Satisfaction and quality of life in women who undergo breast surgery: a qualitative study.

Background: In cosmetic and reconstructive breast surgery, measurement of patient-reported outcomes has become increasingly important to research efforts and clinical care. We aimed to describe how breast conditions and breast surgery impact on patient satisfaction and quality of life.

Methods: We conducted qualitative, in-depth interviews with 48 women who had undergone either breast reduction (n = 15), breast augmentation (n = 12), or breast reconstruction (n = 21) surgery in order to begin to build a theoretical understanding of patient satisfaction and quality of life in breast surgery patients.

The science behind quality-of-life measurement: a primer for plastic surgeons.

Plastic surgeons perform a wide range of surgical procedures that have diverse clinical goals and complex effects on patients' lives. In recent years, quality-of-life outcomes have become increasingly important to clinical practice and plastic surgery research. It is important, therefore, that plastic surgeons understand the scientific issues surrounding the appropriate development and use of questionnaires that measure quality of life; they may then directly shape how new measures are developed and used, and define the future of outcome measurement in plastic surgery.

Friedreich's ataxia impact scale: a new measure striving to provide the flexibility required by today's studies.

To develop, using modern techniques of rating scale construction, a new patient reported rating scale for clinical studies of Friedreich's ataxia (FA) that strives to meet the measurement needs of different types of study. Qualitative research methods were used to generate a conceptual framework of the impact of FA, and a pool of items necessary to construct a subscale for each area identified. This item pool was then administered to 492 people with FA.

Improving the evaluation of therapeutic interventions in multiple sclerosis: the role of new psychometric methods.

Objectives: In this monograph we examine the added value of new psychometric methods (Rasch measurement and Item Response Theory) over traditional psychometric approaches by comparing and contrasting their psychometric evaluations of existing sets of rating scale data. We have concentrated on Rasch measurement rather than Item Response Theory because we believe that it is the more advantageous method for health measurement from a conceptual, theoretical and practical perspective. Our intention is to provide an authoritative document that describes the principles of Rasch measurement and the practice of Rasch analysis in a clear, detailed, non-technical form that is accurate and accessible to clinicians and researchers in health measurement.

Dense chromatin plates in metaphase chromosomes.

In a previous work we observed multilayered plate-like structures surrounding partially denatured HeLa chromosomes at metaphase ionic conditions. This unexpected finding has led us to carry out an extensive investigation of these structures. Our results show that plates can also be found in metaphase chromosomes from chicken lymphocytes.

Measuring quality of life in dysphonic patients: a systematic review of content development in patient-reported outcomes measures.

To review existing patient reported outcomes measures (PROMs) used in dysphonic populations to assess the procedures used in their development and the extent to which these meet current development standards for content generation and psychometric evaluation. The study is a systematic review. A systematic review of Medline, Cumulative Index to Nursing & Allied Health, and Health and Psychosocial Instruments databases was completed using voice, quality of life, and PROMs as keywords.

Interaction of age and specific saliva component output on caries.

Background And Aims: The purpose of this study was to explore the relationship between individual salivary components, dental caries and age, utilizing the data from the Oral Health: San Antonio Longitudinal Study of Aging (OH:SALSA).

Methods: The study population comprised a well-defined stratified sample of 811 dentate men and women. Subjects were divided into four age groups from 35 to 75+ years old.

Measuring patient outcomes in breast augmentation: introducing the BREAST-Q Augmentation module.

The Breast-Q Augmentation module is a new and unique questionnaire for measuring patient-reported outcomes following breast augmentation. It has undergone a rigorous development and validation process and is currently the only questionnaire for breast augmentation that meets international and federal standards for questionnaire development. The Breast-Q Augmentation module covers a comprehensive set of concerns of breast augmentation patients, including satisfaction with breasts and impact on quality of life.

Risk factors for stroke after coronary artery bypass grafting.

Background: Stroke is a feared complication after coronary artery bypass grafting surgery (CABG), with an incidence between 1.3 and 4.3%.

Evaluating family-centred service in paediatric oncology with the measure of processes of care (MPOC-20).

Background: In order to evaluate the family-centeredness of paediatric oncology services, a psychometrically sound measure of family-centred services is needed. We performed a comprehensive evaluation of the psychometric properties of the 20-item Measure of Processes of Care (MPOC-20) in parents of children undergoing treatment for cancer at five paediatric oncology centres in Canada.

Methods: The sample included 411 parents (80% response rate).

Functional and metabolic implications of biotin deficiency for the rat heart.

The tricarboxylic acid (TCA) cycle is the main ATP provider for the heart. TCA carbons must be replenished by anaplerosis for normal cardiac function. Biotin is cofactor of the anaplerotic enzymes pyruvate and propionyl-CoA carboxylases.

The cervical dystonia impact profile (CDIP-58): can a Rasch developed patient reported outcome measure satisfy traditional psychometric criteria?

Background: The United States Food and Drug Administration (FDA) are currently producing guidelines for the scientific adequacy of patient reported outcome measures (PROMs) in clinical trials, which will have implications for the selection of scales used in future clinical trials. In this study, we examine how the Cervical Dystonia Impact Profile (CDIP-58), a rigorous Rasch measurement developed neurologic PROM, stands up to traditional psychometric criteria for three reasons: 1) provide traditional psychometric evidence for the CDIP-58 in line with proposed FDA guidelines; 2) enable researchers and clinicians to compare it with existing dystonia PROMs; and 3) help researchers and clinicians bridge the knowledge gap between old and new methods of reliability and validity testing.

