outcome measures

成果措施
  • 文章类型: Journal Article
    国家牛皮癣基金会随机调查,美国银屑病患者的分层样本,以确定不可接受的银屑病关节炎(PsA)症状状态的患病率及其对抑郁和社会参与的影响。可接受和不可接受的PsA水平使用关于疾病9的Psoriatic关节炎影响的确定的截止点(可接受≤4vs不可接受>4)来定义。银屑病严重程度由体表面积定义:轻度<3%,中度-重度≥3%。使用患者健康问卷2评估抑郁症。通过患者报告的结果信息测量系统评估社会参与社会角色和活动的能力-SF4a。分析队列包括801例PsA患者。59.6%的参与者报告了不可接受的疾病活动水平(Psoriatic关节炎对疾病的影响>4)。在调整了年龄之后,性别,和牛皮癣的严重程度,有可能抑郁的个体(OR=0.014,P<.001)和参与社会角色和活动能力有限的个体(OR=0.05,P<.001)不太可能经历可接受的PsA活动水平。最终,结果表明,大多数美国PsA患者的疾病活动水平不可接受,这与抑郁症的患病率增加和社会参与的局限性有关。
    The National Psoriasis Foundation surveyed a random, stratified sample of individuals with psoriatic disease in the United States to determine the prevalence of an unacceptable psoriatic arthritis (PsA) symptom state and its effect on depression and social participation. Acceptable and unacceptable levels of PsA were defined using established cutoff points (acceptable ≤4 vs unacceptable >4) on the Psoriatic Arthritis Impact of Disease 9. Psoriasis severity was defined by body surface area: mild < 3%, moderate-severe ≥ 3%. Depression was assessed utilizing the Patient Health Questionnaire 2. Social participation was assessed by the Patient Reported Outcome Information Measurement System Ability to Participate in Social Role and Activities-SF4a. The analysis cohort comprised 801 patients with PsA. Unacceptable disease activity level (Psoriatic Arthritis Impact of Disease >4) was reported by 59.6% of participants. After adjusting for age, sex, and psoriasis severity, individuals with likely depression (OR = 0.014, P < .001) and those with limited ability to participate in social roles and activities (OR = 0.05, P < .001) were less likely to experience acceptable levels of PsA activity. Ultimately, the results demonstrated that most United States patients with PsA have unacceptable levels of disease activity, which is associated with increased prevalence of depression and limitations in social participation.
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  • 文章类型: Journal Article
    患者报告的膝关节相关评分和量表广泛用于报告前交叉韧带(ACL)手术的临床结果。了解此类措施的心理测量特性对于认识到此类措施可能带来的局限性至关重要。这项研究的目的是回顾有关ACL手术中使用的患者报告结果测量(PROMs)的心理测量特性的可用证据。确定了11项研究,大多数是前瞻性队列研究。八个英语,识别并评估ACL特定患者报告的结果指标:Lysholm评分,Tegner活动量表(TAS),辛辛那提得分,ACL-生活质量(QOL)评分,国际膝关节文献委员会(IKDC)主观膝关节表格(SKF),膝关节损伤和骨关节炎结果评分(KOOS)-ACL评分,和ACL-返回运动损伤(RSI)量表。只有Lysholm的分数,ACL-QOL,IKDCSKF,和ACL-RSI进行了内部一致性评估,具有可接受的Cronbach'sα(α>0.70)。大多数评分系统都进行了重测可靠性评估,其中四个(Lysholm得分,TAS,辛辛那提得分,和IKDCSKF)具有可接受的组内相关系数(ICC)值(ICC>0.70)。评估了大多数与IKDC具有良好相关性的指标的标准有效性。三个测量反应性的仪器的效应大小和标准化反应平均值很大(Lysholm评分,TAS,和辛辛那提评分)和中等(ACL-QOL)。Lysholm评分的证据更强大,更有力,TAS,ACL-QOL,IKDCSKF。然而,他们的心理测量特性以及他们正在评估的与膝盖相关的健康状况存在差异。因此,没有一个可以普遍适用于所有ACL损伤患者。在选择报告ACL损伤或ACL手术研究的结果时,识别这些参数至关重要。
