Patient-based Outcome Measures Research Articles

Evaluation of Improvement in Chronic Rhinosinusitis After Endoscopic Sinus Surgery Using Sino-Nasal Outcome Test-22 (SNOT22) Symptom Score.

Sino-Nasal Outcome Test (SNOT-22) symptom score is the most widely used questionnaire due to its easy interpretation with respect to quality of life (QOL) in patients with chronic rhinosinusitis (CRS). It helps in deciding further treatment plan in patients with refractory CRS despite maximal medical therapy (MMT). Endoscopic sinus surgery (ESS) is suggested in patients not responding to medical treatment. The preoperative and post-operative QOL for patients with CRS is assessed using SNOT-22. To assess SNOT-22 score change in CRS resistant to MMT. This is a longitudinal study conducted from April 2021-September 2022 included patients diagnosed to have CRS, satisfying the inclusion criteria. SNOT-22 for symptom severity assessed at the first visit, 1week and 12weeks and after MMT. Patients who failed MMT, posted for ESS. Post-operatively SNOT-22 symptom score re-assessed at 15days, 1month, 2months and 3months. 56 patients (male-51% and female-49%) who failed to respond to MMT included in the study. The five major troublesome symptoms nasal blockage (92.86%), need to blow nose (75%), facial pressure/pain (53.57%), post nasal discharge (51.79%), and sneezing (42.86%). The mean SNOT-22 symptom score when compared with pre-operatively (69.54 ± 8.973) and after FESS (2.09 ± 1.881) had improved significantly (p < 0.001). CRS is more frequently seen in males aged between 21 and 30years. The patient-based outcome measures, like SNOT-22 helps to foresee the extent of post- operative improvement. The effective management of CRS is by surgical intervention.

Comparative study on efficacy of SNOT 22 outcome in nasal surgery using teflon splinting for chronic rhinosinusitis

&lt;p&gt;&lt;strong&gt;Background:&lt;/strong&gt; CRS is defined as inflammation in the nose and paranasal sinus and it is characterized by two or more cardinal symptoms. There is a growing need for a simple, reliable, system-specific standardized outcome measure that can help us explore CRS in a more uniform way and help us to take into account patients’ HRQoL. SNOT covers a broad range of health and health-related quality of life problems including physical problems, functional limitations, and emotional consequences.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods:&lt;/strong&gt; we report a case series of 60 patients, divided into 2 groups of 30 each. 1&lt;sup&gt;st&lt;/sup&gt; group underwent FESS+septoturbinoplasty while the 2&lt;sup&gt;nd&lt;/sup&gt; group underwent FESS+septoturbinoplasty with teflon splinting. Patients were asked to score their symptoms on SNOT 22 questionnaire pre-operatively and post-operatively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results:&lt;/strong&gt; Significant changes were noted in nasal related and quality of life domain and less significant changes noted in ear/facial related and psychological domains in group 2.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; patient-based outcome measures like SNOT 22, is helpful tool for quantifying changes in symptoms and useful for predicting post-operative improvement. It is both patient and researcher-friendly.&lt;/p&gt;

Predictors of two-year patient satisfaction following elective knee surgery

BackgroundPatient satisfaction metrics are increasingly being utilized as tools to evaluate the quality of healthcare and affect reimbursements. The objectives of this study were to (1) identify factors associated with two-year patient satisfaction after elective knee surgery, (2) compare the Surgical Satisfaction Questionnaire-8 (SSQ-8) and a numeric satisfaction scale (NSS), and (3) determine if two-year patient satisfaction can be predicted based on preoperative factors. MethodsA total of 365 patients undergoing elective knee surgery at a single center were administered questionnaires to assess demographics, medical history, and various patient-reported outcomes preoperatively and at two years postoperatively. Patient satisfaction was measured at two years postoperatively with SSQ-8 and NSS. Bivariate and multivariate statistical analyses were performed to identify significant associations and independent predictors of satisfaction. ResultsSSQ-8 and NSS scores were significantly correlated (rs = 0.68, P < 0.0001). Lower SSQ-8 and NSS scores were associated with black race, higher BMI, more comorbidities, unemployment, smoking, higher ASA score, and greater Met Expectations (P < 0.05). Better scores on patient-based outcome measures and better improvement from baseline were significantly correlated with higher satisfaction on both SSQ-8 and NSS. Multivariable analysis identified greater Met Expectations and higher two-year Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Interference scores as independent predictors of greater SSQ-8 scores (adjusted r2 = .52). Greater Met Expectations and better two-year PROMIS Social Satisfaction scores were independent predictors of NSS score (adjusted r2 = .41). In contrast, when only preoperative variables were considered, the multivariable regression model accounted for only 14% of the variance in SSQ-8 and 6% of the variance in NSS. ConclusionWhile there are multiple preoperative factors that are associated with two-year patient satisfaction after knee surgery, those factors contribute relatively little to satisfaction. Meeting expectations and better patient-based outcomes at two years are more important.

