patient perception

患者感知
  • 文章类型: Journal Article
    背景:在牙科中引入了聚醚醚酮(PEEK)作为金属合金的替代品。
    目的:与Dead-soft同轴固定固位体(DSC)相比,评估PEEK固定固位体在保持下颌前牙稳定性和参与者满意度方面的有效性。
    方法:单中心,双臂平行组随机临床试验。
    方法:接受预调正畸矫治器治疗的患者的小不规则指数(LII)≤0.5mm已纳入试验。PEEK保持器通过计算机辅助设计和制造制备成圆形0.8毫米电线,并将DSC线小心地适应下前牙的舌面。主要结果是LII评估的下前牙的稳定性,而次要结果是咬合参数的变化,保持器故障,患者满意度。数据是在脱粘阶段(T0)收集的,1个月(T1),3个月(T3),开始试验后6个月(T6),除了病人的满意度,在T1和T6使用电子表格记录。
    方法:参与者的单一盲法。
    结果:共有46名年龄在12-28岁的参与者被随机分配到两组中(每组n=23)。只有一名参与者退出;因此,对45名参与者进行了分析。DSC组在T3时显示LII的显著增加。两个保持器组的咬合测量具有可比性,故障频率,和生存时间,没有显著差异。与PEEK组相比,DSC组中的患者报告了其牙齿位置变化的统计学意义。
    结果:没有有害影响的报道。
    结论:由于干预的性质,有限的随访时间和无法使操作者失明。
    结论:保留6个月后,PEEK固定器在保持牙齿对齐方面与DSC固定器同样有效,在故障频率方面没有显著差异,存活率,一般患者满意度。
    背景:https://register。临床试验.gov.(NCT05557136)。
    BACKGROUND: Poly-ether-ether-ketone (PEEK) was introduced in dentistry as an alternative to metal alloys.
    OBJECTIVE: To assess the effectiveness of PEEK-fixed retainers in preserving the stability of mandibular anterior and participant satisfaction as compared to the Dead-soft coaxial fixed retainer (DSC).
    METHODS: A single-centre, two-arm parallel groups randomized clinical trial.
    METHODS: The patients treated with pre-adjusted orthodontic appliances who have a Little\'s Irregularity Index (LII) ≤ 0.5 mm have been enrolled in the trial. PEEK retainers were prepared to round 0.8 mm wire by computer-aided design and manufacturing, and the DSC wire was carefully adapted to the lingual surface of the lower anterior teeth. The primary outcome was the stability of lower anterior teeth as assessed by LII, while the secondary outcomes were changes in occlusal parameters, retainer failure, and patient satisfaction. The data were collected at the debonding stage (T0), 1 month (T1), 3 months (T3), and 6 months (T6) after starting the trial, except for patient\'s satisfaction, which was recorded using an electronic form at T1 and T6.
    METHODS: Single blinding of participants.
    RESULTS: A total of 46 participants with an age range of 12-28 years old were randomly allocated to the two groups (n = 23 in each). Only one participant dropped out; therefore, 45 participants were analysed. The DSC group showed a significant increase in LII at T3. Both retainer groups had comparable occlusal measurements, failure frequency, and survival time, with no significant difference. The patients in the DSC group reported a statistically significant perception of change in the position of their teeth compared to those in the PEEK group.
    RESULTS: No harmful effects have been reported.
    CONCLUSIONS: Limited follow-up duration and the inability to blind the operator due to the nature of the intervention.
    CONCLUSIONS: After 6-month retention, the PEEK retainer was equally effective to DSC retainers in maintaining the teeth alignment, with no significant differences regarding the failure frequency, survival rate, and general patient satisfaction.
    BACKGROUND: https://register.clinicaltrials.gov. (NCT05557136).
