Evidence-based Assessment Tools Research Articles

Economic and Clinical Outcomes Resulting From the Stage 4 Chronic Kidney Disease Case Management Quality Improvement Initiative.

Purpose of Study:Chronic kidney disease (CKD) is a costly and burdensome public health concern. The goal of this study was to evaluate the impact on outcomes and utilization of a pilot program to identify and engage beneficiaries with CKD at risk for progression from Stage 4 to Stage 5.Primary Practice Settings:A quality improvement initiative was conducted to assess the impact of case management on costs and outcomes among 7,720 Cigna commercial medical beneficiaries with Stage 4 CKD enrolled in the United States between January 2012 and October 2012.Methodology and Sample:Claims data were analyzed to compare 3,861 beneficiaries randomized to receive condition-focused case management with 3,859 controls, with follow-up through July 2013. After using an algorithm to identify beneficiaries at highest risk of progression, a case management team implemented, among those assigned to the intervention, an evidence-based assessment tool, provided education and follow-up, engaged nephrologists and other providers, and conducted weekly rounds. Primary outcome measures were hospital admissions, emergency department visits, nephrologist visits, dialysis, arteriovenous (AV) fistula creation, and total medical costs. Analysis of variance techniques were used to test group differences.Results:As compared with controls, intervention beneficiaries were 12% more likely to have fistula creation (p = .004). Intervention beneficiaries were observed to have savings of $199 per member per month (PMPM), F = 23.05, p = .04. This difference equated to 6% lower total medical costs in the intervention group. Savings observed were derived half from improved in-network utilization and half from reduced hospital costs.Implications for Case Management Practice:The observed 12% increased rate of creation of AV fistulas and $199 (6%) decrease in PMPM cost between the intervention and control groups corresponded to a savings of more than $18 million in 2015 U.S. dollars (USD).On the basis of observation of substantial improvements in outcomes and cost savings, health plan administrators could better serve those at highest risk of progression by implementing focused case management.Our findings support the value of care coordination between nephrologists, providers, and health plan case managers in improving outcomes and reducing total medical costs among beneficiaries at risk for CKD progression from Stage 4 to Stage 5.

Assessment tool for the instructional design of simulation-based team training courses: the ID-SIM.

To achieve an expert performance of care teams, adequate simulation-based team training courses with an effective instructional design are essential. As the importance of the instructional design becomes ever more clear, an objective assessment tool would be valuable for educators and researchers. Therefore, we aimed to develop an evidence-based and objective assessment tool for the evaluation of the instructional design of simulation-based team training courses. A validation study in which we developed an assessment tool containing an evidence-based questionnaire with Visual Analogue Scale (VAS) and a visual chart directly translating the results of the questionnaire. Psychometric properties of the assessment tool were tested using five descriptions of simulation-based team training courses. An expert-opinion-based ranking from poor to excellent was obtained. Ten independent raters assessed the five training courses twice, by using the developed questionnaire with an interval of 2 weeks. Validity and reliability analyses were performed by using the scores from the raters and comparing them with the expert's ranking. Usability was assessed by an 11-item survey. A 42-item questionnaire, using VAS, and a propeller chart were developed. The correlation between the expert-opinion-based ranking and the evaluators' scores (Spearman correlation) was 0.95, and the variance due to subjectivity of raters was 3.5% (VTraining*Rater). The G-coefficient was 0.96. The inter-rater reliability (intraclass correlation coefficient (ICC)) was 0.91 (95% CI 0.77 to 0.99), and intra-rater reliability for the overall score (ICC) was ranging from 0.91 to 0.99. We developed an evidence-based and reliable assessment tool for the evaluation of the instructional design of a simulation-based team training: the ID-SIM. The ID-SIM is available as a free mobile application.

Examining the accessibility of high-quality physical activity behaviour change support freely available online for men with prostate cancer.

