a number of randomly chosen Bennett-Brassard 1984 (BB84) qubits to the committer at a given point in space-time. The committer carries out measurements in one of the two BB84 bases, depending on the committed bit value, and transmits the outcomes securely at (or near) light speed in opposite directions to remote agents. These agents unveil the bit by returning the outcomes to adjacent agents of the receiver. The protocol's security relies only on simple properties of quantum information and the impossibility of superluminal signalling. PMID:23030073

  3. Patient-reported outcome measures in arthroplasty registries.

    PubMed

    Rolfson, Ola; Eresian Chenok, Kate; Bohm, Eric; Lübbeke, Anne; Denissen, Geke; Dunn, Jennifer; Lyman, Stephen; Franklin, Patricia; Dunbar, Michael; Overgaard, Søren; Garellick, Göran; Dawson, Jill

    2016-07-01

    The International Society of Arthroplasty Registries (ISAR) Steering Committee established the Patient-Reported Outcome Measures (PROMs) Working Group to convene, evaluate, and advise on best practices in the selection, administration, and interpretation of PROMs and to support the adoption and use of PROMs for hip and knee arthroplasty in registries worldwide. The 2 main types of PROMs include generic (general health) PROMs, which provide a measure of general health for any health state, and specific PROMs, which focus on specific symptoms, diseases, organs, body regions, or body functions. The establishment of a PROM instrument requires the fulfillment of methodological standards and rigorous testing to ensure that it is valid, reliable, responsive, and acceptable to the intended population. A survey of the 41 ISAR member registries showed that 8 registries administered a PROMs program that covered all elective hip or knee arthroplasty patients and 6 registries collected PROMs for sample populations; 1 other registry had planned but had not started collection of PROMs. The most common generic instruments used were the EuroQol 5 dimension health outcome survey (EQ-5D) and the Short Form 12 health survey (SF-12) or the similar Veterans RAND 12-item health survey (VR-12). The most common specific PROMs were the Hip disability and Osteoarthritis Outcome Score (HOOS), the Knee injury and Osteoarthritis Outcome Score (KOOS), the Oxford Hip Score (OHS), the Oxford Knee Score (OKS), the Western Ontario and McMaster Universities Arthritis Index (WOMAC), and the University of California at Los Angeles Activity Score (UCLA). PMID:27168175

  4. Health outcomes in diabetics measured with Minnesota Community Measurement quality metrics

    PubMed Central

    Takahashi, Paul Y; St Sauver, Jennifer L; Finney Rutten, Lila J; Jacobson, Robert M; Jacobson, Debra J; McGree, Michaela E; Ebbert, Jon O

    2015-01-01

    Objective Our objective was to understand the relationship between optimal diabetes control, as defined by Minnesota Community Measurement (MCM), and adverse health outcomes including emergency department (ED) visits, hospitalizations, 30-day rehospitalization, intensive care unit (ICU) stay, and mortality. Patients and methods In 2009, we conducted a retrospective cohort study of empaneled Employee and Community Health patients with diabetes mellitus. We followed patients from 1 September 2009 until 30 June 2011 for hospitalization and until 5 January 2014 for mortality. Optimal control of diabetes mellitus was defined as achieving the following three measures: low-density lipoprotein (LDL) cholesterol <100 mg/mL, blood pressure <140/90 mmHg, and hemoglobin A1c <8%. Using the electronic medical record, we assessed hospitalizations, ED visits, ICU stays, 30-day rehospitalizations, and mortality. The chi-square or Wilcoxon rank-sum tests were used to compare those with and without optimal control. We used Cox proportional hazard models to estimate the associations between optimal diabetes mellitus status and each outcome. Results We identified 5,731 empaneled patients with diabetes mellitus; 2,842 (49.6%) were in the optimal control category. After adjustment, we observed that non-optimally controlled patients had higher risks for hospitalization (hazard ratio [HR] 1.11; 95% confidence interval [CI] 1.00–1.23), ED visits (HR 1.15; 95% CI 1.06–1.25), and mortality (HR 1.29; 95% CI 1.09–1.53) than diabetic patients with optimal control. No differences were observed in ICU stay or 30-day rehospitalization. Conclusion Diabetic patients without optimal control had higher risks of adverse health outcomes than those with optimal control. Patients with optimal control defined by the MCM were associated with decreased morbidity and mortality. PMID:25565873

  5. Measuring Outcomes for Young Children and Their Families. Outcome Indicators for Everyday Kids, Everyday Lives: A Vision for Pennsylvania's Children

    ERIC Educational Resources Information Center

    Trivette, Carol M.; Dunst, Carl J.

    2011-01-01

    This monograph includes the final report for a project funded by the Pennsylvania Developmental Disabilities Council for "Measuring Outcomes for Children" (2008 RFP). The goal of the project was to "develop and demonstrate the effectiveness of an instrument designed to measure life outcomes of children with disabilities being…

  6. Outcome measures in MMN revisited: further improvement needed.

    PubMed

    Pruppers, Mariëlle H J; Draak, Thomas H P; Vanhoutte, Els K; Van der Pol, W-Ludo; Gorson, Kenneth C; Léger, Jean-Marc; Nobile-Orazio, Eduardo; Lewis, Richard A; van den Berg, Leonard H; Faber, Catharina G; Merkies, Ingemar S J

    2015-09-01

    The objectives of this study were to provide an overview of the outcome measures (OMs) applied in clinical trials in multifocal motor neuropathy (MMN) and to determine the responsiveness of a core set of selected OMs as part of the peripheral neuropathy outcome measures standardization (PeriNomS) study. The following OMs were serially applied in 26 patients with newly diagnosed or relapsing MMN, receiving intravenous immunoglobulin (assessments: T0/T3/T12 months): 14 muscle pairs MRC (Medical Research Council) scale, the Neuropathy Impairment Scale motor-subset, a self-evaluation scale, grip strength, and MMN-RODS© (Rasch-built overall disability scale). All data, except the grip strength, were subjected to Rasch analyses before determining responsiveness. For grip strength, responsiveness was examined using a combined anchor- (SF-36 question-2) and distribution-based (½ × SD) minimum clinically important difference (MCID) techniques, determining the proportion of patients exceeding both the identified cut-offs. For the remaining scales, the magnitude of change for each patient on each scale was determined using the MCID related to the individual SE (responder definition: MCID-SE ≥ 1.96). Overall, a great assortment of measures has been used in MMN trials with different responsiveness definitions. For the selected OMs, responsiveness was poor and only seen in one fourth to one third of the patients, the grip strength being more responsive. Despite the efforts taken to standardize outcome assessment, further clinimetric responsiveness studies are needed in MMN. PMID:26115442

  7. Learning disability and epilepsy. 1, towards common outcome measures.

    PubMed

    Kerr, M P; Espie, C A

    1997-10-01

    A major component of the population of people who have epilepsy are people with a learning disability. As a group, such individuals often have complex epilepsy which is refractory to treatment. Current available measures to assess the outcomes of therapeutic interventions in epilepsy are based on seizure frequency, seizure severity and quality-of-life measures, but have not been validated in people with a learning disability. Thus, we do not know if such measures of outcome serve the needs of this group. This review examines how able we are to assess the efficacy of our interventions to control epilepsy in people with learning disability. It is suggested that a standard data set is necessary as the basis of the assessment of any therapeutic intervention. Central components of this data set would encompass a definition of important characteristics of an individual, a description of their epilepsy and an assessment of the impact of their condition on both their own and their carer's health. The approach to obtaining this information should employ a methodology which can allow for environmental influences. PMID:9663796

  8. How measurement artifacts affect cerebral autoregulation outcomes: A technical note on transfer function analysis.

    PubMed

    Meel-van den Abeelen, Aisha S S; de Jong, Daan L K; Lagro, Joep; Panerai, Ronney B; Claassen, Jurgen A H R

    2016-05-01

    Cerebral autoregulation (CA) is the mechanism that aims to maintain adequate cerebral perfusion during changes in blood pressure (BP). Transfer function analysis (TFA), the most reported method in literature to quantify CA, shows large between-study variability in outcomes. The aim of this study is to investigate the role of measurement artifacts in this variation. Specifically, the role of distortion in the BP and/or CBFV measurementon TFA outcomes was investigated. The influence of three types of artifacts on TFA outcomes was studied: loss of signal, motion artifacts, and baseline drifts. TFA metrics of signals without the simulated artifacts were compared with those of signals with artifacts. TFA outcomes scattered highly when more than 10% of BP signal or over 8% of the CBFV signal was lost, or when measurements contained one or more artifacts resulting from head movement. Furthermore, baseline drift affected interpretation of TFA outcomes when the power in the BP signal was 5 times the power in the LF band. In conclusion, loss of signal in BP and loss in CBFV, affects interpretation of TFA outcomes. Therefore, it is vital to validate signal quality to the defined standards before interpreting TFA outcomes. PMID:26935320

  9. Patient-reported outcome measures in inflammatory bowel disease

    PubMed Central

    El-Matary, Wael

    2014-01-01

    Patient-reported outcome measures (PROMs) are increasingly used in both research and clinical health settings. With the recent development of United States Food and Drug Administration guidance on PROMs, more attention is being devoted to their role and importance in health care. Several methodological challenges in the development, validation and implementation of PROMs must be resolved to ensure their appropriate utilization and interpretation. The present review discusses recent developments and updates in PROMs, with specific focus on the area of inflammatory bowel disease. PMID:25390615

  10. Demystifying Results-Based Performance Measurement.

    ERIC Educational Resources Information Center

    Jorjani, Hamid

    Many evaluators are convinced that Results-based Performance Measurement (RBPM) is an effective tool to improve service delivery and cost effectiveness in both public and private sectors. Successful RBPM requires self-directed and cross-functional work teams and the supporting infrastructure to make it work. There are many misconceptions and…

  11. Longitudinal evaluation of patient-reported outcomes measurement information systems measures in pediatric chronic pain.

    PubMed

    Kashikar-Zuck, Susmita; Carle, Adam; Barnett, Kimberly; Goldschneider, Kenneth R; Sherry, David D; Mara, Constance A; Cunningham, Natoshia; Farrell, Jennifer; Tress, Jenna; DeWitt, Esi Morgan

    2016-02-01

    The Patient-Reported Outcomes Measurement Information System (PROMIS) initiative is a comprehensive strategy by the National Institutes of Health to support the development and validation of precise instruments to assess self-reported health domains across healthy and disease-specific populations. Much progress has been made in instrument development, but there remains a gap in the validation of PROMIS measures for pediatric chronic pain. The purpose of this study was to investigate the construct validity and responsiveness to change of 7 PROMIS domains for the assessment of children (ages: 8-18) with chronic pain--Pain Interference, Fatigue, Anxiety, Depression, Mobility, Upper Extremity Function, and Peer Relationships. The PROMIS measures were administered at the initial visit and 2 follow-up visits at an outpatient chronic pain clinic (CPC; N = 82) and at an intensive amplified musculoskeletal pain day-treatment program (N = 63). Aim 1 examined construct validity of PROMIS measures by comparing them with corresponding "legacy" measures administered as part of usual care in the CPC sample. Aim 2 examined sensitivity to change in both CPC and amplified musculoskeletal pain samples. Longitudinal growth models showed that PROMIS' Pain Interference, Anxiety, Depression, Mobility, Upper Extremity, and Peer Relationship measures and legacy instruments generally performed similarly with slightly steeper slopes of improvement in legacy measures. All 7 PROMIS domains showed responsiveness to change. Results offered initial support for the validity of PROMIS measures in pediatric chronic pain. Further validation with larger and more diverse pediatric pain samples and additional legacy measures would broaden the scope of use of PROMIS in clinical research. PMID:26447704

  12. Recent results from tokamak divertor plasma measurements

    SciTech Connect

    Allen, S.L.

    1996-05-01

    New diagnostics have been developed to address key divertor physics questions, including: target plate heat flux reduction by radiation, basic edge transport issues, and plasma wall interactions (PWI) such as erosion. A system of diagnostics measures the target plate heat flux (imaging IR thermography) and particle flux (probes, pressure and Penning gauges, and visible emission arrays). Recently, T{sub e},n{sub e}, and P{sub e} (electron pressure) have been measured in 2-D with divertor Thomson Scattering. During radiative divertor operation T{sub e} is less than 2 eV, indicating that new atomic processes are important. Langmuir probes measure higher T{sub e} in some cases. In addition, the measured P{sub e} near the separatrix at the target plate is lower than the midplane pressure, implying radial momentum transport. Bolometer arrays, inverted with reconstruction algorithms, provide the 2-D core and divertor radiation profiles. Spectroscopic measurements identify the radiating species and provide information on impurity transport; both absolute chordal measurements and tomographic reconstructions of images are used. Either intrinsic carbon or an inert species (e.g., injected Ne) are usually observed, and absolute particle inventories are obtained. Computer codes are both benchmarked with the experimental data and provide important consistency checks. Several techniques are used to measure fundamental plasma transport and fluctuations, including probes and reflectometry. PWI issues are studied with in-situ coupons and insertable samples (DiMES). Representative divertor results from DIII-D with references to results on other tokamaks will be presented.

  13. Intelligent outcome measures in liaison psychiatry: essential even if not desirable

    PubMed Central

    Tadros, George

    2016-01-01

    Service development is guided by outcome measures that inform service commissioners and providers. Those in liaison psychiatry should be encouraged to develop a positive approach that integrates the collection of outcome measures into everyday clinical practice. The Framework for Routine Outcome Measurement in Liaison Psychiatry (FROM-LP) is a very useful tool to measure service quality and clinical effectiveness, using a combination of clinician-rated and patient-rated outcome measures and patient-rated experience measures. However, it does not include measures of cost-effectiveness or training activities. The FROM-LP is a significant step towards developing nationally unified outcome measures. PMID:27512588

  14. Connecting Stuttering Management and Measurement: I. Core Speech Measures of Clinical Process and Outcome

    ERIC Educational Resources Information Center

    Shenker, Rosalee C.

    2006-01-01

    Background: There will always be a place for stuttering treatments designed to eliminate or reduce stuttered speech. When those treatments are required, direct speech measures of treatment process and outcome are needed in clinical practice. Aims: Based on the contents of published clinical trials of such treatments, three "core" measures of…

  15. Selecting Rehabilitation Outcome Measures for People with Multiple Sclerosis

    PubMed Central

    Potter, Kirsten; Allen, Diane D.; Bennett, Susan E.; Brandfass, Kathi G.; Widener, Gail L.; Yorke, Amy M.

    2015-01-01

    Despite the well-known benefits of using standardized outcome measures (OMs) in clinical practice, a variety of barriers interfere with their use. In particular, rehabilitation therapists lack sufficient knowledge in selecting appropriate OMs. The challenge is compounded when working with people with multiple sclerosis (MS) owing to heterogeneity of the patient population and symptom variability in individual patients. To help overcome these barriers, the American Physical Therapy Association appointed the Multiple Sclerosis Outcome Measures Task Force to review and make evidence-based recommendations for OM use in clinical practice, education, and research specific to people with MS. Sixty-three OMs were reviewed based on their clinical utility, psychometric properties, and a consensus evaluation of the appropriateness of use for people with MS. We sought to illustrate use of the recommendations for two cases. The first case involves a 43-year-old man with new-onset problems after an exacerbation. The second case pertains to an outpatient clinic interested in assessing the effectiveness of their MS rehabilitation program. For each case, clinicians identified areas that were important to assess and various factors deemed important for OM selection. Criteria were established and used to assist in OM selection. In both cases, the described processes narrowed the selection of OMs and assisted with choosing the most appropriate ones. The recommendations, in addition to the processes described in these two cases, can be used by clinicians in any setting working with patients with MS across the disability spectrum. PMID:26300704

  16. Goal Attainment Scaling. A responsive measure of client outcomes.

    PubMed

    Forbes, D A

    1998-12-01

    Goal Attainment Scaling (GAS) was developed by Kiresuk and Sherman in 1968. Although highly criticized in the early years of its conception, GAS is beginning to be recognized as a reliable, valid, and responsive outcome measurement approach. This article describes the application of GAS, using elderly home health care clients as an example. Reliability and validity issues are examined. Criticism of GAS is often based on traditional psychometric assumptions associated with normative assessment and does not reflect the evaluative nature of the GAS methodology. The advantages and limitations of GAS are discussed. Goal Attainment Scaling has the potential to demonstrate the important contribution home health care programs make to clients by measuring the change that has occurred during their admission to the program. This kind of information is required by policy makers, case managers, and home health care providers to develop policy, allocate limited resources, and offer appropriate and effective services. PMID:10025309

  17. Measuring the Outcome of Biomedical Research: A Systematic Literature Review

    PubMed Central

    Thonon, Frédérique; Boulkedid, Rym; Delory, Tristan; Rousseau, Sophie; Saghatchian, Mahasti; van Harten, Wim; O’Neill, Claire; Alberti, Corinne

    2015-01-01

    Background There is an increasing need to evaluate the production and impact of medical research produced by institutions. Many indicators exist, yet we do not have enough information about their relevance. The objective of this systematic review was (1) to identify all the indicators that could be used to measure the output and outcome of medical research carried out in institutions and (2) enlist their methodology, use, positive and negative points. Methodology We have searched 3 databases (Pubmed, Scopus, Web of Science) using the following keywords: [Research outcome* OR research output* OR bibliometric* OR scientometric* OR scientific production] AND [indicator* OR index* OR evaluation OR metrics]. We included articles presenting, discussing or evaluating indicators measuring the scientific production of an institution. The search was conducted by two independent authors using a standardised data extraction form. For each indicator we extracted its definition, calculation, its rationale and its positive and negative points. In order to reduce bias, data extraction and analysis was performed by two independent authors. Findings We included 76 articles. A total of 57 indicators were identified. We have classified those indicators into 6 categories: 9 indicators of research activity, 24 indicators of scientific production and impact, 5 indicators of collaboration, 7 indicators of industrial production, 4 indicators of dissemination, 8 indicators of health service impact. The most widely discussed and described is the h-index with 31 articles discussing it. Discussion The majority of indicators found are bibliometric indicators of scientific production and impact. Several indicators have been developed to improve the h-index. This indicator has also inspired the creation of two indicators to measure industrial production and collaboration. Several articles propose indicators measuring research impact without detailing a methodology for calculating them. Many

  18. Entanglement-assisted guessing of complementary measurement outcomes

    NASA Astrophysics Data System (ADS)

    Berta, Mario; Coles, Patrick J.; Wehner, Stephanie

    2014-12-01

    Heisenberg's uncertainty principle implies that if one party (Alice) prepares a system and randomly measures one of two incompatible observables, then another party (Bob) cannot perfectly predict the measurement outcomes. This implication assumes that Bob does not possess an additional system that is entangled to the measured one; indeed, the seminal paper of Einstein, Podolsky, and Rosen (EPR) showed that maximal entanglement allows Bob to perfectly win this guessing game. Although not in contradiction, the observations made by EPR and Heisenberg illustrate two extreme cases of the interplay between entanglement and uncertainty. On the one hand, no entanglement means that Bob's predictions must display some uncertainty. Yet on the other hand, maximal entanglement means that there is no more uncertainty at all. Here we follow an operational approach and give an exact relation—an equality—between the amount of uncertainty as measured by the guessing probability and the amount of entanglement as measured by the recoverable entanglement fidelity. From this equality, we deduce a simple criterion for witnessing bipartite entanglement and an entanglement monogamy equality.

  19. Results.

    ERIC Educational Resources Information Center

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

    2001-01-01

    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)

  20. Preliminary results of radiation measurements on EURECA

    NASA Technical Reports Server (NTRS)

    Benton, E. V.; Frank, A. L.

    1995-01-01

    The eleven-month duration of the EURECA mission allows long-term radiation effects to be studied similarly to those of the Long Duration Exposure Facility (LDEF). Basic data can be generated for projections to crew doses and electronic and computer reliability on spacecraft missions. A radiation experiment has been designed for EURECA which uses passive integrating detectors to measure average radiation levels. The components include a Trackoscope, which employs fourteen plastic nuclear track detector (PNTD) stacks to measure the angular dependence of high LET (greater than or equal to 6 keV/micro m) radiation. Also included are TLD's for total absorbed doses, thermal/resonance neutron detectors (TRND's) for low energy neutron fluences and a thick PNTD stack for depth dependence measurements. LET spectra are derived from the PNTD measurements. Preliminary TLD results from seven levels within the detector array show that integrated does inside the flight canister varied from 18.8 +/- 0.6 cGy to 38.9 +/- 1.2 cGy. The TLD's oriented toward the least shielded direction averaged 53% higher in dose than those oriented away from the least shielded direction (minimum shielding toward the least shielded direction varied from 1.13 to 7.9 g/cm(exp 2), Al equivalent). The maximum dose rate on EURECA (1.16 mGy/day) was 37% of the maximum measured on LDEF and dose rates at all depths were less than measured on LDEF. The shielding external to the flight canister covered a greater solid angle about the canister than the LDEF experiments.

  1. Preliminary results of radiation measurements on EURECA

    NASA Technical Reports Server (NTRS)

    Benton, E. V.; Frank, A. L.

    1995-01-01

    The eleven-month duration of the EURECA mission allows long term radiation effects to be studied similarly to those of the Long Duration Exposure Facility (LDEF). Basic data can be generated for projections of crew doses and electronic and computer reliability on spacecraft missions. A radiation experiment has been designed for EURECA which uses passive integrating detectors to measure average radiation levels. The components include a Trackoscope, which employs fourteen plastic nuclear track detector (PNTD) stacks to measure the angular dependence of LET (greater than or equal to 6 keV/microns) radiation. Also included are TLD's for total absorbed doses, thermal/resonance neutron detectors (TRND's) for low energy neutron fluences and a thick PNTD stack for depth dependence measurements. LET spectra are derived from the PNTD measurements. Preliminary TLD results from seven levels within the detector array show that integrated doses inside the flight canister varied from 18.8 plus or minus 0.6 cGy to 38.9 plus or minus 1.2 cGy. The TLD's oriented toward the least shielded direction averaged 53 percent higher in dose than those oriented away from the least shielded direction (minimum shielding toward the least shielded direction varied from 1.13 to 7.9 g/cm(exp 2), Al equivalent). The maximum dose rate on EURECA (1.16 mGy/day) was 37 percent of the maximum measured on LDEF and dose rates at all depths were less than measured on LDEF. The shielding external to the flight canister covered a greater solid angle about the canister than in the LDEF experiments.

  2. Measuring Stress Before and During Pregnancy: A Review of Population-Based Studies of Obstetric Outcomes

    PubMed Central

    Witt, Whitney; Litzelman, Kristin; Cheng, Erika R; Wakeel, Fathima; Barker, Emily S.

    2013-01-01

    Objectives Mounting evidence from clinic and convenience samples suggests that stress is an important predictor of adverse obstetric outcomes. Using a proposed theoretical framework, this review identified and synthesized the population-based literature on the measurement of stress prior to and during pregnancy in relation to obstetric outcomes. Methods Population-based, peer-reviewed empirical articles that examined stress prior to or during pregnancy in relation to obstetric outcomes were identified in the PubMed and PsycInfo databases. Articles were evaluated to determine the domain(s) of stress (environmental, psychological, and/or biological), period(s) of stress (preconception and/or pregnancy), and strength of the association between stress and obstetric outcomes. Results Thirteen studies were evaluated. The identified studies were all conducted in developed countries. The majority of studies examined stress only during pregnancy (n=10); three examined stress during both the preconception and pregnancy periods (n=3). Most studies examined the environmental domain (e.g., life events) only (n=9), two studies examined the psychological domain only, and two studies examined both. No study incorporated a biological measure of stress. Environmental stressors before and during pregnancy were associated with worse obstetric outcomes, although some conflicting findings exist. Conclusions Few population-based studies have examined stress before or during pregnancy in relation to obstetric outcomes. Although considerable variation exists in the measurement of stress across studies, environmental stress increased the risk for poor obstetric outcomes. Additional work using a lifecourse approach is needed to fill the existing gaps in the literature and to develop a more comprehensive understanding of the mechanisms by which stress impacts obstetric outcomes. PMID:23447085

  3. Technical Characteristics of General Outcome Measures (GOMs) in Reading for Students with Significant Cognitive Disabilities

    ERIC Educational Resources Information Center

    Wallace, Teri; Ticha, Renata; Gustafson, Kathy

    2010-01-01

    This study examined the technical characteristics of newly created general outcome measures (GOMs) in reading for students with significant cognitive disabilities. The participants were 31 students with significant cognitive disabilities, and the GOMs used produced reliable data. Early results establishing the validity of the GOMs suggest that…

  4. Development of the FOCUS (Focus on the Outcomes of Communication under Six), a Communication Outcome Measure for Preschool Children

    ERIC Educational Resources Information Center

    Thomas-Stonell, Nancy L.; Oddson, Bruce; Robertson, Bernadette; Rosenbaum, Peter L.

    2010-01-01

    Aim: Our aim was to develop an outcome measure, called Focus on the Outcomes of Communication Under Six (FOCUS), that captures real-world changes in preschool children's communication. Conceptually grounded in the World Health Organization International Classification of Functioning, Disability and Health framework, the FOCUS items were derived…

  5. The King's Outcome Scale for Childhood Head Injury and Injury Severity and Outcome Measures in Children with Traumatic Brain Injury

    ERIC Educational Resources Information Center

    Calvert, Sophie; Miller, Helen E.; Curran, Andrew; Hameed, Biju; McCarter, Renee; Edwards, Richard J.; Hunt, Linda; Sharples, Peta Mary

    2008-01-01

    The aim of this study was to relate discharge King's Outcome Scale for Childhood Head Injury (KOSCHI) category to injury severity and detailed outcome measures obtained in the first year post-traumatic brain injury (TBI). We used a prospective cohort study. Eighty-one children with TBI were studied: 29 had severe, 15 moderate, and 37 mild TBI. The…

  6. Vision and vision-related outcome measures in multiple sclerosis

    PubMed Central

    Balcer, Laura J.; Miller, David H.; Reingold, Stephen C.

    2015-01-01

    Visual impairment is a key manifestation of multiple sclerosis. Acute optic neuritis is a common, often presenting manifestation, but visual deficits and structural loss of retinal axonal and neuronal integrity can occur even without a history of optic neuritis. Interest in vision in multiple sclerosis is growing, partially in response to the development of sensitive visual function tests, structural markers such as optical coherence tomography and magnetic resonance imaging, and quality of life measures that give clinical meaning to the structure-function correlations that are unique to the afferent visual pathway. Abnormal eye movements also are common in multiple sclerosis, but quantitative assessment methods that can be applied in practice and clinical trials are not readily available. We summarize here a comprehensive literature search and the discussion at a recent international meeting of investigators involved in the development and study of visual outcomes in multiple sclerosis, which had, as its overriding goals, to review the state of the field and identify areas for future research. We review data and principles to help us understand the importance of vision as a model for outcomes assessment in clinical practice and therapeutic trials in multiple sclerosis. PMID:25433914

  7. Vision and vision-related outcome measures in multiple sclerosis.

    PubMed

    Balcer, Laura J; Miller, David H; Reingold, Stephen C; Cohen, Jeffrey A

    2015-01-01

    Visual impairment is a key manifestation of multiple sclerosis. Acute optic neuritis is a common, often presenting manifestation, but visual deficits and structural loss of retinal axonal and neuronal integrity can occur even without a history of optic neuritis. Interest in vision in multiple sclerosis is growing, partially in response to the development of sensitive visual function tests, structural markers such as optical coherence tomography and magnetic resonance imaging, and quality of life measures that give clinical meaning to the structure-function correlations that are unique to the afferent visual pathway. Abnormal eye movements also are common in multiple sclerosis, but quantitative assessment methods that can be applied in practice and clinical trials are not readily available. We summarize here a comprehensive literature search and the discussion at a recent international meeting of investigators involved in the development and study of visual outcomes in multiple sclerosis, which had, as its overriding goals, to review the state of the field and identify areas for future research. We review data and principles to help us understand the importance of vision as a model for outcomes assessment in clinical practice and therapeutic trials in multiple sclerosis. PMID:25433914

  8. Aquarius Third Stokes Parameter Measurements: Initial Results

    NASA Technical Reports Server (NTRS)

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

    2012-01-01

    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.

  9. Scale Model Thruster Acoustic Measurement Results

    NASA Technical Reports Server (NTRS)

    Kenny, R. Jeremy; Vargas, Magda B.

    2013-01-01

    Subscale rocket acoustic data is used to predict acoustic environments for full scale rockets. Over the last several years acoustic data has been collected during horizontal tests of solid rocket motors. Space Launch System (SLS) Scale Model Acoustic Test (SMAT) was designed to evaluate the acoustics of the SLS vehicle including the liquid engines and solid rocket boosters. SMAT is comprised of liquid thrusters scalable to the Space Shuttle Main engines (SSME) and Rocket Assisted Take Off (RATO) motors scalable to the 5-segment Reusable Solid Rocket Motor (RSTMV). Horizontal testing of the liquid thrusters provided an opportunity to collect acoustic data from liquid thrusters to characterize the acoustic environments. Acoustic data was collected during the horizontal firings of a single thruster and a 4-thruster (Quad) configuration. Presentation scope. Discuss the results of the single and 4-thruster acoustic measurements. Compare the measured acoustic levels of the liquid thrusters to the Solid Rocket Test Motor V - Nozzle 2 (SRTMV-N2).

  10. Exploring the Implementation and Use of Outcome Measurement in Practice: A Qualitative Study

    ERIC Educational Resources Information Center

    Skeat, J.; Perry, A.

    2008-01-01

    Background: Outcome measurement is important to clinical practice--yet outcome many speech and language therapists find it difficult to apply measures in practice, and not all clinicians and services have been able to implement and/or use outcome measurement successfully. To date there has been little research to explain why implementation is…

  11. Neighbourhood social capital: measurement issues and associations with health outcomes.

    PubMed

    Mackenbach, J D; Lakerveld, J; van Lenthe, F J; Kawachi, I; McKee, M; Rutter, H; Glonti, K; Compernolle, S; De Bourdeaudhuij, I; Feuillet, T; Oppert, J-M; Nijpels, G; Brug, J

    2016-01-01

    We compared ecometric neighbourhood scores of social capital (contextual variation) to mean neighbourhood scores (individual and contextual variation), using several health-related outcomes (i.e. self-rated health, weight status and obesity-related behaviours). Data were analysed from 5,900 participants in the European SPOTLIGHT survey. Factor analysis of the 13-item social capital scale revealed two social capital constructs: social networks and social cohesion. The associations of ecometric and mean neighbourhood-level scores of these constructs with self-rated health, weight status and obesity-related behaviours were analysed using multilevel regression analyses, adjusted for key covariates. Analyses using ecometric and mean neighbourhood scores, but not mean neighbourhood scores adjusted for individual scores, yielded similar regression coefficients. Higher levels of social network and social cohesion were not only associated with better self-rated health, lower odds of obesity and higher fruit consumption, but also with prolonged sitting and less transport-related physical activity. Only associations with transport-related physical activity and sedentary behaviours were associated with mean neighbourhood scores adjusted for individual scores. As analyses using ecometric scores generated the same results as using mean neighbourhood scores, but different results when using mean neighbourhood scores adjusted for individual scores, this suggests that the theoretical advantage of the ecometric approach (i.e. teasing out individual and contextual variation) may not be achieved in practice. The different operationalisations of social network and social cohesion were associated with several health outcomes, but the constructs that appeared to represent the contextual variation best were only associated with two of the outcomes. PMID:26879117

  12. The importance of outcome measurement in quality assurance.

    PubMed

    Bauman, M K

    1991-04-01

    Quality assurance in health care has been an evolutionary process, beginning thousands of years ago with expressions of concern about how to care for other human beings properly. Perhaps the most notable of these expressions were those recorded by Hippocrates in his discourses on medical ethics. In more recent times, we easily are able to trace the evolution of quality assurance beliefs from emphases placed first on structure, then on process, then on a combination of structure and process, to now when we see a gradual awakening to the importance of a third element, patient outcomes. Quality, in any endeavor, does not just happen. It is, rather, the result of trial and error, practice, and hard work. In short, it is the result of learning, and hand-in-hand with learning goes communicating. By taking patient outcomes into consideration, we create a feedback system, a communication process conducive to learning in that it effectively opens up the avenues joining the three elements of health care: (1) structure, (2) process, and (3) patient outcome. We live in an era of fast-paced change where time is a precious commodity; we cannot, especially in the health care industry, afford to waste it. In seeking to formulate a systematic approach to quality assurance, focusing on only one of the three components of health care identified to date would be foolish. Effective change is based on effective communication, and from years of experience, it is clear that the best approach to high quality assurance is one that takes all elements into account.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2045443

  13. Update on Outcome Measure Development for Large Vessel Vasculitis: Report from OMERACT 12

    PubMed Central

    Aydin, Sibel Zehra; Direskeneli, Haner; Sreih, Antoine; Alibaz-Oner, Fatma; Gul, Ahmet; Kamali, Sevil; Hatemi, Gulen; Kermani, Tanaz; Mackie, Sarah L.; Mahr, Alfred; Meara, Alexa; Milman, Nataliya; Nugent, Heidi; Robson, Joanna; Tomasson, Gunnar; Merkel, Peter A.

    2015-01-01

    Objective The rarity of large vessel vasculitis (LVV) is a major factor limiting randomized controlled trials in LVV, resulting in treatment choices in these diseases that are guided mainly by observational studies and expert opinion. Further complicating trials in LVV is the absence of validated and meaningful outcome measures. The Outcome Measures in Rheumatology (OMERACT) vasculitis working group initiated the Large Vessel Vasculitis task force in 2009 to develop data-driven, validated outcome tools for clinical investigation in LVV. This report summarizes the progress that has been made on a disease activity assessment tool and patient-reported outcomes in LVV as well as the group’s research agenda. Methods The OMERACT LVV task force brought an international group of investigators and patient research partners together to work collaboratively on developing outcome tools. The group initially focused on disease activity assessment tools in LVV. Following a systematic literature review, an international Delphi exercise was conducted to obtain expert opinion on principles and domains for disease assessment. The OMERACT vasculitis working group’s LVV task force is also conducting qualitative research with patients, including interviews, focus groups, and engaging patients as research partners, all to ensure that the approach to disease assessment includes measures of patients’ perspectives and that patients have input into the research agenda and process. Results The preliminary results of both the Delphi exercise and the qualitative interviews were discussed at the OMERACT 12 (2014) meeting and the completion of the analyses will produce an initial set of domains and instruments to form the basis of next steps in the research agenda. Conclusion The research agenda continues to evolve, with the ultimate goal of developing an OMERACT-endorsed core set of outcome measures for use in clinical trials of LVV. PMID:26077399

  14. Patient-reported outcome measures in arthroplasty registries

    PubMed Central

    Bohm, Eric; Franklin, Patricia; Lyman, Stephen; Denissen, Geke; Dawson, Jill; Dunn, Jennifer; Eresian Chenok, Kate; Dunbar, Michael; Overgaard, Søren; Garellick, Göran; Lübbeke, Anne

    2016-01-01

    Abstract — The International Society of Arthroplasty Registries (ISAR) Patient-Reported Outcome Measures (PROMs) Working Group have evaluated and recommended best practices in the selection, administration, and interpretation of PROMs for hip and knee arthroplasty registries. The 2 generic PROMs in common use are the Short Form health surveys (SF-36 or SF-12) and EuroQol 5-dimension (EQ-5D). The Working Group recommends that registries should choose specific PROMs that have been appropriately developed with good measurement properties for arthroplasty patients. The Working Group recommend the use of a 1-item pain question (“During the past 4 weeks, how would you describe the pain you usually have in your [right/left] [hip/knee]?”; response: none, very mild, mild, moderate, or severe) and a single-item satisfaction outcome (“How satisfied are you with your [right/left] [hip/knee] replacement?”; response: very unsatisfied, dissatisfied, neutral, satisfied, or very satisfied). Survey logistics include patient instructions, paper- and electronic-based data collection, reminders for follow-up, centralized as opposed to hospital-based follow-up, sample size, patient- or joint-specific evaluation, collection intervals, frequency of response, missing values, and factors in establishing a PROMs registry program. The Working Group recommends including age, sex, diagnosis at joint, general health status preoperatively, and joint pain and function score in case-mix adjustment models. Interpretation and statistical analysis should consider the absolute level of pain, function, and general health status as well as improvement, missing data, approaches to analysis and case-mix adjustment, minimal clinically important difference, and minimal detectable change. The Working Group recommends data collection immediately before and 1 year after surgery, a threshold of 60% for acceptable frequency of response, documentation of non-responders, and documentation of incomplete or

  15. Preliminary Results From the Champ Occultation Measurements

    NASA Astrophysics Data System (ADS)

    Hajj, G.; Dong, D.; Iijima, B.; Kuang, D.; Kursinski, R.; Mannucci, A.; Meehan, T.; Romans, L.; de la Torre Juárez, M.; Yunck, T.

    2001-05-01

    Champ collects 200-250 globally distributed GPS occultations every day providing a wealth of information on atmospheric parameters such as pressure, temperature, humidity between 0-60 km altitude and electron density above 60 km altitude. There are several aspects to the Champ occultation measurements which distinguish them from prior measurements (such as from GPS/MET, Oersted and SAC-C): (1) They are taken during solar maximum; (2) they are collected with a new generation receiver ("BlackJack") which provides high quality L1 and L2 measurements even when the DoD anti-spoofing of the GPS signal is turned on; (3) the tracking loop in the receiver is optimized to allow the occulted signal to descend very low in the atmosphere (<1km from the surface). A further distinction comes from the fact that selective availability (the dithering of the GPS clocks) was permanently turned off by DoD, therefore reducing or eliminating the need for 1-second ground measurements previously used to difference out high frequency GPS clock drifts. This talk will present results obtained at JPL from the early Champ occultation data sets, first collected in February, 2001, and will address the specific issues listed above. Specifically, we will present (a) statistics on how low in the atmosphere occultations are able to probe as a function of geographical latitudes and humidity conditions; (b) the limitations on higher altitude atmospheric retrievals (between 30-60 km) caused by the ionosphere at different local times and solar conditions, including comparisons to GPS/MET data taken during solar minimum; (c) individual and statistical comparisons of temperature and water vapor to atmospheric analyses such as NCEP and ECMWF and other data sets such as radiosondes; (d) the impact of including or excluding high rate ground data.

  16. The impact of performance incentives on child health outcomes: results from a cluster randomized controlled trial in the Philippines.

    PubMed

    Peabody, John W; Shimkhada, Riti; Quimbo, Stella; Solon, Orville; Javier, Xylee; McCulloch, Charles

    2014-08-01

    Improving clinical performance using measurement and payment incentives, including pay for performance (or P4P), has, so far, shown modest to no benefit on patient outcomes. Our objective was to assess the impact of a P4P programme on paediatric health outcomes in the Philippines. We used data from the Quality Improvement Demonstration Study. In this study, the P4P intervention, introduced in 2004, was randomly assigned to 10 community district hospitals, which were matched to 10 control sites. At all sites, physician quality was measured using Clinical Performance Vignettes (CPVs) among randomly selected physicians every 6 months over a 36-month period. In the hospitals randomized to the P4P intervention, physicians received bonus payments if they met qualifying scores on the CPV. We measured health outcomes 4-10 weeks after hospital discharge among children 5 years of age and under who had been hospitalized for diarrhoea and pneumonia (the two most common illnesses affecting this age cohort) and had been under the care of physicians participating in the study. Health outcomes data collection was done at baseline/pre-intervention and 2 years post-intervention on the following post-discharge outcomes: (1) age-adjusted wasting, (2) C-reactive protein in blood, (3) haemoglobin level and (4) parental assessment of child's health using general self-reported health (GSRH) measure. To evaluate changes in health outcomes in the control vs intervention sites over time (baseline vs post-intervention), we used a difference-in-difference logistic regression analysis, controlling for potential confounders. We found an improvement of 7 and 9 percentage points in GSRH and wasting over time (post-intervention vs baseline) in the intervention sites relative to the control sites (P ≤ 0.001). The results from this randomized social experiment indicate that the introduction of a performance-based incentive programme, which included measurement and feedback, led to improvements in

  17. Development of core outcome sets in hidradenitis suppurativa: systematic review of outcome measure instruments to inform the process.

    PubMed

    Ingram, J R; Hadjieconomou, S; Piguet, V

    2016-08-01

    The recent hidradenitis suppurativa (HS) Cochrane review identified outcome measure heterogeneity as an important issue to address when designing future HS trials. Our objective was to follow the Harmonising Outcome Measures for Eczema (HOME) roadmap, by performing a systematic review of HS outcome measure instruments to inform the development of an HS core outcome set. We performed a systematic review to identify validation evidence for outcome measure instruments used in HS randomized controlled trials (RCTs), and assessed the methodological quality of all HS outcome measure validity studies using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. The 12 RCTs included in the Cochrane review utilized 30 outcome measure instruments, including 16 physician-reported instruments, 11 patient-reported instruments and three composite measures containing elements of both. Twenty-seven (90%) of the instruments lacked any validation data. Two further instruments have been developed and partially validated. Of the seven studies meeting our inclusion criteria, six were of 'fair' or 'poor' methodological quality, in part because most of the studies were not primarily designed for instrument validation. The HiSCR instrument is supported by good-quality validation data, but there are gaps, including assessment of internal consistency, inter-rater reliability and minimal clinically important difference, and convergent validity fell below the acceptable range for some comparisons. Multiple, usually unvalidated, outcome measure instruments have been used in HS RCTs. Where validation evidence is available there are issues of low methodological quality or incomplete validity assessment and so, currently, no instruments can be fully recommended. PMID:26873867

  18. Predominant Leg Pain Is Associated With Better Surgical Outcomes in Degenerative Spondylolisthesis and Spinal Stenosis: Results from the Spine Patient Outcomes Research Trial (SPORT)

    PubMed Central

    Pearson, Adam; Blood, Emily; Lurie, Jon; Abdu, William; Sengupta, Dilip; Frymoyer, John W.; Weinstein, James

    2010-01-01

    Study Design As-treated analysis of the Spine Patient Outcomes Research Trial (SPORT). Objective To compare baseline characteristics and surgical and nonoperative outcomes in degenerative spondylolisthesis (DS) and spinal stenosis (SpS) patients stratified by predominant pain location (i.e. leg vs. back). Summary of Background Data Evidence suggests that degenerative spondylolisthesis (DS) and spinal stenosis (SpS) patients with predominant leg pain may have better surgical outcomes than patients with predominant low back pain (LBP). Methods The DS cohort included 591 patients (62% underwent surgery), and the SpS cohort included 615 patients (62% underwent surgery). Patients were classified as leg pain predominant, LBP predominant or having equal pain according to baseline pain scores. Baseline characteristics were compared between the three predominant pain location groups within each diagnostic category, and changes in surgical and nonoperative outcome scores were compared through two years. Longitudinal regression models including baseline covariates were used to control for confounders. Results Among DS patients at baseline, 34% had predominant leg pain, 26% had predominant LBP, and 40% had equal pain. Similarly, 32% of SpS patients had predominant leg pain, 26% had predominant LBP, and 42% had equal pain. DS and SpS patients with predominant leg pain had baseline scores indicative of less severe symptoms. Leg pain predominant DS and SpS patients treated surgically improved significantly more than LBP predominant patients on all primary outcome measures at one and two years. Surgical outcomes for the equal pain groups were intermediate to those of the predominant leg pain and LBP groups. The differences in nonoperative outcomes were less consistent. Conclusions Predominant leg pain patients improved significantly more with surgery than predominant LBP patients. However, predominant LBP patients still improved significantly more with surgery than with

  19. Responsiveness of outcome measures in patients with superior labral anterior and posterior lesions

    PubMed Central

    Mowinckel, Petter; Schrøder, Cecilie Piene; Liavaag, Sigurd; Reikerås, Olav; Brox, Jens Ivar

    2014-01-01

    Background Evaluation of patients with superior labral anterior and posterior (SLAP) lesions requires outcome measures validated for the purpose. The present study aimed to evaluate the responsiveness of the Rowe score, Oxford Instability Shoulder Score (OISS), Western Ontario Shoulder Instability Index (WOSI) and EuroQol (EQ-5D and EQ-VAS) in patients treated for SLAP lesions. Methods Eighty-nine patients were included: 34 had arthroscopic labral repair, 28 had mini-open biceps tenodesis and 27 had physical treatment. The outcome measures were administrated before treatment and after 6 months. Responsiveness was evaluated using standardized response mean (SRM), area under receiver-operating characteristic curve (ROCAUC), reliable chance proportion (RCP) statistics and hypothesis testing. Minimal clinically important change (MCIC) estimates were reported. Results All outcome measures had high values of SRM (0.86–1.92). RCPs for the improved group were 68% to 79% for OISS, WOSI and Rowe score, and 15% to 49% for EuroQol. ROCAUC was >0.70 for all outcomes. MCIC estimates were 8 and 10 for OISS; 451 and 569 for WOSI; 17 and 18 for Rowe score; 0.39 and 0.53 for EQ-5D; and 35 and 41 for EQ-VAS. Responsiveness tested with hypotheses favours the shoulder-specific outcomes. Conclusions OISS, WOSI and Rowe score are more responsive than EuroQol in evaluation of patients with SLAP lesions.

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

    PubMed

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

    2013-12-01

    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

  1. Systematic review of outcome measures in trials of pediatric anaphylaxis treatment

    PubMed Central

    2014-01-01

    Background Considerable heterogeneity has been observed in the selection and reporting of disease-specific pediatric outcome measures in randomized controlled trials (RCTs). This makes interpretation of results and comparison across trials challenging. Outcome measures in pediatric anaphylaxis trials have never previously been systematically assessed. This systematic review (SR) identified and assessed outcome measures used in RCTs of anaphylaxis treatment in children. As a secondary objective, this SR assessed the evidence for current treatment modalities for anaphylaxis in the pediatric population. Methods We searched MEDLINE, EMBASE, The Cochrane Library, Cochrane Central Register of Controlled Trials (CENTRAL), and CINAHL from 2001 until December 2012. We also searched websites listing ongoing trials. We included randomized and controlled trials of anaphylaxis treatment in patients 0–18 years of age. Two authors independently assessed articles for inclusion. Results No published studies fulfilled the inclusion criteria. Conclusions There is an alarming absence of RCTs evaluating the treatments for anaphylaxis in children. High quality studies are needed and are possible to design, despite the severe and acute nature of this condition. Consensus about the selection and validation of appropriate outcome measures will enhance the quality of research and improve the care of children with anaphylaxis. Trial registration CRD42012002685 PMID:24950840

  2. SAGE III solar ozone measurements: Initial results

    NASA Technical Reports Server (NTRS)

    Wang, Hsiang-Jui; Cunnold, Derek M.; Trepte, Chip; Thomason, Larry W.; Zawodny, Joseph M.

    2006-01-01

    Results from two retrieval algorithms, o3-aer and o3-mlr , used for SAGE III solar occultation ozone measurements in the stratosphere and upper troposphere are compared. The main differences between these two retrieved (version 3.0) ozone are found at altitudes above 40 km and below 15 km. Compared to correlative measurements, the SAGE II type ozone retrievals (o3-aer) provide better precisions above 40 km and do not induce artificial hemispheric differences in upper stratospheric ozone. The multiple linear regression technique (o3_mlr), however, can yield slightly more accurate ozone (by a few percent) in the lower stratosphere and upper troposphere. By using SAGE III (version 3.0) ozone from both algorithms and in their preferred regions, the agreement between SAGE III and correlative measurements is shown to be approx.5% down to 17 km. Below 17 km SAGE III ozone values are systematically higher, by 10% at 13 km, and a small hemispheric difference (a few percent) appears. Compared to SAGE III and HALOE, SAGE II ozone has the best accuracy in the lowest few kilometers of the stratosphere. Estimated precision in SAGE III ozone is about 5% or better between 20 and 40 km and approx.10% at 50 km. The precision below 20 km is difficult to evaluate because of limited coincidences between SAGE III and sondes. SAGE III ozone values are systematically slightly larger (2-3%) than those from SAGE II but the profile shapes are remarkably similar for altitudes above 15 km. There is no evidence of any relative drift or time dependent differences between these two instruments for altitudes above 15-20 km.

  3. Network measures predict neuropsychological outcome after brain injury

    PubMed Central

    Warren, David E.; Power, Jonathan D.; Bruss, Joel; Denburg, Natalie L.; Waldron, Eric J.; Sun, Haoxin; Petersen, Steven E.; Tranel, Daniel

    2014-01-01

    Hubs are network components that hold positions of high importance for network function. Previous research has identified hubs in human brain networks derived from neuroimaging data; however, there is little consensus on the localization of such hubs. Moreover, direct evidence regarding the role of various proposed hubs in network function (e.g., cognition) is scarce. Regions of the default mode network (DMN) have been frequently identified as “cortical hubs” of brain networks. On theoretical grounds, we have argued against some of the methods used to identify these hubs and have advocated alternative approaches that identify different regions of cortex as hubs. Our framework predicts that our proposed hub locations may play influential roles in multiple aspects of cognition, and, in contrast, that hubs identified via other methods (including salient regions in the DMN) might not exert such broad influence. Here we used a neuropsychological approach to directly test these predictions by studying long-term cognitive and behavioral outcomes in 30 patients, 19 with focal lesions to six “target” hubs identified by our approaches (high system density and participation coefficient) and 11 with focal lesions to two “control” hubs (high degree centrality). In support of our predictions, we found that damage to target locations produced severe and widespread cognitive deficits, whereas damage to control locations produced more circumscribed deficits. These findings support our interpretation of how neuroimaging-derived network measures relate to cognition and augment classic neuroanatomically based predictions about cognitive and behavioral outcomes after focal brain injury. PMID:25225403

  4. Using Cross-Cultural Dimensions Exercises to Improve and Measure Learning Outcomes in International Business Courses

    ERIC Educational Resources Information Center

    Zainuba, Mohamed; Rahal, Ahmad

    2012-01-01

    This article proposes an approach for using cross-cultural dimensions exercises to improve and measure learning outcomes in international business courses. The following key issues are highlighted: (a) what are the targeted learning outcomes to be assessed, (b) how to measure the accomplishment of these learning outcomes, (c) the input measures…

  5. 45 CFR 287.145 - What measures will be used to determine NEW Program outcomes?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Program outcomes? 287.145 Section 287.145 Public Welfare Regulations Relating to Public Welfare OFFICE OF... What measures will be used to determine NEW Program outcomes? Each grantee must develop its own... must identify planned program outcomes and the measures the Tribe will use to determine them. ACF...

