Objective: To calibrate an item bank of anxiety-related questions for use in orthopedic patients within a computer-adaptive test. Design: This is a psychometric study. Setting: The sample of orthopedic patients was recruited in two orthopedic rehabilitation clinics in Germany. Subjects: A total of 474 orthopedic rehabilitation patients were recruited for this study. Interventions: Not applicable. Main measures: The main measure is an adapted version of an existing anxiety item pool for cardiovascular rehabilitation patients. Results: The results of the confirmatory factor analysis and Mokken analysis confirmed a one-factor structure and double monotonicity. An anxiety item bank (48 items) could be developed and calibrated using Rasch analysis. It fitted to the Rasch model with a non-significant item–trait interaction ( χ2(203) = 172.59; P = .94) and was free of differential item functioning. Unidimensionality could be verified and the person separation reliability was .96. The category threshold parameters varied between 4.72 and 3.16 (7.88 logits). Conclusion: The unidimensional anxiety item bank provides the basis for a computer-adaptive test to assess a wide range of anxiety in rehabilitation patients with orthopedic diseases with very good psychometric characteristics.
IntroductionThe integration of a web-based computer-adaptive patient-reported outcome test (CAT) platform with persuasive design optimised features including recommendations for action into routine healthcare could provide a promising way to translate reliable diagnostic results into action. This study aims to evaluate the effectiveness and cost-effectiveness of such a platform for depression and anxiety (RehaCAT+) compared with the standard diagnostic system (RehaCAT) in cardiological and orthopaedic health clinics in routine care.Methods and analysisA two-arm, pragmatic, cluster-randomised controlled trial will be conducted. Twelve participating rehabilitation clinics in Germany will be randomly assigned to a control (RehaCAT) or experimental group (RehaCAT+) in a 1:1 design. A total sample of 1848 participants will be recruited across all clinics. The primary outcome, depression severity at 12 months follow-up (T3), will be assessed using the CAT Patient-Reported Outcome Measurement Information System Emotional Distress-Depression Item set. Secondary outcomes are depression at discharge (T1) and 6 months follow-up (T2) as well as anxiety, satisfaction with participation in social roles and activities, pain impairment, fatigue, sleep, health-related quality of life, self-efficacy, physical functioning, alcohol, personality and health economic-specific general quality of life and socioeconomic cost and benefits at T1-3. User behaviour, acceptance, facilitating and hindering factors will be assessed with semistructured qualitative interviews. Additionally, a smart sensing substudy will be conducted, with daily ecological momentary assessments and passive collection of smartphone usage variables. Data analysis will follow the intention-to-treat principle with additional per-protocol analyses. Cost-effectiveness analyses will be conducted from a societal perspective and the perspective of the statutory pension insurance.Ethics and disseminationThe study will be conducted according to the Declaration of Helsinki. The Ethics Committee of Ulm University, has approved the study (on 24 February 2021 ref. 509/20). Written informed consent will be obtained for all participants. Results will be published via peer-reviewed journals.Trial registration numberDRKS00027447
nϭ1520) and 192 for BevacizumabϩInterferon (B, nϭ171). Approximately one quarter of patients were lost in the second month of treatment (Tϭ39%; Soϭ36%, Pϭ35%; Eϭ28%; Suϭ25%; Bϭ21%). CONCLUSIONS: Persistence in first line treatment of mRCC is very low. Best persistence can be observed for BevacizumabϩInterferon which is the only intravenous treatment in this indication. Further research may be required to evaluate if the increased use of oral treatments has a negative impact on patient adherence and if adequate measures are required to improve this situation. OBJECTIVES:Although ovarian cancer has been widely studied, there is very little documentation of patient reported outcomes (PRO) for patients with platinumsensitive ovarian cancer (PSOC). Initial therapy for ovarian cancer typically consists of surgery followed by platinum-based chemotherapy. Patients are considered platinum-sensitive if disease recurrence occurs more than 6 months after completion of platinum-based treatment. The objective of this literature review was to obtain a clear picture of patient reported outcomes (PROs) including health related quality of life (HRQoL), patient preferences, and health status utility for patients with PSOC. METHODS: A systematic literature review of the peer-reviewed literature was conducted in Medline and Embase using the Cochrane approach. Studies reporting and analyzing PROs, HRQoL, patient preferences, and health status utility in patients with PSOC over the past 10 years were identified. RESULTS: The review identified 19 studies reporting PROs for PSOC patients, of which 9 were PSOC only, 7 were a combination of platinum-sensitive and resistant patients and 3 were platinum-treated recurrent patients. Of these 19 studies, there was a wide variation, with limited commonality, on the types of treatment regimens reported. In general, QoL did not differ between therapies for PSOC patients. However, in one study when docetaxel and carboplatin were given sequentially vs. in combination, an improvement in QoL was demonstrated. Another study showed that statistically significant higher QoL scores were found in pegylated liposomal doxorubicin treated patients than in gemcitabine patients. CONCLUSIONS: Given the limited number of PSOC references and variations in treatment regimens, it was difficult to identify common themes in patient preferences and PROs for this patient population. PSOC patients' preferences and perceptions of treatment are important; however, this information is missing in the evidence base. Further research is needed to identify treatment options which improve QoL and add value to PSOC patients' treatment experience.
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.