Methods: We evaluated traditional psychometric properties of data quality, scaling assumptions, targeting, reliability and validity in a group of 391 people with CD.

Reduced E-cadherin expression correlates with disease progression in Paget's disease of the vulva but not Paget's disease of the breast.

The growth and metastasis of many cancers is due in part to loss of cell-cell adhesion. E-cadherin, plakoglobin and beta-catenin are important in cell adhesion. Our aim was to examine the presence of these molecules in Paget's disease of the vulva and Paget's disease of the breast, and to correlate any differences in their expression with the presence of invasive disease or an underlying carcinoma.

Prenatal diagnosis of clubfoot in low-risk population: associated anomalies and long-term outcome.

Objectives: To evaluate associated congenital anomaly risk, need for surgical treatment and long-term outcome in prenatally diagnosed clubfoot.

Methods: A retrospective study of 20 663 pregnant women who underwent routine ultrasound scanning at 18 to 22 weeks of gestation. Clubfoot was considered as complex or isolated if other structural or chromosomal abnormalities were also present or not.

Clinical research in breast surgery: reduction and postmastectomy reconstruction.

In the last decade, entirely new techniques in breast reduction and reconstruction have evolved. What remains unclear is whether or not these new procedures, some of which carry additional surgical risk and cost, are superior from a patient perspective. Thus, plastic surgeons are ever more reliant on clinical research to provide high-level evidence to facilitate clinical decision-making, as well as policy negotiations and advocacy.

Rating scales as outcome measures for clinical trials in neurology: problems, solutions, and recommendations.

Have state-of-the-art clinical trials failed to deliver treatments for neurodegenerative diseases because of shortcomings in the rating scales used? This Review assesses two methodological limitations of rating scales that might help to answer this question. First, the numbers generated by most rating scales do not satisfy the criteria for rigorous measurements. Second, we do not really know which variables most rating scales measure.

Measuring quality of life in cosmetic and reconstructive breast surgery: a systematic review of patient-reported outcomes instruments.

Background: Patient-reported outcomes in cosmetic and reconstructive breast surgery are increasingly important for clinical research endeavors. Traditional surgical outcomes, centered on morbidity and mortality, remain important but are no longer sufficient on their own. Quality of life has become a crucial research topic augmenting traditional concerns focused on complications and survival.

Vocational rehabilitation services for people with multiple sclerosis: what patients want from clinicians and employers.

Background: The NSF for Long-term Neurological Conditions highlights the need for vocational rehabilitation services. Although the barriers to work for people with MS (pwMS) have been clearly identified, there has been little research that identifies the type of support required.

Objective: To identify what pwMS require from a vocational rehabilitation service in terms of content and service delivery.

The Sino-Nasal Outcome Test (SNOT): can we make it more clinically meaningful?

Objective: To test whether subscales should be used when analyzing the Sino-Nasal Outcome Test (SNOT).

Study Design And Setting: Prospective cohort study involved 87 acute NHS hospitals in England and Wales.

Results: With the use of exploratory factor analysis we found evidence for the existence of four unique constructs within the SNOT.

A systematic review of patient-reported outcome measures in head and neck cancer surgery.

Objective: To identify, summarize, and evaluate patient-reported outcome questionnaires for use in head and neck cancer surgery with the view to making recommendations for future research.

Data Sources: A systematic review of the English-language literature, with the use of head-and-neck-surgery-specific keywords, was performed in the following databases: Medline, Embase, HAPI, CINAHL, Science/Social Sciences Citation Index, and PsycINFO from 1966 to March 2006. DATA EXTRACTION AND STUDY SELECTION: All English-language instruments identified as patient-reported outcome questionnaires that measure quality of life and/or satisfaction that had undergone development and validation in a head and neck cancer surgery population were included.

CDIP-58 can measure the impact of botulinum toxin treatment in cervical dystonia.

We compared the responsiveness of the Cervical Dystonia Impact Profile (CDIP-58), Medical Outcome Study Short Form-Health Survey (SF-36), Functional Disability Questionnaire (FDQ), and Pain and Activities of Daily Living subscales of the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) in participants with cervical dystonia treated with botulinum toxin A. Subscales of CDIP-58 were more sensitive in detecting statistical and clinical change than comparable subscales of the SF-36, FDQ, and TWSTRS.

Should patients participate in clinical decision making? An optimised balance block design controlled study of goal setting in a rehabilitation unit.

Objectives: The recent National Service Framework for Long Term Conditions recommends that patients participate more in decision making about their care. However, few protocols exist to support this. One potentially useful method is goal setting, but little has been done to evaluate the added value of increasing patient participation in this way.

Exploring disability rating scale responsiveness II: do more response options help?

The Barthel Index (BI) may underestimate disability change because its items have few response options. We examined whether a similar scale with more response options (Functional Independence Measure, FIM) was more responsive (n = 1,396). The FIM had greater potential for responsiveness and identified more people who changed.