Insulin therapy plays a crucial role in the management of type 2 diabetes as the disease progresses.Over the past century,insulin formulations have undergone significant modifications and bioengineering,resulting in a...Insulin therapy plays a crucial role in the management of type 2 diabetes as the disease progresses.Over the past century,insulin formulations have undergone significant modifications and bioengineering,resulting in a diverse range of available insulin products.These products show distinct pharmacokinetic and pharmacodynamic profiles.Consequently,various insulin regimens have em-erged for the management of type 2 diabetes,including premixed formulations and combinations of basal and bolus insulins.The utilization of different insulin regimens yields disparate clinical outcomes,adverse events,and,notably,patient-reported outcomes(PROs).PROs provide valuable insights from the patient’s perspective,serving as a valuable mine of information for enhancing healthcare and informing clinical decisions.Adherence to insulin therapy,a critical patient-reported outcome,significantly affects clinical outcomes and is influenced by multiple factors.This review provides insights into the clinical effectiveness of various insulin preparations,PROs,and factors impacting insulin therapy adherence,with the aim of enhancing healthcare practices and informing clinical decisions for individuals with type 2 diabetes.展开更多
BACKGROUND Hip dysplasia(HD)is characterized by insufficient acetabular coverage of the femoral head,leading to a predisposition for osteoarthritis.While radiographic measurements such as the lateral center edge angle...BACKGROUND Hip dysplasia(HD)is characterized by insufficient acetabular coverage of the femoral head,leading to a predisposition for osteoarthritis.While radiographic measurements such as the lateral center edge angle(LCEA)and Tönnis angle are essential in evaluating HD severity,patient-reported outcome measures(PROMs)offer insights into the subjective health impact on patients.AIM To investigate the correlations between machine-learning automated and manual radiographic measurements of HD and PROMs with the hypothesis that artificial intelligence(AI)-generated HD measurements indicating less severe dysplasia correlate with better PROMs.METHODS Retrospective study evaluating 256 hips from 130 HD patients from a hip preservation clinic database.Manual and AI-derived radiographic measurements were collected and PROMs such as the Harris hip score(HHS),international hip outcome tool(iHOT-12),short form(SF)12(SF-12),and Visual Analogue Scale of the European Quality of Life Group survey were correlated using Spearman's rank-order correlation.RESULTS The median patient age was 28.6 years(range 15.7-62.3 years)with 82.3%of patients being women and 17.7%being men.The median interpretation time for manual readers and AI ranged between 4-12 minutes per patient and 31 seconds,respectively.Manual measurements exhibited weak correlations with HHS,including LCEA(r=0.18)and Tönnis angle(r=-0.24).AI-derived metrics showed similar weak correlations,with the most significant being Caput-Collum-Diaphyseal(CCD)with iHOT-12 at r=-0.25(P=0.042)and CCD with SF-12 at r=0.25(P=0.048).Other measured correlations were not significant(P>0.05).CONCLUSION This study suggests AI can aid in HD assessment,but weak PROM correlations highlight their continued importance in predicting subjective health and outcomes,complementing AI-derived measurements in HD management.展开更多
Chinese medicine (CM) has been an experience based practice over the past three thousand years. The safety and efficacy of CM has been practised through experience, rather than nowadays’ modern scientific measurement...Chinese medicine (CM) has been an experience based practice over the past three thousand years. The safety and efficacy of CM has been practised through experience, rather than nowadays’ modern scientific measurements. In this way, the development of CM has not been keeping pace with the advance in science and technology and the progress in orthodox medicine. In order to meet the requirements of modern science and technology, an evidence based approach must be adopted. Reassurance is needed to convince people for safety and efficacy of CM and give confidence to the evidence based demands ——“Tradition is confirmed by Modern Science” (1) .展开更多
Objective: To compare patient-reported outcomes after implantation of the ZA9003 intraocular lens(IOLs), or the MCX11 ASP IOLs or the spherical IOLs(HQ-201HEP). Methods: Prospective nonrandomized controlled trial was ...Objective: To compare patient-reported outcomes after implantation of the ZA9003 intraocular lens(IOLs), or the MCX11 ASP IOLs or the spherical IOLs(HQ-201HEP). Methods: Prospective nonrandomized controlled trial was used. A total of 105 patients(210 eyes) were divided into three groups according to the type of IOLs: ZA9003(35 patients, 70 eyes), MCX11 ASP(35 patients, 70 eyes) or HQ-201HEP(35 patients, 70 eyes). The main outcome was scores of Catquest nine-item short-form questionnaire. Additional outcome was best corrected visual acuities, spherical aberration(SA) and total higher-order aberrations(HOAs). Results: The global score was significantly lower in the spherical IOL group than the aspherical IOL group of-020 μm SA(P < 0.05) and the aspherical IOL group of-027 μm SA(P < 0.05), and no significant difference was found in the global score between the aspherical IOL group of-020 μm SA than the aspherical IOL group of-027 μm SA(P > 0.05). Significant differences were also found in question 2, question 5, question 6 and question 8 between the spherical IOLs and the aspherical IOLs. Conclusion: Implantation of an aspherical IOL could improve vision-related quality of life compared with a spherical IOL. However, there were no statistically significant differences in vision-related quality of life between aspheric IOLs with different negative spherical aberrations.展开更多
Objective:To investigate and analyze the changes of nutritional status in patients undergoing postoperative adjuvant chemotherapy for gastrointestinal tumors based on patient-reported outcomes.Methods:From July 2020 t...Objective:To investigate and analyze the changes of nutritional status in patients undergoing postoperative adjuvant chemotherapy for gastrointestinal tumors based on patient-reported outcomes.Methods:From July 2020 to March 2021,60 patients with gastrointestinal tumor who received adjuvant chemotherapy for the first time after surgery under the oncology department of a third-level,first-class hospital in Shaanxi Province were recruited by convenience sampling.The patient-reported nutritional evaluation outcomes within 24 hours after admission and during the fourth chemotherapy cycle incorporated nutritional risk screening 2002(NRS2002),Functional Assessment of Anorexia/Cachexia Therapy(FAACT),psychological pain screening,Generalized Anxiety Disorder Assessment(GAD-7),Patient Health Questionnaire-9(PHQ-9)to screen for depression,dietary self-assessment,health index scale(EQ-5D),and nutrition supervisor overall assessment scale.Results:The self-reported nutritional evaluation outcomes by adjuvant chemotherapy patients showed an upward trend along with their chemotherapy cycle.Their PG-SGA score,FAACT score,psychological pain score,and EQ-5D score during the fourth cycle were better than those during the first chemotherapy cycle(p<0.05)・Conclusion:Based on the patient・reported nutritional evaluation outcomes,the nutritional status and quality of life of patients with gastrointestinal tumors during chemotherapy did not worsen.Medical staff should timely evaluate the nutritional status of patients with gastrointestinal tumors during chemotherapy and implement reasonable nutritional intervention to improve the quality of life of patients.In the future,patient-reported outcomes should be considered for integration into clinical practice in order to facilitate patient participation in decision-making and improve their medical experience.展开更多
AIM To establish minimum clinically important difference(MCID) for measurements in an orthopaedic patient population with joint disorders.METHODS Adult patients aged 18 years and older seeking care for joint condition...AIM To establish minimum clinically important difference(MCID) for measurements in an orthopaedic patient population with joint disorders.METHODS Adult patients aged 18 years and older seeking care for joint conditions at an orthopaedic clinic took the Patient-Reported Outcomes Measurement Information System Physical Function(PROMIS~? PF) computerized adaptive test(CAT), hip disability and osteoarthritis outcome score for joint reconstruction(HOOS JR), and the knee injury and osteoarthritis outcome score for joint reconstruction(KOOS JR) from February 2014 to April 2017. MCIDs were calculated using anchorbased and distribution-based methods. Patient reports of meaningful change in function since their first clinic encounter were used as an anchor.RESULTS There were 2226 patients who participated with a mean age of 61.16(SD = 12.84) years, 41.6% male, and 89.7% Caucasian. Mean change ranged from 7.29 to 8.41 for the PROMIS~? PF CAT, from 14.81 to 19.68 for the HOOS JR, and from 14.51 to 18.85 for the KOOS JR. ROC cut-offs ranged from 1.97-8.18 for the PF CAT, 6.33-43.36 for the HOOS JR, and 2.21-8.16 for the KOOS JR. Distribution-based methods estimated MCID values ranging from 2.45 to 21.55 for the PROMIS~? PF CAT; from 3.90 to 43.61 for the HOOS JR, and from 3.98 to 40.67 for the KOOS JR. The median MCID value in the range was similar to the mean change score for each measure and was 7.9 for the PF CAT, 18.0 for the HOOS JR, and 15.1 for the KOOS JR.CONCLUSION This is the first comprehensive study providing a wide range of MCIDs for the PROMIS? PF, HOOS JR, and KOOS JR in orthopaedic patients with joint ailments.展开更多
