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Value in Health : the Journal of the... May 2023
Topics: Humans; Economics, Medical; Outcome Assessment, Health Care; Economics
PubMed: 36914093
DOI: 10.1016/j.jval.2023.03.002 -
Current Opinion in Pediatrics Dec 2019Randomized controlled trials leading to innovations that improve outcomes in acute life-threatening illnesses in children are scarce. A key issue is how we refocus... (Review)
Review
PURPOSE OF REVIEW
Randomized controlled trials leading to innovations that improve outcomes in acute life-threatening illnesses in children are scarce. A key issue is how we refocus research on outcomes that matter and are more relevant to those making emergency decisions, and those involved with managing and living with the late-outcome. We have used information from recent trials in critically ill children - in particular those illnesses without any primary neurologic involvement - to develop an approach to brain-related outcomes that will maximize child and family benefit from research.
RECENT FINDINGS
Fifteen recent pediatric critical care trials illustrate four types of brain-related outcomes assessment: death or organ-system-failures - as illustrated by studies in systemic illness; neurological and neuropsychological outcomes - as illustrated by the glycemic control studies; cognitive outcomes - as illustrated by a sedative trial; and composite outcomes - as illustrated by the therapeutic hypothermia studies.
SUMMARY
The 15 research trials point to five areas that will need to be addressed and incorporated into future trial design, including use of: neurologic monitoring during intensive care unit admission; postdischarge outcomes assessments; strategies to improve retention in long-term follow-up; child and family-centered outcomes; and core outcomes datasets.
Topics: Brain; Critical Illness; Humans; Intensive Care Units; Outcome Assessment, Health Care; Patient Selection; Quality of Life; Randomized Controlled Trials as Topic
PubMed: 31693587
DOI: 10.1097/MOP.0000000000000826 -
Journal of Plastic, Reconstructive &... Nov 2023Surgical care today is no longer evaluated only on clinical outcomes but also on holistic patient wellbeing. Patient-reported outcomes (PROs) are a representation of the... (Review)
Review
Surgical care today is no longer evaluated only on clinical outcomes but also on holistic patient wellbeing. Patient-reported outcomes (PROs) are a representation of the patient's perspective on their results and wellbeing. The aim of this review is to establish PROs as the center of healthcare and plastic surgery, to delineate important PROs in plastic surgery practice and research, to discuss the future of PROs within our discipline, and to encourage surgeons to incorporate PROs into their practice. PROs are an important parallel of clinical outcomes in that they can use the patient's perspective to 1) support clinical findings, 2) detect differences in care when there are no clear clinical differences, 3) track progress longitudinally, and 4) support systemic improvements in healthcare. Plastic surgery as a field is naturally aligned with PROs because, as a discipline, we focus on patient form and function. The emerging forefronts of plastic surgery such as lymphedema care, gender-affirming care, peripheral nerve surgery, migraine surgery, and breast implant illness are critically dependent on PROs. In the next decade, we predict that there will be a continued proliferation of robust PRO measures and integration into healthcare delivery. Outcomes research in surgery should continue to evolve as surgeons provide increasingly more benefits to improve patient wellbeing. Plastic surgeons must continue to play a prominent role in the future of PROs.
Topics: Humans; Patient Reported Outcome Measures; Outcome Assessment, Health Care; Delivery of Health Care; Surgeons; Plastic Surgery Procedures
PubMed: 37688832
DOI: 10.1016/j.bjps.2023.08.008 -
Current Oncology Reports Aug 2023The current panorama of measurement tools for use in cancer rehabilitation is reviewed. For rehabilitation purposes, evaluating function is of the highest priority. (Review)
Review
PURPOSE OF REVIEW
The current panorama of measurement tools for use in cancer rehabilitation is reviewed. For rehabilitation purposes, evaluating function is of the highest priority.
