Condition-specific Questionnaires Research Articles

Brazilian Portuguese Translation and Validation of the Pelvic Organ Prolapse/Incontinence Sexual Questionnaire-IUGA revised.

Condition-specific sexual questionnaires are important patient-reported outcome measures. The aim of this study was to translate and validate the Pelvic Organ Prolapse/Incontinence Sexual Questionnaire-International Urogynecology Association Revised (PISQ-IR) into Brazilian Portuguese and to clinically validate it in a Brazilian Portuguese-speaking population. Translation and validation of the PISQ-IR was performed according to the International Urogynecological Association-recommended process and guidelines. For external validity, PISQ-IR subscales were compared with the clinical measures, Pelvic Organ Prolapse Quantification system (POP-Q) stage, pelvic floor muscle tone, and Oxford Grading Scale (Pearson correlations). Descriptive statistics, internal consistency (Cronbach's alpha coefficient), and test-retest reliability (interclass correlation coefficient) were calculated for all PISQ-IR subscales. A total of 120 sexually active and 106 not sexually active women were enrolled in the study between March 2015 and July 2019. Internal consistency was acceptable, with Cronbach's alpha values 0.60-0.80, except for the sexual arousal and orgasm, sexual arousal and partner-related issues, sexual arousal and condition-specific issues, global rating of sexual quality and condition impact subscales. PISQ-IR demonstrated good reliability (α > 0.6, CIC = 0.996). The agreement for each individual questionnaire item also individually presented substantial agreement between the assessments (κ 0.61-0.8). There was a correlation between PISQ-IR and POP, mixed, stress and fecal incontinence diagnosis and a positive correlation with pelvic floor muscle function according to the Oxford Scale in sexually active women. For sexually inactive women there was a correlation between PISQ-IR and mixed urinary symptoms. The Brazilian Portuguese version of PISQ-IR is a reliable and valid tool that can be easily used for the identification and assessment of sexual function in Brazilian Portuguese-speaking women with pelvic floor disorders.

Impact of Periodontal Diseases on Oral Health-Related Quality of Life: A Study with a Condition-Specific Questionnaire in Croatian Population.

The aim of this study was to translate and validate the condition-specific Oral Health Impact Profile (OHIP) in the Croatian cultural context and assess the impact of periodontal diseases and nonsurgical periodontal therapy on quality of life (QoL). A cross-sectional study was carried out on 150 individuals: 50 periodontally healthy, 50 with gingivitis, and 50 with periodontitis who self-administrated the OHIP. The participants' age ranged between 18 and 71 years, with the median age of 45 (34-57) years. Forty-seven percent of the participants were females. The validity and reliability of the Croatian OHIP version were tested. The impact of gingivitis and periodontitis on QoL was assessed. Changes in QoL induced by nonsurgical periodontal therapy in 20 patients with periodontitis were analyzed. Categorical data were presented by absolute and relative frequencies. The normality of the distribution of continuous variables was tested by the Shapiro-Wilk test. Continuous data were described by the median and the limits of the interquartile range (IQR). Differences in continuous variables between two independent groups were tested with the Mann-Whitney U test, and between three groups with the Kruskal-Wallis test (post hoc Conover). The Wilcoxon signed-rank test was used to examine the differences in the total score before and after therapy. All p values were two-sided. The level of significance was set at alpha of 0.05. The analysis detected a single-factor structure that explained for the 56.9% of the variance. Cronbach's alpha value was 0.937, which indicated an excellent internal consistency. Overall OHIP score reported a strong correlation with the subjective estimate of periodontal problems (Rho = 0.92; p < 0.001). Test-retest reliability was high (r = 0.984; p < 0.001). The periodontitis group had the highest OHIP score (28 [23-34]), followed by the gingivitis group (14 [12-20]) and the periodontally healthy group (9 [5-11]; p < 0.001). Nonsurgical periodontal therapy significantly improved the QoL in those with periodontitis (p < 0.001). The condition-specific Croatian version of the OHIP instrument can be considered adequate to measure the impact of periodontal diseases on oral health-related QoL. Periodontal diseases, especially periodontitis, have a negative effect on the patient's QoL. Nonsurgical periodontal treatment can improve patients' QoL.

Retzius sparing robot-assisted radical prostatectomy: optimizing functional results.