While the internet is considered a promising avenue for providing physical activity support to prostate cancer survivors, little is known about the accessibility of quality websites in the real world. This work aimed to explore what websites prostate cancer survivors are likely to find when seeking physical activity support online and to evaluate their quality using evidenced-based criteria. A search strategy was developed in consultation with prostate cancer survivors (n=44) to reflect the most common ways they are likely to search the internet. The search was then conducted by a single reviewer, and identified websites were assessed for quality by two reviewers using an evidence-based quality assessment tool developed for this study. Discrepancies were resolved by a third reviewer. Of the 45 identified websites, 13 (29%) received a high quality rating, 22 (49%) received a moderate rating and 10 (22%) received a low quality rating. Higher-quality websites tended to have a .org or .gov domain and tended to be located using searches specific to prostate cancer or prostate cancer and exercise. Very few websites contained complete information regarding the physical activity guidelines for cancer survivors, and no websites provided comprehensive behaviour change support. There are some good-quality physical activity websites accessible to men with prostate cancer. However, they may be difficult to find and/or require updating to include complete recommendations and more behaviour change support. Efforts to improve physical activity information online and strategies to direct prostate cancer survivors to higher-quality websites and support services are needed to ensure safety and efficacy.

Development of an atrophic acne scar risk assessment tool.

Acne is a chronic dermatological disease predominantly afflicting young adults and is often associated with the development of scars. Acne scarring is usually avoidable when acne is managed early and effectively. However, acne patients often fail to seek early treatment. New and innovative tools to raise awareness are needed. This study presents the development and assessment of a tool aiming to assess the risk of atrophic acne scars. A systematic literature review of clinical risk factors for acne scars, a Delphi-like survey of dermatological experts in acne and secondary data analysis, were conducted to produce an evidence-based risk assessment tool. The tool was assessed both with a sample of young adults with and without scars and was assessed via a database cross-validation. A self-administered tool for risk assessment of developing atrophic acne scars in young adults was developed. It is a readily comprehensible and practical tool for population education and for use in medical practices. It comprises of four risk factors: worst ever severity of acne, duration of acne, family history of atrophic acne scars and lesion manipulation behaviours. It provides a dichotomous outcome: lower vs. higher risk of developing scars, thereby categorizing nearly two-thirds of the population correctly, with sensitivity of 82% and specificity of 43%. The present tool was developed as a response to current challenges in acne scar prevention. A potential benefit is to encourage those at risk to self-identify and to seek active intervention of their acne. In clinical practice, we expect this tool may help clinicians identify patients at risk of atrophic acne scarring and underscore their requirement for rapid and effective acne treatment.

Assessment of palliative care services in western Kenya.

The need for palliative care services is rapidly increasing due to the rising number of patients with non-communicable diseases. The objective of this study was to assess the current availability and barriers to palliative care and healthcare worker knowledge and perceptions on palliative pain control in western Kenya. An evidence-based 40-question assessment tool was conducted between October 2015 and February 2016 in Siaya County, western Kenya. All level 4 and 5 facilities (e.g., regional and district hospitals) were assessed, as well as a selection of lower-level facilities chosen via convenience sampling, stratified by facility level (e.g., dispensaries, health centers, and health clinics). A key informant at each of 22 facilities was surveyed and included 1 medical officer (5%), 12 clinical officers (55%), and 9 nurses (41%). Key themes included training and education, awareness of palliative care and hospice, services provided, and pain control. All 22 providers had heard of palliative care and 4 (18%) had received formal training. Fourteen (64%) providers knew that morphine was on the World Health Organization (WHO) essential medication list, 8 (36%) had previously prescribed opioids, and 5 (23%) had prescribed them for palliation. Provider concerns for opioid use included its addictive properties (59%), appropriate dosing (9%), cost (5%), side effects (9%), and availability (5%). Palliative care and hospice services were identified by providers as important components in the management of chronic illnesses in western Kenya. Further provider education as well as increased access to pain medications including opioids is necessary to improve the care of patients in western Kenya.

