Feasibility study of the Digital Patient Benefit Assessment Scale (P-BAS): A Digital Tool to Assess Individual Patient Goals.

The study objective was to assess the feasibility of the Patient Benefit Assessment Scale (P-BAS), a digital tool designed to enable older outpatients (≥70 years) to elucidate at home their individual goals regarding their current medical issue. Several digital tools are developed to assist older people in identifying their goals, thereby facilitating the process of shared decision making. However, studies on the feasibility of these digital tools, especially in older patients, are limited.

Diagnostic accuracy of the Dutch version of the 4AT for delirium detection in a mixed patient population and setting.

Background: Delirium is an acute disturbance in attention, awareness and cognition. Immediate detection in older adults is recommended because delirium is associated with adverse outcomes. The 4 'A's Test (4AT) is a short screening instrument for delirium.

Goal-based outcomes of hospitalisation of older adults are predicted by gender, confidence, quality of life and type of goals.

Purpose: Although patient-reported outcome measures (PROMs) might reflect relevant outcomes from patient perspective, they do not always reflect what the individual patient finds important. Our objectives were to assess which PROM was best suited to evaluate patient-relevant outcomes of hospitalisation and to assess which factors predicted this PROM.

Methods: A longitudinal study was conducted among hospitalised older patients.

Head-to-head comparison of 14 prediction models for postoperative delirium in elderly non-ICU patients: an external validation study.

Objectives: Delirium is associated with increased morbidity, mortality, prolonged hospitalisation and increased healthcare costs. The number of clinical prediction models (CPM) to predict postoperative delirium has increased exponentially. Our goal is to perform a head-to-head comparison of CPMs predicting postoperative delirium in non-intensive care unit (non-ICU) elderly patients to identify the best performing models.

Adaptation of the Patient Benefit Assessment Scale for Hospitalised Older Patients: development, reliability and validity of the P-BAS picture version.

Background: The Patient Benefit Assessment Scale for Hospitalised Older Patients (P-BAS HOP) is a tool developed to both identify the priorities of the individual patient and to measure the outcomes relevant to him/her, resulting in a Patient Benefit Index (PBI), indicating how much benefit the patient had experienced from the hospitalisation. The reliability and the validity of the P-BAS HOP appeared to be not yet satisfactory and therefore the aims of this study were to adapt the P-BAS HOP and transform it into a picture version, resulting in the P-BAS-P, and to evaluate its feasibility, reliability, validity, responsiveness and interpretability.

Methods: Process of instrument development and evaluation performed among hospitalised older patients including pilot tests using Three-Step Test-Interviews (TSTI), test-retest reliability on baseline and follow-up, comparing the PBI with Intraclass Correlation Coefficient (ICC), and hypothesis testing to evaluate the construct validity.

Plasma 5-HIAA activity indicative of serotonergic disturbances in cognitively impaired, elderly patients experiencing postoperative delirium.

Objectives: Delirium frequently arises in older demented and non-demented patients in postoperative, clinical settings. To date, the underlying pathophysiological mechanisms remain poorly understood. Monoamine neurotransmitter alterations have been linked to delirium and cognitive impairment.

Determinants of trajectories of fatigability and mobility among older medical patients during and after hospitalization; an explorative study.

Background: Fatigability is an important marker of functional decline in community dwelling older people, yet its relationship with functional decline after hospitalization is unclear. The objectives of this study were to identify trajectories of fatigability and mobility over time and to examine the association between demographic and clinical characteristics and these trajectories in medical patients aged 70 years and older admitted to a Dutch tertiary care teaching hospital.

Methods: In this prospective cohort study with baseline (in-hospital), discharge, three-, and six-months post discharge follow-up measurements, fatigability was assessed by the physical subscale of the Pittsburgh Fatigability Scale (PFS).

Association between dementia parental family history and mid-life modifiable risk factors for dementia: a cross-sectional study using propensity score matching within the Lifelines cohort.