    Patient-reported knee-related rating scores and scales are widely used in reporting the clinical outcomes of anterior cruciate ligament (ACL) surgery. Understanding the psychometric properties of such measures is vital to recognizing the limitations that such measures may confer. The aim of this study was to review the available evidence as to the psychometric properties of patient-reported outcome measures (PROMs) used in ACL surgery. Eleven studies were identified, the majority being prospective cohort studies. Eight English, ACL-specific patient-reported outcome measures were identified and evaluated: Lysholm score, Tegner Activity Scale (TAS), Cincinnati score, ACL-Quality of Life (QOL) score, International Knee Documentation Committee (IKDC) Subjective Knee Form (SKF), Knee Injury and Osteoarthritis Outcome Score (KOOS)-ACL score, and ACL-Return to Sport Injury (RSI) scale. Only the Lysholm score, ACL-QOL, IKDC SKF, and ACL-RSI were evaluated for internal consistency, having an acceptable Cronbach\'s α (α>0.70). Most of the scoring systems were assessed for test-retest reliability, with four of them (Lysholm score, TAS, Cincinnati score, and IKDC SKF) having acceptable intraclass correlation coefficient (ICC) values (ICC > 0.70). Criterion validity was assessed for most measures with a good correlation with the IKDC. Effect sizes and standardized response means were large for three instruments that measured responsiveness (Lysholm score, TAS, and Cincinnati score) and moderate for one (ACL-QOL). Evidence is stronger and more robust for the Lysholm score, TAS, ACL-QOL, and IKDC SKF. However, there is variation in their psychometric properties as well as the aspect of knee-related health they are assessing. Hence, none can be universally applicable to all patients with ACL injuries. Recognizing these parameters is vital when choosing which instrument to use in reporting the outcomes of ACL injury or ACL surgery studies.
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  • 文章类型: Journal Article
    背景:结果测量仪器(OMI)用于衡量治疗效果。在中风后失语症康复中,需要有意义变化的基准来支持对患者结果的解释。这项研究是一项研究计划的一部分,旨在为核心OMI建立最小重要变化(MIC)值(患者认为自己发生了重要变化的最小变化)。作为这个过程的第一步,探讨了失语症患者和临床医生的观点,并就临床意义改变的阈值达成共识.
    方法:采用顺序混合方法设计。参与者包括中风后失语症患者和言语病理学家。失语症患者根据中风后的时间进行有目的地采样,年龄和性别,而言语病理学家根据他们的工作环境(医院或社区)进行采样。每个参与者都参加了一个焦点小组,然后是一个带有调查内容的共识讲习班。在焦点小组中,探索了测量失语症恢复过程中有意义变化的经验和方法。定性数据采用反身性主题分析进行转录和分析。在共识研讨会上,参与者对语言核心结果结构有意义变化的阈值进行了投票,通信,情绪健康和生活质量,使用6点评分量表(更糟糕的是,稍差一点,没有变化,略有改善,大大改善并完全恢复)。共识被先验地定义为70%的协议。使用描述性统计报告投票结果。
    结果:5名失语症患者(n=4,卒中后>6个月;n=5,<65岁;n=3,男性)和8名言语病理学家(n=4,医院设置;n=4,社区设置)参加了四个焦点小组之一(持续时间:92-112分钟)。确定了四个主题,描述了有意义的变化如下:(1)每个人的不同;(2)小的持续改进;(3)通过个人相关目标的进展来衡量;(4)受个人因素的影响。“轻微改善”被认为是中风后6个月内锚定评定量表(75%-92%)的MIC阈值,而在6个月后,有一种趋势是支持“大大改善”(36%-66%)。
    结论:我们对失语症患者和言语病理学家的混合方法研究提供了新的证据来告知MIC在失语症康复中的定义。未来的研究将旨在为核心OMI建立MIC值。
    这项工作是有中风后失语症生活经验的人之间参与的结果,包括失语症患者,家庭成员,临床医生和研究人员。在整个研究周期中进行参与,以确保研究任务是参与者可以接受和容易理解的,并且研究结果与失语症社区相关。这种参与包括共同开发结果的简单英文摘要。根据昆士兰州健康消费者指南,顾问获得了报酬。临床医生的采访指南由从事失语症康复工作的言语病理学家试行。
    BACKGROUND: Outcome measurement instruments (OMIs) are used to gauge the effects of treatment. In post-stroke aphasia rehabilitation, benchmarks for meaningful change are needed to support the interpretation of patient outcomes. This study is part of a research programme to establish minimal important change (MIC) values (the smallest change above which patients perceive themselves as importantly changed) for core OMIs. As a first step in this process, the views of people with aphasia and clinicians were explored, and consensus was sought on a threshold for clinically meaningful change.
