Single-item Scores Research Articles

Single-Item Assessment of Quality of Life: Associations with Well-Being, Mood, Health Correlates, and Lifestyle.

Background: Quality of life (QoL) is traditionally assessed using multiple-item questionnaires. These can be either general, global assessments of QoL or disease-specific questionnaires. However, the use of single-item QoL scales is becoming increasingly popular, as these are more time- and cost-effective, with a readily available and easy-to-interpret outcome. In particular, these are often preferred for quick assessments (e.g., 'at home' testing and mobile phone assessments), and other cases when time constraints are common (e.g., clinical trials and clinical practice). Previous research revealed that multiple-item questionnaires and single-item assessments of QoL have the same validity and reliability. Here we further evaluate the relationship of QoL, assessed with a single-item QoL scale, with well-being, mood, health correlates (e.g., immune fitness, and having underlying diseases), and lifestyle (e.g., sleep, nutrition). Methods: Data from two online surveys are presented. In Study 1, 100 students participated. The single-item QoL score was compared with the World Health Organization Well-Being Index (WHO-5), a single-item score of sleep quality, the Regensburg Insomnia Scale (RIS) score, and the Healthy Diet Scale (HDS). Study 2 comprised a survey among 1415 Dutch adults. Single-item QoL was evaluated and compared with assessments of mood, health correlates (immune fitness and disease status), and lifestyle factors (e.g., sleep, nutrition, stress). Results: The first study revealed significant correlations between QoL and well-being, sleep quality, insomnia ratings, and attaining a healthy diet. The second study revealed significant correlations between QoL and mood, health status, and lifestyle factors (e.g., the ability to cope with stress). Conclusions: The results presented here demonstrate that the single-item QoL scale is an effective and easy-to-implement assessment tool that can be used in both clinical practice and research.

How do illness perceptions impact device acceptance in patients with an implantable cardioverter defibrillator?

Abstract Background The implantable cardioverter defibrillator (ICD) is the first-line treatment for the prevention of sudden cardiac death in patients at high risk of a life-threatening arrhythmia. Illness perceptions encompass the cognitive and emotional representations each ICD patient has about their health condition, thus influencing coping strategies and health behaviors essential to adjusting to life with their device and underlying heart disease. We investigate how illness perceptions are prospectively linked to device acceptance in ICD patients. Purpose To examine how illness perceptions at ICD implantation are associated with patient device acceptance one-year post-implantation. Methods Secondary analysis of the ACQUIRE-ICD, national, multi-center, randomised controlled trial. Illness perceptions were measured with the Brief Illness Perceptions Questionnaire (B-IPQ) with 350 first-time ICD or cardiac resynchronization therapy defibrillator (CRT-D) recipients filling out the questionnaire at ICD implantation. B-IPQ was only assessed at baseline. Patient device acceptance, a disease-specific quality of life measure for ICD patients, was measured at both ICD implantation and at 12 months follow-up with the Florida Patient Acceptance Survey (FPAS). Of the 350 patients, 261 patients (75%) completed FPAS at 12 months follow-up. Results The participants’ mean age was 59.7 ± 11.4 years with the majority being male (83%). Total illness perceptions scores were categorised into low experienced threat (n = 182, 52%), medium experienced threat (n = 82, 23%), and high experienced threat (n = 86, 25%). In the multivariate analysis, high experienced threat at ICD implantation was associated with significantly lower device acceptance at 12 months follow-up compared to low (B = -5.80, 95% CI [- 10.61, – -1.00], p = .018) and moderate experienced illness threat (B = -7.35, 95% CI [- 12.32, – -2.38], p = .004) while adjusting for device acceptance at baseline, age, sex, NYHA-class, indication, ischemic heart disease, education, intervention group and device type. In an exploratory analysis investigating associations of all 8 B-IPQ illness perception dimensions (single item-scores) simultaneously regressed on 12-months total FPAS-scores with baseline FPAS-scores as covariate, B-IPQ item 4 measuring treatment control showed the strongest association (B = 0.94, 95% CI [0.13, – 1.76], p = .023) with higher perceived treatment control linked with higher device acceptance. Conclusion ICD patients with high experienced illness threat at ICD implantation had substantially lower device acceptance at one-year post-implantation compared to patients with low-to-moderate experienced illness threat. Perceptions of treatment control at ICD implantation appear to be a potential mediator of this relationship.