The aim of this study is to critically evaluate the existing body of evidence regarding the efficacy of Retzius-sparing radical prostatectomy (RS-RARP) in achieving improved functional outcomes. Moreover, we explored possible strategies to further optimize functional outcomes. Following PRISMA guidelines, a systematic review (PROSPERO ID CRD42024539915) was performed on 9th September 2023 on PubMed, Scopus, and Web of Science. Only original articles in the English language reporting functional outcomes after RS-RARP were included. Overall, the search string yielded 99 results on PubMed, 122 on Scopus, and 120 on Web Of Science. After duplicate exclusion, initial screening and eligibility evaluation, a total of 47 studies were included in the qualitative analysis, corresponding to a cohort of 13.196 patients. All studies reported continence recovery. RS-RARP appeared to achieve better and faster continence recovery compared to S-RARP. However, it should be noted that continence definition was heterogeneous and not based on validated condition-specific questionnaires. Seven (15%) studies provided for any sort of rehabilitation for urinary incontinence after RS-RARP. 22 studies analyzed potency recovery rates, showing no difference between RS-RARP and S-RARP. The evaluation of this outcome poses a great challenge due to the lack of standardized assessment tools and reporting methods. Only two studies reported on the consistent use of post-operative PDE5i as penile rehabilitation. The current review highlights the satisfactory functional results of Retzius-sparing robot assisted radical prostatectomy, which holds true irrespective of disease stage and prostate volume, with promising results even in patients previously treated for BPH or in the salvage setting. How can we optimize those results? The answer does not probably lie in further refinement of the surgical technique, but in giving greater attention to patient counselling and rehabilitation strategies in order to minimize regret and maximize satisfaction.

Laparoscopic cholecystectomy versus conservative management for adults with uncomplicated symptomatic gallstones: the C-GALL RCT.

Gallstone disease is a common gastrointestinal disorder in industrialised societies. The prevalence of gallstones in the adult population is estimated to be approximately 10-15%, and around 80% remain asymptomatic. At present, cholecystectomy is the default option for people with symptomatic gallstone disease. To assess the clinical and cost-effectiveness of observation/conservative management compared with laparoscopic cholecystectomy for preventing recurrent symptoms and complications in adults presenting with uncomplicated symptomatic gallstones in secondary care. Parallel group, multicentre patient randomised superiority pragmatic trial with up to 24 months follow-up and embedded qualitative research. Within-trial cost-utility and 10-year Markov model analyses. Development of a core outcome set for uncomplicated symptomatic gallstone disease. Secondary care elective settings. Adults with symptomatic uncomplicated gallstone disease referred to a secondary care setting were considered for inclusion. Participants were randomised 1: 1 at clinic to receive either laparoscopic cholecystectomy or observation/conservative management. The primary outcome was quality of life measured by area under the curve over 18 months using the Short Form-36 bodily pain domain. Secondary outcomes included the Otago gallstones' condition-specific questionnaire, Short Form-36 domains (excluding bodily pain), area under the curve over 24 months for Short Form-36 bodily pain domain, persistent symptoms, complications and need for further treatment. No outcomes were blinded to allocation. Between August 2016 and November 2019, 434 participants were randomised (217 in each group) from 20 United Kingdom centres. By 24 months, 64 (29.5%) in the observation/conservative management group and 153 (70.5%) in the laparoscopic cholecystectomy group had received surgery, median time to surgery of 9.0 months (interquartile range, 5.6-15.0) and 4.7 months (interquartile range 2.6-7.9), respectively. At 18 months, the mean Short Form-36 norm-based bodily pain score was 49.4 (standard deviation 11.7) in the observation/conservative management group and 50.4 (standard deviation 11.6) in the laparoscopic cholecystectomy group. The mean area under the curve over 18 months was 46.8 for both groups with no difference: mean difference -0.0, 95% confidence interval (-1.7 to 1.7); p-value 0.996; n = 203 observation/conservative, n = 205 cholecystectomy. There was no evidence of differences in quality of life, complications or need for further treatment at up to 24 months follow-up. Condition-specific quality of life at 24 months favoured cholecystectomy: mean difference 9.0, 95% confidence interval (4.1 to 14.0), p < 0.001 with a similar pattern for the persistent symptoms score. Within-trial cost-utility analysis found observation/conservative management over 24 months was less costly than cholecystectomy (mean difference -£1033). A non-significant quality-adjusted life-year difference of -0.019 favouring cholecystectomy resulted in an incremental cost-effectiveness ratio of £55,235. The Markov model continued to favour observation/conservative management, but some scenarios reversed the findings due to uncertainties in longer-term quality of life. The core outcome set included 11 critically important outcomes from both patients and healthcare professionals. The results suggested that in the short term (up to 24 months) observation/conservative management may be a cost-effective use of National Health Service resources in selected patients, but subsequent surgeries in the randomised groups and differences in quality of life beyond 24 months could reverse this finding. Future research should focus on longer-term follow-up data and identification of the cohort of patients that should be routinely offered surgery. This trial is registered as ISRCTN55215960. This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 14/192/71) and is published in full in Health Technology Assessment; Vol. 28, No. 26. See the NIHR Funding and Awards website for further award information.