Commentary About Cheit's Witch-Hunt Narrative: The Historical Context.

Ross Cheit's lengthy study is strongest when he describes in detail the findings of his 13 years of research into the original records of the key "witch hunt" cases of the 1980s to set the record straight, when possible, about what really happened. However, because this was partial history that focused primarily on the interplay between academic psychology and the media in a limited number of cases, a commentary about the broader historical and institutional context may lead to a more optimistic conclusion than Cheit seems to reach. Since this latest discovery of child sexual abuse (and its partial suppression with the rapid and predictable construction of the witch-hunt narrative), professionals across a range of disciplines continue to refine statistical science to document the prevalence and impact of child sexual abuse. They continue to enhance our understanding about children's memory and suggestibility. They have steadily refined methods to elicit full and accurate information from alleged child victims, created child advocacy centers with multidisciplinary teams to handle cases skillfully, and have developed evidence-based assessment tools and treatment protocols for substantiated victims. This solid and continuing academic output, coupled with nationwide institutionalization of the childhood trauma and maltreatment fields in organizations such as the National Child Advocacy Center, the American Professional Society on the Abuse of Children, and the National Child Traumatic Stress Network make this rediscovery of child sexual abuse different from the many other discoveries and suppressions that preceded it.

A Framework for Assessing Enablers and Risks in Health and Care System Integration

A Framework for Assessing Enablers and Risks in Health and Care System Integration

Development of an evidence-based fall risk assessment tool and evaluation of interrater reliability and nurses' perceptions of the tool's clarity and usability.

To develop and test interrater reliability of an evidence-based fall risk assessment tool for nurses and to investigate how nurses perceived the clarity and usability of the tool. In phase 1, an evidence-based fall risk assessment tool was developed based on a literature review and expert discussion. The finalized tool assessed 11 risk factors and comprised 23 items. In phase 2, reliability testing was done. Two nurses out of a possible 125 participating nurses independently assessed each participating patient on admission with the assessment tool. The nurses then provided feedback on the clarity and usability of the tool. The interrater reliability was estimated by the percentage agreement, Cohen's kappa, and prevalence- and bias-adjusted kappa. Of the 164 patients who were recruited, 114 patients participated. After adjustment for prevalence and bias, only "frequent urination" and "night-time toileting" showed a less-than-substantial interrater agreement. Assessment of the items "cognitive impairment" and "night-time toileting" were most frequently reported to be problematic. The evidence-based fall risk assessment tool requires further modification and re-examination of interrater reliability is warranted. In particular, the cognitive impairment items need to be reconsidered in order to enable nurses to better assess patient cognition on the admission day.

Contraceptive Knowledge Assessment: validity and reliability of a novel contraceptive research tool

ObjectivesClinicians and researchers need an accurate tool assessing contraceptive knowledge in order to understand the effectiveness of teaching efforts. However, most widely used indices are outdated. The objective of this study is to create an evidence-based assessment tool and determine its validity and reliability for measuring contraceptive knowledge. Study designThe study team developed the 25-question multiple-choice tool entitled the Contraceptive Knowledge Assessment (CKA). Expert reviewers examined content validity and semistructured patient interviews acquired feedback on subject matter and comprehension. A two-tiered approach explored criterion validity via (1) comparison with the gold standard (Contraceptive Knowledge Inventory) and (2) comparison between groups with lower and higher contraceptive knowledge. Repeat testing after 2–4 weeks evaluated test–retest reliability. ResultsSix experts and seven patients provided feedback on the initial CKA. One hundred two reproductive-aged male and female patients and 27 medical students completed the final CKA with an overall mean patient score of 9/25 (36%). The mean score on the CKA was higher than the mean score on the gold standard (9.1 vs. 5.8, p<.001). Patients scored lower on the CKA than did medical students (9.1 [36.4%] vs.19.4 [77.6%], p<.005). There were no differences within patients' results with repeat testing over time (p=.667). ConclusionsThe CKA is a valid and reliable tool to measure a patient's level of knowledge regarding contraception. This research tool may allow for the assessment of baseline knowledge, educational gaps, and improvement after an intervention. Knowledge may be lower than previous studies suggest, signifying need for improved education on contraception and better understanding of the relationship between knowledge and behavior change. ImplicationsThe CKA provides an evidence-based, reliable, and validated assessment of contraceptive knowledge. This modern tool may help to determine the effectiveness of interventions to improve education on contraception.