    METHODS: Sequential mixed-methods design was employed. Participants included people with post-stroke aphasia and speech pathologists. People with aphasia were purposively sampled based on time post-stroke, age and gender, whereas speech pathologists were sampled according to their work setting (hospital or community). Each participant attended a focus group followed by a consensus workshop with a survey component. Within the focus groups, experiences and methods for measuring meaningful change during aphasia recovery were explored. Qualitative data were transcribed and analysed using reflexive thematic analysis. In the consensus workshop, participants voted on thresholds for meaningful change in core outcome constructs of language, communication, emotional well-being and quality of life, using a six-point rating scale (much worse, slightly worse, no change, slightly improved, much improved and completely recovered). Consensus was defined a priori as 70% agreement. Voting results were reported using descriptive statistics.
    RESULTS: Five people with aphasia (n = 4, > 6 months after stroke; n = 5, < 65 years; n = 3, males) and eight speech pathologists (n = 4, hospital setting; n = 4, community setting) participated in one of four focus groups (duration: 92-112 min). Four themes were identified describing meaningful change as follows: (1) different for every single person; (2) small continuous improvements; (3) measured by progress towards personally relevant goals; and (4) influenced by personal factors. \'Slightly improved\' was agreed as the threshold of MIC on the anchor-rating scale (75%-92%) within 6 months of stroke, whereas after 6 months there was a trend towards supporting \'much improved\' (36%-66%).
    CONCLUSIONS: Our mixed-methods research with people with aphasia and speech pathologists provides novel evidence to inform the definition of MIC in aphasia rehabilitation. Future research will aim to establish MIC values for core OMIs.
    UNASSIGNED: This work is the result of engagement between people with lived experience of post-stroke aphasia, including people with aphasia, family members, clinicians and researchers. Engagement across the research cycle was sought to ensure that the research tasks were acceptable and easily understood by participants and that the outcomes of the study were relevant to the aphasia community. This engagement included the co-development of a plain English summary of the results. Advisors were remunerated in accordance with Health Consumers Queensland guidelines. Interview guides for clinicians were piloted by speech pathologists working in aphasia rehabilitation.
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  • 文章类型: Journal Article
    社会联系对于长期护理(LTC)居民的生活质量和护理至关重要。然而,关于如何衡量它缺乏共识,这限制了找到改善和损害LTC家庭社会联系的能力。因此,我们旨在系统地审查和评估LTC居民现有社会联系衡量标准的衡量标准属性,为了确定哪个,如果有的话,措施可以推荐。从成立到2022年4月,我们搜索了八个电子数据库,以获取有关社交联系(包括社交网络,互动,订婚,支持,隔离,连通性,和孤独)为LTC居民。我们使用基于Consensus的标准来选择健康测量指标(COSMIN)指南,以评估每个确定的测量报告的测量特性并提出建议。我们确定了62项研究,报告了38项措施;21项测量的生活质量,幸福感或生活满意度,并包括社会联系子量表或独立项目以及17项专门针对社会联系的措施。我们发现几乎没有关于心理测量特性的高质量证据,如足够的内容效度(n=0),结构效度(n=3),内部一致性(n=3),可靠性(n=1),测量误差(n=0),结构效度(n=4),标准有效性(n=0)和响应性(n=0)。没有任何措施在所有这些方面都表现出令人满意的心理测量特性,所以没有可以推荐使用。34项措施有可能被推荐,但需要进一步研究以评估其质量,其余4项不建议使用。因此,我们的审查发现,现有的措施没有足够的证据来建议评估LTC房屋居民的社会联系。需要对现有仪器进行进一步的验证和可靠性研究或开发新的措施,以便能够准确测量LTC居民的社会联系,以进行未来的观察和干预研究。
    社会联系是长期护理院以人为本的基础。现有措施的可靠性和有效性证据不足。根据现有证据,不能推荐使用当前的措施。未来的研究需要一个可靠和有效的社会联系衡量标准。
