Average Administration Time Research Articles

Recorded Word Recognition Testing Is Worth the Time.

The goal of this study was to provide evidence of the inherent variability associated with monitored live voice (MLV) presentation methods and encourage audiologists to more closely follow best practice of using recorded stimuli. To accomplish the goal, administration times for word recognition testing were compared between MLV and MP3 recorded stimuli presented directly from an audiometer (computer assisted, CA). Furthermore, the variability of administration time across testers was evaluated. Fifty-word NU-6 lists were presented via MLV and CA to listeners with typical hearing (TH; defined as a four-frequency [500, 1000, 2000, and 4000 Hz] pure-tone average [PTA] of 20 dB HL or better) and hearing loss (HL; defined as a four-frequency PTA poorer than 20 dB HL). Audiologists and doctor of audiology students administered the word lists. Administration times were compared between the two presentation methods (MLV and CA). MLV administration time was significantly shorter than CA presentation time for both the TH and HL groups. There was also a significant difference in word recognition scores (WRS) between the TH and HL groups only when using the CA method. Most notably, there was significantly more variability in the administration time for MLV presentation across testers compared to the CA method. Data were compared to Mendel and Owen (2011), and MLV administration time was found to be significantly shorter than CA and compact disk (CD) administration time. Despite the shorter average administration time for MLV presentation compared to CA or CD, the significant variability in administration time among individual testers limits the clinical value of the test results. In addition, WRS for those with hearing loss were significantly poorer than those with TH when using CA but not for MLV, indicating that MLV is not sensitive to the presence of sensorineural hearing loss. Thus, using recorded word recognition is strongly recommended.

The application of waterless empirical taste test（WETT®） in 159 Chinese healthy subjects

Objective:This study examined the influences of age and gender on the taste function of a sizable sample of healthy Chinese subjects using the Waterless Empirical Taste Test（WETT®）, and provided scientific evidences for taste evaluation in clinic. Methods:A total of 159 subjects were tested based on strict inclusion and exclusion criteria. The 53 stimuli strips, presented on monomer cellulose pads, were designed to test 5 basic taste functions including sour, sweet, bitter, salty and umami of all subjects. The analysis was computed in SAS 9.4 statistical software. Results:The total taste score of the subjects was 35.00±8.94; the average test administration time was（21.61±7.80） min. The total test scores decreased across age categories（young group: 37.41±8.12, middle-aged group: 34.48±9.04, elderly group: 29.31±8.64）, the correlation coefficient between the total test scores and age was r=-0.335, P<0.05. There were significant differences in sour and bitter scores among different age groups（Psour=0.019, Pbitter<0.001）. Overall, women outperformed men on the total test（[36.53±8.72]vs[32.93±8.87], P=0.012）. There were correlations among individual taste of scores, and the correlation coefficient between umami and total score was the strongest（rumami/total=0.700，P<0.05）. Conclusion:This study demonstrated that a simple self-administered taste test, the WETT®, could be applied to Chinese healthy people. Age and gender-effects are the main factors which affect gustatory function.

177Lu-Dotatate administration using an infusion pump or a peristaltic pump: comparison of two methods

Objectives177Lu-oxodotreotide (Lutathera) is an intravenous peptide receptor radionuclide therapy to treat unresectable metastatic digestive neuroendocrine tumours. The recommended method for Lutathera administration is gravity infusion; however, other appropriate and safe...

Preliminary Results of MyCog, a Brief Assessment for the Detection of Cognitive Impairment in Primary Care

Early detection of Cognitive impairment (CI) is imperative to identify potentially treatable underlying conditions or provide supportive services when due to progressive conditions such as Alzheimer’s Disease. While primary care settings are ideal for identifying CI, it frequently goes undetected. We developed ‘MyCog’, a brief technology-enabled, 2-step assessment to detect CI and dementia in primary care settings. We piloted MyCog in 80 participants 65 and older recruited from an ongoing cognitive aging study. Cases were identified either by a documented diagnosis of dementia or mild cognitive impairment (MCI) or based on a comprehensive cognitive battery. Administered via an iPad, Step 1 consists of a single self-report item indicating concern about memory or other thinking problems and Step 2 includes two cognitive assessments from the NIH Toolbox: Picture Sequence Memory (PSM) and Dimensional Change Card Sorting (DCCS). 39%(31/80) participants were considered cognitively impaired. Those who expressed concern in Step 1 (n=52, 66%) resulted in a 37% false positive and 3% false negative rate. With the addition of the PSM and DCCS assessments in Step 2, the paradigm demonstrated 91% sensitivity, 75% specificity and an area under the ROC curve (AUC)=0.82. Steps 1 and 2 had an average administration time of <7 minutes. We continue to optimize MyCog by 1) examining additional items for Step 1 to reduce the false positive rate and 2) creating a self-administered version to optimize use in clinical settings. With further validation, MyCog offers a practical, scalable paradigm for the routine detection of cognitive impairment and dementia.