Value of Boston Questionnaire in Carpal Tunnel Syndrome

Objectives: The Boston Carpal Tunnel Questionnaire (BCTQ) is a patient-based outcome measure that has been developed for patients with Carpal tunnel syndrome (CTS). The purpose of this study was to investigate the association between BCTQ scores and electrophysiological findings in patients with CTS. Subjects and Methods: This study included 174 individuals (control group [n = 68] and patient group [n = 106]) admitted to Erciyes University Hospital Department of Neurology between August 2019 and November 2019 with complaints of pain, numbness, and paresthesia in the unilateral or bilateral median nerve trace and diagnosed with idiopathic CTS or normal after electrophysiological testing. The Turkish version of the BCTQ was applied to these patients. Results: The mean age of the participants was 46.6 (standard deviation ± 11.9). One hundred and fifty-seven (90.2%) of all the participants were female. Among patients, 29.9% (n = 52) had mild, 21.8% (n = 38) had moderate, and 9.2% (n = 16) had severe CTS. Both the Symptom Severity Scale (SSS) and functional status scale (FSS) scores were evaluated between the groups, and there was a significant difference between the groups (P &lt; 0.001 and P = 0.001, respectively). Although there was a significant difference between the groups, the huge overlap in the distribution of the scores indicated that discrimination of an individual according to FSS/SSS scores is unrealistic in the clinical setting. Conclusion: The BCTQ will not be sufficient and objective in the diagnosis and management of CTS. Today, electrophysiological tests are still the gold standard for the diagnosis of CTS, and referring the patient to the electromyography EMG laboratory is necessary for early diagnosis and determining the effective treatment method.

Non-surgical periodontal therapy effectively improves patient-reported outcomes: A systematic review.

Modern lifespan oral health research focuses on understanding the impact of periodontitis (or therapy) on clinical and patient-based outcome measures to provide effective care, improve patient safety according to the quality standards. For better targeted intervention and effective disease management, this systematically review aimed to investigate the relationship between non-surgical periodontal therapy and patient-based outcomes using OHIP-14. Seven Databases were searched for studies on patient-based outcomes responses to periodontal treatment. The time-period defined from search was from January 1977 to January 2019. Two independent reviewers carried out data search, selection of studies, data extraction and quality assessment using Mixed Method Appraisal Tool. Prospective cohort studies, intervention studies and observational studies written in English demonstrating non-surgical periodontal therapy response on the patient-reported outcomes (using Oral Health Impact Profile 14) were included in the review. Thirteen studies were included in the review, which comprised of three randomised control trials, nine case series, and one was a quasi-experimental study. Eleven out of the 13 studies reported significant improvement in OHIP-14 scores amongst participants who had undergone non-surgical periodontal therapy. Physical disability, psychological discomfort and functional limitation were domains that improved significantly after non-surgical periodontal therapy in these studies. Physical pain was a common finding in short-term follow-up but improved significantly in long-term follow-up studies. Based on clinical and patient-based outcomes measurement, it is recommended that non-surgical periodontal therapy is a "gold standard" approach towards improving patient-based outcomes, reducing co-morbidities and enhancing patient safely immediately and in long term.