    Social connection is important for long-term care (LTC) residents\' quality of life and care. However, there is a lack of consensus on how to measure it and this limits ability to find what improves and impairs social connection in LTC homes. We therefore aimed to systematically review and evaluate the measurement properties of existing measures of social connection for LTC residents, to identify which, if any, measures can be recommended. We searched eight electronic databases from inception to April 2022 for studies which reported on psychometric properties of a measure of any aspect(s) of social connection (including social networks, interaction, engagement, support, isolation, connectedness, and loneliness) for LTC residents. We used COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines to evaluate the measurement properties reported for each identified measure and make recommendations. We identified 62 studies reporting on 38 measures; 21 measured quality of life, well-being or life satisfaction and included a social connection subscale or standalone items and 17 measures specifically targeted social connection. We found there was little high-quality evidence on psychometric properties such as sufficient content validity (n = 0), structural validity (n = 3), internal consistency (n = 3), reliability (n = 1), measurement error (n = 0), construct validity (n = 4), criterion validity (n = 0) and responsiveness (n = 0). No measures demonstrated satisfactory psychometric properties on all these aspects, so none could be recommended for use. Thirty-four measures have the potential to be recommended but require further research to assess their quality and the remaining four are not recommended for use. Our review therefore found that no existing measures have sufficient evidence to be recommended for assessment of social connection in residents of LTC homes. Further validation and reliability studies of existing instruments or the development of new measures are needed to enable accurate measurement of social connection in LTC residents for future observational and interventional studies.
    UNASSIGNED: Social connection is fundamental to person-centered care in long-term care homes.There is insufficient evidence for the reliability and validity of existing measures.No current measures can be recommended for use based on existing evidence.A reliable and valid measure of social connection is needed for future research.
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  • 文章类型: Journal Article
    背景:SMA是一种遗传性神经肌肉疾病,可导致进行性肌肉无力和萎缩。一些研究表明,SMA的负担在许多水平上都非常高。目前使用的功能评估工具不能完全解决疾病对患者生活的影响。这项定性研究的目的是确定与患者相关的SMA方面,并设计可用于评估目的的项目。
    结果:在马德里举行的SMA家庭年度会议期间举办了五次焦点小组会议,西班牙。焦点小组由SMAI型儿童的父母组成,II-III型儿童,II-III型保姆儿童的父母,成年患者,和沃克孩子的父母。两名经过培训的主持人使用半结构化指南进行了焦点小组,以根据科学和患者咨询委员会的意见涵盖先前商定的主题。该指南适用于不同的群体。根据参与者传达的信息,SMA为患者及其父母带来了很高的疾病负担。负担是在身体上感知的,心理,和社会领域。患者的身体领域与参与者最相关,特别是对于非流动儿童的父母,其次是运动秤的限制,以捕捉所有的变化,父母的心理负担,治疗期望和患者的心理负担。十个领域是被确定为受疾病影响的主要领域:流动性和独立性,疲劳和易疲劳,感染和医院咨询,脊柱侧凸和挛缩,脆弱性,疼痛,喂养,花在护理上的时间,呼吸,睡觉和休息。
    结论:这项研究证实了评估未在功能性运动量表中评估的疾病其他方面的必要性。疾病其他方面的措施,如疼痛,疲劳,喂养,也应该考虑。以有效且可靠的方式测量这些方面的患者报告结果仪器将非常有用。这项研究产生了一系列相关的新项目,用于评估SMA对患者日常生活的影响。
    BACKGROUND: SMA is a hereditary neuromuscular disease that causes progressive muscle weakness and atrophy. Several studies have shown that the burden of SMA is very high at many levels. Functional assessment tools currently used do not completely address the impact of the disease in patients\' life. The objective of this qualitative study was to identify aspects of SMA that are relevant to patients and to design items useful for assessment purposes.
