Preferred Assessment Tool Research Articles

Mastectomy Skin Flap Perfusion Assessment Prior to Breast Reconstruction: A Narrative Review.

Predicting the viability of the skin flaps after mastectomy is of high importance and significance in immediate breast reconstruction. Numerous methods have been used and are readily available. This review aims to describe and compare the current preferred perfusion assessment tools. Four major scientific databases-Web of Science, PubMed, Embase, and Scopus-were consulted to retrieve reviews, meta-analyses, clinical trials, experimental studies, and case reports focused on skin flap perfusion assessment following mastectomy. English-language articles published within the last 10 years were included. The most recent search was conducted on 31 July 2024. A summary focused on the relevant information of all included studies was drafted, and the results of the studies have been synthetized and compared. A total of 58 studies have been included in this review. Indocyanine green angiography (ICG-A) is the preferred and most-used method of evaluating perfusion, especially in high-risk patients, while new technologies show promising results and might be of great interest in the future. Perfusion assessment tools complement and should not replace clinical evaluation.

The use of a preference assessment tool with young children diagnosed with autism

The use of a preference assessment tool with young children diagnosed with autism

O244: Patients’ priorities in Vulval lichen sclerosus – results of a patient and public involvement for a study investigating autologous lipotransfer and platelet-rich plasma in Vulval lichen sclerosus

Abstract Background Vulval lichen sclerosus (VLS) is a high-burden, under-researched chronic skin disease. It is characterised by itching, pain, sexual dysfunction and poor quality of life. Up to 70% of patients develop fibrosis and vulval architectural changes. The only evidence-based treatment includes topical steroids. New potential surgical treatments include autologous fat transfer (AFG) and platelet-rich plasma (PRP) injections but high-level evidence supporting these treatments is sparse. Aims To identify patients’ research priorities and evaluate the acceptability of AFG and PRP as treatments for VLS and design a trial co-produced by patients. Methods One-to-one interviews, focus groups and online questionnaires were used to investigate patients’ research priorities, acceptability of treatments, preferred outcome assessment tools, views on a sham procedure and trial design. Results A focus group (n=18) and an online patient survey (n=809) identified the top research priorities: changes to vulval anatomy, emotional impact on intimate relationships, inability to have penetrative intercourse and pain during intercourse. Patients reported poor quality of life and said that addressing these would be life-changing. Ninety-nine percent of patients agreed that this trial should be performed and 73% were willing to take part if a sham procedure was used. A patient advisory group (n=5) has been created to co-produce the trial. Conclusion VLS is a complex disease with no core outcome set. Patient co-production is a keystone to a successful trial design and ensures that research is aligned with patients’ priorities. This research defines the key priorities of research into current surgical interventions for VLS.

Reflecting on Experiences of Senior Medical Students' External Clinical Teaching Visits in General Practice Placements: A Pilot Study.

Australian general practice training uses external clinical teaching (ECT) visits for formative work-based assessments. ECT visits appoint senior general-practitioners (GPs) observe trainee GPs' consultations, provide feedback, and make performance-enhancing recommendations. As ECT visits are one of the best assessment tools in Australian GP training, there is limited evidence of its use in undergraduate teaching. This study aims to introduce ECT visits and evaluate assessment tools during senior medical students' GP placement. This study included external and internal GP supervisors and twenty-five Chinese and Australian students during GP placements. The supervisors provided structured in-person feedback, while the ECT assessment tool used a standardised, validated feedback platform to assess every component of a consultation. Students' feedback was recorded and collected by both internal and external supervisors, and then semantically analysed by external supervisors. Twenty-five ECT visit feedbacks were collected and analysed semantically. All participating students rated ECT visits excellently and confirmed the relevance of assessment tools for discussions with supervisors to achieve the designed learning outcomes. Chinese students rated the assessment tools as innovative from a cultural perspective and recommended the ECT visit teaching model and assessment tools to their home university, whereas Australian students suggested more ECT visits during GP placements. Time management was a limitation for both the students and supervisors. ECT visit is an innovative placement teaching model and work-based assessment tool for senior medical students' GP placements, and is rated as the most preferred formative assessment tool. The limitations of this study include small group of students/supervisors and lack of patient feedback; however, all of these limitations can be overcome by involving multiple GP clinics in ongoing large-scale study. ECT visits can be introduced quantitatively into students' GP placement curricula to improve clinical reasoning, learning, and quality assurance with assessments during clinical placements.