Objective evaluation of postoperative changes in real-life activity levels in the postoperative course of lumbar spinal surgery using wearable trackers

BackgroundLumbar spinal disease causes disabilities in performing daily activities. Operative treatments are aimed at pain relief and rapid return to routine activity. Patient-based outcome measures are used to evaluate pathologies and therapeutic effects associated with lumbar spinal disease. Nevertheless, it remains unknown as to how much such treatment improves activity levels.The purpose of the current study was to measure changes in activity levels before and after lumbar spinal surgery using a wearable activity tracker and to analyze the differences between results and patient-based outcomes.MethodsSixty patients who underwent lumbar surgery were studied. The physical activity of participants was objectively evaluated using a wearable Micro-Motion logger system (Actigraph). We measured the amount of activity before and at 1, 3, 6, and 12 months after the surgery to evaluate postoperative changes. The Japanese Orthopaedic Association Back Pain Evaluation Questionnaire, Oswestry Disability Index, Roland-Morris Disability Questionnaire and visual analog scale were used to assess patient-based outcomes of pain and activities of daily living-related scores; we analyzed the relationships between scores and actual activity levels.ResultsThe amount of actual activity decreased significantly 1 month after the surgery compared to that during the preoperative period, which then improved after 3 months postoperatively (p < 0.01). Furthermore, there was a significant improvement 6 months after the surgery compared to that during the preoperative period (p < 0.05). The changes in activity for each period were strongly correlated, regardless of the period. In contrast, a significant improvement was observed at 1 month after the surgery in almost all items of the patient-based questionnaires (p < 0.05).ConclusionsThe objective activity tracker demonstrated that lumbar surgery results in the amount of activity decreasing 1 month just after surgery followed by gradual postoperative recovery within 3 months. By contrast, patient-based outcomes showed improvement in 1 month that was significantly different from the change in actual activity, indicating a gap between patient-oriented clinical scores and their actual activities.

Quality Control of Emergency Dental Care in Mures County

Satisfaction of dental patients is an indicator of the quality of dental health care, and it is a patient-based outcome measure. The main objective of this four-year retrospective questionaire based study was to assess the satisfaction of patients who attended the Dental Emergency Medical Office at Mobile Emergency Service for Resuscitation and Extrication Tirgu Mures between 2014-2017. A total of 909 questionnaires were completed in the analyzed four-year period. The average value of staff scoring, waiting time to take over by the medical staff, doctor's time for consultation, the clarity of information received about investigations and medical procedures performed lead to a satisfaction percentage of 95.2% The score on the quality of the received medical services resulted in a satisfaction rate of 95.6% The results of the study confirmed the necessity of setting up this type of dental office that is available to all those affected by dental diseases requiring emergency treatment. Keywords: satisfaction, dental emergency treatment, retrospective questionnaire-based stud

Long-term Outcomes Following Lumbar Microendoscopic Diskectomy and Microendoscopic Decompression: Minimum 10-year Follow-up Evaluation Performed Using a Patient-based Outcome Measure.

Retrospective study of prospectively collected outcome data. No studies have evaluated the long-term outcomes following microendoscopic diskectomy for lumbar disk herniation (MEDH) and microendoscopic decompression for lumbar spinal stenosis (MEDS) using the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ). To assess the minimum 10-year outcomes following MEDH and MEDS. Seventy-six patients were classified into three groups: disk herniation (DH) group (33 patients underwent MEDH); spinal stenosis (SS) group (23 patients underwent MEDS); and degenerative spondylolisthesis (DS) group (20 DS patients underwent MEDS). The follow-up rate was 50.3% (76/151). The results were statistically compared using Scheffé's F test for differences among the DH, SS, and DS groups. The paired t test was used to compare the preoperative and postoperative visual analog scale (VAS) scores. The degrees of improvement (DOIs) on JOABPEQ and the intensities of improvement (IOIs) on VAS at the first follow-up evaluation (FFE) (mean: 12 months after the operation) and at the most recent follow-up evaluation (MRFE) (mean: 126 months) of the DH group were statistically compared by the paired t test. DOIs and IOIs at MRFE of the SS group (mean: 126 months) and DS group (mean: 125 months) were statistically compared by the unpaired t test. A p value < 0.05 was considered statistically significant. Statistical comparisons of the DOIs in all five functional scores and IOIs in low back pain (LBP), leg pain, and leg numbness showed no significant differences among the DH, SS, and DS groups. The effectiveness rates of pain-related disorders, gait disturbance, and social life disturbance in JOABPEQ were almost equally high in all three groups. Significant decreases in LBP, leg pain, and numbness, as measured with VAS, were noted at MRFE in all three groups. No significant differences were observed between FFE and MRFE concerning the DOIs and IOIs of the DH group, and between the SS and DS groups concerning the DOIs and IOIs at MRFE. Clinical 1-year outcomes of MEDH were thought to be maintained for > 10 years, and MEDS leads to the same clinical long-term outcomes with DS as without DS. Moreover, MEDH and MEDS were almost equally effective for > 10 years not only in improving LBP, leg pain, and numbness but also especially in improving pain-related disorders, gait disturbance, and social life disturbance by detailed quality-of-life assessment using JOABPEQ.