Oral care practice guidelines for the care-dependent hospitalized adult outside of the intensive care unit setting

Abstract Background Many nurses lack evidence-based knowledge to deliver appropriate oral care, viewing oral care in the care-dependent patient as a comfort measure and giving it a low clinical priority. An estimated 44%—65% of hospitalized care-dependent patients do not receive adequate oral care, an intervention that can prevent aspiration pneumonia or pneumonitis. Purpose The purpose of this study was to develop a standardized assessment for oral care in the hospitalized care-dependent adult outside of the intensive care unit setting at a regional health system in the Southeast United States. The long-term goal is to reduce the risk of aspiration and resulting complications. Methods The study used the theoretical foundations of relationship-based care and the logic model. An interdisciplinary team of institutional stakeholders from 2 acute care hospitals identified an appropriate evidence-based oral assessment tool, developed policy and practice guidelines to inform oral care, and developed both implementation and evaluation plans to pilot the project and assess short and long term outcomes. Discussion The standards developed in this study create a process to ensure care-dependent adults outside of the intensive care unit setting will receive an oral assessment daily, or every shift, as determined by the oral assessment score, and that oral care is provided in accordance with practice guidelines to reduce risk of aspiration. Conclusion This study advances nursing practice by addressing a gap in practice and promotes positive social change by improving the quality of care provided to all care-dependent patients. Improvement of patient outcomes resulting from the reduction of risk for aspiration and reduction of the financial burden of unnecessary resources used to care for patients who aspirate and suffer complications are additional outcomes expected of this initiative.

Identifying Meningitis During an Anthrax Mass Casualty Incident: Systematic Review of Systemic Anthrax Since 1880.

Bacillus anthracis, the causative agent of anthrax, is a potential bioterrorism agent. Anthrax meningitis is a common manifestation of B. anthracis infection, has high mortality, and requires more aggressive treatment than anthrax without meningitis. Its rapid identification and treatment are essential for successful management of an anthrax mass casualty incident. Three hundred six published reports from 1880 through 2013 met predefined inclusion criteria. We calculated descriptive statistics for abstracted cases and conducted multivariable regression on separate derivation and validation cohorts to identify clinical diagnostic and prognostic factors for anthrax meningitis. One hundred thirty-two of 363 (36%) cases with systemic anthrax met anthrax meningitis criteria. Severe headache, altered mental status, meningeal signs, and other neurological signs at presentation independently predicted meningitis in the derivation cohort and were tested as a 4-item assessment tool for use during anthrax mass casualty incidents. Presence of any 1 factor on admission had a sensitivity for finding anthrax meningitis of 89% (83%) in the adult (pediatric) validation cohorts. Anthrax meningitis was unlikely in the absence of any of these signs or symptoms (likelihood ratio [LR]- = 0.12 [0.19] for adult [pediatric] cohorts), while presence of 2 or more made meningitis very likely (LR+ = 26.5 [30.0]). Survival of anthrax meningitis was predicted by treatment with a bactericidal agent (P = .005) and use of multiple antimicrobials (P = .01). We developed an evidence-based assessment tool for screening patients for meningitis during an anthrax mass casualty incident. Its use could improve both patient outcomes and resource allocation in such an event.