Assessing specific items of Indian VSMS: Perspective of medical and rehabilitation professionals

Background: Adaptive behavior plays a crucial role in daily functioning, involving a complex interplay between individuals and their environment. In India, the Vineland Social Maturity Scale (VSMS) has been the preferred assessment tool for measuring adaptive behaviors, despite its age of over 85 years. However, periodic evaluation is necessary to ensure its continued relevance. Aim: This study aims to critically evaluate selected items of the Indian version of the VSMS. Materials and Methods: A survey form was developed through a focus group discussion (FGD), comprising 20 items from the Indian adaptation of the VSMS. The form was converted into a Google Form and distributed to medical and rehabilitation specialists across India. The responses were collected, recorded, and analyzed in an Excel sheet. Results: Of the 107 responses received, 14 were incomplete and excluded, leaving 93 complete for analysis. The analysis revealed that less than half of the surveyed items and domains received ratings of disagreement from over a quarter of the respondents concerning their frequency, relevance, and diagnostic value. Conclusion: This study underscores the need for a dynamic approach to defining and assessing adaptive behavior, especially in the Indian context. It highlights the importance of revising existing scales, incorporating technology-related items, and considering societal and cultural norms shifts. While acknowledging its limitations, this research sets the stage for future investigations to gain a more nuanced understanding of adaptive behaviors amidst changing societal dynamics. Ultimately, these efforts aim to develop more comprehensive and relevant assessment tools for adaptive behavior in today's rapidly evolving world.

Disease Activity Indices in Systemic Lupus Erythematosus: What Is New?

Systemic lupus erythematosus (SLE) is a complicated multisystem autoimmune disease that carries substantial mortality and morbidity. The development of new therapies is partly hindered by the lack of a flawless instrument to gauge disease activity in different organs for the primary efficacy outcome. Until a global consensus is reached regarding the most preferred assessment tool, application of any of the existing disease activity indices is acceptable in clinical practice and research. However, one should have a more thorough understanding of the strength and limitations of individual disease activity instruments. This article updates the SLE disease activity indices commonly used in clinical trials and their latest stage of development.

The multiple-stimulus-without-replacement preference assessment tool and its predictive validity.

This study demonstrates the use of two web-based programs, one to identify video preferences and the other to assess their reinforcing effects. We used the Multiple-Stimulus-Without-Replacement Preference Assessment Tool (MSWO PAT) to identify the video preference hierarchies of seven participants, ages 4-11 years old. We then used a customized reinforcer assessment program that arranged a concurrent-chains preparation with programmed conjugate schedules of reinforcement. Button presses emitted by participants modulated the quality (volume and opacity) of selected videos on a moment-to-moment basis, allowing us to identify the reinforcing effects of the videos in little time. The results showed that the preference assessment had predictive value for five of seven participants. We discuss the MSWO PAT, parameters that may affect the identification of preferences and the use of conjugate schedules to identify reinforcers.

Effectiveness of a Decision Aid Plus Standard Care in Surgical Management Among Patients With Early Breast Cancer

