A Behavior-Based Model to Validate Electronic Systems Designed to Collect Patient-Reported Outcomes: Model Development and Application.

Background: The merits of technology have been adopted in capturing patient-reported outcomes (PROs) by incorporating PROs into electronic systems. Following the development of an electronic system, evaluation of system performance is crucial to ensuring the collection of meaningful data. In contemporary PRO literature, electronic system validation is overlooked, and evidence on validation methods is lacking.

Ultrasound Urodynamics: A Review of Ultrasound Imaging Techniques for Enhanced Bladder Functional Diagnostics.

Purpose Of Review: Invasive urodynamics are currently used to diagnose disorders of bladder function. However, due to patient discomfort as well as artifacts induced by catheters and non-physiologic filling, less invasive screening tools that can improve diagnostic information, such as ultrasound are required. The purpose of this review is to assess different modalities of ultrasound as applied to functional bladder imaging.

Patient-initiated follow-up in gynaecology: Patient and clinician views.

Objectives: Follow-up appointments in the UK National Health Service account for up to two thirds of outpatient activity, but there is a significant resource impact in providing time fixed follow-up appointments. Increasingly patient initiated follow-up is being used, to make follow-up appointments work better for patients both in terms of timing and necessity, and to reduce unnecessary outpatient activity. The objective of this study was to use a modified questionnaire to evaluate patient and clinician views regarding Patient-Initiated Follow-Up (PIFU) in gynaecology services and identify subgroups suited to this pathway of care.

Management of small (T1-T2) anal margin squamous cell carcinoma: clinical outcomes following local excision alone.

Aim: Squamous cell carcinomas of the anus are normally treated with synchronous chemoradiotherapy (CRT). Small, localized anal margin tumours may be adequately treated by local excision (LE) alone. This study aims to investigate the outcomes of patients with anal margin tumours treated with LE alone, reserving the use of CRT for salvage on local recurrence (LR).

Impact of surgeon volume on 18-month unclosed ileostomy rate after restorative rectal cancer resection.

Aim: The impact of surgeon volume on 18-month unclosed ileostomy rates after rectal cancer surgery has not been fully explored. The aim of this study was to describe the effect of surgeon volume and evaluate factors predictive of an unclosed ileostomy.

Method: Patients undergoing anterior resection with a diverting ileostomy for rectal cancer from March 2004 to October 2018 were identified from a prospectively maintained database.

What is the role of the multidisciplinary team meeting in primary prolapse surgery and are alternative formats acceptable?

Introduction And Hypothesis: In 2019, the UK National Institute for Health and Care Excellence (NICE) recommended discussion of all primary prolapse cases at a multidisciplinary team (MDT) meeting prior to surgery. However, following the COVID-19 pandemic, face-to-face meetings were suspended. The aim of this study was to evaluate the role of MDT meetings in an observational retrospective review of primary prolapse cases and determine whether alternatives to face-to-face MDT meetings such as virtual and remote paper result in different outcomes.

Patient experience of virtual urogynaecology services during Covid-19 pandemic.

Introduction And Hypothesis: Due to increasing burden on outpatient services, there is a drive from NHS policy makers to utilise virtual clinics to help curb unsustainable demand. During the COVID-19 pandemic, urogynaecology clinics were converted to telephone consultation (TC). We used this opportunity to evaluate patient perspective and identify which patients may be best suited to TC.

Patient initiated follow up in Obstetrics and Gynaecology: A systematic review.

Background: The demand for outpatient hospital appointments has risen steadily over recent years, almost doubling since 2008; now standing at 120 million appointments per year. Initiatives to reduce unnecessary appointments are a key area of interest, as they can be an effective way of both improving patient care and satisfaction, as well as reducing NHS costs. Patient Initiated Follow-Up (PIFU) provides an alternative to traditional hospital instigated follow-up, by which patients have autonomy in their future care, allowing them to make appointments based on their own perception of need.

Systematic review of sexual function in older women.

Objective: As life expectancy increases and women are remaining healthy in to older age, sexual function in later life is an increasingly important and relevant topic for both women and clinicians. As a foundation to a wider project examining sexual function in later life, we undertook a systematic review and meta-analysis to investigate sexual frequency and sexual function in women over the age of 60.

Methods: A literature search of the AMED (Allied and Complementary Medicine), EMBASE and MEDLINE databases was performed, using search terms including 'sexual function', 'elderly', 'female', 'woman', 'sexuality'.

Patient experience of telephone consultations in gynaecology: a service evaluation.

Objective: To investigate patient perspective of telephone consultations (TCs) in gynaecology and identify which patients benefit most from a telemedicine system.

Design: Service evaluation.

Setting: Gynaecology outpatient services at a tertiary referral hospital.

Incorporating Process Utility into Cost-Effectiveness Analysis via a Bolt-On Domain to the SF-6D: An Exploratory Study.

Background: Within the UK, standard methods of economic evaluation centre on the maximisation of the quality-adjusted life-year (QALY). However, preference-based measures used to estimate QALYs may not be suited to all economic evaluations, as they routinely measure only health outcomes.

Aim: This study used an economic evaluation alongside a clinical trial (EEACT) comparing patients' preferences for a telephone versus a face-to-face consultation to incorporate process utility into cost-effectiveness analyses.

Can electronic assessment tools improve the process of shared decision-making? A systematic review.

Background: Patient involvement in decision-making plays a prominent role in improving the quality of healthcare. Despite this, shared decision-making is not routinely implemented. However, electronic assessment tools that capture patients' history, symptoms, opinions and values prior to their medical appointment are used by healthcare professionals during patient consultations to facilitate shared decision-making.