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  • 文章类型: Journal Article
    患者的感知涉及患者对其健康状况的想法和信念。它还与医疗依从性和结果有关。然而,患者的感知和医生在医疗记录中的文档之间经常出现差异,导致误解和不理想的医患沟通。在这项研究中,我们评估了生成人工智能(AI)在比较患者问卷和乳腺外科医师记录中记录的患者感知内容方面的功效.我们通过与人类创造的真相进行比较,评估了生成AI的精确度和召回率。我们的结果表明,在理解和对比症状以及患者和医生不同记录的全部内容方面,生成AI的高性能。F1得分从0.77到0.97不等。这些结果凸显了生成AI对医疗保健场景中更深入的相互理解的潜在贡献。
    Patient perception involves a patient\'s thoughts and beliefs regarding their health status. It is also associated with medical compliance and outcomes. However, discrepancies often arise between patient perception and physicians\' documentation within the medical records, resulting in misunderstanding and suboptimal doctor-patient communication. In this study, we assessed the efficacy of generative artificial intelligence (AI) in comparing the content of patient perception as recorded in patient questionnaires and physicians\' records of the Department of Breast Surgery. We evaluated the precision and recall of the generative AI by comparison with human-created ground truth. Our results demonstrated the high performance of the generative AI in comprehending and contrasting symptoms and the entire content recorded differently by patients and physicians, with F1 scores ranging from 0.77 to 0.97. These results highlight the potential contribution of a generative AI to deeper mutual comprehension in healthcare scenarios.
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  • 文章类型: Journal Article
    关于一般人群对前交叉韧带(ACL)移植物选择的看法知之甚少。
    使用先前验证的在线市场平台,评估一般人群对在ACL重建中使用同种异体移植物和自体移植物的看法。
    通过在线市场分发了一项有34个问题的前瞻性调查。收集基线人口统计信息后,确定了参与者对同种异体移植或自体移植进行ACL重建的偏好.所有受访者都完成了教育前调查,审查了一份循证教育表,并完成了教育后调查以评估他们的理解。完成后,参与者被问及他们更喜欢哪种移植物。然后询问参与者是否愿意根据外科医生的建议改变他们的偏好。最后,参与者被要求对教育表中最具影响力的因素进行排名.
    横断面研究。
    完成调查的参与者有491人(平均年龄,39.9年[范围,19-72岁];244名男性,241女,和6名非二元/第三性别参与者)。在阅读教育表之前,276(56%)报告没有移植偏好,146(30%)首选自体移植物,和69(14%)优选同种异体移植物。阅读提供的纸张后,226名(46%)参与者首选自体移植,185(38%)首选同种异体移植物,和80(16%)没有偏好。教育前测试的平均分是45%,教育后测验的平均得分明显更高(61%;P<0.01)。总的来说,345名参与者(83.9%)表示,如果他们的外科医生推荐,他们会改变对自体移植或同种异体移植的偏好。外科医生偏好(n=330;67%),提供的教育信息(n=117;24%),和先前的知识(n=44;9%)是进行移植物选择的最重要因素。在教育前后选择每种移植物类型的参与者的平均年龄如下:同种异体移植物(37.8±10.1vs40.6±11.8岁;P=0.05),自体移植(38±11.5vs39.5±10.1年;P=.21),无偏好(41.5±11.2vs39.4±11.8年;P=.16)。
    与信息询问前相比,教育导致更多的人报告偏爱移植物类型(同种异体移植物或自体移植物)。此外,如果外科医生推荐,83.9%的参与者愿意改变他们的移植物选择。
    UNASSIGNED: Little is known regarding the opinions of the general population on anterior cruciate ligament (ACL) graft options.
    UNASSIGNED: To evaluate the general population\'s perception of the use of allografts versus autografts in ACL reconstruction using a previously validated online marketplace platform.
    UNASSIGNED: A prospective 34-question survey was distributed via the online marketplace. After collecting baseline demographics, participant preferences for ACL reconstruction with an allograft or autograft were established. All respondents completed a preeducation survey, reviewed an evidence-based education sheet, and completed a posteducation survey to assess their understanding. Upon completion, participants were asked which graft they would prefer. Participants were then asked if they would be willing to change their preference based on surgeon recommendation. Finally, participants were asked to rank the factors from the education sheet that were most influential.
    UNASSIGNED: Cross-sectional study.