Quality of Life (QoL) changes after orthognathic surgery: Do they correlate with the quantum of hard and soft tissue change?

Aim: To investigate the relationship between post orthognathic surgery changes in soft and hard tissue cephalometric variables in Class II and Class III patients and quality of life (QoL) measured using a condition-specific QoL questionnaire and to determine cephalometric predictors of the overall OQLQ after surgery. Methods: The sample included 50 orthodontic patients, 28 Class II and 22 Class III skeletal relationships whose treatment included orthognathic surgery. Correlations between cephalometric changes and Orthognathic Quality of Life Questionnaire (OQLQ) were tested by Pearson’s correlation. Multiple linear regression was used to determine cephalometric predictors of the overall OQLQ after surgery. Results: In Class II patients, OQLQ before surgery and changes in SNA were significant predictors for OQLQ after surgery. For Class III patients, OQLQ after surgery was significantly correlated with the change in mandibular plane angle and lower face height (r = 0.6 and r = 0.5 respectively). The decrease in facial angle was negatively correlated with OQLQ (r = -0.4). Mandibular plane angle, mandibular length, and OQLQ before surgery were significant predictors for OQLQ after surgery. Conclusion: QoL improved for Class II and III after orthognathic surgery. Changes in certain cephalometric measurements seem to predict quality of life after orthognathic surgery.

Developing a shortened spine functional index (SFI-10) for patients with sub-acute/chronic spinal disorders: a cross-sectional study

BackgroundBrief whole-spine patient-reported outcome measures (PROMs) provide regional solutions and future directions for quantifying functional status, evidence, and effective interventions. The whole-spine regional Spine Functional Index (SFI-25) is used internationally in clinical and scientific contexts to assess general sub-acute/chronic spine populations. However, to improve structural validity and practicality a shortened version is recommended. This study developed a shortened-SFI from the determined optimal number of item questions that: correlated with criteria PROMs being highly with whole-spine, moderately with regional-spine, condition-specific and patient-specific, and moderately-low with general-health and pain; retained one-dimensional structural validity and high internal consistency; and improved practicality to reduce administrative burden.MethodsA cross-sectional study (n = 505, age = 18-87 yrs., average = 40.3 ± 10.1 yrs) of sub-acute/chronic spine physiotherapy outpatients from an international sample of convenience. Three shortened versions of the original SFI-25 were developed using 1) qualitative ‘content-retention’ methodology, 2) quantitative ‘factorial’ methodology, and 3) quantitative ‘Rasch’ methodology, with a fourth ‘random’ version produced as a comparative control. The clinimetric properties were established for structural validity with exploratory (EFA) and confirmatory (CFA) factorial analysis, and Rasch analysis. Criterion validity used the: whole-spine SFI-25 and Functional Rating Index (FRI); regional-spine Neck Disability Index (NDI), Oswestry Disability Index (ODI), and Roland Morris Questionnaire (RMQ), condition-specific Whiplash Disability Questionnaire (WDQ); and patient-specific functional scale (PSFS); and determined floor/ceiling effect. A post-hoc pooled international sub-acute/chronic spine sample (n = 1433, age = 18-91 yrs., average = 42.0 ± 15.7 yrs) clarified the findings and employed the general-health EuroQuol-Index (EQ-5D), and 11-point Pain Numerical Rating Scale (P-NRS) criteria.ResultsA 10-item SFI retained structural validity with optimal practicality requiring no computational aid. The SFI-10 concept-retention-version demonstrated preferred criterion validity with whole-spine criteria (SFI-25 = 0.967, FRI = 0.810) and exceeded cut-off minimums with regional-spine, condition-specific, and patient-specific measures. An unequivocal one-dimensional structure was determined. Internal consistency was satisfactory (α = 0.80) with no floor/ceiling effect. Post-hoc analysis of the international sample confirmed these findings.ConclusionThe SFI-10 qualitative concept-retention version was preferred to quantitative factorial and Rasch versions, demonstrated structural and criterion validity, and preferred correlation with criteria measures. Further longitudinal research is required for reliability, error, and responsiveness, plus an examination of the practical characteristics of readability and administrative burden.

Psychosocial and Behavioral Impact of Three Clinical Presentations of Oligodontia in a Tertiary Hospital.