Dual Antiplatelet Therapy vs Alteplase for Patients With Minor Nondisabling Acute Ischemic Stroke

Intravenous thrombolysis is increasingly used in patients with minor stroke, but its benefit in patients with minor nondisabling stroke is unknown. To investigate whether dual antiplatelet therapy (DAPT) is noninferior to intravenous thrombolysis among patients with minor nondisabling acute ischemic stroke. This multicenter, open-label, blinded end point, noninferiority randomized clinical trial included 760 patients with acute minor nondisabling stroke (National Institutes of Health Stroke Scale [NIHSS] score ≤5, with ≤1 point on the NIHSS in several key single-item scores; scale range, 0-42). The trial was conducted at 38 hospitals in China from October 2018 through April 2022. The final follow-up was on July 18, 2022. Eligible patients were randomized within 4.5 hours of symptom onset to the DAPT group (n = 393), who received 300 mg of clopidogrel on the first day followed by 75 mg daily for 12 (±2) days, 100 mg of aspirin on the first day followed by 100 mg daily for 12 (±2) days, and guideline-based antiplatelet treatment until 90 days, or the alteplase group (n = 367), who received intravenous alteplase (0.9 mg/kg; maximum dose, 90 mg) followed by guideline-based antiplatelet treatment beginning 24 hours after receipt of alteplase. The primary end point was excellent functional outcome, defined as a modified Rankin Scale score of 0 or 1 (range, 0-6), at 90 days. The noninferiority of DAPT to alteplase was defined on the basis of a lower boundary of the 1-sided 97.5% CI of the risk difference greater than or equal to -4.5% (noninferiority margin) based on a full analysis set, which included all randomized participants with at least 1 efficacy evaluation, regardless of treatment group. The 90-day end points were assessed in a blinded manner. A safety end point was symptomatic intracerebral hemorrhage up to 90 days. Among 760 eligible randomized patients (median [IQR] age, 64 [57-71] years; 223 [31.0%] women; median [IQR] NIHSS score, 2 [1-3]), 719 (94.6%) completed the trial. At 90 days, 93.8% of patients (346/369) in the DAPT group and 91.4% (320/350) in the alteplase group had an excellent functional outcome (risk difference, 2.3% [95% CI, -1.5% to 6.2%]; crude relative risk, 1.38 [95% CI, 0.81-2.32]). The unadjusted lower limit of the 1-sided 97.5% CI was -1.5%, which is larger than the -4.5% noninferiority margin (P for noninferiority <.001). Symptomatic intracerebral hemorrhage at 90 days occurred in 1 of 371 participants (0.3%) in the DAPT group and 3 of 351 (0.9%) in the alteplase group. Among patients with minor nondisabling acute ischemic stroke presenting within 4.5 hours of symptom onset, DAPT was noninferior to intravenous alteplase with regard to excellent functional outcome at 90 days. ClinicalTrials.gov Identifier: NCT03661411.

Validation of the Subjective Spine Value: A new single item score for the assessment of spine-specific function

BackgroundSpinal function can be assessed through different patient reported outcome measures (PROMs). Purpose: The aim of the present study was to evaluate a novel single-item score for the assessment of spinal function: The Subjective Spine Value (SSpV). It was hypothesized that the SSpV correlates with the established scores Oswestry disability index (ODI) and Core Outcome Measures Index (COMI).MethodsBetween 08/2020 and 11/2021 151 consecutive patients were prospectively enrolled and completed a questionnaire with the ODI, COMI as well as the SSpV. Patients were divided into 4 groups depending on their specific pathology (Group 1: Degenerative pathologies, Group 2: Tumor, Group 3: Inflammatory / Infection, Group 4: Trauma). Pearson correlation coefficient was used to evaluate correlation between the SSpV and the ODI and COMI separately. Floor and ceiling effects were evaluated.ResultsOverall, the SSpV correlated significantly with both ODI (p = < 0.001; r = − 0.640) and COMI (p = < 0.001; r = − 0.640). This was also observed across all investigated groups (range − 0.420–0.736). No relevant floor or ceiling effects were noticed.ConclusionsThe SSpV is a valid single-item score for the assessment of spinal function. The SSpV offers a useful tool to efficiently assess spinal function in a variety of spinal pathologies.Level of evidenceI, prospective cohort study.