RECENT FINDINGS
From a patient-reported outcome (PRO) standpoint, SF-36 and EORTC-QLQ-C30 are in most common use in cancer rehabilitation research; these are quality of life measures that contain functional subdomains. Newer tools which are based on item response theory and have options for both computer assisted or short form (SF) administration, including the Patient-Reported Outcomes Measurement Information System (PROMIS) and Activity Measure for Post-acute Care (AMPAC) instruments, show increasing use, especially PROMIS Physical Function SF, and, recently, PROMIS Cancer Function Brief 3D, which has been validated in the cancer population, with domains of physical function, fatigue, and social participation, to track clinical rehabilitation outcomes. Evaluating objective measures of function in cancer patients is also crucial. Utilization of clinically feasible tools for cancer rehabilitation, to employ for both screening purposes and for monitoring of rehabilitation treatment efficacy, is an evolving area, much needed to promote further research and improved, consistent clinical care for cancer patients and survivors.
Topics: Humans; Quality of Life; Benchmarking; Outcome Assessment, Health Care; Treatment Outcome; Patient Reported Outcome Measures; Neoplasms
PubMed: 37148415
DOI: 10.1007/s11912-023-01412-6 -
Child: Care, Health and Development Jan 2020There has been a recent, rapid increase in the number of studies of children with medical complexity (CMC) and their families. There is a need for attention to gaps and... (Review)
Review
BACKGROUND
There has been a recent, rapid increase in the number of studies of children with medical complexity (CMC) and their families. There is a need for attention to gaps and patterns in this emerging field of study.
OBJECTIVES
The purpose of this scoping review was to identify patterns and gaps in the evidence related to classification systems, data, and outcomes in studies of CMC.
DATA SOURCES
We searched peer-reviewed journals for reports of quantitative studies focused on CMC outcomes published between 2008 and 2018. On the basis of a structured screening process, we selected 63 reports that met our inclusion criteria.
STUDY APPRAISAL AND SYNTHESIS
We used the methodological framework for scoping studies described by Arskey and O'Malley to map relevant literature in the field and the ECHO model to categorize studies according to three health outcome domains (economic, clinical, and humanistic).
RESULTS
The terminology used to describe and classify CMC differed across studies depending on outcome domain. Two thirds of the reports focused on economic outcomes; fewer than a quarter included child or family quality of life as an outcome. A majority of studies used a single source of data, with robust analyses of administrative, payer, and publicly available data.
CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS
Research on CMC and their families would benefit from standardization of terms and classification systems, the use of measurement strategies that map humanistic outcomes as trajectories, and more attention to outcomes identified as most meaningful to CMC and their families.
Topics: Child; Chronic Disease; Health Services Needs and Demand; Humans; Outcome Assessment, Health Care
PubMed: 31782818
DOI: 10.1111/cch.12725 -
Annals of Allergy, Asthma & Immunology... Nov 2020Food allergy is a common condition that can have a significant impact on the quality of life of affected individuals and their caregivers. Recent years have witnessed an... (Review)
Review
OBJECTIVE
Food allergy is a common condition that can have a significant impact on the quality of life of affected individuals and their caregivers. Recent years have witnessed an increased effort to identify new treatments for food allergy. Here, we review the need to identify core outcomes for measurement in clinical trials of food allergy treatments.
DATA SOURCES
We reviewed the literature regarding core outcome set development, the important role that these play in prioritizing patient-relevant outcomes, and the potential for core outcomes to accelerate the path to product marketing by allowing prompt and reliable evidence synthesis after trial publication.
STUDY SELECTIONS
We reviewed recent clinical trials of food allergy treatments to understand which outcomes have previously been measured, and also reviewed available core outcome set initiatives for other allergic conditions to understand which other outcomes might be explored in future trials.
RESULTS
Clinical trials of food allergy treatments have largely focused on outcomes that are relevant to investigators and commercial investors, especially the threshold of reactivity and immunologic changes. Future trials should consider addressing patient-important outcomes and should report the experiences of both adult and child participants and their caregivers.
CONCLUSION
There is a pressing need for core outcome set development for food allergy treatment trials.