Background: Patient-reported outcomes of the quality of life (QOL) after an open thoracotomy have not been studied. To determine the physical and mental changes in surgical patients is very important for medical staff...Background: Patient-reported outcomes of the quality of life (QOL) after an open thoracotomy have not been studied. To determine the physical and mental changes in surgical patients is very important for medical staffs. The surgical patient’s satisfaction and overall healthy changes were evaluated by the patient-self assessment questionnaires. Materials and Methods: From July 2007 to April 2008, 26 patients with non-small cell lung cancer (NSCLC) underwent surgical resection. The outcome of the QOL was evaluated by using two kinds of questionnaire surveys from the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and the anti-aging QOL assessment (AA-QOL). The EORTC QLQ-C30 consisted of five domains (physical, role, cognitive, emotional, and social functionings) and global QOL. The AA-QOL contained 51 items;30 physical and 21 mental symptoms regarding the elderly and the aging population. The patients replied to the two questionnaires at two different times, i.e., at pre-surgery (baseline) and at post-surgery (2 weeks after the operation). The obtained data of these scores were averaged and compared between the two points of the pre-surgery and post-surgery. Results: Regarding the outcomes of the EORTC QLQ-C30, the physical and social functioning became significantly worse after the surgery. In contrast, the global QOL significantly became better after the surgery. For the symptom at post-surgery, three of which were “nausea and vomiting”, “pain”, and “appetite loss”, became significantly worse compared to those at pre-surgery. Regarding the outcomes of the AA-QOL, the physical symptoms (muscular pain/stiffness, palpitations, dyspnea, no feeling of good health, anorexia, and coughing and sputum) became significantly worse after the surgery. Regarding the mental symptoms, there were no significant differences. Conclusions: Regarding the outcomes based on the changes in the QOL after surgery, the physical symptoms became worse compared to the mental symptoms. To clarify the perioperative healthy changes of the QOL reported by patients with lung cancers is very important for multidisciplinary teamwork, which should play a role in providing the appropriate care and treatment and useful information for a preoperative patient’s decision making of receiving surgical treatment.展开更多
Background: Patient-reported outcomes (PROs) of quality of life (QOL) during chemotherapy involving lung cancer are very important for the medical staffs. Patients’ satisfaction and healthy changes were evaluated by ...Background: Patient-reported outcomes (PROs) of quality of life (QOL) during chemotherapy involving lung cancer are very important for the medical staffs. Patients’ satisfaction and healthy changes were evaluated by the patient-self assessment. Materials and Methods: From July 2007 to April 2008, a total of 19 patients received chemotherapy. The QOL data were collected by using the QOL questionnaire for cancer patients treated with anticancer drugs (QOL-ACD) and the anti-aging QOL assessment (AA-QOL). The AA-QOL contained 51 items: 30 of physical and 21 of mental symptoms of the elderly and the aging population. The patients replied to the questions at two different times, i.e., at pre-chemotherapy (baseline) and at post-chemotherapy (2 weeks after the chemotherapy). Results: Regarding the hematological toxicities, for the grade 3/4 toxicities, there were 12 neutropenia (12/19, 63.2%) and 3 thrombocytopenia (3/19, 15.8%). For the grade 3 febrile neutropenia, there were 5 cases (5/19, 26.3%). Regarding the non-hematological toxicities, there was no grade 3 and grade 4 toxicities. Based on the outcomes of the QOL-ACD, the three items (“physical condition”, “social attitude”, and “overall QOL”) at post-chemotherapy became significantly worse compared to the baseline. Regarding the outcomes of the AA-QOL, 4 items of physical symptoms (“thirst”, “anorexia”, “early satiety”, and “diarrhea”) became significantly worse compared to the baseline. Regarding the mental symptoms, 2 items (“nothing to look forward in life” and “a sense of uselessness”) became significantly worse compared to the baseline. Conclusion: Regarding the PROs of the QOL during the chemotherapy term, both the physical and mental symptoms had become worse. To clarify the changes in the QOL during chemotherapy is very important for multidisciplinary teamwork, which should play the role of providing the appropriate cares and treatment as patient-support.展开更多
Prostate cancer is affecting a higher proportion of male population. Health Related Quality of Life assessment can guide the development of an interdisciplinary and patient-centered care intervention. This study is ai...Prostate cancer is affecting a higher proportion of male population. Health Related Quality of Life assessment can guide the development of an interdisciplinary and patient-centered care intervention. This study is aimed to assess Health Related Quality of Life in prostate cancer patients. Relationships between socio-demographic, clinical characteristics and patient-reported outcomes have been considered. Consecutive outpatients with prostate cancer, admitted at the Urology Clinic of the Instituto Português de Oncologia do Porto, were studied (n = 300). Health Related Quality of Life was assessed as part of the routine practice. The European Organisation for Research and Treatment of Cancer general questionnaire, QLQ-C30, and its specific module for prostate cancer patients, QLQ-PR25, were used. Evolution along time (elapsed since diagnosis, and up to 5 years) was considered in order to search for a prognosis prediction in prostate cancer patients. This study confirms the feasibility of a systematic Health Related Quality of Life assessment. Global Health Related Quality of Life was found to be higher 6 months after diagnosis, decreasing then until the second year after diagnosis and improving thereafter. A peak with better scores was identified at the fifth year after diagnosis. Social and physical dimensions revealed a similar pattern. Clinical significance was found 6 months and 5 years after diagnosis. The prospective analysis of Health Related Quality of Life changes is able to explore the patients’ outcomes in order to find patterns and relationships for prognosis prediction along the disease course. Such approach might promote patient confidence and thus a better cancer experience.展开更多
Background:Lung cancer is one of the most common cancers globally with high incidence and mortality rate.Acupuncture and moxibustion have been used as adjuvant therapies to relieve the symptoms and complications of lu...Background:Lung cancer is one of the most common cancers globally with high incidence and mortality rate.Acupuncture and moxibustion have been used as adjuvant therapies to relieve the symptoms and complications of lung cancer.At present,acupuncture and moxibustion can partially improve the quality of life(QOL)of cancer patients.However,the evidence that acupuncture and moxibustion can improve patient-reported outcomes(PROs)in patients with lung cancer is still insufficient.We aimed to conduct a systematic review and meta-analysis of published randomized controlled trials(RCTs)to determine whether acupuncture and moxibustion can improve PROs among patients with lung cancer,providing a support basis for acupuncture and moxibustion inclusion in relevant guidelines.Methods:We will search the following electronic databases:PubMed,Embase,Cochrane Library,Web of Science,CNKI,CQVIP,Wanfang Data,Sinomed,and gray literature including the ClinicalTrials.gov Database(clinicaltrials.gov)and Chinese Clinical Trial Register(chictr.org.cn).All English and Chinese articles will be searched until July 1,2021.Two researchers independently extracted data.Any disagreement was resolved by discussion until consensus was reached or by consulting a third researcher.The primary outcomes mainly included the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire(EORTC QLQ-C30),functional assessment of cancer therapy-lung(FACT-L),and Karnofsky Performance Status(KPS).The secondary outcomes included improvement of individual lung cancerrelated symptoms and the safety of acupuncture intervention.Discussion:Our study is the first to focus on the PROs of acupuncture and moxibustion for lung cancer treatment.The results will contribute to a deeper understanding of the evidence distribution of acupuncture and moxibustion in PROs,which may support the use of acupuncture and moxibustion in lung cancer patients.展开更多
BACKGROUND Thermal ablation(TA)has been proved to be effective and safe as minimally invasive treatment method for thyroid nodules.However,patients'experience during the procedures and quality of life varies among...BACKGROUND Thermal ablation(TA)has been proved to be effective and safe as minimally invasive treatment method for thyroid nodules.However,patients'experience during the procedures and quality of life varies among operators.AIM To explore strategy to improve quality of life and subjective experiences during TA for papillary thyroid carcinoma(PTC)based on thermal field management(TFM).METHODS This retrospective propensity-matched cohort study was conducted in a single center.A total of 490 patients with PTC treated with TA from September 2023 to August 2024 were studied and divided into two groups(TFM group and non-TFM group)according to treatment strategies.Propensity score matching(PSM)was used to control for confounding factors.Complications,side effect and com-plaints of patients were compared between the two groups.RESULTS A total of 113 patients(41.7±10.6;31 men,82 women)were assigned to the TFM group,and 377 patients(mean age,41.1±10.7 year;116 men,261 women)were assigned to the non-TFM group.After PSM,a total of 108 patients were included in the TFM group,and 216 patients were included in the non-TFM group.The median follow-up was 10 months(range from 4-15 months).The incidence of voice change in the TFM group was significantly lower than that in the non-TFM group(0.9%vs 6.5%;P=0.049).Although there was no statistically significant difference in rate of pain between the two groups,the proportion of complaining of pain in the TFM group was numerically lower than that in the non-TFM group(3.7%vs 9.7%,P=0.090).CONCLUSION TFM,as a novel procedural optimization technique,can effectively improve quality of life and subjective expe-riences of patients during TA for PTC.展开更多