Interrater Reliability of the Scale for the Assessment and Rating of Ataxia, Berg Balance Scale, and Functional Independence Measure Motor Domain in Individuals With Hereditary Cerebellar Ataxia

ObjectiveTo determine the interrater reliability of the Scale for the Assessment and Rating of Ataxia (SARA), Berg Balance Scale (BBS), and motor domain of the FIM (m-FIM) administered by physiotherapists in individuals with a hereditary cerebellar ataxia (HCA). DesignParticipants were assessed by 1 of 4 physiotherapists. Assessments were video-recorded and the remaining 3 physiotherapists scored the scales for each participant. Raters were blinded to each other's scores. SettingAssessments were administered at 3 clinical locations in separate states in Australia. ParticipantsTwenty-one individuals (mean age=47.63 years; SD=18.42; 13 male and 8 female) living in the community with an HCA were recruited (N=21). Main Outcome MeasuresTotal and single-item scores of the SARA, BBS, and m-FIM were examined. The m-FIM was conducted by interview. ResultsIntraclass coefficients (2,1) for the total scores of the m-FIM (0.92; 95% confidence interval [CI], 0.85-0.96), SARA (0.92; 95% CI, 0.86-0.96), and BBS (0.99; 95% CI, 0.98-0.99) indicated excellent interrater reliability. However, there was inconsistent agreement with the individual items, with SARA item 5 (right side) and item 7 (both sides) demonstrating poor interrater reliability and items 1 and 2 demonstrating excellent reliability. ConclusionsThe m-FIM (by interview), SARA, and BBS have excellent interrater reliability for use when assessing individuals with an HCA. Physiotherapists could be considered for administration of the SARA in clinical trials. However, further work is required to improve the agreement of the single-item scores and to examine the other psychometric properties of these scales.

Item analysis of G8 screening in uro-oncologic geriatric patients

Introduction/backgroundThe G8 score is a widespread screening tool for geriatric frailty in oncology. The aim of this study was to evaluate the scores and relevance of G8 items in a standard screening of geriatric patients with uro-oncologic diseases to better understand the results of the assessment.MethodsEighty-two consecutive uro-oncologic geriatric patients aged 75 years and older were evaluated. All patients underwent a G8 screening that consisted of 8 items. Patients with a G8 score above 14 were considered geriatric “fit”, while others were considered to be “frail”. Overall results and single item scores were evaluated. Clinical data were gathered from patients’ charts.ResultsThe mean age of the patients was 82 years (min. 75–max. 102). In 36 of the patients, the G8 score indicated “no-frailty”, and in 46 patients, the G8 score indicated “frailty”. The mean G8 score was 12.9 (min 4–max 17 pts). Item analysis revealed that points were most often lost in items H (polypharmacy), P (comparison of health status to peers) and Age. Fifty-nine, 56 and 52 patients lost points on item Age, item H and item P, respectively. In contrast, the majority of patients reached the maximum score for nutritional items [i.e., items A (food intake), B (weight loss) and F (body mass index (BMI))]. For item A, 73 patients reached the maximum score; for item B, 62 patients reached the maximum score; and for item F, 72 patients reached the maximum score. There were no differences in this distribution pattern when comparing tumour entities, sex, and patients with local vs. metastatic disease.ConclusionThe present study revealed a high percentage of suspicious test results. Potential reasons for these findings include the low threshold of the G8 overall score and the fact that in some items, points were easily lost. Modifications of the test should be considered.

NEURAL MECHANISM OF PHYSICAL EXERCISE IN PREVENTING AND TREATING CARDIOVASCULAR DISEASE BY DEEP LEARNING AND EDGE COMPUTING

This paper is to explore the improvement of clinical symptoms in patients with cardiovascular neurosis (CN) by physical exercise based on the deep learning architecture of edge computing, and to deeply explore the effect of physical exercise on autonomic function. Fifty-two patients with CN in this cardiovascular rehabilitation center were randomly divided into drug group and exercise group, with 26 cases in each group, and their electrocardiogram (ECG) was examined. Based on the deep learning architecture of edge computing, a four-layer stacked sparse auto encoder (SSAE) deep neural network was constructed, and the accuracy rates of least squares support vector machine (LSSVM), message passing neural network (MPNN), convolutional neural network (CNN), and SSAEs were measured to be 95.4%, 93.6%, 96.3%, and 99.5%, respectively. After physical exercise intervention, the total score of Symptom Checklist 90 (SCL-90) as well as each single item score were lower in the exercise group than in the drug group ([Formula: see text]). Heart rate recovery (HRR1) improved more significantly after 1[Formula: see text]min of exercise in patients in the exercise group ([Formula: see text]). The low-frequency (LF) power and normalized low-frequency (LFn) power of blood pressure variability (BPV) parameters in the exercise group were lower than those in the drug group ([Formula: see text]); the total power (TP), high-frequency (HF) power, and normalized high-frequency (HFn) power of heart rate variability (HRV) parameters in the exercise group were higher than those in the drug group ([Formula: see text]), LF/HF in the exercise group was lower than that in the drug group ([Formula: see text]); and the baroreflex sensitivity (BRS) in the exercise group was higher than that in the drug group ([Formula: see text]). A four-layer SSAEs was successfully constructed; the mechanism of exercise may be related to the regulation of cardiovascular autonomic nervous function, and it can effectively prevent and treat the clinical symptoms of patients with CN.

