-
International Journal of Population... 2021Linkage of administrative data for universal state education and National Health Service (NHS) hospital care would enable research into the inter-relationships between...
INTRODUCTION
Linkage of administrative data for universal state education and National Health Service (NHS) hospital care would enable research into the inter-relationships between education and health for all children in England.
OBJECTIVES
We aim to describe the linkage process and evaluate the quality of linkage of four one-year birth cohorts within the National Pupil Database (NPD) and Hospital Episode Statistics (HES).
METHODS
We used multi-step deterministic linkage algorithms to link longitudinal records from state schools to the chronology of records in the NHS Personal Demographics Service (PDS; linkage stage 1), and HES (linkage stage 2). We calculated linkage rates and compared pupil characteristics in linked and unlinked samples for each stage of linkage and each cohort (1990/91, 1996/97, 1999/00, and 2004/05).
RESULTS
Of the 2,287,671 pupil records, 2,174,601 (95%) linked to HES. Linkage rates improved over time (92% in 1990/91 to 99% in 2004/05). Ethnic minority pupils and those living in more deprived areas were less likely to be matched to hospital records, but differences in pupil characteristics between linked and unlinked samples were moderate to small.
CONCLUSION
We linked nearly all pupils to at least one hospital record. The high coverage of the linkage represents a unique opportunity for wide-scale analyses across the domains of health and education. However, missed links disproportionately affected ethnic minorities or those living in the poorest neighbourhoods: selection bias could be mitigated by increasing the quality and completeness of identifiers recorded in administrative data or the application of statistical methods that account for missed links.
HIGHLIGHTS
Longitudinal administrative records for all children attending state school and acute hospital services in England have been used for research for more than two decades, but lack of a shared unique identifier has limited scope for linkage between these databases.We applied multi-step deterministic linkage algorithms to 4 one-year cohorts of children born 1 September-31 August in 1990/91, 1996/97, 1999/00 and 2004/05. In stage 1, full names, date of birth, and postcode histories from education data in the National Pupil Database were linked to the NHS Personal Demographic Service. In stage 2, NHS number, postcode, date of birth and sex were linked to hospital records in Hospital Episode Statistics.Between 92% and 99% of school pupils linked to at least one hospital record. Ethnic minority pupils and pupils who were living in the most deprived areas were least likely to link. Ethnic minority pupils were less likely than white children to link at the first step in both algorithms.Bias due to linkage errors could lead to an underestimate of the health needs in disadvantaged groups. Improved data quality, more sensitive linkage algorithms, and/or statistical methods that account for missed links in analyses, should be considered to reduce linkage bias.
Topics: Child; England; Ethnicity; Hospitals; Humans; Medical Record Linkage; Minority Groups; State Medicine
PubMed: 34568585
DOI: 10.23889/ijpds.v6i1.1671 -
JAMA Otolaryngology-- Head & Neck... Aug 2023It is essential to measure an individual patient's baseline and follow-up abilities to demonstrate changes in clinical outcomes over time. Inherent in this strategy is...
Conditional Minimal Detectable Change for the Cochlear Implant Quality of Life-35 Profile Associated With Improved Functional Abilities 12 Months After Cochlear Implantation.
IMPORTANCE
It is essential to measure an individual patient's baseline and follow-up abilities to demonstrate changes in clinical outcomes over time. Inherent in this strategy is interpreting whether the measured change is clinically significant and beyond measurement error. Conditional minimal detectable change (cMDC) values are widely used in many disciplines but have rarely been established for outcome measures in otolaryngology or hearing research, and never in cochlear implantation.
OBJECTIVE
To determine cMDC values for the Cochlear Implant Quality of Life-35 (CIQOL-35) Profile instrument to enhance our understanding of the initial and ongoing changes in functional abilities from cochlear implants (CIs).
DESIGN, SETTING, AND PARTICIPANTS
Item response theory analyses of responses from a multi-institutional cohort of 705 CI users at a tertiary CI center were used to derive standard error (SE) values for each possible CIQOL-35 domain score. Using an iterative approach, these SE values were used to calculate cMDC values for every possible pre-CI and post-CI domain score combination. We then compared pre-CI to 12-month post-CI CIQOL-35 domains scores in an independent cohort of 65 adult CI users to determine whether the measured change exceeded error to be clinically significant. The analysis took place on December 14, 2022.