TBI-CareQOL family disruption: Family disruption in caregivers of persons with TBI.

Family disruption is often an indirect consequence of providing care for a person with traumatic brain injury (TBI). This article describes the development and preliminary validation of a Family Disruption scale designed for inclusion within the TBI-CareQOL measurement system. Five hundred thirty-four caregivers of persons with TBI (service member/veteran n = 316; civilian n = 218) completed the Family Disruption scale, alongside several other measures of caregiver strain and health-related quality of life. Classical test theory and item response theory (IRT)-based analyses were conducted to develop, and establish reliability and validity of, this scale. Exploratory and confirmatory factor analysis, as well as Samejima's graded response model-related IRT fit analyses, supported the development of a 3-item scale. This final scale is scored on a T score metric (M = 50; SD = 10); higher scores are indicative of more family disruption. Reliability (internal consistency; test-retest stability) was supported for both caregiver groups, and average administration times were under 10 s. Convergent and discriminant validity were supported by strong correlations between Family Disruption and measures of caregiver burden, and smaller correlations with positive aspects of caregiving. As evidence of known-groups validity, caregivers of lower-functioning persons with TBI experienced more family disruption than caregivers of higher functioning individuals. The TBI-CareQOL Family Disruption scale is a brief, reliable, and valid assessment of caregiver perceptions of how caring for an individual with a TBI interferes with family life. This measure is well-suited for inclusion in studies seeking to support family functioning in persons with TBI. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Preoperative cognitive screening tools

• Of the 29 cognitive screening tests that fit inclusion criteria, 7 tests have been used in preoperative settings. • These 7 had an average administration time ranging from one to 10 min. • Memory, language, and attention were the most commonly evaluated cognitive domains. • Most had adequate sensitivity and specificity to detect cognitive impairment/dementia. • The tools discussed are appropriate for lay examiners, are short in duration, and accessible for free or at a low cost.

Validation of the Spanish Version of Newcastle Stroke-Specific Quality of Life Measure (NEWSQOL).

Background: Stroke causes a wide variety of clinical manifestations that may have a negative impact on quality of life. Therefore, it is very important to use specific instruments for measuring quality of life in individuals who suffered a stroke. The aim of this study was to develop a psychometrically validated Spanish version of the Newcastle stroke-specific quality of life measure (NEWSQOL). Methods: A psychometric validation of the Spanish version of the NEWSQOL questionnaire was carried out in 159 patients. The reliability (intraclass correlation coefficient and Cronbach’s alpha coefficient), validity (factorial analysis and Spearman’s coefficient), feasibility (response rate), and the ceiling and floor effects were calculated. Results: Internal consistency showed that Cronbach’s alpha coefficient was 0.93. The test–retest reliability was high or excellent for all domains (range 0.71–0.97 p < 0.001). The response rate of the questionnaire was 100% and the average administration time was 20.5 (±7.2) min. No ceiling effect was detected and two domains (pain and vision) may have a significant potential for floor effect. Construct validity showed that all the variables are important enough to keep them all in the questionnaire. Concerning convergent construct validity, a high correlation was found with the Nottingham Health Profile, the Barthel Index, and the Modified Rankin Scale. Conclusion: The Spanish version of the NEWSQOL questionnaire is reliable, valid, and feasible to evaluate quality of life in the Spanish population.

Development of a computerized adaptive substance use disorder scale for screening and measurement: the CAT-SUD.