The critical role of patient-reported outcome measures(PROMs)in enhancing clinical decision-making and promoting patient-centered care has gained a profound significance in scientific research.PROMs encapsulate a pati...The critical role of patient-reported outcome measures(PROMs)in enhancing clinical decision-making and promoting patient-centered care has gained a profound significance in scientific research.PROMs encapsulate a patient's health status directly from their perspective,encompassing various domains such as symptom severity,functional status,and overall quality of life.By integrating PROMs into routine clinical practice and research,healthcare providers can achieve a more nuanced understanding of patient experiences and tailor treatments accordingly.The deployment of PROMs supports dynamic patient-provider interactions,fostering better patient engagement and adherence to tre-atment plans.Moreover,PROMs are pivotal in clinical settings for monitoring disease progression and treatment efficacy,particularly in chronic and mental health conditions.However,challenges in implementing PROMs include data collection and management,integration into existing health systems,and acceptance by patients and providers.Overcoming these barriers necessitates technological advancements,policy development,and continuous education to enhance the acceptability and effectiveness of PROMs.The paper concludes with recommendations for future research and policy-making aimed at optimizing the use and impact of PROMs across healthcare settings.展开更多
Objective:To investigate whether the combination of chemotherapy with staged Chinese herbal medicine(CHM) therapy could enhance health-related quality of life(QoL) in non-small-cell lung cancer(NSCLC)patients and prol...Objective:To investigate whether the combination of chemotherapy with staged Chinese herbal medicine(CHM) therapy could enhance health-related quality of life(QoL) in non-small-cell lung cancer(NSCLC)patients and prolong the time before deterioration of lung cancer symptoms,in comparison to chemotherapy alone.Methods:A prospective,double-blind,randomized,controlled trial was conducted from December 14,2017 to August 28,2020.A total of 180 patients with stage ⅠB-ⅢA NSCLC from 5 hospitals in Shanghai were randomly divided into chemotherapy combined with CHM(chemo+CHM) group(120 cases) or chemotherapy combined with placebo(chemo+placebo) group(60 cases) using stratified blocking randomization.The European Organization for Research and Treatment of Cancer(EORTC) Quality-of-Life-Core 30 Scale(QLQ-C30) was used to evaluate the patient-reported outcomes(PROs) during postoperative adjuvant chemotherapy in patients with early-stage NSCLC.Adverse events(AEs) were assessed in the safety analysis.Results:Out of the total 180 patients,173 patients(116in the chemo+CHM group and 57 in the chemo+placebo group) were included in the PRO analyses.The initial mean QLQ-C30 Global Health Status(GHS)/QoL scores at baseline were 57.16±1.64 and 57.67±2.25 for the two respective groups(P>0.05).Compared with baseline,the chemo+CHM group had an improvement in QLQ-C30GHS/QoL score at week 18 [least squares mean(LSM) change 17.83,95% confidence interval(CI) 14.29 to 21.38].Conversely,the chemo+placebo group had a decrease in the score(LSM change-13.67,95% CI-22.70 to-4.63).A significant between-group difference in the LSM GHS/QoL score was observed,amounting to 31.63 points(95% CI25.61 to 37.64,P<0.001).The similar trends were observed in physical functioning,fatigue and appetite loss.At week 18,patients in the chemo+CHM group had a higher proportion of improvement or stabilization in GHS/QoL functional and symptom scores compared to chemo+placebo group(P<0.001).The median time to deterioration was longer in the chemo+CHM group for GHS/QoL score [hazard ratio(HR)=0.33,95% CI 0.23 to 0.48,P<0.0010],physical functioning(HR=0.43,95% CI 0.25 to 0.75,P=0.0005),fatigue(HR=0.47,95% CI 0.30 to 0.72,P<0.0001) and appetite loss(HR=0.65,95% CI 0.42to 1.00,P=0.0215).The incidence of AEs was lower in the chemo+CHM group than in the chemo+placebo group(9.83% vs.15.79%,P=0.52).Conclusion:The staged CHM therapy could help improve the PROs of postoperative patients with early-stage NSCLC during adjuvant chemotherapy,which is worthy of further clinical research.(Registry No.NCT03372694)展开更多
Background Sacral neuromodulation (SNM) treatment of refractory urinary symptoms is associated with quality of life improvements using disease-specific instruments. There is a paucity of information relating universal...Background Sacral neuromodulation (SNM) treatment of refractory urinary symptoms is associated with quality of life improvements using disease-specific instruments. There is a paucity of information relating universal health outcomes to effective treatment of urinary symptoms. The objective was to analyze changes in Patient-Reported Outcomes Measurement Information System (PROMIS) item-bank scores following SNM for treating refractory lower urinary tract symptoms (LUTS).Materials and methods This is a sub-analysis collected from an institutional review board approved, retrospective chart review evaluating changes between pre- and post-procedure PROMIS scores in subjects undergoing successful SNM implantation for refractory LUTS at a multidisciplinary adult continence clinic. The difference between pre- and post-procedure PROMIS scores was compared via two-sided Wilcoxon signed-rank test, with p <0.05 considered statistically significant.Results Of the 29 subjects, most were female (89.66%), Caucasian (68.97%), nonsmokers (89.66%) with public insurance (62.07%). The median age was 63years and body mass index was 33.2kg/m^(2). Procedure indications included urinary urge incontinence (83%), mixed urinary incontinence (10%), retention (17.24%), and overactive bladder (3%). Pain Interference and Depression scores had a nonsignificant improvement from 64.2 (ranging 58.9–67.5) to 60.75 (ranging 55.2–67.2), p = 0.21, and 55.2 (ranging 51.5–59.9) to 53.4 (ranging 49.5–61.1), p = 0.33, respectively. Median Physical Function scores demonstrated nonsignificant worsening following implantation from 38.0 (ranging 34.7–40.9) to 36.1 (ranging 33.1–40.8) (p = 0.25). Twenty-one subjects (72%) reported an improvement in at least 1 PROMIS item-bank with 6 subjects (21%) reporting no improvement in any of the item-banks.Conclusions Treatment of refractory LUTS with SNM resulted in no statistically significant changes in the PROMIS item-banks of Physical Function, Pain Interference, or Depression. Further prospective investigation is necessary to delineate the relationship of the self-reported universal-health outcomes in the treatment of LUTS.展开更多
Objective:Endometrial tuberculosis,which commonly affects women of reproductive age,is a significant cause of intrauterine adhesions(IUA),potentially leading to hypomenorrhea,amenorrhea,and infertility.Hysteroscopic a...Objective:Endometrial tuberculosis,which commonly affects women of reproductive age,is a significant cause of intrauterine adhesions(IUA),potentially leading to hypomenorrhea,amenorrhea,and infertility.Hysteroscopic adhesiolysis is the primary treatment for IUA;however,studies specifically addressing its efficacy in tuberculosisinduced IUA remain scarce.This study aims to evaluate the therapeutic outcomes of hysteroscopic adhesiolysis for IUA caused by endometrial tuberculosis.Methods:This retrospective cohort study included patients diagnosed with tuberculosisinduced IUA who underwent hysteroscopic adhesiolysis at the Third Xiangya Hospital of Central South University between May 2014 and October 2022.Clinical data including age,medical history,adhesion severity,surgical treatment,and reproductive outcomes were analyzed.Results:Among 39 patients identified,2 were lost to follow-up.A total of 37 patients were included,with a follow-up duration ranging from 6 months to 9 years.Hypomenorrhea was reported in 24(64.9%)patients,secondary amenorrhea in 10(27.0%)patients,and normal menstruation in 3(8.1%)patients.Most patients presented with primary infertility(59.5%),and only 2(5.4%)had secondary infertility.The median American Fertility Society(AFS)score at initial assessment was 10(range,8−12);8(21.6%)patients had moderate IUA,and 29(78.4%)had severe IUA.A total of 86 surgical procedures were performed across 37 patients,with 27 patients undergoing 2 or more surgeries.Postoperatively,25(67.6%)patients achieved normalization of the uterine cavity,while 12(32.4%)still had a reduced cavity.Only 7(18.9%)patients had a grossly normal endometrium at the final surgery,all of whom had moderate adhesions at the initial procedure.Menstrual flow returned to normal in 12(32.4%)patients,while 25(67.6%)continued to experience hypomenorrhea.Of 29 patients who attempted in vitro fertilization and embryo transfer(IVF-ET),only 6(20.7%)conceived.Among these,4(13.8%)delivered at term via cesarean section;one case was complicated by postpartum hemorrhage due to uterine atony and another by placental adhesion.Conclusion:Endometrial tuberculosis can lead to severe IUA.Hysteroscopic adhesiolysis facilitates cavity restoration and improvement of menstrual conditions,but the overall reproductive outcomes remain suboptimal.展开更多