Science in Practice in Cognitive Behavior Therapy

In honor of the ABCT’s 50th anniversary, I offer observations about the consumption and production of science in the clinical practice setting from the vantage point of my own professional development and the development of cognitive behavior therapy (CBT) more generally. I describe advances in the field that will promote clinicians’ consumption and production of science. Two recent developments that promote practitioners’ consumption of science are the field’s shift from the study of disorders to the study of transdiagnostic mechanisms, and the advent of flexible modular protocols. Two advances that support practitioners’ production of science include the overlapping interests of practitioners and scientists in understanding the mechanisms of action of our effective treatments, and the emergence of software and online tools that make it easy for clinicians to collect and organize the data they obtain during the course of their clinical work. Innovations that can strengthen the role of science in practice include the publication of more single-case studies and increased access to evidence-based assessment tools; I describe ways the ABCT might contribute to both these initiatives.

Noninvasive Tests for Inflammatory Bowel Disease: A Meta-analysis

The clinical presentation of pediatric inflammatory bowel disease (IBD) is often nonspecific and overlaps with functional gastrointestinal disorders. To determine the diagnostic accuracy of symptoms, signs, noninvasive tests, and test combinations that can assist the clinician with the diagnosis of IBD in symptomatic children. A literature search was conducted of Medline and Embase. Two reviewers independently selected studies reporting on the diagnostic accuracy of tests for IBD, with confirmation by endoscopy and histopathology or clinical follow-up, in children with chronic gastrointestinal symptoms. Two reviewers independently extracted data and assessed study quality with the QUADAS-2, an evidence-based quality assessment tool for diagnostic accuracy studies. Nineteen studies were included (N = 2806). Symptoms (abdominal pain, diarrhea, rectal bleeding, and weight loss) had pooled sensitivities ranging from 0.48 to 0.82 and specificities ranging from 0.17 to 0.78. Of all the blood markers, C-reactive protein (CRP) (9 studies) and albumin (6 studies) had the best performance, with pooled sensitivities of 0.63 (0.51-0.73) and 0.48 (0.31-0.66), respectively, and specificities of 0.88 (0.80-0.93) and 0.94 (0.86-0.98). Assessment of fecal calprotectin (FCal) (10 studies) had a pooled sensitivity of 0.99 (0.92-1.00) and a specificity of 0.65 (0.54-0.74). One limitation was that none of the studies was conducted in nonreferred children. In children whose pediatrician is considering an endoscopy, symptoms are not accurate enough to identify low-risk patients in whom an endoscopy can be avoided. FCal, CRP, and albumin findings are potentially of clinical value, given their ability to select children at low risk (negative FCal test result) or high risk (positive CRP or albumin test result) for IBD.

A systematic review of evidence-based assessment practices by allied health practitioners for children with cerebral palsy.

The routine use of psychometrically robust assessment tools is integral to best practice. This systematic review aims to determine the extent to which evidence-based assessment tools were used by allied health practitioners for children with cerebral palsy (CP). The Preferred Reporting Items for Systematic Reviews and Meta-Analysis protocols 2015 was employed. A search strategy applied the free text terms: 'allied health practitioner', 'assessment', and 'cerebral palsy', and related subject headings to seven databases. Included articles reported assessment practices of occupational therapists, physiotherapists, or speech pathologists working with children with CP aged 0 to 18years, published from the year 2000. Fourteen articles met the inclusion criteria. Eighty-eight assessment tools were reported, of which 23 were in high use. Of these, three tools focused on gross motor function and had acceptable validity for use with children with CP: Gross Motor Function Measure, Gross Motor Function Classification System, and goniometry. Validated tools to assess other activity components, participation, quality of life, and pain were used infrequently or not at all. Allied health practitioners used only a few of the available evidence-based assessment tools. Assessment findings in many areas considered important by children and families were rarely documented using validated assessment tools.