    RESULTS: Five focus group sessions were run during an annual SMA families meeting in Madrid, Spain. Focus groups were composed by parents of SMA type I children, sitter children type II-III, parents of sitter children type II-III, adult patients, and parents of walker children. Two trained facilitators conducted the focus groups using a semi-structured guideline to cover previously agreed topics based on the input of a Scientific and Patient Advisory Committee. The guideline was adapted for the different groups. According to what was communicated by participants, SMA entails a high burden of disease for both patients and their parents. Burden was perceived in physical, psychological, and social areas. Patient\'s physical domain was the most relevant for participants, especially for parents of non-ambulant children, followed by limitations of motor scales to capture all changes, parents psychological burden, treatment expectations and patient\'s psychological burden. Ten domains were the main areas identified as impacted by the disease: mobility and independence, fatigue and fatigability, infections and hospital consultations, scoliosis and contractures, vulnerability, pain, feeding, time spent in care, breathing, and sleep and rest.
    CONCLUSIONS: This study confirms the necessity of evaluating other aspects of the disease that are not assessed in the functional motor scale. Measures of other aspects of the disease, such as pain, fatigue, feeding, should be also considered. A patient-reported outcomes instrument measuring such aspects in a valid and reliable way would be very useful. This study generated a list of new items relevant to be systematically measured in the assessment of the impact of SMA on the patients\' everyday life.
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  • 文章类型: Journal Article
    在脊髓损伤(SCI)患者的介入临床试验中,实验生物学的影响,药理学,或与设备相关的干预措施必须与物理和职业治疗干预措施区分开来,因为康复会影响与运动相关的结果。国际脊髓损伤(ISCI)物理治疗-职业治疗基础数据集(PT-OTBDS)的开发旨在跟踪与实验干预措施同时提供的康复干预措施的内容和时间。我们根据用户之间的协议评估了PT-OTBDS的可靠性。在在线培训课程之后,来自7个国家的10个SCI临床中心的物理治疗师(PT)和职业治疗师(OTs)参与.在每个中心,成对的治疗师(治疗治疗师和观察治疗师;PT/PT,OT/OT,或PT/OT)使用PT-OTBDS记录20例患者的治疗内容和时间。分析数据以确定治疗师对之间关于治疗疗程内容的一致性。治疗师特征的影响(专业学科[PT/OT],多年与SCI个人合作的经验),患者特征(损伤程度[四肢瘫痪/截瘫]和严重程度[完全/不完全]),设置(住院/门诊),还分析了该中心是否位于美国和非美国。七个类别中的五个有很高的一致意见,其余两个类别有中等一致意见。对于七个干预类别中的六个,在选择特定类别的病例百分比方面,治疗和观察治疗师之间没有显著差异.治疗师的特点,患者的特点,治疗设置,中心的全球位置对治疗师对之间的协议水平没有有意义的影响。BDS是可靠的跨设置使用,国家,以及各种损伤程度的患者。这项研究还帮助确定了改进教学大纲有价值的其他领域。
    In interventional clinical trials for persons with spinal cord injury (SCI), the influence of experimental biological, pharmacological, or device-related interventions must be differentiated from that of physical and occupational therapy interventions, as rehabilitation influences motor-related outcomes. The International Spinal Cord Injury (ISCI) Physical Therapy-Occupational Therapy Basic Data Set (PT-OT BDS) was developed with the intent to track the content and time of rehabilitation interventions that are delivered concurrently with experimental interventions. We assessed the reliability of the PT-OT BDS based on agreement between users. Following an online training session, physical therapists (PTs) and occupational therapists (OTs) from 10 SCI clinical centers across 7 countries participated. At each center, pairs of therapists (a treating therapist and an observing therapist; PT/PT, OT/OT, or PT/OT) used the PT-OT BDS to record the content and time of therapy sessions for 20 patients. Data were analyzed to determine agreement between therapist pairs regarding the content of the therapy session. The influence of therapist characteristics (professional discipline [PT/OT], years of experience working with individuals with SCI), patient characteristics (level [tetraplegia/paraplegia] and severity [complete/incomplete] of injury), setting (inpatient/outpatient), and whether the center was U.S.- versus non-U.S.-based were also analyzed. There was high agreement for five of seven categories and medium agreement for the remaining two categories. For six of the seven intervention categories, there were no significant differences between the treating and the observing therapists in the percentage of instances that a specific category was selected. Characteristics of the therapists, characteristics of the patient, therapy setting, and global location of the center had no meaningful influence on level of agreement between therapist pairs. The BDS is reliable for use across settings, countries, and with patients of various impairment levels. The study also helped identify additional areas where refinement of the syllabus would be of value.