  6. Measuring and Predicting Patient Dissatisfaction after Anterior Urethroplasty Using Patient Reported Outcomes Measures

    PubMed Central

    Bertrand, Laura A.; Voelzke, Bryan B.; Elliott, Sean P.; Myers, Jeremy B.; Breyer, Benjamin N.; Vanni, Alex J.; McClung, Christopher D.; Tam, Christopher A.; Warren, Gareth J.; Erickson, Bradley A.

    2016-01-01

    Purpose Subjective measures of success after urethroplasty have become increasingly valuable in postoperative monitoring. We examined patient reported satisfaction following anterior urethroplasty using objective measures as a proxy for success. Materials and Methods Men 18 years old or older with urethral strictures undergoing urethroplasty were prospectively enrolled in a longitudinal, multi-institutional urethroplasty outcomes database. Preoperative and postoperative assessment included questionnaires to assess lower urinary tract symptoms, pain, satisfaction and sexual health. Analyses controlling for stricture recurrence (defined as the inability to traverse the reconstructed urethra with a flexible cystoscope) were performed to determine independent predictors of dissatisfaction. Results At a mean followup of 14 months we found a high 89.4% rate of overall postoperative satisfaction in 433 patients and a high 82.8% rate in those who would have chosen the operation again. Men with cystoscopic recurrence were more likely to report dissatisfaction (OR 4.96, 95% CI 2.07–11.90) and men reporting dissatisfaction had significantly worse uroflowmetry measures (each p <0.02). When controlling for recurrence, multivariate analysis revealed that urethra and bladder pain (OR 1.71, 95% CI 1.05–2.77 and OR 2.74, 95% CI 1.12–6.69, respectively), a postoperative decrease in sexual activity (OR 4.36, 95% CI 2.07–11.90) and persistent lower urinary tract symptoms (eg straining to urinate OR 3.23, 1.74-6.01) were independent predictors of dissatisfaction. Conclusions Overall satisfaction after anterior urethroplasty is high and traditional measures of surgical success strongly correlate with satisfaction. However, independently of the anatomical appearance of the reconstructed urethra, postoperative pain, sexual dysfunction and persistent lower urinary tract symptoms were predictors of patient dissatisfaction. PMID:26907509

  7. Functional outcome measures for NF1-associated optic pathway glioma clinical trials

    PubMed Central

    Avery, Robert A.; Allen, Jeffrey C.; Ardern-Holmes, Simone L.; Bilaniuk, Larissa T.; Ferner, Rosalie E.; Gutmann, David H.; Listernick, Robert; Martin, Staci; Ullrich, Nicole J.; Liu, Grant T.

    2013-01-01

    Objective: The goal of the Response Evaluation in Neurofibromatosis and Schwannomatosis Visual Outcomes Committee is to define the best functional outcome measures for future neurofibromatosis type 1 (NF1)-associated optic pathway glioma (OPG) clinical trials. Methods: The committee considered the components of vision, other ophthalmologic parameters affected by OPG, potential biomarkers of visual function, and quality of life measures to arrive at consensus-based, evidence-driven recommendations for objective and measurable functional endpoints for OPG trials. Results: Visual acuity (VA) assessments using consistent quantitative testing methods are recommended as the main functional outcome measure for NF1-OPG clinical trials. Teller acuity cards are recommended for use as the primary VA endpoint, and HOTV as a secondary endpoint once subjects are old enough to complete it. The optic disc should be assessed for pallor, as this appears to be a contributory variable that may affect the interpretation of VA change over time. Given the importance of capturing patient-reported outcomes in clinical trials, evaluating visual quality of life using the Children's Visual Function Questionnaire as a secondary endpoint is also proposed. Conclusions: The use of these key functional endpoints will be essential for evaluating the efficacy of future OPG clinical trials. PMID:24249802

  8. Defining and Measuring Student Competencies: A Content Validation Approach for Business Program Outcome Assessment.

    ERIC Educational Resources Information Center

    Roberson, Michael T.; Carnes, Lana W.; Vice, Janna P.

    2002-01-01

    Points out problems in assessing student learning outcomes. Outlines a content validation approach to outcomes assessment and suggests steps for defining the content domains and developing and adopting measures. (Contains 28 references.) (SK)

  9. Validation of GAITRite and PROMIS as High-Throughput Physical Function Outcome Measures Following ACL Reconstruction

    PubMed Central

    Papuga, M. Owen; Beck, Christopher A.; Kates, Stephen L.; Schwarz, Edward M.; Maloney, Michael D.

    2014-01-01

    New healthcare demands for quality measures of elective procedures, such as anterior cruciate ligament (ACL) reconstructive surgery, warrant the establishment of high through-put outcomes for high volume clinics. To this end we evaluated the PROMIS and GAITRite as physical function outcome measures to quantify early healing and post-operative complications in 106 patients at pre-op and 3, 10, 20 and 52 weeks post-ACL reconstruction with bone-tendon-bone autograft, and compared the results to the current IKDC validated outcome measure. The results showed that both PROMIS and GAITRite were significantly quicker to administer versus IKDC (p < 0.0001). Additional advantages were that PROMIS and GAITRite detected a significant decrease in physical function at 3 weeks post-op, and a significant improvement at 10 weeks post-op, versus pre-op (p<0.001), which were not detected with IKDC. GAITRite was limited by a low ceiling that could not detect improvement of physical function beyond 20 weeks, while both PROMIS and IKDC detected significant improvement out to 52 weeks postop (p<0.001). Linear regressions demonstrated a significant relationship between IKDC and PROMIS, with a combined correlation value of 0.8954 (p<.001) for all time points. Finally, ROC curve analysis demonstrated that PROMIS is a diagnostic test for poor outcomes. PMID:24532421

  10. A SYSTEMATIC REVIEW OF OUTCOME TOOLS USED TO MEASURE LOWER LEG CONDITIONS

    PubMed Central

    Shultz, Susan; Olszewski, Amanda; Ramsey, Olivia; Schmitz, Michelle; Wyatt, Verrelle

    2013-01-01

    Background Context: A variety of self‐report and physical performance‐based outcome measures are commonly used to assess progress and recovery in the lower leg, ankle, and foot. A requisite attribute of any outcome measure is its ability to detect change in a condition, a construct known as “responsiveness”. There is a lack of consistency in how responsiveness is defined in all outcome measures. Purpose: The purpose of this study was to review the currently used recovery outcome measures for lower leg, ankle and foot conditions in order to determine and report recommended responsiveness values. Methods: A systematic literature search that included electronic searches of PubMed, CINAHL and SportDiscus as well extensive cross‐referencing was performed in January, 2013. Studies were included if each involved: 1) a prospective, longitudinal study of any design; 2) any condition associated with the lower leg, ankle or foot; 3) a measure of responsiveness; and 4) was an acceptable type of outcome measure (eg. self‐report, physical performance, or clinician report). The quality of the included articles was assessed by two independent authors using the responsiveness sub‐component of the Consensus‐based Standards for the selection of health Measurement Instruments (COSMIN). Results: Sixteen different studies met the inclusion criteria for this systematic review. The most commonly used outcome measures were the Foot and Ankle Ability Measure and the Lower Extremity Functional Scale. Responsiveness was calculated in a variety of methods including effect size, standardized response mean, minimal clinically important difference/importance, minimal detectable change, and minimal important change. Conclusion: Based on the findings of this systematic review there is a lack of consistency for reporting responsiveness among recovery measures used in the lower leg, ankle or foot studies. It is possible that the variability of conditions that involve the lower leg

  11. Psychometric properties of carer-reported outcome measures in palliative care: A systematic review

    PubMed Central

    Michels, Charlotte TJ; Boulton, Mary; Adams, Astrid; Wee, Bee; Peters, Michele

    2016-01-01

    Background: Informal carers face many challenges in caring for patients with palliative care needs. Selecting suitable valid and reliable outcome measures to determine the impact of caring and carers’ outcomes is a common problem. Aim: To identify outcome measures used for informal carers looking after patients with palliative care needs, and to evaluate the measures’ psychometric properties. Design: A systematic review was conducted. The studies identified were evaluated by independent reviewers (C.T.J.M., M.B., M.P.). Data regarding study characteristics and psychometric properties of the measures were extracted and evaluated. Good psychometric properties indicate a high-quality measure. Data sources: The search was conducted, unrestricted to publication year, in the following electronic databases: Applied Social Sciences Index and Abstracts, Cumulative Index to Nursing and Allied Health Literature, The Cochrane Library, EMBASE, PubMed, PsycINFO, Social Sciences Citation Index and Sociological Abstracts. Results: Our systematic search revealed 4505 potential relevant studies, of which 112 studies met the inclusion criteria using 38 carer measures for informal carers of patients with palliative care needs. Psychometric properties were reported in only 46% (n = 52) of the studies, in relation to 24 measures. Where psychometric data were reported, the focus was mainly on internal consistency (n = 45, 87%), construct validity (n = 27, 52%) and/or reliability (n = 14, 27%). Of these, 24 measures, only four (17%) had been formally validated in informal carers in palliative care. Conclusion: A broad range of outcome measures have been used for informal carers of patients with palliative care needs. Little formal psychometric testing has been undertaken. Furthermore, development and refinement of measures in this field is required. PMID:26407683

  12. Using Quality of Life to Evaluate Outcomes and Measure Effectiveness

    ERIC Educational Resources Information Center

    Kober, Ralph; Eggleton, Ian R. C.

    2009-01-01

    Evaluating the outcomes achieved by service providers who assist people with intellectual disabilities is extremely important in terms of ascertaining whether service providers achieve their goals. Furthermore, knowledge of the outcomes achieved by service providers better equips those charged with managing them to make strategic decisions to…

  13. Constructing a consensus-based prevention outcome measurement instrument.

    PubMed

    Siegal, H A; Lane, D T; Falck, R S; Wang, J; Carlson, R G; Rahman, A; Chambers, D T

    2001-01-01

    This article describes Ohio's Prevention Evaluation Project (PEP). The purpose of the project was to develop a process and instrument to assess behavioral and attitudinal outcomes in primary drug abuse prevention programs targeting young people aged twelve to seventeen. One of PEP's principal achievements was the inclusion of community prevention program providers from throughout the state in the evaluation instrument development. The effort produced a self-administered questionnaire to capture data on young peoples' drug use practices, attitudes toward drugs, and problematic behaviors. Most significantly, the product produced was the acceptance and endorsement of community-based programs. The forty-one-item questionnaire has good to excellent reliability for virtually all measures, as assessed by the test-retest method. The instrument is a product of a process that brought together a university-based research team, state alcohol and drug abuse prevention administrators, and representatives of public programs. PEP demonstrates how to productively link service providers, administrators, and evaluators to develop a process for assessing the effectiveness of prevention programs. The process and tools described serve as a model for other communities wanting to evaluate their prevention programming. PMID:11487991

  14. Measuring Networking as an Outcome Variable in Undergraduate Research Experiences.

    PubMed

    Hanauer, David I; Hatfull, Graham

    2015-01-01

    The aim of this paper is to propose, present, and validate a simple survey instrument to measure student conversational networking. The tool consists of five items that cover personal and professional social networks, and its basic principle is the self-reporting of degrees of conversation, with a range of specific discussion partners. The networking instrument was validated in three studies. The basic psychometric characteristics of the scales were established by conducting a factor analysis and evaluating internal consistency using Cronbach's alpha. The second study used a known-groups comparison and involved comparing outcomes for networking scales between two different undergraduate laboratory courses (one involving a specific effort to enhance networking). The final study looked at potential relationships between specific networking items and the established psychosocial variable of project ownership through a series of binary logistic regressions. Overall, the data from the three studies indicate that the networking scales have high internal consistency (α = 0.88), consist of a unitary dimension, can significantly differentiate between research experiences with low and high networking designs, and are related to project ownership scales. The ramifications of the networking instrument for student retention, the enhancement of public scientific literacy, and the differentiation of laboratory courses are discussed. PMID:26538387

  15. Measuring Networking as an Outcome Variable in Undergraduate Research Experiences

    PubMed Central

    Hanauer, David I.; Hatfull, Graham

    2015-01-01

    The aim of this paper is to propose, present, and validate a simple survey instrument to measure student conversational networking. The tool consists of five items that cover personal and professional social networks, and its basic principle is the self-reporting of degrees of conversation, with a range of specific discussion partners. The networking instrument was validated in three studies. The basic psychometric characteristics of the scales were established by conducting a factor analysis and evaluating internal consistency using Cronbach’s alpha. The second study used a known-groups comparison and involved comparing outcomes for networking scales between two different undergraduate laboratory courses (one involving a specific effort to enhance networking). The final study looked at potential relationships between specific networking items and the established psychosocial variable of project ownership through a series of binary logistic regressions. Overall, the data from the three studies indicate that the networking scales have high internal consistency (α = 0.88), consist of a unitary dimension, can significantly differentiate between research experiences with low and high networking designs, and are related to project ownership scales. The ramifications of the networking instrument for student retention, the enhancement of public scientific literacy, and the differentiation of laboratory courses are discussed. PMID:26538387

  16. Measuring Training Results: Key to Managerial Commitment.

    ERIC Educational Resources Information Center

    Bell, James D.; Kerr, Deborah L.

    1987-01-01

    The author discusses application of Del Gaizo's four-level evaluation model to a business communications skills course for support and secretarial staff. The four measurement levels are (1) happiness, (2) learning, (3) practical application, and (4) bottom line. (CH)

  17. Outcome Preferences in Patients With Noninfectious Uveitis: Results of a Best–Worst Scaling Study

    PubMed Central

    Yu, Tsung; Holbrook, Janet T.; Thorne, Jennifer E.; Flynn, Terry N.; Van Natta, Mark L.; Puhan, Milo A.

    2015-01-01

    Purpose To estimate patient preferences regarding potential adverse outcomes of local versus systemic corticosteroid therapies for noninfectious uveitis by using a best–worst scaling (BWS) approach. Methods Local and systemic therapies are alternatives for noninfectious uveitis that have different potential adverse outcomes. Patients participating in the Multicenter Uveitis Steroid Treatment Trial Follow-up Study (MUST FS) and additional patients with a history of noninfectious uveitis treated at two academic medical centers (Johns Hopkins University and University of Pennsylvania) were surveyed about their preferences regarding six adverse outcomes deemed important to patients. Using “case 1” BWS, patients were asked to repeatedly select the most and least worrying from a list of outcomes (in the survey three outcomes per task). Results Eighty-two patients in the MUST FS and 100 patients treated at the academic medical centers completed the survey. According to BWS, patients were more likely to select vision not meeting the requirement for driving (individual BWS score: median = 3, interquartile range, 0–5), development of glaucoma (2, 1–4), and needing eye surgery (1, 0–3) as the most worrying outcomes as compared to needing medicine for high blood pressure/cholesterol (−2, −4 to 0), development of cataracts (−2, −3 to −1), or infection (sinusitis) (−3, −5 to 0). Larger BWS scores indicated the outcomes were more worrying to patients. Conclusions Patients with noninfectious uveitis considered impaired vision, development of glaucoma, and need for eye surgery worrying adverse outcomes, which suggests that it is especially desirable to avoid these outcomes if possible. (ClinicalTrials.gov number, NCT00132691.) PMID:26501236

  18. Workaholism: definition, measurement, and preliminary results.

    PubMed

    Spence, J T; Robbins, A S

    1992-02-01

    Questionnaires were developed to assess the concept of workaholism, defined in terms of high scores on measures of work involvement and driveness and low scores on a measure of enjoyment of work, and to contrast this profile with work enthusiasm, defined as high work involvement and enjoyment and low driveness. Additional scales were devised to test several predictions about the correlates of workaholism. A test battery including these scales was given in a mail survey to a national sample of male (n = 134) and female (n = 157) social workers with academic positions. The psychometric properties of the scales are described. Cluster analyses for each sex revealed groups who corresponded to the workaholic and work enthusiast profiles as well as several other profiles. As predicted, workaholics were higher than work enthusiasts (among other groups) on measures of perfectionism, nondelegation of responsibility, and job stress. They were also higher on a measure of health complaints. Investigations are being initiated to determine the association of workaholism and other score profiles with objectively diagnosed cardiac disorders and with measures of occupational performance. PMID:16370875

  19. The barriers and facilitators to routine outcome measurement by allied health professionals in practice: a systematic review

    PubMed Central

    2012-01-01

    Background Allied Health Professionals today are required, more than ever before, to demonstrate their impact. However, despite at least 20 years of expectation, many services fail to deliver routine outcome measurement in practice. This systematic review investigates what helps and hinders routine outcome measurement of allied health professionals practice. Methods A systematic review protocol was developed comprising: a defined search strategy for PsycINFO, MEDLINE and CINHAL databases and inclusion criteria and systematic procedures for data extraction and quality appraisal. Studies were included if they were published in English and investigated facilitators and/or barriers to routine outcome measurement by allied health professionals. No restrictions were placed on publication type, design, country, or year of publication. Reference lists of included publications were searched to identify additional papers. Descriptive methods were used to synthesise the findings. Results 960 papers were retrieved; 15 met the inclusion criteria. Professional groups represented were Physiotherapy, Occupational Therapy, and Speech and Language Therapy. The included literature varied in quality and design. Facilitators and barriers to routine outcome measurement exist at individual, managerial and organisational levels. Key factors affecting professionals’ use of routine outcome measurement include: professionals’ level of knowledge and confidence about using outcome measures, and the degree of organisational and peer-support professionals received with a view to promoting their work in practice. Conclusions Whilst the importance of routinely measuring outcomes within the allied health professions is well recognised, it has largely failed to be delivered in practice. Factors that influence clinicians’ ability and desire to undertake routine outcome measurement are bi-directional: they can act as either facilitators or barriers. Routine outcome measurement may only be

  20. Recent results from satellite beacon measurements

    NASA Technical Reports Server (NTRS)

    Darosa, A. V.

    1973-01-01

    The techniques are reviewed for measuring ionospheric electron content, the most important parameter in the study of transionospheric propagation. Data collected since 1964 have yielded a synoptic description of the behavior of the electron content in midlatitudes. Empirical relationships between the level of solar activity and the electron content were developed permitting the prognostication of the electron content values. Construction of such prognostication schemes was stimulated by current efforts to create accurate satellite borne navigation systems. Gravity waves propagating in the thermosphere leave a signature in the electron content records. Studies of such records have allowed the identification of the position of the gravity wave source, and its radiation pattern. A one-to-one relationship between these waves and polar substorms was revealed. Electron content measurements were used to monitor the protonosphere with good time resolution. Protonospheric storms were observed with this technique. Slab thickness data obtained from content measurements were used to determine the neutral air temperature in the thermosphere.

  1. Transforming Course Evaluations into a Meaningful Measure of Student Outcomes Achievement

    ERIC Educational Resources Information Center

    McCullough, Christopher A.

    2008-01-01

    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…

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

    ERIC Educational Resources Information Center

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

    2011-01-01

    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…

  3. How to Measure Results of Sales Training

    ERIC Educational Resources Information Center

    Hahne, C. E.

    1977-01-01

    Describes the development of a training program for salespeople (trainees and managers) called Dimensional Sales Training (DST). It is noted that DST is designed to increase sales, build skills, and improve performance, while providing a systematic process of collecting data for measuring program effectiveness. (EM)

  4. Measuring Competition: Inconsistent Definitions, Inconsistent Results

    ERIC Educational Resources Information Center

    Linick, Matthew Allen

    2014-01-01

    There is a developing literature examining how charter schools, through the effects of competition, impact performance in public school districts and district-run public schools, also known as the second-level effects of competition. What follows is an examination of how competition is measured in this literature that offers a critique of existing…

  5. Variation in Outcomes of Quality Measurement by Data Source

    PubMed Central

    Angier, Heather; Gold, Rachel; Gallia, Charles; Casciato, Allison; Tillotson, Carrie J.; Marino, Miguel; Mangione-Smith, Rita; DeVoe, Jennifer E.

    2016-01-01

    OBJECTIVE To evaluate selected Children’s Health Insurance Program Reauthorization Act claims-based quality measures using claims data alone, electronic health record (EHR) data alone, and both data sources combined. METHODS Our population included pediatric patients from 46 clinics in the OCHIN network of community health centers, who were continuously enrolled in Oregon’s public health insurance program during 2010. Within this population, we calculated selected pediatric care quality measures according to the Children’s Health Insurance Program Reauthorization Act technical specifications within administrative claims. We then calculated these measures in the same cohort, by using EHR data, by using the technical specifications plus clinical data previously shown to enhance capture of a given measure. We used the k statistic to determine agreement in measurement when using claims versus EHR data. Finally, we measured quality of care delivered to the study population, when using a combined dataset of linked, patient-level administrative claims and EHR data. RESULTS When using administrative claims data, 1.0% of children (aged 3–17) had a BMI percentile recorded, compared with 71.9% based on the EHR data (κ agreement [k] ≤ 0.01), and 72.0% in the combined dataset. Among children turning 2 in 2010, 20.2% received all recommended immunizations according to the administrative claims data, 17.2% according to the EHR data (k = 0.82), and 21.4% according to the combined dataset. CONCLUSIONS Children’s care quality measures may not be accurate when assessed using only administrative claims. Adding EHR data to administrative claims data may yield more complete measurement. PMID:24864178

  6. The Aphasia Communication Outcome Measure (ACOM): Dimensionality, Item Bank Calibration, and Initial Validation

    ERIC Educational Resources Information Center

    Hula, William D.; Doyle, Patrick J.; Stone, Clement A.; Hula, Shannon N. Austermann; Kellough, Stacey; Wambaugh, Julie L.; Ross, Katherine B.; Schumacher, James G.; St. Jacque, Ann

    2015-01-01

    Purpose: The purpose of this study is to investigate the structure and measurement properties of the Aphasia Communication Outcome Measure (ACOM), a patient-reported outcome measure of communicative functioning for persons with aphasia. Method: Three hundred twenty-nine participants with aphasia responded to 177 items asking about communicative…

  7. Fast excitation wiggler field measurement results

    SciTech Connect

    Armendariz, J.; Gallardo, J.; Romano, T.; van Steenbergen, A.

    1992-08-01

    As part of the program of Inverse Free Electron Laser (IFEL) Accelerator Development, the development of fast excitation, planar wigglers with high K magnitude has been pursued. This paper discusses the observed characteristics of a variable period length, tapered, wiggler as well as the procedures of measurement. The behaviour of a constant period length magnet with varying Vanadium Permendur (VaP) and field reflector thickness is also discussed.

  8. Relative Humidity Measurement Assurance Program Results

    NASA Technical Reports Server (NTRS)

    Cerezo, Miguel

    1993-01-01

    During the summer of 1992, the National Conference of Standards Laboratories sponsored a relative humidity measurement assurance program (RHMAP) whose purpose was to enable each participating center to assess the quality of relative humidity calibrations being performed by their respective standards laboratories. This paper presents the data which was submitted by the participants during the first round of the program and shows the multi-laboratory comparisons of the 20%, 50%, and 80% relative humidity meaurements performed.

  9. Outcome among community dwelling older adults with schizophrenia: results using five conceptual models.

    PubMed

    Cohen, Carl I; Pathak, Richa; Ramirez, Paul M; Vahia, Ipsit

    2009-04-01

    There have been few studies examining the outcome of schizophrenia in later life. Using five conceptual models, we test two hypotheses with respect to range of outcomes among older schizophrenia outpatients and how they compare to their age peers in the community. We operationalized five outcome measures from the following conceptual models: Remission, adapting criteria of Andreasen et al. (The American Journal of Psychiatry, 162:441-449, 2005); Recovery, adapting the criteria by Liberman et al. (International Review of Psychiatry, 14:256-272, 2002); Community Integration using the model of Wong and Solomon (Mental Health Services Research, 4:13-28, 2002); Subjective and Objective Successful Aging using the model of Rowe and Kahn (Science, 237:143-149, 1987). The schizophrenia (S) group consisted of 198 community-dwelling persons aged 55 and over who developed schizophrenia before age 45 and a community comparison (CC) group (N = 113). Remission and recovery criteria were met by 49 and 17% of the S group, respectively. There were significant differences between the S and CC groups in the distribution of community integration and successful aging scales: 41% of the CC group met at least 10 of 12 criteria versus 23% of the S group on the Community Integration Scale; 19% of the CC group met all six criteria vs. 2% of the S group on the Objective Successful Aging Scale; 27% of the CC group vs. 13% of the S group met all six criteria on the Subjective Successful Aging Scale. Correlations among the five outcome measures ranged from r = .19 to .48 (median value: r = .26 or 7% shared variance). There is wide variability in outcome in later life depending on which measure is used. Rather than one universal indicator, each measure offers a different perspective that can provide useful guidelines for researchers, clinicians, and policy makers. PMID:18787951

  10. Can community change be measured for an outcomes-based initiative? A comparative case study of the success by 6 initiative.

    PubMed

    Minich, Lisa; Howe, Steven; Langmeyer, Daniel; Corcoran, Kevin

    2006-12-01

    One of the challenges facing nonprofit organizations today is the demand for measurable results. Increasingly, these organizations are focusing less on program outputs and program outcomes in favor of community outcomes or changes demonstrated in the larger community. Success by 6(R) is a popular United Way initiative that emphasizes defining and measuring community outcomes. In this paper, we describe our work with 24 Success by 6(R) initiatives around the country. It is clear that not all of these initiatives are measuring community outcomes. Of those initiatives that are experiencing some success measuring community outcomes, similar measurement strategies are reported. Additionally, our experience suggests several United Way employees express dissatisfaction with the logic model as a framework for defining and measuring community outcomes although no preferred alternative model is identified. Evaluators working with community-wide initiatives must find ways to communicate the differences between program and community outcomes to key stakeholders and funders. PMID:17004126

  11. Efficacy Outcome Measures for Procedural Sedation Clinical Trials in Adults: An ACTTION Systematic Review.

    PubMed

    Williams, Mark R; McKeown, Andrew; Dexter, Franklin; Miner, James R; Sessler, Daniel I; Vargo, John; Turk, Dennis C; Dworkin, Robert H

    2016-01-01

    Successful procedural sedation represents a spectrum of patient- and clinician-related goals. The absence of a gold-standard measure of the efficacy of procedural sedation has led to a variety of outcomes being used in clinical trials, with the consequent lack of consistency among measures, making comparisons among trials and meta-analyses challenging. We evaluated which existing measures have undergone psychometric analysis in a procedural sedation setting and whether the validity of any of these measures support their use across the range of procedures for which sedation is indicated. Numerous measures were found to have been used in clinical research on procedural sedation across a wide range of procedures. However, reliability and validity have been evaluated for only a limited number of sedation scales, observer-rated pain/discomfort scales, and satisfaction measures in only a few categories of procedures. Typically, studies only examined 1 or 2 aspects of scale validity. The results are likely unique to the specific clinical settings they were tested in. Certain scales, for example, those requiring motor stimulation, are unsuitable to evaluate sedation for procedures where movement is prohibited (e.g., magnetic resonance imaging scans). Further work is required to evaluate existing measures for procedures for which they were not developed. Depending on the outcomes of these efforts, it might ultimately be necessary to consider measures of sedation efficacy to be procedure specific. PMID:26678470

  12. Using theory and evidence to drive measurement of patient, nurse and organizational outcomes of professional nursing practice.

    PubMed

    Jeffs, Lianne; Sidani, Souraya; Rose, Donald; Espin, Sherry; Smith, Orla; Martin, Kirsten; Byer, Charlie; Fu, Kaiyan; Ferris, Ella

    2013-04-01

    An evolving body of literature suggests that the implementation of evidence based clinical and professional guidelines and strategies can improve patient care. However, gaps exist in our understanding of the effect of implementation of guidelines on outcomes, particularly patient outcomes. To address this gap, a measurement framework was developed to assess the impact of an organization-wide implementation of two nursing-centric best-practice guidelines on patient, nurse and organizational level outcomes. From an implementation standpoint, we anticipate that our data will show improvements in the following: (i) patient satisfaction scores and safety outcomes; (ii) nurses ability to value and engage in evidence based practice; and (iii) organizational support for evidence-informed nursing care that results in quality patient outcomes. Our measurement framework and multifaceted methodological approach outlined in this paper might serve as a blueprint for other organizations in their efforts to evaluate the impacts associated with implementation of clinical and professional guidelines and best practices. PMID:23577971

  13. Exploring outcome measures for exercise intervention in people with Parkinson's disease.

    PubMed

    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

    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

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

    PubMed Central

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

    2012-01-01

    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

  15. Predicting Outcome of Childhood Bacterial Meningitis With a Single Measurement of C-Reactive Protein

    PubMed Central

    Peltola, Heikki; Roine, Irmeli; Cruzeiro, Manuel Leite; Bernardino, Luis

    2016-01-01

    Introduction: C-reactive protein (CRP), a marker of inflammation, shows high serum levels in invasive bacterial infections. We investigated the potential of a single CRP measurement at different phases of acute childhood bacterial meningitis to predict outcomes. Methods: Using whole-blood finger-prick samples with no centrifugation, CRP was measured quantitatively on arrival and on day 3 or 4 in children participating in 2 prospective, randomized, double-blind treatment studies conducted in Latin America or Angola. The results were compared with patient outcomes. Results: Although initial CRP values from 669 children gave useful prognostic information, the 3rd or 4th day measurements taken from 275 children associated significantly with seizures, slow recovery and low scores on the Glasgow Outcome Scale, with odds ratios for CRP values above the median (62 mg/L) ranging from 2 to 6, 2 to 5, and 3 to 5 (Latin America–Angola), respectively. Hearing impairment, although not full deafness, was 3 to 7 times more likely if CRP was above the median soon after hospitalization. Conclusions: Especially in resource-poor settings, clinicians have few simple-enough tools to identify the child with meningitis who requires maximum attention. CRP is a worthy addition. PMID:26986770

  16. Are validated outcome measures used in distal radial fractures truly valid?

    PubMed Central

    Nienhuis, R. W.; Bhandari, M.; Goslings, J. C.; Poolman, R. W.; Scholtes, V. A. B.

    2016-01-01

    Objectives Patient-reported outcome measures (PROMs) are often used to evaluate the outcome of treatment in patients with distal radial fractures. Which PROM to select is often based on assessment of measurement properties, such as validity and reliability. Measurement properties are assessed in clinimetric studies, and results are often reviewed without considering the methodological quality of these studies. Our aim was to systematically review the methodological quality of clinimetric studies that evaluated measurement properties of PROMs used in patients with distal radial fractures, and to make recommendations for the selection of PROMs based on the level of evidence of each individual measurement property. Methods A systematic literature search was performed in PubMed, EMbase, CINAHL and PsycINFO databases to identify relevant clinimetric studies. Two reviewers independently assessed the methodological quality of the studies on measurement properties, using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. Level of evidence (strong / moderate / limited / lacking) for each measurement property per PROM was determined by combining the methodological quality and the results of the different clinimetric studies. Results In all, 19 out of 1508 identified unique studies were included, in which 12 PROMs were rated. The Patient-rated wrist evaluation (PRWE) and the Disabilities of Arm, Shoulder and Hand questionnaire (DASH) were evaluated on most measurement properties. The evidence for the PRWE is moderate that its reliability, validity (content and hypothesis testing), and responsiveness are good. The evidence is limited that its internal consistency and cross-cultural validity are good, and its measurement error is acceptable. There is no evidence for its structural and criterion validity. The evidence for the DASH is moderate that its responsiveness is good. The evidence is limited that its reliability and the

  17. An investigation of outcome expectancies as a predictor of treatment response for combat veterans with PTSD: Comparison of clinician, self-report, and biological measures

    PubMed Central

    Price, Matthew; Maples, Jessica L.; Jovanovic, Tanja; Norrholm, Seth D.; Heekin, Mary; Rothbaum, Barbara O.

    2015-01-01

    Background Outcome expectancy, or the degree to which a client believes that therapy will result in improvement, is related to improved treatment outcomes for multiple disorders. There is a paucity of research investigating this relation in regards to PTSD. Additionally, the bulk of the research on outcome expectancy and treatment outcomes has relied mostly on self-report outcome measures. Methods The relation between outcome expectancy on self-report measures, clinician-rated measures, and two biological indices (fear potentiated startle and cortisol reactivity) of PTSD symptoms was explored. The sample included combat veterans (N= 116) treated with virtual reality exposure therapy for PTSD. Results Results supported a negative association between outcome expectancy and both self-report and clinician-rated symptoms at the conclusion of treatment, but outcome expectancy was related to the magnitude of change during treatment for self-report measures only. Outcome expectancy was unrelated to biological measures of treatment response. Conclusions These findings suggest that outcome expectancy may be related to patient and clinician perceptions of outcomes but not biological indices of outcome for PTSD. PMID:25703611

  18. Current Status, Goals, and Research Agenda for Outcome Measures Development in Behçet Syndrome: Report from OMERACT 2014

    PubMed Central

    Hatemi, Gulen; Ozguler, Yesim; Direskeneli, Haner; Mahr, Alfred; Gul, Ahmet; Levi, Virna; Aydin, Sibel Z.; Mumcu, Gonca; Sertel-Berk, Ozlem; Stevens, Randall M.; Yazici, Hasan; Merkel, Peter A.

    2016-01-01

    Objective There is an unmet need for reliable, validated, and widely accepted outcomes and outcome measures for use in clinical trials in Behçet syndrome (BS). Our report summarizes initial steps taken by the Outcome Measures in Rheumatology (OMERACT) vasculitis working group toward developing a core set of outcome measures for BS according to the OMERACT methodology, including the OMERACT Filter 2.0, and discussions during the first meeting of the BS working group held during OMERACT 12 (2014). Methods During OMERACT 12, some of the important challenges in developing outcomes for BS were outlined and discussed, and a research agenda was drafted. Results Among topics discussed were the advantages and disadvantages of a composite measure for BS that evaluates several organs/organ systems; bringing patients and physicians together for discussions about how to assess disease activity; use of organ-specific measures developed for other diseases; and the inclusion of generic, disease-specific, or organ-specific measures. The importance of incorporating patients’ perspectives, concerns, and ideas into outcome measure development was emphasized. Conclusion The planned research agenda includes conducting a Delphi exercise among physicians from different specialties that are involved in the care of patients with BS and among patients with BS, with the aim of identifying candidate domains and subdomains to be assessed in randomized clinical trials of BS, and candidate items for a composite measure. The ultimate goal of the group is to develop a validated and widely accepted core set of outcomes and outcome measures for use in clinical trials in BS. PMID:26373563

  19. Measuring Learning Outcomes in Higher Education: Motivation Matters

    ERIC Educational Resources Information Center

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

    2012-01-01

    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…

  20. Optimizing healthcare at the population level: results of the improving cardiovascular outcomes in Nova Scotia partnership.

    PubMed

    Cox, Jafna; Johnstone, David; Nemis-White, Joanna; Montague, Terrence

    2008-01-01

    Disease management is increasingly considered a valid strategy in the chronic care of our aging patient populations with multiple diseases. The Improving Cardiovascular Outcomes in Nova Scotia (ICONS) project examined whether a community-oriented health management partnership would lead to enhanced care and improved outcomes across an entire healthcare system. ICONS was a prospective cohort study, with baseline and repeated measurements of care and outcomes fed back to all project partners, along with other interventions aimed at optimizing care; preceding interval cohorts served as controls to post-intervention cohorts. The setting was the province of Nova Scotia, whose population is approximately 950,000. All 34,060 consecutive adult patients hospitalized in Nova Scotia with acute myocardial infarction (AMI), unstable angina (UA) or congestive heart failure (CHF) October 1997-March 2002 were included. Interventions were a combination of serial audits and feedbacks of practices and outcomes, web-based publication of findings, newsletter-based education and reminders, physician small-group workshops, pharmacy monitoring and compliance programs, care maps, algorithms, discharge forms and patient information cards. Rates of use of evidence-based marker therapies were the primary outcome measure. Secondary measures included one-year, all-cause mortality and re-hospitalization. Evidence-based prescription practices, for all target diseases, continuously and markedly improved over time. At the population level, there were no changes in one-year mortality for any disease state, although use of proven therapies predicted survival at the individual level throughout the five-year period for all disease states. Rates of re-hospitalization decreased significantly for all disease states over the course of ICONS; but most traditional positive and negative predictors of this outcome, like advanced age and use of proven therapies, respectively, were not predictive. ICONS

  1. Possible clinical outcome measures for clinical trials in patients with multiple sclerosis

    PubMed Central

    Goldman, Myla D.; Motl, Robert W.; Rudick, Richard A.

    2010-01-01

    Multiple sclerosis (MS) is a chronic inflammatory and neurodegenerative disease with both clinical and pathological heterogeneity. The complexity of the MS population has offered challenges to the measurement of MS disease progression in therapeutic trials. The current standard clinical outcome measures are relapse rate, Expanded Disability Severity Scale (EDSS), and the MS Functional Composite (MSFC). These measures each have strengths and some weakness. Two additional measures, the six-minute walk and accelerometry, show promise in augmenting current measures. MS therapeutics is a quickly advancing field which requires sensitive clinical outcome measures that can detect small changes in disability that reliably reflect long-term changes in sustained disease progression in a complex population. A single clinical outcome measure of sustained disease progression may remain elusive. Rather, an integration of current and new outcome measures may be most appropriate and utilization of different measures depending on the MS population and stage of the disease may be preferred. PMID:21179614

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

    PubMed Central

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

    2012-01-01

    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

  3. Scale Model Thruster Acoustic Measurement Results

    NASA Technical Reports Server (NTRS)

    Vargas, Magda; Kenny, R. Jeremy

    2013-01-01

    The Space Launch System (SLS) Scale Model Acoustic Test (SMAT) is a 5% scale representation of the SLS vehicle, mobile launcher, tower, and launch pad trench. The SLS launch propulsion system will be comprised of the Rocket Assisted Take-Off (RATO) motors representing the solid boosters and 4 Gas Hydrogen (GH2) thrusters representing the core engines. The GH2 thrusters were tested in a horizontal configuration in order to characterize their performance. In Phase 1, a single thruster was fired to determine the engine performance parameters necessary for scaling a single engine. A cluster configuration, consisting of the 4 thrusters, was tested in Phase 2 to integrate the system and determine their combined performance. Acoustic and overpressure data was collected during both test phases in order to characterize the system's acoustic performance. The results from the single thruster and 4- thuster system are discussed and compared.

  4. Suspected acute exacerbation of idiopathic pulmonary fibrosis as an outcome measure in clinical trials

    PubMed Central

    2013-01-01

    Background Acute exacerbation of idiopathic pulmonary fibrosis has become an important outcome measure in clinical trials. This study aimed to explore the concept of suspected acute exacerbation as an outcome measure. Methods Three investigators retrospectively reviewed subjects enrolled in the Sildenafil Trial of Exercise Performance in IPF who experienced a respiratory serious adverse event during the course of the study. Events were classified as definite acute exacerbation, suspected acute exacerbation, or other, according to established criteria. Results Thirty-five events were identified. Four were classified as definite acute exacerbation, fourteen as suspected acute exacerbation, and seventeen as other. Definite and suspected acute exacerbations were clinically indistinguishable. Both were most common in the winter and spring months and were associated with a high risk of disease progression and short-term mortality. Conclusions In this study one half of respiratory serious adverse events were attributed to definite or suspected acute exacerbations. Suspected acute exacerbations are clinically indistinguishable from definite acute exacerbations and represent clinically meaningful events. Clinical trialists should consider capturing both definite and suspected acute exacerbations as outcome measures. PMID:23848435

  5. A Systematic Review of Outcome Measurements and Quality of Studies Evaluating Fixed Tooth-Supported Restorations

    PubMed Central

    Patel, Devangkumar Rajnikant; O'Brien, Tim; Petrie, Aviva; Petridis, Haralampos

    2014-01-01

    Purpose The purpose of this systematic review was to review clinical studies of fixed tooth-supported prostheses, and to assess the quality of evidence with an emphasis on the assessment of the reporting of outcome measurements. Multiple hypotheses were generated to compare the effect of study type on different outcome modifiers and to compare the quality of publications before and after January 2005. Materials and Methods An electronic search was conducted using specific databases (MEDLINE via Ovid, EMBASE via Ovid, Cochrane Library) through July 2012. This was complemented by hand searching the past 10 years of issues of the Journal of Oral Rehabilitation, Journal of Prosthetic Dentistry, Journal of Prosthodontics, and the International Journal of Prosthodontics. All experimental and observational clinical studies evaluating survival, success, failure, and complications of tooth-supported extracoronal fixed partial dentures, crowns, and onlays were included. No restrictions on age or follow-up time were placed. Results The electronic search generated 14,869 papers, of which 206 papers were included for full-text review. Hand-searching added 23 papers. Inclusion criteria were met by 182 papers and were included for the review. The majority were retrospective studies. Only 8 (4.4%) were randomized controlled trials. The majority of the studies measured survival and failure, and few studies recorded data on success; however, more than 60% of the studies failed to define survival, success, and failure. Many studies did not use any standardized criteria for assessment of the quality of the restorations and, when standardized criteria were used, they were modified, thereby not allowing for comparisons with other studies. There was an increase of 21.8% in the number of studies evaluating outcome measurements of all-ceramic restorations in past 8 years. Conclusions Prosthodontic literature presents with a reduced percentage of RCTs compared to other disciplines in

  6. An outcome-based learning model to identify emerging threats : experimental and simulation results.

    SciTech Connect

    Martinez-Moyano, I. J.; Conrad, S. H.; Andersen, D. F.; Decision and Information Sciences; SNL; Univ. at Albany

    2007-01-01

    The authors present experimental and simulation results of an outcome-based learning model as it applies to the identification of emerging threats. This model integrates judgment, decision making, and learning theories to provide an integrated framework for the behavioral study of emerging threats.

  7. Multiple trauma in children: predicting outcome and long-term results

    PubMed Central

    Letts, Mervyn; Davidson, Darin; Lapner, Peter

    2002-01-01

    Objective To analyze the management of pediatric trauma and the efficacy of the Pediatric Trauma Score (PTS) in classifying injury severity and predicting prognosis. Design A retrospective case series. Setting The Children’s Hospital of Eastern Ontario, a major pediatric trauma centre. Patients One hundred and forty-nine traumatized children with 2 or more injuries to 1 body system or a single injury to 2 or more body systems. Interventions Use of the PTS and Glasgow Coma Scale score in trauma management. Main outcome measures Types of injuries sustained, complications, missed injuries, psychosocial effects and residual deficiencies. Results The average PTS was 8.5 (range from −3 to 11). The total number of injuries sustained was 494, most commonly closed head injury (86). Forty-two percent of children with an average trauma score of 8.5 were treated surgically. There were 13 missed injuries, and complications were encountered in 57 children, the most common being secondary to fractures. Forty-eight (32%) children had residual long-term deficiency, most commonly neurologic deficiency secondary to head injury. Conclusions Fractures should be stabilized early to decrease long-term complications. A deficiency of the PTS is the weighting of open fractures of a minor bone. For example, metacarpal fracture is given the same weight as an open fracture of the femur. Neuropsychologic difficulties secondary to trauma are a major sequela of trauma in children. PMID:11939656

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

    PubMed

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

    2013-09-01

    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

  9. Female College Students’ Media Use and Academic Outcomes: Results from a Longitudinal Cohort Study

    PubMed Central

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

    2013-01-01

    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

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

    ERIC Educational Resources Information Center

    Butler, Karen L.; Dawkins, Phyllis Worthy

    2008-01-01

    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…

  11. Nonprofit Organizations and Outcome Measurement: From Tracking Program Activities to Focusing on Frontline Work

    ERIC Educational Resources Information Center

    Benjamin, Lehn M.

    2012-01-01

    Why do we continue to see evidence that nonprofit staff feel like outcome measurement is missing important aspects of their work? Based on an analysis of over 1,000 pages of material in 10 outcome measurement guides and a focused literature review of frontline work in three types of nonprofit organizations, this article shows that existing outcome…

  12. Measures for the Final Common Core of Constructs. The Project on State-Level Child Outcomes.

    ERIC Educational Resources Information Center

    Child Trends, Inc., Washington, DC.

    The Project on State-Level Child Outcomes, a federal project designed to improve the measurement of child outcomes in state welfare evaluations and in other state data systems. This document provides measures for the common core of constructs that state representatives developed at the second national-level meeting of the Project's planning phase.…

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

    ERIC Educational Resources Information Center

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

    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…

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

    ERIC Educational Resources Information Center

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

    2008-01-01

    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…

  15. Measurement properties of patient-reported outcome measures (PROMs) in adults with obstructive sleep apnea (OSA): A systematic review.

    PubMed

    Abma, Inger L; van der Wees, Philip J; Veer, Vik; Westert, Gert P; Rovers, Maroeska

    2016-08-01

    This systematic review summarizes the evidence regarding the quality of patient-reported outcome measures (PROMs) validated in patients with obstructive sleep apnea (OSA). We performed a systematic literature search of all PROMs validated in patients with OSA, and found 22 measures meeting our inclusion criteria. The quality of the studies was assessed using the consensus-based standards for the selection of health status measurement instruments (COSMIN) checklist. The results showed that most of the measurement properties of the PROMs were not, or not adequately, assessed. For many identified PROMs there was no involvement of patients with OSA during their development or before the PROM was tested in patients with OSA. Positive exceptions and the best current candidates for assessing health status in patients with OSA are the sleep apnea quality of life index (SAQLI), Maugeri obstructive sleep apnea syndrome (MOSAS) questionnaire, Quebec sleep questionnaire (QSQ) and the obstructive sleep apnea patient-oriented severity index (OSAPOSI). Even though there is not enough evidence to fully judge the quality of these PROMs as outcome measure, when interpreted with caution, they have the potential to add value to clinical research and clinical practice in evaluating aspects of health status that are important to patients. PMID:26433776

  16. Core Outcome Sets and Multidimensional Assessment Tools for Harmonizing Outcome Measure in Chronic Pain and Back Pain.

    PubMed

    Kaiser, Ulrike; Neustadt, Katrin; Kopkow, Christian; Schmitt, Jochen; Sabatowski, Rainer

    2016-01-01

    Core Outcome Sets (COSs) are a set of domains and measurement instruments recommended for application in any clinical trial to ensure comparable outcome assessment (both domains and instruments). COSs are not exclusively recommended for clinical trials, but also for daily record keeping in routine care. There are several COS recommendations considering clinical trials as well as multidimensional assessment tools to support daily record keeping in low back pain. In this article, relevant initiatives will be described, and implications for research in COS development in chronic pain and back pain will be discussed. PMID:27589816

  17. Impact of Funding Source on Clinical Trial Results Including Cardiovascular Outcome Trials.

    PubMed

    Riaz, Haris; Raza, Sajjad; Khan, Muhammad Shahzeb; Riaz, Irbaz Bin; Krasuski, Richard A

    2015-12-15

    Previous authors have suggested a higher likelihood for industry-sponsored (IS) studies to have positive outcomes than non-IS studies, though the influence of publication bias was believed to be a likely confounder. We attempted to control for the latter using a prepublication database to compare the primary outcome of recent trials based on sponsorship. We used the "advanced search" feature in the clinicaltrials.gov website to identify recently completed phase III studies involving the implementation of a pharmaceutical agent or device for which primary data were available. Studies were categorized as either National Institutes of Health (NIH) sponsored or IS. Results were labeled "favorable" if the results favored the intervention under investigation or "unfavorable" if the intervention fared worse than standard medical treatment. We also performed an independent literature search to identify the cardiovascular trials as a case example and again categorized them into IS versus NIH sponsored. A total of 226 studies sponsored by NIH were found. When these were compared with the latest 226 IS studies, it was found that IS studies were almost 4 times more likely to report a positive outcome (odds ratio [OR] 3.90, 95% confidence interval [CI] 2.6087 to 5.9680, p <0.0001). As a case example of a specialty, we also identified 25 NIH-sponsored and 215 IS cardiovascular trials, with most focusing on hypertension therapy (31.6%) and anticoagulation (17.9%). IS studies were 7 times more likely to report favorable outcomes (OR 7.54, 95% CI 2.19 to 25.94, p = 0.0014). They were also considerably less likely to report unfavorable outcomes (OR 0.11, 95% CI 0.04 to 0.26, p <0.0001). In conclusion, the outcomes of large clinical studies especially cardiovascular differ considerably on the basis of their funding source, and publication bias appears to have limited influence on these findings. PMID:26611124

  18. Targeted Estimation of Binary Variable Importance Measures with Interval-Censored Outcomes

    PubMed Central

    van der Laan, Mark J.; Page, Kimberly

    2015-01-01

    In most experimental and observational studies, participants are not followed in continuous time. Instead, data is collected about participants only at certain monitoring times. These monitoring times are random and often participant specific. As a result, outcomes are only known up to random time intervals, resulting in interval-censored data. In contrast, when estimating variable importance measures on interval-censored outcomes, practitioners often ignore the presence of interval censoring, and instead treat the data as continuous or right-censored, applying ad hoc approaches to mask the true interval censoring. In this article, we describe targeted minimum loss–based estimation (TMLE) methods tailored for estimation of binary variable importance measures with interval-censored outcomes. We demonstrate the performance of the interval-censored TMLE procedure through simulation studies and apply the method to analyze the effects of a variety of variables on spontaneous hepatitis C virus clearance among injecton drug users, using data from the “International Collaboration of Incident HIV and HCV in Injecting Cohorts” project. PMID:24637001

  19. Predicting stroke outcome using DCE-CT measured blood velocity

    NASA Astrophysics Data System (ADS)

    Oosterbroek, Jaap; Bennink, Edwin; Dankbaar, Jan Willem; Horsch, Alexander D.; Viergever, Max A.; Velthuis, Birgitta K.; de Jong, Hugo W. A. M.