The Evaluation of Single-Sided Total Knee Arthroplasty Versus Simultaneous Bilateral Total Knee Arthroplasty Improvements and Postoperative Progression Based on Patient-Based Outcome Scoring: A Rural Retrospective Clinical Orthopaedic Study.

Introduction:Both graduated single-sided total knee arthroplasty (SSTKA) and simultaneous bilateral total knee arthroplasty (SBTKA) are viable options for bilateral knee arthritis, and deciding which option to pursue is still debated. We aim to compare the two modalities using the patient-based oxford knee score and Visual analog pain scores in micropolitan settings.Methods:Oxford knee score and Visual analog pain scores were administered preoperatively and postoperatively 1, 6, and 12 months to 115 patients who underwent total knee arthroplasty. The 115 cohort was divided into two groups, those who underwent SSTKA and those who received SBTKA.Results:Cross-group analysis showed a significant difference with oxford scores at the 1-month postoperative interval (P = 0.026). The within-group analysis of the delta oxford knee scores displayed postoperative improvement at the 0.05 level of significance at 1, 6, and 12 months.Discussion:This study indicates that the patient-based outcome measures for the SBTKA group lagged behind the SSTKA group. The overall improvement a year out from surgery is comparable, and both groups had significant improvement in function. The SBTKA patient group had markedly lower functional outcome measures based on oxford scores at 1 month post-op compared with the SSTKA group; this may help in decision-making and patient selection.

Postoperatif tibia plato kırıklı hastalarda Tıbbi Sonuç Çalışması Kısa Form 36 (SF-36) ile konvansiyonel objektif sonuç ölçekleri arasındaki ilişki.

Objective: Patient-based outcome measures are actively utilized within the subjective health status and functional status of life. The aim of this study was to evaluate the correlation between existing Knee Society Score(KSS), Knee injury and Osteoarthritis Outcome Score (KOOS), Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and the Medical Outcomes Study Short Form-36 (SF-36) and to evaluate their correlation with each other as well as to evaluate their measurement capabilities.Materials and Methods: In the study, we have retrospectively evaluated 43 healthy knees and 43 operated knees of a total of 43 patients with Schatzker type 2 and type 3 tibial plateau fractures that were treated surgically between July 2010 and March 2016 in our clinic. Patients were evaluated weekly with SF-36 General Physical Functional Score and also with the WOMAC, KSS and KOOS scoring systems, which are scoring systems that are used to address specifically the problems with the knee joint. Result and Conclusion: The KSS Functional Score and the KOOS Daily Functional Score were found to be reliable for the functional evaluation of the knee joint. We believe that the numerical scoring system used by WOMAC Functional Scoring causes distraction and we believe that the measurement effectiveness is reduced as a result. As a result of this study, we think that we need to be very careful when selecting and using evaluation scales where the responses are first matched to numerical values.

Rationale and Options for Choosing an Optimal Closure Technique for Primary Midsagittal Osteochondrotomy of the Sternum. Part 1: A Theoretical and Critical Review of Functional Anatomy, Biomechanics, and Fracture Healing.