To investigate the psychosocial and behavioral impact of oligodontia across three presentation types and determine if presentation type can infer impact. Thirty patients who had been diagnosed and treated for oligodontia between 2006 and 2021 were identified from hospital records. Patients received two questionnaires: (1) a modified version of a condition-specific questionnaire- the Cleft Research Questionnaire (CRQ), used to investigate demographic, life, and treatment details and impacts-and (2) the Oral Health Impact Profile (OHIP-14), used to investigate the oral health-related quality of life. Patients were assigned to three presentations (Types 1 to 3) of oligodontia, identified according to the edentulous space present and complexity of prosthodontic treatment required. The hypothesis that there is a relationship between oligodontia type and study variables was tested. Twenty-two questionnaires were completed and returned. There were 13 men and 9 women. The age range was from 16 to 32 years. In total, 18 patients had nonsyndromic oligodontia and 4 had oligodontia associated with anhidrotic ectodermal dysplasia (AED). The main areas of impact were patient-reported: life less satisfying (64.5%, n &#61; 14; pretreatment), making friends (45%, n &#61; 10), school participation (45%, n &#61; 10), and public speaking (45%, n &#61; 10). No relationship was discovered between the degree of physical effect of the presentation type and study variables, including the degree of psychosocial impact or life satisfaction. Oligodontia can have a negative functional and social impact on a patient prior to prosthodontic treatment. Prosthodontic treatment improved the life satisfaction for most patients. Psychosocial outcomes could not be inferred by the presentation type of oligodontia.

Amsterdam complex pelvic pain symptom scale with subscales: Based on a Norwegian translation, psychometric assessment and modification of the Amsterdam hyperactive pelvic floor scale.

Women with an abnormally high pelvic floor muscle tone may have a clinical presentation that is complex, involving urinary, anorectal and/or sexual dysfunction, genital/pelvic pain and psychological distress. The Amsterdam Hyperactive Pelvic Floor Scale (AHPFS) is a Dutch 30-item condition-specific self-report questionnaire developed to measure these complex pelvic pain symptoms. The aim of this study was to translate the Dutch version into Norwegian, to assess the psychometric properties, and to present a valid factor structure. Translation, back-translation and a review of the back-translated version were performed. Thereafter, a pilot test including feedback from six clinical experts and cognitive interviews with 11 patients from the target group was conducted. Next, a field test was performed among women who were (1) patients at the gynecological outpatient clinic/pelvic floor physiotherapist at St. Olav's Hospital, (2) members of the Vulvodynia or the Endometriosis Patient Associations or (3) female students and employees from the Faculty of Medicine and Health Science, the Norwegian University of Science and Technology, in a web-based survey. To ensure a sample with symptomatic women, only women who scored ≥11 according to the Dutch prespecified factor structure were included in the statistical analyses (n = 232). Content/face validity demonstrated that the questionnaire was perceived as relevant, comprehensive and understandable. Some adjustments in the instructions of the questionnaire and the response categories were made, which lead to the Norwegian translation ACPPS-30. Assessment of the questionnaire's dimensionality revealed a five-factor structure similar to the original Dutch Amsterdam Hyperactive Pelvic Floor Scale (AHPFS) but without the Urinary tract infection factor and seven other items. The translated and modified ACPPS-16 total score and subscales correlated as expected with scales measuring similar conditions. Test-retest reliability demonstrated good stability for scales (intraclass correlation coefficient 0.85-0.93) and single items (weighted kappa values from 0.34 to 0.90). A modified Norwegian version ACPPS-30 was presented, in addition to a shorter version with only 16 of the translated items distributed among five factors similar to the original Dutch version (ACPPS-16). Both versions proved to be valid, stable and reliable tools to investigate complex pelvic pain symptoms possibly due to an abnormally high-toned pelvic floor muscle.

The impact of orthodontic treatment on a young person’s quality of life, esthetics, and self-esteem in hypodontia: A longitudinal study

This research aimed to evaluate the impact of orthodontic treatment on a young person's oral health-related quality of life, self-esteem, and esthetics concerning hypodontia. A prospective longitudinal hospital-based study recruited 97 participants with hypodontia, aged 11-18 years. Forty-one participants (42%) originally planned to have space closure and the remainder space opening, with subsequent prosthetic replacement. The following questionnaires were completed before and after orthodontic treatment: the child perception questionnaire, Bristol condition-specific questionnaire for hypodontia (BCSQ), the child health questionnaire, and the Oral Aesthetic Subjective Impact Scale (OASIS). The Wilcoxon and matched pairs t tests approach was applied to compare before and after orthodontic treatment for significant testing (P<0.05). Fifteen participants were lost to follow-up, resulting in 82 participants completing orthodontic treatment, with an average age of 13.8 ± 1.71 years. A total of 282 teeth were missing in the sample. Treatment resulted in significantly lower indexes (P<0.001) to overall BCSQ, OASIS, appearance, and how others would treat them. In comparing the 2 subgroups, those treated with space closure had significantly reduced functional limitations (child perception questionnaire), appearance concerns, self-esteem (child health questionnaire), OASIS, and overall BCSQ scores. Orthodontic treatment in participants with hypodontia appears to significantly impact a range of psychological and esthetic scales. In particular, space closure appears to significantly improve the quality of life of participants compared with those undergoing space opening.