    UNASSIGNED: There were 491 participants that completed the survey (mean age, 39.9 years [range, 19-72 years]; 244 male, 241 female, and 6 nonbinary/third-gender participants). Before reading the education sheet, 276 (56%) reported no graft preferences, 146 (30%) preferred autograft, and 69 (14%) preferred allograft. After reading the provided sheet, 226 (46%) participants preferred autograft, 185 (38%) preferred allograft, and 80 (16%) had no preference. The mean score on the preeducation test was 45%, and the mean score on the posteducation test was significantly greater (61%; P < .01). Overall, 345 participants (83.9%) stated they would change their preference for autograft or allograft if their surgeon recommended it. Surgeon preference (n = 330; 67%), educational information provided (n = 117; 24%), and previous knowledge (n = 44; 9%) were the most important factors for making graft selections. The mean ages of the participants selecting each graft type before and after education were as follows: allograft (37.8 ± 10.1 vs 40.6 ± 11.8 years; P = .05), autograft (38 ± 11.5 vs 39.5 ± 10.1 years; P = .21), and no preference (41.5 ± 11.2 vs 39.4 ± 11.8 years; P = .16).
    UNASSIGNED: Education resulted in a greater number of individuals\' reporting a preference in graft type (either allograft or autograft) compared with preinformation questioning. In addition, 83.9% of the participants were willing to switch their graft choice if recommended by their surgeon.
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  • 文章类型: Journal Article
    手术切除是早期肺癌的主要治疗方法,但是对患者真正重要的结果知之甚少。我们研究的目的是确定对接受肺癌手术的患者最重要的术后结局方面,并探讨临床和人口统计学因素对其重要性评级的影响。
    我们对2021年11月至2022年5月在我们机构接受非小细胞肺癌肺切除术的患者进行了一项横断面研究。在手术前,使用自行开发的问卷和欧洲癌症研究与治疗组织核心健康相关生活质量问卷(EORTCQLQ-C30)对患者进行了调查。进行有序逻辑回归以确定个体患者因素与结果重要性评级之间的关联。
    40名患者在研究期间完成了调查。患者优先考虑肿瘤学结果,95%的R0切除和癌症复发评级为“非常重要”。其他重要因素包括总生存率(90%),术后并发症(例如,心肌梗塞:92.5%,感染:87.5%),以及再次手术的需要(82.5%)。与健康相关的生活质量因素,例如慢性疼痛(77.5%)和恢复正常的身体和运动水平(75%)的能力,也很重视。某些患者临床和人口统计学因素显示出与某些结果的重要性显著关联。术前健康相关的生活质量评分不影响结果重要性评分。
    这项研究提供了对接受肺癌手术的患者最重要的结果的见解。肿瘤结果和术后并发症被优先考虑,而瘢痕相关因素则不那么重要。患者的偏好因人口统计学和临床因素而异。了解这些偏好可以增强胸外科肿瘤学中的共同决策并改善以患者为中心的护理。
    UNASSIGNED: Surgical resection is the primary treatment for early-stage lung cancer, but little is known about the outcomes that truly matter to patients. This aim of our study was to identify the aspects of postoperative outcomes that matter most to patients undergoing lung cancer surgery and explore the influence of clinical and demographic factors on their importance ratings.
    UNASSIGNED: We performed a cross-sectional study of patients undergoing lung resection for non-small cell lung cancer at our institution from November 2021 to May 2022. Patients were surveyed using a self-developed questionnaire and the European Organisation for Research and Treatment of Cancer core health-related quality of life questionnaire (EORTC QLQ-C30) prior to surgery. Ordinal logistic regression was performed to determine associations between individual patient factors and outcome importance ratings.
    UNASSIGNED: Forty patients completed the survey during the study period. Patients prioritized oncologic outcomes, with 95% rating R0 resection and cancer recurrence as \"very important\". Other important factors included overall survival (90%), postoperative complications (e.g., myocardial infarction: 92.5%, infection: 87.5%), and the need for reoperation (82.5%). Health-related quality of life factors, such as chronic pain (77.5%) and the ability to return to normal physical and exercise levels (75%), were also highly valued. Certain patient clinical and demographic factors demonstrated significant associations with importance placed on certain outcomes. Preoperative health-related quality of life scores did not influence outcome importance ratings.
    UNASSIGNED: This study provides insights into the outcomes that matter most to patients undergoing lung cancer surgery. Oncologic outcomes and postoperative complications were prioritized, while scar-related factors were less important. Patient preferences varied based on demographic and clinical factors. Understanding these preferences can enhance shared decision-making and improve patient-centered care in thoracic surgical oncology.