Long-Term Changes in Poststroke Depressive Symptoms: Effects of Functional Disability and Social Support.

Long-term changes in specific depressive symptoms have rarely been studied in stroke patients. Such changes and the effects of social support and functional disability on specific symptoms after a long-term follow-up period (LTP) were investigated. The Montgomery-Åsberg Depression Rating Scale (MADRS), ENRICHD Social Support Instrument, and modified Rankin Scale (mRS) for functional disability were administered at baseline, a 6-month follow-up, and an LTP (35-83 months). Effects of social support and poor functional outcome (mRS score of 3 to 6) on the 10 single items included on the MADRS were identified. Among 222 patients, mRS score, total MADRS score, and all single-item scores except "concentration difficulties," "inability to feel," and "suicidal thoughts" improved at the 6-month follow-up. From the 6-month follow-up to the LTP, the total MADRS score and half of the single-item scores worsened, although the functional outcome measure continued to improve. In multivariable linear regression tests, low social support was associated with "reduced sleep" (standardized β=0.20; 95% CI=0.06 to 0.34, p=0.005) and "pessimistic thoughts" (standardized β=0.16, 95% CI=0.03 to 0.30, p=0.019), and poor functional outcome was associated with all specific symptoms (standardized β values=0.18-0.43, all p<0.02) except "reduced sleep." Although total MADRS and single-item scores improved in parallel with improvements in functional outcome at the 6-month follow-up, these scores worsened afterward. The lack of social support and presence of functional disability were both associated with total MADRS scores. However, specific symptoms were differentially affected, suggesting that tailored strategies should be applied to manage depression in stroke patients.

Translation and validation of the Spanish version of the Pedi-EAT-10 questionnaire for screening of dysphagia

IntroductionThe Pedi-EAT-10 is a quick and simple validated tool for screening for dysphagia in the paediatric age group. The objective of our study was to translate and adapt the scale to Spanish and assess its psychometric properties, level of difficulty and speed of completion. Patients and methodsFollowing the forward and back translation and the approval by the research team of the Spanish version of the Pedi-EAT-10, we carried out a prospective study in a group of patients with dysphagia and a group of children who were healthy or had minor disease. Their legal guardians completed the questionnaire and reported the duration and difficulty of the test. ResultsThe study included 87 cases of dysphagia and 91 controls. The Cronbach alpha for internal consistency was 0.87. Most correlations between single item scores and the total scale score were greater than 0.65 (P < .001). The Pedi-EAT-10 scores were significantly higher in patients with dysphagia in every age group (P < .001), evincing a high sensibility and specificity for the screening of dysphagia. In the control group, the mean time taken to complete the questionnaire was 2.18 ± 1.98 min, and all participants found it easy. ConclusionsWe verified the validity, reliability and internal consistency of the Spanish version of the Pedi-EAT-10. It is an easy and quick instrument that can be used for screening of dysphagia in paediatric clinical practice.

Validación al español del cuestionario PEDI-EAT-10 para el cribado de disfagia

IntroductionThe Pedi-EAT-10 is a quick and simple validated tool for screening for dysphagia in the paediatric age group. The objective of our study was to translate and adapt the scale to Spanish and assess its psychometric properties, level of difficulty and speed of completion. Patients and methodsFollowing the forward and back translation and the approval by the research team of the Spanish version of the Pedi-EAT-10, we carried out a prospective study in a group of patients with dysphagia and a group of children who were healthy or had minor disease. Their legal guardians completed the questionnaire and reported the duration and difficulty of the test. ResultsThe study included 87 cases of dysphagia and 91 controls. The Cronbach alpha for internal consistency was 0.87. Most correlations between single item scores and the total scale score were greater than 0.65 (P<.001). The Pedi-EAT-10 scores were significantly higher in patients with dysphagia in every age group (P<.001), evincing a high sensibility and specificity for the screening of dysphagia. In the control group, the mean time taken to complete the questionnaire was 2.18±1.98 minutes, and all participants found it easy. ConclusionsWe verified the validity, reliability and internal consistency of the Spanish version of the Pedi-EAT-10. It is an easy and quick instrument that can be used for screening of dysphagia in paediatric clinical practice.