Validity and reliability of the Turkish version of the Optimality Index-US (OI-US) to assess maternity care outcomes

Backgroundalthough obstetrical interventions are used commonly in Turkey, there is no standardized evidence-based assessment tool to evaluate maternity care outcomes. The Optimality Index-US (OI-US) is an evidence-based tool that was developed for the purpose of measuring aggregate perinatal care processes and outcomes against an optimal or best possible standard. This index has been validated and used in Netherlands, USA and UK until now. Objectivethe objective of this study was to adapt the OI-US to assess maternity care outcomes in Turkey. Designtranslation and back translation were used to develop the Optimality Index-Turkey (OI-TR) version. To evaluate the content validity of the OI-TR, an expert panel group (n=10) reviewed the items and evidence-based quality of the OI-TR for application in Turkey. Following the content validity process, the OI-TR was used to assess 150 healthy and 150 high-risk pregnant women who gave birth at a high volume, urban maternity hospital in Turkey. The scores between the two groups were compared to assess the discriminant validity of the OI-TR. The percentage of agreement between two raters and the Kappa statistic were calculated to evaluate the reliability. Findingscontent validity was established for the OI-TR by an expert group. Discriminant validity was confirmed by comparing the OI scores of healthy pregnant women (mean OI score=77.65%) and those of high-risk pregnant women (mean OI score=78.60%). The percentage of agreement between the two raters was 96.19, and inter-rater agreement was provided for each item in the OI-TR. ConclusionOI-TR is a valid and reliable tool that can be used to assess maternity care outcomes in Turkey. The results of this study indicate that although the risk statuses of the women differed, the type of care they received was essentially the same, as measured by the OI-TR. Care was not individualised based on risk and for a majority of items was inconsistent with evidence based practice, which is not optimal. Implications for practiceuse of the OI-TR will help to provide a standardized way to assess maternity care process and outcomes of maternity care in Turkey which can inform future research aimed at improving maternity care outcomes.

Infant and Early Childhood Mental Health

Infant and Early Childhood Mental Health

The use of behavior change theory in Internet-based asthma self-management interventions: a systematic review.

BackgroundThe high prevalence rate of asthma represents a major societal burden. Advancements in information technology continue to affect the delivery of patient care in all areas of medicine. Internet-based solutions, social media, and mobile technology could address some of the problems associated with increasing asthma prevalence.ObjectiveThis review evaluates Internet-based asthma interventions that were published between 2004 and October 2014 with respect to the use of behavioral change theoretical frameworks, applied clinical guidelines, and assessment tools.MethodsThe search term (Asthma AND [Online or Internet or Mobile or Application or eHealth or App]) was applied to six bibliographic databases (Ovid MEDLINE, PubMed, BioMed Central, ProQuest Computing, Web of Knowledge, and ACM Digital Library) including only English-language articles published between 2004 and October 2014. In total, 3932 articles matched the priori search terms and were reviewed by the primary reviewer based on their titles, index terms, and abstracts. The matching articles were then screened by the primary reviewer for inclusion or exclusion based on their abstract, study type, and intervention objectives with respect to the full set of priori inclusion and exclusion criteria; 331 duplicates were identified and removed. A total of 85 articles were included for in-depth review and the remaining 3516 articles were excluded. The primary and secondary reviewer independently reviewed the complete content of the 85 included articles to identify the applied behavioral change theories, clinical guidelines, and assessment tools. Findings and any disagreement between reviewers were resolved by in-depth discussion and through a consolidation process for each of the included articles.ResultsThe reviewers identified 17 out of 85 interventions (20%) where at least one model, framework, and/or construct of a behavioral change theory were applied. The review identified six clinical guidelines that were applied across 30 of the 85 interventions (35%) as well as a total of 21 assessment tools that were applied across 32 of the 85 interventions (38%).ConclusionsThe findings of this literature review indicate that the majority of published Internet-based interventions do not use any documented behavioral change theory, clinical guidelines, and/or assessment tools to inform their design. Further, it was found that the application of clinical guidelines and assessment tools were more salient across the reviewed interventions. A consequence, as such, is that many Internet-based asthma interventions are designed in an ad hoc manner, without the use of any notable evidence-based theoretical frameworks, clinical guidelines, and/or assessment tools.