Patients with early breast cancer must choose between undergoing breast conservation surgery or mastectomy. This decision is often difficult as there are trade-offs between breast conservation and adverse effects, and women with higher decisional conflict have a harder time choosing the therapy that suits their preferences. To study the impact of a decision aid with a patient preference assessment tool for surgical decision-making on patients' decisional conflict scale (DCS) score. This 3-group randomized clinical trial was conducted between June 2017 and December 2019 at a single high-volume tertiary care cancer center in Mumbai, India. A research questionnaire comprising 16 questions answered on a Likert scale (from 1, strongly agree, to 5, strongly disagree) was used to measure DCS scores and other secondary psychological variables, with higher scores indicating more decisional conflict. The Navya Patient Preference Tool (Navya-PPT) was developed as a survey-based presentation of evidence in an adaptive, conjoint analysis-based module for and trade-offs between cosmesis, adverse effects of radiotherapy, and cost of mandatory radiation following breast-conserving surgery. Adult patients with histologically proven early breast cancer (cT1-2, N0-1) who were eligible for breast-conserving surgery as per clinicoradiological assessment were included. Those who were pregnant or unable to read the research questionnaire or who had bilateral breast cancer were excluded. Data were analyzed from January to June 2020. Patients were randomized 1:1:1 to study groups: standard care including clinical explanation about surgery (control), standard care plus the Navya-PPT provided to the patient alone (solo group), and standard care plus the Navya-PPT provided to the patient and a caregiver (joint group). The primary end point of the study was DCS score. The study was 80% powered with 2-sided α = .01 to detect an effect size of 0.25 measured by Cohen d, F test analysis of variance, and fixed effects. A total of 245 female patients (median [range] age, 48 [23-76] years) were randomized (82 to control, 83 to the solo group, and 80 to the joint group). The median (range) pathological tumor size was 2.5 (0-6) cm. A total of 153 participants (62.4%) had pN0 disease, 185 (75.5%) were hormone receptor positive, 197 (80.4%) were human epidermal growth factor receptor 2 negative, 144 (58.6%) were of middle or lower socioeconomic status, and 114 (46.5%) had an education level lower than a college degree. DCS score was significantly reduced in the solo group compared with control (1.34 vs 1.66, respectively; Cohen d, 0.50; SD, 0.31; P < .001) and the joint group compared with control (1.31 vs 1.66, respectively; Cohen d, 0.54; SD, 0.31; P < .001). The results of this study demonstrated lower decisional conflict as measured by DCS score following use of the online, self-administered Navya-PPT among patients with early breast cancer choosing between breast-conserving surgery vs mastectomy. Clinical Trials Registry of India Identifier: CTRI/2017/11/010480.

What adult patients prefer for reporting their pain levels, and frequency of reassessment when in the emergency department

ObjectivesThis study interviewed adult patients presenting to the emergency department (ED) for various pain conditions enquiring about their preferred tool for reporting pain severity and preferred time interval between initial assessment and subsequent pain reassessments. MethodsA prospective observational (cross-sectional) study was conducted in adult patients with acute pain in a tertiary care hospital ED setting. Patients' initial pain score was recorded using NRS (numerical rating scale) pain scale, and appropriate analgesia offered. Once the patient had been evaluated by an attending physician, a research team member interviewed the patient regarding the pain reassessment time and preferred pain assessment tool. The pain assessment tools evaluated in this study were NRS, PS (picture scale or face pain scale), VRS (verbal rating scale), and VAS (visual analogue scale). The patients were presented with the four pain assessment tools (in their primary language) through an audio-visual on an electronic tablet display. Results200 (138 male, mean age 36.5 ± 11.17) patients participated in the study. With increasing age, pain reassessment interval increased by 0.19 min (95% CI 0.03–0.36 min). Males requested pain reassessment 6.7 min (95% CI 2.2–10.8) faster than females. In this study, the preferred interval for pain reassessment was reported as a mean of 22.8 (SD + −13.6) minutes. There was no relationship reported between time reassessment and pain severity (P = 0.22). Out of 200 subjects, irrespective of the initial pain scores, 100 preferred NRS. NRS was preferred by patients with mild to moderated pain due to the perception of being faster. However, patients with severe pain choose a non-NRS scale to prioritize accuracy. ConclusionThere was no influence found between the initial pain severity scores and the desired frequency of pain reassessment. However, associations were identified between the time for pain reassessment interval and age, sex, and geographical region. Patients with severe pain preferred PS or VRS while patients with mild/moderate pain preferred the NRS.

Nursing Home Resident Preferences for Daily Care and Activities: A Latent Class Analysis of National Data.

Uncovering subgroups of nursing home residents sharing similar preference patterns is useful for developing systematic approaches to person-centered care. This study aimed to (i) identify preference patterns among long-stay residents, and (ii) examine the associations of preference patterns with resident and facility characteristics. This study was a national cross-sectional analysis of Minimum Data Set assessments in 2016. Using resident-rated importance for 16 preference items in the Preference Assessment Tool as indicators, we conducted latent class analysis to identify preference patterns and examined their associations with resident and facility characteristics. We identified 4 preference patterns. The high salience group (43.5% of the sample) was the most likely to rate all preferences as important, whereas the low salience group (8.7%) was the least likely. The socially engaged (27.2%) and the socially independent groups (20.6%) featured high importance ratings on social/recreational activities and maintaining privacy/autonomy, respectively. The high salience group reported more favorable physical and sensory function than the other 3 groups and lived in facilities with higher staffing of activity staff. The low salience and socially independent groups reported a higher prevalence of depressive symptoms, whereas the low salience or socially engaged groups reported a higher prevalence of cognitive impairment. Preference patterns also varied by race/ethnicity and gender. Our study advanced the understanding of within-individual variations in preferences, and the role of individual and environmental factors in shaping preferences. The findings provided implications for providing person-centered care in NHs.