The sternum is central in binding the bilateral costal structures to form the anterior wall of the thorax. The airtight subatmospheric pressure cavity of the thorax during respiration and episodes of cough produces significant dynamic forces acting perpetually on its walls, influencing functions of the contained viscera. The embryonic development of the sternum concurs with that of the heart and parts of the pectoral girdle. Any imperfection of the sternum, whether congenital or iatrogenic, can significantly compromise the normal physiology of the thoracic wall and cardio-respiratory systems. Midsagittal osteochondrotomy (division) of the sternum is a necessary step to access the mediastinum for an open cardiac procedure. To return the thorax to its normal function, it is imperative that surgeons have thorough working knowledge of the surgical anatomy of the sternum and the biomechanics of an intact and disrupted thoracic wall. Patient-based outcome measures of an index cardiac surgery can only be considered conclusive if the divided sternum heals over time to have full benefit of the surgery. Here, the essential topographical anatomy and embryology of the sternum, thoracic biomechanics, fracture biology, and surgical access to the mediastinum are reviewed to provide a better understanding of the performance and importance of the healed sternum.

Spine Registries: Where Do We Stand?

To curb the unsustainable rise in health care costs, novel payment models are being explored which focus on value rather than volume. Underlying this reform is an accurate understanding of costs and outcomes. The Patient Protection and Affordable Care Act, the Institute of Medicine, and the Agency for Healthcare Research and Quality have specifically advocated for the use of registries to help define the real-world effectiveness of surgical interventions to help guide health care reform. Registries can help define value by documenting surgical efficacy, and specifically by reporting patient-based outcome measures. Over the past 10 years, several spine registries have been initiated and some others have expanded. These are providing a repository of evidence for surgical value. Herein, we will review the components of a well-designed registry and provide examples of such registries and their impact on health care delivery.

S38. Boston questionnaire and neurophysiological findings in carpal tunnel syndrome in Sri Lanka

Although the common clinical presentation of carpal tunnel syndrome (CTS) is the presence of numbness or pain in the hand, many attempts have been made to develop a score based on clinical findings. Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) is a standardised, patient-based outcome measure of symptom severity and functional status. It has been widely used in different populations. The objective of this study was to find out BCTQ findings among Sri Lankan patients suspected with CTS and correlate the findings with neurophysiological parameters. In a group of 147 patients suspected of carpal tunnel syndrome (CTS) based on the presence of numbness or pain in the hand, BCTQ was administered as an interview-based questionnaire format and the nerve conduction tests were performed on the median and ulnar nerves using a Natus EMG machine at the Neurophysiological Unit of the Teaching Hospital, Peradeniya, Sri Lanka. Neurophysiological grading was done according to the scale described by Bland in 2000. Mean age was 49.4 ± 11.9 years. BCTQ symptom and functional scores showed no correlation with the severity of CTS grading. In BCTQ, questions on numbness (r = 0.3, P < 0.001), numbness at night (r = 0.3, P < 0.05) and numbness causing waking up (r = 0.2, P < 0.05) were significantly correlated with the severity of CTS grading. Mean symptom and functional scores were comparable with a previous Indian study which showed a lower score than that was reported for the western CTS patients. In 19.7% of patients neurophysiological findings were normal. Neurophysiological severity in CTS could be predicted by the scores related to numbness in BCTQ.

Is Antimicrobial Photodynamic Therapy Effective as an Adjunct to Scaling and Root Planing in Patients with Chronic Periodontitis? A Systematic Review.

The aim of this systematic review was to investigate whether antimicrobial photodynamic therapy (aPDT) as either a primary mode of treatment or an adjunct to non-surgical treatment was more effective than scaling and root planing (SRP) alone in treating chronic periodontitis in terms of clinical attachment level (CAL) gain and probing depth (PD) reduction. The focused question was developed using the Patient, Intervention, Comparison, and Outcome (PICO) format, and two authors independently searched the Medline, EMBASE, Cochrane Library, Web of Science, Google Scholar, and Scopus databases for relevant studies from January 2008 to December 2016. Twenty studies included in this systematic review were randomized clinical trials (RCTs) or quasi-RCTs of aPDT compared to placebo, no intervention, or non-surgical treatment in an adult population. Basic study characteristics, photosensitizing agents and wavelengths used in aPDT, frequency of aPDT application, effect of aPDT on clinical parameters, antimicrobial effect of aPDT in chronic periodontitis, effect of immunological parameters following aPDT and patient-based outcome measures were collected from the studies. Although there was a wide range of heterogeneity in the included studied, they all indicated that aPDT has the potential to be an effective adjunct in the treatment of chronic periodontitis. Long-term, multicenter studies with larger sample sizes are needed before aPDT can be recommended as an effective treatment modality.

