Seeding the value based health care and standardised measurement of quality of life after burn debate

Edgar, Dale W.; Daele, Ulrike Van; Spronk, Inge; Baar, Margriet E. van; Loey, Nancy E. Van; Wood, Fiona; Kazis, Lewis; Meirte, Jill

doi:10.1016/j.burns.2020.05.024

Cited by 8 publications

(3 citation statements)

References 16 publications

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“…A further discussion and debate to understand how to assess the effect of scar management interventions holistically is now needed. In 2020, Edgar and colleagues called for a discussion regarding the best practice in quality-of-life assessment in burns, suggesting that a refocusing on the impact of 'scarring of the mind' on recovery of quality of life was needed, as opposed to a sole reliance on scar outcomes [12]. The case presented here is analogous, though with a challenge to the distinction between scar and quality-of-life outcomes.…”

Section: What Is Requiredmentioning

confidence: 92%

“…Implementation of this requires an agreement on which tools to use to ensure the standardisation of clinical research assessment, comparability of outcomes across studies and to facilitate a more effective synthesis of evidence of effectiveness. Currently, there are a number of tools available; the BSHS-B is the most commonly used and recommended by Edgar and colleagues [12]; there is also the scar-specific quality-of-life tool, the BBSIP [14], and more recently, the development of the CARe burn scales in the UK [15]. An agreement on which scales to routinely use in the evaluation of scar management interventions is needed, for example, according to conceptual content [5,7], validation evidence [16], availability for adults and children, and also to assess the impact on parents.…”

Section: What Is Requiredmentioning

confidence: 99%

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Towards the Holistic Assessment of Scar Management Interventions

Mathers

2022

EBJ

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Presently, research assessments of burn scar management interventions focus on measures of scarring and scar features. However, qualitative research demonstrates that patients experience scarring and scar management therapies holistically. Patient-centred assessment should reflect this. An agreement is required regarding what to assess, which tools and measures to use and at what time points. Key issues include (1) whether and how burn- or scar-related quality-of-life measures could be included in the assessment of scar management interventions and how these are weighed against scar measures; (2) routine inclusion of the assessment of treatment burden (or treatment experience) in comparative research and (3) generating further understanding of the relationship between scar management and psychosocial adaptation, along with an assessment of this. A debate concerning a holistic and standardized evaluation of scar management interventions is needed to ensure that future evidence-based decisions are made in a patient-centred manner.

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Section: What Is Requiredmentioning

confidence: 92%

Section: What Is Requiredmentioning

confidence: 99%

Towards the Holistic Assessment of Scar Management Interventions

Mathers

2022

EBJ

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“…7 VBHC has not yet been systematically implemented in burn care, and is proposed to deliver a major positive impact as a driver for opportunities to reduce variation in practice for the broad spectrum of patient characteristics, the multitude of primarily empirical treatment strategies currently used, the lack of gold or evidence-based standards and the high relative costs of interventions. 8–11 Results achieved by implementing VBHC in other contexts include improved patient value and satisfaction, decreased hospital stay, fewer complications, and enhanced quality of life. 12–14 These outcomes, if achieved through the burn VBHC context, would clearly constitute a worthwhile investment for patients and burn care services.…”

Section: Introductionmentioning

confidence: 99%

The Short- and Long-Term Outcome Priorities of a Western Australian Adult Burn Population

Spronk,

Wood,

Fear

et al. 2023

Journal of Burn Care &Amp; Research

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To optimize patient recovery, understanding which outcomes are most important to burn patients is key. However, research to determine what outcomes are patient priorities is limited. Therefore, we assessed what outcomes are most important to Western Australian burn patients, separately in the short-term (<6 months) and long-term (6-24 months) after injury. Adult patients who had a burn injury 3-36 months ago completed a survey, rating the importance of 36 short- and long-term outcomes. The survey items were ranked according to the number of patients reporting the outcome as “very important.” Results were compared between subgroups based on age, gender, burn size, and number of surgeries. Ninety-three patients were included. In the short-term, “not having a wound infection” (87.1%), “good wound healing” (83.9%), and “walking or moving around” (74.7%) were the most important outcomes. “Lifting or moving something” (67.6%), “walking or moving around” (66.2%), and “being independent” (66.2%) were reported as most important in the long-term. Scar-related outcomes were more important to females and to patients with multiple surgeries; mental health outcomes were priorities for females and patients with major burns; walking and moving around to males and older patients; and social and financial outcomes were rated highly by patients with major burns and multiple surgeries. In conclusion, the most important outcomes were consistent across time periods, indicating the importance of core outcomes in longitudinal follow-up. The wide range of priority outcomes and differences between subgroups underlines the need for multidisciplinary care and a patient-centered approach to support patients.

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