Objective:To develop a patient-reported traditional Chinese medicine kidney deficiency pattern(TCMKDP)scale for colorectal cancer(CRC)patients and evaluate its reliability and validity.Methods:We administered the TCM-...Objective:To develop a patient-reported traditional Chinese medicine kidney deficiency pattern(TCMKDP)scale for colorectal cancer(CRC)patients and evaluate its reliability and validity.Methods:We administered the TCM-KDP questionnaire to postoperative patients with stage II and III CRC as part of a multicenter randomized controlled trial(RCT)conducted in China from December 2018 to September 2021.The TCM-KDP scale consists of eight items on patient-reported symptoms and is scored on a five-point Likert scale.The scale’s reliability was assessed using Cronbach’s a and test-retest reliability,while content validity was evaluated with the content validity index.We compared the differences in serum cytokine levels and other clinical factors between patients with higher and lower KDP scores.Results:Of the 378 patients analyzed in the original RCT,352(93.2%)completed the TCM-KDP questionnaire.The Cronbach’s a of the eight-item TCM-KDP scale was 0.734,and the test-retest reliability was 0.745.Our exploratory factor analysis yielded eight factors that explained the variance of 50.34%.The mean TCM-KDP score was 2.80±0.92.Compared with patients with stage II CRC,those with stage III CRC had significantly higher TCM-KDP scores(2.25 vs.2.50,P=.026).We categorized all patients into highor low-KDP score groups(the cut-off score was 2.8).Patients with lower TCM-KDP scores had significantly higher serum interleukin-1b expression levels(P=.04).Conclusion:The patient-reported TCM-KDP scale demonstrated relatively good feasibility,internal consistency,and test-retest reliability among patients with CRC.Future studies could apply this scale to other cancer types and diseases.展开更多
BACKGROUND Meniscal tears are one of the most common knee injuries.After the diagnosis of a meniscal tear has been made,there are several factors physicians use to guide clinical decision-making.The influence of time ...BACKGROUND Meniscal tears are one of the most common knee injuries.After the diagnosis of a meniscal tear has been made,there are several factors physicians use to guide clinical decision-making.The influence of time between injury and isolated meniscus repair on patient outcomes is not well described.Assessing this relationship is important as it may influence clinical decision-making and can add to the preoperative patient education process.We hypothesized that increasing the time from injury to meniscus surgery would worsen postoperative outcomes.AIM To investigate the current literature for data on the relationship between time between meniscus injury and repair on patient outcomes.METHODS PubMed,Academic Search Complete,MEDLINE,CINAHL,and SPORTDiscus were searched for studies published between January 1,1995 and July 13,2023 on isolated meniscus repair.Exclusion criteria included concomitant ligament surgery,incomplete outcomes or time to surgery data,and meniscectomies.Patient demographics,time to injury,and postoperative outcomes from each study were abstracted and analyzed.RESULTS Five studies met all inclusion and exclusion criteria.There were 204(121 male,83 female)patients included.Three of five(60%)studies determined that time between injury and surgery was not statistically significant for postoperative Lysholm scores(P=0.62),Tegner scores(P=0.46),failure rate(P=0.45,P=0.86),and International Knee Documentation Committee scores(P=0.65).Two of five(40%)studies found a statistically significant increase in Lysholm scores with shorter time to surgery(P=0.03)and a statistically significant association between progression of medial meniscus extrusion ratio(P=0.01)and increasing time to surgery.CONCLUSION Our results do not support the hypothesis that increased time from injury to isolated meniscus surgery worsens postoperative outcomes.Decision-making primarily based on injury interval is thus not recommended.展开更多
Background: The maternal and neonatal morbidity caused by prolonged labour, maternal exhaustion and other factors push clinicians to speed up the delivery process by employing equipment such as vacuum suction or force...Background: The maternal and neonatal morbidity caused by prolonged labour, maternal exhaustion and other factors push clinicians to speed up the delivery process by employing equipment such as vacuum suction or forceps to save the newborn. The purpose of this study was to determine the prevalence of vacuum-assisted vaginal delivery (VAVD) and its associated short-term maternal and neonatal outcomes at Ndola Teaching Hospital. Methods: A retrospective cross-sectional descriptive study through the analysis of routine data for women with singleton-term pregnancies who delivered by vacuum compared with spontaneous vaginal delivery was done at a tertiary hospital for the years 2020 and 2021. Chi-square and Logistic regression were used to investigate factors of vacuum delivery and to adjust for potential confounders. Results: Results showed that VAVD was mostly performed in women who had delayed second stage of labour (25.4%), maternal exhaustion (16.0%), foetal distress in the second stage of labour (12.3%). The overall VAVD prevalence was 3.7% (581/15591). Logistic regression showed that multiparous women were noted to be 87.5% (aOR 0.125;95% CI 0.025 - 0.629;p = 0.012) less likely to undergo VAVD compared to nulliparous women. Registrars were almost 6 times (aOR 5.650;95% CI 1.458 - 22.222, p = 0.012) more likely to conduct VAVD compared to midwives. Episiotomy was 3 times (aOR 3.390;95% CI 1.185 - 9.524;p Conclusion: The findings indicate the underutilisation of VAVD at NTH based on the low prevalence of 3.7%. VAVD outcomes were affected by multiparity, skill level and Episiotomy procedure, in addition, VAVD influenced admission to the NICU. Hence, there is a need to increase skills in VAVD among first-line healthcare workers such as midwives and intern doctors.展开更多
This study investigates the effects of AI-mediated communication (AMC) on trust-building and negotiation outcomes in professional remote collaboration settings. Through a mixed-methods approach combining experimental ...This study investigates the effects of AI-mediated communication (AMC) on trust-building and negotiation outcomes in professional remote collaboration settings. Through a mixed-methods approach combining experimental design and qualitative analysis (N = 120), we examine how AI intermediaries influence communication dynamics, relationship building, and decision-making processes. Results indicate that while AMC initially creates barriers to trust formation, it ultimately leads to enhanced communication outcomes and stronger professional relationships when implemented with appropriate transparency and support. The study revealed a 31% improvement in cross-cultural understanding and a 24% increase in negotiation satisfaction rates when using AI-mediated channels with proper transparency measures. These findings contribute to the theoretical understanding of technology-mediated communication and practical applications for organizations implementing AI communication tools.展开更多
This editorial offers insights from a minireview by Venkatesh et al,who explored pharmacological adjuvants for diabetic vitrectomy.Specifically,they synthesized current knowledge and evaluated the efficacy of various ...This editorial offers insights from a minireview by Venkatesh et al,who explored pharmacological adjuvants for diabetic vitrectomy.Specifically,they synthesized current knowledge and evaluated the efficacy of various adjunctive therapies in improving the outcomes of diabetic retinopathy and managing associated complications.Herein,we highlight the key roles of pharmacological adjuvants in optimizing surgical techniques,minimizing intraoperative challenges,and enhancing postoperative recovery.We further discuss the potential implications of this approach for clinical practice and future research directions in this evolving field.Overall,this editorial underscores the importance of incorporating pharmacological adjuvants into standard diabetic vitrectomy care to improve surgical outcomes and thus patients’quality of life.展开更多
文摘Insulin therapy plays a crucial role in the management of type 2 diabetes as the disease progresses.Over the past century,insulin formulations have undergone significant modifications and bioengineering,resulting in a diverse range of available insulin products.These products show distinct pharmacokinetic and pharmacodynamic profiles.Consequently,various insulin regimens have em-erged for the management of type 2 diabetes,including premixed formulations and combinations of basal and bolus insulins.The utilization of different insulin regimens yields disparate clinical outcomes,adverse events,and,notably,patient-reported outcomes(PROs).PROs provide valuable insights from the patient’s perspective,serving as a valuable mine of information for enhancing healthcare and informing clinical decisions.Adherence to insulin therapy,a critical patient-reported outcome,significantly affects clinical outcomes and is influenced by multiple factors.This review provides insights into the clinical effectiveness of various insulin preparations,PROs,and factors impacting insulin therapy adherence,with the aim of enhancing healthcare practices and informing clinical decisions for individuals with type 2 diabetes.