Patient reported outcome measures for spinal disorders

The systematic collection of patient-based outcomes in spine care will inform the debate regarding the efficacy of various treatment and allow them to be comparable to other spine disease-specific and non-diseases-specific outcomes, and to other non-musculoskeletal diseases regarding effect on patient’s global health states. Patient-based outcome measures are usually classified as generic, including global ratings of health status, as well as multidimensional measures of health-related quality of life (HRQOL) or disease-specific measures that are attributable to symptoms and functional limitations caused by a specific condition. In this article, we discuss the recommended core results that should be measured in patients with spinal disorders, instruments used to measure them, and the emergence of PROMIS (Patient-Reported Outcome Measure Information System).

Implant-supported mandibular removable partial dentures; patient-based outcome measures in relation to implant position

ObjectivesTo assess the benefits of implant support to Removable Partial Dentures (RPD) in patients with a bilateral free-ending situation in the mandible and to determine the most favorable implant position: the premolar (PM) or the molar (M) region. MethodsThirty subjects with a bilateral unbounded posterior saddle received 2 PM and 2M implants. A new RPD was placed. Implant support was provided 3 months later. Two PM implants supported the RPD. After 3 months the 2M implants were used or vice versa. Outcome measures included oral health related quality of life (OHIP-NL49), general health status (SF-36), contentment assessed on a Visual Analogue Scale (VAS) and the number of hours that the RPD was worn. Data were collected prior to treatment, 3 months after having functioned with a new RPD and after 3 and 6 months with implant support. Finally, patients expressed their preferred implant position. ResultsThe general health status (SF-36) was not influenced. OHIP-NL49 values and mean wearing-time were statistical significantly more favorable for ISRPD’s, regardless of the implant position. Per day, the ISRPD’s were worn 2–3h more than the unsupported new RPD. Patients’ expectations were met as the VAS-scores of anticipated and realized contentment did not reach a statistical significant level (p>0.05). VAS scores for ISRPD’s with M implant support were higher than for PM implant support. Finally, 56.7% of subjects preferred the M implant support, 13.3% expressed no preference and 30% opted for PM implant support. ConclusionsMandibular implant support favorably influences oral health related patient-based outcome measures in patients with a bilateral free-ending situation. The majority of patients prefer the implant support to be in the molar region. Clinical significancePatients with a bilateral free-ending situation in the mandible opposed by a maxillary denture benefit from implant support to their mandibular removable partial denture. Most patients prefer this support to be in the molar region.

Fibromyalgia in Spondyloarthritis: Effect on Disease Activity Assessment in Clinical Practice.

Spondyloarthritis (SpA) is the second most frequent inflammatory rheumatic disease, characterized by spinal involvement, peripheral arthritis, or enthesitis with marked pain, stiffness, and fatigue. Fibromyalgia (FM) may be associated with SpA, and shares some common symptoms. We aimed to determine how FM influences assessment of SpA disease activity, which is mainly dependent on patient-based outcome measures such as the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) or the Ankylosing Spondylitis Disease Activity Score (ASDAS). This single-center cross-sectional study included consecutive patients with SpA according to the Assessment of SpondyloArthritis International Society criteria. FM was diagnosed according to the 1990 American College of Rheumatology criteria. Patient characteristics, BASDAI, ASDAS/C-reactive protein (CRP), Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Metrology Index, and the Medical Outcomes Study Short Form-36 questionnaire were recorded and compared. The study included 103 patients with SpA; 81 with axial and 22 with peripheral forms. Eighteen patients presented with concomitant FM, of whom 12 had axial SpA and 6 peripheral SpA. Demographic characteristics did not differ except for sex, with a female predominance in the FM group that was more marked in peripheral forms. BASDAI was higher in patients with FM [median (IQR): 4.2 (4.2) vs 2.2 (3.1); p = 0.0068], whereas ASDAS-CRP was not significantly different [median (IQR): 2.7 (2) vs 2 (1.3); p = 0.1264]. Nevertheless, median ASDAS-CRP corresponded to high disease activity in patients with SpA or FM compared with moderate activity in non-FM patients. FM is a frequent comorbidity in patients with SpA, especially in peripheral forms. In patients with SpA-FM, disease activity may be overestimated when measured by BASDAI and to a lesser extent by ASDAS-CRP, and this overestimation could lead to inappropriate treatment escalation.