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  • 文章类型: Journal Article
    背景:我们评估了性别对疾病严重程度的影响,健康相关生活质量(HRQoL),治疗管理,从银屑病关节炎(PsA)患者的角度和患者-医疗保健专业人员(HCP)的互动。
    方法:数据来自HarrisPoll进行的全球在线患者调查(2017年11月2日至2018年3月12日)。符合条件的患者年龄≥18岁,自我报告诊断为PsA>1年,在过去的12个月里拜访了风湿病专家/皮肤科医生,以前曾报道使用≥1种常规合成或生物疾病缓解抗风湿药。数据按性别分层,并进行描述性分析,通过二项式(卡方)检验推断,并通过多元逻辑回归模型。
    结果:纳入1286名患者的数据:52%为女性,48%为男性。通过导致PsA诊断的症状差异,表明男性和女性对疾病严重程度的不同看法。尽管接受了治疗,但仍报告症状;女性报告关节压痛多于男性,皮肤斑块/斑块,和附着物炎。与男性相比,更多的女性报告了PsA对其身体活动和情感/心理健康的主要/中等影响。转换药物的原因因性别而异,随着更多的女性转换,因为他们认为他们的药物不够有效,与他们的关节症状有关。更多的女性比男性非常满意他们与风湿病专家的沟通,更有可能讨论PsA对他们日常生活的影响,他们的治疗满意度,和风湿病专家的治疗目标。
    结论:患者对PsA对HRQoL的影响的看法,治疗管理,与HCPs的互动在男性和女性之间有所不同。报告PsA对身体和情感的主要/中等影响的女性多于男性。在治疗患者时,对于HCPs来说,考虑性别对患者PsA及其症状的潜在影响是很重要的。本文提供的图形简单语言摘要。
    BACKGROUND: We evaluated the impact of gender on disease severity, health-related quality of life (HRQoL), treatment management, and patient-healthcare professional (HCP) interactions from the perspectives of patients with psoriatic arthritis (PsA).
    METHODS: Data were collected from a global online patient survey conducted by The Harris Poll (November 2, 2017 to March 12, 2018). Eligible patients were aged ≥ 18 years, with a self-reported diagnosis of PsA for > 1 year, had visited a rheumatologist/dermatologist in the past 12 months, and had reported previously using ≥ 1 conventional synthetic or biologic disease-modifying antirheumatic drug. Data were stratified by gender and analyzed descriptively, inferentially by binomial (chi-square) tests, and by multivariate logistic regression models.
    RESULTS: Data from 1286 patients who participated were included: 52% were female, 48% were male. Varying perceptions of disease severity between males and females were indicated by differences in symptoms leading to a diagnosis of PsA, and in symptoms reported despite treatment; more females than males reported joint tenderness, skin patches/plaques, and enthesitis. More females than males reported a major/moderate impact of PsA on their physical activity and emotional/mental well-being. Reasons for switching medication differed between genders, with more females switching because they perceived their medication to not be effective enough related to their joint symptoms. More females than males were very satisfied with their communication with their rheumatologist and were more likely to discuss the impact of PsA on their daily lives, their treatment satisfaction, and treatment goals with their rheumatologist.
    CONCLUSIONS: Patients\' perceptions of the impact of PsA on HRQoL, treatment management, and interactions with HCPs varied between males and females. More females than males reported major/moderate physical and emotional impacts of PsA. When treating patients, it is important for HCPs to consider the potential impact of gender on patients\' experience of PsA and its symptoms. Graphical plain language summary available for this article.