The long-term psychosocial consequences of screen-detected ductal carcinoma in situ and invasive breast cancer.

Ductal carcinoma in situ (DCIS) is a risk factor for invasive breast cancer (IBC). The prognosis of DCIS is considerably better than for IBC, yet women do not distinguish between the threat. We aimed to compare the psychosocial consequences of screen-detected DCIS and IBC, and to examine this comparison over time. We surveyed a Danish mammography-screening cohort from 2004 to 2018. We assessed outcomes at six-time points: baseline, 1, 6, 18, 36 months, and 14 years after the screening. We measured psychosocial consequences with the Consequences Of Screening - Breast Cancer (COS-BC): a condition-specific questionnaire that is psychometrically validated and encompasses 14 psychosocial dimensions. We used weighted linear models with generalized estimating equations to compare responses between groups. We used a 1% level of significance. 170 out of 1309 women were diagnosed with breast cancer (13.0%). 23 were diagnosed with DCIS (13.5%) and 147 with IBC (86.5%). From baseline to six months after diagnosis, there were no significant differences between women with DCIS and IBC. However, mean scores indicated that IBC generally was more affected than DCIS. After six months, we observed that women with DCIS and IBC might be affected differently in the long term; mean scores and mean differences showed that IBC were more affected on some scales, while DCIS were on others. Overall, the DCIS and IBC experienced similar levels of psychosocial consequences. Women might benefit from renaming DCIS to exclude cancer nomenclature.

Psychosocial consequences after screening of abdominal aortic aneurysm among 65 year old men

BackgroundIn order to reduce the incidence of abdominal aortic aneurysm rupture and mortality, the Swedish Medical Council has introduced a national abdominal aortic aneurysm (AAA) screening program that offers ultrasound examination of 65-year-old men. Screening programmes of AAA may confer both benefits and harms. The study aim was to investigate the psychosocial consequences of AAA screening among men with screening-detected AAA as compared to men identified as AAA-negative at screening, using an AAA-specific questionnaire. MethodsThis cross-sectional study investigated the psychosocial consequences of AAA screening measured with a condition-specific questionnaire. This study focused on the Experience of the Diagnosis and the Screening Procedure in terms of Anxiety, Sense of Dejection and Existential Values. One hundred and fifty-eight men with AAA (63%) and 275 with normal aorta size (55%) completed the diagnosis-specific questionnaire. ResultsNinety-six percent of men with screening detected AAA did not regret the screening examination, the corresponding figure for controls being 99.6%. Seventy percent of AAA patients were surprised that something was wrong in their body. Some (85%) of men with AAA were current or previous smokers, about half of them (45%) felt guilty about it and 78% of the current smokers in the AAA group had considered stopping smoking. Both groups considered changing lifestyle, although at a higher rate (32%) among AAA cases than controls (20%), with differences both in intention to change their ways to exercise (p = 0.019) and food intake (p = 0.001).Intergroup differences were identified for the majority of items as captured by the questionnaire where men identified with AAA reported more negative psycho-social consequences for all evaluated items except for the items: Regret of the screening examination (p = 0.069) and feeling terrified (p = 0.10). Fifty-one percent of AAA cases stated that they feared rupture, and 12% were anxious about rupture during sexual activity whereas 57% were worried about rupture during intense physical activity. ConclusionMen who were diagnosed with AAA reported more psychosocial consequences compared to controls; still only a minority of AAA cases reported psychosocial consequences in greater occurrence. To some degree, men with AAA also feared rupture during various types of activities. There appears to be a need for improved patient information and easy access to caregivers for men with screening-detected AAA, which might help to reduce psychosocial consequences associated with the diagnosis.