The Psychometric Properties of the Voice Handicap Index in People With Parkinson's Disease

Psychosocial impact of dysphonia in people with Parkinson disease (PD) has been described with the Voice Handicap Index (VHI); however, its psychometric properties when applied in this population are not described. The objective of this study was to examine the psychometric properties of the VHI in people with PD. A cross-sectional study of 151 subjects without cognitive impairment (90 people with PD and 61 controls) was carried out. The VHI was applied along with clinician-based (Mini Mental State Examination, Hoehn and Yahr staging, and Movement Disorder Society-Unified Parkinson's Disease Rating Scale) and patient-based (self-rated voice severity) outcome measures. The psychometric properties of the VHI analyzed were the feasibility, reliability, and construct validity. The average age of the PD population studied was 67 years; 51% had a primary level of education and 81% were retired. On average, they had disease onset duration of 11 years, a mild disease stage, mild to moderate global motor disability and impairment, and a normal to mild self-rated voice severity. The psychometric attributes of the VHI demonstrated that the questionnaire is feasible (missing data less than 1%), reliable (Cronbach α > 0.9), and valid (71.5% of the total variance is explained by five factors, correlates with voice severity, PD disability, and impairment, and differentiates subjects with PD from subjects without PD). The VHI is a reliable and valid tool that can be recommended for the population under study although further work is required to investigate its utility in advanced stages of disease.

Validation of the sino-nasal outcome test-23 in septorhinoplasty surgery.

There has been a great expansion in patient-based outcome measures to face the ever-increasing demand to demonstrate surgical efficacy. However, surgeons have not adopted until now any systematic outcome instrument. The 22-item Sino-Nasal Outcome Test (SNOT-22) is a validated sinonasal outcome score in sinonasal and septorhinoplasty surgery but does not measure aesthetic outcome. The aim of this paper is to validate a modification to the Sino-Nasal Outcomes Test-22 (SNOT-22) with a new question regarding the shape of the nose (SNOT-23). We conducted a prospective cohort study on 69 consecutive patients undergoing septorhinoplasty and a control group of healthy volunteers. Reproducibility, responsiveness to treatment, known group differences and validity of the SNOT-23 were analysed. Scores were compared to visual analogue scales, nasal obstruction symptoms evaluation (NOSE) score and nasal inspiratory peak flow. SNOT-23 has good test-retest reliability and is a valid outcome measure for assessing response to surgery especially with regards to shape of the nose and nasal obstruction when compared to other patient reported measures. SNOT-23 is a valid and reliable tool that can be easily used in routine clinical practice to assess the functional and aesthetic outcomes from septorhinoplasty surgery. The SNOT-23 could be adopted as a universal, easy to use tool in rhinology clinics for the assessment of response to septorhinoplasty and sinus surgery.

Validation of the sino-nasal outcome test-23 in septorhinoplasty surgery

There has been a great expansion in patient-based outcome measures to face the ever-increasing demand to demonstrate surgical efficacy. However, surgeons have not adopted until now any systematic outcome instrument. The 22-item Sino-Nasal Outcome Test (SNOT-22) is a validated sinonasal outcome score in sinonasal and septorhinoplasty surgery but does not measure aesthetic outcome. The aim of this paper is to validate a modification to the Sino-Nasal Outcomes Test-22 (SNOT-22) with a new question regarding the shape of the nose (SNOT-23). We conducted a prospective cohort study on 69 consecutive patients undergoing septorhinoplasty and a control group of healthy volunteers. Reproducibility, responsiveness to treatment, known group differences and validity of the SNOT-23 were analysed. Scores were compared to visual analogue scales, nasal obstruction symptoms evaluation (NOSE) score and nasal inspiratory peak flow. SNOT-23 has good test-retest reliability and is a valid outcome measure for assessing response to surgery especially with regards to shape of the nose and nasal obstruction when compared to other patient reported measures. SNOT-23 is a valid and reliable tool that can be easily used in routine clinical practice to assess the functional and aesthetic outcomes from septorhinoplasty surgery. The SNOT-23 could be adopted as a universal, easy to use tool in rhinology clinics for the assessment of response to septorhinoplasty and sinus surgery.