INTERVENTIONS
The CIQOL-35 Profile instrument and cochlear implantation.
RESULTS
The cMDC values were smaller for the communication domain, and global measure and cMDC values for all domains were larger at the extremes of the measurement scale. Overall, 60 CI users (92.3%) demonstrated improvement beyond cMDC at 12 months post-CI for at least 1 CIQOL-35 domain, and no patients' scores declined beyond cMDC for any domain. The percentage of CI users demonstrating improvement beyond cMDC varied by domain, with communication (53 [81.5%]) showing the largest number of CI users improving, followed by global (42 [64.6%]) and entertainment (40 [60.9%]). In general, CI users who demonstrated improvement in CIQOL-35 domains had greater improvement in speech recognition scores than patients who did not, but the strength and significance of these associations greatly varied by domain and speech material.
CONCLUSIONS AND RELEVANCE
This multistep cohort study found that cMDC values for the CIQOL-35 Profile provided personalized thresholds for detecting real changes in patient self-reported functional abilities over time across multiple domains, which may inform clinical decision-making. Moreover, these longitudinal results reveal the domains with more or less improvement, which may aid in patient counseling.
Topics: Adult; Humans; Cochlear Implants; Cochlear Implantation; Cohort Studies; Quality of Life; Speech Perception; Treatment Outcome
PubMed: 37318794
DOI: 10.1001/jamaoto.2023.1090 -
Inquiry : a Journal of Medical Care... 2023In recent years, the number of students enrolling in universities for higher education has increased, and these students are more diverse than ever before. Moreover, the...
In recent years, the number of students enrolling in universities for higher education has increased, and these students are more diverse than ever before. Moreover, the number of students with disabilities in higher educational institutions is also increasing. Therefore, their support needs are becoming more diverse and specialized. To examine how best to provide support to students who are unable to locate it, this study conducted a survey in which details were collected from students who were involved with university student support organizations, analyze the relationship between subjective adjustment and objective adjustment, and examine the trends in subjective quality of life (QOL). In total, 156 university students (age: mean = 22.14, standard deviation = 2.86, range = 18-7) were surveyed between April 2018 and March 2020. The Japanese version of the World Health Organization Quality of Life, Brief Version, was used to analyze trends in subjective QOL. The average QOL of students who were less likely to receive support was lower than that of the general population. The results also indicated that QOL decreased as the level of disability and health status increased. Furthermore, the results of the analysis of the relationship between the overall domain QOL and the domain-specific QOL suggested that the psychological and environmental domains contributed the most to the overall QOL. Accordingly, students at universities require assistance in a number of areas. Furthermore, it is essential to adjust the content and combination of support according to the objective level of adjustment.
Topics: Humans; Quality of Life; Students; Health Status; Disabled Persons; Surveys and Questionnaires
PubMed: 36964675
DOI: 10.1177/00469580231159728 -
Sichuan Da Xue Xue Bao. Yi Xue Ban =... May 2023Inflammasomes are important components of the innate immune system. They are assembled by cytoplasmic pattern recognition receptors and play a critical role in the... (Review)
Review
Inflammasomes are important components of the innate immune system. They are assembled by cytoplasmic pattern recognition receptors and play a critical role in the pathogenesis and progression of various inflammatory diseases through regulating the release and activation of inflammatory cytokines and inducing cell prytosis. NOD-like receptor family pyrin domain containing protein 3 (NLRP3) inflammasome has been widely studied and has been shown to be closely associated with cardiovascular diseases and metabolic disorders. Bone and joint diseases, such as osteoarthritis and rheumatoid arthritis show high prevalence worldwide and can cause bone and cartilage damage, pain, and dysfunction, adversely affecting the patients' quality of life. The reported findings of some studies indicate that the pathogenesis of various bone and articular diseases is associated with NLRP3 inflammasome. Small molecule antagonists targeting NLRP3 inflammasome have shown considerable therapeutic potentials, but their clinical application still needs further exploration. Herein, we reviewed the composition and function of NLRP3 inflammasome and its association with bone and articular diseases.