    2015-03-01

    CT plays an important role in the diagnosis of acute stroke patients. Dynamic contrast enhanced CT (DCE-CT) can estimate local tissue perfusion and extent of ischemia. However, hemodynamic information of the large intracranial vessels may also be obtained from DCE-CT data and may contain valuable diagnostic information. We describe a novel method to estimate intravascular blood velocity (IBV) in large cerebral vessels using DCE-CT data, which may be useful to help predict stroke outcome. DCE-CT scans from 34 patients with isolated M1 occlusions were included from a large prospective multi-center cohort study of patients with acute ischemic stroke. Gaussians fitted to the intravascular data yielded the time-to-peak (TTP) and cerebral-blood-volume (CBV). IBV was computed by taking the inverse of the TTP gradient magnitude. Voxels with a CBV of at least 10% of the CBV found in the arterial input function were considered part of a vessel. Mid-sagittal planes were drawn manually and averages of the IBV over all vessel-voxels (arterial and venous) were computed for each hemisphere. Mean-hemisphere IBV differences, mean-hemisphere TTP differences, and hemisphere vessel volume differences were used to differentiate between patients with good and bad outcome (modified Rankin Scale score <3 versus ≥3 at 90 days) using ROC analysis. AUCs from the ROC for IBV, TTP, and vessel volume were 0.80, 0.67 and 0.62 respectively. In conclusion, IBV was found to be a better predictor of patient outcome than the parameters used to compute it and may be a promising new parameter for stroke outcome prediction.

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

    SciTech Connect

    Gardner, B.H.; Snell, M.K.; Paulus, W.K. )

    1991-01-01

    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.

  1. Quality of life measurement and outcome in aphasia

    PubMed Central

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

    2014-01-01

    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

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

    ERIC Educational Resources Information Center

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

    2004-01-01

    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…

  3. Outcome Measures of an Intracanal, Endoscopic Transforaminal Decompression Technique: Initial Findings from the MIS Prospective Registry

    PubMed Central

    Sclafani, Joseph A.; Raiszadeh, Kamshad; Laich, Dan; Shen, Jian; Bennett, Matthew; Blok, Robert; Liang, Kevin

    2015-01-01

    Background Minimally invasive transforaminal endoscopic procedures can achieve spinal decompression through either direct or indirect techniques. Subtle variations in trajectory of the surgical corridor can dictate access to the pathologic tissue. Two general strategies exist: the intradiscal “inside-out” technique and the extradiscal, intracanal (IC) technique. The IC technique utilizes a more lateral transforaminal approach than the intradiscal technique, which allows for a more direct decompression of the spinal canal. Objective This study is an assessment of IC patient outcome data obtained through analysis of a previously validated MIS Prospective Registry. Methods Post-hoc analysis was performed on the MIS Prospective Registry database containing 1032 patients. A subgroup of patients treated with the endoscopic IC technique was identified. Patient outcome measures after treatment of symptomatic disk herniation and neuroforaminal stenosis were evaluated. Results A total of 86 IC patients were analyzed. Overall, there was significant improvement in employment and walking tolerance as soon as 6 weeks post-op as well as significant one year VAS and ODI score improvement. Subanalysis of IC patients with two distinct primary diagnoses was performed. Group IC-1 (disc herniation) showed improvement in ODI and VAS back and leg outcomes at 1 year post-op. Group IC-2 (foraminal stenosis) showed VAS back and leg score improvement at one year post-op but did not demonstrate significant improvement in overall ODI outcome at any time point. The one year re-operation rate was 2% (1/40) for group IC-1 and 28% (5/18) for group IC-2. Conclusions The initial results of the MIS Registry IC subgroup show a significant clinical improvement when the technique is employed to treat patients with lumbar disc herniation. The treatment of foraminal stenosis can lead to improved short-term clinical outcome but is associated with a high re-operation rate at 1 year post-op. PMID

  4. Measuring Critical Education Processes and Outcomes: Illustration from a Cluster Randomized Trial in the Democratic Republic of the Congo

    ERIC Educational Resources Information Center

    Halpin, Peter F.; Torrente, Catalina

    2014-01-01

    Using reliable and valid measures of students' outcomes which are sensitive to change is critical for obtaining interpretable and therefore useful results from evaluations of school-based interventions. While measurement development for use in experimental evaluations receives a great deal of attention in the U.S., it lags behind in low-income…

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

    ERIC Educational Resources Information Center

    Ward, Eric F.; Pringle, Robert A.

    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…

  6. Modeling the Offensive-Defensive Interaction and Resulting Outcomes in Basketball

    PubMed Central

    Lamas, Leonardo; Santana, Felipe; Heiner, Matthew; Ugrinowitsch, Carlos; Fellingham, Gilbert

    2015-01-01

    Purpose We analyzed the interaction between offensive (i.e. space creation dynamics -SCDs) and defensive (i.e. space protection dynamics—SPDs) actions in six play outcomes (free shot, contested shot, new SCD, reset, foul, and turnover) in Spanish professional basketball games. Method Data consisted of 1548 SCD-SPD-outcome triples obtained from six play-off games. We used Bayesian methods to compute marginal probabilities of six outcomes following five different SCDs. We also computed probabilities of the six outcomes following the 16 most frequent SCD-SPD combinations. Results The pick action (e.g. pick and roll, pop and pop) was the most prevalent SCD (33%). However, this SCD did not produce the highest probability of a free shot (0.235). The highest probability of a free shot followed the SCD without ball (0.409). The pick was performed not only to attempt scoring but also to initiate offenses, as it produced the highest probability leading to a new SCD (0.403). Additionally, the SPD performed influenced the outcome of the SCD. This reinforces the notion that the opposition (offensive-defensive interaction) should be considered. To the best of our knowledge, in team sports, this is the first study to successfully model the tactical features involved in offense-defense interactions. Our analyses revealed that the high frequency of occurrence of some SCDs may be justified not only by an associated high probability of free shots but also by the possibility of progressively create more space in the defense (i.e. a new SCD as outcome). In the second case, it evidences offensive strategic features of progressive disruption of the defensive system through the concatenation of subsequent offensive actions. PMID:26659134

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

    PubMed Central

    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.

    2012-01-01

    Abstract 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

  8. Measuring Outcomes in Urogynecologic Surgery: “Perspective is Everything” – A Review

    PubMed Central

    Parker-Autry, Candace Y.; Barber, Matthew D.; Kenton, Kimberly; Richter, Holly E.

    2013-01-01

    Over 10 years have passed since the first US National Institutes of Health consensus panel considered standardization of definitions of pelvic floor conditions and criteria utilized for reporting pelvic floor research study outcomes. The literature is replete with pelvic floor outcome studies; however, a consistent standardized approach to the evaluation of patients and characterization of outcomes is still needed. The purpose of this overview is to describe how the use of outcome measures have evolved over time and attempt to help readers utilize the best measures for their clinical and research needs. PMID:22930213

  9. 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...

  10. Outcomes and disease activity measures for assessing treatments in the idiopathic inflammatory myopathies.

    PubMed

    Oddis, Chester V

    2005-04-01

    The assessment and treatment of patients with idiopathic inflammatory myopathy has taken a major step forward over the past few years. Through the efforts of multi-disciplinary international groups of experts interested in the management of patients with myositis, initiatives have led to the development of a core set of outcome measures critical to their assessment. Similarly, the lack of consensus on several issues of clinical trial design has been addressed resulting in the development of a definition of clinical improvement for adult and juvenile patients with inflammatory myopathy using the core set outcomes. The final step in the puzzle of well-designed therapeutic trials in myositis is the determination of consensus guidelines to conduct such trials in adult and pediatric populations of myositis patients. PMID:15760586

  11. In vivo electrical conductivity measurements during and after tumor electroporation: conductivity changes reflect the treatment outcome

    NASA Astrophysics Data System (ADS)

    Ivorra, Antoni; Al-Sakere, Bassim; Rubinsky, Boris; Mir, Lluis M.

    2009-10-01

    Electroporation is the phenomenon in which cell membrane permeability is increased by exposing the cell to short high-electric-field pulses. Reversible electroporation treatments are used in vivo for gene therapy and drug therapy while irreversible electroporation is used for tissue ablation. Tissue conductivity changes induced by electroporation could provide real-time feedback of the treatment outcome. Here we describe the results from a study in which fibrosarcomas (n = 39) inoculated in mice were treated according to different electroporation protocols, some of them known to cause irreversible damage. Conductivity was measured before, within the pulses, in between the pulses and for up to 30 min after treatment. Conductivity increased pulse after pulse. Depending on the applied electroporation protocol, the conductivity increase after treatment ranged from 10% to 180%. The most significant conclusion from this study is the fact that post-treatment conductivity seems to be correlated with treatment outcome in terms of reversibility.

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

    PubMed Central

    2009-01-01

    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

  13. Systematic review of measurement properties of patient-reported outcome measures used in patients undergoing hip and knee arthroplasty

    PubMed Central

    Harris, Kristina; Dawson, Jill; Gibbons, Elizabeth; Lim, Chris R; Beard, David J; Fitzpatrick, Raymond; Price, Andrew J

    2016-01-01

    Objectives To identify patient-reported outcome measures (PROMs) that have been developed and/or used with patients undergoing hip or knee replacement surgery and to provide a shortlist of the most promising generic and condition-specific instruments. Methods A systematic review of the literature was performed to identify measures used in patients undergoing hip and knee replacement and extract and evaluate information on their methodological quality. Results Thirty-two shortlisted measures were reviewed for the quality of their measurement properties. On the basis of the review criteria, the measures with most complete evidence to date are the Oxford Hip Score (OHS) (for patients undergoing hip replacement surgery) and the Oxford Knee Score (OKS), with OKS-Activity and Participation Questionnaire (for patients undergoing knee replacement surgery). Conclusion A large number of these instruments lack essential evidence of their measurement properties (eg, validity, reliability, and responsiveness) in specific populations of patients. Further research is required on almost all of the identified measures. The best-performing condition-specific PROMs were the OKS, OHS, and Western Ontario and McMaster Universities Osteoarthritis Index. The best-performing generic measure was the Short Form 12. Researchers can use the information presented in this review to inform further psychometric studies of the reviewed measures. PMID:27524925

  14. Clinical outcome assessment in malignant glioma trials: measuring signs, symptoms, and functional limitations.

    PubMed

    Blakeley, Jaishri O; Coons, Stephen Joel; Corboy, John R; Leidy, Nancy Kline; Mendoza, Tito R; Wefel, Jeffrey S

    2016-03-01

    The shared goal of all parties developing therapeutics against malignant gliomas is to positively impact the lives of people affected by these cancers. Clinical outcome assessment (COA) tools, including measures of patient-reported outcome, performance outcome, clinician-reported outcome, and observer-reported outcome, allow patient-focused assessments to complement traditional efficacy measures such as overall survival and radiographic endpoints. This review examines the properties of various COA measures used in malignant glioma clinical trials to date and cross references their content to the priority signs, symptoms, and functional limitations defined through a community survey conducted by the National Brain Tumor Society. The overarching goal of this initiative is to identify COA measures that are feasible and have appropriate psychometric properties for use in this patient population as well as highlight where further development is needed. PMID:26989128

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

    PubMed Central

    Lagdon, Susan; Armour, Cherie; Stringer, Maurice

    2014-01-01

    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

  16. Prospective evaluation of outcome measures in free-flap surgery.

    PubMed

    Kelly, John L; Eadie, Patricia A; Orr, David; Al-Rawi, Mogdad; O'Donnell, Margaret; Lawlor, Denis

    2004-08-01

    Free-flap failure is usually caused by venous or arterial thrombosis. In many cases, lack of experience and surgical delay also contribute to flap loss. The authors prospectively analyzed the outcome of 57 free flaps over a 28-month period (January, 1999 to April, 2001). The setting was a university hospital tertiary referral center. Anastomotic technique, ischemia time, choice of anticoagulant, and the grade of surgeon were recorded. The type of flap, medications, and co-morbidities, including preoperative radiotherapy, were also documented. Ten flaps were re-explored (17 percent). There were four cases of complete flap failure (6.7 percent) and five cases of partial failure (8.5 percent). In patients who received perioperative systemic heparin or dextran, there was no evidence of flap failure (p = .08). The mean ischemia time was similar in flaps that failed (95 +/- 29 min) and in those that survived (92 +/- 34 min). Also, the number of anastomoses performed by trainees in flaps that failed (22 percent), was similar to the number in flaps that survived (28 percent). Nine patients received preoperative radiotherapy, and there was complete flap survival in each case. This study reveals that closely supervised anastomoses performed by trainees may have a similar outcome to those performed by more senior surgeons. There was no adverse effect from radiotherapy or increased ischemia time on flap survival. PMID:15356760

  17. Who Wants Outcome Measures and Why Do They Want Them?

    ERIC Educational Resources Information Center

    Folger, John

    This paper raises three broad issues,each with sub-areas. First, what are the consequences of measuring and evaluating the parts of higher education that can be satisfactorily measured? What are the consequences for the parts of education that can not be measured, and for the total enterprise? Second, what kind of assessment systems will be best…

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

    PubMed Central

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

    2014-01-01

    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 antiretroviral 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

  19. The Relation between Nonverbal IQ and Postoperative CI Outcomes in Cochlear Implant Users: Preliminary Result.

    PubMed

    Park, Mina; Song, Jae-Jin; Oh, Seo Jin; Shin, Min-Sup; Lee, Jun Ho; Oh, Seung Ha

    2015-01-01

    Objectives. This study assessed the correlation between performance intelligence and the postoperative cochlear implant (CI) outcome in Korean-speaking children. In addition, the relationship between the performance intelligence subscales and the post-CI speech outcome was evaluated. Materials and Methods. Thirteen pediatric CI users (five males, eight females; median age at implantation 6.2 (range 1.3-14.2) years; median age at intelligence test 9.3 (range 5-16) years) who were tested using the Korean Educational Development Institute-Wechsler Intelligence Scale for children were studied. The correlations between the intelligence scores and 1-2 years postoperative Categories of Auditory Performance (CAP) scores and between subscales of performance and 1-2 years postoperative CAP scores were analyzed. Results. There was no correlation between the categories of verbal intelligence quotient (IQ) and performance IQ for "mentally retarded" and "average," respectively (Spearman's rho = 0.42, P = 0.15). There was a strong correlation between performance IQ and the postoperative CAP scale (Spearman's rho = 0.8977, P = 0.0008). "Picture arrangement" and "picture completion," reflecting social cognition, were strongly correlated with the postoperative CAP scales. Conclusion. Performance intelligence, especially social cognition, was strongly related to the postoperative CI outcome of cochlear implant users. Therefore, auditory rehabilitation, including social rehabilitation, should maximize the postoperative CI outcomes. PMID:26236723

  20. The Relation between Nonverbal IQ and Postoperative CI Outcomes in Cochlear Implant Users: Preliminary Result

    PubMed Central

    Park, Mina; Song, Jae-Jin; Oh, Seo Jin; Shin, Min-Sup; Lee, Jun Ho; Oh, Seung Ha

    2015-01-01

    Objectives. This study assessed the correlation between performance intelligence and the postoperative cochlear implant (CI) outcome in Korean-speaking children. In addition, the relationship between the performance intelligence subscales and the post-CI speech outcome was evaluated. Materials and Methods. Thirteen pediatric CI users (five males, eight females; median age at implantation 6.2 (range 1.3–14.2) years; median age at intelligence test 9.3 (range 5–16) years) who were tested using the Korean Educational Development Institute-Wechsler Intelligence Scale for children were studied. The correlations between the intelligence scores and 1-2 years postoperative Categories of Auditory Performance (CAP) scores and between subscales of performance and 1-2 years postoperative CAP scores were analyzed. Results. There was no correlation between the categories of verbal intelligence quotient (IQ) and performance IQ for “mentally retarded” and “average,” respectively (Spearman's rho = 0.42, P = 0.15). There was a strong correlation between performance IQ and the postoperative CAP scale (Spearman's rho = 0.8977, P = 0.0008). “Picture arrangement” and “picture completion,” reflecting social cognition, were strongly correlated with the postoperative CAP scales. Conclusion. Performance intelligence, especially social cognition, was strongly related to the postoperative CI outcome of cochlear implant users. Therefore, auditory rehabilitation, including social rehabilitation, should maximize the postoperative CI outcomes. PMID:26236723

  1. Outcome measures for clinical trials assessing treatment of cystic fibrosis lung disease

    PubMed Central

    VanDevanter, Donald R; Konstan, Michael W

    2015-01-01

    Cystic fibrosis (CF) is a complex genetic disease characterized by death from loss of lung function. Therapies target pathophysiologic changes associated with pulmonary disease progression. Although therapeutic mechanisms differ, efficacy demonstration is limited to a few accepted outcome measures, each with shortcomings that are becoming more pronounced as CF population health improves. Pulmonary function improvement (as forced expiratory volume in 1 s [FEV1]) and reduction of pulmonary exacerbation risk are commonly used outcomes. Changes in FEV1 decline rate, quality of life, linear growth and/or weight gain are less utilized outcomes. Validated outcomes tend to work best in subjects with more aggressive or advanced lung disease and less so in healthier subjects. Assays of effects on primary therapeutic targets have yet to be validated as surrogate measures of clinical efficacy. As CF population health improves, it will become increasingly difficult to employ current clinical outcome measures to demonstrate efficacy. PMID:26146539

  2. Effect of anxiety on treatment presentation and outcome: results from the Marijuana Treatment Project.

    PubMed

    Buckner, Julia D; Carroll, Kathleen M

    2010-08-15

    Despite emerging evidence of the efficacy of psychotherapies for marijuana dependence, variability in outcome exists. This study examined the role of anxiety on treatment involvement and outcome. Four questions were examined: (1) Is greater anxiety associated with greater impairment at baseline? (2) Is baseline anxiety related to greater marijuana use and problems following treatment? (3) Does adding cognitive-behavioral therapy (CBT) to motivation enhancement therapy (MET) reduce anxiety relative to MET alone; (4) Are reductions in anxiety associated with better outcomes? The sample comprised 450 marijuana-dependent patients in the Marijuana Treatment Project. Marijuana use and anxiety were measured at pretreatment and 4- and 9-month follow-ups. At baseline, anxiety was linked to more marijuana-related problems. CBT was associated with less anxiety at follow-up compared to MET alone. Reductions in anxiety were related to less marijuana use. In fact, reduction in anxiety from baseline to 4-month follow-up was associated with less marijuana use at 9 months, but reduction in marijuana use did not predict subsequent anxiety. Data suggest that anxiety is an important variable that deserves further attention in marijuana-dependence treatment. PMID:20537406

  3. Evaluation of Diverse Community Asthma Interventions: Balancing Health Outcomes with Developing Community Capacity for Evidence-Based Program Measurement.

    PubMed

    Woodhouse, Lynn D; Livingood, William C; Toal, Russ; Keene, DeAnna; Hines, Robert B; Tedders, Stuart; Charles, Simone M; Lawrence, Raymona H; Gunn, Laura H; Williams, Natalie; Kellum, Andrea

    2015-10-01

    The challenge of evaluating community asthma management programs is complicated by balancing the emphasis on health outcomes with the need to build community process capacity for conducting and monitoring evidence-based programs. The evaluation of a Georgia Childhood Asthma Management Program, a Healthcare Georgia Foundation-supported initiative for multiple diverse programs and settings, provides an example of an approach and the results that address this challenge. A "developmental evaluation" approach was applied, using mixed methods of quantitative and qualitative data collection and analysis, to assess the progress of community asthma prevention programs in building community within the context of: where the community is starting, community-level systems changes, and the community's progress toward becoming more outcome measurement oriented and evidence based. Initial evaluation efforts revealed extensive mobilization of community assets to manage childhood asthma. However, there were minimal planned efforts to assess health outcomes and systems changes, and the lack of a logic model-based program design linking evidence-based practices to outcomes. Following developmental technical assistance within evaluation efforts, all programs developed logic models, linking practices to outcomes with data collection processes to assess progress toward achieving the selected outcomes. This developmental approach across diverse projects and communities, along with a quality improvement benchmarking approach to outcomes, created a focus on health status outcome improvement. Specifically, this approach complemented an emphasis on an improved community process capacity to identify, implement, and monitor evidence-based asthma practices that could be used within each community setting. PMID:25658512

  4. Toward Ensuring Health Equity: Readability and Cultural Equivalence of OMERACT Patient-reported Outcome Measures

    PubMed Central

    Petkovic, Jennifer; Epstein, Jonathan; Buchbinder, Rachelle; Welch, Vivian; Rader, Tamara; Lyddiatt, Anne; Clerehan, Rosemary; Christensen, Robin; Boonen, Annelies; Goel, Niti; Maxwell, Lara J.; Toupin-April, Karine; De Wit, Maarten; Barton, Jennifer; Flurey, Caroline; Jull, Janet; Barnabe, Cheryl; Sreih, Antoine G.; Campbell, Willemina; Pohl, Christoph; Duruöz, Mehmet Tuncay; Singh, Jasvinder A.; Tugwell, Peter S.; Guillemin, Francis

    2016-01-01

    Objective The goal of the Outcome Measures in Rheumatology (OMERACT) 12 (2014) equity working group was to determine whether and how comprehensibility of patient-reported outcome measures (PROM) should be assessed, to ensure suitability for people with low literacy and differing cultures. Methods The English, Dutch, French, and Turkish Health Assessment Questionnaires and English and French Osteoarthritis Knee and Hip Quality of Life questionnaires were evaluated by applying 3 readability formulas: Flesch Reading Ease, Flesch-Kincaid grade level, and Simple Measure of Gobbledygook; and a new tool, the Evaluative Linguistic Framework for Questionnaires, developed to assess text quality of questionnaires. We also considered a study assessing cross-cultural adaptation with/without back-translation and/or expert committee. The results of this preconference work were presented to the equity working group participants to gain their perspectives on the importance of comprehensibility and cross-cultural adaptation for PROM. Results Thirty-one OMERACT delegates attended the equity session. Twenty-six participants agreed that PROM should be assessed for comprehensibility and for use of suitable methods (4 abstained, 1 no). Twenty-two participants agreed that cultural equivalency of PROM should be assessed and suitable methods used (7 abstained, 2 no). Special interest group participants identified challenges with cross-cultural adaptation including resources required, and suggested patient involvement for improving translation and adaptation. Conclusion Future work will include consensus exercises on what methods are required to ensure PROM are appropriate for people with low literacy and different cultures. PMID:26077410

  5. Development and Validation of the Keele Musculoskeletal Patient Reported Outcome Measure (MSK-PROM)

    PubMed Central

    2015-01-01

    Objective To develop and validate a patient report outcome measure (PROM) for clinical practice that can monitor health status of patients with a range of musculoskeletal (MSK) disorders. Methods Constructs for inclusion in the MSK-PROM were identified from a consensus process involving patients with musculoskeletal conditions, clinicians, purchasers of healthcare services, and primary care researchers. Psychometric properties of the brief tool, including face and construct validity, repeatability and responsiveness were assessed in a sample of patients with musculoskeletal pain consulting physiotherapy services in the United Kingdom (n=425). Results The consensus process identified 10 prioritised domains for monitoring musculoskeletal health status: pain intensity, quality of life, physical capacity, interference with social/leisure activities, emotional well-being, severity of most difficult thing, activities and roles, understanding independence, and overall impact. As the EuroQol (EQ-5D-5L) is a widely adopted PROMs tool and covers the first four domains listed, to reduce patient burden to a minimum the MSK-PROM was designed to capture the remaining six prioritised domains which are not measured by the EQ-5D-5L. The tool demonstrated excellent reliability, construct validity, responsiveness and acceptability to patients and clinicians for use in clinical practice. Conclusion We have validated a brief patient reported outcome measure (MSK-PROM) for use in clinical practice to measure musculoskeletal health status and monitor outcomes over time using domains that are meaningful to patients and sensitive to change. Further work will establish whether the MSK-PROM is useful in other musculoskeletal healthcare settings. PMID:25928807

  6. The measurement of patient-reported outcomes of refractive surgery: the refractive status and vision profile.

    PubMed Central

    Schein, O D

    2000-01-01

    PURPOSE: To develop a questionnaire, the Refractive Status and Vision Profile (RSVP), to assess health-related quality of life associated with refractive error and its correction. METHODS: The published literature on patient report of visual and overall function was reviewed, and the RSVP was self-administered by 550 participants with refractive error. Cross-sectional validation was performed using standard psychometric techniques. The responsiveness of the RSVP to surgical intervention was assessed prospectively in a subset of 176 patients. The principal outcomes measures were scores on the overall RSVP scale (S) and on 8 RSVP subscales (functioning, driving, concern, expectations, symptoms, glare, optical problems, problems with corrective lenses). RESULTS: The RSVP (S) and its subscales demonstrated very good internal consistency (Cronbach's alpha, 0.70-0.93). S and several subscale scores were independently associated with satisfaction with vision and were more correlated with satisfaction with vision than with either visual acuity or refractive error. Higher refractive error was associated with lower scores on S and on 5 subscales. In the prospective surgical cohort, 15% of patients had some worsening in their total RSVP score; however, substantial variation was seen in the individual subscales where worsening ranged from 7% (problems with corrective lenses) to 41% (driving). The effect size (measure of responsiveness) of the RSVP and most of its subscales was very high. Approximately 14% of patients had significant worsening in 3 or more subscales, and this outcome was found to be independently associated with being dissatisfied with vision following surgery (OR, 5.84; 95% CI, 1.88, 8.13). CONCLUSIONS: The RSVP has been validated as a questionnaire that measures patient-reported quality of life related to refractive error and its correction. It is responsive to surgical intervention and provides important information regarding patient outcomes not available

  7. Measuring the Quality of VET Using the Student Outcomes Survey. Occasional Paper

    ERIC Educational Resources Information Center

    Lee, Wang-Sheng; Polidano, Cain

    2010-01-01

    The aim of this report is to examine the potential use of information from the Student Outcomes Survey, including the use of student course satisfaction information and post-study outcomes, as a means of determining markers of training quality. In an analysis of the student course satisfaction measures, the authors found there are very small…

  8. Measuring Self-Efficacy and Outcome Expectations for Resisting Social Pressures to Smoke

    ERIC Educational Resources Information Center

    Langlois, Marietta A.; Petosa R. Linyak; Hallam, Jeffrey S.

    2006-01-01

    The purpose of this study was to develop a valid and reliable instrument to measure the Social Cognitive Theory (SCT) constructs of smoking refusal skill-efficacy, positive smoking refusal outcome expectations & importance and negative smoking refusal outcome expectations & importance. This article details the rigorous instrument development…

  9. The National Outcomes Measurement System for Pediatric Speech-Language Pathology

    ERIC Educational Resources Information Center

    Mullen, Robert; Schooling, Tracy

    2010-01-01

    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…

  10. Assessing the Psychological Changes of Gifted Students Attending a Residential High School with an Outcome Measurement

    ERIC Educational Resources Information Center

    Rollins, Marlon R.; Cross, Tracy L.

    2014-01-01

    This study examined the psychological changes that 272 students experienced while attending a residential school for gifted adolescents in the Midwest. This article shares the quantitative portion of a mixed-methods study. Outcome measurement data from the Youth Outcome Questionnaire Self-Report 2.0 (YOQ-SR) tracked students' level of…

  11. Longitudinal Prediction of Child Outcomes from Differing Measures of Parenting in a Low-Income Sample

    ERIC Educational Resources Information Center

    Zaslow, Martha J.; Weinfield, Nancy S.; Gallagher, Megan; Hair, Elizabeth C.; Ogawa, John R.; Egeland, Byron; Tabors, Patton O.; De Temple, Jeanne M.

    2006-01-01

    This study examined predictions from preschool parenting measures to middle childhood cognitive and socioemotional child outcomes to explore whether parenting assessment methodologies that require more time, training, and expense yield better predictions of child outcomes than less intensive methodologies. Mother-child dyads (N=278) in low-income…

  12. Achievements in mental health outcome measurement in Australia: Reflections on progress made by the Australian Mental Health Outcomes and Classification Network (AMHOCN)

    PubMed Central

    2012-01-01

    Background Australia’s National Mental Health Strategy has emphasised the quality, effectiveness and efficiency of services, and has promoted the collection of outcomes and casemix data as a means of monitoring these. All public sector mental health services across Australia now routinely report outcomes and casemix data. Since late-2003, the Australian Mental Health Outcomes and Classification Network (AMHOCN) has received, processed, analysed and reported on outcome data at a national level, and played a training and service development role. This paper documents the history of AMHOCN’s activities and achievements, with a view to providing lessons for others embarking on similar exercises. Method We conducted a desktop review of relevant documents to summarise the history of AMHOCN. Results AMHOCN has operated within a framework that has provided an overarching structure to guide its activities but has been flexible enough to allow it to respond to changing priorities. With no precedents to draw upon, it has undertaken activities in an iterative fashion with an element of ‘trial and error’. It has taken a multi-pronged approach to ensuring that data are of high quality: developing innovative technical solutions; fostering ‘information literacy’; maximising the clinical utility of data at a local level; and producing reports that are meaningful to a range of audiences. Conclusion AMHOCN’s efforts have contributed to routine outcome measurement gaining a firm foothold in Australia’s public sector mental health services. PMID:22640939

  13. 26 CFR 801.6 - Business results measures.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 26 Internal Revenue 20 2012-04-01 2012-04-01 false Business results measures. 801.6 Section 801.6... BALANCED SYSTEM FOR MEASURING ORGANIZATIONAL AND EMPLOYEE PERFORMANCE WITHIN THE INTERNAL REVENUE SERVICE § 801.6 Business results measures. (a) In general. The business results measures will consist...

  14. Standardizing ED-based migraine clinical research: a data-driven analysis of commonly-used trial outcome measures

    PubMed Central

    Friedman, Benjamin W; Bijur, Polly E; Lipton, Richard B

    2010-01-01

    Introduction Although many high quality migraine clinical trials have been performed in the emergency department (ED) setting, almost as many different primary outcome measures have been used, making data aggregation and meta-analysis difficult. We assessed commonly used migraine trial outcomes in two ways. First, we examined the association of each commonly used outcome versus the following patient-centered variable: the research subject’s wish, when asked 24 hours after investigational medication administration, to receive the same medication the next time they presented to an ED with migraine (“would take again”). We chose this variable as the criterion standard because it provides a simple, dichotomous, clinically sensible outcome, which allows migraineurs to factor important intangibles of efficacy and adverse effects of treatment into an overall assessment of care. The second part of our analysis assessed how sensitive to true efficacy each outcome measure was by calculating sample size requirements based on results observed in previously conducted clinical trials. Methods Secondary analysis of data previously collected in four ED-based migraine randomized trials performed between 2003 and 2007. In each of these trials, subjects were asked 24 hours after administration of an investigational medication whether or not they would want to receive the same medication the next time they came to the ED with a migraine. Odds ratios (ORs) with 95%CI, adjusted for gender and medication received, were calculated as measures of association between the most commonly used outcome measures and “would take again”. The sensitivity of each outcome measure to treatment efficacy was determined by calculating the sample size that would be required to detect a statistically significant result using estimates of that outcome obtained in two clinical trials. Results Data from 378 subjects were used for this analysis. Adjusted ORs for association of “would take again

  15. Development and evaluation of an Individualized Outcome Measure (IOM) for randomized controlled trials in mental health.

    PubMed

    Pesola, Francesca; Williams, Julie; Bird, Victoria; Freidl, Marion; Le Boutillier, Clair; Leamy, Mary; Macpherson, Rob; Slade, Mike

    2015-12-01

    Pre-defined, researcher-selected outcomes are routinely used as the clinical end-point in randomized controlled trials (RCTs); however, individualized approaches may be an effective way to assess outcome in mental health research. The present study describes the development and evaluation of the Individualized Outcome Measure (IOM), which is a patient-specific outcome measure to be used for RCTs of complex interventions. IOM was developed using a narrative review, expert consultation and piloting with mental health service users (n = 20). The final version of IOM comprises two components: Goal Attainment (GA) and Personalized Primary Outcome (PPO). For GA, patients identify one relevant goal at baseline and rate its attainment at follow-up. For PPO, patients choose an outcome domain related to their goal from a pre-defined list at baseline, and complete a standardized questionnaire assessing the chosen outcome domain at baseline and follow-up. A feasibility study indicated that IOM had adequate completion (89%) and acceptability (96%) rates in a clinical sample (n = 84). IOM was then evaluated in a RCT (ISRCTN02507940). GA and PPO components were associated with each other and with the trial primary outcome. The use of the PPO component of IOM as the primary outcome could be considered in future RCTs. Copyright © 2015 John Wiley & Sons, Ltd. PMID:26184686

  16. Comparative Responsiveness of Pain Outcome Measures Among Primary Care Patients With Musculoskeletal Pain

    PubMed Central

    Krebs, Erin E.; Bair, Matthew J.; Damush, Teresa M.; Tu, Wanzhu; Wu, Jingwei; Kroenke, Kurt

    2016-01-01

    Background Comparative responsiveness data are needed to inform choices about pain outcome measures. Objectives To compare responsiveness of pain intensity, pain-related function, and composite measures, using data from a randomized trial and observational study. Research Design Analysis of responsiveness. Subjects A total of 427 adults with persistent back, hip, or knee pain were recruited from primary care. Methods Participants completed Brief Pain Inventory, Chronic Pain Grade (CPG), Roland disability, SF-36 bodily pain, and pain global rating of change measures. We used the global rating as the anchor for standardized response mean and receiver operating characteristic curve analyses. We used the distribution-based standard error of measurement to estimate minimally important change. To assess responsiveness to the trial intervention, we evaluated standardized effect size statistics stratified by trial arm. Results All measures were responsive to global improvement and all had fair-to-good accuracy in discriminating between participants with and without improvement. SF bodily pain was less responsive than other measures in several analyses. The 3-item PEG was similarly responsive to full Brief Pain Inventory scales. CPG and SF bodily pain were less responsive to the trial intervention and did not perform well among participants with hip/knee pain. Agreement between anchor and distribution-based methods was modest. Conclusions If a brief measure is desired, the 3-item PEG is more responsive than the SF bodily pain scale. CPG and SF bodily pain scales may be relatively poor choices for trial outcome assessment. Both anchor and distribution-based methods should be considered when determining clinically important change. PMID:20856144

  17. Posttraumatic midshaft clavicular shortening does not result in relevant functional outcome changes

    PubMed Central

    Stegeman, Sylvia A; de Witte, Pieter Bas; Boonstra, Sjoerd; de Groot, Jurriaan H; Nagels, Jochem; Krijnen, Pieta; Schipper, Inger B

    2015-01-01

    Background and purpose Shoulder function may be changed after healing of a nonoperatively treated clavicular fracture, especially in cases of clavicular shortening or mal-union. We investigated scapular orientations and functional outcome in healed clavicular fractures with and without clavicular shortening. Patients and methods 32 participants with a healed nonoperatively treated midshaft clavicular fracture were investigated. Motions of the thorax, arm, and shoulder were recorded by standardized electromagnetic 3D motion tracking. The DASH score and Constant-Murley score were used to evaluate functional outcome. Orientation of the scapula and humerus at rest and during standardized tasks, and strength and function of the affected shoulders were compared with corresponding values for the uninjured contralateral shoulders. Results Mean clavicular shortening was 25 mm (SD 16). Scapula protraction had increased by mean 4.4° in rest position in the affected shoulders. During abduction, slightly more protraction, slightly more lateral rotation, and slightly less backward tilt was found for the affected shoulders. For anteflexion, the scapular orientations of the affected shoulders also showed slightly increased protraction, slightly increased lateral rotation, and slightly reduced backward tilt. Scapulohumeral kinematics, maximum humerus angles, and strength were not associated with the degree of clavicular shortening. All participants had excellent performance on the Constant-Murley score and DASH score. Interpretation Scapulohumeral kinematics in shoulders with a healed clavicular fracture differ from those in uninjured shoulders, but these changes are small, do not result in clinically relevant changes in outcome, and do not relate to the amount of clavicular shortening. These findings do not support routine operative reduction and fixation of shortened midshaft clavicular fractures based on the argument of functional outcome. PMID:25872962

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

    NASA Astrophysics Data System (ADS)

    Fitzsimons, James A.; Carr, C. Ben

    2014-09-01

    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.

  19. Psychometrics of the Personal Questionnaire: A client-generated outcome measure.

    PubMed

    Elliott, Robert; Wagner, John; Sales, Célia M D; Rodgers, Brian; Alves, Paula; Café, Maria J

    2016-03-01

    We present a range of evidence for the reliability and validity of data generated by the Personal Questionnaire (PQ), a client-generated individualized outcome measure, using 5 data sets from 3 countries. Overall pretherapy mean internal consistency (alpha) across clients was .80, and within-client alphas averaged .77; clients typically had 1 or 2 items that did not vary with the other items. Analyses of temporal structure indicated high levels of between-clients variance (58%), moderate pretherapy test-retest correlation (r = .57), and high session-to-session Lag-1 autocorrelation (.82). Scores on the PQ provided clear evidence of convergence with a range of outcome measures (within-client r = .41). Mean pre-post effects were large (d = 1.25). The results support a revised caseness cutoff of 3.25 and a reliable change index interval of 1.67. We conclude that PQ data meet criteria for evidence-based, norm-referenced measurement of client psychological distress for supporting psychotherapy practice and research. (PsycINFO Database Record PMID:26075406

  20. MEASURING THE IMPACT OF PARTICULATE MATTER REDUCTIONS BY ENVIRONMENTAL HEALTH OUTCOME INDICATORS

    EPA Science Inventory

    Quantifiable indicators will measure the progress of local and national PM reduction strategies in lowering population exposure to PM and positively impacting public health. These environmental health outcome indicators will ultimately serve to inform and evaluate environmen...

  1. Challenges in measuring outcomes for caregivers of people with mental health problems

    PubMed Central

    Zendjidjian, Xavier Y.; Boyer, Laurent

    2014-01-01

    Patient-reported outcomes (PROs) are increasingly important in health care and mental health research. Furthermore, caregivers become partners in care for patients with mental disorders, and health workers are more attentive to the expectations and needs of caregivers. A number of outcomes for caregivers are measured and used in daily practice in order to promote actions to improve health care systems and progress in research on the impact of mental disorders on their caregivers. This paper proposes an inventory of the different outcomes and different measurement tools used to assess the impact of disorders, raising a number of methodological and conceptual issues that limit the relevance of measurement tools and complicate their use. Finally, we propose some recommendations promoting the development of relevant outcome measures for caregivers and their integration into current systems of care. PMID:25152655

  2. Assessment of murine lung mechanics outcome measures: alignment with those made in asthmatics

    PubMed Central

    Walker, Julia K. L.; Kraft, Monica; Fisher, John T.

    2013-01-01

    Although asthma is characterized as an inflammatory disease, recent reports highlight the importance of pulmonary physiology outcome measures to the clinical assessment of asthma control and risk of asthma exacerbation. Murine models of allergic inflammatory airway disease have been widely used to gain mechanistic insight into the pathogenesis of asthma; however, several aspects of murine models could benefit from improvement. This review focuses on aligning lung mechanics measures made in mice with those made in humans, with an eye toward improving the translational utility of these measures. A brief description of techniques available to measure murine lung mechanics is provided along with a methodological consideration of their utilization. How murine lung mechanics outcome measures relate to pulmonary physiology measures conducted in humans is discussed and we recommend that, like human studies, outcome measures be standardized for murine models of asthma. PMID:23408785

  3. Long-Term Outcomes of Cultivated Limbal Epithelial Transplantation: Evaluation and Comparison of Results in Children and Adults

    PubMed Central

    Ganger, Anita; Vanathi, M.; Mohanty, Sujata; Tandon, Radhika

    2015-01-01

    Purpose. To compare the long-term clinical outcomes of cultivated limbal epithelial transplantation (CLET) in children and adults with limbal stem cell deficiency. Design. Retrospective case series. Methods. Case records of patients with limbal stem cell deficiency (LSCD) who underwent CLET from April 2004 to December 2014 were studied. Outcome measures were compared in terms of anatomical success and visual improvement. Parameters for total anatomical success were avascular, epithelized, and clinically stable corneal surface without conjunctivalization, whereas partial anatomical success was considered when mild vascularization (sparing centre of cornea) and mild conjunctivalization were noted along with complete epithelization. Results. A total of 62 cases underwent the CLET procedure: 38 (61.3%) were children and 24 (38.7%) were adults. Patients with unilateral LSCD (33 children and 21 adults) had autografts and those with bilateral LSCD (5 children and 3 adults) had allografts. Amongst the 54 autografts partial and total anatomical success were noted in 21.2% and 66.6% children, respectively, and 19.0% and 80.9% in adults, respectively (p value 0.23). Visual improvement of 1 line and ≥2 lines was seen in 57.5% and 21.2% children, respectively, and 38% and 38% in adults, respectively (p value 0.31). Conclusion. Cultivated limbal epithelial transplantation gives good long-term results in patients with LSCD and the outcomes are comparable in children and adults. PMID:26770973

  4. Open versus Laparoscopic Surgery: Does the Surgical Technique Influence Pain Outcome? Results from an International Registry

    PubMed Central

    Allvin, Renée; Rawal, Narinder; Johanzon, Eva; Bäckström, Ragnar

    2016-01-01

    Postoperative pain management relevant for specific surgical procedures is debated. The importance of evaluating pain with consideration given to type of surgery and the patient's perspective has been emphasized. In this prospective cohort study, we analysed outcome data from 607 patients in the international PAIN OUT registry for assessment and comparison of postoperative pain outcome within the 24 first hours after laparoscopic and open colonic surgery. Patients from the laparoscopic group scored minimum pain at a higher level than the open group (P = 0.012). Apart from minimum pain, no other significant differences in patient reported outcomes were observed. Maximum pain scores >3 were reported from 77% (laparoscopic) and 68% (open) patients (mean ≥ 5 in both groups). Pain interference with mobilization was reported by 87–93% of patients. Both groups scored high levels of patient satisfaction. In the open group, a higher frequency of patients received a combination of general and regional anaesthesia, which had an impact of the minimum pain score. Our results from registry data indicate that surgical technique does not influence the quality of postoperative pain management during the first postoperative day if adequate analgesia is given. PMID:27127649

  5. 2-year outcomes in Initial survivors with Acute Liver failure: Results from a Prospective, Multicenter Study

    PubMed Central

    Fontana, Robert J.; Ellerbe, Caitlyn; Durkalski, Valerie E.; Rangnekar, Amol; Reddy, K. Rajender; Stravitz, Todd; McGuire, Brendan; Davern, Timothy; Reuben, Adrian; Liou, Iris; Fix, Oren; Ganger, Daniel R; Chung, Raymond T.; Schilsky, Mike; Han, Steven; Hynan, Linda S.; Sanders, Corron; Lee, William M.

    2014-01-01

    BACKGROUND The long-term clinical outcomes in initial survivors with acute liver failure (ALF) are not well known. AIMS The aim of the current study is to provide an overview of the 2 year clinical outcomes amongst initial survivors and liver transplant (LT) recipients that were alive 3 weeks after enrollment in the Acute Liver Failure Study Group (ALFSG). METHODS Outcomes in adult ALFSG patients that were enrolled between 1998 and 2010 were reviewed. RESULTS 2-year patient survival was significantly higher in the 262 LT recipients (92.4%) compared to the 306 acetaminophen (APAP) spontaneous survivors (SS) (89.5%) and 200 non-APAP SS (75.5%) (p < 0.0001). The causes of death were similar in the 3 groups but the time to death was significantly longer in the LT recipients (p< 0.0001). Independent predictors of 2-year mortality in the APAP group were a high serum phosphate level and patient age (c-statistic = 0.65 (0.54, 0.76)), patient age and days from jaundice to ALF onset in the non-APAP group (c-statistic =0.69 (0.60, 0.78)), and patient age, days from jaundice, and higher coma grade in the LT recipients (c-statistic=0.74 (0.61, 0.87)). The LT recipients were significantly more likely to be employed and have a higher educational level (p < 0.05). CONCLUSIONS Two-year outcomes in initial survivors of ALF are generally good but non-APAP patients have a significantly lower survival which may relate to pre-existing medical co-morbidities. Spontaneous survivors with APAP overdose experience substantial morbidity during follow-up from ongoing psychiatric and substance abuse issues. PMID:25039930

  6. An evaluation of interrupted and uninterrupted measurement of vocal stereotypy on perceived treatment outcomes.

    PubMed

    Carroll, Regina A; Kodak, Tiffany

    2014-01-01

    The type of procedure used to measure a target behavior may directly influence the perceived treatment outcomes. In the present study, we examined the influence of different data-analysis procedures on the outcomes of two commonly used treatments on the vocal stereotypy of 2 children with an autism spectrum disorder. In Study 1, we compared an interrupted and uninterrupted data-analysis procedure to measure vocal stereotypy during the implementation of response interruption and redirection (RIRD). The results showed that the interrupted data-analysis procedure overestimated the effectiveness of RIRD. In Study 2, we examined the influence of different data-analysis procedures on the interpretation of the relative effects of 2 different treatments for vocal stereotypy. Specifically, we compared interrupted and uninterrupted data-analysis procedures during the implementation of RIRD and noncontingent reinforcement (NCR) as a treatment for vocal stereotypy. The results showed that, as in Study 1, the interrupted data-analysis procedure overestimated the effectiveness of RIRD; however, this effect was not apparent with NCR. These findings suggest that different types of data analysis can influence the perceived success of a treatment. PMID:24764249

  7. Measuring Social Capital as an Outcome of Service Learning

    ERIC Educational Resources Information Center

    D'Agostino, Maria J.

    2010-01-01

    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…

  8. Feedback from Outcome Measures and Treatment Effectiveness, Treatment Efficiency, and Collaborative Practice: A Systematic Review.

    PubMed

    Gondek, Dawid; Edbrooke-Childs, Julian; Fink, Elian; Deighton, Jessica; Wolpert, Miranda

    2016-05-01

    Due to recent increases in the use of feedback from outcome measures in mental health settings, we systematically reviewed evidence regarding the impact of feedback from outcome measures on treatment effectiveness, treatment efficiency, and collaborative practice. In over half of 32 studies reviewed, the feedback condition had significantly higher levels of treatment effectiveness on at least one treatment outcome variable. Feedback was particularly effective for not-on-track patients or when it was provided to both clinicians and patients. The findings for treatment efficiency and collaborative practice were less consistent. Given the heterogeneity of studies, more research is needed to determine when and for whom feedback is most effective. PMID:26744316

  9. Can Research Design Explain Variation in Head Start Research Results? A Meta-Analysis of Cognitive and Achievement Outcomes

    ERIC Educational Resources Information Center

    Shager, Hilary M.; Schindler, Holly S.; Magnuson, Katherine A.; Duncan, Greg J.; Yoshikawa, Hirokazu; Hart, Cassandra M. D.

    2013-01-01

    This study explores the extent to which differences in research design explain variation in Head Start program impacts. We employ meta-analytic techniques to predict effect sizes for cognitive and achievement outcomes as a function of the type and rigor of research design, quality and type of outcome measure, activity level of control group, and…

  10. Total Hip Arthroplasty Performed Through Direct Anterior Approach Provides Superior Early Outcome: Results of a Randomized, Prospective Study.

    PubMed

    Parvizi, Javad; Restrepo, Camilo; Maltenfort, Mitchell G

    2016-07-01

    Studies suggest that total hip arthroplasty (THA) performed through direct anterior (DA) approach has better functional outcomes than other surgical approaches. The immediate to very early outcomes of DA THA are not known. A prospective, randomized study examined the very early outcome of THA performed through DA versus direct lateral approach. The functional outcomes on day 1, day 2, week 6, week 12, 6 months, and 1 year were measured. Patients receiving DA THA had significantly higher functional scores during the early period following surgery. The difference in functional scores leveled out at 6 months. PMID:27241374

  11. Early Axonal Area Measurement Predicts Early Nerve Regeneration Outcomes.

    PubMed

    Neilson, Michael; Yan, Yuhui; Zhang, Lin-Ling; Wang, Ziyi; Agresti, Michael; Matloub, Hani; Yan, Ji-Gheng

    2016-03-01

    Background Study of peripheral nerve injury and regeneration in laboratory animals can be time consuming and expensive. This study determines if it is possible to reduce time and cost for a peripheral nerve regeneration study. Purpose The purpose of this study was to determine if nerve axonal area (NXA) or nerve fiber counting (NFC) correlates with compound muscle action potential (CMAP) recovery which is known to predict functional muscular recovery in the early stage of nerve regeneration. Methods In this study, six rats had a crush injury of the sciatic nerve without treatment. These rats were evaluated at 4 weeks of recovery with the following assessments: CMAP readings from the extensor digitorum longus, NXA measurement, and NFC. Results NXA correlated with CMAP; NFC did not correlate with CMAP. Conclusion NFC is not a reliable method for predicting muscular recovery in the early stages. NXA is a dependable assessment for muscular recovery in the early stages of nerve regeneration. Using NXA measurement can predict later electrophysiological and functional recovery. Using NXA with CMAP measurement for nerve injury, repair, and treatment in the animal study can save cost and time. PMID:26636887

  12. 26 CFR 801.6 - Business results measures.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 26 Internal Revenue 20 2014-04-01 2014-04-01 false Business results measures. 801.6 Section 801.6... § 801.6 Business results measures. (a) In general. The business results measures will consist of..., financial planning, resource management, and the formulation of case selection criteria. Records of...

  13. Benchmarks for Operative Outcomes of Robotic and Open Radical Prostatectomy: Results from the Health Professionals Follow-up Study

    PubMed Central

    Alemozaffar, Mehrdad; Sanda, Martin; Yecies, Derek; Mucci, Lorelei A.; Stampfer, Meir J.; Kenfield, Stacey A.