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  • 文章类型: Journal Article
    在医疗和康复领域,必须使用评估量表和表现测试等工具来评估帕金森病对受影响个体QoL的影响。短帕金森评价量表(SPES)是一种可靠有效的工具,适用于研究和临床实践,有助于评估电机损伤,日常生活活动,帕金森病患者的运动并发症。该研究的目的是调查SPES-SCOPA量表意大利语版本的有效性和可靠性。
    进行了翻译和文化适应。纳入的患者被诊断为帕金森病,没有并发的病理,MiniMental测试得分高于2,并签署知情同意书;他们是在罗马萨皮恩扎大学人类神经科学系招募的,从2023年2月到2023年11月。通过组内相关系数(ICC)评估重测可靠性,使用Cronbach'sAlpha评估内部一致性,并使用SPES-SCOPA与黄金标准PDQ-39之间的Pearson相关性评估结构效度。
    共招募101名患者。对62例患者进行了评估者间评估,而39人接受了评估者内部评估。分析显示,整个量表的Cronbach\'sAlpha值为0.89的数据具有统计学意义;所有子量表的重测信度结果均具有统计学意义。对于大多数测量,PDQ-39结构域与SPES/SCOPA分量表之间的相关性具有统计学意义。
    这项研究表明,意大利版的SPES-SCOPA量表具有出色的心理测量特性。
    UNASSIGNED: In the medical and rehabilitative field, it is essential to employ tools such as evaluation scales and performance tests to assess the impact of Parkinson\'s disease on QoL of affected individuals. The Short Parkinson\'s Evaluation Scale (SPES) is a reliable and valid tool, applicable both in research and clinical practices, useful in assessing motor damage, activities of daily living, and motor complications in patients with Parkinson\'s disease. The aim of the study is to investigate validity and reliability of the Italian version of the SPES-SCOPA scale.
    UNASSIGNED: Translation and cultural adaptation were performed. Included patients had diagnosis of Parkinson\'s disease, no concurrent pathologies, MiniMental test score above 2 and signed informed consent; they were recruited at the Department of Human Neurosciences in Sapienza University of Rome, from February 2023 to November 2023. Test-retest reliability was evaluated through Intraclass Correlation Coefficient (ICC), internal consistency was assessed using Cronbach\'s Alpha and construct validity using Pearson\'s correlation between SPES-SCOPA and the gold standard PDQ-39.
    UNASSIGNED: 101 patients were recruited. Inter-rater evaluation was conducted on 62 patients, while 39 underwent an intra-rater assessment. The analysis showed statistically significant data with a Cronbach\'s Alpha value of 0.89 for the entire scale; test-retest reliability results are statistically significant for all subscales. Correlation between PDQ-39 domains and SPES/SCOPA subscales were statistically significant for most measurements.
    UNASSIGNED: This research shows that the Italian version of SPES-SCOPA scale has excellent psychometric properties.
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  • 文章类型: Journal Article
    以人为中心的目标在个人环境中捕捉个人的优先事项。目标达成规模(GAS)已用于涉及痴呆症患者(PLWD)的药物试验,但GAS的特征是难以纳入试验和临床实践。我们在痴呆症研究(NIDUS)家族的独立新干预措施试验中使用了GAS,手动护理和支持干预,作为主要结果,并根据设定的目标调整干预措施。我们旨在评估基线目标设定的可行性和内容。
    我们为非临床促进者开发了培训,以便与PLWD和家庭照顾者dyads远程设定个性化的GAS目标,或者单独照顾者,在干预试验中,在COVID-19大流行期间。对设定的目标进行定性内容分析,探讨参与者的优先事项和未满足的需求,考虑如何在心理社会干预试验背景下扩展现有的GAS目标域。
    11名主持人成功地训练了GAS目标的设定和得分。总共有313/328(95%)的参与者能够与主持人合作设定三到五个目标。其中,302个随机参与的二元组设定1043个(平均3.5个,范围3到5个)目标。我们将719个(69%)目标演绎编码到五个现有的GAS域(情绪,行为,自我照顾,认知,和日常生活的工具性活动);324个(31%)目标被归纳编码为四个新领域:照顾者休息,照顾者的心情,照顾者行为,和照顾睡眠。最经常设定的目标与社会支持有关。根据设定目标的人的背景或流行病限制的程度,设定的目标类型几乎没有变化。
    对于未经临床培训的人来说,为社区中的PLWD和家庭护理人员设定GAS整体目标是可行的。GAS有可能促进护理和支持干预措施的个性化,例如NIDUS家庭,并促进推出更个性化的护理。
    目标达成规模(GAS)可以抓住痴呆症患者及其家庭照顾者的有意义的优先事项。心理社会干预RCT使用GAS作为主要结果指标,目标由未经临床培训的促进者合作设定。研究结果强调了使用GAS作为该人群结果指标的可行性。内容分析结果揭示了研究参与者的经验和优先事项的多样性。GAS有可能支持实施更多以人为本的痴呆症护理方法。
    UNASSIGNED: Person-centered goals capture individual priorities in personal contexts. Goal Attainment Scaling (GAS) has been used in drug trials involving people living with dementia (PLWD) but GAS has been characterized as difficult to incorporate into trials and clinical practice. We used GAS in a trial of New Interventions for Independence in Dementia Study (NIDUS)-family, a manualized care and support intervention, as the primary outcome and to tailor the interventions to goals set. We aimed to assess the feasibility and content of baseline goal-setting.