Satisfaction with Health Care Services in the Adult Population of the Federation of Bosnia and Herzegovina during the COVID-19 Pandemic.

Background and Objectives: Patient satisfaction with health care can influence health care-seeking behavior in relation to both minor or major health problems or influence communication and compliance with medical advice, which is especially important in emergencies such as the COVID-19 pandemic. Thus, it is important to continually monitor patient satisfaction with provided care and their dynamics. The aim of this study was to assess patient satisfaction with health care during the COVID-19 pandemic in the adult population of the Federation of Bosnia and Herzegovina (FB&H) and compare it with levels of satisfaction in the same population before the COVID-19 pandemic. Materials and Methods: A representative, population-based survey was implemented in the adult population of the FB&H using the EUROPEP instrument, which measures satisfaction with health care using 23 items. The sample included 740 respondents who were 18 years or older residing in the FB&H and was implemented in December 2020. All data were collected using a system of online panels. The survey questions targeted the nine months from the beginning of the pandemic to the time of data collection, i.e., the period of March to December 2020. Results: The mean composite satisfaction score across all 23 items of the EUROPEP tool was 3.2 points in all age groups; the ceiling effect was 22% for the youngest respondents (18-34 years old), 23% for 35-54 years old, and 26% for the oldest group (55+), showing increasing satisfaction by age. The overall composite score for both females and males was 3.2. The ceiling effect was higher in those with chronic disease (29% vs. 23% in those without chronic disease). The composite mean score for respondents residing in rural vs. urban areas was 3.2 with a ceiling effect of 22% in rural and 24% in urban residents. When comparing mean composite scores surveyed at various points in time in the FB&H, it was found that the score increased from 3.3 to 3.5 between 2011 and 2017 and dropped again to 3.3 in this study. Despite these observations in the overall trends of satisfaction scores, we note that no statistically significant differences were observed between most of the single-item scores in the stratified analysis, pointing to the relative uniformity of satisfaction among the analyzed population subgroups. Conclusions: The rate of satisfaction with health care services in the FB&H was lower during the COVID-19 pandemic compared to 2011 and 2017. Furthermore, while an increasing trend in satisfaction with health care was observed in the FB&H during the years prior to 2020, the COVID-19 pandemic may have contributed to the reversal of this trend. It is important to further monitor the dynamics of patient satisfaction with health care, which could serve as a basis for planning, delivering, and maintaining quality services during the COVID-19 pandemic and other emergencies.

Correlation of matrix metalloproteinase 3 and matrix metalloproteinase 9 levels with non-motor symptoms in patients with Parkinson's disease.

ObjectiveMatrix metalloproteinases (MMPs) are essential for tissue formation, neuronal network remodeling, and blood–brain barrier integrity. MMPs have been widely studied in acute brain diseases. However, the relationship with Parkinson’s disease (PD) remains unclear. The purpose of this study was to evaluate the serum MMP3 and MMP9 levels of PD patients and analyze their correlation with non-motor symptoms.MethodsIn this cross-sectional study, we recruited 73 patients with idiopathic PD and 64 healthy volunteers. Serum MMP3 and MMP9 levels were measured by enzyme-linked immunosorbent assay (ELISA). Patients with PD were assessed for non-motor symptoms using the Non-motor Symptoms Scale (NMSS) and Parkinson’s disease sleep scale (PDSS) and Mini Mental State Examination (MMSE).ResultsSerum MMP3 levels were significantly decreased in PD patients, predominantly those with early-stage PD, compared with controls [12.56 (9.30, 17.44) vs. 15.37 (11.33, 24.41) ng/ml; P = 0.004], and the serum MMP9 levels of PD patients were significantly higher than those of healthy controls [522 (419, 729) vs. 329 (229, 473) ng/ml; P < 0.001]. MMP3 levels were positively correlated with the NMSS total score (r = 0.271, P = 0.020) and the single-item scores for item six, assessing the gastrointestinal tract (r = 0.333, P = 0.004), and there was an inverse correlation between serum MMP3 levels and PDSS score (r = –0.246, P = 0.036); meanwhile, MMP9 levels were positively correlated with the NMSS total score (r = 0.234, P = 0.047), and higher serum MMP9 levels were detected in the cognitive dysfunction subgroup than in the cognitively intact subgroup [658 (504, 877) vs. 502 (397, 608) ng/ml, P = 0.008].ConclusionThe serum MMP3 level of PD patients (especially early-stage patients) was significantly lower than that of the healthy control group, and the MMP9 level was significantly higher than that of the healthy control group. MMP3 and MMP9 levels correlate with sleep disturbance and cognitive function in PD patients, respectively.