Topics: Humans; Inflammasomes; NLR Family, Pyrin Domain-Containing 3 Protein; NLR Proteins; Pyrin Domain; Quality of Life; Arthritis, Rheumatoid
PubMed: 37248605
DOI: 10.12182/20230560105 -
Frontiers in Public Health 2022Women usually have lower levels of moderate-vigorous physical activity (MVPA) than men. This sex gap can be accounted for by differences in MVPA in the work/household,...
BACKGROUND
Women usually have lower levels of moderate-vigorous physical activity (MVPA) than men. This sex gap can be accounted for by differences in MVPA in the work/household, transport, and/or leisure domains. Identifying where the differences lay in a context-specific manner may help close the gap. We aimed to compare MVPA by domain, and the relative contribution of each domain to total MVPA, between men and women in Chile.
METHODS
We analyzed the cross-sectional National Health Survey of Chile 2016-2017 ( = 5,056, 64% women, ≥18 years old). MVPA was estimated with the Global Physical Activity Questionnaire. MVPA was expressed in MET × min/week, and the relative contribution to total MVPA by each domain was expressed as percentage. Analyses were conducted including all participants, and also including participants reporting >0 MET × min/week of MVPA (relative contributions can only be computed in the latter).
RESULTS
Including all participants, women (vs. men) had lower MVPA (median [25-75th percentile]) for work/household (0 [0-960] vs. 0 [0-5,760] MET × min/week), for transport (360 [0-1,200] vs. 600 [0-1,680] MET × min/week), and for leisure domains (0 [0-0] vs. 0 [0-480] MET × min/week). Including only participants with >0 MET × min/week of MVPA, women (vs. men) had lower mean relative contributions to total MVPA from work/household (31.3 vs. 35.9%) and leisure domains (10.8 vs. 16.3%, respectively), but higher from the transport domain (57.9 vs. 47.8%).
CONCLUSION
In Chile, differences in all physical activity domains account for the sex gap in MVPA. Strategies to break job stereotypes, increase opportunities for leisure, and ease active transport are required to encourage MVPA in women.
Topics: Adolescent; Chile; Cross-Sectional Studies; Exercise; Family Characteristics; Female; Humans; Leisure Activities; Male
PubMed: 36249260
DOI: 10.3389/fpubh.2022.1011790 -
Science Immunology Jul 2020Limited data are available for pregnant women affected by SARS-CoV-2. Serological tests are critically important for determining SARS-CoV-2 exposures within both...
Limited data are available for pregnant women affected by SARS-CoV-2. Serological tests are critically important for determining SARS-CoV-2 exposures within both individuals and populations. We validated a SARS-CoV-2 spike receptor binding domain serological test using 834 pre-pandemic samples and 31 samples from COVID-19 recovered donors. We then completed SARS-CoV-2 serological testing of 1,293 parturient women at two centers in Philadelphia from April 4 to June 3, 2020. We found 80/1,293 (6.2%) of parturient women possessed IgG and/or IgM SARS-CoV-2-specific antibodies. We found race/ethnicity differences in seroprevalence rates, with higher rates in Black/non-Hispanic and Hispanic/Latino women. Of the 72 seropositive women who also received nasopharyngeal polymerase chain reaction testing during pregnancy, 46 (64%) were positive. Continued serologic surveillance among pregnant women may inform perinatal clinical practices and can potentially be used to estimate exposure to SARS-CoV-2 within the community.
Topics: Adult; Black or African American; Antibodies, Viral; Betacoronavirus; COVID-19; COVID-19 Testing; Clinical Laboratory Techniques; Cohort Studies; Coronavirus Infections; Female; Health Status Disparities; Hispanic or Latino; Humans; Immunoglobulin G; Immunoglobulin M; Pandemics; Philadelphia; Pneumonia, Viral; Pregnancy; Pregnancy Complications, Infectious; Protein Domains; SARS-CoV-2; Seroepidemiologic Studies; Spike Glycoprotein, Coronavirus; Young Adult
PubMed: 32727884
DOI: 10.1126/sciimmunol.abd5709 -
BMC Medical Education Sep 2023Medical residency is a part of postgraduate medical education and involves clinical training in a selected specialty. It is a challenging step in a physician's... (Observational Study)
Observational Study
BACKGROUND
Medical residency is a part of postgraduate medical education and involves clinical training in a selected specialty. It is a challenging step in a physician's professional development. This study aims to estimate the impact of the residency training program and demographic factors on the trainee's state of well-being (SOW).