Cross-cultural adaptation and validation of the Korean version of the quality of life assessment in spina bifida for children (QUALAS-C-K)

Purpose This study aimed to translate and cross-culturally adapt the QUAlity of Life Assessment in Spina bifida for Children (QUALAS-C) and validate the Korean version of the QUALAS-C (QUALAS-C-K). Materials and Methods Three urologists translated the QUALAS-C into Korean. Facial and content validity were assessed in the pilot study. Back-translation into English was performed. In the main study, the QUALAS-C-K and Korean version of KIDSCREEN-27 were administered simultaneously. Test-retest reliability was confirmed by re-administering the QUALAS-C-K. Internal consistency was verified using Cronbach’s alpha. Factor analysis was performed, and convergent and divergent validity were demonstrated using the Korean version of KIDSCREEN-27. Results A total of 53 children with spina bifida participated in the main study. Cronbach’s alpha for the overall instrument determined good internal consistency (0.72–0.85), the intraclass correlation coefficient showed good stability (0.74–0.77), and the factor analysis converged to the same two-factor structure as in the original version. Construct validity revealed weak-to-moderate associations (r ≤ 0.57) between QUALAS-C-K and K-KIDSCREEN-27, indicating that QUALAS-C-K measures different aspects of the HRQOL than K-KIDSCEEN-27. Conclusions The QUALAS-C-K is a reliable and valid instrument for assessing the health-related quality of life of children with SB in Korea. IMPLICATIONS FOR REHABILITATION Health-related quality of life (HRQOL) is an important patient-reported outcome among children with spina bifida (SB). The QUAlity of Life Assessment of Spina bifida for Children (QUALAS-C) is a self-reported, age-appropriate, and condition-specific HRQOL questionnaire for children with SB, developed in the United States. Our study demonstrated that the Korean version of the QUAlity of Life Assessment of Spina bifida for Children (QUALAS-C-K) is a valid and reliable tool. The QUALAS-C-K is a succinct and valuable questionnaire that can be used to assess HRQOL of children with SB, particularly focusing on bladder and bowel problems in clinical practice and research.

Long-term psychosocial consequences of false-positive screening mammography: a cohort study with follow-up of 12–14 years in Denmark

ObjectiveTo compare the long-term psychosocial consequences of mammography screening among women with breast cancer, normal results and false-positive results.DesignA matched cohort study with follow-up of 12–14 years.SettingDenmark from 2004 to...

Cross-Cultural Adaptation of the Condition-Specific Malocclusion Impact Questionnaire for the Malayalam-speaking Population—A Psychometric Scale Validation Study

ObjectivesThe study aimed to develop a regional version of the Malocclusion Impact Questionnaire (MIQ-Malayalam) for the Malayalam-speaking Indian population.MethodsThe English version of MIQ was translated into Malayalam through a rigorous translation process, followed by cross-cultural adaptation. Young people aged below 18 years who were just about to start orthodontic treatment were invited to complete the Malayalam version of MIQ along with the available native version of the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ). The MIQ-Malayalam was readministered after 14 days to assess test-retest reliability. Treatment need was assessed normatively using the Dental Health Component of the Index of Orthodontic Treatment Need (IOTN-DHC) and subjectively using Aesthetic Component of the Index of Orthodontic Treatment Need (IOTN-AC).ResultsA total of 210 subjects completed the questionnaires (males = 47.2%; females = 52.8%; age = 12-17 years, mean = 15 years and 3 months; standard deviation = 1.9) and 50 completed repeat questionnaires. Internal consistency and test-retest reliability were high (Cronbach’s alpha = 0.952; Intra-class Correlation Coefficient = 0.93). Exploratory factor analysis derived 4 factors with exclusion of 1 item. There were significant differences ( P &lt; .05) in MIQ scores between IOTN-DHC subgroups, ensuring discriminant validity. There was a high correlation between total MIQ and total PIDAQ scores (rho = 0.884), while low between total MIQ and IOTN-AC scores (rho = 0.203).ConclusionThe Malayalam version of MIQ was found to be valid and reliable and can serve as a useful condition-specific measure of oral health-related quality of life.

Symptom and Anatomical Phenotypes Provide Insights Into Interactions of Prolapse Symptoms and Anatomy.