The focus of this paper is on the improvement of substance use disorder (SUD) screening and measurement. Using a multi-dimensional item response theory model, the bifactor model, we provide a psychometric harmonization between SUD, depression, anxiety, trauma, social isolation, functional impairment and risk-taking behavior symptom domains, providing a more balanced view of SUD. The aims are to (1) develop the item-bank, (2) calibrate the item-bank using a bifactor model that includes a primary dimension and symptom-specific subdomains, (3) administer using computerized adaptive testing (CAT) and (4) validate the CAT-SUD in Spanish and English in the United States and Spain. Item bank construction, item calibration phase, CAT-SUD validation phase. Primary care, community clinics, emergency departments and patient-to-patient referrals in Spain (Barcelona and Madrid) and the United States (Boston and Los Angeles). Calibration phase: the CAT-SUD was developed via simulation from complete item responses in 513 participants. Validation phase: 297 participants received the Composite International Diagnostic Interview (CIDI) and the CAT-SUD. A total of 252 items from five subdomains: (1) SUD, (2) psychological disorders, (3) risky behavior, (4) functional impairment and (5) social support. CAT-SUD scale scores and CIDI SUD diagnosis. Calibration: the bifactor model provided excellent fit to the multi-dimensional item bank; 168 items had high loadings (>0.4 with the majority >0.6) on the primary SUD dimension. Using an average of 11 items (four to 26), which represents a 94% reduction in respondent burden (average administration time of approximately 2minutes), we found a correlation of 0.91 with the 168-item scale (precision of 5 points on a 100-point scale). strong agreement was found between the primary CAT-SUD dimension estimate and the results of a structured clinical interview. There was a 20-fold increase in the likelihood of a CIDI SUD diagnosis across the range of the CAT-SUD (AUC=0.85). We have developed a new approach for the screening and measurement of SUD and related severity based on multi-dimensional item response theory. The bifactor model harmonized information from mental health, trauma, social support and traditional SUD items to provide a more complete characterization of SUD. The CAT-SUD is highly predictive of a current SUD diagnosis based on a structured clinical interview, and may be predictive of the development of SUD in the future.

Development of Three Web-Based Computerized Versions of the Kiddie Schedule for Affective Disorders and Schizophrenia Child Psychiatric Diagnostic Interview: Preliminary Validity Data

To present initial validity data on three web-based computerized versions of the Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS-COMP). The sample for evaluating the validity of the clinician-administered KSADS-COMP included 511 youths 6-18 years of age who were participants in the Child Mind Institute Healthy Brain Network. The sample for evaluating the parent and youth self-administered versions of the KSADS-COMP included 158 youths 11-17 years of age recruited from three academic institutions. Average administration time for completing the combined parent and youth clinician-administered KSADS-COMP was less time than previously reported for completing the paper-and-pencil K-SADS with only one informant (91.9 ± 50.1 minutes). Average administration times for the youth and parent self-administered KSADS-COMP were 50.9 ± 28.0 minutes and 63.2 ± 38.3 minutes, respectively, and youths and parents rated their experience using the web-based self-administered KSADS-COMP versions very positively. Diagnoses generated with all three KSADS-COMP versions demonstrated good convergent validity against established clinical rating scales and dimensional diagnostic-specific ratings derived from the KSADS-COMP. When parent and youth self-administered KSADS-COMP data were integrated, good to excellent concordance was also achieved between diagnoses derived using the self-administered and clinician-administered KSADS-COMP versions (area under the curve= 0.89-1.00). The three versions of the KSADS-COMP demonstrate promising psychometric properties, while offering efficiency in administration and scoring. The clinician-administered KSADS-COMP shows utility not only for research, but also for implementation in clinical practice, with self-report preinterview ratings that streamline administration. The self-administered KSADS-COMP versions have numerous potential research and clinical applications, including in large-scale epidemiological studies, in schools, in emergency departments, and in telehealth to address the critical shortage of child and adolescent mental health specialists. Computerized Screening for Comorbidity in Adolescents With Substance or Psychiatric Disorders; https://clinicaltrials.gov/; NCT01866956.

Effect on door‐to‐needle recombinant tissue plasminogen activator administration times for acute ischemic stroke with and without an emergency department pharmacist