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  • 文章类型: Journal Article
    背景和目的:脊髓性肌萎缩症(SMA)患者接受疾病改善治疗(DMT),通常根据在经过验证的功能量表上达到特定的改善阈值,将其分为有反应者或无反应者。这种分类可能会严重影响一些国家的治疗补偿。这项研究的目的是评估被认为是应答者或非应答者的患者对治疗的看法及其益处。方法:在这项非商业多中心研究中,99名接受对症治疗后的SMAI-III型患者在治疗开始时的中位年龄为11.2岁(0.39-57.4岁),根据其治疗结果分为三组。即,那些表现出临床上显着的改善(N=41),那些没有临床显著改善的人(N=18),或那些没有改善的(N=40)。治疗后15个月,使用基于患者总体变化印象(PGIC)量表的患者评分系统评估初始患者或患者的护理人员,包括22个问题,针对SMA患者日常生活中的重要方面和任务。结果:我们发现患者组22个领域中有17个领域的患者对治疗益处的看法没有统计学差异。结论:我们的结果表明,功能性运动量表不能概括患者和患者照顾者对nusinersen治疗SMA效果的经验。
    Background and Objective: Patients with spinal muscular atrophy (SMA) treated with a disease-modifying therapy (DMT) are often classified as responders or non-responders based on the attainment of a specific improvement threshold on validated functional scales. This categorization may significantly impact treatment reimbursement in some countries. The aim of this research is to evaluate the perception of treatments and their benefit by patients considered as responders or non-responders. Methods: In this non-commercial multicenter study, 99 post-symptomatically treated SMA type I-III patients with a median age of 11.2 (0.39-57.4) years at treatment initiation were stratified into three groups based on their treatment outcomes, i.e., those exhibiting clinically significant improvement (N = 41), those with non-clinically significant improvement (N = 18), or those showing no improvement (N = 40). Fifteen months after treatment, the initiation patients or patients\' caregivers were assessed using a patient-rated scoring system based on the Patient Global Impression of Change (PGIC) scale, comprising 22 questions targeting important aspects and tasks in the daily life of patients with SMA. Results: We found no statistical difference in the patient perception of treatment benefits in 17 out of 22 domains across patient groups. Conclusions: Our results suggest that functional motor scales do not recapitulate patients\' and patients\' caregivers\' experience of the effect of nusinersen treatment in SMA.
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  • 文章类型: Journal Article
    目的:为了制定和评估有效性,可靠性,以及将青春期前感知问卷翻译成可移动功能电器的阿拉伯语翻译。
    方法:根据以前使用的问卷起草了一份新的问卷。在内容和面部有效性小组中选择了12名正畸专家,并参加了20名穿着功能性矫治器的青春期前儿童参加了问卷的面部验证。与相同的专家进行两轮内容有效性。验证问卷的最终形式从英语翻译为阿拉伯语。采用内容效度指数(CVI)进行内容效度,采用Cronbachα检验评估问卷的内部一致性信度。
    结果:在第一轮内容有效性中,50个项目与基础结构相关(项目CVI≥0.78),而四项被认为无效(项目CVI<0.78),平均量表CVI为0.93。就专家的面部验证而言,协议的百分比是足够的(96.4%)。通过删除无效项目对问卷进行了修改,添加/修改项目,并合并一些类别。对于第二轮的内容有效性,所有项目均有效(I-CVI≥0.78),总体问卷具有足够的内容效度(Scale-CVI/Ave=0.94).翻译后的有效问卷也实现了患者面部有效性的完美一致性(100%)。内部一致性合适(≥0.7)。
    结论:新的有效,可靠,和翻译问卷(英文和阿拉伯文版本),涵盖了患者在使用可移动功能电器治疗期间的大部分感知方面。
    OBJECTIVE: To developed and evaluate the validity, reliability, and Arabic translation of a questionnaire for preadolescent perception to removable functional appliances.
    METHODS: A new questionnaire was drafted based on previously used questionnaires. Twelve orthodontic experts were selected within content and face validity panel and twenty preadolescents wearing functional appliances were participated in the face validation of the questionnaire. Two rounds of content validity were performed with the same experts. The final form of the validated questionnaire was translated from English to Arabic language. The content validity index (CVI) was used for content validity and the Cronbach\'s alpha test was used to assess the internal consistency reliability of the questionnaire.
    RESULTS: During the first round of content validity, 50 items were relevant to the underlying construct (Item-CVI ≥ 0.78), while four items were considered not valid (Item-CVI < 0.78) and the average scale-CVI was 0.93. In terms of face validation by experts, the percentage of agreement was adequate (96.4%). The questionnaire was modified by removing the non-valid items, adding/modifying items, and merging some categories. For second round of content validity, all items were found to be valid (I-CVI ≥ 0.78) and the overall questionnaire had adequate content validity (Scale-CVI/Ave = 0.94). The translated valid questionnaire also achieved a perfect agreement (100%) for face validity by patients. The internal consistency was appropriate (≥ 0.7).
    CONCLUSIONS: A new valid, reliable, and translated questionnaire (English and Arabic versions) that cover the majority of aspects of patients\' perception during treatment with removable functional appliances has been developed.