    UNASSIGNED: We developed training for nonclinical facilitators to set individualized GAS goals remotely with PLWD and family carer dyads, or carers alone, in the intervention trial, during the COVID-19 pandemic. A qualitative content analysis of the goals set explored participants\' priorities and unmet needs, to consider how existing GAS goal domains might be extended in a psychosocial intervention trial context.
    UNASSIGNED: Eleven facilitators were successfully trained to set and score GAS goals. A total of 313/328 (95%) participants were able to collaboratively set three to five goals with the facilitators. Of these, 302 randomized participating dyads set 1043 (mean 3.5, range 3 to 5) goals. We deductively coded 719 (69%) goals into five existing GAS domains (mood, behavior, self-care, cognition, and instrumental activities of daily living); 324 (31%) goals were inductively coded into four new domains: carer break, carer mood, carer behavior, and carer sleep. The most frequently set goals pertained to social support. There was little variation in types of goals set based on the context of who set them or level of pandemic restrictions in place.
    UNASSIGNED: It is feasible for people without clinical training to set GAS holistic goals for PLWD and family carers in the community. GAS has potential to facilitate personalization of care and support interventions, such as NIDUS-family, and facilitate the roll out of more personalized care.
    UNASSIGNED: Goal Attainment Scaling (GAS) can capture meaningful priorities of people with dementia and their family carers.A psychosocial intervention RCT used GAS as the primary outcome measure and goals were set collaboratively by non-clinically trained facilitators.The findings underscore the feasibility of using GAS as an outcome measure with this population.The content analysis findings unveiled the diversity in experiences and priorities of the study participants.GAS has the potential to support the implementation of more person-centred approaches to dementia care.
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  • 文章类型: Journal Article
    骨关节炎(OA)是一种全球性的肌肉骨骼疾病,主要影响膝关节和髋关节,没有任何FDA批准的疾病改善疗法。动物模型是开发OA疗法的重要研究工具;许多动物研究为开始人体临床试验提供了数据。尽管如此,仍然需要使用动物模型来概括人类经验的策略,以更好地开发治疗方法和理解发病机制。自2016年我们对骨关节炎动物模型的回顾以来,OA研究和模型有了令人兴奋的更新。这篇综述的主要目的是更新OA研究中最新的动物模型和研究的关键特征。
    我们使用了我们现有的分类方法,并在PubMed和书目搜索中筛选了2016年至2023年动物OA模型的文章。相关和高引用的文章被选择纳入这篇叙述性综述。
    对最近的研究进行了分析和分类。我们还将离体模型确定为正在进行的研究领域。每种动物模型在OA的研究中都有自己的益处,并且可以评估各种结果指标。尽管有大量的模型,每个都有其缺点,有限翻译批准的用于人类使用的疗法。
    根据研究的结果指标和目标,研究人员应该为他们的工作选择最好的模型。自2016年以来,已经有几项令人兴奋的研究利用再生工程技术来开发治疗方法并更好地了解OA。
    骨关节炎(OA)是一种慢性衰弱性疾病,无法治愈,主要影响膝关节和髋关节,并经常导致手术关节置换。软骨保护关节免受机械力的影响,并随着年龄或受伤而退化。OA的许多原因仍在调查中,和动物用于临床前研究和测试潜在的新疗法。用于临床前研究的单一共识OA动物模型是不存在的。在这篇文章中,我们回顾了许多OA动物模型,并提供了自2016年以来急需的最新研究和模型开发.