ORGANISATIONAL FACTORS INFLUENCING UPTAKE OF A CARER SUPPORT NEEDS ASSESSMENT TOOL IN PALLIATIVE HOME CARE

IntroductionThe Carer Support Needs Assessment Tool (CSNAT) is a comprehensive, evidence-based tool for carer assessment and support. Successful implementation requires a change from existing practitioner led approaches to carer assessment to one which is facilitated by the practitioner, but led by the carer.Aim(s) and method(s)To identify organisational factors which facilitate or hinder implementation of the CSNAT. The CSNAT was implemented in 6 palliative home care services. Qualitative data were collected via interviews (15), focus groups (2) and workshops (3), with practitioner ‘champions’ and service managers. All were audio-recorded, transcribed and analysed thematically.ResultsUptake of the CSNAT varied between services and was influenced by the receptivity of the context into which it was introduced. ‘Organisational preparedness’, with regard to existing administration systems, working patterns and competing demands, was a key factor. Additionally, facilitation to support implementation of the CSNAT was paramount; this included ‘internal facilitation’ from within the service (e.g. clear organisation steer) and ‘external facilitation’ from the research team (e.g. provision of training and on-going support).Conclusion(s)The study identified two main factors which influence effective implementation of the CSNAT: a) receptivity of the organisational context and b) level of facilitation). These findings are in keeping with theory and practice models relating to sustainable implementation of practice developments. Further work is underway to explore how organisations can best be supported when implementing the CSNAT.Funder NIHR Research for Patient Benefit.

Comparison of self- versus clinician-administered GAIN-Q3 MI

Background Substance abuse services treatment providers are challenged in making decisions regarding evidence-based assessment tools and processes, given the many options available in terms of length/coverage and administration options, including clinician versus self-administration. In Ontario, Canada, we have pilot-tested an assessment tool designed for clinician administration (the GAIN Q3-MI), with the aim being to replace a suite of tools suitable for self-completion. Feedback from the agencies involved in the pilot testing raised concerns about the impact on agency waiting lists if the treatment network was to move to a clinician-administered option. The present project was a small-scale experiment of face-toface versus self-administration of the GAIN tool, intended to assess differences in data quality and completeness, staff feedback on pros and cons, and client feedback on acceptability of the alternative methods of administration.

Breast Cancer EDGE Task Force Outcomes: Clinical Measures of Health Related Quality of Life

Background: Health related quality of life (HRQOL) is a broad multidimensional concept that usually includes subjective evaluations of both positive and negative aspects of life and has been extensively studied in the breast cancer population. The purpose of this review was to identify evidence-based HRQOL assessment tools found in breast cancer research using the methodology of the Oncology Section Cancer EDGE Task Force. Methods: The authors systematically reviewed the literature for outcome measures used to assess HRQOL in published research involving women diagnosed with breast cancer. The goal was to examine the psychometric properties of commonly used HRQOL measures in order to determine their clinical utility. Results: European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ) - Breast 23, BREAST-Q, Functional Assessment of Cancer Therapy (FACT) - Breast, FACT-B+4, EORTC QLQ - Cancer 30, FACT-General, Functional Living Index-Cancer, Ferrans and Powers Quality of Life Index-Cancer Version, Psychological Adjustment to Illness Scale, World Health Organization Quality of Life, and SF-Health Surveys, were highly recommended by the Task Force. Conclusions: A variety of outcome measures have been reported in the literature to assess HRQOL in women diagnosed with breast cancer. Eleven measures were found to have satisfactory psychometric properties and are recommended for clinical use by the researchers on this Task Force.