Using machine learning to improve diagnostic assessment of ASD in the light of specific differential and co-occurring diagnoses.

Diagnostic assessment of ASD requires substantial clinical experience and is particularly difficult in the context of other disorders with behavioral symptoms in the domain of social interaction and communication. Observation measures such as the Autism Diagnostic Observation Schedule (ADOS) do not take into account such co-occurring disorders. We used a well-characterized clinical sample of individuals (n = 1,251) that had received detailed outpatient evaluation for the presence of an ASD diagnosis (n = 481) and covered a range of additional overlapping diagnoses, including anxiety-related disorders (ANX, n = 122), ADHD (n = 439), and conduct disorder (CD, n = 194). We focused on ADOS module 3, covering the age range with particular high prevalence of such differential diagnoses. We used machine learning (ML) and trained random forest models on ADOS single item scores to predict a clinical best-estimate diagnosis of ASD in the context of these differential diagnoses (ASD vs. ANX, ASD vs. ADHD, ASD vs. CD), in the context of co-occurring ADHD, and an unspecific model using all available data. We employed nested cross-validation for an unbiased estimate of classification performance and made available a Webapp to showcase the results and feasibility for translation into clinical practice. We obtained very good overall sensitivity (0.89-0.94) and specificity (0.87-0.89). In particular for individuals with less severe symptoms, our models showed increases of up to 35% in sensitivity or specificity. Furthermore, we analyzed item importance profiles of the ANX, ADHD, and CD models in comparison with the unspecific model revealing distinct patterns of importance for specific ADOS items with respect to differential diagnoses. ML-based diagnostic classification may improve clinical decisions by utilizing the full range of information from detailed diagnostic observation instruments such as the ADOS. Importantly, this strategy might be of particular relevance for older children with less severe symptoms for whom the diagnostic decision is often particularly difficult.

MP16-11 VALIDATION OF A SINGLE ITEM SCREENING MEASURE OF UROLOGIC PATIENT FINANCIAL DISTRESS

You have accessJournal of UrologyCME1 May 2022MP16-11 VALIDATION OF A SINGLE ITEM SCREENING MEASURE OF UROLOGIC PATIENT FINANCIAL DISTRESS Daniel Au, Jared Starkey, Jessica Hamilton, Jeffery Thompson, and William Parker Daniel AuDaniel Au More articles by this author , Jared StarkeyJared Starkey More articles by this author , Jessica HamiltonJessica Hamilton More articles by this author , Jeffery ThompsonJeffery Thompson More articles by this author , and William ParkerWilliam Parker More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002549.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Financial toxicity is an area of increasing focus in healthcare generally and within urologic practice. Patients with financial toxicity are more likely to forgo or delay care with negative clinical consequences. There is little guidance on how to identify patients with financial distress. The COmprehensive Score for financial Toxicity (COST) is a previously validated 12 item measure of healthcare associated financial toxicity. COST is scored from 0 to 44 with lower scores equaling worse financial toxicity. Given questionnaire burden and visit time limitations, multi-item surveys are difficult to utilize. This study aimed to validate a single item screening measure of financial toxicity among a cross section of urology patients. METHODS: All patients completing robotic assisted prostatectomy, transurethral resection of bladder tumor, radical cystectomy, holmium laser enucleation of prostate, intravesical chemodenervation, ureteroscopy laser lithotripsy, and ureteral stent exchange at a single academic medical center during study period were offered enrollment. 182 patients enrolled, peri-op COST surveys were obtained with the following single item measure: “Please indicate the number that best describes how much financial stress you have been experiencing in the past week, including today, on a scale from 0 (no financial distress) to 10 (extreme financial distress).” Pearson’s correlation coefficient compared single item performance to COST. RESULTS: Pre-operatively 69.2% (126), 23.6% (43), and 7.1% (13) of patients had COST scores indicating no/mild, moderate (COST 14-25), and severe (COST ≤13) financial toxicity respectively. Post-operatively 72.5% (132), 22.5% (41), and 5.9% (9) of patients had COST scores of no/mild, moderate, and severe financial toxicity respectively. Single item measure strongly correlated with COST (r=-0.80, 95% CI -0.73,-0.84) pre-op (Figure 1) and post-op (r=-0.75, 95% CI -0.68,-0.81). A cut point of single item score ≥5 had a 77% sensitivity and 85% specificity for moderate to severe financial toxicity. CONCLUSIONS: There are inadequate clinical support tools to assess patients for financial toxicity. Presence and degree of financial toxicity is a clinically relevant metric. This single item measure is a sensitive and practical screening tool for urologic clinical practice. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e279 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Daniel Au More articles by this author Jared Starkey More articles by this author Jessica Hamilton More articles by this author Jeffery Thompson More articles by this author William Parker More articles by this author Expand All Advertisement PDF DownloadLoading ...