    UNASSIGNED: Osteoarthritis (OA) is a global musculoskeletal disorder that affects primarily the knee and hip joints without any FDA-approved disease-modifying therapies. Animal models are essential research tools in developing therapies for OA; many animal studies have provided data for the initiation of human clinical trials. Despite this, there is still a need for strategies to recapitulate the human experience using animal models to better develop treatments and understand pathogenesis. Since our last review on animal models of osteoarthritis in 2016, there have been exciting updates in OA research and models. The main purpose of this review is to update the latest animal models and key features of studies in OA research.
    UNASSIGNED: We used our existing classification method and screened articles in PubMed and bibliographic search for animal OA models between 2016 and 2023. Relevant and high-cited articles were chosen for inclusion in this narrative review.
    UNASSIGNED: Recent studies were analyzed and classified. We also identified ex vivo models as an area of ongoing research. Each animal model offers its own benefit in the study of OA and there are a full range of outcome measures that can be assessed. Despite the vast number of models, each has its drawbacks that have limited translating approved therapies for human use.
    UNASSIGNED: Depending on the outcome measures and objective of the study, researchers should pick the best model for their work. There have been several exciting studies since 2016 that have taken advantage of regenerative engineering techniques to develop therapies and better understand OA.
    UNASSIGNED: Osteoarthritis (OA) is a chronic debilitating disease without any cure that affects mostly the knee and hip joints and often results in surgical joint replacement. Cartilage protects the joint from mechanical forces and degrades with age or in response to injury. The many contributing causes of OA are still being investigated, and animals are used for preclinical research and to test potential new treatments. A single consensus OA animal model for preclinical studies is non-existent. In this article, we review the many animal models for OA and provide a much-needed update on studies and model development since 2016.
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  • 文章类型: Journal Article
    多发性硬化(MS)是一种具有可变神经症状的脱髓鞘和慢性疾病。残疾程度的评分有不同的量表,但是只有少数论文考虑了5次坐立测试(5STS)和30s椅架测试(30CST),这是其他神经系统疾病的有效和容易获得的指标。我们研究的目的是验证其有效性,再现性,和这些测试的响应性。患有MS的患者被纳入AISM门诊设施。纳入标准是EDSS评分小于6.5。我们执行了5STS,30CST,和定时25英尺步行(T25-FW)测试,并在第一次评估中记录EDSS得分。然后,我们记录了5天后的性能(由第二个盲人操作员进行,以确保测试-重测的可重复性),最后一次评估是在12次物理治疗后进行的。我们招募了38名诊断为MS的患者。结果表明,有关有效性的重要数据,再现性,和两个量表的反应能力。数据支持将这些测试添加到相关的临床评估中。这两个测试很简单,可靠,易于管理,数据证实它们可以包括在MS患者的评估中。
    Multiple Sclerosis (MS) is a demyelinating and chronic disease with variable neurological symptoms. There are different scales that score the level of disability, but only few papers have taken into consideration the 5-times sit-to-stand (5STS) test and the 30 s chair stand test (30CST), which are valid and easily obtainable indicators of other neurological diseases. The aim of our research is to verify the validity, reproducibility, and responsiveness of these tests. Patients afflicted with MS were enrolled in the AISM outpatient facility. The inclusion criterion was an EDSS score less than 6.5. We performed the 5STS, 30CST, and timed 25-foot walk (T25-FW) tests and recorded EDSS scores in the first evaluation. Then, we recorded the performance after 5 days (conducted by a second blind operator to ensure test-retest reproducibility), and the last evaluation was made after 12 sessions of physiotherapy. We recruited 38 patients diagnosed with MS. The results show significant data regarding validity, reproducibility, and responsiveness for both scales. The data argue in favor of adding these tests to the relevant clinical assessments. These two tests are simple, reliable, and easy to administer, and the data confirm that they can be included in the evaluation of patients with MS.
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