Women pursue treatment to relieve symptoms, while surgeons repair anatomy, underlining the importance of the relationship between symptoms and anatomy. We hypothesized different anatomical and symptom phenotypes associated with pelvic organ prolapse (POP). Our objective was to investigate prevalence of phenotypes to explore associations of symptoms with anatomical defects. We defined 420 anatomical phenotypes from combinations of POP Quantification parameters and 128 symptom phenotypes from symptoms described by condition-specific questionnaires (Pelvic Floor Disorders Inventory, Short Form of the Personal Experience Questionnaire). We applied these to an anonymized database of 719 subjects with symptomatic pelvic floor disorders. Bar graphs were used to illustrate the distribution of anatomical and symptom phenotypes, as well as anatomical phenotypes of patients with specific symptoms. We then used biclustering analysis with the multiple latent block model, to identify patterns of clustered groups of subjects and features. The most common symptom phenotypes have multiple (3-5) symptoms. A third of the theoretical anatomical phenotypes existed in our cohort. Bar graphs for specific symptom composites demonstrated unique distributions of anatomical phenotypes suggesting associations between anatomy and symptoms. Biclustering converged on 2 subject clusters (C1, C2) and 8 feature clusters. Cluster 1 (68%) represented a younger subpopulation with lower stage POP, more stress urinary incontinence and sexual dysfunction (P < 0.001 all). Cluster 2 had more protrusion (P < 0.001) and obstructed voiding (P = 0.001). Features that clustered together, such as stress urinary incontinence and sexual dysfunction, may represent underlying relationships. We demonstrated a relationship between locations of anatomical POP and certain symptoms, which may generate new hypotheses and guide clinical decision making.

Validation of bladder health scales and function indices for women’s research

Existing bladder-specific measures lack the ability to assess the full range of bladder health, from poor to optimal health. This study aimed to report evidence of validity of the self-administered, multidimensional bladder health scales and function indices for research in adult women. A cross-sectional population-based validation study with random assignment to paper or electronic administration was conducted using national address-based probability sampling supplemented by purposive sampling of women with lower urinary tract symptoms in 7 clinical research centers. Construct validity of the bladder health scales and function indices was guided by a multitrait-multimethod approach using health and condition-specific questionnaires, bladder diaries, expert ratings of bladder health, and noninvasive bladder function testing. Internal dimensional validity was evaluated using factor analysis; internal reliability was assessed using paired t-tests and 2-way mixed-effects intraclass correlation coefficient models. Chi-square, Fisher exact, or t-tests were used for mode comparisons. Convergent validity was evaluated using Pearson correlations with the external construct measures, and known-group validity was established with comparison of women known and unknown to be symptomatic of urinary conditions. The sample included 1072 participants. Factor analysis identified 10 scales, with Cronbach's alpha ranging from 0.74 to 0.94. Intraclass correlation coefficients of scales ranged from 0.55 to 0.94. Convergent validity of the 10 scales and 6 indices ranged from 0.52 to 0.83. Known-group validity was confirmed for all scales and indices. Item distribution was similar by mode of administration. The paper and electronic forms of the bladder health scales and function indices are reliable and valid measures of bladder health for use in women's health research.

Is it okay to choose to receive bad news by telephone? An observational study on psychosocial consequences of diagnostic workup for lung cancer suspicion

Background In-person meeting is considered the gold standard in current communication protocols regarding sensitive information, yet one size may not fit all, and patients increasingly demand or are offered disclosure of bad news by, e.g., telephone. It is unknown how patients’ active preference for communication modality affect psychosocial consequences of receiving potentially bad news. Aim To explore psychosocial consequences in patients, who themselves chose to have results of lung cancer workup delivered either in-person or by telephone compared with patients randomly assigned to either delivery in a recently published randomised controlled trial (RCT). Methods An observational study prospectively including patients referred for invasive workup for suspected lung cancer stratified in those declining (Patient’s Own Choice, POC group) and those participating in the RCT. On the day of invasive workup and five weeks later, patients completed a validated, nine-dimension, condition-specific questionnaire, Consequences of Screening in Lung Cancer (COS-LC). Primary outcome: difference in change in COS-LC dimensions between POC and RCT groups. Results In total, 151 patients were included in the POC group versus 255 in the RCT. Most (70%) in the POC group chose to have results by telephone. Baseline characteristics and diagnostic outcomes were comparable between POC and RCT groups, and in telephone and in-person subgroups too. We observed no statistically significant between-groups differences in any COS-LC score between POC and RCT groups, or between telephone and in-person subgroups in the POC group. Conclusion Continually informed patients’ choice between in-person or telephone disclosure of results of lung cancer workup is not associated with differences in psychosocial outcomes. The present article supports further use of a simple model for how to prepare the patient for potential bad news.

Longitudinal assessment of the impact of orthodontic treatment on adolescents' quality of life: a comparison between boys and girls using a condition specific questionnaire.