基金the University of Texas Southwestern Institutional Review Board(approval No.Stu-2022-1014).
文摘BACKGROUND Hip dysplasia(HD)is characterized by insufficient acetabular coverage of the femoral head,leading to a predisposition for osteoarthritis.While radiographic measurements such as the lateral center edge angle(LCEA)and Tönnis angle are essential in evaluating HD severity,patient-reported outcome measures(PROMs)offer insights into the subjective health impact on patients.AIM To investigate the correlations between machine-learning automated and manual radiographic measurements of HD and PROMs with the hypothesis that artificial intelligence(AI)-generated HD measurements indicating less severe dysplasia correlate with better PROMs.METHODS Retrospective study evaluating 256 hips from 130 HD patients from a hip preservation clinic database.Manual and AI-derived radiographic measurements were collected and PROMs such as the Harris hip score(HHS),international hip outcome tool(iHOT-12),short form(SF)12(SF-12),and Visual Analogue Scale of the European Quality of Life Group survey were correlated using Spearman's rank-order correlation.RESULTS The median patient age was 28.6 years(range 15.7-62.3 years)with 82.3%of patients being women and 17.7%being men.The median interpretation time for manual readers and AI ranged between 4-12 minutes per patient and 31 seconds,respectively.Manual measurements exhibited weak correlations with HHS,including LCEA(r=0.18)and Tönnis angle(r=-0.24).AI-derived metrics showed similar weak correlations,with the most significant being Caput-Collum-Diaphyseal(CCD)with iHOT-12 at r=-0.25(P=0.042)and CCD with SF-12 at r=0.25(P=0.048).Other measured correlations were not significant(P>0.05).CONCLUSION This study suggests AI can aid in HD assessment,but weak PROM correlations highlight their continued importance in predicting subjective health and outcomes,complementing AI-derived measurements in HD management.
文摘Chinese medicine (CM) has been an experience based practice over the past three thousand years. The safety and efficacy of CM has been practised through experience, rather than nowadays’ modern scientific measurements. In this way, the development of CM has not been keeping pace with the advance in science and technology and the progress in orthodox medicine. In order to meet the requirements of modern science and technology, an evidence based approach must be adopted. Reassurance is needed to convince people for safety and efficacy of CM and give confidence to the evidence based demands ——“Tradition is confirmed by Modern Science” (1) .
基金supported by the Health Bureau of Shanghai City(201440029)
文摘Objective: To compare patient-reported outcomes after implantation of the ZA9003 intraocular lens(IOLs), or the MCX11 ASP IOLs or the spherical IOLs(HQ-201HEP). Methods: Prospective nonrandomized controlled trial was used. A total of 105 patients(210 eyes) were divided into three groups according to the type of IOLs: ZA9003(35 patients, 70 eyes), MCX11 ASP(35 patients, 70 eyes) or HQ-201HEP(35 patients, 70 eyes). The main outcome was scores of Catquest nine-item short-form questionnaire. Additional outcome was best corrected visual acuities, spherical aberration(SA) and total higher-order aberrations(HOAs). Results: The global score was significantly lower in the spherical IOL group than the aspherical IOL group of-020 μm SA(P < 0.05) and the aspherical IOL group of-027 μm SA(P < 0.05), and no significant difference was found in the global score between the aspherical IOL group of-020 μm SA than the aspherical IOL group of-027 μm SA(P > 0.05). Significant differences were also found in question 2, question 5, question 6 and question 8 between the spherical IOLs and the aspherical IOLs. Conclusion: Implantation of an aspherical IOL could improve vision-related quality of life compared with a spherical IOL. However, there were no statistically significant differences in vision-related quality of life between aspheric IOLs with different negative spherical aberrations.
文摘Objective:To investigate and analyze the changes of nutritional status in patients undergoing postoperative adjuvant chemotherapy for gastrointestinal tumors based on patient-reported outcomes.Methods:From July 2020 to March 2021,60 patients with gastrointestinal tumor who received adjuvant chemotherapy for the first time after surgery under the oncology department of a third-level,first-class hospital in Shaanxi Province were recruited by convenience sampling.The patient-reported nutritional evaluation outcomes within 24 hours after admission and during the fourth chemotherapy cycle incorporated nutritional risk screening 2002(NRS2002),Functional Assessment of Anorexia/Cachexia Therapy(FAACT),psychological pain screening,Generalized Anxiety Disorder Assessment(GAD-7),Patient Health Questionnaire-9(PHQ-9)to screen for depression,dietary self-assessment,health index scale(EQ-5D),and nutrition supervisor overall assessment scale.Results:The self-reported nutritional evaluation outcomes by adjuvant chemotherapy patients showed an upward trend along with their chemotherapy cycle.Their PG-SGA score,FAACT score,psychological pain score,and EQ-5D score during the fourth cycle were better than those during the first chemotherapy cycle(p<0.05)・Conclusion:Based on the patient・reported nutritional evaluation outcomes,the nutritional status and quality of life of patients with gastrointestinal tumors during chemotherapy did not worsen.Medical staff should timely evaluate the nutritional status of patients with gastrointestinal tumors during chemotherapy and implement reasonable nutritional intervention to improve the quality of life of patients.In the future,patient-reported outcomes should be considered for integration into clinical practice in order to facilitate patient participation in decision-making and improve their medical experience.
基金National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health,No.U01AR067138.