Study ObjectiveA paucity of data exists on the impact emergency department (ED) pharmacists have on a stroke team's door‐to‐needle (DTN) administration time of recombinant tissue plasminogen activator (rTPA). The purpose of this study was to assess the odds of achieving a DTN administration time for rTPA of 60 minutes or less with an ED pharmacist present.MethodsThis was a retrospective, cohort study of patients who received rTPA for acute ischemic stroke (AIS) from May 2017 to May 2018. Patients were included if they were at least 18 years old and received tPA for AIS in the ED. The primary outcome for this study was the likelihood of patients receiving a DTN administration time of 60 minutes or less with or without an ED pharmacist present during a stroke alert at a primary stroke center.ResultsThe electronic medical record of 184 stroke alert patients was reviewed, and 65 patients were included in the final analysis. Baseline characteristics were similar in all aspects. The odds ratio was 3.3 (95% confidence interval [CI]: 1.1‐9.6; P = 0.04) to achieve a DTN administration time of 60 minutes or less when an ED pharmacist was present. The ED pharmacist present group had faster median (47 minutes vs 60 minutes; P = 0.001) and average (49 minutes vs 63 minutes; P = 0.003) DTN administration times compared with the ED pharmacist not present group.ConclusionAn ED pharmacists present during a stroke alert at our faculty resulted in reduced overall DTN rTPA administration times and increased the odds of a patient receiving rTPA less than 60 minutes from arrival for AIS. Further study is required to determine if this finding can be replicated in other EDs.

Comparison of the Michigan Hand Outcomes Questionnaire, Boston Carpal Tunnel Questionnaire, and PROMIS Instruments in Carpal Tunnel Syndrome

Patient-reported outcomes are important to assess improvement after surgery. Commoninstruments for carpal tunnel syndrome include the Michigan Hand Outcomes Questionnaire (MHQ) and Boston Carpal Tunnel Questionnaire (CTQ). The Patient-Reported Outcomes Measurement Information System (PROMIS) are newer measures. We evaluated how the PROMIS Pain Interference (PI) and Upper Extremity (UE) scores change after carpal tunnel release. All adult patients with carpal tunnel syndrome treated surgically were asked to participate in this prospective study. PROMIS instruments, MHQ, and CTQ were completed by 101 patients. Estimated means and standard errors were calculated, and piecewise linear fixed effects regression models were applied to the data. Standardized response means were calculated for each outcome measure. The MHQ Total Score did not show a considerable change from the preoperative to 1-week postoperative visit but improved from the 1-week to 3-month postoperative visit (55 to 80). The CTQ Functional Status Score (FSS) worsened from 2.3 preoperatively to 2.6 at the 1-week postoperative visit before improving through the 3-month postoperative visit (1.6). PROMIS UE showed responsiveness similar to the CTQ FSS with a decline at the 1-week visit, 38 to 33, followed by improvement (45 at 3 mo). However, the standardized response mean values were greater for the CTQ FSS compared with PROMIS UE. The average administration time was shortest for PROMIS UE. The CTQ Symptom Severity Scale and MHQ Pain Scores showed improvements as early as the 1-week visit. The CTQ Symptom Severity Scale improved from 3.1 to 2.3, and MHQ Pain Scores improved from 55 to 46. PROMIS PI did not change at the 1-week visit but improved at 6 weeks and 3 months, from 56 to 52 and 49. The standardized response means for PROMIS PI achieved a large effect size only at 3 months. The CTQ FSS is more responsive than PROMIS UE and the MHQ, with the CTQ FSS showing the largest effect sizes. PROMIS PI does not show the responsiveness seen in the CTQ Symptom Severity Scale and MHQ Pain Score. PROMIS instruments require less time to complete. This study demonstrates the change in PROMIS scores after carpal tunnel release and how they compare with legacy outcome instruments.

Pharmacoeconomic impact of an alternative workflow process for stroke

ObjectiveThe objective of this study was to evaluate a new multidisciplinary process in which intravenous alteplase (tPA) waste, used for acute ischemic stroke (AIS), was salvaged in an attempt to maximize cost effectiveness without impacting door-to-needle (DTN) administration times. DesignThis was a retrospective cohort between May 2017 and February 2018. The primary endpoint evaluated for this study was the total tPA salvaged and total cost savings in U.S. dollars. Secondary endpoints evaluated included overall DTN time in minutes. SettingEmergency department of a primary stroke center. PatientsA convenience sample of sequential adult (>18 years) patients who received tPA in the ED for AIS were included for analysis. InterventionsNew stroke process which involved bedside mixing of tPA and salvaging of excess waste in the main central pharmacy. Measurements and main resultsA total of 50 patients were included in the final analysis. There were 25 patients included in the new process and old process groups respectively. A total of 605 mg of alteplase was salvaged from 25 patients in the new process group which was associated with an estimated cost savings of over $120,000 annually. Patients in the new process group had statistically faster average (52 min vs. 60 min; p = 0.01) and median (50 min vs. 58 min; p = 0.03) DTN administration times. ConclusionPreliminary data, in this pilot study, utilizing a multidisciplinary model for tPA administration led to significant cost savings of tPA and decreases in overall DTN administration times.