Would the Real Loneliness Please Stand Up? The Validity of Loneliness Scores and the Reliability of Single-Item Scores.

Several measures that assess loneliness have been developed for adults. Across three studies, we investigated psychometric features of scores of different versions of the Rasch-Type Loneliness Scale, the University of California Los Angeles Loneliness Scale, and three single-item measures. In Study 1 (N = 697 self-ratings, N = 282 informant-ratings of 160 targets) and Study 2 (N = 1,216 individuals from 608 couples), we investigated convergent validity, self-informant agreement, and nomological nets of the item scores using correlates related to demographic aspects, personality, satisfaction, and network characteristics. In Study 3 (N = 411), we estimated a reliability of for scores of three single-item measures of loneliness. Overall, scores of all measures and their nomological nets were highly correlated within and across studies, indicating that the scores of the included measures are all reliable and valid. Recommendations for choosing a loneliness measure are discussed.

Single-item Work Ability Score as a predictor of rehabilitation and disability pensions: a German longitudinal study among employees with back pain

Single-item Work Ability Score as a predictor of rehabilitation and disability pensions: a German longitudinal study among employees with back pain

Parents' Experience and Satisfaction in Neonatal Intensive Care Units in Ethiopia: A Multicenter Cross-Sectional Study Using an Adapted Version of EMPATHIC-N.

Background: In neonatal intensive care units (NICU) setting, parents' experience and satisfaction permit to evaluate clinical practice and improve the care of infants and parents. Little is known about this topic in low resource settings. The aim of this study was to (1) translate, adapt and validate the EMpowerment of PArents in THe Intensive Care-Neonatology (EMPHATIC-N) questionnaire in two languages in Ethiopia (2) explore parents' satisfaction with the care received in the NICUs in three hospitals; and, (3) explore socio-demographic characteristics and level of the NICU influence on the EMPATHIC-N domains.Methods: This was a cross-sectional multicenter study. Participants were recruited from three different NICUs in Ethiopia upon discharge. We reduced the original EMPATHIC-N instrument to 38 items, culturally adapted and validated it in two local languages. Confirmatory Factor Analysis (CFA) was applied to verify the factor structure of the questionnaire, investigating the relationship between items and the five latent domains. Single item scores and the aggregate scores of the domains were investigated across NICUs and in the sample overall. Differences in the distribution of the domain scores were tested according to socio-demographic participants' characteristics. The scores of four general questions about overall experience and satisfaction were investigated in relation to the participant's characteristics and NICU levels. Qualitative data were collected using four open-ended questions and a synthesis of results was provided.Results: Almost all the parents answered to the questionnaire (92%, n = 386). Questionnaire items on satisfaction on average scored more than four. The highest mean scores were obtained for Parental participation (median: 5.17; iqr: 4.67–5.62), while they were lower for Organization/Hospital environment (median: 4.67; iqr:4.33–5.17). Different levels of parent satisfaction were observed across the NICU levels showing a statistically higher satisfaction in level II NICU compared to the other levels. Education, place of residence and length of stay were associated with parental satisfaction and experience.Conclusion: This study validated two Ethiopian versions of the EMPATHIC-N questionnaire to assess parents' experience and satisfaction during their child's stay in the NICU. The differences found across the three levels of NICU suggest the need to further investigate the determinants of satisfaction.