Objective: Individuals with a parental family history (PFH) of dementia have an increased risk to develop dementia, regardless of genetic risks. The aim of this study is to investigate the association between a PFH of dementia and currently known modifiable risk factors for dementia among middle-aged individuals using propensity score matching (PSM).

Design: A cross-sectional study.

Reproducibility and responsiveness of the Frailty Index and Frailty Phenotype in older hospitalized patients.

Background: There is growing interest for interventions aiming at preventing frailty progression or even to reverse frailty in older people, yet it is still unclear which frailty instrument is most appropriate for measuring change scores over time to determine the effectiveness of interventions. The aim of this prospective cohort study was to determine reproducibility and responsiveness properties of the Frailty Index (FI) and Frailty Phenotype (FP) in acutely hospitalized medical patients aged 70 years and older.

Methods: Reproducibility was assessed by Intra-Class Correlation Coefficients (ICC), standard error of measurement (SEM) and smallest detectable change (SDC); Responsiveness was assessed by the standardized response mean (SRM), and area under the receiver operating characteristic curve (AUC).

Goals and outcomes of hospitalised older people: does the current hospital care match the needs of older people?

Background: Due to the rising number of acutely hospitalised older people in the coming years, there is increased interest in tailoring care to the individual goals and preferences of patients in order to reach patient-centred care.

Aims: To investigate the goals of older hospitalised patients and the extent to which these goals were reached during hospitalisation.

Methods: A single-centre prospective cohort study was performed in The Netherlands between December 2017 and January 2018.

Geriatric Syndromes and Incident Chronic Health Conditions Among 9094 Older Community-Dwellers: Findings from the Lifelines Cohort Study.

Objectives: To determine the association between geriatric syndromes and any specific incident chronic health conditions among older community-dwellers.

Design: Population-based cohort study over a median follow-up period of 43 months.

Setting And Participants: Participants from the Lifelines Cohort Study aged 60 years and older without presence of the studied chronic health conditions at baseline (n = 9094).

Reliability and validity of the Patient Benefit Assessment Scale for Hospitalised Older Patients (P-BAS HOP).

Background: The Patient Benefit Assessment Scale for Hospitalised Older Patients (P-BAS HOP) is a tool which is capable of both identifying the priorities of the individual patient and measuring the outcomes relevant to him/her, resulting in a Patient Benefit Index (PBI) with range 0-3, indicating how much benefit the patient had experienced from the admission. The aim of this study was to evaluate the reliability, validity, responsiveness and interpretability of the P-BAS HOP.

Methods: A longitudinal study among hospitalised older patients with a baseline interview during hospitalisation and a follow-up by telephone 3 months after discharge.

Development of a new tool for the assessment of patient-defined benefit in hospitalised older patients: the Patient Benefit Assessment Scale for Hospitalised Older Patients (P-BAS HOP).

Objectives: To support the shift from disease-oriented towards goal-oriented care, we aimed to develop a tool which is capable both to identify priorities of an individual older hospitalised patient and to measure the outcomes relevant to him.

Design: Mixed-methods design with open interviews, three step test interviews (TSTIs) and a quantitative field test.

Setting: University teaching hospital and a regional teaching hospital.

Delirium, functional decline and quality of life after transcatheter aortic valve implantation: An explorative study.

Aim: Transcatheter aortic valve implantation (TAVI) has become an important treatment option for older patients with severe aortic stenosis. However, not all patients benefit from this procedure in terms of functional outcome and quality of life. This complicates patient selection and shared decision-making.

Uptake and effectiveness of a tailor-made online lifestyle programme targeting modifiable risk factors for dementia among middle-aged descendants of people with recently diagnosed dementia: study protocol of a cluster randomised controlled trial (Demin study).

Introduction: Descendants of patients with dementia have a higher risk to develop dementia. This study aims to investigate the uptake and effectiveness of an online tailor-made lifestyle programme for dementia risk reduction (DRR) among middle-aged descendants of people with recently diagnosed late-onset dementia.

Methods And Analysis: Demin is a cluster randomised controlled trial, aiming to include 21 memory clinics of which 13 will be randomly allocated to the passive (poster and flyer in a waiting room) and 8 to the active recruitment strategy (additional personal invitation by members of the team of the memory clinic).