Topics: Clinical Trials as Topic; Desensitization, Immunologic; Food Hypersensitivity; Humans; Outcome Assessment, Health Care; Quality of Life; Treatment Outcome
PubMed: 32569834
DOI: 10.1016/j.anai.2020.06.023 -
Air Medical Journal 2023Helicopter emergency medical services (HEMS) literature has been assessed in reviews focusing on various diagnoses, but there are few, if any, summaries of the entire... (Review)
Review
OBJECTIVE
Helicopter emergency medical services (HEMS) literature has been assessed in reviews focusing on various diagnoses, but there are few, if any, summaries of the entire body of HEMS outcomes evidence. Our goal was to summarize the existing research addressing patient-centered outcomes potentially accrued with HEMS.
METHODS
As part of the Critical Care Transport Collaborative Outcomes Research Effort, we generated the HEMS Outcomes Assessment Research Database and executed descriptive analyses of longitudinal trends from 1983 to 2022. Both indexed and gray literature sources were incorporated in the HEMS Outcomes Assessment Research Database. Studies were reviewed by at least 2 authors to select those that addressed a patient-centered outcome. Studies addressing solely HEMS logistics were excluded. Categoric analyses were executed with the Fisher exact test, and continuous variables were evaluated for normality with normal quantile plotting and a comparison of medians and 95% confidence intervals.
RESULTS
We found that HEMS outcomes study sample sizes increased steadily from 1983 to 2012, with the most recent decade demonstrating a marked increase in the rate of publication of HEMS outcomes studies. Most research (70.6%) addressed trauma patient outcomes, but recent decades have seen a significant increase in non-trauma studies. Recent decades have also been characterized by an increase in the production of HEMS outcomes research outside of North America and Europe.
CONCLUSION
This study summarizes the current state of the HEMS outcome literature. We highlight increasing contributions from worldwide researchers and increasing focus on HEMS benefits in non-trauma cases, particularly time-critical cases such as cardiac or stroke diagnoses. This provides a basis for further investigations into patient-oriented benefits potentially accrued with HEMS.
Topics: Humans; Air Ambulances; Aircraft; Emergency Medical Services; Europe; Outcome Assessment, Health Care; Retrospective Studies
PubMed: 37996177
DOI: 10.1016/j.amj.2023.07.003 -
Circulation. Cardiovascular Quality and... Sep 2019Qualitative research offers unique opportunities to contribute to cardiovascular outcomes research. Despite the growth in qualitative research over the last decade,... (Review)
Review
Qualitative research offers unique opportunities to contribute to cardiovascular outcomes research. Despite the growth in qualitative research over the last decade, outcomes investigators in cardiology still have relatively little guidance on when and how best to implement these methods in their investigations, leaving the full potential of these methods unrealized. We offer a contemporary look at qualitative methods, including publication trends of qualitative studies in cardiology journals from 1998 to 2018, novel emerging data collection and analytic methods, and current use and examples of cardiovascular outcomes research that apply qualitative methods such as user-centered design, preimplementation evaluation, implementation evaluation, effectiveness evaluation, and policy analysis.
Topics: Biomedical Research; Cardiology; Cardiovascular Diseases; Data Accuracy; Data Collection; Humans; Outcome Assessment, Health Care; Periodicals as Topic; Qualitative Research; Research Design
PubMed: 31510771
DOI: 10.1161/CIRCOUTCOMES.119.005828 -
American Journal of Surgery Jul 2022
Topics: Biomedical Research; Humans; Outcome Assessment, Health Care; Surgeons
PubMed: 35317922
DOI: 10.1016/j.amjsurg.2022.03.013 -
Expert Review of Pharmacoeconomics &... Jun 2024
Topics: Economics, Pharmaceutical; Humans; Outcome Assessment, Health Care; Periodicals as Topic; Journal Impact Factor
PubMed: 38591254
DOI: 10.1080/14737167.2024.2339945