HSS Dysphagia and Dysphonia Inventory (HSS-DDI) Following Anterior Cervical Fusion

Dysphagia and dysphonia are common complications after anterior cervical spine surgery; however, reported prevalences vary greatly due to a lack of reliable clinical standards for measuring postoperative swallowing and speech dysfunction. The Hospital for Special Surgery Dysphagia and Dysphonia Inventory (HSS-DDI) was developed as a patient-derived, patient-reported instrument to measure dysphagia and dysphonia more accurately after anterior cervical spine surgery than existing indices. This multiphase survey-development study implemented a mixed-methods approach. Phase 1 involved qualitative assessment of postoperative patient-reported swallowing or speaking deficiencies to assemble a draft survey. Phase 2 established test-retest reliability and finalized the 31-item HSS-DDI. Phase 3 compared the HSS-DDI with the Swallowing-Quality of Life (SWAL-QOL) questionnaire and the M.D. Anderson Dysphagia Inventory (MDADI) for validity and responsiveness. Phase 1, performed to formulate the draft survey, included 25 patients who were asked about speech and swallowing dysfunction after anterior cervical spine surgery involving at least 3 vertebral levels. Phase 2 included 49 patients who completed the draft survey twice. The mean scores (and standard deviation) for each administration of the HSS-DDI were 67 ± 24 and 75 ± 22, the Cronbach alpha coefficients were both 0.97, and the intraclass correlation coefficient was 0.80. The 31-item HSS-DDI was finalized with all but 2 items having weighted kappa values of ≥0.40. Phase 3 included 127 patients and established external validity, with most correlation coefficients between the HSS-DDI and the SWAL-QOL and MDADI ranging from 0.5 to 0.7. Internal validity was established by identifying worsening HSS-DDI scores with increases in the number of vertebral levels involved (p = 0.02) and in the Surgical Invasiveness Index (p = 0.006). HSS-DDI responsiveness ascertained by effect size (0.73) was better than that of the SWAL-QOL and MDADI. The average administration time for the HSS-DDI was 2 minutes and 25 seconds. The HSS-DDI is efficient, valid, and more responsive to change after anterior cervical spine surgery than existing surveys. The HSS-DDI fills a gap in postoperative assessment by providing a reliable, more clinically sensitive, patient and condition-specific evaluation of dysphagia and dysphonia prospectively and longitudinally.

The Modified Telephone-Administered Minnesota Cognitive Acuity Screen for Mild Cognitive Impairment.

This study aimed to compare the sensitivity and specificity of a modified version of the Minnesota Cognitive Acuity Screen (MCAS-m), by adding learning and recognition memory components, to the original version MCAS to distinguish amnestic mild cognitive impairment (aMCI) from healthy controls (HCs). A total of 30 individuals with aMCI and 30 HCs underwent neuropsychological testing, neurologic examination, laboratory, and brain imaging tests. Once diagnosis was confirmed, participants completed the MCAS and MCAS-m in counterbalanced order. The average administration time was 12.6 minutes for the MCAS and 13.5 minutes for the MCAS-m. Receiver operating characteristic curve analyses showed that the MCAS-m demonstrated 97% sensitivity and 97% specificity for distinguishing between aMCI and HC versus 97% and 87%, respectively, for the original MCAS in this sample. Both the MCAS and the MCAS-m were highly sensitive when distinguishing between normal cognition and aMCI; however, the MCAS-m demonstrated a 10% increase in specificity compared to the original version. Improved specificity is particularly relevant to screening in larger community samples with lower base rates of MCI than clinic populations. This modified screening measure presents a brief and cost-effective tool for identifying MCI. Given the risk of progression from aMCI to Alzheimer disease dementia (AD), the MCAS-m represents a modest improvement in telephone-administered methods for the early detection of AD.

Making Sense of Dementia Screening

Making Sense of Dementia Screening

The diagnostic accuracy of the Ascertain Dementia 8 questionnaire for detecting cognitive impairment in primary care in the community, clinics and hospitals: a systematic review and meta-analysis.