文摘AIM To establish minimum clinically important difference(MCID) for measurements in an orthopaedic patient population with joint disorders.METHODS Adult patients aged 18 years and older seeking care for joint conditions at an orthopaedic clinic took the Patient-Reported Outcomes Measurement Information System Physical Function(PROMIS~? PF) computerized adaptive test(CAT), hip disability and osteoarthritis outcome score for joint reconstruction(HOOS JR), and the knee injury and osteoarthritis outcome score for joint reconstruction(KOOS JR) from February 2014 to April 2017. MCIDs were calculated using anchorbased and distribution-based methods. Patient reports of meaningful change in function since their first clinic encounter were used as an anchor.RESULTS There were 2226 patients who participated with a mean age of 61.16(SD = 12.84) years, 41.6% male, and 89.7% Caucasian. Mean change ranged from 7.29 to 8.41 for the PROMIS~? PF CAT, from 14.81 to 19.68 for the HOOS JR, and from 14.51 to 18.85 for the KOOS JR. ROC cut-offs ranged from 1.97-8.18 for the PF CAT, 6.33-43.36 for the HOOS JR, and 2.21-8.16 for the KOOS JR. Distribution-based methods estimated MCID values ranging from 2.45 to 21.55 for the PROMIS~? PF CAT; from 3.90 to 43.61 for the HOOS JR, and from 3.98 to 40.67 for the KOOS JR. The median MCID value in the range was similar to the mean change score for each measure and was 7.9 for the PF CAT, 18.0 for the HOOS JR, and 15.1 for the KOOS JR.CONCLUSION This is the first comprehensive study providing a wide range of MCIDs for the PROMIS? PF, HOOS JR, and KOOS JR in orthopaedic patients with joint ailments.
文摘Background: Patient-reported outcomes of the quality of life (QOL) after an open thoracotomy have not been studied. To determine the physical and mental changes in surgical patients is very important for medical staffs. The surgical patient’s satisfaction and overall healthy changes were evaluated by the patient-self assessment questionnaires. Materials and Methods: From July 2007 to April 2008, 26 patients with non-small cell lung cancer (NSCLC) underwent surgical resection. The outcome of the QOL was evaluated by using two kinds of questionnaire surveys from the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and the anti-aging QOL assessment (AA-QOL). The EORTC QLQ-C30 consisted of five domains (physical, role, cognitive, emotional, and social functionings) and global QOL. The AA-QOL contained 51 items;30 physical and 21 mental symptoms regarding the elderly and the aging population. The patients replied to the two questionnaires at two different times, i.e., at pre-surgery (baseline) and at post-surgery (2 weeks after the operation). The obtained data of these scores were averaged and compared between the two points of the pre-surgery and post-surgery. Results: Regarding the outcomes of the EORTC QLQ-C30, the physical and social functioning became significantly worse after the surgery. In contrast, the global QOL significantly became better after the surgery. For the symptom at post-surgery, three of which were “nausea and vomiting”, “pain”, and “appetite loss”, became significantly worse compared to those at pre-surgery. Regarding the outcomes of the AA-QOL, the physical symptoms (muscular pain/stiffness, palpitations, dyspnea, no feeling of good health, anorexia, and coughing and sputum) became significantly worse after the surgery. Regarding the mental symptoms, there were no significant differences. Conclusions: Regarding the outcomes based on the changes in the QOL after surgery, the physical symptoms became worse compared to the mental symptoms. To clarify the perioperative healthy changes of the QOL reported by patients with lung cancers is very important for multidisciplinary teamwork, which should play a role in providing the appropriate care and treatment and useful information for a preoperative patient’s decision making of receiving surgical treatment.
文摘Background: Patient-reported outcomes (PROs) of quality of life (QOL) during chemotherapy involving lung cancer are very important for the medical staffs. Patients’ satisfaction and healthy changes were evaluated by the patient-self assessment. Materials and Methods: From July 2007 to April 2008, a total of 19 patients received chemotherapy. The QOL data were collected by using the QOL questionnaire for cancer patients treated with anticancer drugs (QOL-ACD) and the anti-aging QOL assessment (AA-QOL). The AA-QOL contained 51 items: 30 of physical and 21 of mental symptoms of the elderly and the aging population. The patients replied to the questions at two different times, i.e., at pre-chemotherapy (baseline) and at post-chemotherapy (2 weeks after the chemotherapy). Results: Regarding the hematological toxicities, for the grade 3/4 toxicities, there were 12 neutropenia (12/19, 63.2%) and 3 thrombocytopenia (3/19, 15.8%). For the grade 3 febrile neutropenia, there were 5 cases (5/19, 26.3%). Regarding the non-hematological toxicities, there was no grade 3 and grade 4 toxicities. Based on the outcomes of the QOL-ACD, the three items (“physical condition”, “social attitude”, and “overall QOL”) at post-chemotherapy became significantly worse compared to the baseline. Regarding the outcomes of the AA-QOL, 4 items of physical symptoms (“thirst”, “anorexia”, “early satiety”, and “diarrhea”) became significantly worse compared to the baseline. Regarding the mental symptoms, 2 items (“nothing to look forward in life” and “a sense of uselessness”) became significantly worse compared to the baseline. Conclusion: Regarding the PROs of the QOL during the chemotherapy term, both the physical and mental symptoms had become worse. To clarify the changes in the QOL during chemotherapy is very important for multidisciplinary teamwork, which should play the role of providing the appropriate cares and treatment as patient-support.
文摘Prostate cancer is affecting a higher proportion of male population. Health Related Quality of Life assessment can guide the development of an interdisciplinary and patient-centered care intervention. This study is aimed to assess Health Related Quality of Life in prostate cancer patients. Relationships between socio-demographic, clinical characteristics and patient-reported outcomes have been considered. Consecutive outpatients with prostate cancer, admitted at the Urology Clinic of the Instituto Português de Oncologia do Porto, were studied (n = 300). Health Related Quality of Life was assessed as part of the routine practice. The European Organisation for Research and Treatment of Cancer general questionnaire, QLQ-C30, and its specific module for prostate cancer patients, QLQ-PR25, were used. Evolution along time (elapsed since diagnosis, and up to 5 years) was considered in order to search for a prognosis prediction in prostate cancer patients. This study confirms the feasibility of a systematic Health Related Quality of Life assessment. Global Health Related Quality of Life was found to be higher 6 months after diagnosis, decreasing then until the second year after diagnosis and improving thereafter. A peak with better scores was identified at the fifth year after diagnosis. Social and physical dimensions revealed a similar pattern. Clinical significance was found 6 months and 5 years after diagnosis. The prospective analysis of Health Related Quality of Life changes is able to explore the patients’ outcomes in order to find patterns and relationships for prognosis prediction along the disease course. Such approach might promote patient confidence and thus a better cancer experience.
基金Supported by the Project BEBPC-TCM2019XZZX-ZJ0011Shanghai Clinical Research Center for Acupuncture and Moxibustion Accelerating20MC1920500Clinical Key Specialty Construction Foundation of Shanghaishslczdzk04701。
文摘Background:Lung cancer is one of the most common cancers globally with high incidence and mortality rate.Acupuncture and moxibustion have been used as adjuvant therapies to relieve the symptoms and complications of lung cancer.At present,acupuncture and moxibustion can partially improve the quality of life(QOL)of cancer patients.However,the evidence that acupuncture and moxibustion can improve patient-reported outcomes(PROs)in patients with lung cancer is still insufficient.We aimed to conduct a systematic review and meta-analysis of published randomized controlled trials(RCTs)to determine whether acupuncture and moxibustion can improve PROs among patients with lung cancer,providing a support basis for acupuncture and moxibustion inclusion in relevant guidelines.Methods:We will search the following electronic databases:PubMed,Embase,Cochrane Library,Web of Science,CNKI,CQVIP,Wanfang Data,Sinomed,and gray literature including the ClinicalTrials.gov Database(clinicaltrials.gov)and Chinese Clinical Trial Register(chictr.org.cn).All English and Chinese articles will be searched until July 1,2021.Two researchers independently extracted data.Any disagreement was resolved by discussion until consensus was reached or by consulting a third researcher.The primary outcomes mainly included the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire(EORTC QLQ-C30),functional assessment of cancer therapy-lung(FACT-L),and Karnofsky Performance Status(KPS).The secondary outcomes included improvement of individual lung cancerrelated symptoms and the safety of acupuncture intervention.Discussion:Our study is the first to focus on the PROs of acupuncture and moxibustion for lung cancer treatment.The results will contribute to a deeper understanding of the evidence distribution of acupuncture and moxibustion in PROs,which may support the use of acupuncture and moxibustion in lung cancer patients.
基金Supported by National High Level Hospital Clinical Research Funding,No.2022-NHLHCRF-PY-07National Natural Science Foundation of China,No.62176268.