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  • 文章类型: Journal Article
    全面的口腔护理是一项以患者为中心的服务,和个人谁需要它往往面临有限的访问。患者感知作为提高质量的指南,确保患者未来使用服务的意图,并促进向他人推荐。本研究旨在评估患者对初级保健中心(PHC)提供的全面牙科服务的看法。
    这项定性研究基于现象学解释方法,并采用判断抽样的方法。经过验证的面试指南,从相关文献中开发出来,以当地语言对访问PHC的成年人进行访谈,收集他们对所提供服务的意见。采访是在数字录音机上录制的音频,和文件的密码保护。内容饱和度指导了最终访谈参与者数量的确定。翻译和转录采访后,使用ATLAS进行主题分析和编码.ti23适用于Windows。
    共有12名参与者被纳入研究,以下数据饱和。其中,有8名(66.7%)女性和4名(33.3%)男性参与者.通过指定的代码可以识别出十个总体主题,包括积极的观点,中立的观点,负面观点,以前去过的牙科诊所,以前的牙科治疗经验,在中心寻求治疗,转介,关于牙科中心的信息来源,后续访问和改进建议。
    这项研究的结果揭示了患者对PHC提供的全面牙科服务的积极看法。通过有见地的采访,各种优势,并确定了中心和护理提供方面需要改进的地方。这些见解提供了宝贵的建议,可用于提高牙科服务的利用率,确保患者护理的持续改进。
    UNASSIGNED: Comprehensive oral care is a service centered around the patient, and individuals who need it the most often face limited access. Patient perception acts as a guide for enhancing quality, ensuring patients\' future intent to utilize the services and facilitating recommendations to others. The present study aimed to assess the patients\' perception of comprehensive dental services availed at a Primary Health Center (PHC).
    UNASSIGNED: This qualitative study was based on a phenomenological interpretive approach, and judgment sampling method was employed. A validated interview guide, developed from relevant literature was employed in the local language to conduct interviews among adults visiting the PHC, gathering their views regarding the services provided. The interviews were audio recorded on a digital voice recorder, and files were password protected. Content saturation guided the determination of the final number of participants interviewed. After translating and transcribing the interviews, thematic analysis and coding were performed using ATLAS. ti 23 for Windows.
    UNASSIGNED: A total of 12 participants were included in the study, following data saturation. Among them, there were 8(66.7%) female and 4(33.3%) male participants. Ten overarching main themes were discerned through the assigned codes, including positive views, neutral views, negative views, previous dental clinics visited, previous experience with dental treatment, treatments sought at the center, referrals, source of information about the dental center, subsequent visits and suggestions for improvement.
    UNASSIGNED: The findings of this study revealed a positive patient perception of the comprehensive dental services offered at the PHC. Through insightful interviews, various strengths, and areas for improvement regarding the center and care provision were identified. These insights provide valuable suggestions that can be applied to elevate the utilization of dental services, ensuring continuous improvement in patient care.
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  • 文章类型: Journal Article
    关于SARS-CoV-2大流行对德国患者银屑病护理的影响的可用数据有限。
    分析大流行对德国中度至重度银屑病或银屑病关节炎患者在全身治疗下的幸福感和银屑病管理的影响。
    CoronaBest注册记录了SARS-CoV-2感染的事件,并分析了大流行对牛皮癣或牛皮癣关节炎患者的影响。2020年6月,2022年2月,银屑病或银屑病关节炎患者独立接受了目前治疗的标准化问卷,保护措施,幸福,以及COVID-19的个人风险等。
    包括2020年的4,194名患者(平均年龄为47.7岁,女性占41.8%)和2022年的4,818名患者(平均年龄为56.4岁,女性占42.9%)。在2020年和2022年,分别有2.7%和1.7%的患者停止治疗。在绝大多数情况下(>92%),在2020年或2022年,没有针对银屑病治疗的管理采取其他措施.那些有变化的患者报告最频繁:电话而不是面对面就诊(80.2%,2020年为40.5%,2022年为40.5%)或更频繁的控制(27.1%,2020年vs22.0%,2022年)。多数(66.7%,2020年,70.6%,2022年)没有将病毒视为相当大的威胁。医生对COVID-19有充分了解的患者比例从2020年的42.6%增加到2022年的51.8%。2020年,约81.1%的患者和2022年的67.5%的患者表示,他们的整体个人状况没有受到大流行的影响。医生认为大多数患者没有感染SARS-CoV-2的特殊风险。
    系统性治疗的持续存在以及对风险和保护措施的认识的高比率表明,在COVID-19大流行期间,银屑病的医疗保健在很大程度上遵循了当前的国家和国际建议。
    UNASSIGNED: Limited data are available characterizing the impact of the SARS-CoV-2 pandemic on psoriasis care for patients in Germany.