A scoping review to explore patient trust in dentistry: the definition, assessment and dental professionals' perception.

Background A trusting dentist-patient relationship is pivotal in providing person-centred care. This scoping review aims to identify how trust is defined, measured and perceived by dental professionals.Methods The Joanna Briggs Institute framework was adopted. A search strategy was developed using MeSH (Medical Subject Headings) terms and key words. Medline/PubMed, Embase, PsycINFO and CINAHL were searched. Data were synthesised using thematic analysis.Findings In total, 16 studies were included that frequently used quantitative research methodology. Only four studies provided definition of trust. Many studies employed either Dental Trust Scale or Dental Beliefs Survey to measure dentist-patient trust, although others developed their own items. Limited research suggested that the dental professionals appreciated communication was paramount to building a trusting relationship with patients.Conclusion No consensus was found on the definition of trust, nor on a preferred assessment tool to measure dentist-patient trust. The limited evidence intimated that dental professionals acknowledged the importance of effective communication in building a trusting alliance with patients. The scarcity of relevant research highlights the need for more robust investigations of trust in dental care.

Measuring Nursing Home Quality of Life: Validated Measures Are Poorly Correlated With Proxies From MDS and Quality of Life Deficiency Citationsl.

Ensuring quality of life (QoL) is an important goal of person-centered nursing home care. The provision of person-centered care relies on information captured in the Minimum Data Set 3.0 (MDS). It is unclear to what extent MDS items or QoL-related facility deficiency citations correlate with validated measures of nursing home residents' QoL. This study evaluated correlation among MDS items, facility deficiency citations, and residents' QoL from 2 states that currently collect these measures. Cross-sectional study. A total of 11,487 long-stay residents in 356 facilities in Minnesota and 13,835 long-stay residents in 851 facilities in Ohio in2015. The outcome, QoL, was measured using validated instruments (Minnesota QoL survey and Ohio Resident Satisfaction Survey). Predictor variables included scores for Preference Assessment Tool (Section F), Patient Health Questionnaire-9 (Section D) for depressive symptoms from MDS, and count of QoL-related facility deficiency citations from the Certification and Survey Provider Enhanced Reporting database. Spearman's ranked test assessed correlation between predictor and outcome variables. Mixed effects models evaluated associations of QoL summary scores with predictor variables, adjusting for resident- and facility-level characteristics, accounting for clustering at the facility level. In Minnesota and Ohio, predictor variables (Section F and D items, and facility deficiency citations) correlated significantly but poorly with QoL (coefficients ranging from 0.003 to 0.3, P < .001). In the fully adjusted mixed effects model, all predictor variables, demographics, and functional status explained <21% of the total variance in QoL among residents. These findings were consistent in sensitivity analyses stratified by 1-year length of stay and by diagnosis of dementia. MDS items and facility deficiency citations encapsulate a significant but very small proportion of variance in residents' QoL. This indicates the need to measure QoL directly among residents, to plan person-centered care, and to evaluate its performance in nursing home facilities.

Exploring Teacher’s Perspectives about Online Assessment during the COVID-19 Pandemic in a Saudi Context

The emergency transition to online learning due to COVID-19 has forced many sectors to respond quickly. The readiness of educational institutes to attend to the abrupt crisis and shift to teach remotely is practiced at different levels. Online assessment is one of them. Rapid advances in technology and software applications are changing the practices of assessment in innumerable ways. Teachers are encouraged to implement a diverse array of assessment methods to measure the learning process of their students in an online environment which may not be the same as conventional learning. Therefore, the current study aims to explore teachers’ perspectives about online assessment during the COVID-19 pandemic in a Saudi context. This study endeavours to shed light on this aspect of online assessment by answering the main question of challenges and benefits faced by English teachers in an online environment. The study was qualitative in nature deploying semi-structured interviews with English instructors to collect data about the researched matter. The findings revealed that the most preferred online assessment tool teachers used to implement was the multiple-choice format. Also, the analysis showed that challenges associated with online assessment were diverse, and some of them were handled appropriately while others remained. For the advantages, they worked in favour of teachers, students and department. This was observed in the opportunities online assessment could provide to save time, easiness to design, take and record and objectivity in marking. Implications and recommendations were offered for further direction and research.