COVID-19: Technology-Supported Remote Assessment of Pediatric Asthma at Home.

The COVID-19 crisis has pressured hospital-based care for children with high-risk asthma as they have become deprived of regular clinical evaluations. However, COVID-19 also provided important lessons about implementing novel directions for care. Personalized eHealth technology, tailored to the individual and the healthcare system, could substitute elements of hospital care and facilitate early and appropriate medical anticipation in response to imminent loss of control.

Screening instruments for cognitive impairment in older patients in the Emergency Department: a systematic review and meta-analysis.

Background: cognitive impairment is highly prevalent among older patients attending the Emergency Department (ED) and is associated with adverse outcomes.

Methods: we conducted a systematic review and meta-analysis to evaluate the diagnostic accuracy of cognitive screening instruments to rule out cognitive impairment in older patients in the ED. A comprehensive literature search was performed in MEDLINE, EMBASE, CINAHL and CENTRAL.

The influence of a serious game's narrative on students' attitudes and learning experiences regarding delirium: an interview study.

Background: Delirium is a neuropsychiatric syndrome that affects patients' attention and awareness as a result of a physical condition. In recent years, persistent gaps in delirium education have led to suboptimal delirium care. Still, little is known about what are the most important aspects of effective delirium education.

Reasons to Engage in and Learning Experiences From Different Play Strategies in a Web-Based Serious Game on Delirium for Medical Students: Mixed Methods Design.

Background: Although many studies have recently been published on the value of serious games for medical education, little attention has been given to the role of dark play (choosing unacceptable actions in games).

Objective: This study aimed to investigate potential differences in the characteristics of medical students who have the opportunity to choose normal or dark play in a serious game. This study also aimed to compare their reasons for choosing a play strategy and their perceptions of what they learned from their game play.

Translation and validation of the Dutch Pittsburgh Fatigability Scale for older adults.

Background: The original Pittsburgh Fatigability Scale (PFS) was developed to assess perceived fatigability in older adults. The objective of this study was to translate the PFS into Dutch and investigate its validity and reliability among hospitalized older adults aged ≥70 years.

Methods: The PFS was translated into Dutch and pretested for comprehensibility by the Three-Step Test Interview method.

Physical and Pharmacological Restraints in Hospital Care: Protocol for a Systematic Review.

Background: Physical and pharmacological restraints, defined as all measures limiting a person in his or her freedom, are extensively used to handle unsafe or problematic behavior in hospital care. There are increasing concerns as to the extent with which these restraints are being used in hospitals, and whether their benefits outweigh their potential harm. There is currently no comprehensive literature overview on the beneficial and/or adverse effects of the use of physical and pharmacological restraints in the hospital setting.

Clinical impression for identification of vulnerable older patients in the emergency department.

Objectives: To investigate whether the clinical impression of vulnerability and the Dutch Safety Management Program (VMS), a screening instrument on four geriatric domains (activities in daily living, falls, malnutrition, delirium) are useful predictors of 1-year mortality in older patients in the emergency department.

Methods: This was a prospective observational study in the emergency department of a tertiary care teaching hospital. Patients aged 65 years and older visiting the emergency department, and their attending physicians and nurses were included.

Trajectories of self-rated health in an older general population and their determinants: the Lifelines Cohort Study.

Objectives: Poor self-rated health (SRH) is a strong predictor of premature mortality in older adults. Trajectories of poor SRH are associated with multimorbidity and unhealthy behaviours. Whether trajectories of SRH are associated with deviating physiological markers is unclear.

[Assessment instruments in frail older patients; a call for more standardisation].

Objective: To determine the frequency and background of the use of assessment instruments for the Comprehensive Geriatric Assessment by clinical geriatricians and internists in geriatric medicine; the secondary aim was to make an inventory of the willingness to standardise the assessment instruments used.

Design: A descriptive questionnaire study.

Method: In December 2016, we sent out a digital questionnaire (Survey Monkey) to all the hospitals in the Netherlands.