文摘BACKGROUND Thermal ablation(TA)has been proved to be effective and safe as minimally invasive treatment method for thyroid nodules.However,patients'experience during the procedures and quality of life varies among operators.AIM To explore strategy to improve quality of life and subjective experiences during TA for papillary thyroid carcinoma(PTC)based on thermal field management(TFM).METHODS This retrospective propensity-matched cohort study was conducted in a single center.A total of 490 patients with PTC treated with TA from September 2023 to August 2024 were studied and divided into two groups(TFM group and non-TFM group)according to treatment strategies.Propensity score matching(PSM)was used to control for confounding factors.Complications,side effect and com-plaints of patients were compared between the two groups.RESULTS A total of 113 patients(41.7±10.6;31 men,82 women)were assigned to the TFM group,and 377 patients(mean age,41.1±10.7 year;116 men,261 women)were assigned to the non-TFM group.After PSM,a total of 108 patients were included in the TFM group,and 216 patients were included in the non-TFM group.The median follow-up was 10 months(range from 4-15 months).The incidence of voice change in the TFM group was significantly lower than that in the non-TFM group(0.9%vs 6.5%;P=0.049).Although there was no statistically significant difference in rate of pain between the two groups,the proportion of complaining of pain in the TFM group was numerically lower than that in the non-TFM group(3.7%vs 9.7%,P=0.090).CONCLUSION TFM,as a novel procedural optimization technique,can effectively improve quality of life and subjective expe-riences of patients during TA for PTC.
文摘The critical role of patient-reported outcome measures(PROMs)in enhancing clinical decision-making and promoting patient-centered care has gained a profound significance in scientific research.PROMs encapsulate a patient's health status directly from their perspective,encompassing various domains such as symptom severity,functional status,and overall quality of life.By integrating PROMs into routine clinical practice and research,healthcare providers can achieve a more nuanced understanding of patient experiences and tailor treatments accordingly.The deployment of PROMs supports dynamic patient-provider interactions,fostering better patient engagement and adherence to tre-atment plans.Moreover,PROMs are pivotal in clinical settings for monitoring disease progression and treatment efficacy,particularly in chronic and mental health conditions.However,challenges in implementing PROMs include data collection and management,integration into existing health systems,and acceptance by patients and providers.Overcoming these barriers necessitates technological advancements,policy development,and continuous education to enhance the acceptability and effectiveness of PROMs.The paper concludes with recommendations for future research and policy-making aimed at optimizing the use and impact of PROMs across healthcare settings.
基金Supported by Project of Shanghai Municipal Commission of Science and Technology(Nos.16401970700 and 22Y31920400)。
文摘Objective:To investigate whether the combination of chemotherapy with staged Chinese herbal medicine(CHM) therapy could enhance health-related quality of life(QoL) in non-small-cell lung cancer(NSCLC)patients and prolong the time before deterioration of lung cancer symptoms,in comparison to chemotherapy alone.Methods:A prospective,double-blind,randomized,controlled trial was conducted from December 14,2017 to August 28,2020.A total of 180 patients with stage ⅠB-ⅢA NSCLC from 5 hospitals in Shanghai were randomly divided into chemotherapy combined with CHM(chemo+CHM) group(120 cases) or chemotherapy combined with placebo(chemo+placebo) group(60 cases) using stratified blocking randomization.The European Organization for Research and Treatment of Cancer(EORTC) Quality-of-Life-Core 30 Scale(QLQ-C30) was used to evaluate the patient-reported outcomes(PROs) during postoperative adjuvant chemotherapy in patients with early-stage NSCLC.Adverse events(AEs) were assessed in the safety analysis.Results:Out of the total 180 patients,173 patients(116in the chemo+CHM group and 57 in the chemo+placebo group) were included in the PRO analyses.The initial mean QLQ-C30 Global Health Status(GHS)/QoL scores at baseline were 57.16±1.64 and 57.67±2.25 for the two respective groups(P>0.05).Compared with baseline,the chemo+CHM group had an improvement in QLQ-C30GHS/QoL score at week 18 [least squares mean(LSM) change 17.83,95% confidence interval(CI) 14.29 to 21.38].Conversely,the chemo+placebo group had a decrease in the score(LSM change-13.67,95% CI-22.70 to-4.63).A significant between-group difference in the LSM GHS/QoL score was observed,amounting to 31.63 points(95% CI25.61 to 37.64,P<0.001).The similar trends were observed in physical functioning,fatigue and appetite loss.At week 18,patients in the chemo+CHM group had a higher proportion of improvement or stabilization in GHS/QoL functional and symptom scores compared to chemo+placebo group(P<0.001).The median time to deterioration was longer in the chemo+CHM group for GHS/QoL score [hazard ratio(HR)=0.33,95% CI 0.23 to 0.48,P<0.0010],physical functioning(HR=0.43,95% CI 0.25 to 0.75,P=0.0005),fatigue(HR=0.47,95% CI 0.30 to 0.72,P<0.0001) and appetite loss(HR=0.65,95% CI 0.42to 1.00,P=0.0215).The incidence of AEs was lower in the chemo+CHM group than in the chemo+placebo group(9.83% vs.15.79%,P=0.52).Conclusion:The staged CHM therapy could help improve the PROs of postoperative patients with early-stage NSCLC during adjuvant chemotherapy,which is worthy of further clinical research.(Registry No.NCT03372694)
文摘Background Sacral neuromodulation (SNM) treatment of refractory urinary symptoms is associated with quality of life improvements using disease-specific instruments. There is a paucity of information relating universal health outcomes to effective treatment of urinary symptoms. The objective was to analyze changes in Patient-Reported Outcomes Measurement Information System (PROMIS) item-bank scores following SNM for treating refractory lower urinary tract symptoms (LUTS).Materials and methods This is a sub-analysis collected from an institutional review board approved, retrospective chart review evaluating changes between pre- and post-procedure PROMIS scores in subjects undergoing successful SNM implantation for refractory LUTS at a multidisciplinary adult continence clinic. The difference between pre- and post-procedure PROMIS scores was compared via two-sided Wilcoxon signed-rank test, with p <0.05 considered statistically significant.Results Of the 29 subjects, most were female (89.66%), Caucasian (68.97%), nonsmokers (89.66%) with public insurance (62.07%). The median age was 63years and body mass index was 33.2kg/m^(2). Procedure indications included urinary urge incontinence (83%), mixed urinary incontinence (10%), retention (17.24%), and overactive bladder (3%). Pain Interference and Depression scores had a nonsignificant improvement from 64.2 (ranging 58.9–67.5) to 60.75 (ranging 55.2–67.2), p = 0.21, and 55.2 (ranging 51.5–59.9) to 53.4 (ranging 49.5–61.1), p = 0.33, respectively. Median Physical Function scores demonstrated nonsignificant worsening following implantation from 38.0 (ranging 34.7–40.9) to 36.1 (ranging 33.1–40.8) (p = 0.25). Twenty-one subjects (72%) reported an improvement in at least 1 PROMIS item-bank with 6 subjects (21%) reporting no improvement in any of the item-banks.Conclusions Treatment of refractory LUTS with SNM resulted in no statistically significant changes in the PROMIS item-banks of Physical Function, Pain Interference, or Depression. Further prospective investigation is necessary to delineate the relationship of the self-reported universal-health outcomes in the treatment of LUTS.
基金supported by the Wisdom Accumulation and Talent Cultivation Project of Third Xiangya Hosipital of Central South University,China(YX202112).