Mixed methods study to develop the content validity and the conceptual framework of the electronic patient-reported outcome measure for vascular conditions.

Objective: The aim of this paper is to describe the stages undertaken to generate the items and conceptual framework of a new electronic personal assessment questionnaire for vascular conditions.

Design: A mixed methods study: First a survey of vascular clinicians was completed to identify the most common conditions treated in vascular clinics and wards. Quantitative systematic reviews were done to identify validated patient-reported outcome measures (PROMs) for direct inclsuion in the new instrument.

Evaluation of bladder shape using transabdominal ultrasound: Feasibility of a novel approach for the detection of involuntary detrusor contractions.

Conventional assessment of overactive bladder syndrome uses invasive pressure-measuring catheters to detect bladder contractions (urodynamics). We hypothesised that bladder shape changes detected and measured using transabdominal ultrasound scan could provide a non-invasive and clinically useful alternative investigation of bladder contractions. This feasibility study evaluated a novel transabdominal ultrasound scan bladder shape test during conventional urodynamics and physiological bladder filling.

Electronic personal assessment questionnaire for vascular conditions (ePAQ-VAS): development and validity.

Background: This paper describes the development and validation of an electronic personal assessment questionnaire for vascular conditions (ePAQ-VAS) that captures the symptomatology, quality of life and clinically relevant data of patients presenting to vascular services.

Methods: A two-stage survey was conducted in patients attending a tertiary vascular department. Patients completed the ePAQ-VAS remotely online, or on site using an electronic tablet.

Development and initial psychometric testing of a body-image domain within an electronic pelvic floor questionnaire (ePAQ-pelvic floor).

Introduction: Urogynaecological conditions have been shown to negatively impact on body image in a number of previous studies. ePAQ-Pelvic Floor (ePAQ-PF) is a patient-reported outcome measure used in clinical practice to assess urogynaecological conditions and their impact on quality of life. This study aimed to develop and undertake initial psychometric testing of a new domain to assess urogynaecological body image within ePAQ-PF.

What Is the Effect of Body Mass Index on Subjective Outcome Following Vaginal Hysterectomy for Prolapse?

Purpose: Obesity is a significant risk factor for pelvic organ prolapse (POP), but the effects of obesity on outcomes of surgery for POP are poorly understood. The aim of this study was to assess the relationship between POP symptomatology, subjective outcomes of surgery and body mass index (BMI) in women undergoing vaginal hysterectomy for POP.

Methods: Pre- and postoperative data from a validated pelvic floor questionnaire (electronic Personal Assessment Questionnaire-Pelvic Floor) were collected prospectively from 60 women undergoing vaginal hysterectomy for POP.

Development and initial validation of an electronic personal assessment questionnaire for menstrual, pelvic pain and gynaecological hormonal disorders (ePAQ-MPH).

Objective: Menstrual disorders, pelvic-pain and gynaecological hormonal conditions in women can have a significant impact on quality-of-life. Reliable assessment and monitoring of these intimate conditions is challenging. Patient reported outcome measures (PROMs) can be invaluable in providing objective assessment, but no comprehensive PROM assessing all of these conditions and their impact on quality of life is currently available.

Self-management in women with stress incontinence: strategies, outcomes and integration into clinical care.

The objective of this review is to present and discuss up-to-date conservative treatment strategies for the management of stress urinary incontinence (SUI) in women. This review aims to provide an overview of the importance of initial self-management strategies and conservative management options for women with SUI and how these treatments can be integrated into clinical practice. The various treatment modalities available including pelvic floor physiotherapy, biofeedback, and neuromuscular electrical stimulation devices, in addition to lifestyle changes which can significantly affect symptoms, are discussed.

Patient-reported outcome measures which assess body image in urogynaecology patients: a systematic review.

Aim: Urogynaecological conditions can have a significant impact on body image. Patient-reported outcome measures (PROMs) are widely used in urogynaecology to assess symptoms and their impact on quality of life. This systematic review aimed to identify currently available PROMs used to assess body image within a urogynaecological population and to identify the most psychometrically robust and appropriate PROM tools to use in this context.

A systematic review of non-invasive modalities used to identify women with anal incontinence symptoms after childbirth.

Introduction And Hypothesis: Anal incontinence following childbirth is prevalent and has a significant impact upon quality of life (QoL). Currently, there is no standard assessment for women after childbirth to identify these symptoms. This systematic review aimed to identify non-invasive modalities used to identify women with anal incontinence following childbirth and assess response and reporting rates of anal incontinence for these modalities.

A prospective observational study of the impact of an electronic questionnaire (ePAQ-PO) on the duration of nurse-led pre-operative assessment and patient satisfaction.

Objective: Standard pre-operative assessment at our institution involves a comprehensive history and examination by a nurse practitioner. An electronic pre-operative assessment questionnaire, ePAQ-PO® (ePAQ, Sheffield, UK) has previously been developed and validated. This study aimed to determine the impact of ePAQ-PO on nurse consultation times and patient satisfaction in low-risk patients.

Self-Reported Vaginal Laxity-Prevalence, Impact, and Associated Symptoms in Women Attending a Urogynecology Clinic.

Introduction: Vaginal laxity is increasingly recognized as an important condition, although little is known regarding its prevalence and associated symptoms.

Aim: To report the prevalence of self-reported vaginal laxity in women attending a urogynecology clinic and investigate its association with pelvic floor symptoms and female sexual dysfunction.

Method: Data were analyzed from 2,621 women who completed the electronic Personal Assessment Questionnaire-Pelvic Floor (ePAQ-PF).