    2014-01-01

    Background Robot-assisted laparoscopic radical prostatectomy (RALP) has become increasingly common; however, there have been no nationwide, population-based, non–claims-based studies to evaluate differences in outcomes between RALP and open radical retropubic prostatectomy (RRP). Objective To determine surgical, oncologic, and health-related quality of life (HRQOL) outcomes following RALP and RRP in a nationwide cohort. Design, setting, and participants We identified 903 men in the Health Professionals Follow-up Study diagnosed with prostate cancer between 2000 and 2010 who underwent radical prostatectomy using RALP (n = 282) or RRP (n = 621) as primary treatment. Intervention Radical prostatectomy. Outcome measurements and statistical analysis We compared patients undergoing RALP or RRP across a range of perioperative, oncologic, and HRQOL outcomes. Results and limitations Use of RALP increased during the study period, constituting 85.2% of study subjects in 2009, up from 4.5% in 2003. Patients undergoing RALP compared to RRP were less likely to have a lymph node dissection (51.5% vs 85.4%; p < 0.0001), had less blood loss (207.4 ml vs 852.3 ml; p < 0.0001), were less likely to receive blood transfusions (4.3% vs 30.3%; p < 0.0001), and had shorter hospital stays (1.8 d vs 2.9 d; p < 0.0001). Surgical, oncologic, and HRQOL outcomes did not differ significantly among the groups. In multivariate logistic regression models, there were no significant differences in 3- or 5-yr recurrence-free survival comparing RALP versus RRP (hazard ratios: 0.98 [95% confidence interval (CI), 0.46–2.08] and 0.75 [95% CI, 0.18–3.11], respectively). Conclusions In a nationwide cohort of patients undergoing surgical treatment for prostate cancer, RALP was associated with shorter hospital stay, and lower blood loss and transfusion rates than RRP. Surgical oncologic and HRQOL outcomes were similar between groups. Patient summary We studied men throughout the United States with

  14. Three measures of functional outcome for lower limb amputees: a retrospective review.

    PubMed

    Treweek, S P; Condie, M E

    1998-12-01

    Outcome measures are becoming increasingly important in health care. Functional outcome measures are of particular importance for lower limb amputees since much of the rehabilitation process is concerned with increasing mobility and personal independence. The Scottish Physiotherapy Amputee Research Group (SPARG) has used three measures of functional outcome: the Barthel Index, Russek's classification and the Locomotor Index. The review reported here involves 938 patients having a primary amputation at the transtibial or transfemoral level between October 1992 and July 1997. Differences in function due to age and level of amputation are well known clinically and the measures were compared by looking at their ability to detect these differences. The Barthel Index lacked sensitivity because of ceiling effects and should not be considered as a suitable functional outcome measure for amputee patients. Russek's classification does detect significant differences but requires a large number of patients making it unsuitable for single hospital investigations. The Locomotor Index demonstrates significant differences due to age and amputation level despite fewer patients being assessed by this measure during the period covered by this paper. The range of the Locomotor Index can be extended to cover more active amputees by considering its 'advanced activities' subscale separately. The Locomotor Index is a promising measure and should be considered by rehabilitation teams looking for a valid, reliable and sensitive functional outcome measure for use with lower limb amputees. PMID:9881605

  15. General Education Courses at the University of Botswana: Application of the Theory of Reasoned Action in Measuring Course Outcomes

    ERIC Educational Resources Information Center

    Garg, Deepti; Garg, Ajay K.

    2007-01-01

    This study applied the Theory of Reasoned Action and the Technology Acceptance Model to measure outcomes of general education courses (GECs) under the University of Botswana Computer and Information Skills (CIS) program. An exploratory model was validated for responses from 298 students. The results suggest that resources currently committed to…

  16. Defining, Conceptualizing, and Measuring Fidelity of Implementation and Its Relationship to Outcomes in K-12 Curriculum Intervention Research

    ERIC Educational Resources Information Center

    O'Donnell, Carol L.

    2008-01-01

    Education researchers are being asked to conduct rigorous, scientifically based studies of K-12 curriculum interventions; therefore, the need for measuring fidelity of implementation and empirically relating it to outcomes (the chief rationale for this review) is warranted to ensure internal and external validity. The results of this review…

  17. Modeling Verdict Outcomes Using Social Network Measures: The Watergate and Caviar Network Cases.

    PubMed

    Masías, Víctor Hugo; Valle, Mauricio; Morselli, Carlo; Crespo, Fernando; Vargas, Augusto; Laengle, Sigifredo

    2016-01-01

    Modelling criminal trial verdict outcomes using social network measures is an emerging research area in quantitative criminology. Few studies have yet analyzed which of these measures are the most important for verdict modelling or which data classification techniques perform best for this application. To compare the performance of different techniques in classifying members of a criminal network, this article applies three different machine learning classifiers-Logistic Regression, Naïve Bayes and Random Forest-with a range of social network measures and the necessary databases to model the verdicts in two real-world cases: the U.S. Watergate Conspiracy of the 1970's and the now-defunct Canada-based international drug trafficking ring known as the Caviar Network. In both cases it was found that the Random Forest classifier did better than either Logistic Regression or Naïve Bayes, and its superior performance was statistically significant. This being so, Random Forest was used not only for classification but also to assess the importance of the measures. For the Watergate case, the most important one proved to be betweenness centrality while for the Caviar Network, it was the effective size of the network. These results are significant because they show that an approach combining machine learning with social network analysis not only can generate accurate classification models but also helps quantify the importance social network variables in modelling verdict outcomes. We conclude our analysis with a discussion and some suggestions for future work in verdict modelling using social network measures. PMID:26824351

  18. Modeling Verdict Outcomes Using Social Network Measures: The Watergate and Caviar Network Cases

    PubMed Central

    2016-01-01

    Modelling criminal trial verdict outcomes using social network measures is an emerging research area in quantitative criminology. Few studies have yet analyzed which of these measures are the most important for verdict modelling or which data classification techniques perform best for this application. To compare the performance of different techniques in classifying members of a criminal network, this article applies three different machine learning classifiers–Logistic Regression, Naïve Bayes and Random Forest–with a range of social network measures and the necessary databases to model the verdicts in two real–world cases: the U.S. Watergate Conspiracy of the 1970’s and the now–defunct Canada–based international drug trafficking ring known as the Caviar Network. In both cases it was found that the Random Forest classifier did better than either Logistic Regression or Naïve Bayes, and its superior performance was statistically significant. This being so, Random Forest was used not only for classification but also to assess the importance of the measures. For the Watergate case, the most important one proved to be betweenness centrality while for the Caviar Network, it was the effective size of the network. These results are significant because they show that an approach combining machine learning with social network analysis not only can generate accurate classification models but also helps quantify the importance social network variables in modelling verdict outcomes. We conclude our analysis with a discussion and some suggestions for future work in verdict modelling using social network measures. PMID:26824351

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

    PubMed Central

    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

    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

  20. Model-based estimation of measures of association for time-to-event outcomes

    PubMed Central

    2014-01-01

    Background Hazard ratios are ubiquitously used in time to event applications to quantify adjusted covariate effects. Although hazard ratios are invaluable for hypothesis testing, other adjusted measures of association, both relative and absolute, should be provided to fully appreciate studies results. The corrected group prognosis method is generally used to estimate the absolute risk reduction and the number needed to be treated for categorical covariates. Methods The goal of this paper is to present transformation models for time-to-event outcomes to obtain, directly from estimated coefficients, the measures of association widely used in biostatistics together with their confidence interval. Pseudo-values are used for a practical estimation of transformation models. Results Using the regression model estimated through pseudo-values with suitable link functions, relative risks, risk differences and the number needed to treat, are obtained together with their confidence intervals. One example based on literature data and one original application to the study of prognostic factors in primary retroperitoneal soft tissue sarcomas are presented. A simulation study is used to show some properties of the different estimation methods. Conclusions Clinically useful measures of treatment or exposure effect are widely available in epidemiology. When time to event outcomes are present, the analysis is performed generally resorting to predicted values from Cox regression model. It is now possible to resort to more general regression models, adopting suitable link functions and pseudo values for estimation, to obtain alternative measures of effect directly from regression coefficients together with their confidence interval. This may be especially useful when, in presence of time dependent covariate effects, it is not straightforward to specify the correct, if any, time dependent functional form. The method can easily be implemented with standard software. PMID:25106903

  1. Capturing Psychologists' Work in Integrated Care: Measuring and Documenting Administrative Outcomes.

    PubMed

    Kearney, Lisa K; Smith, Clifford A; Pomerantz, Andrew S

    2015-12-01

    With the expansion of integrated primary care and the increased focus on fiscal sustainability, it is critical for clinical managers of these innovative systems to have practical methods for measuring administrative outcomes. Administrative outcomes will assist leadership in the development of efficient, streamlined clinics to provide services to the primary care population. Additionally, administrative measures can be utilized to provide information to assist in guiding resource utilization and management decisions. Several administrative outcomes are suggested for integrated primary care managers to consider for application, including: clinic utilization measures, integrated care administrative measures, wait time and access metrics, and productivity monitors. Effective utilization of these measures can help office managers and clinic leadership not only to maximize patient care, but also to enhance essential business operations, which increase the long-term sustainability of integrated primary care programs. PMID:26645090

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

    PubMed Central

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

    2013-01-01

    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

  3. SLEEP AND TREATMENT OUTCOME IN POSTTRAUMATIC STRESS DISORDER: RESULTS FROM AN EFFECTIVENESS STUDY

    PubMed Central

    Grey, Nick; Clark, David M.; Wild, Jennifer; Stott, Richard; Ehlers, Anke

    2015-01-01

    Background Most patients with posttraumatic stress disorder (PTSD) suffer from sleep problems. Concerns have been raised about possible detrimental effects of sleep problems on the efficacy of psychological treatments for PTSD. In this study, we investigated the relation of session‐to‐session changes in PTSD symptoms and sleep, and tested whether sleep problems predicted poorer short‐ and long‐term treatment outcome. Methods Self‐reported sleep quality, sleep duration, and PTSD symptoms were assessed weekly in a consecutive sample of 246 patients who received cognitive therapy for PTSD (CT‐PTSD; Ehlers & Clark, 2000), and at follow‐up (mean = 247 days posttreatment). Additionally, moderating effects of medication use and comorbid depression were assessed. Results Sleep and PTSD symptoms improved in parallel. The relation was moderated by depression: Sleep problems at the start of therapy did not predict improvement in PTSD symptoms during treatment for patients without comorbid depression. Patients with comorbid depression, however, showed less rapid decreases in PTSD symptoms, but comparable overall outcome, if their sleep quality was poor. Residual sleep problems at the end of treatment did not predict PTSD symptoms at follow‐up once residual PTSD symptoms were taken into account. Conclusions CT‐PTSD leads to simultaneous improvement in sleep and PTSD symptoms. Sleep problems may reduce the speed of recovery in PTSD patients with comorbid depression. For these patients, additional treatment sessions are indicated to achieve comparable outcomes, and additional interventions targeting sleep may be beneficial. For those without comorbid depression, self‐reported sleep problems did not interfere with response to trauma‐focused psychological treatment. PMID:26393429

  4. Measures of between-cluster variability in cluster randomized trials with binary outcomes.

    PubMed

    Thomson, Andrew; Hayes, Richard; Cousens, Simon

    2009-05-30

    Cluster randomized trials (CRTs) are increasingly used to evaluate the effectiveness of health-care interventions. A key feature of CRTs is that the observations on individuals within clusters are correlated as a result of between-cluster variability. Sample size formulae exist which account for such correlations, but they make different assumptions regarding the between-cluster variability in the intervention arm of a trial, resulting in different sample size estimates. We explore the relationship for binary outcome data between two common measures of between-cluster variability: k, the coefficient of variation and rho, the intracluster correlation coefficient. We then assess how the assumptions of constant k or rho across treatment arms correspond to different assumptions about intervention effects. We assess implications for sample size estimation and present a simple solution to the problems outlined. PMID:19378266

  5. Effectiveness of Evidence-based Pneumonia CPOE Order Sets Measured by Health Outcomes

    PubMed Central

    Krive, Jacob; Shoolin, Joel S.; Zink, Steven D.

    2015-01-01

    Objective Evidence-based sets of medical orders for the treatment of patients with common conditions have the potential to induce greater efficiency and convenience across the system, along with more consistent health outcomes. Despite ongoing utilization of order sets, quantitative evidence of their effectiveness is lacking. In this study, conducted at Advocate Health Care in Illinois, we quantitatively analyzed the benefits of community acquired pneumonia order sets as measured by mortality, readmission, and length of stay (LOS) outcomes. Methods In this study, we examined five years (2007–2011) of computerized physician order entry (CPOE) data from two city and two suburban community care hospitals. Mortality and readmissions benefits were analyzed by comparing “order set” and “no order set” groups of adult patients using logistic regression, Pearson’s chi-squared, and Fisher’s exact methods. LOS was calculated by applying one-way ANOVA and the Mann-Whitney U test, supplemented by analysis of comorbidity via the Charlson Comorbidity Index. Results The results indicate that patient treatment orders placed via electronic sets were effective in reducing mortality [OR=1.787; 95% CF 1.170-2.730; P=.061], readmissions [OR=1.362; 95% CF 1.015-1.827; P=.039], and LOS [F (1,5087)=6.885, P=.009, 4.79 days (no order set group) vs. 4.32 days (order set group)]. Conclusion Evidence-based ordering practices have the potential to improve pneumonia outcomes through reduction of mortality, hospital readmissions, and cost of care. However, the practice must be part of a larger strategic effort to reduce variability in patient care processes. Further experimental and/or observational studies are required to reduce the barriers to retrospective patient care analyses. PMID:26392842

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

    PubMed Central

    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

    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

  7. Measuring Treatment Outcomes in Comorbid Insomnia and Fibromyalgia: Concordance of Subjective and Objective Assessments

    PubMed Central

    Mundt, Jennifer M.; Crew, Earl C.; Krietsch, Kendra; Roth, Alicia J.; Vatthauer, Karlyn; Robinson, Michael E.; Staud, Roland; Berry, Richard B.; McCrae, Christina S.

    2016-01-01

    Study Objectives: In insomnia, actigraphy tends to underestimate wake time compared to diaries and PSG. When chronic pain co-occurs with insomnia, sleep may be more fragmented, including more movement and arousals. However, individuals may not be consciously aware of these arousals. We examined the baseline concordance of diaries, actigraphy, and PSG as well as the ability of each assessment method to detect changes in sleep following cognitive behavioral therapy for insomnia (CBT-I). Methods: Adults with insomnia and fibromyalgia (n = 113) were randomized to CBT-I, CBT for pain, or waitlist control. At baseline and posttreatment, participants completed one night of PSG and two weeks of diaries/actigraphy. Results: At baseline, objective measures estimated lower SOL, higher TST, and higher SE than diaries (ps < 0.05). Compared to PSG, actigraphic estimates were higher for SOL and lower for WASO (ps < 0.05). Repeated measures ANOVAs were conducted for the CBT-I group (n = 15), and significant method by time interactions indicated that the assessment methods differed in their sensitivity to detect treatment-related changes. PSG values did not change significantly for any sleep parameters. However, diaries showed improvements in SOL, WASO, and SE, and actigraphy also detected the WASO and SE improvements (ps < 0.05). Conclusions: Actigraphy was generally more concordant with PSG than with diaries, which are the recommended assessment for diagnosing insomnia. However, actigraphy showed greater sensitivity to treatment-related changes than PSG; PSG failed to detect any improvements, but actigraphy demonstrated changes in WASO and SE, which were also found with diaries. In comorbid insomnia/fibromyalgia, actigraphy may therefore have utility in measuring treatment outcomes. Citation: Mundt JM, Crew EC, Krietsch K, Roth AJ, Vatthauer K, Robinson ME, Staud R, Berry RB, McCrae CS. Measuring treatment outcomes in comorbid insomnia and fibromyalgia: concordance of subjective

  8. Association of Claims-Based Quality of Care Measures with Outcomes among Community Dwelling Vulnerable Elders

    PubMed Central

    Zingmond, David S.; Ettner, susan L.; Wilber, Kathleen H.; Wenger, Neil S.

    2013-01-01

    Background Few studies examine the link between measured process of care and outcome. Objective Evaluate the relationship of claims-based assessment of process of care to subsequent function and survival. Research Design Retrospective cohort study using claims from 1999 to assess performance on 41 quality indicators (QIs) from the Assessing Care of Vulnerable Elders (ACOVE) measurement set on functional decline and death in 2000. Setting Community dwelling individuals Subjects All persons > 75 years old enrolled in Medicare and Medicaid in 19 California counties in 1998 and 1999 who received In Home Supportive Services. Measures Quality of care index, Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) need indices, Mortality Results 21,310 persons were eligible for a mean of 7.1 QIs; and received 46% of recommended care. The ADL index increased from 8.1 to 11.6 between baseline and follow-up. The IADL index increased from 13.6 to 14.1. Fifteen percent of the cohort died in 2000. After accounting for number of QIs triggered, baseline function and other covariates, better quality was associated with better function at follow-up. Ten percent better quality was associated at follow-up with 0.21 lower ADL need score (95% confidence interval (CI): 0.25 to 0.17), 0.022 lower IADL need score (95% CI: 0.032 to 0.013) and lower odds of death (0.91, 95% CI: 0.89 to 0.93). Conclusions Routinely collected data implementing ACOVE measures for community vulnerable elders generate quality scores that are directly related to patient functional and survival outcomes. These findings suggest that population-based assessment of care is feasible for vulnerable older persons. PMID:21499140

  9. Recovery Assessment Scale – Domains and Stages (RAS-DS): Its feasibility and outcome measurement capacity

    PubMed Central

    Hancock, Nicola; Scanlan, Justin Newton; Honey, Anne; Bundy, Anita C; O’Shea, Katrina

    2014-01-01

    Objective: A self-report instrument of mental health recovery is needed both to facilitate collaborative, recovery-oriented practice and measure recovery-focused outcomes. The Recovery Assessment Scale – Domains and Stages (RAS-DS) has been developed to simultaneously fulfill these goals. The aim of this study was to test the feasibility and measurement properties of the RAS-DS. Method: Feasibility was examined by 58 consumer-staff pairs volunteering from 3 non-government organisations. Consumers completed the RAS-DS, discussed it with staff, and then both completed Usefulness Questionnaires. The psychometric properties were examined using Rasch analysis with the data from these consumer participants and from additional participants recruited from two Partners in Recovery programs (N=324). Results: Over 70% of consumers reported taking 15 minutes or less to complete the RAS-DS and rated the instrument as easy or very easy to use. Qualitative data from both consumers and staff indicated that, for most, the RAS-DS was an easy to use, meaningful resource that facilitated shared understandings and collaborative goal setting. However, for a very small number of consumers, the instrument was too confronting and hard to use. Rasch analysis demonstrated evidence for excellent internal reliability and validity. Raw scores were highly correlated with Rasch-generated overall scores and thus no transformation is required, easing use for clinicians. Preliminary evidence for sensitivity to change was demonstrated. Conclusions: The results provide evidence of the feasibility and psychometric strengths of the RAS-DS. Although further research is required, the RAS-DS shows promise as a potential addition to the national suite of routine outcome measures. PMID:25526940

  10. Realization of a Binary-Outcome Projection Measurement of a Three-Level Superconducting Quantum System

    NASA Astrophysics Data System (ADS)

    Jerger, Markus; Macha, Pascal; Hamann, Andrés Rosario; Reshitnyk, Yarema; Juliusson, Kristinn; Fedorov, Arkady

    2016-07-01

    Binary-outcome measurements allow one to determine whether a multilevel quantum system is in a certain state while preserving quantum coherence between all orthogonal states. In this paper, we explore different regimes of the dispersive readout of a three-level superconducting quantum system coupled to a microwave cavity in order to implement binary-outcome measurements. By designing identical cavity-frequency shifts for the first and second excited states of the system, we realize strong projective binary-outcome measurements onto its ground state with a fidelity of 94.3%. Complemented with standard microwave control and low-noise parametric amplification, this scheme enables the quantum nondemolition detection of leakage errors and can be used to create sets of compatible measurements to reveal the contextual nature of superconducting circuits.

  11. Direct and Indirect Measures of Learning Outcomes in an MSW Program: What Do We Actually Measure?

    ERIC Educational Resources Information Center

    Calderon, Orly

    2013-01-01

    This study offers a unique perspective on assessment of learning by comparing results from direct and indirect measures in a social work graduate program across two campuses of a single university. The findings suggest that students' perceptions of learning are not necessarily reflective of content and applied skills mastery. Perception of…

  12. Super-resolving angular rotation measurement using binary-outcome homodyne detection.

    PubMed

    Zhang, Zijing; Qiao, Tianyuan; Ma, Kun; Zhang, Jiandong; Cen, Longzhu; Wang, Feng; Zhao, Yuan

    2016-08-01

    There has been much recent interest in high precision angular rotation measurement using photon orbital angular momentum to realize super-resolving angular rotation measurement. It is well known that quantum detection strategies can obtain a quantum-enhanced performance. Here, we prove that binary-outcome homodyne detection method can obtain a narrower signal peak, showing better resolution compared with the existing data processing method. Since the photon loss is unavoidable in the actual non-ideal optical system, this paper further discusses the impact of photon loss on the resolution and sensitivity of angular rotation measurement with binary-outcome homodyne detection method. PMID:27505811

  13. Relationship between changes in coronary atherosclerotic plaque burden measured by intravascular ultrasound and cardiovascular disease outcomes: a systematic literature review.

    PubMed

    Forbes, Carol; Quek, Ruben G W; Deshpande, Sohan; Worthy, Gill; Ross, Janine; Kleijnen, Jos; Gandra, Shravanthi R; Kassahun, Helina; Wong, Nathan D; Nicholls, Stephen J

    2016-06-01

    Objective Evidence from coronary imaging studies suggests an association between increased atherosclerotic plaque burden and cardiovascular disease (CVD) outcomes. A systematic review was performed to evaluate the relationship between coronary atherosclerotic plaque burden changes measured by intravascular ultrasound (IVUS) and CVD outcomes. Research design and methods Rigorous systematic review methodology was used to identify prospective studies of any design assessing the relationship between atherosclerotic plaque volume (percentage or total atheroma volume [PAV or TAV]) changes and CVD outcomes, using multivariable analyses. Main outcome measures CVD outcomes including major adverse cardiac events (MACEs) and major adverse cardiac and cerebrovascular events (MACCEs). Results Literature searches from inception to February 2015 retrieved 6958 records after de-duplication. From these four studies (14 papers) were included. One study reported a significantly lower rate of CVD outcomes associated with a greater reduction in PAV (hazard ratio [HR] 0.26, 95% confidence interval [CI] 0.07-0.83). One study reported that large plaque volume was significantly associated with a greater risk of major adverse cardiac events (MACEs) (HR 1.73, 95% CI: 1.02-2.96). Similarly, a third study reported a significant increase in MACE with an increase in baseline PAV (HR 1.51, 95% CI: 1.06-2.51). Only one potentially inadequately powered Japanese study did not find a statistically significant relationship between PAV changes and MACE. Conclusions The current evidence suggests an independent and statistically significant association between increases in coronary atherosclerotic plaque burden measured by IVUS and greater long-term risk of future CVD outcomes. However, this evidence comes from a limited number of studies which mainly focus on Japanese populations and populations after PCI. Further large prospective studies are required to confirm these findings. PMID:26949994

  14. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) and how to select an outcome measurement instrument

    PubMed Central

    Mokkink, Lidwine B.; Prinsen, Cecilia A. C.; Bouter, Lex M.; de Vet, Henrica C. W.; Terwee, Caroline B.

    2016-01-01

    Background: COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) is an initiative of an international multidisciplinary team of researchers who aim to improve the selection of outcome measurement instruments both in research and in clinical practice by developing tools for selecting the most appropriate available instrument. Method: In this paper these tools are described, i.e. the COSMIN taxonomy and definition of measurement properties; the COSMIN checklist to evaluate the methodological quality of studies on measurement properties; a search filter for finding studies on measurement properties; a protocol for systematic reviews of outcome measurement instruments; a database of systematic reviews of outcome measurement instruments; and a guideline for selecting outcome measurement instruments for Core Outcome Sets in clinical trials. Currently, we are updating the COSMIN checklist, particularly the standards for content validity studies. Also new standards for studies using Item Response Theory methods will be developed. Additionally, in the future we want to develop standards for studies on the quality of non-patient reported outcome measures, such as clinician-reported outcomes and performance-based outcomes. Conclusions: In summary, we plea for more standardization in the use of outcome measurement instruments, for conducting high quality systematic reviews on measurement instruments in which the best available outcome measurement instrument is recommended, and for stopping the use of poor outcome measurement instruments. PMID:26786084

  15. Advances in Patient-Reported Outcomes: The NIH PROMIS(®) Measures.

    PubMed

    Broderick, Joan E; DeWitt, Esi Morgan; Rothrock, Nan; Crane, Paul K; Forrest, Christopher B

    2013-01-01

    Patient-reported outcomes (PRO) are questionnaire measures of patients' symptoms, functioning, and health-related quality of life. They are designed to provide important clinical information that generally cannot be captured with objective medical testing. In 2004, the National Institutes of Health launched a research initiative to improve the clinical research enterprise by developing state-of-the-art PROs. The NIH Patient-Reported Outcomes Measurement System (PROMIS) and Assessment Center are the products of that initiative. Adult, pediatric, and parent-proxy item banks have been developed by using contemporary psychometric methods, yielding rapid, accurate measurements. PROMIS currently provides tools for assessing physical, mental, and social health using short-form and computer-adaptive testing methods. The PROMIS tools are being adopted for use in clinical trials and translational research. They are also being introduced in clinical medicine to assess a broad range of disease outcomes. Recent legislative developments in the United States support greater efforts to include patients' reports of health experience in order to evaluate treatment outcomes, engage in shared decision-making, and prioritize the focus of treatment. PROs have garnered increased attention by the Food and Drug Administration (FDA) for evaluating drugs and medical devices. Recent calls for comparative effectiveness research favor inclusion of PROs. PROs could also potentially improve quality of care and disease outcomes, provide patient-centered assessment for comparative effectiveness research, and enable a common metric for tracking outcomes across providers and medical systems. PMID:25848562

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

    ERIC Educational Resources Information Center

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

    2004-01-01

    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…

  17. The Benchmarking Capacity of a General Outcome Measure of Academic Language in Science and Social Studies

    ERIC Educational Resources Information Center

    Mooney, Paul; Lastrapes, Renée E.

    2016-01-01

    The amount of research evaluating the technical merits of general outcome measures of science and social studies achievement is growing. This study targeted criterion validity for critical content monitoring. Questions addressed the concurrent criterion validity of alternate presentation formats of critical content monitoring and the measure's…

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

    ERIC Educational Resources Information Center

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

    2008-01-01

    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…

  19. Measuring Students' Transition into University and Its Association with Learning Outcomes

    ERIC Educational Resources Information Center

    Pampaka, Maria; Williams, Julian; Hutcheson, Graeme

    2012-01-01

    Previously we showed how we measured pedagogy and revealed its association with learning outcomes of sixth-form college mathematics students. In this project we followed a similar approach to the study of university transition. We particularly sought to identify the students' perceptions of the transitional experience, and measure the association…

  20. Outcomes Measurement in Voice Disorders: Application of an Acoustic Index of Dysphonia Severity

    ERIC Educational Resources Information Center

    Awan, Shaheen N.; Roy, Nelson

    2009-01-01

    Purpose: The purpose of this experiment was to assess the ability of an acoustic model composed of both time-based and spectral-based measures to track change following voice disorder treatment and to serve as a possible treatment outcomes measure. Method: A weighted, four-factor acoustic algorithm consisting of shimmer, pitch sigma, the ratio of…

  1. Clinical and Patient-reported Outcomes of a Zirconia Oral Implant: Three-year Results of a Prospective Cohort Investigation.

    PubMed

    Spies, B C; Balmer, M; Patzelt, S B M; Vach, K; Kohal, R J

    2015-10-01

    The objective of this study was to determine the clinical, radiographic, and patient-reported outcomes of a 1-piece alumina-toughened zirconia implant restored with single crowns (SCs) or 3-unit fixed dental prostheses (FDPs) after 3 y of observation. Forty patients received 53 implants, placed in a 1-stage operation with immediate temporization. Finally, 50 implants were restored with 24 SCs and 13 FDPs. To evaluate peri-implant bone loss, standardized radiographs were taken at implant insertion, at final restoration delivery, and after 1 and 3 y. Additionally, several soft tissue parameters and patient-reported outcome measures were evaluated. Linear mixed models with random intercept for each patient and patients as clusters were used to compare subgroups. Three patients did not receive a SC due to early implant loss, and 1 patient died. As a result, 36 patients with 49 implants were followed-up for 3 y, giving a cumulative survival rate of 94.2%. The average marginal bone loss amounted to 0.79 mm (SCs, 0.47 mm; FDPs, 1.07 mm; P < 0.001). After the delivery of the final prosthetic restoration, further bone loss was not statistically significant (0.09 mm; P = 0.700). Probing depth, clinical attachment level, and modified bleeding index increased significantly at the implant sites, whereas gingival recession decreased significantly. Compared with the pretreatment questionnaires, the patient-reported outcome measures showed a permanently improved perception of function, aesthetics, sense, speech and self-esteem. The survival rate of the investigated ceramic implant system seems to be comparable to reported survival rates of titanium implants when immediately restored. The recorded parameters suggest its potential for clinical utilization. PMID:26232388

  2. TBI-QOL: Development and Calibration of Item Banks to Measure Patient Reported Outcomes Following Traumatic Brain Injury

    PubMed Central

    Tulsky, David S.; Kisala, Pamela A.; Victorson, David; Carlozzi, Noelle; Bushnik, Tamara; Sherer, Mark; Choi, Seung W.; Heinemann, Allen W.; Chiaravalloti, Nancy; Sander, Angelle M.; Englander, Jeffrey; Hanks, Robin; Kolakowsky-Hayner, Stephanie; Roth, Elliot; Gershon, Richard; Rosenthal, Mitchell; Cella, David

    2016-01-01

    Objective: To use a patient-centered approach or participatory action research design combined with advanced psychometrics to develop a comprehensive patient-reported outcomes (PRO) measurement system specifically for individuals with traumatic brain injury (TBI). This TBI Quality-of-Life (TBI-QOL) measurement system expands the work of other large PRO measurement initiatives, that is, the Patient-Reported Outcomes Measurement Information System and the Neurology Quality-of-Life measurement initiative. Setting: Five TBI Model Systems centers across the United States. Participants: Adults with TBI. Design: Classical and modern test development methodologies were used. Qualitative input was obtained from individuals with TBI, TBI clinicians, and caregivers of individuals with TBI through multiple methods, including focus groups, individual interviews, patient consultation, and cognitive debriefing interviews. Item pools were field tested in a large multisite sample (n = 675) and calibrated using item response theory methods. Main Outcomes Measures: Twenty-two TBI-QOL item banks/scales. Results: The TBI-QOL consists of 20 independent calibrated item banks and 2 uncalibrated scales that measure physical, emotional, cognitive, and social aspects of health-related quality of life. Conclusions: The TBI-QOL measurement system has potential as a common data element in TBI research and to enhance collection of health-related quality-of-life and PRO data in rehabilitation research and clinical settings. PMID:25931184

  3. Simulation as a New Tool to Establish Benchmark Outcome Measures in Obstetrics

    PubMed Central

    2015-01-01

    Background There are not enough clinical data from rare critical events to calculate statistics to decide if the management of actual events might be below what could reasonably be expected (i.e. was an outlier). Objectives In this project we used simulation to describe the distribution of management times as an approach to decide if the management of a simulated obstetrical crisis scenario could be considered an outlier. Design Twelve obstetrical teams managed 4 scenarios that were previously developed. Relevant outcome variables were defined by expert consensus. The distribution of the response times from the teams who performed the respective intervention was graphically displayed and median and quartiles calculated using rank order statistics. Results Only 7 of the 12 teams performed chest compressions during the arrest following the ‘cannot intubate/cannot ventilate’ scenario. All other outcome measures were performed by at least 11 of the 12 teams. Calculation of medians and quartiles with 95% CI was possible for all outcomes. Confidence intervals, given the small sample size, were large. Conclusion We demonstrated the use of simulation to calculate quantiles for management times of critical event. This approach could assist in deciding if a given performance could be considered normal and also point to aspects of care that seem to pose particular challenges as evidenced by a large number of teams not performing the expected maneuver. However sufficiently large sample sizes (i.e. from a national data base) will be required to calculate acceptable confidence intervals and to establish actual tolerance limits. PMID:26107661

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

    PubMed Central

    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

    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

  5. Single Versus Multilevel Fusion, For Single Level Degenerative Spondylolisthesis And Multilevel Lumbar Stenosis. Four-Year Results of the Spine Patient Outcomes Research Trial

    PubMed Central

    Smorgick, Yossi; Park, Daniel K.; Baker, Kevin C; Lurie, Jon D.; Tosteson, Tor D.; Zhao, Wenyan; Herkowitz, Harry; Fischgrund, Jeffrey S; Weinstein, James N.

    2013-01-01

    Study design A subanalysis study. Objective To compare surgical outcomes and complications of multi level decompression and single level fusion to multi level decompression and multi level fusion for patients with multilevel lumbar stenosis and single level degenerative spondylolisthesis. Summary of Background Data In patients with degenerative spondylolisthesis who are treated surgically, decompression and fusion provides a better clinical outcome than decompression alone. Surgical treatment for multilevel lumbar stenosis and degenerative spondylolisthesis typically includes decompression and fusion of the spondylolisthesis segment and decompression with or without fusion for the other stenotic segments. To date, no study has compared the results of these two surgical options for single level degenerative spondylolisthesis with multilevel stenosis. Methods The results from a multicenter randomized and observational study, the Spine Patient Outcomes Research Trial (SPORT) comparing multilevel decompression and single level fusion and multi level decompression and multi level fusion for spinal stenosis with spondylolisthesis, were analyzed. The primary outcomes measures were the Bodily Pain and Physical Function scales of the Medical Outcomes Study 36-item Short-Form General Health Survey (SF-36) and the modified Oswestry Disability Index at 1,2, 3 and 4 years postoperatively. Secondary analysis consisted of stenosis bothersomeness index, low back pain bothersomeness, leg pain, patient satisfaction, and self-rated progress. Results Overall 207 patients were enrolled to the study, 130 had multlilevel decompression with one level fusion and 77 patients had multi level decompression and multi-level fusion. For all primary and secondary outcome measures, there were no statistically significant differences in surgical outcomes between the two surgical techniques. However, operative time and intraoperative blood loss were significantly higher in the multilevel fusion

  6. Prospective clinical trial comparing outcome measures between Furlow and von Langenbeck Palatoplasties for UCLP.

    PubMed

    Williams, William N; Seagle, M Brent; Pegoraro-Krook, Maria Ines; Souza, Telma V; Garla, Luis; Silva, Marcos L; Machado Neto, José S; Dutka, Jeniffer C R; Nackashi, John; Boggs, Steve; Shuster, Jonathan; Moorhead, Jacquelyn; Wharton, William; Graciano, Maria I G; Pimentel, Maria C; Feniman, Mariza; Piazentin-Penna, Silvia H A; Kemker, Joseph; Zimmermann, Maria C; Bento-Gonçalvez, Cristina; Borgo, Hilton; Marques, Ilza L; Martinelli, Angela P M C; Jorge, José C; Antonelli, Patrick; Neves, Josiane F A; Whitaker, Melina E

    2011-02-01

    The goal of this prospective randomized clinical trial was to compare 2 cohorts of standardized cleft patients with regard to functional speech outcome and the presence or absence of palatal fistulae. The 2 cohorts are randomized to undergo either a conventional von Langenbeck repair with intravelar velarplasty or the double-opposing Z-plasty Furlow procedure. A prospective 2 × 2 × 2 factorial clinical trial was used in which each subject was randomly assigned to 1 of 8 different groups: 1 of 2 different lip repairs (Spina vs. Millard), 1 of 2 different palatal repair (von Langenbeck vs. Furlow), and 1 of 2 different ages at time of palatal surgery (9-12 months vs. 15-18 months). All surgeries were performed by the same 4 surgeons. A cul-de-sac test of hypernasality and a mirror test of nasal air emission were selected as primary outcome measures for velopharyngeal function. Both a surgeon and speech pathologist examined patients for the presence of palatal fistulae. In this study, the Furlow double-opposing Z-palatoplasty resulted in significantly better velopharyngeal function for speech than the von Langenbeck procedure as determined by the perceptual cul-de-sac test of hypernasality. Fistula occurrence was significantly higher for the Furlow procedure than for the von Langenbeck. Fistulas were more likely to occur in patients with wider clefts and when relaxing incisions were not used. PMID:21042188

  7. Outcome measures based on classification performance fail to predict the intelligibility of binary-masked speech.

    PubMed

    Kressner, Abigail Anne; May, Tobias; Rozell, Christopher J

    2016-06-01

    To date, the most commonly used outcome measure for assessing ideal binary mask estimation algorithms is based on the difference between the hit rate and the false alarm rate (H-FA). Recently, the error distribution has been shown to substantially affect intelligibility. However, H-FA treats each mask unit independently and does not take into account how errors are distributed. Alternatively, algorithms can be evaluated with the short-time objective intelligibility (STOI) metric using the reconstructed speech. This study investigates the ability of H-FA and STOI to predict intelligibility for binary-masked speech using masks with different error distributions. The results demonstrate the inability of H-FA to predict the behavioral intelligibility and also illustrate the limitations of STOI. Since every estimation algorithm will make errors that are distributed in different ways, performance evaluations should not be made solely on the basis of these metrics. PMID:27369123

  8. Measuring situation awareness in emergency settings: a systematic review of tools and outcomes

    PubMed Central

    Cooper, Simon; Porter, Joanne; Peach, Linda

    2014-01-01

    Background Nontechnical skills have an impact on health care outcomes and improve patient safety. Situation awareness is core with the view that an understanding of the environment will influence decision-making and performance. This paper reviews and describes indirect and direct measures of situation awareness applicable for emergency settings. Methods Electronic databases and search engines were searched from 1980 to 2010, including CINAHL, Ovid Medline, Pro-Quest, Cochrane, and the search engine, Google Scholar. Access strategies included keyword, author, and journal searches. Publications identified were assessed for relevance, and analyzed and synthesized using Oxford evidence levels and the Critical Appraisal Skills Programme guidelines in order to assess their quality and rigor. Results One hundred and thirteen papers were initially identified, and reduced to 55 following title and abstract review. The final selection included 14 papers drawn from the fields of emergency medicine, intensive care, anesthetics, and surgery. Ten of these discussed four general nontechnical skill measures (including situation awareness) and four incorporated the Situation Awareness Global Assessment Technique. Conclusion A range of direct and indirect techniques for measuring situation awareness is available. In the medical literature, indirect approaches are the most common, with situation awareness measured as part of a nontechnical skills assessment. In simulation-based studies, situation awareness in emergencies tends to be suboptimal, indicating the need for improved training techniques to enhance awareness and improve decision-making. PMID:27147872

  9. Esophagogastric junction distensibility measurements during Heller myotomy and POEM for achalasia predict postoperative symptomatic outcomes

    PubMed Central

    Teitelbaum, Ezra N.; Soper, Nathaniel J.; Pandolfino, John E.; Kahrilas, Peter J.; Hirano, Ikuo; Boris, Lubomyr; Nicodème, Frédéric; Lin, Zhiyue; Hungness, Eric S.

    2015-01-01

    Background The functional lumen imaging probe (FLIP) is a novel diagnostic tool that can be used to measure esophagogastric junction (EGJ) distensibility. In this study we performed intraoperative FLIP measurements during laparoscopic Heller myotomy (LHM) and peroral esophageal myotomy (POEM) for treatment of achalasia and evaluated the relationship between EGJ distensibility and postoperative symptoms. Methods Distensibility index (DI) (defined as the minimum cross-sectional area at the EGJ divided by distensive pressure) was measured with FLIP at two time points during LHM and POEM: 1) at baseline after induction of anesthesia, and 2) after operation completion. Results Measurements were performed in 20 patients undergoing LHM and 36 undergoing POEM. Both operations resulted in an increase in DI, although this increase was larger with POEM (7±3.1 vs. 5.1±3.4mm2/mmHg, p<.05). The two patients (both LHM) with the smallest increases in DI (1 and 1.6mm2/mmHg) both had persistent symptoms postoperatively and, overall, LHM patients with larger increases in DI had lower postoperative Eckardt scores. In the POEM group, there was no correlation between change in DI and symptoms; however, all POEM patients experienced an increase in DI of >3mm2/mmHg. When all patients were divided into thirds based on final DI, none in the lowest DI group (<6mm2/mmHg) had symptoms suggestive of reflux (i.e., GerdQ score >7), as compared with 20% in the middle third (6–9mm2/mmHg) and 36% in the highest third (>9mm2/mmHg). Patients within an “ideal” final DI range (4.5–8.5 mm2/mmHg) had optimal symptomatic outcomes (i.e. Eckardt≤1 and GerdQ≤7) in 88% of cases, compared with 47% in those with a final DI above or below that range (p<.05). Conclusions Intraoperative EGJ distensibility measurements with FLIP were predictive of postoperative symptomatic outcomes. These results provide initial evidence that FLIP has the potential to act as a useful calibration tool during operations

  10. Epidemiology, management and outcome of gastroschisis in Sub-Saharan Africa: Results of an international survey

    PubMed Central

    Wright, Naomi J.; Zani, Augusto; Ade-Ajayi, Niyi

    2015-01-01

    Background: The aim was to compare gastroschisis (GS) epidemiology, management and outcome in low-income countries (LIC) in Sub-Saharan Africa (SSA) with middle- (MIC) and high-income countries (HIC). Materials and Methods: A 10-question survey was administered at the 2012 Pan-African Paediatric Surgery Association Congress. Results are presented as median (range); differences were analysed using contingency tests. Results: A total of 82 delegates (28 countries [66 institutions]) were divided into LIC (n = 11), MIC (n = 6) and HIC (n = 11). In LIC, there were fewer surgeons and more patients. LIC reported 22 cases (1-184) GS/institution/year, compared to 12 cases (3-23)/institution/year in MICs and 15 cases (1-100)/institution/year in HICs. Antenatal screening was less readily available in LIC. Access to parenteral nutrition and neonatal intensive care in LIC was 36% and 19%, compared to 100% in HIC. Primary closure rates were similar in LIC and HIC at 58% and 54%, respectively; however, the majority of staged closure utilised custom silos in LIC and preformed silos in HIC. In LIC, mortality was reported as >75% by 61% delegates and 50-75% by 33%, compared to <25% by 100% of HIC delegates (P < 0.0001). Conclusions: Gastroschisis is a problem encountered by surgeons in SSA. Mortality is high and resources in many centres inadequate. We propose the implementation of a combined epidemiological research, service delivery training and resource provision programme to help improve our understanding of GS in SSA whilst attempting to improve outcome. PMID:25659541

  11. Long-term results of oncoplastic breast surgery with latissimus dorsi flap reconstruction: a pilot study of the objective cosmetic results and patient reported outcome

    PubMed Central

    Kim, Kyeong-Deok; Kim, Zisun; Kuk, Jung Cheol; Jeong, Jaehong; Choi, Kyu Sung; Hur, Sung Mo; Jeong, Gui Ae; Chung, Jun Chul; Cho, Gyu Seok; Shin, Eung Jin; Kim, Hyung Chul; Kang, Sang-Gue; Lee, Min Hyuk

    2016-01-01

    Purpose The goal of oncoplastic breast surgery is to restore the appearance of the breast and improve patient satisfaction. Thus, the assessment of cosmetic results and patient-reported outcomes (PROs) using appropriately constructed and validated instruments is essential. The aim of the present study was to assess the long-term objective cosmetic results and corresponding PROs after oncoplastic breast surgery. Methods Cosmetic results were assessed by the patients, a medical panel, and a computer program (BCCT.core). PROs were assessed using BREAST-Q, a questionnaire that measures the perception of patients having breast surgery. The cosmetic results and PROs were analyzed in patients who underwent quadrantectomy and partial breast reconstruction utilizing the latissimus dorsi flap. Results The mean duration of the follow-up period was 91.6 months (range, 33.3–171.0 months), and mean age of the patients was 51 years old (range, 33–72 years). The mean tumor size was 2.1 cm (range, 0.9–5.5 cm). There was fair agreement between the medical panel and BCCT.core score (K = 0.32, P < 0.001), and a statistically significant correlation between the BCCT.core score and medical panel cosmetic results was identified (r = 0.606, P < 0.001). A better BCCT.core result was related to a higher PRO of each BREAST-Q domain—satisfaction with breasts (R2 = 0.070, P = 0.039), satisfaction with outcome (R2 = 0.087, P = 0.021), psychosocial well-being (R2 = 0.085, P = 0.023), sexual well-being (R2 = 0.082, P = 0.029), and satisfaction with information (R2 = 0.064, P = 0.049). Conclusion Our long-term results of oncoplastic surgery achieved a high level of patient satisfaction with good cosmetic results. The medical panel and BCCT.core results correlated well with the PROs of the patients using valid, reliable, and procedure-specific measures. PMID:26942154

  12. Urinary Phthalate Metabolite Concentrations and Reproductive Outcomes among Women Undergoing in Vitro Fertilization: Results from the EARTH Study

    PubMed Central

    Hauser, Russ; Gaskins, Audrey J.; Souter, Irene; Smith, Kristen W.; Dodge, Laura E.; Ehrlich, Shelley; Meeker, John D.; Calafat, Antonia M.; Williams, Paige L.