    UNASSIGNED: To analyze patient perception and impact of the pandemic on well-being and psoriasis management of German patients with moderate-to-severe psoriasis or psoriasis arthritis under systemic therapies.
    UNASSIGNED: The CoronaBest registry captures events of SARS-CoV-2 infections and analyzes the impact of the pandemic on patients with psoriasis or psoriasis arthritis. In June 2020, and independently in February 2022, patients with psoriasis or psoriasis arthritis received a standardized questionnaire for current treatment, protective measures, well-being, and individual risks for COVID-19, among others.
    UNASSIGNED: Included were 4,194 patients in 2020 (mean age of 47.7 years and 41.8% women) and 4,818 patients in 2022 (mean age of 56.4 and 42.9% women). Treatment discontinuations were observed in 2.7% and 1.7% of patients in 2020 and 2022, respectively. In the vast majority of the cases (>92%), no additional measures were taken concerning the management of psoriasis treatments in either 2020 or 2022. Those patients with changes reported most frequently: telephone calls instead of face-to-face visits (80.2%, in 2020 vs 40.5% in 2022) or more frequent controls (27.1%, 2020 vs 22.0%, 2022). A majority (66.7%, 2020, and 70.6%, 2022) did not perceive the virus as a considerable threat. The proportion of patients feeling well informed about COVID-19 by physicians increased from 42.6% in 2020 to 51.8% in 2022. About 81.1% of patients in 2020 and 67.5% in 2022 stated that their overall personal condition was not affected due to the pandemic. Physicians attributed no special risk of contracting SARS-CoV-2 in most of the patients.
    UNASSIGNED: A high rate of systemic treatment persistence and awareness of risks and protective measures indicate that health care for psoriasis largely followed current national and international recommendations during the COVID-19 pandemic.
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  • 文章类型: Journal Article
    背景:许多临床试验使用系统方法来监测不良事件(AE)并确定等级(严重程度),期待,以及与临床医生确定的治疗的相关性。然而,在这个过程中,患者的观点仍然缺乏。
    目的:在一项泌尿外科手术试验中,比较临床医生与患者的AE严重程度分级。次要目标是评估患者AE分级与决策和生活质量结果之间的关联,并确定患者观点是否随时间变化。
    方法:这是一项计划中的补充研究,“不良事件报告中的患者观点”(PPAR),一项随机试验,比较3种手术方法治疗阴道顶端脱垂。在家长审判中,每6个月根据标准化方案收集患者经历的AE,其中临床医生对AE严重程度进行分级(轻度,中度,严重/危及生命)。在这项子研究中,我们获得了19个预定的“PPARAE”的额外纵向患者视角。患者提供了他们自己的严重程度分级(轻度,中度,严重/非常严重/危及生命)在初始评估以及术后12和36个月。临床医生和患者被掩盖了彼此的报告。主要结果是评分者之间的协议(kappa统计,κ)用于初始临床医生和患者评估之间的AE严重程度,结合轻度和中度的患者等级。不良事件严重程度与决策后悔量表(DRS)之间的关联对决策量表(SDS)的满意度,简短形式的健康调查-12(SF-12),使用连续量表的Spearman相关系数(ρ)评估患者-总体改善印象(PGI-I)评分,PGI-I的Mantel-Haenszel卡方检验,和T检验或卡方检验,比较严重与其他等级的评估。为了描述患者观点随时间的变化,使用加权kappa系数估算了观察者内的AE严重程度等级随时间的一致性.