Special Educators’ Preference in Assessing Students With Special Needs Amidst Pandemic

The study aimed to perceive the preferred assessment tools utilized by special education teachers with the new learning modalities in correspondence to the pandemic started to burgeon. It employed Braun and Clarke's Thematic Analysis which the researchers used to evaluate and analyze the qualitative data in the study. Moreover, the study focused on the alternative assessment, which branches out into two types: Performance-based and authentic. The investigation of the study entails thematic analysis, which divulges three themes: "Current Assessment used in the new learning modality," "Challenges encountered by the special education teachers," and "Assessment recommendation." The inferred extracted narrative of the five special education teachers as participants counted as a conception of experiences. (1) Special education teachers' preferred assessment caters to specific needs of the students through performance-based and authentic assessments (2) Special Education teachers' preferred assessment anchors specific modification in assessment tools through alternative assessments (3) Special Education teachers' preferred assessment encompasses available learning resources both for students and teachers. Based on the three conceptions, the following preference surfaced as promulgated: Special Educators' discretion in assessing students with special needs in an online and offline learning mode.&#x0D; The study aimed to perceive the preferred assessment tools utilized by special education teachers with the new learning modalities in correspondence to the pandemic started to burgeon. It employed Braun and Clarke's Thematic Analysis which the researchers used to evaluate and analyze the qualitative data in the study. Moreover, the study focused on the alternative assessment, which branches out into two types: Performance-based and authentic. The investigation of the study entails thematic analysis, which divulges three themes: "Current Assessment used in the new learning modality," "Challenges encountered by the special education teachers," and "Assessment recommendation." The inferred extracted narrative of the five special education teachers as participants counted as a conception of experiences. (1) Special education teachers' preferred assessment caters to specific needs of the students through performance-based and authentic assessments (2) Special Education teachers' preferred assessment anchors specific modification in assessment tools through alternative assessments (3) Special Education teachers' preferred assessment encompasses available learning resources both for students and teachers. Based on the three conceptions, the following preference surfaced as promulgated: Special Educators' discretion in assessing students with special needs in an online and offline learning mode.

Developing an Assessment of Contraceptive Preferences in Botswana: Piloting a Novel Approach Using Best-Worst Scaling of Attributes.

IntroductionTo develop an attribute-based method for assessing patient contraceptive preferences in Botswana and pilot its use to explore the relationship between patient contraceptive preferences and the contraceptive methods provided or recommended to patients by clinicians.MethodsA list of contraceptive attributes was developed with input from patients, clinicians, and other stakeholders. We assessed patient preferences for attributes of contraceptives using a discrete choice “best-worst scaling” approach and a multi-attribute decision-making method that linked patient attribute preferences to actual contraceptive method characteristics. Attribute-based patient method preferences and clinician recommendations were compared in 100 women seeking contraceptive services, and 19 clinicians who provided their care. For 41 of the patients, the short-term reliability of their preference scores was also examined.ResultsFor 57 patients who wanted more children in the future, the degree of concordance between patients and clinicians was 7% when comparing the top attribute-based contraceptive preference for each woman with the clinician-provided/recommended method. When the top two model-based preferred contraceptive methods were considered, concordance was 28%. For 43 women who did not want more children, concordance was 0% when using the patient's model-based “most-preferred” method, and 14% when considering the top two methods. Assessment of the short-term reliability of preference scores yielded an intraclass correlation coefficient of 0.93.ConclusionsA best-worst scaling assessment of attributes of contraceptives was designed and piloted in Botswana as a Contraceptive Preference Assessment Tool. The preference assessment was found to have high short-term reliability, which supports its potential use as a measurement tool. There was very low concordance between women's attribute-based contraceptive preferences and their clinician's provision/recommendations of contraceptive methods. Using such a preference assessment tool could encourage greater patient involvement and more tailored discussion in contraceptive consultations.