    2015-01-01

    Background: Evidence from both animal and human studies suggests that exposure to phthalates may be associated with adverse female reproductive outcomes. Objective: We evaluated the associations between urinary concentrations of phthalate metabolites and outcomes of assisted reproductive technologies (ART). Methods: This analysis included 256 women enrolled in the Environment and Reproductive Health (EARTH) prospective cohort study (2004–2012) who provided one to two urine samples per cycle before oocyte retrieval. We measured 11 urinary phthalate metabolites [mono(2-ethylhexyl) phthalate (MEHP), mono(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), mono(2-ethyl-5-oxohexyl) phthalate (MEOHP), mono(2-ethyl-5-carboxypentyl) phthalate (MECPP), mono-isobutyl phthalate (MiBP), mono-n-butyl phthalate (MBP), monobenzyl phthalate (MBzP), monoethyl phthalate (MEP), monocarboxyisooctyl phthalate (MCOP), monocarboxyisononyl phthalate (MCNP), and mono(3-carboxypropyl) phthalate (MCPP)]. We used generalized linear mixed models to evaluate the association of urinary phthalate metabolites with in vitro fertilization (IVF) outcomes, accounting for multiple IVF cycles per woman. Results: In multivariate models, women in the highest as compared with lowest quartile of MEHP, MEHHP, MEOHP, MECPP, ΣDEHP (MEHP + MEHHP + MEOHP + MECPP), and MCNP had lower oocyte yield. Similarly, the number of mature (MII) oocytes retrieved was lower in the highest versus lowest quartile for these same phthalate metabolites. The adjusted differences (95% CI) in proportion of cycles resulting in clinical pregnancy and live birth between women in the fourth versus first quartile of ΣDEHP were –0.19 (–0.29, –0.08) and –0.19 (–0.28, –0.08), respectively, and there was also a lower proportion of cycles resulting in clinical pregnancy and live birth for individual DEHP metabolites. Conclusions: Urinary concentrations of DEHP metabolites were inversely associated with oocyte yield, clinical pregnancy

  13. Approaches to risk-adjusting outcome measures applied to criminal justice involvement after community service.

    PubMed

    Banks, S M; Pandiani, J A; Bramley, J

    2001-08-01

    The ethic of fairness in program evaluation requires that measures of behavioral health agency performance be sensitive to differences in those agencies' caseload composition. The authors describe two traditional approaches to the statistical risk adjustment of outcome measures (stratification weighting and pre-post measurement) that are designed to account for differences in caseload composition and introduce a method that incorporates the strengths of both approaches. Procedures for deriving each of these measures are described in detail and demonstrated in the evaluation of a statewide system of community-based behavioral health care programs. This evaluation examines the degree to which service recipients get into trouble with the law after treatment. Three measures are recommended for inclusion in outcome-oriented "report cards," and the interpretation of each measure is discussed. Finally, the authors suggest formats for graphic and tabular presentation of the risk-adjusted evaluation for sharing findings with diverse stakeholder groups. PMID:11497020

  14. TEFTOM: A Promising General Trauma Expectation/Outcome Measure—Results of a Validation Study on Pan-American Ankle and Distal Tibia Trauma Patients

    PubMed Central

    Suk, Michael; Buckley, Richard E.; Paccola, Cleber A. J.; Lorich, Dean G.; Helfet, David L.; Hanson, Beate

    2013-01-01

    Background. In orthopedics, there is no instrument specifically designed to assess patients' expectations of their final surgery outcome in general trauma populations. We developed the Trauma Expectation Factor Trauma Outcome Measure (TEFTOM) to investigate the fulfilment of patients' expectations one year after surgery as a measure of general trauma surgical outcomes. The aim of this paper was to assess the psychometric characteristics of this new general trauma outcome measure. Methods. The questionnaire was tested in 201 ankle and distal tibia fracture patients scheduled for surgery. Patients were followed up for twelve months. The TEFTOM questionnaire was evaluated for its criterion validity, internal consistency, reproducibility, and responsiveness. Results. TOM showed good criterion validity against the American Academy of Orthopaedic Surgeons Foot and Ankle Scale (Pearson's correlation coefficient = 0.69–0.77). Internal consistency was acceptable for TEF (Cronbach's alpha = 0.65–0.76) and excellent for TOM (Cronbach's alpha = 0.76–0.85). Reproducibility was moderate to very good (intraclass coefficient correlation (ICC) ≥0.67) for TEF and very good (ICC ≥0.92) for TOM. TOM also proved to be responsive to changes in patients' condition over time (Wald test; P < 0.001). Conclusions. TEFTOM is a promising tool for measuring general trauma outcomes in terms of patients' expectation fulfilment that proved to be valid, internally consistent, reproducible, and responsive to change. PMID:24967116

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

    PubMed

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

    2014-05-01

    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

  16. Assessing success--a commentary on the necessity of outcomes measures.

    PubMed

    Sanghani, Ruchi M; Carlin, Alexandra L; Moler, Alexander K

    2015-01-01

    Measurements for outcomes reporting are not fully formed and utilized in the American addiction industry, though formulated and adopted elsewhere in the world. While studies have established demographic information about those needing and receiving treatment as well as the facilities that offer such treatment, short- and long-term outcomes are scantily reported. This commentary serves as a call to action to developing such metrics in the US by illustrating the benefits to treatment providers and clients of creating outcomes standards, and the subsequent improvements in quality of care needed to reach those standards. Benefits of developing these metrics beyond improved quality of care may also include a more efficient allocation of resources, such as time and money. Additionally, the delivery of more effective, personalized, and outcomes-driven addiction treatment may increase client buy-in and foster a more open communication channel between clients and providers during and after treatment. PMID:25971315

  17. TU-A-BRD-01: Outcomes of Hypofractionated Treatments - Initial Results of the WGSBRT

    SciTech Connect

    Li, X; Lee, P; Ohri, N; Joiner, M; Kong, F; Jackson, A

    2014-06-15

    Stereotactic Body Radiation Therapy (SBRT) has emerged in recent decades as a treatment paradigm that is becoming increasingly important in clinical practice. Clinical outcomes data are rapidly accumulating. Although published relations between outcomes and dose distributions are still sparse, the field has progressed to the point where evidence-based normal tissue dose-volume constraints, prescription strategies, and Tumor Control Probability (TCP) and Normal Tissue Complication Probability (NTCP) models can be developed. The Working Group on SBRT (WGSBRT), under the Biological Effects Subcommittee of AAPM, is a group of physicists and physicians working in the area of SBRT. It is currently performing critical literature reviews to extract and synthesize usable data and to develop guidelines and models to aid with safe and effective treatment. The group is investigating clinically relevant findings from SBRT in six anatomical regions: Cranial, Head and Neck, Thoracic, Abdominal, Pelvic, and Spinal. In this session of AAPM 2014, interim results are presented on TCP for lung and liver, NTCP for thoracic organs, and radiobiological foundations:• Lung TCP: Detailed modeling of TCP data from 118 published studies on early stage lung SBRT investigates dose response and hypothesized mechanisms to explain the improved outcomes of SBRT. This is presented from the perspective of a physicist, a physician, and a radiobiologist.• Liver TCP: For primary and metastatic liver tumors, individual patient data were extracted from published reports to examine the effects of biologically effective dose on local control.• Thoracic NTCP: Clinically significant SBRT toxicity of lung, rib / chest wall and other structures are evaluated and compared among published clinical data, in terms of risk, risk factors, and safe practice.• Improving the clinical utility of published toxicity reports from SBRT and Hypofractionated treatments. What do we want, and how do we get it? Methods

  18. Is consuming yoghurt associated with weight management outcomes? Results from a systematic review

    PubMed Central

    Eales, J; Lenoir-Wijnkoop, I; King, S; Wood, H; Kok, F J; Shamir, R; Prentice, A; Edwards, M; Glanville, J; Atkinson, R L

    2016-01-01

    Background: Yoghurt is part of the diet of many people worldwide and is commonly recognised as a ‘health food'. Epidemiological studies suggest that yoghurt may be useful as part of weight management programs. In the absence of comprehensive systematic reviews, this systematic review investigated the effect of yoghurt consumption by apparently healthy adults on weight-related outcomes. Methods: An extensive literature search was undertaken, as part of a wider scoping review, to identify yoghurt studies. A total of 13 631 records were assessed for their relevance to weight-related outcomes. Results: Twenty-two publications were eligible according to the review protocol. Cohort studies (n=6) and cross-sectional studies (n=7) all showed a correlation between yoghurt and lower or improved body weight/composition. Six randomised controlled trials (RCTs) and one controlled trial had various limitations, including small size and short duration. One RCT showed significant effects of yoghurt on weight loss, but was confounded by differences in calcium intake. One trial showed nonsignificant weight gain and the remaining five trials showed nonsignificant weight losses that were greater in yoghurt consumers. Conclusions: Yoghurt consumption is associated with lower body mass index, lower body weight/weight gain, smaller waist circumference and lower body fat in epidemiological studies. RCTs suggest weight reduction effects, but do not permit determination of a cause–effect relationship. Well-controlled, adequately powered trials in research and community settings appear likely to identify a modest but beneficial effect of yoghurt consumption for prevention of weight gain and management of obesity. The ready availability of yoghurt (a nutrient-dense food) and its ease of introduction to most diets suggests that educating the public to eat yoghurt as part of a balanced and healthy diet may potentially contribute to improved public health. Future carefully designed RCTs

  19. Validation of a core outcome measure for palliative care in Africa: the APCA African Palliative Outcome Scale

    PubMed Central

    2010-01-01

    Background Despite the burden of progressive incurable disease in Africa, there is almost no evidence on patient care or outcomes. A primary reason has been the lack of appropriate locally-validated outcome tools. This study aimed to validate a multidimensional scale (the APCA African Palliative Outcome Scale) in a multi-centred international study. Methods Validation was conducted across 5 African services and in 3 phases: Phase 1. Face validity: content analysis of qualitative interviews and cognitive interviewing of POS; Phase 2. Construct validity: correlation of POS with Missoula-Vitas Quality of Life Index (Spearman's rank tests); Phase 3. Internal consistency (Cronbach's alpha calculated twice using 2 datasets), test-retest reliability (intraclass correlation coefficients calculated for 2 time points) and time to complete (calculated twice using 2 datasets). Results The validation involved 682 patients and 437 family carers, interviewed in 8 different languages. Phase 1. Qualitative interviews (N = 90 patients; N = 38 carers) showed POS items mapped well onto identified needs; cognitive interviews (N = 73 patients; N = 29 carers) demonstrated good interpretation; Phase 2. POS-MVQoLI Spearman's rank correlations were low-moderate as expected (N = 285); Phase 3. (N = 307, 2nd assessment mean 21.2 hours after first, SD 7.2) Cronbach's Alpha was 0.6 on both datasets, indicating expected moderate internal consistency; test-retest found high intra-class correlation coefficients for all items (0.78-0.89); median time to complete 7 mins, reducing to 5 mins at second visit. Conclusions The APCA African POS has sound psychometric properties, is well comprehended and brief to use. Application of this tool offers the opportunity to at last address the omissions of palliative care research in Africa. PMID:20100332

  20. Outcomes Assessment for Beginning and Intermediate Spanish: One Program's Process and Results

    ERIC Educational Resources Information Center

    Houston, Tony

    2005-01-01

    Outcomes assessment is a process by which an academic unit defines and articulates its program goals and assesses its attainment of those goals. This article chronicles one language division's efforts at outcomes assessment for beginning and intermediate Spanish. The evidence used for program assessment consisted of WebCAPE placement scores,…

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

    PubMed Central

    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

    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

  2. Different measures, different outcomes? Survey into the effectiveness of chronic pain clinics in a London tertiary referral center

    PubMed Central

    Shah, Savan; Ho, Alexandra C; Kuehler, Bianca M; Childs, Susan R; Towlerton, Glyn; Goodall, Ian D; Bantel, Carsten

    2015-01-01

    Background Chronic pain clinics aim to improve challenging conditions, and although numerous studies have evaluated specific aspects of therapies and outcomes in this context, data concerning service impact on outcome measures in a general pain population are sparse. In addition, current trends in commissioning increasingly warrant services to provide evidence for their effectiveness. While a plethora of outcome measures, such as pain-intensity or improvement scores, exist for this purpose, it remains surprisingly unclear which one to use. It also remains uncertain what variables predict treatment success. Objectives This cross-sectional study was conducted to evaluate clinic performance employing different tools (pain scores, pain categories, responder analysis, subjective improvement, satisfaction), and to determine predictors of outcome measures. Patients and methods Patients attending scheduled clinic follow-up appointments were approached. They were asked to complete the modified short-form Brief Pain Inventory (BPI-SF) that also included assessments for satisfaction and subjective improvement. Comparisons were made with BPI-SF responses that were completed by each patient on admission. Nonparametric tests were employed to evaluate service impact and to determine predictors for outcome. Results Data of 118 patients were analyzed. There was considerable variation in impact of pain clinics depending on the outcome measure employed. While median pain scores did not differ between admission and follow-up, scores improved individually in 30% of cases, such that more patients had mild pain on follow-up than on admission (relative risk 2.7). Furthermore, while only 41% reported at least moderate subjective improvement after admission to the service, the majority (83%) were satisfied with the service. Positive treatment responses were predicted by “number of painful regions” and “changes in mood”, whereas subjective improvement was predicted by

  3. Early-onset glaucoma in Axenfeld-Rieger anomaly: long-term surgical results and visual outcome.

    PubMed

    Mandal, A K; Pehere, N

    2016-07-01

    PurposeTo determine the long-term surgical and visual outcomes in Indian children with early-onset glaucoma associated with Axenfeld-Rieger anomaly (ARA).MethodsThis is a retrospective analysis of 44 eyes of 24 consecutive children with early-onset glaucoma (within 3 years of age) and ARA who underwent glaucoma surgery over a 20-year period (1991-2010) by a single surgeon. Main outcome measures were pre- and postoperative intraocular pressures (IOPs), corneal clarity, visual acuities (VAs), refractive errors, success rate, time of surgical failure, and complications.ResultsThe series consisted of 38 primary combined trabeculotomy-trabeculectomy (CTT) and 6 primary trabeculectomy procedures (Schlemm's canal could not be identified in these eyes). There was a statistically significant reduction in IOP postoperatively (27.07±4.88 vs 14.88±3.62 mm Hg; P<0.0001) with a mean reduction of 45.14%. Success probability by Kaplan-Meier survival analysis was 93% till 5 years, and then 88.1%, 82.3%, 70.5%, 56.4%, and 42.3% at year 6, 7, 8, 9, and 10, respectively. Preoperative corneal edema was present in 43/44 eyes (97.72%) and cleared in 42 eyes (97.67%). There was one case each with intraoperative hyphema and with shallow chamber postoperatively and both were successfully managed successfully. There was no incidence of endophthalmitis or any other sight-threatening complication. Data on VA were available in 34 eyes (77.3%). At final follow-up visit, 15 (44.1%) eyes had best corrected VA ⩾6/18.ConclusionsPrimary CTT is safe and effective for early-onset glaucoma associated with ARA. It leads to excellent IOP control and satisfactory visual outcome. PMID:27055677

  4. Preferred reporting items for studies mapping onto preference-based outcome measures: The MAPS statement.

    PubMed

    Petrou, Stavros; Rivero-Arias, Oliver; Dakin, Helen; Longworth, Louise; Oppe, Mark; Froud, Robert; Gray, Alastair

    2015-01-01

    'Mapping' onto generic preference-based outcome measures is increasingly being used as a means of generating health utilities for use within health economic evaluations. Despite publication of technical guides for the conduct of mapping research, guidance for the reporting of mapping studies is currently lacking. The MAPS (MApping onto Preference-based measures reporting Standards) statement is a new checklist, which aims to promote complete and transparent reporting of mapping studies. The primary audiences for the MAPS statement are researchers reporting mapping studies, the funders of the research, and peer reviewers and editors involved in assessing mapping studies for publication.A de novo list of 29 candidate reporting items and accompanying explanations was created by a working group comprised of six health economists and one Delphi methodologist. Following a two-round, modified Delphi survey with representatives from academia, consultancy, health technology assessment agencies and the biomedical journal editorial community, a final set of 23 items deemed essential for transparent reporting, and accompanying explanations, was developed. The items are contained in a user friendly 23 item checklist. They are presented numerically and categorised within six sections, namely: (i) title and abstract; (ii) introduction; (iii) methods; (iv) results; (v) discussion; and (vi) other. The MAPS statement is best applied in conjunction with the accompanying MAPS explanation and elaboration document.It is anticipated that the MAPS statement will improve the clarity, transparency and completeness of reporting of mapping studies. To facilitate dissemination and uptake, the MAPS statement is being co-published by eight health economics and quality of life journals, and broader endorsement is encouraged. The MAPS working group plans to assess the need for an update of the reporting checklist in five years' time.This statement was published jointly in Applied Health Economics

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

    PubMed Central

    McGrady, Meghan E.; Rosenthal, Susan L.

    2010-01-01

    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

  6. Health economics research into supporting carers of people with dementia: A systematic review of outcome measures

    PubMed Central

    2012-01-01

    Advisory bodies, such as the National Institute for Health and Clinical Excellence (NICE) in the UK, advocate using preference based instruments to measure the quality of life (QoL) component of the quality-adjusted life year (QALY). Cost per QALY is used to determine cost-effectiveness, and hence funding, of interventions. QALYs allow policy makers to compare the effects of different interventions across different patient groups. Generic measures may not be sensitive enough to fully capture the QoL effects for certain populations, such as carers, so there is a need to consider additional outcome measures, which are preference based where possible to enable cost-effectiveness analysis to be undertaken. This paper reviews outcome measures commonly used in health services research and health economics research involving carers of people with dementia. An electronic database search was conducted in PubMed, Medline, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, the National Health Service Economic Evaluation Database (NHS EED), Database of Abstracts of Reviews of Effects (DARE) and Health Technology Assessment database. Studies were eligible for inclusion if they included an outcome measure for carers of people with dementia. 2262 articles were identified. 455 articles describing 361 studies remained after exclusion criteria were applied. 228 outcome measures were extracted from the studies. Measures were categorised into 44 burden measures, 43 mastery measures, 61 mood measures, 32 QoL measures, 27 social support and relationships measures and 21 staff competency and morale measures. The choice of instrument has implications on funding decisions; therefore, researchers need to choose appropriate instruments for the population being measured and the type of intervention undertaken. If an instrument is not sensitive enough to detect changes in certain populations, the effect of an intervention may be underestimated, and hence

  7. Health economics research into supporting carers of people with dementia: a systematic review of outcome measures.

    PubMed

    Jones, Carys; Edwards, Rhiannon Tudor; Hounsome, Barry

    2012-01-01

    Advisory bodies, such as the National Institute for Health and Clinical Excellence (NICE) in the UK, advocate using preference based instruments to measure the quality of life (QoL) component of the quality-adjusted life year (QALY). Cost per QALY is used to determine cost-effectiveness, and hence funding, of interventions. QALYs allow policy makers to compare the effects of different interventions across different patient groups. Generic measures may not be sensitive enough to fully capture the QoL effects for certain populations, such as carers, so there is a need to consider additional outcome measures, which are preference based where possible to enable cost-effectiveness analysis to be undertaken. This paper reviews outcome measures commonly used in health services research and health economics research involving carers of people with dementia. An electronic database search was conducted in PubMed, Medline, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, the National Health Service Economic Evaluation Database (NHS EED), Database of Abstracts of Reviews of Effects (DARE) and Health Technology Assessment database. Studies were eligible for inclusion if they included an outcome measure for carers of people with dementia. 2262 articles were identified. 455 articles describing 361 studies remained after exclusion criteria were applied. 228 outcome measures were extracted from the studies. Measures were categorised into 44 burden measures, 43 mastery measures, 61 mood measures, 32 QoL measures, 27 social support and relationships measures and 21 staff competency and morale measures. The choice of instrument has implications on funding decisions; therefore, researchers need to choose appropriate instruments for the population being measured and the type of intervention undertaken. If an instrument is not sensitive enough to detect changes in certain populations, the effect of an intervention may be underestimated, and hence

  8. DTI measures track and predict motor function outcomes in stroke rehabilitation utilizing BCI technology

    PubMed Central

    Song, Jie; Nair, Veena A.; Young, Brittany M.; Walton, Leo M.; Nigogosyan, Zack; Remsik, Alexander; Tyler, Mitchell E.; Farrar-Edwards, Dorothy; Caldera, Kristin E.; Sattin, Justin A.; Williams, Justin C.; Prabhakaran, Vivek

    2015-01-01

    Tracking and predicting motor outcomes is important in determining effective stroke rehabilitation strategies. Diffusion tensor imaging (DTI) allows for evaluation of the underlying structural integrity of brain white matter tracts and may serve as a potential biomarker for tracking and predicting motor recovery. In this study, we examined the longitudinal relationship between DTI measures of the posterior limb of the internal capsule (PLIC) and upper-limb motor outcomes in 13 stroke patients (median 20-month post-stroke) who completed up to 15 sessions of intervention using brain–computer interface (BCI) technology. Patients’ upper-limb motor outcomes and PLIC DTI measures including fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD), and mean diffusivity (MD) were assessed longitudinally at four time points: pre-, mid-, immediately post- and 1-month-post intervention. DTI measures and ratios of each DTI measure comparing the ipsilesional and contralesional PLIC were correlated with patients’ motor outcomes to examine the relationship between structural integrity of the PLIC and patients’ motor recovery. We found that lower diffusivity and higher FA values of the ipsilesional PLIC were significantly correlated with better upper-limb motor function. Baseline DTI ratios were significantly correlated with motor outcomes measured immediately post and 1-month-post BCI interventions. A few patients achieved improvements in motor recovery meeting the minimum clinically important difference (MCID). These findings suggest that upper-limb motor recovery in stroke patients receiving BCI interventions relates to the microstructural status of the PLIC. Lower diffusivity and higher FA measures of the ipsilesional PLIC contribute toward better motor recovery in the stroke-affected upper-limb. DTI-derived measures may be a clinically useful biomarker in tracking and predicting motor recovery in stroke patients receiving BCI interventions. PMID

  9. DTI measures track and predict motor function outcomes in stroke rehabilitation utilizing BCI technology.

    PubMed

    Song, Jie; Nair, Veena A; Young, Brittany M; Walton, Leo M; Nigogosyan, Zack; Remsik, Alexander; Tyler, Mitchell E; Farrar-Edwards, Dorothy; Caldera, Kristin E; Sattin, Justin A; Williams, Justin C; Prabhakaran, Vivek

    2015-01-01

    Tracking and predicting motor outcomes is important in determining effective stroke rehabilitation strategies. Diffusion tensor imaging (DTI) allows for evaluation of the underlying structural integrity of brain white matter tracts and may serve as a potential biomarker for tracking and predicting motor recovery. In this study, we examined the longitudinal relationship between DTI measures of the posterior limb of the internal capsule (PLIC) and upper-limb motor outcomes in 13 stroke patients (median 20-month post-stroke) who completed up to 15 sessions of intervention using brain-computer interface (BCI) technology. Patients' upper-limb motor outcomes and PLIC DTI measures including fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD), and mean diffusivity (MD) were assessed longitudinally at four time points: pre-, mid-, immediately post- and 1-month-post intervention. DTI measures and ratios of each DTI measure comparing the ipsilesional and contralesional PLIC were correlated with patients' motor outcomes to examine the relationship between structural integrity of the PLIC and patients' motor recovery. We found that lower diffusivity and higher FA values of the ipsilesional PLIC were significantly correlated with better upper-limb motor function. Baseline DTI ratios were significantly correlated with motor outcomes measured immediately post and 1-month-post BCI interventions. A few patients achieved improvements in motor recovery meeting the minimum clinically important difference (MCID). These findings suggest that upper-limb motor recovery in stroke patients receiving BCI interventions relates to the microstructural status of the PLIC. Lower diffusivity and higher FA measures of the ipsilesional PLIC contribute toward better motor recovery in the stroke-affected upper-limb. DTI-derived measures may be a clinically useful biomarker in tracking and predicting motor recovery in stroke patients receiving BCI interventions. PMID:25964753

  10. Is hyperglycaemia an independent predictor of poor outcome after acute stroke? Results of a long-term follow up study.

    PubMed Central

    Weir, C. J.; Murray, G. D.; Dyker, A. G.; Lees, K. R.

    1997-01-01

    OBJECTIVE: To determine whether raised plasma glucose concentration independently influences outcome after acute stroke or is a stress response reflecting increased stroke severity. DESIGN: Long-term follow up study of patients admitted to an acute stroke unit. SETTING: Western Infirmary, Glasgow. SUBJECTS: 811 patients with acute stroke confirmed by computed tomography. Analysis was restricted to the 750 non-diabetic patients. MAIN OUTCOME MEASURES: Survival time and placement three months after stroke. RESULTS: 645 patients (86%) had ischaemic stroke and 105 patients (14%) haemorrhagic stroke. Cox's proportional hazards modelling with stratification according to Oxfordshire Community Stroke Project categories identified increased age (relative hazard 1.36 per decade; 95% confidence interval 1.21 to 1.53), haemorrhagic stroke (relative hazard 1.67; 1.22 to 2.28), time to resolution of symptoms > 72 hours (relative hazard 2.15; 1.15 to 4.05), and hyperglycaemia (relative hazard 1.87; 1.43 to 2.45) as predictors of mortality. The effect of glucose concentration on survival was greatest in the first month. CONCLUSIONS: Plasma glucose concentration above 8 mmol/l after acute stroke predicts a poor prognosis after correcting for age, stroke severity, and stroke subtype. Raised plasma glucose concentration is therefore unlikely to be solely a stress response and should arguably be treated actively. A randomised trial is warranted. PMID:9158464

  11. Comparison of Single-Level and Multiple-Level Outcomes of Total Disc Arthroplasty: 24-Month Results

    PubMed Central

    Ritter-Lang, Karsten; Gössel, Lutz; Dreßler, Nadine

    2015-01-01

    Background Low back pain is one of the most prevalent problems in industrialized countries, affecting as many as 80% of all adults at some time in their lives. Among the significant contributors to low back pain is degenerative disc disease (DDD). Although fusion has been well accepted for treatment of DDD, high rates of complications and stress to adjacent segments remain a concern. Lumbar total disc replacement (TDR) was developed with a goal of preserving motion and avoiding various fusion-related complications, but the relative merits of single vs. multiple level arthroplasty remain unclear. Methods This is a multi-center, single arm, prospective post-market registry of the M6-L, consisting of consecutive patients presenting with lumbar DDD who agreed to participate. This paper reports on those patients who have completed at least 24 months of followup to date. Clinical outcome measures include the Oswestry Disability Index (ODI) and back and leg Visual Analogue Scales (VAS). Radiographic analysis of disc angle and range of motion (ROM) was also performed. Results Results for 83 patients comprising 121 implants in two cohorts (49 single level (SL), 34 multiple levels (ML)) are reported. Both cohorts experienced significant improvement at 24 months including significant decreases in ODI and VAS. Relative to SL procedures, ML procedures demonstrated either comparable results, or results that trended favorably towards the ML procedures. Index and global ROM at 24 months were not significantly different between the two cohorts, while the disc angles were larger in the SL cohort regardless of index level. Conclusions This is the first study to report clinical and radiographic outcomes of TDR with the M6-L in SL vs ML procedures with two years of followup. The results suggest initial device safety and effectiveness when used for the treatment of lumbar degenerative disc disease at one or more levels. PMID:26056629

  12. Spectral measurements in critical assemblies: MCNP specifications and calculated results

    SciTech Connect

    Stephanie C. Frankle; Judith F. Briesmeister

    1999-12-01

    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.

  13. Comparative Study of Outcome Measures and Analysis Methods for Traumatic Brain Injury Trials

    PubMed Central

    Alali, Aziz S.; Vavrek, Darcy; Barber, Jason; Dikmen, Sureyya; Nathens, Avery B.

    2015-01-01

    Abstract Batteries of functional and cognitive measures have been proposed as alternatives to the Extended Glasgow Outcome Scale (GOSE) as the primary outcome for traumatic brain injury (TBI) trials. We evaluated several approaches to analyzing GOSE and a battery of four functional and cognitive measures. Using data from a randomized trial, we created a “super” dataset of 16,550 subjects from patients with complete data (n=331) and then simulated multiple treatment effects across multiple outcome measures. Patients were sampled with replacement (bootstrapping) to generate 10,000 samples for each treatment effect (n=400 patients/group). The percentage of samples where the null hypothesis was rejected estimates the power. All analytic techniques had appropriate rates of type I error (≤5%). Accounting for baseline prognosis either by using sliding dichotomy for GOSE or using regression-based methods substantially increased the power over the corresponding analysis without accounting for prognosis. Analyzing GOSE using multivariate proportional odds regression or analyzing the four-outcome battery with regression-based adjustments had the highest power, assuming equal treatment effect across all components. Analyzing GOSE using a fixed dichotomy provided the lowest power for both unadjusted and regression-adjusted analyses. We assumed an equal treatment effect for all measures. This may not be true in an actual clinical trial. Accounting for baseline prognosis is critical to attaining high power in Phase III TBI trials. The choice of primary outcome for future trials should be guided by power, the domain of brain function that an intervention is likely to impact, and the feasibility of collecting outcome data. PMID:25317951

  14. Higher Chest Wall Dose Results in Improved Locoregional Outcome in Patients Receiving Postmastectomy Radiation

    SciTech Connect

    Panoff, Joseph E.; Takita, Cristiane; Hurley, Judith; Reis, Isildinha M.; Zhao, Wei; Rodgers, Steven E.; Gunaseelan, Vijayalakshmi; Wright, Jean L.

    2012-03-01

    Purpose: Randomized trials demonstrating decreased locoregional recurrence (LRR) and improved overall survival (OS) in women receiving postmastectomy radiation therapy (PMRT) used up to 50 Gy to the chest wall (CW), but in practice, many centers boost the CW dose to {>=}60 Gy, despite lack of data supporting this approach. We evaluated the relationship between CW dose and clinical outcome. Methods and Materials: We retrospectively reviewed medical records of 582 consecutively treated patients who received PMRT between January 1999 and December 2009. We collected data on patient, disease, treatment characteristics, and outcomes of LRR, progression-free survival (PFS) and OS. Results: Median follow-up from the date of diagnosis was 44.7 months. The cumulative 5-year incidence of LRR as first site of failure was 6.2%. CW dose for 7% (43 patients) was {<=}50.4 Gy (range, 41.4-50.4 Gy) and 93% received >50.4 Gy (range, 52.4-74.4 Gy). A CW dose of >50.4 Gy vs. {<=}50.4 Gy was associated with lower incidence of LRR, a 60-month rate of 5.7% (95% confidence interval [CI], 3.7-8.2) vs. 12.7% (95% CI, 4.5-25.3; p = 0.054). Multivariate hazard ratio (HR) for LRR controlling for race, receptor status, and stage was 2.62 (95% CI, 1.02-7.13; p = 0.042). All LRR in the low-dose group occurred in patients receiving 50 to 50.4 Gy. Lower CW dose was associated with worse PFS (multivariate HR, 2.73; 95% CI, 1.64-4.56; p < 0.001) and OS (multivariate HR, 3.88; 95% CI, 2.16-6.99; p < 0.001). Conclusions: The addition of a CW boost above 50.4 Gy resulted in improved locoregional control and survival in this cohort patients treated with PMRT for stage II-III breast cancer. The addition of a CW boost to standard-dose PMRT is likely to benefit selected high-risk patients. The optimal technique, target volume, and patient selection criteria are unknown. The use of a CW boost should be studied prospectively, as has been done in the setting of breast conservation.

  15. Mercury in fish and adverse reproductive outcomes: results from South Carolina

    PubMed Central

    2014-01-01

    Background Mercury is a metal with widespread distribution in aquatic ecosystems and significant neurodevelopmental toxicity in humans. Fish biomonitoring for total mercury has been conducted in South Carolina (SC) since 1976, and consumption advisories have been posted for many SC waterways. However, there is limited information on the potential reproductive impacts of mercury due to recreational or subsistence fish consumption. Methods To address this issue, geocoded residential locations for live births from the Vital Statistics Registry (1995–2005, N = 362,625) were linked with spatially interpolated total mercury concentrations in fish to estimate potential mercury exposure from consumption of locally caught fish. Generalized estimating equations were used to test the hypothesis that risk of low birth weight (LBW, <2,500 grams) or preterm birth (PTB, <37 weeks clinical gestation) was greater among women living in areas with elevated total mercury in fish, after adjustment for confounding. Separate analyses estimated term LBW and PTB risks using residential proximity to rivers with fish consumption advisories to characterize exposure. Results Term LBW was more likely among women residing in areas in the upper quartile of predicted total mercury in fish (odds ratio [OR] = 1.04; 95% confidence interval [CI]: 1.00-1.09) or within 8 kilometers of a river with a ‘do not eat’ fish advisory (1.05; 1.00-1.11) compared to the lowest quartile, or rivers without fish consumption restrictions, respectively. When stratified by race, risks for term LBW or PTB were 10-18% more likely among African-American (AA) mothers living in areas with the highest total fish mercury concentrations. Conclusions To our knowledge, this is the first study to examine the relationship between fish total mercury concentrations and adverse reproductive outcomes in a large population-based sample that included AA women. The ecologic nature of exposure assessment in this study

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

    PubMed Central

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

    2013-01-01

    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

  17. Measurement of Educational Progress in the Context of Local Demographics: Using General Outcome Measurement as a Basis for the Development and Use of Local Norms

    ERIC Educational Resources Information Center

    Koehler-Hak, Kathrine M.

    2014-01-01

    General outcome measurement, a specific type of formative evaluation, can be used to assess progress toward long-term academic goals. Curriculum-based measurement is a widely used type of general outcome measurement. When used to develop local norms, curriculum-based measurement data are helpful in making individual student and systems-level…

  18. Cognitive and Typing Outcomes Measured Simultaneously with Slow Treadmill Walking or Sitting: Implications for Treadmill Desks

    PubMed Central

    Larson, Michael J.; LeCheminant, James D.; Hill, Kyle; Carbine, Kaylie; Masterson, Travis; Christenson, Ed

    2015-01-01

    Purpose This study compared cognitive (attention, learning, and memory) and typing outcomes during slow treadmill walking or sitting. Seventy-five healthy individuals were randomly assigned to a treadmill walking group (n=37; 23 female) or sitting group (n=38; 17 female). Methods The treadmill walking group completed a series of tests while walking at 1.5 mph. The sitting group performed the same tests while sitting at a standard desk. Tests performed by both groups included: the Rey Auditory Verbal Learning Test and a modified version of the Paced Auditory Serial Attention Test. In addition, typing performance was evaluated. Results Participants in the treadmill walking group performed worse on the Rey Auditory Verbal Learning Test for total learning than the sitting group; the main effect was significant (F(1,73)=4.75, p=0.03, ηp2=0.06); however, short- and long-delay recall performance did not differ between groups (p>0.05). For the Paced Auditory Serial Attention Test, total number of correct responses was lower in the treadmill walking group relative to the sitting group; the main effect was significant (F(1,73)=4.97, p=0.03, ηp2=0.06). The performance of both groups followed the same learning slope (Group x Trial interactions were not significant) for the Rey Auditory Verbal Learning Test and Paced Auditory Serial Attention Test. Individuals in the treadmill walking group performed significantly worse for all measures of typing (p<0.05). Conclusion Walking on a treadmill desk may result in a modest difference in total learning and typing outcomes relative to sitting, but those declines may not outweigh the benefit of the physical activity gains from walking on a treadmill. PMID:25874910

  19. Stimulus, Task, and Learning Effects on Measures of Temporal Resolution: Implications for Predictors of Language Outcome

    ERIC Educational Resources Information Center

    Smith, Nicholas A.; Trainor, Laurel J.; Gray, Kellie; Plantinga, Judy A.; Shore, David I.

    2008-01-01

    Purpose: Some studies find that temporal processing ability predicts language outcome whereas other studies do not. Resolution of this debate is hindered by the variety of temporal measures used, nonsensory loading of the tasks, and differential amounts of practice across studies. The goal of this study was to examine the effects of stimulus…

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

    ERIC Educational Resources Information Center

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

    2012-01-01

    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…

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

    ERIC Educational Resources Information Center

    Fingerhut, Patricia E.

    2009-01-01

    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…

  2. Cost Effectiveness in Evaluation Technical Assistance: Different Aspects of Measuring Cost and Outcomes.

    ERIC Educational Resources Information Center

    Estes, Gary D.

    The paper focuses on the Title I Evaluation Technical Assistance Centers to illustrate issues of measuring costs and deciding on outcome criteria before promoting "cost-effective" approaches. Effects are illustrated for varying resource allocations among personnel, travel, materials, and phone costs as a function of emphasizing workshops, on-site…

  3. Student Identification with Business Education Models: Measurement and Relationship to Educational Outcomes

    ERIC Educational Resources Information Center

    Halbesleben, Jonathon R. B.; Wheeler, Anthony R.

    2009-01-01

    Although management scholars have provided a variety of metaphors to describe the role of students in management courses, researchers have yet to explore students' identification with the models and how they are linked to educational outcomes. This article develops a measurement tool for students' identification with business education models and…

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

    ERIC Educational Resources Information Center

    Australian Institute of Health and Welfare, 2011

    2011-01-01

    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…

  5. A Measurement Feedback System (MFS) Is Necessary to Improve Mental Health Outcomes

    ERIC Educational Resources Information Center

    Bickman, Leonard

    2008-01-01

    The importance of measurement feedback system (MFS) for the improvement of mental health services for youths is discussed. As feedback obtained from clients and families is subject to distortions, a standardized MFS including clinical processes, contexts, outcomes, and feedback to clinicians and supervisors is necessary for improvement in quality…

  6. Development of an Outcome Measurement Tool for a Teen Parent Wraparound Program

    ERIC Educational Resources Information Center

    Fries, Derrick; Carney, Karen J.; Blackman-Urteaga, Laura; Savas, Sue Ann

    2012-01-01

    This article chronicles the search for and development of an outcome measurement tool for teen parents receiving community-based wraparound services. The criteria for selecting functional assessment tools available in the literature is presented along with the barriers experienced in using two of these well-cited tools. The rationale for in-house…

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

    ERIC Educational Resources Information Center

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

    2004-01-01

    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…

  8. Measuring the Outcomes of Vocational Education and Training. Review of Research.

    ERIC Educational Resources Information Center

    Dumbrell, Tom

    Outcome measures are one of three key dimensions of the performance of Australia's vocational education and training (VET) system. The government, employers, students, and the broader community all share an interest in ensuring that Australia's VET system produces skills needed in the labor market. However, each group's views of what constitutes a…

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

    ERIC Educational Resources Information Center

    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

    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…

  10. A Comparison of Several Outcome Measures Used to Evaluate a Psychiatric Clerkship.

    ERIC Educational Resources Information Center

    Cuerdon, Timothy; And Others

    The teaching of interviewing skills is increasingly incorporated into clinical medicine courses in American medical schools, yet the attempts to evaluate the effectiveness of these efforts have been woefully inadequate. Typical outcome measures have included paper and pencil tests of knowledge, preceptor evaluations of clinical performance, and…

  11. From Constructs to Measures: Finalizing the Common Core. The Project on State-Level Child Outcomes.

    ERIC Educational Resources Information Center

    Child Trends, Inc., Washington, DC.

    The U.S. Department of Health and Human Services' Office of Planning, Research, and Evaluation at the Administration for Children and Families, and the Office of the Assistant Secretary for Planning and Evaluation, are working together with states and other groups to improve the measurement of child outcomes in state welfare evaluations and in…

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

    ERIC Educational Resources Information Center

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

    2012-01-01

    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…

  13. Different Tests, Different Answers: The Stability of Teacher Value-Added Estimates across Outcome Measures

    ERIC Educational Resources Information Center

    Papay, John P.

    2011-01-01

    Recently, educational researchers and practitioners have turned to value-added models to evaluate teacher performance. Although value-added estimates depend on the assessment used to measure student achievement, the importance of outcome selection has received scant attention in the literature. Using data from a large, urban school district, I…

  14. Advanced Placement Results, 2013-14. Measuring Up. D&A Report No.15.01

    ERIC Educational Resources Information Center

    Gilleland, Kevin; Muli, Juliana

    2015-01-01

    Advanced Placement (AP) outcomes for Wake County Public School System (WCPSS) students have continued an upward trend for over 18 years, out-performing the state and the nation in all measures. In 2013-14 there were 13,757 exams taken by 6,955 WCPSS test-takers with almost 76% of the exams resulting in scores at or above 3, outperforming Guilford…

  15. Operationalising the capability approach for outcome measurement in mental health research.

    PubMed

    Simon, Judit; Anand, Paul; Gray, Alastair; Rugkåsa, Jorun; Yeeles, Ksenija; Burns, Tom

    2013-12-01

    Amartya Sen's multidimensional capability approach focuses on the importance of freedoms to be or do things people have reason to value. It is an alternative to standard utilitarian welfarism, the theoretical approach to quality-adjusted life years (QALYs) and cost-utility analyses. Despite the limitations of the utility approach in capturing non-health benefits and broader welfare inequalities, there have been very limited applications of the capability approach in the mental health context where these issues are imperative. We report the development and application of a multidimensional instrument, the OxCAP-MH, which aims to operationalise the capability approach for outcome measurement in mental health research. The study was carried out as part of an ongoing programme on community coercion experienced by service users with severe and enduring mental illness being treated using Community Treatment Orders. Capabilities data were collected at baseline in the OCTET RCT for 333 'revolving door' mental health service users who were in involuntary hospital treatment at the time of recruitment in England (2008-2011). The research focused on the identification of capabilities domains most affected by mental illness and their association with socio-demographic and clinical factors and other measures of well-being such as the EQ-5D and Global Assessment of Functioning (GAF) scales. The OxCAP-MH item response rate was 90%-68%. There were significant correlations between service users' overall capability scores and the GAF, EQ-5D VAS and EQ-5D-3L utilities (corr = 0.249, 0.514, 0.415, respectively). The most affected capability domains were: 'Daily activities', 'Influencing local decisions', 'Enjoying recreation', 'Planning one's life' and 'Discrimination'. Age had a mixed effect, while female service users and those with a primary diagnosis of schizophrenia or longer illness duration reported significantly lower capability scores. The results support the feasibility and

  16. CT-Guided Lumbar Sympathectomy: Results and Analysis of Factors Influencing the Outcome

    SciTech Connect

    Heindel, Walter; Ernst, Stefan; Manshausen, Gudrun; Gawenda, Michael; Siemens, Peter; Krahe, Thomas; Walter, Michael; Lackner, Klaus

    1998-07-15

    Purpose: To prospectively analyze the effectiveness of computed tomography-guided percutaneous lumbar sympathectomy (CTLS) in patients with peripheral arterial occlusive disease in relation to angiographic findings and vascular risk factors. Methods: Eighty-three patients were treated by CTLS. After clinical evaluation of the risk profile and diagnostic intraarterial digital subtraction arteriography, 14 patients underwent unilateral, and 69 bilateral one-level treatment. Follow-up studies took place on the day following the intervention, after 3 weeks, and after 3 months. Results: A total of 152 interventions were performed in 83 patients. After 3 months, clinical examination of 54 patients (5 patients had died, 24 were lost to follow-up) revealed improvement in 46% (25/54), no change in 39% (21/54), and worsening (amputation) in 15% (8/54). There was no significant statistical correlation among any of the analyzed factors (diabetes mellitus, arterial hypertension, smoking, hyperlipidemia, obesity, hyperuricemia, number of risk factors, ankle-arm index, and angiography score) and the outcome after CTLS. Three major complications occurred: one diabetic patient developed a retroperitoneal abscess 2 weeks after CTLS, and in two other patients ureteral strictures were detected 3 months and 2 years after CTLS, respectively. Conclusion: As no predictive criteria for clinical improvement in an individual patient could be identified, CTLS, as a safe procedure, should be employed on a large scale in patients who are unsuitable for treatment by angioplasty or revascularization.

  17. Does a Quality Improvement Intervention for Anxiety Result in Differential Outcomes for Lower Income Patients?

    PubMed Central

    Sullivan, Greer; Sherbourne, Cathy; Chavira, Denise A.; Craske, Michelle G.; Gollineli, Daniela; Han, Xiaotong; Rose, Raphael D.; Bystritsky, Alexander; Stein, Murray B.; Roy-Byrne, Peter

    2013-01-01

    Objective This study examined the effects of a collaborative care intervention for anxiety disorders in primary care on lower income participants relative to those with higher incomes. The authors hypothesized that lower income patients might show less improvement or improve at a lower rate given that they experience greater economic stress over the treatment course. Alternatively, lower income patients could improve at a higher rate because the intervention facilitates access to evidence-based treatment, which typically is less available to persons with lower incomes. Method The authors compared baseline demographic and clinical characteristics of patients with lower (n=287) and higher (n=717) income using t-tests and chi-square tests for continuous and categorical variables respectively. For the longitudinal analysis of intervention effects by income group, the authors jointly modeled the outcomes at the four assessment times by study site; income; time; intervention; time and intervention; income and time; income and intervention; and time, intervention and income. Results Although lower-income participants were more ill and disabled at baseline than those in the higher income group, the two income groups were very similar in their clinical response. The lower income participants experienced a comparable degree of clinical improvement, despite receiving fewer treatment sessions, less relapse prevention, and less continuous care. Conclusions These findings contribute to the ongoing discussion as to whether or not, and to what extent, quality improvement interventions work equally well across income groups or require tailoring for specific vulnerable populations. PMID:23377641

  18. Methods and results of boundary layer measurements on a glider

    NASA Technical Reports Server (NTRS)

    Nes, W. V.

    1978-01-01

    Boundary layer measurements were carried out on a glider under natural conditions. Two effects are investigated: the effect of inconstancy of the development of static pressure within the boundary layer and the effect of the negative pressure difference in a sublaminar boundary layer. The results obtained by means of an ion probe in parallel connection confirm those results obtained by means of a pressure probe. Additional effects which have occurred during these measurements are briefly dealt with.

  19. An International Standard Set of Patient-Centered Outcome Measures After Stroke

    PubMed Central

    Salinas, Joel; Sprinkhuizen, Sara M.; Ackerson, Teri; Bernhardt, Julie; Davie, Charlie; George, Mary G.; Gething, Stephanie; Kelly, Adam G.; Lindsay, Patrice; Liu, Liping; Martins, Sheila C.O.; Morgan, Louise; Norrving, Bo; Ribbers, Gerard M.; Silver, Frank L.; Smith, Eric E.; Williams, Linda S.

    2016-01-01

    Background and Purpose— Value-based health care aims to bring together patients and health systems to maximize the ratio of quality over cost. To enable assessment of healthcare value in stroke management, an international standard set of patient-centered stroke outcome measures was defined for use in a variety of healthcare settings. Methods— A modified Delphi process was implemented with an international expert panel representing patients, advocates, and clinical specialists in stroke outcomes, stroke registers, global health, epidemiology, and rehabilitation to reach consensus on the preferred outcome measures, included populations, and baseline risk adjustment variables. Results— Patients presenting to a hospital with ischemic stroke or intracerebral hemorrhage were selected as the target population for these recommendations, with the inclusion of transient ischemic attacks optional. Outcome categories recommended for assessment were survival and disease control, acute complications, and patient-reported outcomes. Patient-reported outcomes proposed for assessment at 90 days were pain, mood, feeding, selfcare, mobility, communication, cognitive functioning, social participation, ability to return to usual activities, and health-related quality of life, with mobility, feeding, selfcare, and communication also collected at discharge. One instrument was able to collect most patient-reported subdomains (9/16, 56%). Minimum data collection for risk adjustment included patient demographics, premorbid functioning, stroke type and severity, vascular and systemic risk factors, and specific treatment/care-related factors. Conclusions— A consensus stroke measure Standard Set was developed as a simple, pragmatic method to increase the value of stroke care. The set should be validated in practice when used for monitoring and comparisons across different care settings. PMID:26604251

  20. Use of scoring systems for assessing and reporting the outcome results from shoulder surgery and arthroplasty.

    PubMed

    Booker, Simon; Alfahad, Nawaf; Scott, Martin; Gooding, Ben; Wallace, W Angus

    2015-03-18

    To investigate shoulder scoring systems used in Europe and North America and how outcomes might be classified after shoulder joint replacement. All research papers published in four major journals in 2012 and 2013 were reviewed for the shoulder scoring systems used in their published papers. A method of identifying how outcomes after shoulder arthroplasty might be used to categorize patients into fair, good, very good and excellent outcomes was explored using the outcome evaluations from patients treated in our own unit. A total of 174 research articles that were published in the four journals used some form of shoulder scoring system. The outcome from shoulder arthroplasty in our unit has been evaluated using the constant score (CS) and the oxford shoulder score and these scores have been used to evaluate individual patient outcomes. CSs of < 30 = unsatisfactory; 30-39 = fair; 40-59 = good; 60-69 = very good; and 70 and over = excellent. The most popular shoulder scoring systems in North America were Simple Shoulder Test and American shoulder and elbow surgeons standard shoulder assessment form score and in Europe CS, Oxford Shoulder Score and DASH score. PMID:25793164

  1. Use of scoring systems for assessing and reporting the outcome results from shoulder surgery and arthroplasty

    PubMed Central

    Booker, Simon; Alfahad, Nawaf; Scott, Martin; Gooding, Ben; Wallace, W Angus

    2015-01-01

    To investigate shoulder scoring systems used in Europe and North America and how outcomes might be classified after shoulder joint replacement. All research papers published in four major journals in 2012 and 2013 were reviewed for the shoulder scoring systems used in their published papers. A method of identifying how outcomes after shoulder arthroplasty might be used to categorize patients into fair, good, very good and excellent outcomes was explored using the outcome evaluations from patients treated in our own unit. A total of 174 research articles that were published in the four journals used some form of shoulder scoring system. The outcome from shoulder arthroplasty in our unit has been evaluated using the constant score (CS) and the oxford shoulder score and these scores have been used to evaluate individual patient outcomes. CSs of < 30 = unsatisfactory; 30-39 = fair; 40-59 = good; 60-69 = very good; and 70 and over = excellent. The most popular shoulder scoring systems in North America were Simple Shoulder Test and American shoulder and elbow surgeons standard shoulder assessment form score and in Europe CS, Oxford Shoulder Score and DASH score. PMID:25793164

  2. Endovascular Treatment of Venous Sinus Stenosis in Idiopathic Intracranial Hypertension: Complications, Neurological Outcomes, and Radiographic Results

    PubMed Central

    Starke, Robert M.; Wang, Tony; Ding, Dale; Durst, Christopher R.; Crowley, R. Webster; Chalouhi, Nohra; Hasan, David M.; Dumont, Aaron S.; Jabbour, Pascal; Liu, Kenneth C.

    2015-01-01

    Introduction. Idiopathic intracranial hypertension (IIH) may result in a chronic debilitating disease. Dural venous sinus stenosis with a physiologic venous pressure gradient has been identified as a potential etiology in a number of IIH patients. Intracranial venous stenting has emerged as a potential treatment alternative. Methods. A systematic review was carried out to identify studies employing venous stenting for IIH. Results. From 2002 to 2014, 17 studies comprising 185 patients who underwent 221 stenting procedures were reported. Mean prestent pressure gradient was 20.1 mmHg (95% CI 19.4–20.7 mmHg) with a mean poststent gradient of 4.4 mmHg (95% CI 3.5–5.2 mmHg). Complications occurred in 10 patients (5.4%; 95% CI 4.7–5.4%) but were major in only 3 (1.6%). At a mean clinical follow-up of 22 months, clinical improvement was noted in 130 of 166 patients with headaches (78.3%; 95% CI 75.8–80.8%), 84 of 89 patients with papilledema (94.4%; 95% CI 92.1–96.6%), and 64 of 74 patients with visual symptoms (86.5%; 95% CI 83.0–89.9%). In-stent stenosis was noted in six patients (3.4%; 95% CI 2.5–4.3%) and stent-adjacent stenosis occurred in 19 patients (11.4%; 95% CI 10.4–12.4), resulting in restenting in 10 patients. Conclusion. In IIH patients with venous sinus stenosis and a physiologic pressure gradient, venous stenting appears to be a safe and effective therapeutic option. Further studies are necessary to determine the long-term outcomes and the optimal management of medically refractory IIH. PMID:26146651

  3. A multidimensional Framework for Routine Outcome Measurement in Liaison Psychiatry (FROM-LP)†

    PubMed Central

    Trigwell, Peter; Kustow, James

    2016-01-01

    In the field of liaison psychiatry, as in all areas of healthcare, there is an essential need for well-organised and consistent collection of information on outcomes, from a range of perspectives. This special article introduces, and describes the development of, the multidimensional Framework for Routine Outcome Measurement in Liaison Psychiatry (FROM-LP). This was challenging owing to the variety of service settings and types of intervention which characterise liaison psychiatry. Similar challenges may be faced by other specialties and this, along with the direct relevance of much of the eventual content of the framework, will broaden the interest of this article. PMID:27512587

  4. Drinking Goal Choice and Outcomes in a Web-based Alcohol Intervention: Results from VetChange

    PubMed Central

    Enggasser, Justin L.; Hermos, John A.; Rubin, Amy; Lachowicz, Mark; Rybin, Denis; Brief, Deborah J.; Roy, Monica; Helmuth, Eric; Rosenbloom, David; Keane, Terence M.

