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Medical Sciences	100%

Selected Abstracts

Monitoring the care of lung cancer patients: linking audit and care pathways

JOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 1 2001
E. Kaltenthaler BSc
Abstract Clinical audit plays an important role in monitoring the provision of care for patients whatever their condition. Care pathways define the steps and expected course of events in the care of patients with a specific clinical problem over a set time scale. This paper describes a study undertaken in a multisite cancer unit to develop a tool for monitoring the progress of lung cancer patients through a care pathway and auditing key standards within the pathway. Important issues associated with the development of this tool are highlighted. The process of developing this tool involved the following steps: a review of the literature dealing with the management of lung cancer patients; interviews with key personnel in primary, secondary, tertiary and palliative care; development of a paper-based series of forms representing key steps in the patient's care pathway; 3-month trial of the paper-based tool; analysis of completion rates and interviews with form users to evaluate effectiveness; and recommendations for creating an electronic record using the experience and lessons learned from the paper version. The paper forms developed through this multistage process were found to be acceptable to users and have the potential to provide accurate information at key points for audit throughout the patient's time within the health-care system for their lung cancer condition. The flexibility of this methodology allows it to be adapted readily to a variety of clinical situations and conditions. [source]

Development and validation of an electronic version of the Rhinoconjunctivitis Quality of Life Questionnaire

ALLERGY, Issue 9 2007
E. F. Juniper
Background:, As clinicians and pharmaceutical companies move from paper versions of health status questionnaires to electronic versions, it cannot be assumed that adaptations to other media will produce valid data. Aims:, The aims of this study were to (1) adapt the Rhinoconjunctivitis Quality of Life Questionnaire [RQLQ(S); standardized version], for the Palm Treo 650, (2) test the device for ease and accuracy of understanding and (3) examine the validity of the electronic version by comparing it with the original paper version of the RQLQ(S). Methods:, Seventy adults with current rhinoconjunctivitis symptoms completed the electronic and paper versions of the RQLQ(S). They were randomized to complete either the paper or the electronic version first. After a 2-h break, they completed the other version. Results:, Concordance between paper and electronic versions for the overall RQLQ(S) score was acceptable with an intraclass correlation coefficient of 0.95 and there was no evidence of bias (P = 0.13). Concordance for the seven individual domains ranged from 0.86 to 0.94. A small but significant bias was observed in the activity and sleep domains (P = 0.02). Completion times were quicker with paper (4.1 vs 4.9 min, P < 0.0001). About 51% of patients preferred electronic, 17% preferred paper and 31% had no preference. Conclusions:, This electronic version of the RQLQ(S) was easy for patients to use and the concordance between paper and this version on the Palm Treo 650 provides evidence of the validity of this electronic version. [source]

Evaluation of Melbourne Edge Test contrast sensitivity measures in the visually impaired

OPHTHALMIC AND PHYSIOLOGICAL OPTICS, Issue 4 2005
James S. Wolffsohn
Abstract Aim:, Contrast sensitivity (CS) provides important information on visual function. This study aimed to assess differences in clinical expediency of the CS increment-matched new back-lit and original paper versions of the Melbourne Edge Test (MET) to determine the CS of the visually impaired. Methods:, The back-lit and paper MET were administered to 75 visually impaired subjects (28,97 years). Two versions of the back-lit MET acetates were used to match the CS increments with the paper-based MET. Measures of CS were repeated after 30 min and again in the presence of a focal light source directed onto the MET. Visual acuity was measured with a Bailey,Lovie chart and subjects rated how much difficulty they had with face and vehicle recognition. Results:, The back-lit MET gave a significantly higher CS than the paper-based version (14.2 ± 4.1 dB vs 11.3 ± 4.3 dB, p < 0.001). A significantly higher reading resulted with repetition of the paper-based MET (by 1.0 ± 1.7 dB, p < 0.001), but this was not evident with the back-lit MET (by 0.1 ± 1.4 dB, p = 0.53). The MET readings were increased by a focal light source, in both the back-lit (by 0.3 ± 0.81, p < 0.01) and paper-based (1.2 ± 1.7, p < 0.001) versions. CS as measured by the back-lit and paper-based versions of the MET was significantly correlated to patients' perceived ability to recognise faces (r = 0.71, r = 0.85 respectively; p < 0.001) and vehicles (r = 0.67, r = 0.82 respectively; p < 0.001), and with distance visual acuity (both r = ,0.64; p < 0.001). Conclusions:, The CS increment-matched back-lit MET gives higher CS values than the old paper-based test by approximately 3 dB and is more repeatable and less affected by external light sources. Clinically, the MET score provides information on patient difficulties with visual tasks, such as recognising faces. [source]