Management of Psychiatric Disorders with HIV and Dermatological Disorders.

Management of Psychiatric Disorders with HIV and Dermatological Disorders.

Evaluation of a survey for acute care programme directors on the utilisation of point-of-care ultrasound

PurposePoint-of-care ultrasound (POCUS) is ultrasound brought to the patient’s bedside and performed in ‘real time’ by the healthcare provider. The utility of POCUS to facilitate management of the acutely ill...

Evaluating the impact of the Patient Preference Assessment Tool on clinicians' recommendations for phase I oncology clinical trials.

Many groups recommend assessment of patient preferences particularly for patients with advanced, incurable cancer. We, therefore, developed the Patient Preference Assessment Tool (PPAT) to ascertain patient preferences in order to inform clinician recommendations and improve shared decision-making. The aim of this study is to assess the PPAT's impact on clinicians' strength of recommendations for phase I oncology clinical trials. Clinicians recorded the strength of their recommendation on a Likert scale before viewing the patient's PPAT. After viewing the PPAT, the clinician discussed the clinical trial with the patient and then recorded the strength of recommendation again. If there was a change, the clinician noted the reason for the change: clinical findings or patient preference. Clinicians were interviewed about the acceptability of the tool. Our threshold for determining if a change in recommendation due to the PPAT was significant was 20%, given the multiple factors influencing a clinician's recommendation. We also noted the type of phase I conversation observed based on classifications defined in prior work-priming, treatment-options, trial logistics, consent. N=29. The strength of the clinicians' recommendations changed due to patient preferences in 7 of 29 (24%) of the conversations. The seven changes due to preferences were all in the 23 treatment-options conversations, for an impact rate of 30% in this type of conversation. 82% of clinicians found the PPAT useful. The PPAT was impactful in an academic setting, exceeding our 20% impact threshold. This tool helps achieve the important goal of incorporating patient preferences into shared decision-making about clinical trials.

Feedback on Teaching and Assessment Methodologies, being practiced in Islam Dental College

Background: The students are in the best position to judge the effectiveness of any teaching system. They may comment logically to assess the teaching and evaluation methods. Aim: To analyze the student's feedback on teaching methodologies and effectiveness of methods being practiced in department of Prosthodontics in Islam Dental College Sialkot. Methods: The cross sectional study was conducted in Islam Dental College Sialkot with a specially designed questionnaire. The study subjects were 100 students, 50 each from 3rd year and final year BDS. The questionnaire was based on methods of teaching and assessments, in terms of content, time and relevance. Results: Majority (85%) agreed on the reliability of multimedia and digital methods of teaching .A huge number (73%) were also satisfied with delivery and content of the lectures.80% students were satisfied with teaching in lecture halls. 30% and 40% were not satisfied with teaching in clinics and OPDs respectively. Multiple Choice questions were the most favored type of assessment methods with 45% agreement. Conclusion: Students were satisfaction with the teaching methods being practice in Islam dental College. MCQs were considered preferred assessment tools. There is a dire need to innovate Clinical and OPD Teaching regime in the dental colleges. As the lapse has a significant impact on knowledge and skill of the students. Keywords: Blended Learning, Assessment tools, Feedback, teaching methods

Evaluation tool for assessing the influence of structural health monitoring on decision-maker risk preferences

Different rationally behaving individuals can make different decisions even under same conditions. Concept of risk preference is one way of describing this discrepancy. Risk preference refers to the way decision-makers weight different risky options. Expected utility theory is a popular way to treat this weighting mathematically. Previous research in the field of structural health monitoring has shown that in a multi-stakeholder decision-making, discrepancies in risk preferences between the stakeholders can have large effects on the feasibility of structural health monitoring implementation. Results from that previous research obtained using expected utility theory showed that under certain conditions, differences in stakeholder risk attitudes can make the value of structural health monitoring system even negative. As the overall aim of structural health monitoring is to enable systematic data-based management of infrastructure, understanding of risk preferences and their effect on the structural health monitoring decision-making is of paramount importance. In this work, we created a risk preference assessment tool that is derived from Domain-Specific Risk-Taking scale. We propose the tool and explain its development and validation. The validation results indicate that the proposed assessment tool is technically sound and has high potential in the future valuation of human factors influencing decision-making based on structural health monitoring.