Objective: To perform a systematic review assessing the impact of the different management options on health-related quality of life (HRQoL) of patients with localized renal masses or renal cell carcinomas (LRM/LRCC). Materials and Methods: Searches covering PubMed, Embase (Ovid), CENTRAL, PsycINFO (Ovid), CINAHL (EBSCO), and Cochrane Central Register of Controlled Trials (CENTRAL) databases was conducted for papers published up to 25 April 2021. Methods as per Cochrane Handbook were followed. “Modality” of treatment included radical nephrectomy (RN), nephron-sparing surgery (NSS), thermal ablation (TA), and active surveillance (AS). “Approach” was categorized as open incision and minimally invasive surgery (MIS). Risk of bias was assessed by ROBINS-I and Cochrane RoB 2 for observational studies and randomized controlled trials, respectively and certainty of the evidence by GRADE. Results: Sixteen observational studies and 1 randomized controlled trial (2.370 patients) met inclusion criteria. Fifteen different patient reported outcome measures (PROMs) were identified. Heterogeneity prevented quantitative analysis. Generic HRQoL decreases after RN and NSS, recovers within 6 to 12 months, and mostly overlaps with baseline values, irrespective of modality. Cancer-specific HRQoL improve faster after open-NSS than open-RN. The detrimental effect of RN may persist long-term in cross-evaluations. QoL scales significantly decrease after open surgery and MIS during the first weeks but improve faster after MIS. They are similar for both approaches at 1-year. Long-term cancer-specific QoL is similar for MIS and open procedures. Fear of recurrence is lower in older patients and affected by neither modality nor approach. Conclusions: Low quality evidence supports the use of MIS over the open approach when HRQoL is considered in the management of LRMs/LRCCs; data regarding the effect of the treatment modality of the LRM/LRCC show contradictory outcomes.
Objective : As the number of mobile health applications increases, quality assessment becomes a capital feature of any mobile application design. Besides the professional evaluation conducted before marketing the app, the perceptions of the subjects to whom is intended will determine the successful widespread dissemination. Hence, the implementation of a given app may be impaired by the lack of a validated translation and cross-cultural adaptation. We aimed to validate in the Turkish language the User Version of the Mobile Application Rating Scale, an English original scale designed to assess the quality of mobile health applications. Materials and methods: A well-established and predefined process of cross-cultural adaptation and translation to Turkish of the User Version of the Mobile Application Rating Scale according to the World Health Organization guidelines was performed using a common, readily available, free-of-charge application. Internal consistency and reliability were tested in a population sample by Cronbach’s α and r WG index, respectively. Results: The total User Version of the Mobile Application Rating Scale score had good internal consistency (Cronbach’s α = 0.87). Internal consistencies of its subscales were also acceptable: with Cronbach’s α of 0.71, 0.78, 0.71, and 0.73 for engagement, functionality, aesthetics, and information, respectively. Cronbach’s α of the satisfaction subscale was 0.46. The User Version of the Mobile Application Rating Scale total and subscales scores had a strong within-group agreement, all of them with r wg indexes between 0.78 and 0.87 over baseline to 1 month. Conclusion: The Turkish version of the User Version of the Mobile Application Rating Scale is consistent with the English original version and is a reliable and valid tool to assess the quality of mobile applications by Turkish users.
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