    2014-01-01

    Objectives To describe characteristics of participants who chose moderation and abstinence drinking goals, and to examine post-treatment drinking outcomes based on patterns of goal choice during a Web-based alcohol intervention for returning U.S. Veterans. Method We conducted a descriptive secondary analysis of a subsample of 305 of 600 Veterans who participated in a clinical trial of VetChange, an 8-module, cognitive-behavioral intervention. Participants self-selected abstinence or moderation drinking goals, initially at Module 3, and weekly during subsequent modules. Alcohol use and alcohol-related problems were measured using the Alcohol Use Disorders Identification Test (AUDIT), Quick Drink Screen (QDS), and Short Inventory of Problems (SIP-2R). Results Initial goal choices were 86.9% moderation and 13.1% abstinence. Approximately 20% of participants from each initial choice changed goals during the intervention; last goal choices were 68.6% moderation and 31.4% abstinence. Participants who initially chose moderation reported higher percent heavy drinking days at baseline; participants who initially chose abstinence were more likely to report recent substance abuse treatment and were older. Post-intervention levels of alcohol use and alcohol-related problems were significantly reduced in all goal-choice patterns (i.e., Moderation Only, Abstinence Only, Moderation to Abstinence, and Abstinence to Moderation; all measures p < 0.05 or less). Baseline drinking severity did not differentially relate to outcomes across goal-choice patterns. Conclusions Participants in a Web-based alcohol intervention for returning U.S. Veterans demonstrated improvements in drinking regardless of whether they chose an abstinence or moderation drinking goal, and whether the goal was maintained or changed over the course of the intervention. PMID:25671224

  5. Challenges and Opportunities in Using Patient-reported Outcomes in Quality Measurement in Rheumatology.

    PubMed

    Wahl, Elizabeth R; Yazdany, Jinoos

    2016-05-01

    Use of patient-reported outcome measures (PROs) in rheumatology research is widespread, but use of PRO data to evaluate the quality of rheumatologic care delivered is less well established. This article reviews the use of PROs in assessing health care quality, and highlights challenges and opportunities specific to their use in rheumatology quality measurement. It first explores other countries' experiences collecting and evaluating national PRO data to assess quality of care. It describes the current use of PROs as quality measures in rheumatology, and frames an agenda for future work supporting development of meaningful quality measures based on PROs. PMID:27133495

  6. The Role of Clinical and Instrumented Outcome Measures in Balance Control of Individuals with Multiple Sclerosis

    PubMed Central

    Kanekar, Neeta; Aruin, Alexander S.

    2013-01-01

    Purpose. The aim of the study was to investigate differences in balance control between individuals with multiple sclerosis (MS) and healthy control subjects using clinical scales and instrumented measures of balance and determine relationships between balance measures, fatigue, and disability levels in individuals with MS with and without a history of falls. Method. Twelve individuals with MS and twelve healthy controls were evaluated using the Berg Balance and Activities-specific Balance Confidence Scales, Modified Clinical Test of Sensory Interaction on Balance, and Limits of Stability Tests as well as Fatigue Severity Scale and Barthel Index. Results. Mildly affected individuals with MS had significant balance performance deficits and poor balance confidence levels (P < 0.05). MS group had higher sway velocities and diminished stability limits (P < 0.05), significant sensory impairments, high fatigue and disability levels (P < 0.05). Sway velocity was a significant predictor of balance performance and the ability to move towards stability limits for the MS group. For the MS-fallers group, those with lower disability levels had faster movement velocities and better balance performance. Conclusion. Implementation of both clinical and instrumented tests of balance is important for the planning and evaluation of treatment outcomes in balance rehabilitation of people with MS. PMID:23766907

  7. The ALSFRS as an outcome measure in therapeutic trials and its relationship to symptom onset

    PubMed Central

    Proudfoot, Malcolm; Jones, Ashley; Talbot, Kevin; Al-Chalabi, Ammar; Turner, Martin R.

    2016-01-01

    Abstract The reduction in ALS Functional Rating Score (ALSFRS) from reported symptom onset to diagnosis is used to estimate rate of disease progression. ALSFRS decline may be non-linear or distorted by drop-outs in therapeutic trials, reducing the reliability of change in slope as an outcome measure. The PRO-ACT database uniquely allows such measures to be explored using historical data from negative therapeutic trials. The decline of functional scores was analysed in 18 pooled trials, comparing rates of decline based on symptom onset with rates calculated between interval assessments. Strategies to mitigate the effects of trial drop-out were considered. Results showed that progression rate calculated by symptom onset underestimated the subsequent rate of disability accumulation, although it predicted survival more accurately than four-month interval estimates of δALSFRS or δFVC. Individual ALSFRS and FVC progression within a typical trial duration were linear. No simple solution to correct for trial drop-out was identified, but imputation using δALSFRS appeared least disruptive. In conclusion, there is a trade-off between the drive to recruit trial participants soon after symptom onset, and reduced reliability of the ALSFRS-derived progression rate at enrolment. The need for objective markers of disease activity as an alternative to survival-based end-points is clear and pressing. PMID:26864085

  8. Outcome of Radial Head Arthroplasty in Comminuted Radial Head Fractures: Short and Midterm Results

    PubMed Central

    Moghaddam, Arash; Raven, Tim Friedrich; Dremel, Eike; Studier-Fischer, Stefan; Grutzner, Paul Alfred; Biglari, Bahram

    2016-01-01

    Background: Comminuted radial head fractures are often associated with secondary injuries and elbow instability. Objectives: The aim of this retrospective study was to evaluate how well the modular metallic radial head implant EVOLVE® prosthesis restores functional range of motion (ROM) and stability of the elbow in acute care. Patients and Methods: Eighty-five patients with comminuted radial head fractures and associated injuries received treatment with an EVOLVE® prosthesis between May 2001 and November 2009. Seventy-five patients were available for follow-up. On average, patients were followed for 41.5 months (33.0: 4.0 - 93.0). Outcome assessment was done on the basis of pain, ROM, strength, radiographic findings, and functional rating scores such as Broberg and Morrey, the Mayo elbow performance index (MEPI), and disabilities of the arm, shoulder and hand (DASH). Our study is currently the largest analysis of clinical outcome of a modular radial head replacement in the literature. Results: Overall, there were 2 (2.7%) Mason II fractures, 21 (28%) Mason III fractures, and 52 (69.3%) Mason IV fractures. Arbeitsgemeinschaft fur osteosynthesefragen (AO) classification was also determined. Of the 85 patients in our study, 75 were available for follow-up. Follow-up averaged 41.5 months (range, 4 - 93 months). Average scores for the cohort were as follows: Morrey, 85.7 (median 90.2; range 44.4 - 100); MEPI, 83.3 (85.0; 40.0 - 100); and DASH 26.1 points (22.5; 0.0 - 75.8). Mean flexion/extension in the affected joint was 125.7°/16.5°/0° in comparison to the noninjured side 138.5°/0°/1.2°. Mean pronation/supination was 70.5°/0°/67.1° in comparison to the noninjured side 83.6°/0°/84.3°. Handgrip strength of the injured compared to the non-injured arm was 78.8%. The following complications were also documented: 58 patients had periprosthetic radioluceny shown to be neither clinically significant nor relevant according to evaluated scores; 26 patients had

  9. MEASURING AND IMPROVING RESPIRATORY OUTCOMES IN CYSTIC FIBROSIS LUNG DISEASE: OPPORTUNITIES AND CHALLENGES TO THERAPY

    PubMed Central

    Zemanick, Edith T.; Harris, J. Kirk; Conway, Steven; Konstan, Michael W.; Marshall, Bruce; Quittner, Alexandra L.; Retsch-Bogart, George; Saiman, Lisa; Accurso, Frank J.

    2010-01-01

    Cystic fibrosis (CF) is a life-shortening disease with significant morbidity. Despite overall improvements in survival, patients with CF experience frequent pulmonary exacerbations and declining lung function, which often accelerates during adolescence. New treatments target steps in the pathogenesis of lung disease, such as the basic defect in CF (CF Transmembrane Conductance Regulator [CFTR]), pulmonary infections, inflammation, and mucociliary clearance. These treatments offer hope but also present challenges to patients, clinicians, and researchers. Comprehensive assessment of efficacy is critical to identify potentially beneficial treatments. Lung function and pulmonary exacerbation are the most commonly used outcome measures in CF clinical research. Other outcome measures under investigation include measures of CFTR function; biomarkers of infection, inflammation, lung injury and repair; and patient-reported outcomes. Molecular diagnostics may help elucidate the complex CF airway microbiome. As new treatments are developed for patients with CF, efforts should be made to balance treatment burden with quality of life. This review highlights emerging treatments, obstacles to optimizing outcomes, and key future directions for research. PMID:19833563

  10. The National Neurosurgery Quality and Outcomes Database Qualified Clinical Data Registry: 2015 measure specifications and rationale.

    PubMed

    Parker, Scott L; McGirt, Matthew J; Bekelis, Kimon; Holland, Christopher M; Davies, Jason; Devin, Clinton J; Atkins, Tyler; Knightly, Jack; Groman, Rachel; Zyung, Irene; Asher, Anthony L

    2015-12-01

    Meaningful quality measurement and public reporting have the potential to facilitate targeted outcome improvement, practice-based learning, shared decision making, and effective resource utilization. Recent developments in national quality reporting programs, such as the Centers for Medicare & Medicaid Services Qualified Clinical Data Registry (QCDR) reporting option, have enhanced the ability of specialty groups to develop relevant quality measures of the care they deliver. QCDRs will complete the collection and submission of Physician Quality Reporting System (PQRS) quality measures data on behalf of individual eligible professionals. The National Neurosurgery Quality and Outcomes Database (N(2)QOD) offers 21 non-PQRS measures, initially focused on spine procedures, which are the first specialty-specific measures for neurosurgery. Securing QCDR status for N(2)QOD is a tremendously important accomplishment for our specialty. This program will ensure that data collected through our registries and used for PQRS is meaningful for neurosurgeons, related spine care practitioners, their patients, and other stakeholders. The 2015 N(2)QOD QCDR is further evidence of neurosurgery's commitment to substantively advancing the health care quality paradigm. The following manuscript outlines the measures now approved for use in the 2015 N(2)QOD QCDR. Measure specifications (measure type and descriptions, related measures, if any, as well as relevant National Quality Strategy domain[s]) along with rationale are provided for each measure. PMID:26621418

  11. Assessing the results: phase 1 hyperlipidemia outcomes in 27 health plans.

    PubMed

    Latts, L M

    2001-04-16

    In phase 1 of this hyperlipidemia outcomes management program, characteristics of 7,619 patients treated with statins at 27 US managed care plans were determined. Nearly 40% (3,018 patients) had documented coronary heart disease (CHD). Most (65%) had at least two CHD risk factors. Hyperlipidemia treatment included simvastatin (39%), atorvastatin (25%), fluvastatin (14%), pravastatin (12%), and lovastatin (2%). On-treatment low-density lipoprotein cholesterol (LDL-C) levels were available for 79% of patients; however, only 46% had both baseline and follow-up levels recorded in their charts. Of patients for whom follow-up data were available, 3,779 (63%) achieved their target LDL-C levels as recommended by the National Cholesterol Education Program (NCEP). Target LDL-C levels were reached by 1,381 (87%) of the patients with a goal of 160 mg/dL, 1,326 (65%) of those with a goal of 130 mg/dL, and 1,072 (44%) of those with a goal of 100 mg/dL. Overall, 66% of patients who met their treatment goal and 24% of those who did not required no more than a 25% reduction in LDL-C. In contrast, 8% of patients who achieved goals and 36% of patients who did not required >40% reduction in LDL-C. Phase 1 results did not suggest any substantial difference among statins for achievement of NCEP goals or decrease in LDL-C. These results show that therapy with statins is effective for achievement of NCEP targets in most patients and that there is potential for improvement in the quality and cost-effectiveness of statin therapy with carefully planned interventions. PMID:11311193

  12. Bridging Differences in Outcomes of Pharmacoepidemiological Studies: Design and First Results of the PROTECT Project

    PubMed Central

    Abbing-Karahagopian, Victoria; Kurz, Xavier; de Vries, Frank; van Staa, Tjeerd P.; Alvarez, Yolanda; Hesse, Ulrik; Hasford, Joerg; Liset van, Dijk; Francisco J. de, Abajo; Weil, John G.; Lamiae Grimaldi, -Bensouda; Egberts, Antoine C.G.; Robert F., Reynolds; Olaf H., Klungel

    2014-01-01

    Background: Observational pharmacoepidemiological (PE) studies on drug safety have produced discrepant results that may be due to differences in design, conduct and analysis. Purpose: The pharmacoepidemiology work-package (WP2) of the Pharmacoepidemiological Research on Outcomes of Therapeutics by a European ConsorTium (PROTECT) project aims at developing, testing and disseminating methodological standards for design, conduct and analysis of pharmacoepidemiological studies applicable to different safety issues using different databases across European countries. This article describes the selection of the safety issues and the description of the databases to be systematically studied. Methods: Based on two consensus meetings and a literature search, we selected five drug-adverse event (AE) pairs to be evaluated in different databases. This selection was done according to pre-defined criteria such as regulatory and public health impact, and the potential to investigate a broad range of methodological issues. Results: The selected drug-AE pairs are: 1) inhaled long-acting beta-2 agonists and acute myocardial infarction; 2) antimicrobials and acute liver injury; 3) antidepressants and/or benzodiazepines and hip fracture; 4) anticonvulsants and suicide/suicide attempts; and 5) calcium channel blockers and malignancies. Six European databases, that will be used to evaluate the drug-AE pairs retrospectively, are also described. Conclusion: The selected drug-AE pairs will be evaluated in PE studies using common protocols. Based on consistencies and discrepancies of these studies, a framework for guiding methodological choices will be developed. This will increase the usefulness and reliability of PE studies for benefit-risk assessment and decision-making. PMID:24218995

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

    PubMed Central

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

    2014-01-01

    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

  14. Review of outcome measurement instruments in Alzheimer's disease drug trials: psychometric properties of global scales.

    PubMed

    Oremus, M; Perrault, A; Demers, L; Wolfson, C

    2000-01-01

    The use of global outcome measures with strong psychometric properties in Alzheimer's disease (AD) drug trials is encouraged. This article focuses on Clinician Global Impression of Change scales, the Clinical Dementia Rating, and the Global Deterioration Scale to provide (1) a review of psychometric properties, (2) a critique of how these properties are assessed in the literature, and (3) a basis for evaluating, from the standpoint of psychometric properties, the appropriateness of using a given global scale in a drug trial. Reported reliability and validity estimates for the aforementioned scales range from fair to very good, but small sample sizes and/or inappropriate measures of correlation weaken the quality of the evidence. There is also a dearth of published information on responsiveness to change. Researchers planning AD drug trials should consider these issues, along with the interval between test administrations for test-retest reliability, to help select appropriate global outcome measurement instruments. PMID:11128059

  15. On the Information Content of the Results of Measurements

    NASA Astrophysics Data System (ADS)

    Batura, N. I.

    2016-03-01

    Based on the introduced measure of experimental information, an approach is suggested that simplifies the planning of an experiment, as well as the processing and interpretation of its results. The approach considered is quite universal and can be used in experimental investigation of a wide range of processes (phenomena) described by linear (relative to the parameters investigated) models. The results of numerical calculation that illustrate the effectiveness of the proposed approach are presented. The calculation is carried out with the aid of the example of solving a model problem of processing the results of nonstationary temperature measurements.

  16. Patient population management: taking the leap from variance analysis to outcomes measurement.

    PubMed

    Allen, K M

    1998-01-01

    Case managers today at BCHS have a somewhat different role than at the onset of the Collaborative Practice Model. They are seen throughout the organization as: Leaders/participants on cross-functional teams. Systems change agents. Integrating/merging with quality services and utilization management. Outcomes managers. One of the major cross-functional teams is in the process of designing a Care Coordinator role. These individuals will, as one of their functions, assume responsibility for daily patient care management activities. A variance tracking program has come into the Utilization Management (UM) department as part of a software package purchased to automate UM work activities. This variance program could potentially be used by the new care coordinators as the role develops. The case managers are beginning to use a Decision Support software, (Transition Systems Inc.) in the collection of data that is based on a cost accounting system and linked to clinical events. Other clinical outcomes data bases are now being used by the case manager to help with the collection and measurement of outcomes information. Hoshin planning will continue to be a framework for defining and setting the targets for clinical and financial improvements throughout the organization. Case managers will continue to be involved in many of these system-wide initiatives. In the words of Galileo, 1579, "You need to count what's countable, measure what's measurable, and what's not measurable, make measurable." PMID:9601411

  17. Measuring the impact and outcomes of maternal child health federal programs.

    PubMed

    Taylor, Yhenneko J; Nies, Mary A

    2013-07-01

    Improving maternal and child health is a key objective of the United Nations' Millennium Development Goals and the Healthy People goals for improving the health of Americans. Government initiatives are important particularly for reducing disparities that affect disadvantaged populations. Head Start, Healthy Start, WIC and Medicaid are four federal programs that target disparities in maternal and child health outcomes. This paper reviews recent evaluations of these programs to identify outcomes assessed and opportunities for further evaluation of these programs. We conducted a review of recent evaluation studies assessing the impact of four maternal and child health programs on a health or healthcare outcome. Sources for published literature included the PubMed, Academic Search Complete, CINAHL and PsycInfo databases. Titles and abstracts of studies were examined to determine if they met inclusion criteria. Included studies were categorized by type of outcome examined. Twenty peer-reviewed studies published between January 2006 and June 2011 met inclusion criteria. The majority of studies examined infant outcomes (11), followed by breastfeeding/nutrition (4), maternal health (3), and unintended pregnancy (2). Measures used were consistent across studies; however, findings on the impact of programs were mixed reflecting differences in selection of comparison group, data source and statistical methods. The impact of maternal and child health programs may vary by setting and population served, but inconclusive findings remain. Health service researchers can build upon current evaluations to increase our understanding of what works, help target resources, and improve evaluation of programs in the future. PMID:22729661

  18. A meta-analysis of the effects of placement on academic and social skill outcome measures of students with disabilities.

    PubMed

    Oh-Young, Conrad; Filler, John

    2015-12-01

    This study involved an investigation of differences between outcome measures of students with disabilities placed in more integrated settings with those of students placed in less integrated settings. A meta-analysis was conducted using the findings from 24 studies published in peer-reviewed journals from 1980 through 2013. Results from the analyses suggest that there were significant differences (p<0.0001) between placement settings with the majority of students with disabilities in more integrated settings outperforming those in less integrated settings on both academic and social outcome measures. Overall these findings, combined with those from two prior meta-analytic studies, provide evidence spanning over 80 years suggesting separate settings are not as beneficial as are more integrated settings. Implications related to practice and policy, as well as avenues for future study, are discussed. PMID:26342328

  19. Infection in home health care: Results from national Outcome and Assessment Information Set data

    PubMed Central

    Shang, Jingjing; Larson, Elaine; Liu, Jianfang; Stone, Patricia

    2015-01-01

    Background Patients in home health care (HHC), the fastest growing health care sector, are at risk for infection. The existing research on infection in HHC is often limited by small sample sizes, local scope of inquiry, and a lack of current data. There is no national study examining agency-level infection rates. Methods This secondary data analysis used a 20% random sample of the 2010 national Outcome and Assessment Information Set (OASIS) data. An infection case was identified when the HHC patient was hospitalized or received emergency care for respiratory infection, urinary tract infection, intravenous catheter-related infection, wound infection, or deterioration. Proportions of infection cases out of the total number of patients were calculated for the whole sample and for each HHC agency. Results The final analysis included 199,462 patients from 8,255 HHC agencies. Approximately 3.5% of patients developed infections during their HHC stay, leading to emergency care treatment or hospitalization. Seventeen percent of unplanned hospitalizations among HHC patients were caused by infections. The agency-level infection rate ranged from 0%–34%, with an average of 3.5%. Conclusion To our knowledge, this is the first study to examine the proportion of hospitalizations or emergency care treatment caused by infection in HHC and the agency-level infection rate at a national level by using OASIS data. These data demonstrate that infection is a serious problem in HHC, and infection rates varied between agencies. The variance in agency level rates may be caused by differences in infection control policies and practices. Better infection surveillance system in HHC is needed to benchmark quality of care. PMID:25681302

  20. Communicating the results of randomized clinical trials: do patients understand multidimensional patient-reported outcomes?

    PubMed

    McNair, Angus G K; Brookes, Sara T; Davis, Christopher R; Argyropoulos, Miltiadis; Blazeby, Jane M

    2010-02-10

    PURPOSE Evidence suggests that patient-reported outcomes (PROs) from randomized trials in oncology may not influence clinical decision making and patient choice. Reasons for this are currently unclear and little is known about patients' interpretation of PROs. This study assessed patients' understanding of multidimensional PROs in a graphical format. PATIENTS AND METHODS Semistructured interviews in which patients interpreted a series of graphs depicting simple, then multiple different hypothetical PROs associated with two treatments with identical chances of survival were audio recorded. The interviewer and a blinded observer (listening to audio recordings) scored patients' understanding of the graphs. Logistic regression examined the associations between patient understanding of the graphs and clinical and sociodemographic details. Results One hundred thirty-two patients with esophageal and gastric cancer were interviewed and 115 understood the first two graphs depicting different PROs of two treatments (87%; 95% CI,81 to 93). Simultaneous interpretation of adverse and beneficial treatment effects was achieved by 74 (66%; 95% CI, 57 to 75). Graphs showing complex, longitudinal data were correctly interpreted by 97 (73%; 95% CI, 66 to 81) and 108 (81%; 95% CI, 75 to 88), respectively. Univariable analyses demonstrated associations between patient understanding and patient age, educational level, and cancer site (P < or = .02 for all); however, in a multivariable model each of these associations was attenuated. CONCLUSION Most patients understand graphical multidimensional PROs, although a smaller majority were able to interpret more complex, or simultaneous, presentations. Additional work is needed to define methods for communicating clinical and PRO data from trials to allow patients to make informed treatment choices. PMID:20065187

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

    PubMed Central

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

    2014-01-01

    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

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

    PubMed

    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

    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

  3. Galectin-3, Renal Function, and Clinical Outcomes: Results from the LURIC and 4D Studies.

    PubMed

    Drechsler, Christiane; Delgado, Graciela; Wanner, Christoph; Blouin, Katja; Pilz, Stefan; Tomaschitz, Andreas; Kleber, Marcus E; Dressel, Alexander; Willmes, Christoph; Krane, Vera; Krämer, Bernhard K; März, Winfried; Ritz, Eberhard; van Gilst, Wiek H; van der Harst, Pim; de Boer, Rudolf A

    2015-09-01

    Galectin-3 has been linked to incident renal disease, experimental renal fibrosis, and nephropathy. However, the association among galectin-3, renal function, and adverse outcomes has not been described. We studied this association in two large cohorts of patients over a broad range of renal function. We measured galectin-3 concentrations in baseline samples from the German Diabetes mellitus Dialysis (4D) study (1168 dialysis patients with type 2 diabetes mellitus) and the Ludwigshafen Risk and Cardiovascular Health (LURIC) study (2579 patients with coronary angiograms). Patients were stratified into three groups: eGFR of ≥90 ml/min per 1.73 m(2), 60-89 ml/min per 1.73 m(2), and <60 ml/min per 1.73 m(2). We correlated galectin-3 concentrations with demographic, clinical, and biochemical parameters. The association of galectin-3 with clinical end points was assessed by Cox proportional hazards regression within 10 years (LURIC) or 4 years (4D) of follow-up. Mean±SD galectin-3 concentrations were 12.8±4.0 ng/ml (eGFR≥90 ml/min per 1.73 m(2)), 15.6±5.4 ng/ml (eGFR 60-89 ml/min per 1.73 m(2)), 23.1±9.9 ng/ml (eGFR<60 ml/min per 1.73 m(2)), and 54.1±19.6 ng/ml (dialysis patients of the 4D study). Galectin-3 concentration was significantly associated with clinical end points in participants with impaired kidney function, but not in participants with normal kidney function. Per SD increase in log-transformed galectin-3 concentration, the risks of all-cause mortality, cardiovascular mortality, and fatal infection increased significantly. In dialysis patients, galectin-3 was associated with the combined end point of cardiovascular events. In conclusion, galectin-3 concentrations increased with progressive renal impairment and independently associated with cardiovascular end points, infections, and all-cause death in patients with impaired renal function. PMID:25568176

  4. Assessing methods for measurement of clinical outcomes and quality of care in primary care practices

    PubMed Central

    2012-01-01

    Purpose To evaluate the appropriateness of potential data sources for the population of performance indicators for primary care (PC) practices. Methods This project was a cross sectional study of 7 multidisciplinary primary care teams in Ontario, Canada. Practices were recruited and 5-7 physicians per practice agreed to participate in the study. Patients of participating physicians (20-30) were recruited sequentially as they presented to attend a visit. Data collection included patient, provider and practice surveys, chart abstraction and linkage to administrative data sets. Matched pairs analysis was used to examine the differences in the observed results for each indicator obtained using multiple data sources. Results Seven teams, 41 physicians, 94 associated staff and 998 patients were recruited. The survey response rate was 81% for patients, 93% for physicians and 83% for associated staff. Chart audits were successfully completed on all but 1 patient and linkage to administrative data was successful for all subjects. There were significant differences noted between the data collection methods for many measures. No single method of data collection was best for all outcomes. For most measures of technical quality of care chart audit was the most accurate method of data collection. Patient surveys were more accurate for immunizations, chronic disease advice/information dispensed, some general health promotion items and possibly for medication use. Administrative data appears useful for indicators including chronic disease diagnosis and osteoporosis/ breast screening. Conclusions Multiple data collection methods are required for a comprehensive assessment of performance in primary care practices. The choice of which methods are best for any one particular study or quality improvement initiative requires careful consideration of the biases that each method might introduce into the results. In this study, both patients and providers were willing to participate in and

  5. Patient-Reported Outcomes and Total Health Care Expenditure in Prediction of Patient Satisfaction: Results From a National Study

    PubMed Central

    Zhang, Weiping; Chen, Wei; Bounsanga, Jerry; Cheng, Christine; Franklin, Jeremy D; Crum, Anthony B; Voss, Maren W; Hon, Shirley D

    2015-01-01

    Background Health care quality is often linked to patient satisfaction. Yet, there is a lack of national studies examining the relationship between patient satisfaction, patient-reported outcomes, and medical expenditure. Objective The aim of this study is to examine the contribution of physical health, mental health, general health, and total health care expenditures to patient satisfaction using a longitudinal, nationally representative sample. Methods Using data from the 2010-2011 Medical Expenditure Panel Survey, analyses were conducted to predict patient satisfaction from patient-reported outcomes and total health care expenditures. The study sample consisted of adult participants (N=10,157), with sampling weights representative of 233.26 million people in the United States. Results The results indicated that patient-reported outcomes and total health care expenditure were associated with patient satisfaction such that higher physical and mental function, higher general health status, and higher total health care expenditure were associated with higher patient satisfaction. Conclusions We found that patient-reported outcomes and total health care expenditure had a significant relationship with patient satisfaction. As more emphasis is placed on health care value and quality, this area of research will become increasingly needed and critical questions should be asked about what we value in health care and whether we can find a balance between patient satisfaction, outcomes, and expenditures. Future research should apply big data analytics to investigate whether there is a differential effect of patient-reported outcomes and medical expenditures on patient satisfaction across different medical specialties. PMID:27227131

  6. Capabilities and Characteristics of Digital Measurement Feedback Systems: Results from a Comprehensive Review.

    PubMed

    Lyon, Aaron R; Lewis, Cara C; Boyd, Meredith R; Hendrix, Ethan; Liu, Freda

    2016-05-01

    Measurement feedback systems (MFS) are a class of health information technology (HIT) that function as an implementation support strategy for integrating measurement based care or routine outcome monitoring into clinical practice. Although many MFS have been developed, little is known about their functions. This paper reports findings from an application of health information technology-academic and commercial evaluation (HIT-ACE), a systematic and consolidated evaluation method, to MFS designed for use in behavioral healthcare settings. Forty-nine MFS were identified and subjected to systematic characteristic and capability coding. Results are presented with respect to the representation of characteristics and capabilities across MFS. PMID:26860952

  7. Recommendations for a Core Outcome Set for Measuring Standing Balance in Adult Populations: A Consensus-Based Approach

    PubMed Central

    Sibley, Kathryn M.; Howe, Tracey; Lamb, Sarah E.; Lord, Stephen R.; Maki, Brian E.; Rose, Debra J.; Scott, Vicky; Stathokostas, Liza; Straus, Sharon E.; Jaglal, Susan B.

    2015-01-01

    Background Standing balance is imperative for mobility and avoiding falls. Use of an excessive number of standing balance measures has limited the synthesis of balance intervention data and hampered consistent clinical practice. Objective To develop recommendations for a core outcome set (COS) of standing balance measures for research and practice among adults. Methodology A combination of scoping reviews, literature appraisal, anonymous voting and face-to-face meetings with fourteen invited experts from a range of disciplines with international recognition in balance measurement and falls prevention. Consensus was sought over three rounds using pre-established criteria. Data sources The scoping review identified 56 existing standing balance measures validated in adult populations with evidence of use in the past five years, and these were considered for inclusion in the COS. Results Fifteen measures were excluded after the first round of scoring and a further 36 after round two. Five measures were considered in round three. Two measures reached consensus for recommendation, and the expert panel recommended that at a minimum, either the Berg Balance Scale or Mini Balance Evaluation Systems Test be used when measuring standing balance in adult populations. Limitations Inclusion of two measures in the COS may increase the feasibility of potential uptake, but poses challenges for data synthesis. Adoption of the standing balance COS does not constitute a comprehensive balance assessment for any population, and users should include additional validated measures as appropriate. Conclusions The absence of a gold standard for measuring standing balance has contributed to the proliferation of outcome measures. These recommendations represent an important first step towards greater standardization in the assessment and measurement of this critical skill and will inform clinical research and practice internationally. PMID:25768435

  8. Measurement error and outcomes defined by exceeding a threshold: biased findings in comparative effectiveness trials.

    PubMed

    Bůžková, Petra

    2012-01-01

    In medical studies, the long-term level of a risk factor exceeding a threshold is often an outcome of interest. In practice, such a risk factor may not be directly measurable. Instead, outcome variables are based on a single or multiple biomedical measurements that have substantial variability. This variability is due to measurement error in a strict sense, true day-to-day variability, or a combination of the two. Estimates of prevalence based on such outcomes are biased; some individuals with long-term levels below the threshold will be diagnosed, and some with long-term levels above the threshold will not be diagnosed. From a public health point of view, this is a relatively minor concern; it is much less important than the fact that many individuals are not tested at all. However, in comparative effectiveness research studies, such as clinical trials evaluating a new treatment as compared with a placebo or a gold standard treatment, the combination of a noisy measurement and a threshold can distort the studies' conclusions in important ways. Using simulations and theoretical formulas, we systematically describe the bias of prevalence difference and prevalence ratio when comparing arms and its effect on trial conclusions. PMID:22888090

  9. Breast Reduction versus Breast Reduction Plus Implants: A Comparative Study with Measurements and Outcomes

    PubMed Central

    2014-01-01

    Background: Breast reduction is well-known to provide an improvement in physical symptoms. However, measurements show that this procedure is less effective in restoring upper-pole fullness. Breast implants effectively augment the upper pole. This study was undertaken to determine the effectiveness and safety of this treatment combination. Methods: This retrospective study consists of 3 parts: (1) a clinical study, (2) breast measurements, and (3) an outcome study. Eighty consecutive women undergoing breast reduction (n = 56) or breast reduction plus implants (n = 24) were evaluated. All breast implants were inserted submuscularly. All patients were treated with the same vertical reduction technique, using a medially based pedicle and intraoperative nipple positioning. Measurements were compared between preoperative photographs and photographs taken at least 3 months after surgery (n = 51). Patient surveys (n= 56) were evaluated. Results: There was no significant difference in complication or reoperation rates between groups. Both procedures elevated the breast mound and lower-pole level and increased the breast parenchymal ratio (upper-pole area/lower-pole area). Breast implants significantly increased upper-pole projection (P < 0.01). All surveyed patients who had simultaneous implants reported that they were pleased with their decision. Physical symptoms were reduced in both groups. Patient satisfaction was 92.5% for breast reduction and 93.8% for breast reduction plus implants. Both groups reported an improvement in quality of life. Conclusions: Vertical breast reduction with a medial pedicle may be combined safely and effectively with breast implants in patients who desire upper-pole fullness. PMID:25587515

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

    ERIC Educational Resources Information Center

    Giloth, Robert; Phillips, William

    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…

  11. Student Learning Outcomes. Students' Survey Results on Advanced Education and Employment Benefits.

    ERIC Educational Resources Information Center

    State Univ. of New York, Saratoga Springs. Empire State Coll.

    This report on student educational outcomes is based on 1982/83 surveys of 1978 through 1982 graduates of programs at the Genesee Valley Regional Center (n=135) and the Metropolitan Regional Center of the Empire State College (ESC) (n=144) of New York. The report reflects information concerning graduates' current employment circumstances, graduate…

  12. Relationship Between Upper Respiratory Tract Influenza Test Result and Clinical Outcomes Among Critically Ill Influenza Patients

    PubMed Central

    Reddy, Krishna P.; Bajwa, Ednan K.; Parker, Robert A.; Onderdonk, Andrew B.; Walensky, Rochelle P.

    2016-01-01

    Among critically ill patients with lower respiratory tract (LRT)-confirmed influenza, we retrospectively observed worse 28-day clinical outcomes in upper respiratory tract (URT)-negative versus URT-positive subjects. This finding may reflect disease progression and highlights the need for influenza testing of both URT and LRT specimens to improve diagnostic yield and possibly inform prognosis. PMID:26966696

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

    ERIC Educational Resources Information Center

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

    2010-01-01

    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…

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

    ERIC Educational Resources Information Center

    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

    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…

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

    ERIC Educational Resources Information Center

    Hilton, John, III; Plummer, Kenneth

    2013-01-01

    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…

  16. 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

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

    2013-01-01

    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

  17. Modeling risk for severe adverse outcomes using angiogenic factor measurements in women with suspected preterm preeclampsia

    PubMed Central

    Palomaki, Glenn E; Haddow, James E; Haddow, Hamish R M; Salahuddin, Saira; Geahchan, Carl; Cerdeira, Ana Sofia; Verlohren, Stefan; Perschel, Frank H; Horowitz, Gary; Thadhani, Ravi; Karumanchi, S Ananth; Rana, Sarosh

    2015-01-01

    Introduction Preeclampsia (PE) is a pregnancy-specific syndrome associated with adverse maternal and fetal outcomes. Patient-specific risks based on angiogenic factors might better categorize those who might have a severe adverse outcome. Methods Women evaluated for suspected PE at a tertiary hospital (2009–2012) had pregnancy outcomes categorized as ‘referent’ or ‘severe’, based solely on maternal/fetal findings. Outcomes that may have been influenced by a PE diagnosis were considered ‘unclassified’. Soluble fms-like tyrosine kinase (sFlt1) and placental growth factor (PlGF) were subjected to bivariate discriminant modeling, allowing patient-specific risks to be assigned for severe outcomes. Results Three hundred twenty-eight singleton pregnancies presented at ≤34.0 weeks' gestation. sFlt1 and PlGF levels were adjusted for gestational age. Risks above 5 : 1 (10-fold over background) occurred in 77% of severe (95% CI 66 to 87%) and 0.7% of referent (95% CI <0.1 to 3.8%) outcomes. Positive likelihood ratios for the modeling and validation datasets were 19 (95% CI 6.2–58) and 15 (95% CI 5.8–40) fold, respectively. Conclusions This validated model assigns patient-specific risks of any severe outcome among women attending PE triage. In practice, women with high risks would receive close surveillance with the added potential for reducing unnecessary preterm deliveries among remaining women. © 2015 The Authors. Prenatal Diagnosis published by John Wiley & Sons Ltd. PMID:25641027

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

    PubMed

    Tomlinson, Alan; Hair, Mario; McFadyen, Angus

    2013-10-01

    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

  19. Comparison of measures to assess outcomes in total hip replacement surgery.

    PubMed Central

    Dawson, J; Fitzpatrick, R; Murray, D; Carr, A

    1996-01-01

    OBJECTIVES--To compare the performance of a disease specific and a general health questionnaire in assessing changes resulting from total hip replacement. DESIGN--Two stage prospective study of patients undergoing total hip replacement surgery involving an assessment at a clinic before and six months after surgery. 60(32%) patients were followed up by post. SETTING--Outpatient departments at a specialist orthopaedic hospital and peripheral clinics within Oxfordshire. PATIENTS--188 patients admitted for unilateral total hip replacement between February and mid-August 1994. MAIN MEASURES--Patients' self assessed scores with the 12 item Oxford hip score and SF-36 general health questionnaire together with surgeons' assessment with Charnley hip score obtained before and again at six months after surgery. RESULTS--186 patients were followed up six months after total hip replacement; a subsample (n=60) by post. Of the 60 postal patients, 59(98.3%) fully completed the Oxford hip score compared with 44(73.3%) who fully completed the SF-36. For the followup sample as a whole, post operative changes in scores produced a large effect size of 2.75 on the Oxford hip score, compared with -1.89 physical function (SF-36), -2.13 pain (SF-36). With the exception of physical function and role (physical), postoperative SF-36 scores were shown to be similar to or better than those found by two population surveys on patients of comparable age. The responsiveness of a disease specific questionnaire, the Oxford hip score, and relevant sections of a general questionnaire, SF-36, were found to be similar as assessed by three different criteria. CONCLUSIONS--A disease specific questionnaire, the Oxford hip score, and a general state of health questionnaire, SF-36, performed similarly in assessing outcomes of total hip replacement except that the disease specific questionnaire resulted in a higher completion rate and greater responsiveness in some sections. On the other hand the general

  20. Outcome measures of interventions in the study of children of substance-abusing parents.

    PubMed

    Kumpfer, K L

    1999-05-01

    Children of substance-abusing parents, including children of alcoholics (COAs), are one of the highest risk groups of youth for substance-abuse problems. For both genetic and family environmental reasons, COAs and children of drug abusers are very vulnerable to becoming alcohol or other drug abusers.1,2 With drug use rates increasing in the past 7 years,3 prevention practitioners must work harder to identify and evaluate effective ways to prevent future substance abuse in these at-risk children. Most prevention programs designed specifically for COAs or children of drug abusers have struggled with identifying, attracting, maintaining, and measuring outcomes. This article focuses on general and unique measurement methods and instrument problems in prevention interventions for children of substance-abusing parents. Part I covers the need for improved measurement in research and practice with children of substance-abusing parents and recommended measures for different hypothesized outcome variables. Part II covers considerations in selecting measures, and Part III covers how to select measures. This article concludes with recommendations to improve measurement in research and practice. PMID:10224200

  1. Adjustment as process and outcome: Measuring adjustment to HIV in Uganda.

    PubMed

    Martin, Faith; Russell, Steve; Seeley, Janet

    2016-05-01

    'Adjustment' in health refers to both processes and outcomes. Its measurement and conceptualisation in African cultures is limited. In total, 263 people living with HIV and receiving anti-retroviral therapy in clinics in Uganda completed a translated Mental Adjustment to HIV Scale, depression items from the Hopkins checklist and demographic questions. Factor analysis revealed four Mental Adjustment to HIV factors of active coping, cognitive-social adjustment, hopelessness and denial/avoidance. Correlations with depression supported the Mental Adjustment to HIV's validity and the importance of active adjustment, while the role of cognitive adjustment was unclear. Factors were process or outcome focussed, suggesting a need for theory-based measures in general. PMID:25030794

  2. Assessment of Aging Individuals with Down Syndrome in Clinical Trials: Results of Baseline Measures

    ERIC Educational Resources Information Center

    Sano, Mary; Aisen, Paul S.; Dalton, Arthur J.; Andrews, Howard F.; Tsai, Wei-Yann

    2005-01-01

    A major challenge to developing therapeutic interventions for cognitive loss and dementia in aging individuals with Down syndrome (DS) is the selection of appropriate outcome measures. This report describes the adaptation of the Brief Praxis Test (a nonverbal cognitive test) as a primary outcome measure, as well as the selection of secondary…

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

    ERIC Educational Resources Information Center

    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

    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…

  4. Examining the Effects of Displaying Clicker Voting Results on High School Students' Voting Behaviors, Discussion Processes, and Learning Outcomes

    ERIC Educational Resources Information Center

    Chien, Yu-Ta; Lee, Yu-Hsien; Li, Tsung-Yen; Chang, Chun-Yen

    2015-01-01

    This study explores the relationship between students' clicking behaviors, discussion processes, learning outcomes, and a prominent feature of clicker systems--the whole class' response results aggregated by clickers in real time. The results indicate that, while teaching Newton's laws of motion, displaying the real-time responses of the whole…

  5. Managing for Results--Linking Performance Measures and Budgets.

    ERIC Educational Resources Information Center

    McGee, William L.; Fountain, James R., Jr.

    1995-01-01

    The Government Accounting Standards Board notion of service efforts and accomplishments reporting is one step in a process of managing for results that includes strategic planning, development and use of performance measures of managing ongoing programs, and outputs to budgetary appropriation. Reports a trial application to one school district.…

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

    PubMed

    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

    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

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

    ERIC Educational Resources Information Center

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

    1999-01-01

    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)

  8. Pragmatic Characteristics of Patient-Reported Outcome Measures are Important for Use in Clinical Practice

    PubMed Central

    Kroenke, Kurt; Monahan, Patrick O.; Kean, Jacob

    2015-01-01

    Objective Measures for assessing patient-reported outcomes (PROs) that may have initially been developed for research are increasingly being recommended for use in clinical practice as well. While psychometric rigor is essential, this paper focuses on pragmatic characteristics of PROs that may enhance uptake into clinical practice. Methods Three sources were drawn upon in identifying pragmatic criteria for PROs: 1) selected literature review including recommendations by other expert groups; 2) key features of several model public domain PROs; 3) the author' experience in developing practical PROs. Results Eight characteristics of a practical PRO include: 1) actionability (i.e., scores guide diagnostic or therapeutic actions/decision-making); 2) appropriateness for the relevant clinical setting; 3) universality (i.e., for screening, severity assessment, and monitoring across multiple conditions); 4) self-administration; 5) item features (number of items and bundling issues); 6) response options (option number and dimensions, uniform vs. varying options, timeframe, intervals between options); 7) scoring (simplicity, interpretability); and 8) accessibility (nonproprietary, downloadable, available in different languages and for vulnerable groups, incorporated into electronic health records) Conclusion Balancing psychometric and pragmatic factors in the development of PROs is important for accelerating the incorporation of PROs into clinical practice. PMID:25962972

  9. Modifying the Clinical Outcomes in Routine Evaluation Measure for Use with People Who Have a Learning Disability

    ERIC Educational Resources Information Center

    Marshall, Keith; Willoughby-Booth, Simon

    2007-01-01

    There are few reliable self-report measures suitable for people with a learning disability in reporting psychological distress. This study examines the modification of the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM), exploring its reliability, using two different presentation styles. One style included a sequencing task then…

  10. Some Lessons to Be Learned from a Decade of General Education Outcomes Assessment with the ACT COMP Measures.

    ERIC Educational Resources Information Center

    Yarbrough, Donald B.

    1992-01-01

    This article reviews the literature addressing uses of the American College Testing College Outcome Measures Program (ACT COMP), the most frequently used standardized measure of cognitive general education outcomes. It concludes that worthwhile evaluations of ACT COMP uses require well-crafted general education program evaluations. Recommendations…

  11. 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

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

    2013-01-01

    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

  12. The effectiveness of providing peer benchmarked feedback to hip replacement surgeons based on patient-reported outcome measures—results from the PROFILE (Patient-Reported Outcomes: Feedback Interpretation and Learning Experiment) trial: a cluster randomised controlled study

    PubMed Central

    Boyce, Maria B; Browne, John P

    2015-01-01

    Objective To test whether providing surgeons with peer benchmarked feedback about patient-reported outcomes is effective in improving patient outcomes. Design Cluster randomised controlled trial. Setting Secondary care—Ireland. Participants Surgeons were recruited through the Irish Institute of Trauma and Orthopaedic Surgery, and patients were recruited in hospitals prior to surgery. We randomly allocated 21 surgeons and 550 patients. Intervention Surgeons in the intervention group received peer benchmarked patient-reported outcome measures (PROMs) feedback and education. Main outcome variable Postoperative Oxford Hip Score (OHS). Results Primary outcome data were available for 11 intervention surgeons with responsibility for 230 patients and 10 control surgeons with responsibility for 228 patients. The mean postoperative OHS for the intervention group was 40.8 (95% CI 39.8 to 41.7) and for the control group was 41.9 (95% CI 41.1 to 42.7). The adjusted effect estimate was −1.1 (95% CI −2.4 to 0.2, p=0.09). Secondary outcomes were the Hip Osteoarthritis Outcome Score (HOOS), EQ-5D and the proportion of patients reporting a problem after surgery. The mean postoperative HOOS for the intervention group was 36.2 and for the control group was 37.1. The adjusted effect estimate was −1.1 (95% CI −2.4 to 0.3, p=0.1). The mean postoperative EQ-5D for the intervention group was 0.85 and for the control group was 0.87. The adjusted effect estimate was −0.02 (95% CI −0.05 to 0.008, p=0.2). 27% of intervention patients and 24% of control patients reported at least one complication after surgery (adjusted OR=1.2, 95% CI 0.6 to 2.3, p=0.6). Conclusions Outcomes for patients operated on by surgeons who had received peer benchmarked PROMs data were not statistically different from the outcomes of patients operated on by surgeons who did not receive feedback. PROMs information alone seems to be insufficient to identify opportunities for quality improvement. Trial

  13. Patient-Reported Outcome Measures-What Data Do We Really Need?

    PubMed

    Lyman, Stephen; Hidaka, Chisa

    2016-06-01

    The Center for Medicaid and Medicare Services has recently announced the inclusion of several patient-reported outcome measures (PROMs), including the abbreviated Hip Disability and Osteoarthritis Outcome Score and Knee Injury and Osteoarthritis Outcome Score for joint replacement (HOOS, JR and KOOS, JR) for the purpose of quality assessment in total hip and total knee replacement (THR and TKR). Historically, Center for Medicaid and Medicare Services and other agencies have used measures of process (eg, % vaccinated) or adverse events (eg, infection rates, readmission rates) for quality assessment. However, the use of PROMs has become a priority based on stated goals by the National Quality Strategy and Institute of Medicine for a more patient-centered approach. Here, we review several general health and joint-specific PROMs, which have been extensively used in research to assess treatment efficacy and discuss their relevance to the new criteria for quality assessment, particularly for THR and TKR. Although we expect HOOS, JR and KOOS, JR to yield much useful information in the near term, these surveys are likely an interim solution. In the future, we anticipate that novel measurement platforms, such as wearable technologies or patient-specific surveys, may open new and exciting avenues of research to discover which types of data-perhaps not previously available-best represent patient quality of life and satisfaction after THR, TKR, or other orthopedic procedures. PMID:27157278

  14. DWPF STARTUP FRIT VISCOSITY MEASUREMENT ROUND ROBIN RESULTS

    SciTech Connect

    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

    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.

  15. The economics of mitigation and remediation measures - preliminary results

    NASA Astrophysics Data System (ADS)

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

    2012-07-01

    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.

  16. Homocysteine-Lowering and Cardiovascular Disease Outcomes in Kidney Transplant Recipients: Primary Results from the Folic Acid for Vascular Outcome Reduction in Transplantation (FAVORIT) Trial

    PubMed Central

    Bostom, Andrew G.; Carpenter, Myra A.; Kusek, John W.; Levey, Andrew S.; Hunsicker, Lawrence; Pfeffer, Marc A.; Selhub, Jacob; Jacques, Paul F.; Cole, Edward; Gravens-Mueller, Lisa; House, Andrew A.; Kew, Clifton; McKenney, Joyce L.; Pacheco-Silva, Alvaro; Pesavento, Todd; Pirsch, John; Smith, Stephen; Solomon, Scott; Weir, Matthew

    2015-01-01

    Background Kidney transplant recipients, like other patients with chronic kidney disease (CKD), experience excess risk of cardiovascular disease (CVD) and elevated total homocysteine (tHcy) concentrations. Observational studies of patients with CKD suggest increased homocysteine is a risk factor for CVD. The impact of lowering total homocysteine (tHcy) levels in kidney transplant recipients is unknown. Methods and Results In a double-blind controlled trial, we randomized 4110 stable kidney transplant recipients to a multivitamin that included either a high dose (n=2056) or low dose (n=2054) of folic acid, vitamin B6, and vitamin B12 to determine whether decreasing tHcy concentrations reduced the rate of the primary composite arteriosclerotic CVD outcome (myocardial infarction, stroke, CVD death, resuscitated sudden death, coronary artery or renal artery revascularization, lower extremity arterial disease, carotid endarterectomy or angioplasty, or abdominal aortic aneurysm repair). Mean follow-up was 4.0 years. Treatment with the high dose multivitamin reduced homocysteine but did not reduce the rates of the primary outcome (n= 547 total events; hazards ratio [95% confidence interval] = 0.99 [0.84–1.17]), or secondary outcomes of all-cause mortality (n=431 deaths; 1.04 [0.86–1.26]) or dialysis-dependent kidney failure (n=343 events; 1.15 [0.93–1.43]) compared to the low dose multivitamin. Conclusions Treatment with a high dose folic acid, B6, and B12 multivitamin in kidney transplant recipients did not reduce a composite cardiovascular disease outcome, all-cause mortality, or dialysis-dependent kidney failure despite significant reduction in homocysteine level. PMID:21482964

  17. Toward improved spectral measures of /s/: Results from adolescents

    PubMed Central

    Koenig, Laura L.; Shadle, Christine H.; Preston, Jonathan L.; Mooshammer, Christine R.

    2014-01-01

    Purpose To introduce theoretically-driven acoustic measures of /s/ that reflect aerodynamic and articulatory conditions. The measures were evaluated by assessing whether they revealed expected changes over time and labiality effects, along with possible gender differences suggested by past work. Method Productions of /s/ were extracted from various speaking tasks from typically-speaking adolescents (6 boys; 6 girls). Measures were made of relative spectral energies in low- (550–3000 Hz), mid- (3000–7000 Hz), and high-frequency regions (7000–11025 Hz); the mid-frequency amplitude peak; and temporal changes in these parameters. Spectral moments were also obtained to permit comparison with existing work. Results Spectral balance measures in low–mid and mid–high frequency bands varied over the time course of /s/, capturing the development of sibilance at mid-fricative along with showing some effects of gender and labiality. The mid-frequency spectral peak was significantly higher in non-labial contexts, and in girls. Temporal variation in the mid-frequency peak differentiated ±labial contexts while normalizing over gender. Discussion The measures showed expected patterns, supporting their validity. Comparison of these data with studies of adults suggests some developmental patterns that call for further study. The measures may also serve to differentiate some cases of typical and misarticulated /s/. PMID:23785194

  18. Blue Cone Monochromacy: Visual Function and Efficacy Outcome Measures for Clinical Trials

    PubMed Central

    Iannaccone, Alessandro; Roman, Alejandro J.; Ditta, Lauren C.; Jennings, Barbara J.; Yatsenko, Svetlana A.; Sheplock, Rebecca; Sumaroka, Alexander; Swider, Malgorzata; Schwartz, Sharon B.; Wissinger, Bernd; Kohl, Susanne; Jacobson, Samuel G.