The aim of this study was to compare the impact of the first year of wearing of a fixed orthodontic appliance on the Oral Health-Related Quality of Life (OHRQoL) between boys and girls, by means of a condition-specific instrument. The study included 69 adolescents aged 10 to 18 years, who were undergoing orthodontic treatment with a fixed appliance. Of the 69 adolescents, 38 were girls (55.1%) and 31 were boys (44.9%). They answered the Brazilian version of the Impact of Fixed Appliance Measure (B-IFAM) questionnaire three months (T1) and one year (T2) after the fixed appliance was installed. This questionnaire contains 43 questions, distributed across nine domains. The higher the scores, the more negative the perception of the adolescent concerning the impact of the fixed appliance on his/her OHRQoL. Sociodemographic and clinical variables were also analyzed, and statistical analysis was performed. For the domains, the effect size (the magnitude of the difference between girls and boys) and the minimal clinically important difference were also calculated. The adjusted regression showed that there was a significantly greater increase in the overall B-IFAM score in girls than in boys, indicating a more negative perception of the OHRQoL over the study time [Coefficient=11.77 (3.47- 20.60), p=0.006]. From T1 to T2, there was a significantly greater increase in the scores (more negative perception of OHRQoL over time) in girls than in boys for the domains aesthetics (p=0.034) and physical impact (p=0.011). These differences were clinically significant. The effect size (the magnitude of the difference) was moderate. The impact of wearing a fixed appliance on the OHRQoL was more negative in girls than in boys during the first year of orthodontic treatment.

P02 Utilising electronic PROMs to measure a change in health following elective laparoscopic cholecystectomy: a feasibility study

Abstract Introduction The collection of Patient Reported Outcome Measures (PROMs) has many benefits for clinical practice. However, there are also many barriers that prevent them from becoming a part of routine clinical care. The aim of this feasibility study was to pilot the use of a digital platform to facilitate the routine collection of pre- and postoperative electronic PROMs (ePROMs) in patients undergoing elective laparoscopic cholecystectomy, and to validate the use of existing PROs for our population. Methods Patients listed for elective laparoscopic cholecystectomy were asked to complete digital versions of the Otago gallstones Condition-Specific Questionnaire (CSQ), and the RAND 36-item health survey (SF36). An assessment of methodological quality of ePROM questionnaires was also performed. Results Preoperative ePROMs were completed in 200 patients undergoing laparoscopic cholecystectomy. Despite participant drop out a significant improvement in quality of life was seen across all health domains postoperatively when compared with baseline preoperative values for both disease specific (emotional functioning; preoperative: 48.9, 30-days: 15.6, 3-months: 16.7, 6-months: 7.9, p &amp;lt; 0.05) and generic (emotional well-being; preoperative: 60.1, 30-days: 73.7, 3-months: 74.3, 6-months: 73.5, p &amp;lt; 0.05) PROMs. Methodological quality was assessed as good to excellent in both digital questionnaires used. Conclusion The collection of ePROMs is possible with current technological advances. Although it may be an acceptable and convenient process for patients, and a useful measure of quality-of-life trends for clinicians, further developmental work is necessary to improve accessibility for patients and to reduce reporting bias. Take-home message ePROMs are an acceptable and useful measure of quality-of-life trends for patients and clinicians, however further development is required to improve its usability in the clinical setting.

Utilising Electronic PROMs to Measure a Change in Health Following Elective Laparoscopic Cholecystectomy: A Feasibility Study

BackgroundThe collection of patient-reported outcome measures (PROMs) has many benefits for clinical practice. However, there are many barriers that prevent them from becoming a part of routine clinical care. The aim of this feasibility study was to pilot the use of a digital platform to facilitate the routine collection of pre- and post-operative electronic PROMs (ePROMs) in participants undergoing elective laparoscopic cholecystectomy and to validate the use of existing patient-reported outcomes for our population.MethodsParticipants scheduled for elective laparoscopic cholecystectomy were asked to complete digital versions of the Otago gallstones Condition-Specific Questionnaire (CSQ), and the RAND 36-item health survey (SF36). An assessment of methodological quality of ePROM questionnaires was also performed.ResultsPreoperative ePROMs were completed by 200 participants undergoing laparoscopic cholecystectomy. Post-operatively attrition was high (completion at 30 days, 3 months, and 6months: n = 61, 54, and 38, respectively) due to difficulties accessing our ePROMs portal. Of those able to complete, a significant improvement in quality of life was seen across all health domains post-operatively when compared with baseline preoperative values for both disease-specific and generic PROMs. Methodological quality was assessed as good to excellent in both digital questionnaires.ConclusionThe collection of ePROMs is possible with current technological advances. Although it may be an acceptable, and convenient process for patients, and a useful measure of quality-of-life trends for clinicians, further developmental work is necessary to improve accessibility for patients, improve compliance, and reduce reporting bias from high attrition rates.