Psychometric properties of the Childhood Experience of Care and Abuse Questionnaire (CECA.Q) in a sample of individuals with schizophrenia from Poland

Aim of the study: The Childhood Experience of Care and Abuse Questionnaire (CECA.Q) is a semi-structured self-report that has been developed to record a history of adverse childhood experiences (ACEs). Moreover, the CECA.Q has been widely used in subjects with psychotic disorders. In this study, we aimed to investigate psychometric properties of the Polish version of the CECA.Q in individuals with schizophrenia spectrum disorders. Material and methods: The CECA.Q was administered to 127 individuals with schizophrenia spectrum disorders (aged 39.1 ± 13.8 years, 48.0% males). Internal consistency was assessed using the Cronbach’s  and polychoric correlations. Confirmatory factor analysis (CFA) was performed using the unweighted least squares estimation method. Results: The Cronbach’s  was as follows: 0.835 for mother antipathy, 0.780 for mother neglect, 0.845 for father antipathy, 0.849 for father neglect, 0.787 for mother physical abuse, 0.831 for father physical abuse and 0.870 for sexual abuse, indicating acceptable-to-good internal consistency. Correlations of single item scores with the total scores of specific categories of ACEs were significant. The CFA confirmed factorial structure of the CECA.Q with acceptable goodness-of-fit indices. Conclusions: The present study indicates good psychometric properties of the CECA.Q in subjects with schizophrenia spectrum disorders. This self-report can be implemented by studies investigating ACEs in this clinical population in Poland.

Defining the optimal cut-point of self-reported ART adherence to achieve viral suppression in the era of contemporary HIV therapy: a cross-sectional study

BackgroundWhen considering adherence to antiretroviral therapy (ART) for HIV, many different cut-points are used. The primary goals of this study were to identify a level of self-reported medication adherence that best distinguished HIV viral suppression from non-suppression, and to compare the ability of a single-item and a 3-item adherence questionnaire to predict HIV viral suppression.MethodsThis cross-sectional analysis included 380 persons with HIV (PWH) from the Florida Cohort study who completed a self-reported ART adherence measure within 30-days of having an HIV viral load test. We used Receiver Operating Characteristic (ROC) curve analyses and ROCContrast to compare the ability of a single-item and a 3-item self-reported adherence measure to predict HIV viral suppression (defined as ≤ 200 copies/mL). We used the Youden index and chi square statistics to assess specific cut-points, and repeated the analysis with a different definition of HIV viral suppression (≤ 1000 copies/mL).ResultsThe mean percent adherence was 92.4% using the single-item score and 90.4% using the 3-item score; 81.6% had viral suppression. The areas under the curve for the single-item and 3-item adherence measures were generally poor overall and not significantly different from each other (0.589 and 0.580, p = 0.67). The Youden index identified cut-points of 93% and 89% as maximizing the sensitivity and specificity for the single-item and 3-item measures, respectively, whereas a cut-point of 80% on the single-item measure was best able to discriminate those with viral suppression (58% vs. 84%, p < 0.001). Results were similar with viral suppression defined as ≤ 1000 copies/mL.ConclusionsIn this sample of PWH, a single question on medication adherence was as good as a 3-item questionnaire in predicting HIV viral suppression, although neither had good discriminatory ability. A cut-point close to 90% adherence maximized sensitivity and specificity, although viral suppression was very similar for nearly all measures above 80%.

Prediction of caregiver quality of life in amyotrophic lateral sclerosis using explainable machine learning

Amyotrophic Lateral Sclerosis (ALS) is a rare neurodegenerative, fatal and currently incurable disease. People with ALS need support from informal caregivers due to the motor and cognitive decline caused by the disease. This study aims to identify caregivers whose quality of life (QoL) may be impacted as a result of caring for a person with ALS. In this study, we worked towards the identification of the predictors of a caregiver’s QoL in addition to the development of a model for clinical use to alert clinicians when a caregiver is at risk of experiencing low QoL. The data were collected through the Irish ALS Registry and via interviews on several topics with 90 patient and caregiver pairs at three time-points. The McGill QoL questionnaire was used to assess caregiver QoL—the MQoL Single Item Score measures the overall QoL and was selected as the outcome of interest in this work. The caregiver’s existential QoL and burden, as well as the patient’s depression and employment before the onset of symptoms were the features that had the highest impact in predicting caregiver quality of life. A small subset of features that could be easy to collect was used to develop a second model to use it in a clinical setting. The most predictive features for that model were the weekly caregiving duties, age and health of the caregiver, as well as the patient’s physical functioning and age of onset.