METHODS
This was an observational cross-sectional study carried out in the year 2019-2020, which aimed to measure the SOW of residents undergoing clinical training in Riyadh, Saudi Arabia. A total of 260 residents participated in the study. A self-administered validated online the World Health Organization, Quality of Life Scale questionnaire- BREF was distributed to collect the data. The collected information on four different domains was analysed and compared across the baseline characteristics and different specialties. When appropriate, the independent sample t-test, bivariate correlation analysis, and ANOVA tests were used.
RESULTS
A total of 260 resident responses were included in the final analysis The results revealed a significant difference in physical health scores (p = 0.006), social relationship scores (p = 0.038), and environmental scores (p < 0.001) while no significant difference was found in psychological health scores among the physicians' specialties (p = 0.053). Post hoc comparison found statistically significant variations in the physical health domain between the medical and emergency specialties (p = 0.007), as well as surgical and emergency specialties (p = 0.024). There was also a significant difference between medical and emergency specialties (p = 0.008) in the social relationship domain. In the environment domain, significant variation was reported between medical specialties and emergency specialties (p = 0.001), as well asbetween surgical specialties and emergency specialties (p = 0.045). Female residents reported significantly lower quality of life in the physical (p = 0.020) and psychological (p = 0.032) domains.
CONCLUSIONS
A significant relationship was found between physical, social, and environmental domains according to residents' specialties. The factors that affected one or more domains included age, female gender, marital status, disease status, the number of on-calls received, and workload. We emphasize the importance of implementing policies to regulate working hours and on-call schedules as well as prioritizing mental health support.
Topics: Female; Animals; Saudi Arabia; Cross-Sectional Studies; Quality of Life; Medicine; Correlation of Data
PubMed: 37684578
DOI: 10.1186/s12909-023-04596-4 -
Neurology Nov 2022Infratentorial superficial siderosis (iSS) is a rare but disabling neurologic condition characterized by progressive hearing loss and balance and mobility problems. The... (Observational Study)
Observational Study
BACKGROUND AND OBJECTIVES
Infratentorial superficial siderosis (iSS) is a rare but disabling neurologic condition characterized by progressive hearing loss and balance and mobility problems. The functional decline in these neurologic domains with iSS progression is likely to adversely affect health-related quality of life (HRQoL). We studied the HRQoL of adults with iSS using 2 common generic HRQoL measures (Health Utilities Index Mark III [HUI3] and EuroQoL EQ5D [5 Level]) to determine the most affected domains and evaluate the association between HRQoL scores and disease duration.
METHODS
This observational study was an anonymous online survey. Following institutional Research Ethics Committee approval, we contacted dedicated international organizations, charities, and patient groups identified through online searches, social media, and collaborative networks, to distribute the study information and study link, inviting their members diagnosed with iSS to participate. Participation required access to a digital device connected to the Internet, confirmation of eligibility (aged 18 years and older and previously diagnosed with iSS), and informed consent to participate in the survey, which included study-specific questions (demographics, iSS, and hearing) and HRQoL questionnaires. Survey responses were captured by the Research Electronic Data Capture survey software and analyzed using the SPSS statistical package. Linear regression analysis was performed to investigate the association between HRQoL scores and disease duration.
RESULTS
Of 50 participants, 60% were male; the median (interquartile range [IQR]) age was 60 (15) years. The median (IQR) multiattribute scores for HUI3 and EQ5D were 0.36 (0.53) and 0.64 (0.33), respectively. The most frequently affected domains (moderate or worse category) were hearing (64%) and pain (48%) for HUI3 and mobility (54%) and pain (50%) for EQ5D. There was a weak association between disease duration and multiattribute scores for HUI3 (R = 0.353; adjusted R = 0.096; b = -0.008; = 0.047) but not EQ5D.
DISCUSSION
Our findings demonstrate low HRQoL scores that capture low functional status in several domains typically affected in iSS, suggesting that iSS has a major adverse effect on quality of life in multiple functional domains. Measures of HRQoL in iSS should be included in clinical and research settings, including treatment trials.
Topics: Adult; Humans; Male; Female; Quality of Life; Cross-Sectional Studies; Siderosis; Surveys and Questionnaires; Deafness; Pain
PubMed: 36008145
DOI: 10.1212/WNL.0000000000201115 -
Annals of Agricultural and... Sep 2023Diabetes is commonly classified as a chronic disease of affluence due to the frequency of its incidence and the rate of its spreading. The aim of the study was to...