    2015-01-01

    Background Blue Cone Monochromacy (BCM) is an X-linked retinopathy caused by mutations in the OPN1LW / OPN1MW gene cluster, encoding long (L)- and middle (M)-wavelength sensitive cone opsins. Recent evidence shows sufficient structural integrity of cone photoreceptors in BCM to warrant consideration of a gene therapy approach to the disease. In the present study, the vision in BCM is examined, specifically seeking clinically-feasible outcomes for a future clinical trial. Methods BCM patients (n = 25, ages 5–72) were studied with kinetic and static chromatic perimetry, full-field sensitivity testing, and eye movement recordings. Vision at the fovea and parafovea was probed with chromatic microperimetry. Results Kinetic fields with a Goldmann size V target were generally full. Short-wavelength (S-) sensitive cone function was normal or near normal in most patients. Light-adapted perimetry results on conventional background lights were abnormally reduced; 600-nm stimuli were seen by rods whereas white stimuli were seen by both rods and S-cones. Under dark-adapted conditions, 500-nm stimuli were seen by rods in both BCM and normals. Spectral sensitivity functions in the superior retina showed retained rod and S-cone functions in BCM under dark-adapted and light-adapted conditions. In the fovea, normal subjects showed L/M-cone mediation using a 650-nm stimulus under dark-adapted conditions, whereas BCM patients had reduced sensitivity driven by rod vision. Full-field red stimuli on bright blue backgrounds were seen by L/M-cones in normal subjects whereas BCM patients had abnormally reduced and rod-mediated sensitivities. Fixation location could vary from fovea to parafovea. Chromatic microperimetry demonstrated a large loss of sensitivity to red stimuli presented on a cyan adapting background at the anatomical fovea and surrounding parafovea. Conclusions BCM rods continue to signal vision under conditions normally associated with daylight vision. Localized and retina

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

    PubMed Central

    2014-01-01

    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 < .0001). A total of 153 participants (6.9%) experienced a cardiovascular event. After adjusting for traditional risk factors, total arterial compliance was modestly associated with increased risk for composite events (HR 1.07 per 1SD, p = 0.03) while the association between ascending aortic distensibility and composite events trended towards significance (HR 1.18 per 1SD, p = 0.08). Total arterial compliance and aortic distensibility were independently associated with nonfatal cardiac events (HR 1.11 per 1SD, p = 0.001 and HR 1.45 per 1SD, p = 0.0005, respectively), but not with cardiovascular death or nonfatal extra-cardiac vascular events. Arch pulse wave velocity was independently associated with nonfatal extra-cardiac vascular events (HR

  20. Preliminary Results from the Smoke Aerosol Measurement Experiment - Reflight

    NASA Astrophysics Data System (ADS)

    Urban, D. L.; Ruff, G. A.; Mulholland, G. W.; Yuan, Z.; Cleary, T.; Yang, J.; Meyer, M. E.; Bryg, V. M.

    2012-01-01

    Preliminary results are presented from the Reflight of the Smoke Aerosol Measurement Experiment (SAME- R) which was conducted during Expedition 24 (July- September 2010). The reflight experiment built upon the results of the original flight during Expedition 15 by adding diagnostic measurements and expanding the test matrix. Five different materials representative of those found in spacecraft (Teflon, Kapton, cotton, silicone rubber and Pyrell) were heated to temperatures below the ignition point with conditions controlled to provide repeatable sample surface temperatures and air flow. Particle size determinations were made using aerosol instruments and by capturing particles for ground based examination in a Transmission Electron Microscope (TEM). Overall the majority of the average smoke particle sizes were found to be in the 200 to 400 nanometer range with the some of the quiescent cases producing substantially larger particles. When combined with particle morphology data from the TEM analysis, these results can be used to guide the design of future smoke detectors.

  1. The Cloud Physics Lidar: Instrument Description and Initial Measurement Results

    NASA Technical Reports Server (NTRS)

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

    2001-01-01

    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.

  2. Advancing children's health care and outcomes through the pediatric quality measures program.

    PubMed

    Mistry, Kamila B; Chesley, Francis; LLanos, Karen; Dougherty, Denise

    2014-01-01

    In 2009 Congress passed the Children's Health Insurance Program Reauthorization Act (CHIPRA), which presented an unprecedented opportunity to measure and improve health care quality and outcomes for children. The Agency for Healthcare Research and Quality, in partnership with the Centers for Medicare & Medicaid Services, has worked to fulfill a number of quality measurement provisions under CHIPRA, including establishing the Pediatric Quality Measures Program (PQMP). The PQMP was charged with establishing a publicly available portfolio of new and enhanced evidence-based pediatric quality measures for use by Medicaid/Children's Health Insurance Program and other public and private programs and to also provide opportunities to improve and strengthen the Child Core Set of quality measures. This article focuses on the PQMP and provides an overview of the program's goals and related activities, lessons learned, and future opportunities. PMID:25169453

  3. Preferred Reporting Items for Studies Mapping onto Preference-Based Outcome Measures: The MAPS Statement.

    PubMed

    Petrou, Stavros; Rivero-Arias, Oliver; Dakin, Helen; Longworth, Louise; Oppe, Mark; Froud, Robert; Gray, Alastair

    2015-10-01

    'Mapping' onto generic preference-based outcome measures is increasingly being used as a means of generating health utilities for use within health economic evaluations. Despite the publication of technical guides for the conduct of mapping research, guidance for the reporting of mapping studies is currently lacking. The MAPS (MApping onto Preference-based measures reporting Standards) statement is a new checklist, which aims to promote complete and transparent reporting of mapping studies. The primary audiences for the MAPS statement are researchers reporting mapping studies, the funders of the research, and peer reviewers and editors involved in assessing mapping studies for publication. A de novo list of 29 candidate reporting items and accompanying explanations was created by a working group comprising six health economists and one Delphi methodologist. Following a two-round modified Delphi survey with representatives from academia, consultancy, health technology assessment agencies and the biomedical journal editorial community, a final set of 23 items deemed essential for transparent reporting, and accompanying explanations, was developed. The items are contained in a user-friendly 23-item checklist. They are presented numerically and categorised within six sections, namely: (1) title and abstract; (2) introduction; (3) methods; (4) results; (5) discussion; and (6) other. The MAPS statement is best applied in conjunction with the accompanying MAPS explanation and elaboration document. It is anticipated that the MAPS statement will improve the clarity, transparency and completeness of reporting of mapping studies. To facilitate dissemination and uptake, the MAPS statement is being co-published by seven health economics and quality-of-life journals, and broader endorsement is encouraged. The MAPS working group plans to assess the need for an update of the reporting checklist in 5 years' time. PMID:26232201

  4. Pulse height spectrum measurement experiment for code benchmarking: first results

    SciTech Connect

    Sale, K E; Hall, J M; Brown, C M

    2000-10-27

    The authors have completed a set of gamma-ray pulse height benchmark experiments using a high purity germanium detector to measure absolute counting rate spectra from {sup 60}Co, {sup 137}Cs and {sup 57}Co isotopic sources. The detector was carefully shielded and collimated so that the geometry of the system was completely known. The measured absolute pulse height spectrum counting rates as a function of detector position relative to the source are compared to energy deposit spectra calculated using the Monte Carlo radiation transport code COG. They present here a small subset of our results. The agreement between the calculated and measured spectra and known sources of discrepancies will be discussed.

  5. Increased Trauma Center Volume Is Associated With Improved Survival After Severe Injury: Results of a Resuscitation Outcomes Consortium Study

    PubMed Central

    Minei, Joseph P.; Fabian, Timothy C.; Guffey, Danielle M.; Newgard, Craig D.; Bulger, Eileen M.; Brasel, Karen J.; Sperry, Jason L.; MacDonald, Russell D.

    2014-01-01

    Structured Abstract OBJECTIVE The Resuscitation Outcomes Consortium (ROC) is a network of 11 centers and 60 hospitals conducting emergency care research. For many procedures, high volume centers demonstrate superior outcomes versus low volume centers. This remains controversial for trauma center outcomes. This study investigated the relationship of trauma center volume on outcome. METHODS This study was a secondary analysis of prospectively collected data from the ROC multicenter out-of-hospital Hypertonic Saline Trial in patients with GCS ≤ 8 (traumatic brain injury [TBI]) or SBP ≤ 90 and pulse ≥ 110 (shock). Regression analyses evaluated associations between trauma volume and the following outcomes: 24 hour mortality, 28 day mortality, ventilator free days (VFD), Multiple Organ Dysfunction Scale (MODS) incidence, worst MODS score, and poor 6 month Glasgow outcome scale extended. RESULTS 2070 patients were analyzed: 1251 in the TBI cohort and 819 in the shock cohort. Overall, 24-hour and 28-day mortality were 16% and 25%, respectively. For every increase of 500 trauma center admissions, there was a 7% decreased odds of both 24-hour and 28-day mortalities for all patients. As trauma center volume increased, non-organ dysfunction complications increased, VFD increased and worst MODS score decreased. The associations with higher trauma center volume were similar for the TBI cohort, including better neurologic outcomes at 6 months, but not for the shock cohort. CONCLUSIONS Increased trauma center volume was associated with increased survival, more ventilator free days and less severe organ failure. Trauma system planning and implementation should avoid unnecessary duplication of services. PMID:25115421

  6. The performance of the Health of the Nation Outcome Scales as measures of clinical severity.

    PubMed

    Müller, Mario; Vandeleur, Caroline; Weniger, Godehard; Prinz, Susanne; Vetter, Stefan; Egger, Stephan T

    2016-05-30

    The aim of this study was to examine the performance of the Health of the Nation Outcome Scales (HoNOS) against other measures of functioning and mental health in a full three-year cohort of admissions to a psychiatric hospital. A sample of N=1719 patients (35.3% females, aged 17-78 years) was assessed using observer-rated measures and self-reports of psychopathology at admission. Self-reports were available from 51.7% of the sample (34.4% females, aged 17-76 years). Functioning and psychopathology were compared across five ICD-10 diagnostic groups: substance use disorders, schizophrenia and psychotic disorders, affective disorders, anxiety/somatoform disorders and personality disorders. Associations between the measures were examined, stratifying by diagnostic subgroup. The HoNOS were strongly linked to other measures primarily in psychotic disorders (except for the behavioral subscale), while those with substance use disorders showed rather poor links. Those with anxiety/somatoform disorders showed null or only small associations. This study raises questions about the overall validity of the HoNOS. It seems to entail different levels of validity when applied to different diagnostic groups. In clinical practice the HoNOS should not be used as a stand-alone instrument to assess outcome but rather as part of a more comprehensive battery including diagnosis-specific measures. PMID:27137958

  7. Measurement results of DIPIX pixel sensor developed in SOI technology

    NASA Astrophysics Data System (ADS)

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

    2013-08-01

    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.

  8. Results from the G0 forward angle measurement

    SciTech Connect

    J. Liu

    2006-07-01

    The results from the G0 forward angle experiment are reported in this talk. The parity-violating asymmetry of elastic e-p scattering has been measured within the range of the four-momentum transfer (Q2) from 0.12 to 1.0 (GeV/c)2, which yields linear combinations of the strange electric and magnetic form factors of the nucleon, G{sub E}{sup s} + etaG{sub M}{sup s}, in the same Q2 range. The G0 results, combined with the measurements from other experiments, indicate that G{sub E}{sup s} and G{sub M}{sup s} are both likely non-zero.

  9. Outcomes of a Mobile Health Coaching Platform: 12-Week Results of a Single-Arm Longitudinal Study

    PubMed Central

    Walsh, James K

    2016-01-01

    Background The number of mobile health coaching applications is expanding at a rapid rate. An application that uses a guiding intelligence to deliver an individualized structured program has the potential to provide a significant benefit. However, there are few studies of this approach that examine multiple clinical outcomes in a longitudinal manner. Objective The objective of the study was to conduct a 12-week evaluation of participants using the YouPlus Health mobile coaching platform, specifically examining the effects on body weight, waist measurement, blood pressure, lipid profile, glycohemoglobin (A1C), and maximum volume of oxygen consumption (VO2 max). Methods A quasi-experimental research design was used. This included a single-arm pre and post intervention assessment of outcomes. Participants underwent a 12-week intervention in which they received the entirety of the mobile health coaching program via an application on their mobile phones and were evaluated in the same physician’s office setting every two weeks. Data regarding app usage was continuously collected and maintained in a database. Results 10 subjects were enrolled in and completed the pilot study. The mean weight loss was 13.5 lbs. which represented 7.3% of baseline (P=.005). Mean waist circumference was reduced by 7.2 cm or 6.6% of baseline (P=.005). Both systolic (SBP) and diastolic (DBP) blood pressure measures were significantly lower after 12 weeks of intervention. Mean SBP fell 18.6 mmHg (P=.005) and mean DBP declined 6.4 mmHg (P=.005). VO2 max increased by an average of 3.13 ml/kg/min from baseline to study end (P=.005). From baseline to end-of-study HDL levels increased significantly by 4.0 mg/dL (P=.04) Total cholesterol, LDL, triglycerides, and glycohemoglobin (A1C) trended in the desired direction but did not meet statistical significance. All of the participants in the study completed the necessary in-app tutorials and also completed the in-app questions and received feedback

  10. Prediction of responders for outcome measures of Locomotor Experience Applied Post Stroke trial

    PubMed Central

    Dobkin, Bruce H. K.; Nadeau, Stephen E.; Behrman, Andrea L.; Wu, Samuel S.; Rose, Dorian K.; Bowden, Mark; Studenski, Stephanie; Lu, Xiaomin; Duncan, Pamela W.

    2015-01-01

    The Locomotor Experience Applied Post Stroke rehabilitation trial found equivalent walking outcomes for body weight-supported treadmill plus overground walking practice versus home-based exercise that did not emphasize walking. From this large database, we examined several clinically important questions that provide insights into recovery of walking that may affect future trial designs. Using logistic regression analyses, we examined predictors of response based on a variety of walking speed-related outcomes and measures that captured disability, physical impairment, and quality of life. The most robust predictor was being closer at baseline to the primary outcome measure, which was the functional walking speed thresholds of 0.4 m/s (household walking) and 0.8 m/s (community walking). Regardless of baseline walking speed, a younger age and higher Berg Balance Scale score were relative predictors of responding, whether operationally defined by transitioning beyond each speed boundary or by a continuous change or a greater than median increase in walking speed. Of note, the cutoff values of 0.4 and 0.8 m/s had no particular significance compared with other walking speed changes despite their general use as descriptors of functional levels of walking. No evidence was found for any difference in predictors based on treatment group. Clinical Trial Registration ClinicalTrials.gov; NCT00243919, “Locomotor Experience Applied Post Stroke Trial”; http://www.clinicaltrials.gov PMID:24805892

  11. The chemotherapy-induced peripheral neuropathy outcome measures standardization study: from consensus to the first validity and reliability findings

    PubMed Central

    Cavaletti, G.; Cornblath, D. R.; Merkies, I. S. J.; Postma, T. J.; Rossi, E.; Frigeni, B.; Alberti, P.; Bruna, J.; Velasco, R.; Argyriou, A. A.; Kalofonos, H. P.; Psimaras, D.; Ricard, D.; Pace, A.; Galiè, E.; Briani, C.; Dalla Torre, C.; Faber, C. G.; Lalisang, R. I.; Boogerd, W.; Brandsma, D.; Koeppen, S.; Hense, J.; Storey, D.; Kerrigan, S.; Schenone, A.; Fabbri, S.; Valsecchi, M. G.; Mazzeo, A.; Pace, A.; Pessino, A.; Schenone, A.; Toscano, A.; Argyriou, A.A.; Brouwer, B.; Frigeni, B.; Piras, B.; Briani, C.; Dalla Torre, C.; Dominguez Gonzalez, C.; Faber, C. G.; Tomasello, C.; Binda, D.; Brandsma, D.; Cortinovis, D.; Psimaras, D.; Ricard, D.; Storey, D.; Cornblath, D.R.; Galiè, E.; Lindeck Pozza, E.; Rossi, E.; Vanhoutte, E.K.; Lanzani, F.; Pastorelli, F.; Altavilla, G.; Cavaletti, G.; Granata, G.; Kalofonos, H.P.; Ghignotti, I.; Merkies, I.S.J.; Bruna, J.; Hense, J.; Heimans, J.J.; Mattavelli, L.; Padua, L.; Reni, L.; Bakkers, M.; Boogerd, M.; Campagnolo, M.; Cazzaniga, M.; Eurelings, M.; Leandri, M.; Lucchetta, M.; Penas Prado, M.; Russo, M.; Valsecchi, M.G.; Piatti, M.L.; Alberti, P.; Bidoli, P.; Grant, R.; Plasmati, R.; Velasco, R.; Lalisang, R.I.; Meijer, R.J.; Fabbri, S.; Dorsey, S. G.; Galimberti, S.; Kerrigan, S.; Koeppen, S.; Postma, T.J.; Boogerd, W.; Grisold, W.

    2013-01-01

    Background Chemotherapy-induced peripheral neuropathy (CIPN) is a debilitating and dose-limiting complication of cancer treatment. Thus far, the impact of CIPN has not been studied in a systematic clinimetric manner. The objective of the study was to select outcome measures for CIPN evaluation and to establish their validity and reproducibility in a cross-sectional multicenter study. Patients and methods After literature review and a consensus meeting among experts, face/content validity were obtained for the following selected scales: the National Cancer Institute-Common Toxicity Criteria (NCI-CTC), the Total Neuropathy Score clinical version (TNSc), the modified Inflammatory Neuropathy Cause and Treatment (INCAT) group sensory sumscore (mISS), the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30, and CIPN20 quality-of-life measures. A total of 281 patients with stable CIPN were examined. Validity (correlation) and reliability studies were carried out. Results Good inter-/intra-observer scores were obtained for the TNSc, mISS, and NCI-CTC sensory/motor subscales. Test–retest values were also good for the EORTC QLQ-C30 and CIPN20. Acceptable validity scores were obtained through the correlation among the measures. Conclusion Good validity and reliability scores were demonstrated for the set of selected impairment and quality-of-life outcome measures in CIPN. Future studies are planned to investigate the responsiveness aspects of these measures. PMID:22910842

  12. Preliminary result of Indonesian strain map based on geodetic measurements

    NASA Astrophysics Data System (ADS)

    Susilo, Meilano, Irwan; Abidin, Hasanuddin Z.; Sapiie, Benyamin; Efendi, Joni; Wijanarto, Antonius B.

    2016-05-01

    GPS measurements from 1993 until 2014 across Indonesia region are providing longer time series at 2 - 3 millimetre-level precision from which surface velocity estimates are derived. In this study, we use this GPS velocities field to construct a crustal strain rate map and not including the physical model yet. In our preliminary result, we only compute the magnitude of the strain rate. The strain map is useful to construct the deformation model in Indonesia and to support the Indonesia datum.

  13. Terminated Trials in the ClinicalTrials.gov Results Database: Evaluation of Availability of Primary Outcome Data and Reasons for Termination

    PubMed Central

    Williams, Rebecca J.; Tse, Tony; DiPiazza, Katelyn; Zarin, Deborah A.

    2015-01-01

    Background Clinical trials that end prematurely (or “terminate”) raise financial, ethical, and scientific concerns. The extent to which the results of such trials are disseminated and the reasons for termination have not been well characterized. Methods and Findings A cross-sectional, descriptive study of terminated clinical trials posted on the ClinicalTrials.gov results database as of February 2013 was conducted. The main outcomes were to characterize the availability of primary outcome data on ClinicalTrials.gov and in the published literature and to identify the reasons for trial termination. Approximately 12% of trials with results posted on the ClinicalTrials.gov results database (905/7,646) were terminated. Most trials were terminated for reasons other than accumulated data from the trial (68%; 619/905), with an insufficient rate of accrual being the lead reason for termination among these trials (57%; 350/619). Of the remaining trials, 21% (193/905) were terminated based on data from the trial (findings of efficacy or toxicity) and 10% (93/905) did not specify a reason. Overall, data for a primary outcome measure were available on ClinicalTrials.gov and in the published literature for 72% (648/905) and 22% (198/905) of trials, respectively. Primary outcome data were reported on the ClinicalTrials.gov results database and in the published literature more frequently (91% and 46%, respectively) when the decision to terminate was based on data from the trial. Conclusions Trials terminate for a variety of reasons, not all of which reflect failures in the process or an inability to achieve the intended goals. Primary outcome data were reported most often when termination was based on data from the trial. Further research is needed to identify best practices for disseminating the experience and data resulting from terminated trials in order to help ensure maximal societal benefit from the investments of trial participants and others involved with the study

  14. Results from 1984 airborne Doppler lidar wind measurements

    NASA Technical Reports Server (NTRS)

    Rothermel, Jeffry

    1986-01-01

    Observations made with the revised Airborne Doppler Lidar System (ADLS) during research flights in the summer of 1984 are described. The functioning of the ADLS system is described. The research flights measured the flow around Mt. Shasta about 3 km above the surrounding terrain as well as the flow in the area of the Carquenez Strait in the Sacramento River Valley. The flight tracks are described and the resulting scan radial velocities are shown and discussed. The results demonstrate the success of the modifications made in order to correct major error sources present in the 1981 flights of the ADLS system.

  15. Aerodynamics of Dragonfly in Hover: Force measurements and PIV results

    NASA Astrophysics Data System (ADS)

    Deng, Xinyan; Hu, Zheng

    2009-11-01

    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).

  16. Does Previous Hip Surgery Effect the Outcome of Tönnis Triple Periacetabular Osteotomy? Mid-Term Results.

    PubMed

    Konya, Mehmet Nuri; Aydn, Bahattin Kerem; Yldrm, Timur; Sofu, Hakan; Gürsu, Sarper

    2016-03-01

    Hip dysplasia (HD) is 1 of the major reasons of coxarthrosis. The goal of the treatment of HD by Tönnis triple pelvic osteotomy (TPAO) is to improve the function of hip joint while relieving pain, delaying and possibly preventing end-stage arthritis. The aim of this study is to compare the clinical and radiological results of TPAO to determine if previous surgery has a negative effect on TPAO.Patients operated with TPAO between 2005 and 2010, included in this study. Patients divided into 2 groups: primary acetabular dysplasia (PAD) and residual acetabular dysplasia (RAD). Prepostoperatively, hip range of motion, Harris hip score (HHS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) hip score, visual analog scores (VAS), impingement tests, and also the presence of Trendelenburg sign (TS) were investigated for clinical evaluation. For radiological analysis pre-postoperative, anterior-posterior (AP) pelvis and faux profile radiographs were used. Acetabular index, lateral center edge (LCE) angle, and Sharp angles were measured by AP pelvis; anterior center edge (ACE) angle were measured by faux profile radiography. All the clinical and radiological data of the groups were analyzed separately for the pre-postoperative scores also the amount of improvement in all parameters were analyzed.SPSS20 (SPSS Inc., Chicago, IL) was used for statistical analysis. Wilcoxon test, McNemar test, paired t tests, and Mann-Whitney U tests were used to compare the groups. P < 0.05 were defined as statistically significant.Study included 27 patients: 17 patients were in PAD and 10 patients were in RAD. The mean follow-up period was 6.2 years (5.2-10.3 years). In all patients, the radiological and the clinical outcomes were better after TPAO except the flexion of the hip parameter. When the patient groups were evaluated as pre-postoperatively, more statistically significant parameters were found in the PAD group when compared with RAD group. Extension

  17. Does Previous Hip Surgery Effect the Outcome of Tönnis Triple Periacetabular Osteotomy? Mid-Term Results

    PubMed Central

    Konya, Mehmet Nuri; Aydın, Bahattin Kerem; Yıldırım, Timur; Sofu, Hakan; Gürsu, Sarper

    2016-01-01

    Abstract Hip dysplasia (HD) is 1 of the major reasons of coxarthrosis. The goal of the treatment of HD by Tönnis triple pelvic osteotomy (TPAO) is to improve the function of hip joint while relieving pain, delaying and possibly preventing end-stage arthritis. The aim of this study is to compare the clinical and radiological results of TPAO to determine if previous surgery has a negative effect on TPAO. Patients operated with TPAO between 2005 and 2010, included in this study. Patients divided into 2 groups: primary acetabular dysplasia (PAD) and residual acetabular dysplasia (RAD). Prepostoperatively, hip range of motion, Harris hip score (HHS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) hip score, visual analog scores (VAS), impingement tests, and also the presence of Trendelenburg sign (TS) were investigated for clinical evaluation. For radiological analysis pre–postoperative, anterior–posterior (AP) pelvis and faux profile radiographs were used. Acetabular index, lateral center edge (LCE) angle, and Sharp angles were measured by AP pelvis; anterior center edge (ACE) angle were measured by faux profile radiography. All the clinical and radiological data of the groups were analyzed separately for the pre–postoperative scores also the amount of improvement in all parameters were analyzed. SPSS20 (SPSS Inc., Chicago, IL) was used for statistical analysis. Wilcoxon test, McNemar test, paired t tests, and Mann–Whitney U tests were used to compare the groups. P < 0.05 were defined as statistically significant. Study included 27 patients: 17 patients were in PAD and 10 patients were in RAD. The mean follow-up period was 6.2 years (5.2–10.3 years). In all patients, the radiological and the clinical outcomes were better after TPAO except the flexion of the hip parameter. When the patient groups were evaluated as pre–postoperatively, more statistically significant parameters were found in the PAD group when compared with RAD

  18. Pathways to Results: How Practitioners Address Student Access, Outcomes, and Equity in an Associate Degree Nursing Program

    ERIC Educational Resources Information Center

    Pickel, Jessica; Bragg, Debra D.

    2015-01-01

    At a time when the nation is focusing so much attention on college completion, what do we know about how students are completing their community college programs? Does the open-access mission of community colleges translate into equitable outcomes? Pathways to Results (PTR) engages practitioners in using data to close equity gaps for student…

  19. Outcome Results from "Yo Veo": A Visual Intervention for Teachers Working with Immigrant Latino/Latina Students

    ERIC Educational Resources Information Center

    Chapman, Mimi V.; Hall, William J.

    2016-01-01

    Objective: This study reports results from the outcome evaluation of "Yo Veo," a visual intervention with schoolteachers, which structures conversations about challenges that teachers face teaching Latino/Latina immigrant students. Method: The intervention was delivered to teachers at two middle schools in the southeastern United States,…

  20. Financial Health of the Higher Education Sector: Financial Results and TRAC Outcomes 2013-14. Issues Paper 2015/07

    ERIC Educational Resources Information Center

    Higher Education Funding Council for England, 2015

    2015-01-01

    This report provides an overview of the financial health of the Higher Education Funding Council for England (HEFCE)-funded higher education sector in England. The analysis covers financial results for the academic year 2013-14, as submitted to HEFCE in December 2014, as well as the outcomes from the sector's Transparent Approach to Costing (TRAC)…

  1. Item Banks for Measuring Emotional Distress From the Patient-Reported Outcomes Measurement Information System (PROMIS®): Depression, Anxiety, and Anger

    PubMed Central

    Pilkonis, Paul A.; Choi, Seung W.; Reise, Steven P.; Stover, Angela M.; Riley, William T.; Cella, David

    2011-01-01

    The authors report on the development and calibration of item banks for depression, anxiety, and anger as part of the Patient-Reported Outcomes Measurement Information System (PROMIS®). Comprehensive literature searches yielded an initial bank of 1,404 items from 305 instruments. After qualitative item analysis (including focus groups and cognitive interviewing), 168 items (56 for each construct) were written in a first person, past tense format with a 7-day time frame and five response options reflecting frequency. The calibration sample included nearly 15,000 respondents. Final banks of 28, 29, and 29 items were calibrated for depression, anxiety, and anger, respectively, using item response theory. Test information curves showed that the PROMIS item banks provided more information than conventional measures in a range of severity from approximately −1 to +3 standard deviations (with higher scores indicating greater distress). Short forms consisting of seven to eight items provided information comparable to legacy measures containing more items. PMID:21697139

  2. Outcome of arthroscopic subscapularis tendon repair: Are the results improving with improved techniques and equipment?: A retrospective case series

    PubMed Central

    Arun, G R; Kumar, Pradeep; Patnaik, Sarthak; Selvaraj, Karthik; Rajan, David; Singh, Anant; Kumaraswamy, Vinay

    2016-01-01

    Background: Rotator cuff tears are a common cause of shoulder pain and dysfunction. More recently, there has been a renewed interest in understanding the subscapularis tears. There are multiple articles in the literature showing the short term results of isolated subscapularis tendon repair. However, the midterm and long term outcome studies for arthroscopic subscapularis repair are few. This study evaluates the functional outcome after arthroscopic subscapularis repair. Materials and Methods: The records of 35 patients who underwent an arthroscopic subscapularis repair between May 2008 and June 2012 were included in this retrospective study. The records of all patients were reviewed. There were 22 males and 13 female patients with mean age of 58.2 years (range 41-72 years). All patients had a complete history, physical examination, and radiographs of their shoulders. Visual analogue scale (VAS), range of movements, power of cuff muscles, and modified University of California at Los Angeles (UCLA) score were assessed. Results: The mean followup was 2.8 years (range 2-4 year). Functional outcome after arthroscopic subscapularis repair has an excellent outcome as analysed by clinical outcome, VAS score and UCLA score. Results were analyzed and had statistically significant values. The VAS for pain improved significantly (P < 0.001), and the mean modified UCLA score improved significantly (P < 0.001) from 14.24 ± 4.72 preoperatively to 33.15 ± 2.29 at 2 years postoperative. According to the UCLA system, there were 22 excellent, 11 good, and 2 fair results. Around 95% of patients returned to their usual work after surgery. Conclusion: At a median followup of 2 years, 95% of patients had a good to excellent result after an arthroscopic subscapularis tendon repair. We conclude that the midterm results show that arthroscopic subscapularis repair remains a good option for the treatment of patients with subscapularis tendon repair. PMID:27293291

  3. Results of ozone measurements in Northern Germany: A case study

    NASA Technical Reports Server (NTRS)

    Schmidt, Manfred

    1994-01-01

    At most of the German ozone recording stations which have records over a sufficiently long period, the results of the summer months of 1989 showed the highest values since the beginning of the measurements. One of the reasons for this phenomenon was the high duration of sunshine in that summer; for example, in Potsdam near Berlin in May 1989 the sunshine duration was the highest in May since the beginning of the records in 1893. For that reason we selected this summer for a case study. The basis for the study was mainly the ozone measuring stations of the network of Lower Saxony and the Federal Office of Environment (Umweltbundesamt). The results of these summer measurements point to intense sources of ozone, probably in form of gaseous precursors, in the Middle German industrial areas near Leipzig and Halle and in Northwestern Czechoslovakia, with coal-mining, chemical and petrochemical industries, coking plants and others. The maps of average ozone concentrations, number or days with high ozone maxima, ozone-windroses of the stations, etc., suggest that these areas could be a main source of precursors and of photochemical ozone production in summer smog episodes in Central Europe. Stations on the North Sea coast, at which early ozone measurements were made by our institute in 1973/74 are compared with similarly located stations of the Lower Saxon network in 1989 and the results show a reversal of the ozone-windroses. In 1973/74, the highest ozone concentrations were correlated with wind directions from the sea while in 1989 these concentrations were correlated with directions from the continent. In the recent years, photochemical ozone production on the continent is probably predominant, while in former years the higher ozone content of the maritime subpolar air masses has been explained by stratospheric-tropospheric exchange.

  4. Comparison of length of stay and outcomes of patients with positive versus negative blood culture results

    PubMed Central

    Hozhabri, Neda S. T.; Armstrong, Kris; Puthottile, Jason; Benavides, Raul; Beal, Stacy

    2015-01-01

    In the United States, sepsis is the leading cause of death in critically ill patients. The fatality rate for severe sepsis is about 40%, and treatment costs over $16 billion annually. It is critical to identify and treat the source of sepsis. While there are varying guidelines determining when to draw blood for culture, at Baylor University Medical Center at Dallas, blood cultures are ordered for patients with new onset of fever, immunosuppression, or a suspicion of an underlying infectious etiology. We conducted a retrospective study of patients who had blood cultures after hospital admission or in the emergency department in December 2013. We compared length of stay and outcomes of patients with positive versus negative blood cultures. There was no significant difference for length of stay or outcomes among patients with positive and negative blood cultures. For patients admitted from the emergency department, there was a longer length of stay for patients with positive cultures; however, the overall prognosis was not worse. PMID:25552786

  5. Short and long term measures of anxiety exhibit opposite results.

    PubMed

    Fonio, Ehud; Benjamini, Yoav; Golani, Ilan

    2012-01-01

    Animal models of human diseases of the central nervous system, generalized anxiety disorder included, are essential for the study of the brain-behavior interface and obligatory for drug development; yet, these models fail to yield new insights and efficacious drugs. By increasing testing duration hundredfold and arena size tenfold, and comparing the behavior of the common animal model to that of wild mice, we raise concerns that chronic anxiety might have been measured at the wrong time, for the wrong duration, and in the wrong animal. Furthermore, the mice start the experimental session with a short period of transient adaptation to the novel environment (habituation period) and a long period reflecting the respective trait of the mice. Using common measures of anxiety reveals that mice exhibit opposite results during these periods suggesting that chronic anxiety should be measured during the post-habituation period. We recommend tools for measuring the transient period, and provide suggestions for characterizing the post habituation period. PMID:23119008

  6. Comparing dynamic treatment regimes using repeated-measures outcomes: modeling considerations in SMART studies.

    PubMed

    Lu, Xi; Nahum-Shani, Inbal; Kasari, Connie; Lynch, Kevin G; Oslin, David W; Pelham, William E; Fabiano, Gregory; Almirall, Daniel

    2016-05-10

    A dynamic treatment regime (DTR) is a sequence of decision rules, each of which recommends a treatment based on a patient's past and current health status. Sequential, multiple assignment, randomized trials (SMARTs) are multi-stage trial designs that yield data specifically for building effective DTRs. Modeling the marginal mean trajectories of a repeated-measures outcome arising from a SMART presents challenges, because traditional longitudinal models used for randomized clinical trials do not take into account the unique design features of SMART. We discuss modeling considerations for various forms of SMART designs, emphasizing the importance of considering the timing of repeated measures in relation to the treatment stages in a SMART. For illustration, we use data from three SMART case studies with increasing level of complexity, in autism, child attention deficit hyperactivity disorder, and adult alcoholism. In all three SMARTs, we illustrate how to accommodate the design features along with the timing of the repeated measures when comparing DTRs based on mean trajectories of the repeated-measures outcome. Copyright © 2015 John Wiley & Sons, Ltd. PMID:26638988

  7. Association of sunlight exposure and photoprotection measures with clinical outcome in systemic lupus erythematosus.

    PubMed

    Vilá, L M; Mayor, A M; Valentín, A H; Rodríguez, S I; Reyes, M L; Acosta, E; Vilá, S

    1999-06-01

    This study was designed to explore the relationship of sunlight exposure and ultraviolet (UV) light protection measures with clinical outcome in systemic lupus erythematosus (SLE). A structured questionnaire was administered to sixty Puerto Rican SLE patients, to assess their attitudes and behavior regarding sunlight exposure and photoprotection measures. Medical records were reviewed to evaluate the clinical outcome measures that included: clinical manifestations, number of SLE-related hospitalizations, number of exacerbations and pharmacologic treatment. Almost all (98.3%) patients were well acquainted of sunlight effects on disease activity. Two thirds were exposed to direct sunlight for an average of less than one hour per day and 33.3% for one hour or more. Thirty patients (50%) reported use of sunscreen, with sun protective factor of 15 or greater, when exposed to sunlight. Less than 40% of patients regularly wore hat or long-sleeves clothes to protect from sunlight. Although there were some clinical differences between the groups with different sunlight exposure times, none reached statistical significance. Also, no significant differences were found between the groups in regards to sunlight protective clothes. However, patients that regularly used sunscreen had significantly lower renal involvement (13.3 vs 43.3%), thrombocytopenia (13.3 vs 40%), hospitalizations (26.7 vs. 76.7%), and requirement of cyclophosphamide treatment (6.7 vs. 30%) than patients that did not used it (P < 0.05). We conclude that use of sunscreen photoprotection was associated with a better clinical outcome in our SLE patients. These findings further support the importance and benefits of photoprotective measures in patients with SLE. PMID:10461313

  8. An Outcome Measure of Functionality and Pain in Patients with Low Back Disorder: A Validation Study of the Iranian version of Low Back Outcome Score

    PubMed Central

    Nayeb Aghaei, Hossein; Azhari, Shirzad; Shazadi, Sohrab; Khayat Kashany, Hamid; Mohammadi, Hassan Reza; Montazeri, Ali

    2016-01-01

    Study Design Cross-sectional study. Purpose This study aimed to cross-culturally translate and validate the low back outcome score (LBOS) in Iran. Overview of Literature Lumbar disc hernia (LDH) is the most common diagnoses of low back pain and imposes a heavy burden on both individual and society. Instruments measuring patient reported outcomes should satisfy cetain psychometric properties. Methods The translation and cross-cultural adaptation of the original questionnaire was performed using Beaton's guideline. A total of 163 patients with LDH were asked to respond to the questionnaire at three points in time: preoperative and twice within 1-week interval after surgery assessments. The Oswestry disabilty index (ODI) was also completed. The internal consistency, test-retest, convergent validity, and responsiveness to change were assessed. Responsiveness to change also was assessed comparing patients' pre- and postoperative scores. Results The mean age of the cohort was 49.8 years (standard deviation=10.1). The Cronbach's alpha coefficients for the LBOS at preoperative and postoperative assessments ranged from 0.77 to 0.79, indicating good internal consistency. Test-retest reliability as performed by intraclass correlation coefficient was found to be 0.82 (0.62–0.91). The instrument discriminated well between sub-groups of patients who differed in the Finneson-Cooper score. The ODI correlated strongly with the LBOS score, lending support to its good convergent validity (r=––0.83; p<0.001). Further analysis also indicated that the questionnaire was responsive to change (p<0.001). Conclusions The Iranian version of LBOS performed well and the findings suggest that it is a valid measure of back pain treatment evaluation among LDH patients. PMID:27559453

  9. Results from the BABAR Fully Inclusive Measurement of B? Xs?

    SciTech Connect

    Aubert, B.; Barate, R.; Boutigny, D.; Couderc, F.; Karyotakis, Y.; Lees, J.P.; Poireau, V.; Tisserand, V.; Zghiche, A.; Grauges, E.; Palano, A.; Pappagallo, M.; Pompili, A.; Chen, J.C.; Qi, N.D.; Rong, G.; Wang, P.; Zhu, Y.S.; Eigen, G.; Ofte, I.; Stugu, B. /University of Bergen, Institute of Physics, N-5007 Bergen, Norway /LBL, Berkeley /UC, Berkeley /Birmingham U. /Ruhr U., Bochum /Bristol U. /British Columbia U. /Brunel U. /Novosibirsk, IYF /UC, Irvine /UCLA /UC, Riverside /UC, San Diego /UC, Santa Barbara /UC, Santa Cruz /Caltech /Cincinnati U. /Colorado U. /Colorado State U. /Dortmund U. /Dresden, Tech. U. /Ecole Polytechnique /Edinburgh U. /Ferrara U. /INFN, Ferrara /Frascati /Genoa U. /INFN, Genoa /Harvard U. /Heidelberg U. /Imperial Coll., London /Iowa U. /Iowa State U. /Orsay, LAL /LLNL, Livermore /Liverpool U. /Queen Mary, U. of London /Royal Holloway, U. of London /Louisville U. /Manchester U. /Maryland U. /Massachusetts U., Amherst /MIT, LNS /McGill U. /Milan U. /INFN, Milan /Mississippi U. /Montreal U. /Mt. Holyoke Coll. /Naples U. /INFN, Naples /NIKHEF, Amsterdam /Notre Dame U. /Ohio State U. /Oregon U. /Padua U. /INFN, Padua /Paris U., VI-VII /Pennsylvania U. /Perugia U. /INFN, Perugia /Pisa U. /INFN, Pisa /Prairie View A-M /Princeton U. /Rome U. /INFN, Rome /Rostock U. /Rutherford /DAPNIA, Saclay /University of South Carolina, Columbia, South Carolina 29208, USA /SLAC /Stanford U., Phys. Dept. /SUNY, Stony Brook /Tennessee U. /Texas U. /Texas U., Dallas /Turin U. /INFN, Turin /Trieste U. /INFN, Trieste /Valencia U., IFIC /Vanderbilt U. /Victoria U. /Warwick U. /Wisconsin U., Madison /Yale U. /Yale U. /Yale U. /Yale U. /Yale U. /Yale U.

    2005-09-20

    We present preliminary results from a lepton-tagged fully-inclusive measurement of B {yields} X{sub s}{gamma} decays, where X{sub s} is any strange hadronic state. Results are based on a BABAR data set of 88.5 million B{bar B} pairs at the {Upsilon}(4S) resonance. We present a reconstructed photon energy spectrum in the {Upsilon}(4S) frame, and partial branching fractions above minimum reconstructed photon energies of 1.9, 2.0, 2.1 and 2.2 GeV. We then convert these to measurements of partial branching fractions and truncated first and second moments of the true photon energy distribution in the B rest frame, above the same minimum photon energy values. The full correlation matrices between the first and second moments are included to allow fitting to any parameterized theoretical calculation. We also measure the direct CP asymmetry {Alpha}{sub CP}(B {yields} X{sub s+d{gamma}}) (based on the charge of the tagging lepton) above a reconstructed photon energy of 2.2 GeV.

  10. Validating English- and Spanish-language patient-reported outcome measures in underserved patients with rheumatic disease

    PubMed Central

    2011-01-01

    Introduction Rheumatic diseases are among the most common and debilitating health problems in the United States. These diseases are chronic, can result in severe decrements of physical and psychosocial functioning and affect patients' overall quality of life. A consensus regarding the best patient outcomes to be measured in randomized, controlled trials and prospective natural history studies is essential to provide best estimates of efficacy and safety of interventions across diverse patient populations. Methods Face-to-face English- and Spanish-language cognitive interviews were conducted among urban Hispanic and African American patients with rheumatic disease to develop a questionnaire booklet. Six measures validating patient-reported outcomes were included: the Arthritis Self-Efficacy Scale, the Stanford Health Assessment Questionnaire Disability Index, the Wong-Baker Faces Pain Scale, the Short Acculturation Scale, the Center for Epidemiologic Studies Depression Scale and the Inventory of Complementary and Alternative Medicine Practices. A sample of patients (n = 15) attending the National Institute of Arthritis and Musculoskeletal and Skin Diseases Community Health Center participated in the initial interviews. Revised measures were further tested for reliability in a separate sample of patients (n = 109) upon enrollment at the health center. Results Cognitive interviews provided feedback for questionnaire modifications and methods to enhance content validity and data quality, including discarding redundant questions, providing visual aids and concrete examples when appropriate and increasing the use of racially and ethnically concordant interviewers. The cognitive interviews further elucidated that some contextual assumptions and language usage in the original questionnaires may not have taken each respondent's environmental and sociocultural context into consideration. Internal reliability for previously tested measures remained high (Cronbach's α = 0

  11. Results from power quality measurements in Germany - An overview

    SciTech Connect

    Gerdes, G.J.; Santjer, F.

    1996-12-31

    Grid interferences caused by wind turbines (WT) are getting a severe problem in Germany with the fast increasing number of installed turbines. The wind energy capacity was doubled annually in the past three years. The actual situation and the plannings for the next years will lead to a situation, where high wind energy penetration will exercise a big influence on the power and voltage quality of local utility networks. Measurements performed in Germany according to a national guideline show a big variety in power quality performance of WT`s, which does affect the requirements for grid connection and thus the economical situation of wind energy projects to a large extent. The results from more than 25 power quality measurements will be discussed in this paper. 5 refs., 5 figs., 1 tab.

  12. Atmospheric Measurements by the Geoscience Laser Altimeter System: Initial Results

    NASA Technical Reports Server (NTRS)

    Spinhirne, J. D.; Palm, S. P.; Hlavka, D. L.; Hart, W. D.; Mahesh, A.; Welton, E. J.

    2003-01-01

    The Geoscience Laser Altimeter System launched in early 2003 is the first satellite instrument in space to globally observe the distribution of clouds and aerosol through laser remote sensing. The instrument is a basic backscatter lidar that operates at two wavelengths, 532 and 1064 nm. The mission data products for atmospheric observations include the calibrated, observed, attenuated backscatter cross section for cloud and aerosol; height detection for multiple cloud layers; planetary boundary layer height; cirrus and aerosol optical depth and the height distribution of aerosol and cloud scattering cross section profiles. The data is expected to significantly enhance knowledge in several areas of atmospheric science, in particular the distribution, transport and influence of atmospheric aerosol. Measurements of the coverage and height of polar and cirrus cloud should be significantly more accurate than previous global measurement. Initial result from the first several months of operation will be presented.

  13. Developing a patient-centered outcome measure for complementary and alternative medicine therapies I: defining content and format

    PubMed Central

    2011-01-01

    Background Patients receiving complementary and alternative medicine (CAM) therapies often report shifts in well-being that go beyond resolution of the original presenting symptoms. We undertook a research program to develop and evaluate a patient-centered outcome measure to assess the multidimensional impacts of CAM therapies, utilizing a novel mixed methods approach that relied upon techniques from the fields of anthropology and psychometrics. This tool would have broad applicability, both for CAM practitioners to measure shifts in patients' states following treatments, and conventional clinical trial researchers needing validated outcome measures. The US Food and Drug Administration has highlighted the importance of valid and reliable measurement of patient-reported outcomes in the evaluation of conventional medical products. Here we describe Phase I of our research program, the iterative process of content identification, item development and refinement, and response format selection. Cognitive interviews and psychometric evaluation are reported separately. Methods From a database of patient interviews (n = 177) from six diverse CAM studies, 150 interviews were identified for secondary analysis in which individuals spontaneously discussed unexpected changes associated with CAM. Using ATLAS.ti, we identified common themes and language to inform questionnaire item content and wording. Respondents' language was often richly textured, but item development required a stripping down of language to extract essential meaning and minimize potential comprehension barriers across populations. Through an evocative card sort interview process, we identified those items most widely applicable and covering standard psychometric domains. We developed, pilot-tested, and refined the format, yielding a questionnaire for cognitive interviews and psychometric evaluation. Results The resulting questionnaire contained 18 items, in visual analog scale format, in which each line was

  14. The longer-term health outcomes for children born as a result of IVF treatment. Part II--Mental health and development outcomes.

    PubMed

    Hart, Roger; Norman, Robert J

    2013-01-01

    BACKGROUND Limited data exist with regard to longer-term mental health and psychological functioning of children born from IVF treatment. With the known adverse perinatal outcome for children born from IVF treatment, it would be expected that there is a negative impact upon their mental development. METHODS A search strategy restricted to studies relating to the medical condition of children of at least 1 year of age, born from IVF treatment was performed to include case series, data linkage and prospective studies published from 1 January 2000 to 1 April 2012. RESULTS Limited long-term follow-up data suggest that there is an increase in the incidence of cerebral palsy and neurodevelopmental delay related to the confounders of prematurity and low birthweight. Previous reports of associations with autism and attention-deficit disorder are believed to be related to maternal and obstetric factors. There exists a potential increase in the prevalence of early adulthood clinical depression and binge drinking in the offspring of IVF, with the reassuring data of no changes with respect to cognitive development, school performance, social functioning and behaviour. Whether these potential associations are related to the IVF treatment, the adverse obstetric outcomes associated with IVF treatment, the genetic or subsequent environmental influences on the children is yet to be determined. CONCLUSIONS In general, the longer-term mental and emotional health outcome for children born from IVF treatment is reassuring, and is very similar to that of naturally conceived children; however, further studies are required to explore any association with depression, and its causality in more detail. PMID:23449643

  15. Predictors of fatal outcomes resulting from acute Escherichia coli mastitis in dairy cows.

    PubMed

    Hagiwara, Seiichi; Mori, Kouichiro; Nagahata, Hajime

    2016-06-01

    To evaluate the prognostic criteria for identifying cows at an increased risk of a fatal outcome from acute Escherichia coli mastitis, the potential cut-off values for five diagnostic parameters associated with a high mortality were determined by receiver operator characteristic curve analysis. These criteria were hematocrit value >32%, blood non-esterified fatty acid concentration >0.4 mEq/l, antithrombin activity <120%, platelet count <15 × 10(4)/ml and presence of dysstasia. Exceeding the cut-off values for at least three parameters on day 2 after onset predicted fatality (predictive value 87.5). When these prognostic criteria were applied to 34 clinical cases, cows that met three criteria were seven times more likely to die than cows that met fewer than three criteria. PMID:26875836

  16. Predictors of fatal outcomes resulting from acute Escherichia coli mastitis in dairy cows

    PubMed Central

    HAGIWARA, Seiichi; MORI, Kouichiro; NAGAHATA, Hajime

    2016-01-01

    To evaluate the prognostic criteria for identifying cows at an increased risk of a fatal outcome from acute Escherichia coli mastitis, the potential cut-off values for five diagnostic parameters associated with a high mortality were determined by receiver operator characteristic curve analysis. These criteria were hematocrit value >32%, blood non-esterified fatty acid concentration >0.4 mEq/l, antithrombin activity <120%, platelet count <15 × 104/ml and presence of dysstasia. Exceeding the cut-off values for at least three parameters on day 2 after onset predicted fatality (predictive value 87.5). When these prognostic criteria were applied to 34 clinical cases, cows that met three criteria were seven times more likely to die than cows that met fewer than three criteria. PMID:26875836

  17. Increasing disparities between resource inputs and outcomes, as measured by certain health deliverables, in biomedical research

    PubMed Central

    Bowen, Anthony; Casadevall, Arturo

    2015-01-01

    Society makes substantial investments in biomedical research, searching for ways to better human health. The product of this research is principally information published in scientific journals. Continued investment in science relies on society’s confidence in the accuracy, honesty, and utility of research results. A recent focus on productivity has dominated the competitive evaluation of scientists, creating incentives to maximize publication numbers, citation counts, and publications in high-impact journals. Some studies have also suggested a decreasing quality in the published literature. The efficiency of society’s investments in biomedical research, in terms of improved health outcomes, has not been studied. We show that biomedical research outcomes over the last five decades, as estimated by both life expectancy and New Molecular Entities approved by the Food and Drug Administration, have remained relatively constant despite rising resource inputs and scientific knowledge. Research investments by the National Institutes of Health over this time correlate with publication and author numbers but not with the numerical development of novel therapeutics. We consider several possibilities for the growing input-outcome disparity including the prior elimination of easier research questions, increasing specialization, overreliance on reductionism, a disproportionate emphasis on scientific outputs, and other negative pressures on the scientific enterprise. Monitoring the efficiency of research investments in producing positive societal outcomes may be a useful mechanism for weighing the efficacy of reforms to the scientific enterprise. Understanding the causes of the increasing input-outcome disparity in biomedical research may improve society’s confidence in science and provide support for growing future research investments. PMID:26283360

  18. Increasing disparities between resource inputs and outcomes, as measured by certain health deliverables, in biomedical research.