BackgroundThe prevalence of cognitive impairment is increasing due to the aging population, and early detection is essential clinically. The Ascertain Dementia 8 (AD8) questionnaire is a brief informant-based measure recently developed to assess early cognitive impairment, however, its overall diagnostic performance is controversial. The objective of this meta-analysis was to assess the diagnostic accuracy of the AD8 for cognitive impairment.MethodsAll relevant studies were collected from databases including MEDLINE, EMBASE and the Cochrane Library up to April 2017. We used QUADAS-2 to assess the methodological quality after the systematic search. The accuracy data and potential confounding variables were extracted from the eligible studies which included those in English and non-English. All analyses were performed using the Midas module in Stata 14.0 and Meta-DiSc 1.4 software.ResultsSeven relevant studies including 3728 subjects were collected, and classified into two subgroups according to the severity of cognitive impairment. The overall sensitivity (0.72, 0.91) was superior to specificity (0.67, 0.78). The pooled negative likelihood ratio (0.17, 0.13) was better than the positive likelihood ratio (2.52, 3.94). The areas under the summary receiver operating characteristic curve were 0.83 and 0.92, respectively. Meta-regression analysis showed that location (community versus non-community) may be the source of heterogeneity. The average administration time was less than 3 minutes.ConclusionOur findings suggest that the AD8 is a competitive tool for clinically screening cognitive impairment and has an optimal administration time in the busy primary care setting. Subjects with an AD8 score ≧2 should be highly suspected to have cognitive impairment and a further definite diagnosis is needed.

Validación del Timed up and go test como predictor de riesgo de caídas en sujetos con artritis reumatoide. Parte I: confiabilidad y aplicabilidad clínica

IntroductionPersons with rheumatoid arthritis (RA) have a high risk of falls. There is a need for tools that identify at-risk patients. The Timed Up and Go test (TUG) is used to predict the risk of falls but it is essential to study its psychometric properties. The aim of this study was to establish intra- and interobserver reliability, test-retest reliability and the clinical applicability of the TUG test in persons with a diagnosis of RA. Material and methodObservational, prospective, longitudinal study. intra- and interobserver reliability and the test-retest reliability of the TUG were established with intraclass correlation coefficients (ICC). Bland-Altman plots were constructed for intra- and interobserver reliability. ResultsThe intraobserver reliability ICC for the two assessors was 0.98 (95% CI 0.96-0.99) and 0.99 (95% CI 0.98-0.99), and was 0.97 (95% CI 0.95-0.98) at normal speed and 0.99 (95% CI 0.99-0.99) at maximal speed. The interobserver reliability ICC at normal speed was 0.99 (95% CI 0.98-0.99) and 0.99 (95% CI 0.99-0.99) at maximal speed. The test-retest reliability ICC was 0.77 (95% CI 0.61-0.87) at normal speed and 0.91 (95% CI 0.83-0.95) at maximal speed. A total of 23% of the participants reported minimal difficulty in understanding the test. The average administration time was 90seconds. ConclusionThis study identifies the intra- and interobserver reliability, test-retest reliability and the clinical applicability of the TUG test at normal and maximal speed in RA patients.

Comparison of the Michigan Hand Outcomes Questionnaire, Boston Carpal Tunnel Questionnaire, and PROMIS Instruments in Carpal Tunnel Syndrome

There is no financial information to disclose. Patient reported outcomes (PRO) are increasingly important to assess improvement following surgery. Commonly used instruments for carpal tunnel syndrome include Michigan Hand Outcomes Questionnaire (MHQ) and Boston Carpal Tunnel Questionnaire (CTQ). These were a Grade B recommendation in the 2009 AAOS clinical practice guidelines. The Patient Reported Outcomes Measurements System (PROMIS) instruments are newer PRO designed to measure various health domains. We tested the null hypothesis that PROMIS Pain Interference (PI) and Upper Extremity (UE) scores will have similar responsiveness when compared to the MHQ and CTQ following Carpal Tunnel Release. Secondary analysis included the time to completion of each PRO instrument. All adult patients with carpal tunnel syndrome treated surgically during the study period were asked to participate in this prospective study. The PROMIS instruments, MHQ, and CTQ were completed by 101 patients prior to surgery and postoperatively at 1-week, 6-week, and 3-month visits. Estimated mean and standard errors for each outcome measure were calculated and a piecewise linear mixed effects regression model was applied to the data. The MHQ Total Score did not show significant change from the preoperative to 1-week visit, but there was a significant improvement from the 1-week to 3-month visit (55.1 to 80.2). The CTQ Functional Status Score (FSS) worsened from 2.3 preoperatively to 2.6 at the 1-week visit before improving at the 6-week and 3-month visits (1.8 and 1.6). PROMIS Upper Extremity showed responsiveness similar to the CTQ FSS with a decline at the 1-week visit, 38.4 to 32.7, followed by increases at the 6-week and 3-month visits (41.5 and 44.8). The average administration time was shortest for PROMIS UE and longest for the MHQ. CTQ Symptoms Severity Scale (SSS) and MHQ Pain Scores showed improvements as early as the 1-week visit. The CTQ SSS improved from 3.1 to 2.3 and MHQ Pain Scores improved from 54.9 to 45.5. The PROMIS Pain Interference Score did not change at the 1-week visit, but demonstrated improvements at 6-weeks and 3-months, from 56.5 to 52.2 and 49.3. The CTQ FSS and PROMIS Upper Extremity instruments are more responsive, demonstrating both an initial decline in function 1-week postoperatively followed by improvement at the 6-week and 3-month visits, when compared to the MHQ. PROMIS Pain Interference does not show the responsiveness seen in the CTQ SSS and MHQ Pain Score. PROMIS instruments require less time to complete.

