Background: To determine the frequency of persistent disease activity following 3 loading doses of anti-vascular endothelial growth factor (VEGF) agents, and the anatomic and demographic predictors of early persistent disease activity among patients with neovascular age-related macular degeneration (nAMD). Methods: In a retrospective real-world cohort study, 281 consecutive patients with nAMD were reviewed at baseline and after 3 anti-VEGF injections for pre-defined indicators of disease activity. Optical coherence tomography (OCT) features such as subretinal fluid, intraretinal cysts and intraretinal fluid were assessed by reading-center certified graders. Multiple logistic regression was performed on demographic and anatomic factors. Results: At month 3, 66.1% of patients had persistent disease activity. The best-corrected visual acuity (BCVA) improvement was 0.16 LogMAR for those with no disease activity compared to 0 for patients with persistent activity (p < 0.001). The significant risk factors for persistent activity at 3 months were male gender (odds ratio [OR] 0.54, 95% confidence interval [CI] 0.32-0.93, p = 0.025), intraretinal cysts at baseline (OR 2.95, 95% CI 1.67-5.20, p < 0.001) and subretinal fluid at baseline (OR 3.17, 95% CI 1.62-6.18, p = 0.002). At 3 months, 58% of patients had features of activity on OCT. Patients with intraretinal cysts and intraretinal fluid at baseline had worse BCVA at month 3 compared to patients without these OCT features (0.69 vs. 0.43, p < 0.001, and 0.62 vs. 0.43, p < 0.001, respectively). Conclusions: In a real-world study, 66.1% of nAMD patients have persistent disease activity after the initial loading dose, with poorer BCVA compared to those without. Baseline OCT features (intraretinal cysts and subretinal fluid) are useful predictors of persistent disease activity at month 3.
Background Low back pain is a leading cause of disability worldwide. Health literacy has been associated with pain intensity and pain control. However, there is a paucity of evidence regarding this association. In the field of low back pain research, inconsistent reporting of outcomes has been highlighted. To address this issue a Core Outcome Set has been developed. Objectives The objectives of this scoping review were: (1) The health literacy measures currently employed for low back pain and the aspects of health literacy they include. (2) The low back pain health outcomes included in such work. (3) The extent to which these health outcomes reflect the Core Outcome Set for Clinical Trials in Non-Specific Low Back Pain. Methods The search included thirteen bibliographic databases, using medical subject heading terms for low back pain and health literacy, and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. The eligibility criteria were defined by the Joanna Briggs Institute PCC mnemonic. A thematic framework approach was used for analysis. Results The search yielded ten relevant studies for inclusion, amongst which a total of nine health literacy measures and 50 health outcome measures were used. Most health literacy measures focused on functional health literacy, with few assessing communicative and critical health literacy. The health outcomes assessed by the included studies could be broadly categorised into: Pain, Disability, Behaviour, Knowledge and Beliefs, and Resource Utilisation. Most of these outcome measures studied (36 out of 50) did not directly reflect the Core Outcome Set for Clinical Trials in Non-Specific Low Back Pain. Conclusions To allow for comparison across findings and the development of a rigorous evidence base, future work should include the Core Outcome Set for Clinical Trials in Non-Specific Low Back Pain. There is an urgent need to broaden the evidence-base to include regions where low back pain morbidity is high, but data is lacking. Such work demands the incorporation of comprehensive measures of health literacy that have both generic and culturally sensitive components.
BACKGROUND: The World Health Organisation highlights back pain as a leading and growing cause of disability worldwide. In the field of chronic pain, higher health literacy is linked to lower pain intensity and better pain control. However, there remains a paucity of evidence, with a recent systematic review finding only three studies meeting its inclusion criteria. OBJECTIVES: This scoping review had two objectives in exploring research in chronic pain, which were to identify:1) The health literacy measures currently employed. 2) The back-pain health outcomes included in such work and the extent to which these reflect the core outcome set for clinical trials in non-specific low back pain.METHODS: The search broadened the search strategy used in the systematic review. It was conducted using thirteen bibliographic databases, employing medical subject heading (MeSH) terms for back pain and health literacy, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. A thematic framework approach was used for analysis.RESULTS: The search yielded ten relevant studies for inclusion, amongst which a total of nine health literacy measures and 50 health outcome measures were used. The health outcomes assessed by the included studies could be broadly categorised into: Pain, Disability, Behaviour, Knowledge and Beliefs, and Resource Utilisation. Most outcome measures employed (36 out of 50) were not directly relevant to addressing the core outcome set for clinical trials in non-specific low back pain.CONCLUSIONS: A dearth of studies in this field of research was noted, especially in Asia and low-middle income countries. Methodological limitations were identified, including in study design and outcome measures. To allow for comparison across findings and the development of a rigorous evidence base, future work should include the core outcome set for clinical trials in non-specific low back pain. Furthermore, research thus far has focused on a narrow range of populations and there is an urgent need to broaden the evidence-base to include those with characteristics known to be moderators in health outcomes. Such work demands the incorporation of comprehensive measures of health literacy that have both generic and culturally sensitive components.
BACKGROUND: The World Health Organisation highlights low back pain as a leading and growing cause of disability worldwide. In the field of chronic pain, higher health literacy is linked to lower pain intensity and better pain control. However, there remains a paucity of evidence, with a recent systematic review finding only three studies meeting its inclusion criteria. OBJECTIVES: This scoping review had two objectives in exploring research in chronic back pain, which were to identify:1) The health literacy measures currently employed for back pain and the aspects of health literacy they include.2) The back-pain health outcomes included in such work and the extent to which these reflect the core outcome set for clinical trials in non-specific low back pain.METHODS: The search broadened the search strategy used in the systematic review, with the eligibility criteria defined by the Joanna Briggs Institute PCC mnemonic, namely: · Population – Patients with LBP (≥ 10% of study population), of any age, gender, or race· Concept – Relationship of LBP health outcomes to HL· Context – Any healthcare setting, in any geographical settingIt was conducted using thirteen bibliographic databases, employing medical subject heading (MeSH) terms for low back pain and health literacy, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. A thematic framework approach was used for analysis.RESULTS: The search yielded ten relevant studies for inclusion, amongst which a total of nine health literacy measures and 50 health outcome measures were used. The health outcomes assessed by the included studies could be broadly categorised into: Pain, Disability, Behaviour, Knowledge and Beliefs, and Resource Utilisation. Most outcome measures employed (36 out of 50) were not directly relevant to addressing the core outcome set for clinical trials in non-specific low back pain.CONCLUSIONS: A dearth of studies in this field of research was noted, especially in Asia and low-middle income countries. Methodological limitations were identified, including in study design and outcome measures. To allow for comparison across findings and the development of a rigorous evidence base, future work should include the core outcome set for clinical trials in non-specific low back pain. Furthermore, research thus far has focused on a narrow range of populations and there is an urgent need to broaden the evidence-base to include those with characteristics known to be moderators in health outcomes. Such work demands the incorporation of comprehensive measures of health literacy that have both generic and culturally sensitive components.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.