    PubMed

    Bowen, Anthony; Casadevall, Arturo

    2015-09-01

    Society makes substantial investments in biomedical research, searching for ways to better human health. The product of this research is principally information published in scientific journals. Continued investment in science relies on society's confidence in the accuracy, honesty, and utility of research results. A recent focus on productivity has dominated the competitive evaluation of scientists, creating incentives to maximize publication numbers, citation counts, and publications in high-impact journals. Some studies have also suggested a decreasing quality in the published literature. The efficiency of society's investments in biomedical research, in terms of improved health outcomes, has not been studied. We show that biomedical research outcomes over the last five decades, as estimated by both life expectancy and New Molecular Entities approved by the Food and Drug Administration, have remained relatively constant despite rising resource inputs and scientific knowledge. Research investments by the National Institutes of Health over this time correlate with publication and author numbers but not with the numerical development of novel therapeutics. We consider several possibilities for the growing input-outcome disparity including the prior elimination of easier research questions, increasing specialization, overreliance on reductionism, a disproportionate emphasis on scientific outputs, and other negative pressures on the scientific enterprise. Monitoring the efficiency of research investments in producing positive societal outcomes may be a useful mechanism for weighing the efficacy of reforms to the scientific enterprise. Understanding the causes of the increasing input-outcome disparity in biomedical research may improve society's confidence in science and provide support for growing future research investments. PMID:26283360

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

    PubMed

    Kwok, H K; Stevens, N

    1995-01-01

    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

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

    PubMed Central

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

    2014-01-01

    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

  1. [Psychometric properties of Q-DIO, an instrument to measure the quality of documented nursing diagnoses, interventions and outcomes].

    PubMed

    Müller-Staub, Maria; Lunney, Margaret; Lavin, Mary Ann; Needham, Ian; Odenbreit, Matthias; van Achterberg, Theo

    2010-04-01

    The instrument Q-DIO was developed in the years 2005 till 2006 to measure the quality of documented nursing diagnoses, interventions, and nursing sensitive patient outcomes. Testing psychometric properties of the Q-DIO (Quality of nursing Diagnoses, Interventions and Outcomes.) was the study aim. Instrument testing included internal consistency, test-retest reliability, interrater reliability, item analyses, and an assessment of the objectivity. To render variation in scores, a random strata sample of 60 nursing documentations was drawn. The strata represented 30 nursing documentations with and 30 without application of theory based, standardised nursing language. Internal consistency of the subscale nursing diagnoses as process showed Cronbach's Alpha 0.83 [0.78, 0.88]; nursing diagnoses as product 0.98 [0.94, 0.99]; nursing interventions 0.90 [0.85, 0.94]; and nursing-sensitive patient outcomes 0.99 [0.95, 0.99]. With Cohen's Kappa of 0.95, the intrarater reliability was good. The interrater reliability showed a Kappa of 0.94 [0.90, 0.96]. Item analyses confirmed the fulfilment of criteria for degree of difficulty and discriminative validity of the items. In this study, Q-DIO has shown to be a reliable instrument. It allows measuring the documented quality of nursing diagnoses, interventions and outcomes with and without implementation of theory based, standardised nursing languages. Studies for further testing of Q-DIO in other settings are recommended. The results implicitly support the use of nursing classifications such as NANDA, NIC and NOC. PMID:20361409

  2. The Selection and Use of Outcome Measures in Palliative and End-of-Life Care Research: The MORECare International Consensus Workshop

    PubMed Central

    Evans, Catherine J.; Benalia, Hamid; Preston, Nancy J.; Grande, Gunn; Gysels, Marjolein; Short, Vicky; Daveson, Barbara A.; Bausewein, Claudia; Todd, Chris; Higginson, Irene J.

    2013-01-01

    Context A major barrier to widening and sustaining palliative care service provision is the requirement for better selection and use of outcome measures. Service commissioning is increasingly based on patient, carer, and service outcomes as opposed to service activity. Objectives To generate recommendations and consensus for research in palliative and end-of-life care on the properties of the best outcome measures, enhancing the validity of proxy-reported data and optimal data collection time points. Methods An international expert “workshop” was convened and an online consensus survey was undertaken using the MORECare Transparent Expert Consultation to generate recommendations and level of agreement. We focused on three areas: 1) measurement properties, 2) use of proxies, and 3) measurement timing. Data analysis comprised descriptive analysis of aggregate scores and collation of narrative comments. Results There were 31 workshop attendees; 29 recommendations were included in the online survey, completed by 28 experts. The top three recommendations by area were the following: 1) the properties of the best outcome measures are responsive to change over time and capture clinically important data, 2) to enhance the validity of proxy data requires clear and specific guidelines to aid lay individuals' and/or professionals' completion of proxy measures, and 3) data collection time points need clear identification to establish a baseline. Conclusion Outcome measurement in palliative and end-of-life care requires the use of psychometrically robust measures that are clinically responsive, with defined data collection time points to establish a baseline and clear administration guidelines to complete proxy measures. To further the field requires clinical imperatives to more closely inform recommendations on outcome measurement. PMID:23628515

  3. Primary outcome indices in illicit drug dependence treatment research: systematic approach to selection and measurement of drug use end-points in clinical trials

    PubMed Central

    Donovan, Dennis M.; Bigelow, George E.; Brigham, Gregory S.; Carroll, Kathleen M.; Cohen, Allan J.; Gardin, John G.; Hamilton, John A.; Huestis, Marilyn A.; Hughes, John R.; Lindblad, Robert; Marlatt, G. Alan; Preston, Kenzie L.; Selzer, Jeffrey A.; Somoza, Eugene C.; Wakim, Paul G.; Wells, Elizabeth A.

    2012-01-01

    Aims Clinical trials test the safety and efficacy of behavioral and pharmacological interventions in drug-dependent individuals. However, there is no consensus about the most appropriate outcome(s) to consider in determining treatment efficacy or on the most appropriate methods for assessing selected outcome(s). We summarize the discussion and recommendations of treatment and research experts, convened by the US National Institute on Drug Abuse, to select appropriate primary outcomes for drug dependence treatment clinical trials, and in particular the feasibility of selecting a common outcome to be included in all or most trials. Methods A brief history of outcomes employed in prior drug dependence treatment research, incorporating perspectives from tobacco and alcohol research, is included. The relative merits and limitations of focusing on drug-taking behavior, as measured by self-report and qualitative or quantitative biological markers, are evaluated. Results Drug-taking behavior, measured ideally by a combination of self-report and biological indicators, is seen as the most appropriate proximal primary outcome in drug dependence treatment clinical trials. Conclusions We conclude that the most appropriate outcome will vary as a function of salient variables inherent in the clinical trial, such as the type of intervention, its target, treatment goals (e.g. abstinence or reduction of use) and the perspective being taken (e.g. researcher, clinical program, patient, society). It is recommended that a decision process, based on such trial variables, be developed to guide the selection of primary and secondary outcomes as well as the methods to assess them. PMID:21781202

  4. Perceived value of stroke outcome measures across the post-acute care continuum: a qualitative case study.

    PubMed

    Danzl, Megan M; Hunter, Elizabeth G

    2013-04-01

    Connecting the continuum of post-acute care stroke services may be important for easing patients' transition between settings and facilitating recovery and community reintegration. The use of outcome measures is suggested as one means of connecting the continuum. The purpose of this qualitative case study is to describe administrators' and physiotherapists' perceived value of an outcomes program across the post-acute care stroke continuum at a rehabilitation hospital. Data were collected through individual interviews and focus groups with 18 participants. Three themes emerged on the value of the outcomes program: 1) enhanced communication; 2) supports clinical decision-making; and 3) value of objective data. These findings lend support for the use of standardized outcome measures by physiotherapists in stroke rehabilitation. Findings from this study may be useful for organizations and physiotherapists who wish to integrate outcome measures into practice. PMID:23039017

  5. Measurement results obtained from air quality monitoring system

    SciTech Connect

    Turzanski, P.K.; Beres, R.

    1995-12-31

    An automatic system of air pollution monitoring operates in Cracow since 1991. The organization, assembling and start-up of the network is a result of joint efforts of the US Environmental Protection Agency and the Cracow environmental protection service. At present the automatic monitoring network is operated by the Provincial Inspection of Environmental Protection. There are in total seven stationary stations situated in Cracow to measure air pollution. These stations are supported continuously by one semi-mobile (transportable) station. It allows to modify periodically the area under investigation and therefore the 3-dimensional picture of creation and distribution of air pollutants within Cracow area could be more intelligible.

  6. Patient-reported outcomes in multiple sclerosis: Relationships among existing scales and the development of a brief measure.

    PubMed

    Chua, Alicia S; Glanz, Bonnie I; Guarino, Anthony J; Cook, Sandra L; Greeke, Emily E; Little, Grace E; Chitnis, Tanuja; Healy, Brian C

    2015-11-01

    Several patient-reported outcome (PRO) measures are commonly used in multiple sclerosis (MS) research, but the relationship among items across measures is uncertain. We proposed to evaluate the associations between items from a standard battery of PRO measures used in MS research and to develop a brief, reliable and valid instrument measure by combining these items into a single measure. Subjects (N = 537) enrolled in CLIMB complete a PRO battery that includes the Center for Epidemiologic Studies Depression Scale, Medical Outcomes Study Modified Social Support Survey, Modified Fatigue Impact Scale and Multiple Sclerosis Quality of Life-54. Subjects were randomly divided into two samples: calibration (n = 269) and validation (n = 268). In the calibration sample, an Exploratory Factor Analysis (EFA) was used to identify latent constructs within the battery. The model constructed based on the EFA was evaluated in the validation sample using Confirmatory Factor Analysis (CFA), and reliability and validity were assessed for the final measure. The EFA in the calibration sample revealed an eight factor solution, and a final model with one second-order factor along with the eight first-order factors provided the best fit. The model combined items from each of the four parent measures, showing important relationships among the parent measures. When the model was fit using the validation sample, the results confirmed the validity and reliability of the model. A brief PRO for MS (BPRO-MS) that combines MS-related psychosocial and quality of life domains can be used to assess overall functioning in mildly disabled MS patients. PMID:26590669

  7. Partial Breast Radiation Therapy With Proton Beam: 5-Year Results With Cosmetic Outcomes

    SciTech Connect

    Bush, David A.; Do, Sharon; Lum, Sharon; Garberoglio, Carlos; Mirshahidi, Hamid; Patyal, Baldev; Grove, Roger; Slater, Jerry D.

    2014-11-01

    Purpose: We updated our previous report of a phase 2 trial using proton beam radiation therapy to deliver partial breast irradiation (PBI) in patients with early stage breast cancer. Methods and Materials: Eligible subjects had invasive nonlobular carcinoma with a maximal dimension of 3 cm. Patients underwent partial mastectomy with negative margins; axillary lymph nodes were negative on sampling. Subjects received postoperative proton beam radiation therapy to the surgical bed. The dose delivered was 40 Gy in 10 fractions, once daily over 2 weeks. Multiple fields were treated daily, and skin-sparing techniques were used. Following treatment, patients were evaluated with clinical assessments and annual mammograms to monitor toxicity, tumor recurrence, and cosmesis. Results: One hundred subjects were enrolled and treated. All patients completed the assigned treatment and were available for post-treatment analysis. The median follow-up was 60 months. Patients had a mean age of 63 years; 90% had ductal histology; the average tumor size was 1.3 cm. Actuarial data at 5 years included ipsilateral breast tumor recurrence-free survival of 97% (95% confidence interval: 100%-93%); disease-free survival of 94%; and overall survival of 95%. There were no cases of grade 3 or higher acute skin reactions, and late skin reactions included 7 cases of grade 1 telangiectasia. Patient- and physician-reported cosmesis was good to excellent in 90% of responses, was not changed from baseline measurements, and was well maintained throughout the entire 5-year follow-up period. Conclusions: Proton beam radiation therapy for PBI produced excellent ipsilateral breast recurrence-free survival with minimal toxicity. The treatment proved to be adaptable to all breast sizes and lumpectomy cavity configurations. Cosmetic results appear to be excellent and unchanged from baseline out to 5 years following treatment. Cosmetic results may be improved over those reported with photon

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

    PubMed Central

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

    2013-01-01

    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

  9. Betting on the outcomes of measurements: a Bayesian theory of quantum probability

    NASA Astrophysics Data System (ADS)

    Pitowsky, Itamar

    We develop a systematic approach to quantum probability as a theory of rational betting in quantum gambles. In these games of chance, the agent is betting in advance on the outcomes of several (finitely many) incompatible measurements. One of the measurements is subsequently chosen and performed and the money placed on the other measurements is returned to the agent. We show how the rules of rational betting imply all the interesting features of quantum probability, even in such finite gambles. These include the uncertainty principle and the violation of Bell's inequality among others. Quantum gambles are closely related to quantum logic and provide a new semantics for it. We conclude with a philosophical discussion on the interpretation of quantum mechanics.

  10. Application of terahertz radiation to soil measurements: initial results.

    PubMed

    Dworak, Volker; Augustin, Sven; Gebbers, Robin

    2011-01-01

    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

  11. Moving beyond Mindfulness: Defining Equanimity as an Outcome Measure in Meditation and Contemplative Research

    PubMed Central

    Gard, Tim; Hoge, Elizabeth A.; Hölzel, Britta K.; Kerr, Catherine; Lazar, Sara W.; Olendzki, Andrew; Vago, David R.

    2014-01-01

    In light of a growing interest in contemplative practices such as meditation, the emerging field of contemplative science has been challenged to describe and objectively measure how these practices affect health and well-being. While “mindfulness” itself has been proposed as a measurable outcome of contemplative practices, this concept encompasses multiple components, some of which, as we review here, may be better characterized as equanimity. Equanimity can be defined as an even-minded mental state or dispositional tendency toward all experiences or objects, regardless of their origin or their affective valence (pleasant, unpleasant, or neutral). In this article we propose that equanimity be used as an outcome measure in contemplative research. We first define and discuss the inter-relationship between mindfulness and equanimity from the perspectives of both classical Buddhism and modern psychology and present existing meditation techniques for cultivating equanimity. We then review psychological, physiological, and neuroimaging methods that have been used to assess equanimity, either directly or indirectly. In conclusion, we propose that equanimity captures potentially the most important psychological element in the improvement of well-being, and therefore should be a focus in future research studies. PMID:25750687

  12. Implementing organizational systems to measure outcome-related processes of end-stage renal disease care.

    PubMed

    Capelli, J P

    1994-08-01

    The process to implement a continuous quality improvement program for the patient with end-stage renal disease requires a basic understanding of the complex medical and often psychological circumstances that affect these patients. The organizational elements require, therefore, a recognition and integration of functions from all those involved in delivering care. This includes the medical, nursing, social work, dietary, and technical staff. In the development and establishment of the quality assessment and improvement program at Our Lady of Lourdes Medical Center, experience has identified certain basic elements to use in the organizational and functional aspects of the system to achieve a measurable level of success. The primary element in establishing such a program begins with the commitment at the highest level of the organizational structure. Selection of leadership whose responsibility is to provide education and direction of staff participants should follow. Through leadership, education, and early staff involvement, physician support is gained that provides the operational elements for a successful program. A multidisciplinary team, representative of the various aspects of care, can then develop a quality assessment and improvement plan that establishes clinical indicators used to measure various quality components. A data collection and review process is the next phase of implementation of the organizational system to measure the various types of outcome and/or processes of care. The process is one of continued education based on outcome data for all staff members involved in care. PMID:8048443

  13. A Pilot Randomized Trial Evaluating Lymphedema Self-Measurement with Bioelectrical Impedance, Self-Care Adherence, and Health Outcomes

    PubMed Central

    Shih, Ya-Chen Tina; Doersam, Jennifer K.; Rhoten, Bethany Andrews; Schultze, Benjamin S.; Dietrich, Mary S.

    2014-01-01

    Abstract Background: Less than half of breast cancer survivors with lymphedema perform self-care as directed. Effective lymphedema self-care is required to obtain acceptable health outcomes. Self-Regulation Theory suggests that objective self-measurement of physiological conditions is necessary to promote self-regulation/self-care. Bioelectric Impedance Spectroscopy (BIS) represents a potential self-measurement method for arm lymphedema. The purpose of this pilot study was to examine the impact of arm self-measurement on daily self-care activities and health outcomes in breast cancer survivors with lymphedema. Methods and Results: A pilot randomized clinical trial compared outcomes between breast cancer survivors with lymphedema who self-monitored for 3 months and breast cancer survivors with lymphedema who did not self-monitor. Data were collected at baseline, months 1, 2, 3, and 4. Eighty-six women with lymphedema were screened: 62 were eligible, 50 were enrolled, 10 withdrew, and 1 had incomplete data, thus N=39. No between group differences were noted in participant characteristics. The self-monitored group had higher days of garment use (p=0.005) that remained stable after self-monitoring stopped. The median number of days of simple manual lymphatic drainage increased in the intervention group (p=0.004) with a downward trend after self-monitoring ceased. Conclusions: Objective self-monitoring of arms using BIS is possible. Self-monitoring may positively impact self-care behaviors. Highly symptomatic patients may require coaching or other psychological support to improve their self-care. Studies that combine a cognitive behavioral therapy component along with self-measurement should be considered as potential interventions to impact lymphedema self-care. Other applications of self-monitoring warrant investigation. PMID:25412401

  14. Outcome Rating Scale and Session Rating Scale in Psychological Practice: Clinical Utility of Ultra-Brief Measures

    ERIC Educational Resources Information Center

    Campbell, Alistair; Hemsley, Samantha

    2009-01-01

    The validity and reliability of the Outcome Rating Scale (ORS) and the Session Rating Scale (SRS) were evaluated against existing longer measures, including the Outcome Questionnaire-45, Working Alliance Inventory, Depression Anxiety Stress Scale-21, Quality of Life Scale, Rosenberg Self-Esteem Scale and General Self-efficacy Scale. The measures…

  15. Periodontal Research: Basics and beyond – Part II (Ethical issues, sampling, outcome measures and bias)

    PubMed Central

    Avula, Haritha

    2013-01-01

    A good research beginning refers to formulating a well-defined research question, developing a hypothesis and choosing an appropriate study design. The first part of the review series has discussed these issues in depth and this paper intends to throw light on other issues pertaining to the implementation of research. These include the various ethical norms and standards in human experimentation, the eligibility criteria for the participants, sampling methods and sample size calculation, various outcome measures that need to be defined and the biases that can be introduced in research. PMID:24174747

  16. HOMs simulation and measurement results of IHEP02 cavity

    NASA Astrophysics Data System (ADS)

    Zheng, Hong-Juan; Zhai, Ji-Yuan; Zhao, Tong-Xian; Gao, Jie

    2015-11-01

    In accelerator RF cavities, there exists not only the fundamental mode which is used to accelerate the beam, but also higher order modes (HOMs). The higher order modes excited by the beam can seriously affect beam quality, especially for the higher R/Q modes. 1.3 GHz low-loss 9-cell superconducting cavity as a candidate for ILC high gradient cavity, the properties of higher order mode has not been studied carefully. IHEP based on existing low loss cavity, designed and developed a large grain size 1.3 GHz low-loss 9-cell superconducting cavity (IHEP02 cavity). The higher order mode coupler of IHEP02 used TESLA coupler's design. As a result of the limitation of the mechanical design, the distance between higher order mode coupler and end cell is larger than TESLA cavity. This paper reports on measured results of higher order modes in the IHEP02 1.3 GHz low-loss 9-cell superconducting cavity. Using different methods, Qe of the dangerous modes passbands have been obtained. The results are compared with TESLA cavity results. R/Q of the first three passbands have also been obtained by simulation and compared with the results of the TESLA cavity. Supported by Knowledge Innovation Project of The Chinese Academy of Sciences

  17. Recent Results of TMD Measurements from Jefferson Lab Hall A

    SciTech Connect

    Jiang, Xiaodong

    2013-10-01

    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.

  18. Neutrino measurements from the Sun and Earth: Results from Borexino

    NASA Astrophysics Data System (ADS)

    Bellini, G.; Benziger, J.; Bick, D.; Bonfini, G.; Bravo, D.; Caccianiga, B.; Cadonati, L.; Calaprice, F.; Caminata, A.; Cavalcante, P.; Chavarria, A.; Chepurnov, A.; D'Angelo, D.; Davini, S.; Derbin, A.; Empl, A.; Etenko, A.; Fomenko, K.; Franco, D.; Gabriele, F.; Galbiati, C.; Gazzana, S.; Ghiano, C.; Giammarchi, M.; Göger-Neff, M.; Goretti, A.; Gromov, M.; Hagner, C.; Hungerford, E.; Ianni, Aldo; Ianni, Andrea; Kobychev, V.; Korablev, D.; Korga, G.; Kryn, D.; Laubenstein, M.; Lehnert, B.; Lewke, T.; Litvinovich, E.; Lombardi, F.; Lombardi, P.; Ludhova, L.; Lukyanchenko, G.; Machulin, I.; Manecki, S.; Maneschg, W.; Marcocci, S.; Meindl, Q.; Meroni, E.; Meyer, M.; Miramonti, L.; Misiaszek, M.; Montuschi, M.; Mosteiro, P.; Muratova, V.; Oberauer, L.; Obolensky, M.; Ortica, F.; Otis, K.; Pallavicini, M.; Papp, L.; Perasso, L.; Pocar, A.; Ranucci, G.; Razeto, A.; Re, A.; Romani, A.; Rossi, N.; Saldanha, R.; Salvo, C.; Schönert, S.; Simgen, H.; Skorokhvatov, M.; Smirnov, O.; Sotnikov, A.; Sukhotin, S.; Suvorov, Y.; Tartaglia, R.; Testera, G.; Vignaud, D.; Vogelaar, R. B.; von Feilitzsch, F.; Wang, H.; Winter, J.; Wojcik, M.; Wright, A.; Wurm, M.; Zaimidoroga, O.; Zavatarelli, S.; Zuber, K.; Zuzel, G.

    2015-07-01

    Important neutrino results came recently from Borexino, a massive, calorimetric liquid scintillator detector installed at the underground Gran Sasso Laboratory. With its unprecedented radiopurity levels achieved in the core of the detection medium, it is the only experiment in operation able to study in real time solar neutrino interactions in the challenging sub-MeV energy region. The recently achieved breakthrough observation of the fundamental pp flux, the precise measurement of the 7Be solar neutrino flux, and the results concerning the pep, 8B and CNO fluxes, together with their physics implications, are described in this work. Moreover, the detector has also provided a clean detection of terrestrial neutrinos, from which they emerge as a new probe of the interior of the Earth.

  19. Neutrino measurements from the Sun and Earth: Results from Borexino

    SciTech Connect

    Bellini, G.; Caccianiga, B.; D’Angelo, D.; Giammarchi, M.; Lombardi, P.; Ludhova, L.; Meroni, E.; Miramonti, L.; Ranucci, G. Re, A.; Benziger, J.; Bick, D.; Hagner, C.; Meyer, M.; Bonfini, G.; Cavalcante, P.; Gabriele, F.; Gazzana, S.; Ianni, Aldo; Laubenstein, M.; and others

    2015-07-15

    Important neutrino results came recently from Borexino, a massive, calorimetric liquid scintillator detector installed at the underground Gran Sasso Laboratory. With its unprecedented radiopurity levels achieved in the core of the detection medium, it is the only experiment in operation able to study in real time solar neutrino interactions in the challenging sub-MeV energy region. The recently achieved breakthrough observation of the fundamental pp flux, the precise measurement of the {sup 7}Be solar neutrino flux, and the results concerning the pep, {sup 8}B and CNO fluxes, together with their physics implications, are described in this work. Moreover, the detector has also provided a clean detection of terrestrial neutrinos, from which they emerge as a new probe of the interior of the Earth.

  20. Perkins Core Performance Measures: Results and Targets, 1999-2000.

    ERIC Educational Resources Information Center

    McHewitt, Earl R.; Taylor, Garry

    This document describes the Virginia Community College System (VCCS) Core Indicators for the Perkins III Core Performance Standards and Measures. Core indicators and measures include: (1) student attainment, measured by academic and technical skills; (2) completion, measured by graduation rate; (3) placement and persistence, measured by placement,…

  1. LDEF: Dosimetric measurement results (AO 138-7 experiment)

    NASA Technical Reports Server (NTRS)

    Bourrieau, J.

    1992-01-01

    One of the objectives of the AO 138-7 experiment on board the LDEF was a total dose measurement with Thermo Luminescent Detectors (TLD 100). Two identical cases, both including 5 TLDs inside various aluminum shields, are exposed to the space environment in order to obtain the absorbed dose profile induced. Radiation fluence received during the total mission length was computed, taking into account the trapped particles (solar maximum and solar minimum periods) and the cosmic rays; due to the magnetospheric shielding, the solar proton fluences are negligible on the LDEF orbit. The total dose induced by these radiations inside a semi-infinite plane shield of Al are computed with radiation transport codes. TLD reading are performed after flight; due to the mission duration increase, a post-flight calibration was necessary in order to cover the range of the flight induced dose. The results obtained, similar (+ or - 30 pct.) in both cases, are compared with the dose profile computation. In practice, these LDEF results, with less than a factor 1.4 between measurements and forecasts, reinforce the validity of the computation methods and models used for the long term evaluation of space radiation intensity on low inclination Earth orbits.

  2. Accuracy of endodontic microleakage results: autoradiographic vs. volumetric measurements.

    PubMed

    Ximénez-Fyvie, L A; Ximénez-García, C; Carter-Bartlett, P M; Collado-Webber, F J

    1996-06-01

    The correlation between autoradiographic and volumetric leakage measurements was evaluated. Seventy-two anterior teeth with a single canal were selected and divided into three groups of 24. Group 1 served as control (no obturation), group 2 was obturated with gutta-percha only, and group 3 was obturated with gutta-percha and endodontic sealer. Samples were placed in a vertical position in 48-well cell culture plates and immersed in 1 ml of [14C]urea for 14 days. One-mm-thick horizontal serial sections were cut with a diamond disk cooled with liquid-nitrogen gas. Linear penetration was recorded by five independent evaluators from autoradiographs. Volumetric results were based on counts per minute registered in a liquid scintillation spectrometer. Pearson's correlation coefficient test was used to determine the lineal correlation between both methods of evaluation. No acceptable correlation values were found in any of the three groups (group 1, r = 0.34; group 2, r = 0.23; group 3, r = 0.20). Our results indicate that there is no correlation between linear and volumetric measurements of leakage. PMID:8934988

  3. Fan Noise Source Diagnostic Test: LDV Measured Flow Field Results

    NASA Technical Reports Server (NTRS)

    Podboy, Gary C.; Krupar, Martin J.; Hughes, Christopher E.; Woodward, Richard P.

    2003-01-01

    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.

  4. Intracytoplasmic morphologically selected sperm injection results in improved clinical outcomes in couples with previous ICSI failures or male factor infertility: a meta-analysis.

    PubMed

    Setti, Amanda S; Braga, Daniela P A F; Figueira, Rita C S; Iaconelli, Assumpto; Borges, Edson

    2014-12-01

    The objective of this study was to perform the first meta-analysis to compare conventional intracytoplasmic sperm injection (ICSI) outcomes and intracytoplasmic morphologically selected sperm injection (IMSI) outcomes in couples with previous ICSI failures (IF) or male factor infertility (MF). A systematic review was performed by searching Medline database to identify articles reporting on the comparison between ICSI and IMSI outcomes in couples with IF or MF. The main outcome measures were the implantation, pregnancy and miscarriage rates. Thirteen studies fulfilled our predetermined criteria. The overall results of meta-analysis for implantation (OR: 2.88; CI: 2.13-3.89), pregnancy (OR: 2.07; CI: 1.22-3.50) and miscarriage rates (OR: 0.31; CI: 0.14-0.67) were in favor of IMSI in couples with IF. Additionally, the overall result of meta-analysis for implantation (OR: 1.56; CI: 1.11-2.18) and pregnancy rate (OR: 1.61; CI: 1.17-2.23) were in favor of IMSI in couples with MF. IMSI increases the odds of implantation by 50% and pregnancy by 60% in couples with MF. In light of improved clinical outcomes, we recommend promoting the IMSI method in couples with MF. Moreover, IMSI results in a 3-fold increase in implantation rate, a 2-fold increase in pregnancy rate and a 70% decrease in miscarriage rate as compared to ICSI in couples with IF, however, as no randomized evidence exists, randomized studies are needed to confirm the IMSI benefits in couples with IF. PMID:25461360

  5. Measuring student engagement in science classrooms: An investigation of the contextual factors and longitudinal outcomes

    NASA Astrophysics Data System (ADS)

    Spicer, Justina Judy

    This dissertation includes three separate but related studies that examine the different dimensions of student experiences in science using data from two different datasets: the High School Longitudinal Study of 2009 (HSLS:09), and a dataset constructed using the Experience Sampling Method (ESM). This mixed-dataset approach provides a unique perspective on student engagement and the contexts in which it exists. Engagement is operationalized across the three studies using aspects of flow theory to evaluate how the challenges in science classes are experienced at the student level. The data provides information on a student's skill-level and efficacy during the challenge, as well as their interest level and persistence. The data additionally track how situations contribute to optimal learning moments, along with longitudinal attitudes and behaviors towards science. In the first part of this study, the construct of optimal moments is explored using in the moment data from the ESM dataset. Several different measures of engagement are tested and validated to uncover relationships between various affective states and optimal learning experiences with a focus on science classrooms. Additional analyses include investigating the links between in the moment engagement (situational), and cross-situational (stable) measures of engagement in science. The second part of this dissertation analyzes the ESM data in greater depth by examining how engagement varies across students and their contextual environment. The contextual characteristics associated with higher engagement levels are evaluated to see if these conditions hold across different types of students. Chapter three more thoroughly analyzes what contributes to students persisting through challenging learning moments, and the variation in levels of effort put forth when facing difficulty while learning in science. In chapter four, this dissertation explores additional outcomes associated with student engagement in science

  6. Maternal pre-pregnancy BMI and adverse pregnancy outcomes among Chinese women: Results from the C-ABCS.

    PubMed

    Ding, X-X; Xu, S-J; Hao, J-H; Huang, K; Su, P-Y; Tao, F-B

    2016-04-01

    The aim of this study was to investigate associations between pre-pregnancy body mass index (BMI) and adverse pregnancy outcomes among Chinese pregnant women. A prospective population-based cohort study was performed using data collected as part of the China-Anhui Birth Cohort Study or C-ABCS. A total of 13,121 pregnant women who received the first prenatal visit were enrolled from November 2008 to October 2010. Logistic regression analysis was used to calculate associations between pre-pregnancy BMI and pregnancy outcomes. Results indicated that the increased pre-pregnancy BMI was associated with a number of adverse pregnancy outcomes such as hypertensive disorder (adjusted relative risk (ARR) 2.3, 95% confidence interval [CI] 1.5-3.6), gestational diabetes (ARR 3.5, 95% CI 2.3-5.2), caesarean delivery (ARR 2.0, 95% CI 1.6-2.4), and medically indicated preterm delivery (ARR 1.8, 95% CI 1.1-2.9). Women with pre-pregnancy BMI above the normal range pose an increased risk of adverse pregnancy outcomes. PMID:26492517

  7. LDEF: Dosimetric measurement results (AO 138-7 experiment)

    NASA Technical Reports Server (NTRS)

    Bourrieau, J.

    1993-01-01

    One of the objectives of the AO 138-7 experiment on board the Long Duration Exposure Facility (LDEF) was a total dose measurement with Thermo Luminescent Detectors (TLD 100). Two identical packages, both of them including five TLD's inside various aluminum shields, are exposed to the space environment in order to obtain the absorbed dose profile. Radiation fluence received during the total mission length was computed, taking into account the trapped particles (AE8 and AP8 models during solar maximum and minimum periods) and the cosmic rays; due to the magnetospheric shielding the solar proton fluences are negligible on the LDEF orbit. The total dose induced by these radiations inside a semi infinite plane shield of aluminum are computed with the radiation transport codes available at DERTS. The dose profile obtained is in good agreement with the evaluation by E.V. Benton. TLD readings are performed after flight; due to the mission duration increase a post flight calibration was necessary in order to cover the range of the in flight induced dose. The results obtained, similar (plus or minus 30 percent) for both packages, are compared with the dose profile computation. For thick shields it seems that the measurements exceed the forecast (about 40 percent). That can be due to a cosmic ray and trapped proton contributions coming from the backside (assumed as perfectly shielded by the LDEF structure in the computation), or to an underestimate of the proton or cosmic ray fluences. A fine structural shielding analysis should be necessary in order to determine the origin of this slight discrepancy between forecast and in flight measurements. For the less shielded dosimeters, mainly exposed to the trapped electron flux, a slight overestimation of the dose (less than 40 percent) appears. Due to the dispersion of the TLD's response, this cannot be confirmed. In practice these results obtained on board LDEF, with less than a factor 1.4 between measurements and forecast

  8. Moderate energy restriction with high protein diet results in healthier outcome in women

    PubMed Central

    2010-01-01

    Background The present study compares two different weight reduction regimens both with a moderately high protein intake on body composition, serum hormone concentration and strength performance in non-competitive female athletes. Methods Fifteen normal weighted women involved in recreational resistance training and aerobic training were recruited for the study (age 28.5 ± 6.3 yr, height 167.0 ± 7.0 cm, body mass 66.3 ± 4.2 kg, body mass index 23.8 ± 1.8, mean ± SD). They were randomized into two groups. The 1 KG group (n = 8; energy deficit 1100 kcal/day) was supervised to reduce body weight by 1 kg per week and the 0.5 KG group (n = 7; energy deficit 550 kcal/day) by 0.5 kg per week, respectively. In both groups protein intake was kept at least 1.4 g/kg body weight/day and the weight reduction lasted four weeks. At the beginning of the study the energy need was calculated using food and training diaries. The same measurements were done before and after the 4-week weight reduction period including total body composition (DXA), serum hormone concentrations, jumping ability and strength measurements Results During the 4-week weight reduction period there were no changes in lean body mass and bone mass, but total body mass, fat mass and fat percentage decreased significantly in both groups. The changes were greater in the 1 KG group than in the 0.5 KG group in total body mass (p < 0.001), fat mass (p < 0.001) and fat percentage (p < 0.01). Serum testosterone concentration decreased significantly from 1.8 ± 1.0 to 1.4 ± 0.9 nmol/l (p < 0.01) in 1 KG and the change was greater in 1 KG (30%, p < 0.001) than in 0.5 KG (3%). On the other hand, SHBG increased significantly in 1 KG from 63.4 ± 17.7 to 82.4 ± 33.0 nmol/l (p < 0.05) during the weight reducing regimen. After the 4-week period there were no changes in strength performance in 0.5 KG group, however in 1 KG maximal strength in bench press decreased (p < 0.05) while endurance strength in squat and counter

  9. Neoplastic meningitis resulting from hematological malignancies: pharmacokinetic considerations and maximizing outcome

    PubMed Central

    Grewal, Jai; Saria, Marlon; Grewal, Harpreet K; Kesari, Santosh

    2012-01-01

    Neoplastic meningitis, also known as leptomeningeal metastases, is a complication of various types of cancer that occurs when tumor cells enter the cerebrospinal fluid (CSF), travel along CSF pathways and grow. Treatment options include drug delivery directly into the CNS or systemic administration for targeted action in the CNS. CNS drug delivery is limited by the blood–brain barrier and the blood–CSF barrier. It may be possible to partially overcome this by using high-dose systemic therapy; however, this is done at the possible expense of increased systemic toxicity. Intra-CSF drug delivery bypasses the blood–brain barrier and allows direct access of the chemotherapeutic agent to the CSF. Because neoplastic meningitis occurs in an increasingly large percentage of all cancer patients, it is imperative to optimize drug delivery to the CSF and meninges. Both the pharmacokinetic profile of the chemotherapeutic agent and the site of administration influence therapeutic efficacy. Achieving prolonged therapeutic cytotoxic drug concentrations and even distribution in the CSF will improve efficacy. In this article we summarize data on the efficacy, safety and outcome of high-dose systemic and intra-CSF treatments. PMID:22396850

  10. A review of functional outcome measures for cervical spine disorders: literature review

    PubMed Central

    Bussières, André

    1994-01-01

    The purpose of this paper is to assess the reliability, validity and usefulness of three outcome measures: cervical ranges of motion, sagittal neck muscle strength and presence or absence of the flexion relaxation phenomenon (FRP) in the neck. The literature search included the Index Medicus and computerized database of MEDLINE for relevant material. Articles were selected if they contained primary data on neck range of motion, sagittal muscle strength and FRP. The results of 59 articles and 2 textbooks were analyzed. Normative values of cervical ROM have been reported in healthy subjects ranging in age from 18 to 74 years. The extent of degrees of motion lost per year did not differ between male or female subjects, but females started with higher degrees of active range of motion, which they maintained throughout life. Instrumented methods of recording muscle strength have included strain gauge dynamometers and modified sphygmomanometers. Parameters such as gender, age and stature were also observed to have important effects on muscle strength. The ratio of extension to flexion maximum isometric peak force has been estimated to range between 1.40-1.70 in normal subjects. Therefore, the extensor muscles of the neck are approximately 40% stronger then the neck flexor muscles. Evidence suggested that neck pain sufferers have weaker neck flexors than normal subjects. The FRP refers to the absence of myoelectrical activity in extensor muscles upon full forward flexion and has been documented in the cervical spine of asymptomatic subjects. In conclusion, inclinometric methods used for measurements of cervical range of motion were found to be safe, effective and reliable. The Cervical Range of Motion Device appeared to be well suited for clinical practice. The ratio of cervical extension-flexion maximum isometric voluntary contraction has been determined in asymptomatic subjects. The presence of the FRP in the neck has also been observed in normals. Future study is

  11. 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

    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

    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

  12. Physiotherapists use of and perspectives on the importance of patient-reported outcome measures for shoulder dysfunction

    PubMed Central

    Michener, Lori A

    2014-01-01

    Background Many patient-reported outcome measures (PROs) for shoulder dysfunctions have acceptable psychometric properties. The present study examined current PRO usage and perceived importance. Methods Delegates at the 2010 International Congress of Shoulder and Elbow Therapists were invited to participate in this cross-sectional observational study. Research Electronic Data Capture (REDCap) web-based tools were used to design an online questionnaire, which was e-mailed to participants. Results Participants (n = 101) reflected an 84% response rate. PRO use was considered ‘extremely’ or ‘very’ important by the majority of clinicians (76%) and researchers (98%). Most commonly used as a primary outcome by clinicians and researchers, respectively, were the Disabilities of the Arm Shoulder Hand Questionnaire (DASH) (40%, 44%) and the Oxford Shoulder Scale (OSS) (36%, 22%) and, as secondary outcomes, the DASH (33%, 28%), OSS (17%, 8%), the Shoulder Pain and Disability Index (SPADI) (8%,18%), and American Shoulder and Elbow Surgeons standardized assessment form (ASES) (8%, 13%). Psychometric properties were rated as ‘extremely’ or ‘very’ important by 86% to 96% of participants. Conclusions The majority of shoulder therapists consider PRO use to be very important and psychometric properties to be critical in PRO selection. The DASH, OSS, SPADI and ASES are most commonly used in clinical practice and research studies.

  13. The VVSymQ® instrument: Use of a new patient-reported outcome measure for assessment of varicose vein symptoms

    PubMed Central

    Turner-Bowker, Diane M; Elash, Celeste A; Wright, David

    2015-01-01

    Introduction No existing patient-reported outcome instrument focuses solely on assessment of varicose veins symptoms that are bothersome to patients. Methods The VVSymQ® instrument is a five-item patient-reported outcome that assesses symptoms most important to patients with varicose veins (heaviness, achiness, swelling, throbbing and itching). This paper describes how the VVSymQ® instrument was incorporated into an electronic daily diary to monitor key outcomes over time and capture treatment benefit in two randomized, controlled, phase 3 clinical trials. Results Patients were highly compliant in completing the electronic daily diary, and the VVSymQ® instrument demonstrated ability to detect overall change and ability to detect change that is meaningful to patients. Conclusion The VVSymQ® instrument is a reliable, valid instrument responsive to measuring change in the patient experience of varicose vein symptoms pre- and post-intervention, and is uniquely focused on patient-reported symptoms compared with other widely used questionnaires completed by clinicians. PMID:26183669

  14. Observer bias in randomized clinical trials with measurement scale outcomes: a systematic review of trials with both blinded and nonblinded assessors

    PubMed Central

    Hróbjartsson, Asbjørn; Thomsen, Ann Sofia Skou; Emanuelsson, Frida; Tendal, Britta; Hilden, Jørgen; Boutron, Isabelle; Ravaud, Philippe; Brorson, Stig

    2013-01-01

    Background: Clinical trials are commonly done without blinded outcome assessors despite the risk of bias. We wanted to evaluate the effect of nonblinded outcome assessment on estimated effects in randomized clinical trials with outcomes that involved subjective measurement scales. Methods: We conducted a systematic review of randomized clinical trials with both blinded and nonblinded assessment of the same measurement scale outcome. We searched PubMed, EMBASE, PsycINFO, CINAHL, Cochrane Central Register of Controlled Trials, HighWire Press and Google Scholar for relevant studies. Two investigators agreed on the inclusion of trials and the outcome scale. For each trial, we calculated the difference in effect size (i.e., standardized mean difference between nonblinded and blinded assessments). A difference in effect size of less than 0 suggested that nonblinded assessors generated more optimistic estimates of effect. We pooled the differences in effect size using inverse variance random-effects meta-analysis and used metaregression to identify potential reasons for variation. Results: We included 24 trials in our review. The main meta-analysis included 16 trials (involving 2854 patients) with subjective outcomes. The estimated treatment effect was more beneficial when based on nonblinded assessors (pooled difference in effect size −0.23 [95% confidence interval (CI) −0.40 to −0.06]). In relative terms, nonblinded assessors exaggerated the pooled effect size by 68% (95% CI 14% to 230%). Heterogeneity was moderate (I2 = 46%, p = 0.02) and unexplained by metaregression. Interpretation: We provide empirical evidence for observer bias in randomized clinical trials with subjective measurement scale outcomes. A failure to blind assessors of outcomes in such trials results in a high risk of substantial bias. PMID:23359047

  15. An Introduction to Item Response Theory for Patient-Reported Outcome Measurement

    PubMed Central

    Nguyen, Tam H.; Han, Hae-Ra; Kim, Miyong T.

    2015-01-01

    The growing emphasis on patient-centered care has accelerated the demand for high-quality data from patient-reported outcome (PRO) measures. Traditionally, the development and validation of these measures has been guided by classical test theory. However, item response theory (IRT), an alternate measurement framework, offers promise for addressing practical measurement problems found in health-related research that have been difficult to solve through classical methods. This paper introduces foundational concepts in IRT, as well as commonly used models and their assumptions. Existing data on a combined sample (n = 636) of Korean American and Vietnamese American adults who responded to the High Blood Pressure Health Literacy Scale and the Patient Health Questionnaire-9 are used to exemplify typical applications of IRT. These examples illustrate how IRT can be used to improve the development, refinement, and evaluation of PRO measures. Greater use of methods based on this framework can increase the accuracy and efficiency with which PROs are measured. PMID:24403095

  16. An introduction to item response theory for patient-reported outcome measurement.

    PubMed

    Nguyen, Tam H; Han, Hae-Ra; Kim, Miyong T; Chan, Kitty S

    2014-01-01

    The growing emphasis on patient-centered care has accelerated the demand for high-quality data from patient-reported outcome (PRO) measures. Traditionally, the development and validation of these measures has been guided by classical test theory. However, item response theory (IRT), an alternate measurement framework, offers promise for addressing practical measurement problems found in health-related research that have been difficult to solve through classical methods. This paper introduces foundational concepts in IRT, as well as commonly used models and their assumptions. Existing data on a combined sample (n = 636) of Korean American and Vietnamese American adults who responded to the High Blood Pressure Health Literacy Scale and the Patient Health Questionnaire-9 are used to exemplify typical applications of IRT. These examples illustrate how IRT can be used to improve the development, refinement, and evaluation of PRO measures. Greater use of methods based on this framework can increase the accuracy and efficiency with which PROs are measured. PMID:24403095

  17. Measuring Costs and Outcomes of Tele-Intervention When Serving Families of Children who are Deaf/Hard-of-Hearing

    PubMed Central

    Blaiser, Kristina M.; Behl, Diane; Callow-Heusser, Catherine; White, Karl R.

    2013-01-01

    Background: Optimal outcomes for children who are deaf/hard-of-hearing (DHH) depend on access to high quality, specialized early intervention services. Tele-intervention (TI), the delivery of early intervention services via telehealth technology, has the potential to meet this need in a cost-effective manner. Method: Twenty-seven families of infants and toddlers with varying degrees of hearing loss participated in a randomized study, receiving their services primarily through TI or via traditional in-person home visits. Pre- and post-test measures of child outcomes, family and provider satisfaction, and costs were collected. Results: The TI group scored statistically significantly higher on the expressive language measure than the in-person group (p =.03). A measure of home visit quality revealed that the TI group scored statistically significantly better on the Parent Engagement subscale of the Home Visit Rating Scales-Adapted & Extended (HOVRS-A+; Roggman et al., 2012). Cost savings associated with providing services via TI increased as the intensity of service delivery increased. Although most providers and families were positive about TI, there was great variability in their perceptions. Conclusions: Tele-intervention is a promising cost-effective method for delivering high quality early intervention services to families of children who are DHH. PMID:25945213

  18. [Standards and outcome measures in cardiovascular rehabilitation. Position paper GICR/IACPR].

    PubMed

    Griffo, Raffaele; Ambrosetti, Marco; Furgi, Giuseppe; Carlon, Roberto; Chieffo, Carmine; Favretto, Giuseppe; Febo, Oreste; Corrà, Ugo; Fattirolli, Francesco; Giannuzzi, Pantaleo; Greco, Cesare; Piepoli, Massimo F; Temporelli, Pier Luigi; Tramarin, Roberto; Urbinati, Stefano

    2012-12-01

    Despite major improvements in diagnostics and interventional therapies, cardiovascular diseases remain a major health care and socio-economic problem in Italy. Costs and resources required are increasing in close correlation to both the improved quality of care and to the population ageing. There is an overwhelming evidence of the efficacy of cardiac rehabilitation (CR) in terms of reduction in morbidity and mortality after acute cardiac events. CR services are by definition multi-factorial and comprehensive. Furthermore, systematic analysis and monitoring of the process of delivery and outcomes is of paramount importance. The aim of this position paper promoted by the Italian Association for Cardiovascular Prevention and Rehabilitation (GICR-IACPR) is to provide specific recommendations to assist CR staff in the design, evaluation and development of their care delivery organization. The position paper should also assist health care providers, insurers, policy makers and consumers in the recognition of the quality of care requirements, standards and outcome measure, quality and performance indicators, and professional competence involved in such organization and programs. The position paper i) include comprehensive CR definition and indications, ii) describes priority criteria based on the clinical risk for admission to both inpatient or outpatient CR, and iii) defines components and technological, structural and organizing requirements for inpatient or outpatient CR services, with specific indicators and standards, performance measures and required professional skills. A specific chapter is dedicated to the requirements for highly specialized CR services for patients with more advanced cardiovascular diseases. PMID:23659104

  19. Methods and preliminary measurement results of liquid Li wettability

    SciTech Connect

    Zuo, G. Z. Hu, J. S.; Ren, J.; Sun, Z.; Yang, Q. X.; Li, J. G.; Zakharov, L. E.; Mansfield, D. K.

    2014-02-15

    A test of lithium wettability was performed in high vacuum (< 3 × 10{sup −4} Pa). High magnification images of Li droplets on stainless steel substrates were produced and processed using the MATLAB{sup ®} program to obtain clear image edge points. In contrast to the more standard “θ/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.

  20. The first geocenter estimation results using GPS measurements

    NASA Technical Reports Server (NTRS)

    Malla, R. P.; Wu, S. C.

    1990-01-01

    The center of mass of the Earth is the natural and unambiguous origin of a geocentric satellite dynamical system. A geocentric reference frame assumes that the origin of its coordinate axes is at the geocenter, in which all relevant observations and results can be referred and in which geodynamic theories or models for the dynamic behavior of Earth can be formulated. In practice, however, a kinematically obtained terrestrial reference frame may assume an origin other than the geocenter. A fast and accurate method of determining origin offset from the geocenter is highly desirable. Global Positioning System (GPS) measurements, because of their abundance and broad distribution, provide a powerful tool to obtain this origin offset in a short period of time. Two effective strategies have been devised. Data from the first Central and South America (Casa Uno) global GPS experiment were studied to demonstrate the ability of recovering the geocenter location with present-day GPS satellites and receivers.