    结果:在360名随机分组的患者中,219例(61%)经历了总共527例PPAR不良事件(91%为中度,9%为严重/威胁生命的临床医生分级)。患者平均年龄为67岁,87%是白人,和12%的西班牙裔。报告任何PPAR事件的患者,最常见的是尿路感染(61%),从头尿失禁(35%),压力性尿失禁(22%),和大便失禁(13%)。临床医生和参与者严重程度分级之间的总体一致性较差(κ=0.24(95CI0.14,0.34)。在414名临床医生中,患者120级(29%)轻度,80(19%)严重。在临床医生评定为严重的39个不良事件中,患者15级(38%)轻度或中度。报告的最严重AE的初始患者分级与较差的DRS轻度相关(ρ=0.2,p=0.01),SF-12(ρ=-0.24,p<0.01)和PGI-I(p<0.01)。AE严重程度与SDS之间没有关联。最初分级为“严重”的患者更后悔,生活质量较低,与严重程度最差的人相比,全球对健康的印象较差(p<0.05)。在12个月(κ=0.48(95%CI0.39,0.58))和36个月(κ=0.45(95%CI0.37,0.53))时,患者的初始严重程度与后来的时间点之间的一致性相当。
    结论:临床医生和患者对AE严重程度的看法是不一致的。从患者的角度来看,更严重的严重程度与以患者为中心的结果相关。包括患者视角提供了用于评估外科手术的附加信息。
    Many clinical trials use systematic methodology to monitor adverse events and determine grade (severity), expectedness, and relatedness to treatments as determined by clinicians. However, patient perspectives are often not included in this process.
    This study aimed to compare clinician vs patient grading of adverse event severity in a urogynecologic surgical trial. Secondary objectives were to estimate the association of patient grading of adverse events with decision-making and quality of life outcomes and to determine if patient perspective changes over time.
    This was a planned supplementary study (Patient Perspectives in Adverse Event Reporting [PPAR]) to a randomized trial comparing 3 surgical approaches to vaginal apical prolapse. In the parent trial, adverse events experienced by patients were collected per a standardized protocol every 6 months during which clinicians graded adverse event severity (mild, moderate, severe/life-threatening). In this substudy, we obtained additional longitudinal patient perspectives for 19 predetermined \"PPAR adverse events.\" Patients provided their own severity grading (mild, moderate, severe/very severe/life-threatening) at initial assessment and at 12 and 36 months postoperatively. Clinicians and patients were masked to each other\'s reporting. The primary outcome was the interrater agreement (kappa statistic) for adverse event severity between the initial clinician and patient assessment, combining patient grades of mild and moderate. The association between adverse event severity and the Decision Regret Scale, Satisfaction with Decision Scale, the 12-Item Short-Form Health Survey, and Patient Global Impression of Improvement scores was assessed using the Spearman correlation coefficient (ρ) for continuous scales, the Mantel-Haenszel chi-square test for Patient Global Impression of Improvement, and t tests or chi-square tests comparing the assessments of patients who rated their adverse events or symptoms as severe with those who gave other ratings. To describe patient perspective changes over time, the intraobserver agreement was estimated for adverse event severity grade over time using weighted kappa coefficients.
    Of the 360 randomly assigned patients, 219 (61%) experienced a total of 527 PPAR adverse events (91% moderate and 9% severe/life-threatening by clinician grading). Mean patient age was 67 years; 87% were White and 12% Hispanic. Among the patients reporting any PPAR event, the most common were urinary tract infection (61%), de novo urgency urinary incontinence (35%), stress urinary incontinence (22%), and fecal incontinence (13%). Overall agreement between clinician and participant grading of severity was poor (kappa=0.24 [95% confidence interval, 0.14-0.34]). Of the 414 adverse events that clinicians graded as moderate, patients graded 120 (29%) as mild and 80 (19%) as severe. Of the 39 adverse events graded as severe by clinicians, patients graded 15 (38%) as mild or moderate. Initial patient grading of the most severe reported adverse event was mildly correlated with worse Decision Regret Scale (ρ=0.2; P=.01), 12-Item Short-Form Health Survey (ρ=-0.24; P<.01), and Patient Global Impression of Improvement (P<.01) scores. There was no association between adverse event severity and Satisfaction with Decision Scale score. Patients with an initial grading of \"severe\" had more regret, lower quality of life, and poorer global impressions of health than those whose worst severity grade was mild (P<.05). Agreement between the patients\' initial severity ratings and their ratings at 12 months (kappa=0.48 [95% confidence interval, 0.39-0.58]) and 36 months (kappa=0.45 [95% confidence interval, 0.37-0.53]) was fair.
    Clinician and patient perceptions of adverse event severity are discordant. Worse severity from the patient perspective was associated with patient-centered outcomes. Including the patient perspective provides additional information for evaluating surgical procedures.
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