文摘Objective:Endometrial tuberculosis,which commonly affects women of reproductive age,is a significant cause of intrauterine adhesions(IUA),potentially leading to hypomenorrhea,amenorrhea,and infertility.Hysteroscopic adhesiolysis is the primary treatment for IUA;however,studies specifically addressing its efficacy in tuberculosisinduced IUA remain scarce.This study aims to evaluate the therapeutic outcomes of hysteroscopic adhesiolysis for IUA caused by endometrial tuberculosis.Methods:This retrospective cohort study included patients diagnosed with tuberculosisinduced IUA who underwent hysteroscopic adhesiolysis at the Third Xiangya Hospital of Central South University between May 2014 and October 2022.Clinical data including age,medical history,adhesion severity,surgical treatment,and reproductive outcomes were analyzed.Results:Among 39 patients identified,2 were lost to follow-up.A total of 37 patients were included,with a follow-up duration ranging from 6 months to 9 years.Hypomenorrhea was reported in 24(64.9%)patients,secondary amenorrhea in 10(27.0%)patients,and normal menstruation in 3(8.1%)patients.Most patients presented with primary infertility(59.5%),and only 2(5.4%)had secondary infertility.The median American Fertility Society(AFS)score at initial assessment was 10(range,8−12);8(21.6%)patients had moderate IUA,and 29(78.4%)had severe IUA.A total of 86 surgical procedures were performed across 37 patients,with 27 patients undergoing 2 or more surgeries.Postoperatively,25(67.6%)patients achieved normalization of the uterine cavity,while 12(32.4%)still had a reduced cavity.Only 7(18.9%)patients had a grossly normal endometrium at the final surgery,all of whom had moderate adhesions at the initial procedure.Menstrual flow returned to normal in 12(32.4%)patients,while 25(67.6%)continued to experience hypomenorrhea.Of 29 patients who attempted in vitro fertilization and embryo transfer(IVF-ET),only 6(20.7%)conceived.Among these,4(13.8%)delivered at term via cesarean section;one case was complicated by postpartum hemorrhage due to uterine atony and another by placental adhesion.Conclusion:Endometrial tuberculosis can lead to severe IUA.Hysteroscopic adhesiolysis facilitates cavity restoration and improvement of menstrual conditions,but the overall reproductive outcomes remain suboptimal.
基金supported by Scientific and Technological Innovation Project of China Academy of Chinese Medical Sciences,Youth Program(C12021A01819)China National Key R&D Plan Special Program for Modernization of Traditional Chinese Medicine,Ministry of Science and Technology of the People’s Republic of China,2017YFC1700604+1 种基金Scientific and Technological Innovation Project of China Academy of Chinese Medical Sciences(CI2021B009)Innovation Team and Talents Cultivation Program of National Administration of Traditional Chinese Medicine(ZYYCXTD-C-202205).
文摘Objective:To develop a patient-reported traditional Chinese medicine kidney deficiency pattern(TCMKDP)scale for colorectal cancer(CRC)patients and evaluate its reliability and validity.Methods:We administered the TCM-KDP questionnaire to postoperative patients with stage II and III CRC as part of a multicenter randomized controlled trial(RCT)conducted in China from December 2018 to September 2021.The TCM-KDP scale consists of eight items on patient-reported symptoms and is scored on a five-point Likert scale.The scale’s reliability was assessed using Cronbach’s a and test-retest reliability,while content validity was evaluated with the content validity index.We compared the differences in serum cytokine levels and other clinical factors between patients with higher and lower KDP scores.Results:Of the 378 patients analyzed in the original RCT,352(93.2%)completed the TCM-KDP questionnaire.The Cronbach’s a of the eight-item TCM-KDP scale was 0.734,and the test-retest reliability was 0.745.Our exploratory factor analysis yielded eight factors that explained the variance of 50.34%.The mean TCM-KDP score was 2.80±0.92.Compared with patients with stage II CRC,those with stage III CRC had significantly higher TCM-KDP scores(2.25 vs.2.50,P=.026).We categorized all patients into highor low-KDP score groups(the cut-off score was 2.8).Patients with lower TCM-KDP scores had significantly higher serum interleukin-1b expression levels(P=.04).Conclusion:The patient-reported TCM-KDP scale demonstrated relatively good feasibility,internal consistency,and test-retest reliability among patients with CRC.Future studies could apply this scale to other cancer types and diseases.
文摘BACKGROUND Meniscal tears are one of the most common knee injuries.After the diagnosis of a meniscal tear has been made,there are several factors physicians use to guide clinical decision-making.The influence of time between injury and isolated meniscus repair on patient outcomes is not well described.Assessing this relationship is important as it may influence clinical decision-making and can add to the preoperative patient education process.We hypothesized that increasing the time from injury to meniscus surgery would worsen postoperative outcomes.AIM To investigate the current literature for data on the relationship between time between meniscus injury and repair on patient outcomes.METHODS PubMed,Academic Search Complete,MEDLINE,CINAHL,and SPORTDiscus were searched for studies published between January 1,1995 and July 13,2023 on isolated meniscus repair.Exclusion criteria included concomitant ligament surgery,incomplete outcomes or time to surgery data,and meniscectomies.Patient demographics,time to injury,and postoperative outcomes from each study were abstracted and analyzed.RESULTS Five studies met all inclusion and exclusion criteria.There were 204(121 male,83 female)patients included.Three of five(60%)studies determined that time between injury and surgery was not statistically significant for postoperative Lysholm scores(P=0.62),Tegner scores(P=0.46),failure rate(P=0.45,P=0.86),and International Knee Documentation Committee scores(P=0.65).Two of five(40%)studies found a statistically significant increase in Lysholm scores with shorter time to surgery(P=0.03)and a statistically significant association between progression of medial meniscus extrusion ratio(P=0.01)and increasing time to surgery.CONCLUSION Our results do not support the hypothesis that increased time from injury to isolated meniscus surgery worsens postoperative outcomes.Decision-making primarily based on injury interval is thus not recommended.
文摘Background: The maternal and neonatal morbidity caused by prolonged labour, maternal exhaustion and other factors push clinicians to speed up the delivery process by employing equipment such as vacuum suction or forceps to save the newborn. The purpose of this study was to determine the prevalence of vacuum-assisted vaginal delivery (VAVD) and its associated short-term maternal and neonatal outcomes at Ndola Teaching Hospital. Methods: A retrospective cross-sectional descriptive study through the analysis of routine data for women with singleton-term pregnancies who delivered by vacuum compared with spontaneous vaginal delivery was done at a tertiary hospital for the years 2020 and 2021. Chi-square and Logistic regression were used to investigate factors of vacuum delivery and to adjust for potential confounders. Results: Results showed that VAVD was mostly performed in women who had delayed second stage of labour (25.4%), maternal exhaustion (16.0%), foetal distress in the second stage of labour (12.3%). The overall VAVD prevalence was 3.7% (581/15591). Logistic regression showed that multiparous women were noted to be 87.5% (aOR 0.125;95% CI 0.025 - 0.629;p = 0.012) less likely to undergo VAVD compared to nulliparous women. Registrars were almost 6 times (aOR 5.650;95% CI 1.458 - 22.222, p = 0.012) more likely to conduct VAVD compared to midwives. Episiotomy was 3 times (aOR 3.390;95% CI 1.185 - 9.524;p Conclusion: The findings indicate the underutilisation of VAVD at NTH based on the low prevalence of 3.7%. VAVD outcomes were affected by multiparity, skill level and Episiotomy procedure, in addition, VAVD influenced admission to the NICU. Hence, there is a need to increase skills in VAVD among first-line healthcare workers such as midwives and intern doctors.
文摘This study investigates the effects of AI-mediated communication (AMC) on trust-building and negotiation outcomes in professional remote collaboration settings. Through a mixed-methods approach combining experimental design and qualitative analysis (N = 120), we examine how AI intermediaries influence communication dynamics, relationship building, and decision-making processes. Results indicate that while AMC initially creates barriers to trust formation, it ultimately leads to enhanced communication outcomes and stronger professional relationships when implemented with appropriate transparency and support. The study revealed a 31% improvement in cross-cultural understanding and a 24% increase in negotiation satisfaction rates when using AI-mediated channels with proper transparency measures. These findings contribute to the theoretical understanding of technology-mediated communication and practical applications for organizations implementing AI communication tools.
文摘This editorial offers insights from a minireview by Venkatesh et al,who explored pharmacological adjuvants for diabetic vitrectomy.Specifically,they synthesized current knowledge and evaluated the efficacy of various adjunctive therapies in improving the outcomes of diabetic retinopathy and managing associated complications.Herein,we highlight the key roles of pharmacological adjuvants in optimizing surgical techniques,minimizing intraoperative challenges,and enhancing postoperative recovery.We further discuss the potential implications of this approach for clinical practice and future research directions in this evolving field.Overall,this editorial underscores the importance of incorporating pharmacological adjuvants into standard diabetic vitrectomy care to improve surgical outcomes and thus patients’quality of life.
