Objective: To develop a set of core outcome measures for use in randomized controlled trials (RCTs) and longitudinal observational studies in juvenile idiopathic arthritis (JIA)-associated uveitis.
Methods: The literature relating to outcome measures used in studies of uveitis in childhood and adolescence was reviewed. A set of core outcomes and domains was established using the Delphi process. This was reviewed by a representative multinational interdisciplinary working group. Nominal group technique consensus was reached on face and content validity of the range and content of the domains. The outcomes and the appropriate instruments for uveitis trials were adapted to the age ranges of patients with JIA-associated uveitis.
Results: Consensus was reached that data should be reported at defined time points in longitudinal studies with patients stratified by prognostic markers. Visual acuity testing should be age appropriate. The severity of uveitis (measured as anterior chamber cell grade) and duration of active inflammation should be documented. Visually significant structural complications should be recorded and quantified with standard measures. The responses to treatment and corticosteroid-sparing effects of treatment should be documented. Patient-reported disease activity and age-specific uveitis-related quality of life should be reported using appropriate questionnaires.
Conclusion: The proposed outcome measures in JIA-associated uveitis should aid in the standardization and comparison of future RCTs of the treatment regimens for this disease. The proposed outcome measures will be verified in a prospective validation study.
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http://dx.doi.org/10.1002/acr.21674 | DOI Listing |
JAMA Netw Open
January 2025
Department of Radiology, Keio University School of Medicine, Tokyo, Japan.
Importance: The integration of patient-reported outcome (PRO) assessments in cardiovascular care has encountered considerable obstacles despite their established clinical relevance.
Objective: To assess the impact of a physician- and patient-friendly electronic PRO (ePRO) monitoring system on the quality of cardiovascular care in clinical practice.
Design, Setting, And Participants: This open-label, multicenter, pilot randomized clinical trial was phase 2 of a multiphase study that was conducted from October 2022 to October 2023 and focused on the implementation and evaluation of an ePRO monitoring system in outpatient clinics in Japan.
JAMA Netw Open
January 2025
Department of Psychiatry and Behavioral Sciences, University of California San Francisco.
Importance: Mindfulness meditation may improve well-being among employees; however, effects of digital meditation programs are poorly understood.
Objective: To evaluate the effects of digital meditation vs a waiting list condition on general and work-specific stress and whether greater engagement in the intervention moderates these effects.
Design, Setting, And Participants: This randomized clinical trial included a volunteer sample of adults (aged ≥18 years) employed at a large academic medical center who reported mild to moderate stress, had regular access to a web-connected device, and were fluent in English.
JAMA Netw Open
January 2025
Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston, Massachusetts.
Importance: Nearly all Medicare Advantage (MA) plans offer dental, vision, and hearing benefits not covered by traditional Medicare (TM). However, little is known about MA enrollees' use of those benefits or how much they cost MA insurers or enrollees.
Objective: To estimate use, out-of-pocket (OOP) spending, and insurer payments for dental, hearing, and vision services among Medicare beneficiaries.
Curr Opin Crit Care
January 2025
Spaulding Rehabilitation Hospital, Department of Physical Medicine and Rehabilitation, Charlestown.
Purpose Of Review: To increase knowledge of the natural history of recovery and long-term outcome following severe traumatic brain injury (sTBI).
Recent Findings: Recovery of consciousness and complex behaviors that presage subsequent functional recovery frequently occurs well beyond the first 7 days after injury, which is typically the time period widely used in the ICU for prognostic decision-making and establishing goals of care for. Similarly, recovery of functional independence occurs between 1 and 10 years postinjury in a substantial proportion of patients who do not recover command-following during the acute hospitalization.
J Nephrol
January 2025
Department of Medicine, Division of Nephrology, Loma Linda University Medical Center, Loma Linda, CA, USA.
The increasing prevalence of kidney failure highlights the crucial need for effective patient-physician communication to improve health-related quality of life and ensure adherence to treatment plans. This narrative review evaluates communication practices in the context of advanced kidney disease, focusing on the frameworks of shared decision-making, advanced care planning, and communication skills training among nephrologists. The findings highlight the significant gaps in patient-physician communication, particularly in the domains of advanced care planning, shared decision-making, and dialysis withdrawal.
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