INTRODUCTION AND OBJECTIVE
Diabetes is commonly classified as a chronic disease of affluence due to the frequency of its incidence and the rate of its spreading. The aim of the study was to evaluate the quality of life of geriatric patients with type 2 diabetes.
MATERIAL AND METHODS
294 seniors diagnosed with type 2 diabetes living in the Lower Silesian Province in south-western Poland took part in the study. The study used a self-developed questionnaire collecting clinical and socio-demographic data, the WHOQOL-Bref questionnaire, Acceptance of Illness Scale (AIS), Self-Care of Diabetes Inventory (SCODI) and the Geriatric Depression Scale (GDS).
RESULTS
Significant relationships of QoL with BMI, level of education and place of residence, were observed. BMI was significantly negatively correlated with the psychological domain of functioning and the environmental functioning, the level of education was correlated with physical health, psychological and environmental functioning, while the place of residence was correlated with the perception of the QoL and environmental functioning. Acceptance of illness was positively correlated with the perception of QoL and one's physical health. The results of regression analyses in predicting QoL in all domains showed that all models were a good fit for the data (p < 0.001), and the single predictor was maintenance of self-care. The level of depression was negatively correlated to a statistically significant degree with the perception of QoL and one's health condition.
CONCLUSIONS
BMI, level of education and place of residence had the highest impact on the quality of life of the participants. The quality of life of the participants improved with the increase in the acceptance of their illness. The higher the level of depression exhibited by the participants, the poorer they evaluated their quality of life.
Topics: Humans; Aged; Quality of Life; Diabetes Mellitus, Type 2; Chronic Disease; Educational Status; Surveys and Questionnaires
PubMed: 37772527
DOI: 10.26444/aaem/168415 -
Health Services Research Aug 2023To illustrate the association between the sociodemographic characteristics of hospital markets and the geographic patterns of Medicare hospital value-based purchasing...
OBJECTIVE
To illustrate the association between the sociodemographic characteristics of hospital markets and the geographic patterns of Medicare hospital value-based purchasing (HVBP) scores.
DATA SOURCES AND STUDY SETTING
This is a secondary analysis of United States hospitals with a HVBP Total Performance Score (TPS) for 2019 in the Centers for Medicare and Medicaid Services (CMS) Hospital Compare database (4/2021 release) and American Community Survey (ACS) data for 2015-2019.
STUDY DESIGN
This is a cross-sectional study using spatial multivariable autoregressive models with HVBP TPS and component domain scores as dependent variables and hospital market demographics as the independent variables.
DATA COLLECTION/EXTRACTION METHODS
We calculated hospital market demographics using ZIP code level data from the ACS, weighted the 2019 CMS inpatient Hospital Service Area file.
PRINCIPAL FINDINGS
Spatial autoregressive models using eight nearest neighbors with diversity index, race and ethnicity distribution, families in poverty, unemployment, and lack of health insurance among residents ages 19-64 years provided the best model fit. Diversity index had the highest statistically significant contribution to lower TPS (ß = -12.79, p < 0.0001), followed by the percent of the population coded to "non-Hispanic, some other race" (ß = -2.59, p < 0.0023), and the percent of families in poverty (ß = -0.26, p < 0.0001). Percent of the population was non-Hispanic American Indian/Alaskan Native (ß = 0.35, p < 0.0001) and percent non-Hispanic Asian (ß = 0.12, p < 0.02071) were associated with higher TPS. Lower predicted TPS was observed in large urban cities throughout the US as well as in states throughout the Southeastern US. Similar geographic patterns were observed for the predicted Patient Safety, Person and Community Engagement, and Efficiency and Cost Reduction domain scores but are not for predicted Clinical Outcomes scores.
CONCLUSIONS
The lower predicted scores seen in cities and in the Southeastern region potentially reflect an inherent-that is, structural-association between market sociodemographics and HVBP scores.
Topics: Aged; Humans; United States; Value-Based Purchasing; Cross-Sectional Studies; Medicare; Hospitals; Demography; Geography
PubMed: 36755373
DOI: 10.1111/1475-6773.14141