Psychometric Properties of the Patient-Reported Outcomes Measure of Pharmaceutical Therapy for Quality of Life (PROMPT-QOL)

ObjectivesTo assess the psychometric properties of a novel instrument for medication management, the Patient-Reported Outcomes Measure of Pharmaceutical Therapy for Quality of Life (PROMPT-QOL), using both conventional psychometrics and Rasch analysis in a large sample. MethodsThis study was conducted with 1156 adult outpatients continuously taking any medicines at least 3 months from three university hospitals in Bangkok, Thailand, between July 2014 and March 2015. The psychometric properties were assessed in five steps: 1) assessment of dimensional structure, 2) item selection, 3) assessment of practicality, 4) assessment of reliability, and 5) assessment of criterion and known-groups validity. ResultsThe PROMPT-QOL contained 43 items including nine domains, and their five-point Likert scale functioning worked well. Most items fulfilled the item selection criteria. The PROMPT-QOL took an average administration time of 13.4 ± 5.8 minutes. Only two items had missing data of 0.1% to 0.2%. All domains provided good to excellent test-retest reliability with intraclass correlation coefficients between 0.67 and 0.83. All domains of the PROMPT-QOL yielded high Cronbach’s α values between 0.77 and 0.89, greater than an acceptable level of 0.70, except for the Availability and Accessibility domain (0.58). A multiple regression showed that the Medication Effectiveness domain was the strongest predictor of the overall QOL of the PROMPT-QOL, followed by the Therapeutic Relationships, Psychological Impacts, Convenience, and Availability and Accessibility domains (adjusted R2 ~ 52%). As expected, patients with higher PROMPT-QOL domain scores were associated with being younger, more educated, having a lower number of medicines, patients’ perceptions of better disease control, having no adverse drug reactions, and medicine preference. ConclusionsThe PROMPT-QOL was practical, reliable, and valid for Thai patients.

A Review Of Common And Quick Tests In Executive Function In Adults With Neurological Disorder

Purpose: As a higher cognitive function is controlled Executive function by frontal cortex. It is consisted of Decision-making، planning، inhibition، organization and working memory. According to high prevalence of executive dysfunction in adults with neurological disorders such as Dementia and stroke and considering to applying appropriate tests in neurological patients and aging people in order to diagnose executive dysfunction quickly and correctly، In this study we aimed to review common and quick executive function tests.Methods: This research was a review study on common and quick executive function tests in adults. A search was conducted using some databases including Iran medex، SID، Magiran، Google scholar، Medline، Science Direct، Scopus and Web of Science. The tests were investigated regarding to the date of publishing، method of administration، target populations، subscales، time administration and psychometric features.Results: According to inclusion and exclusion criteria of this study، we found 26 common and quick tests، Most of them were in English and just one of them was a Persian version. Thirteen tests of them were translated or modified version of original English test. Ten tests of them were very quick with average administration time about 10 minute and the other need 30 minute to administer.Conclusion: Regarding to importance of evaluating of executive function in neurological patients especially individuals with Dementia beside existence of a lot of tests in other languages and lack of quick executive function tests in Persian , results of current study can help neurologist, speech and language pathologist and other experts to be familiar with common quick tests and their clinical application. These results also recommend researchers and clinicians to translate and adapt some of the quick and easy administer Executive function tests in Persian.