Treatment Evaluation (treatment + evaluation)

Distribution by Scientific Domains

Selected Abstracts

Validation of the Chinese version of the MacNew Heart Disease Health-related Quality of Life questionnaire

Doris S. F. Yu RN PhD
Abstract Rationale, Patient-reported outcomes such as health-related quality of life (HRQL) describe or characterize what patients have experienced as a result of their health care. However, treatment outcome comparisons among different pure or mixed populations of patients with myocardial infarction, angina or heart failure cannot be made using existing coronary heart disease (CHD)-specific HRQL instruments. Aims and objectives, The aim of this study was to evaluate the psychometric properties of the Chinese version of the MacNew in a cohort of Hong Kong patients diagnosed with CHD. Methods, Chinese translations of a CHD-specific HRQL instrument, the MacNew Heart Disease HRQL questionnaire (MacNew), the Short-form 36 Health Survey and the Hospital Anxiety and Depression Scale were administered to 365 Chinese-speaking patients with CHD at baseline and again 3 months later (n = 363). The Medical Outcomes Trust Scientific Advisory Committee criteria were used to examine the psychometric properties of the Chinese MacNew Heart Disease HRQL questionnaire. Results, The results warrant recommending the use of the MacNew as an outcome measure to enhance treatment evaluation in Chinese patients with CHD and a diagnosis of myocardial infarction, angina or heart failure, substantiating previous psychometric data on the MacNew in a number of different studies in patients speaking seven different languages. Conclusion, The MacNew questionnaire may have value as a core CHD questionnaire for treatment outcome comparisons among pure or mixed populations of patients with myocardial infarction, angina or heart failure. [source]

Automatic model-based evaluation of magnetic resonance-guided radio frequency ablation lesions with histological correlation

Roee S. Lazebnik PhD
Abstract Purpose To develop a model-based method for automatic evaluation of radio frequency (RF) ablation treatment using magnetic resonance (MR) images. Materials and Methods RF current lesions were generated in a rabbit thigh model using MR imaging (MRI) guidance. We created a 12-parameter, three-dimensional, globally deformable model with quadric surfaces that delineates lesion boundaries and is automatically fitted to MR grayscale data. We applied this method to in vivo T2 - and contrast-enhanced (CE) T1 -weighted MR images acquired immediately post-ablation and four days later. We then compared results to manually segmented MR and three-dimensional registered corresponding histological boundaries of cellular damage. Results Resulting lesions featured a two-boundary appearance with an inner region and an outer hyperintense margin on MR images. For automated vs. manual MR boundaries, the mean errors over all specimens were 0.19 ± 0.51 mm and 0.27 ± 0.52 mm for the inner surface, and ,0.29 ± 0.40 mm and ,0.12 ± 0.17 mm for the outer surface, for T2 - and CE T1 -weighted images, respectively. For automated vs. histological boundaries, mean errors over all specimens were 0.07 ± 0.64 mm and 0.33 ± 0.71 mm for the inner surface, and ,0.27 ± 0.69 mm and 0.02 ± 0.43 mm for the outer surface, for T2 - and CE T1 -weighted images, respectively. All boundary errors compared favorably to MR voxel dimensions, which were 0.7 mm in-plane and 3.0 mm thick. Conclusion The method is accurate both in describing MR-apparent boundaries and in predicting histological response and has applications in lesion visualization, volume estimation, and treatment evaluation. J. Magn. Reson. Imaging 2004;19:245,254. © 2004 Wiley-Liss, Inc. [source]

Evaluation of the meaningfulness of health-related quality of life improvements as assessed by the SF-36 and the EQ-5D VAS in patients with active Crohn's disease

Summary Background, Crohn's disease (CD) is a chronic inflammatory illness characterized by episodic abdominal pain, diarrhoea, fever, bleeding and obstruction. While the Crohn's Disease Activity Index (CDAI) remains the most commonly accepted measure for assessing the disease status in clinical trials, patient-reported outcome (PRO) instruments are being utilized more frequently to provide information about health-related quality of life (HRQOL). To facilitate interpretation of results, it is common to identify a meaningful unit of PRO score change, such as a minimal clinically important difference (MCID). Aim, To define and apply MCID estimates for the SF-36 and EuroQol-5D visual analogue scale (EQ-5D VAS) for use in CD treatment evaluation. Methods, Data from two phase III randomized controlled trials of certolizumab pegol were utilized. MCID estimates were computed from one trial using anchor-based and distribution-based methods. These estimates were applied to data from the other trial. Results, SF-36 PCS and MCS MCID estimates ranged from 1.6 to 7.0 and 2.3 to 8.7 respectively, depending on approach. EQ-5D VAS MCID estimates ranged from 4.2 to 14.8. Conclusions, For the first time, the MCID values provided interpretation guidelines for PRO results in CD. This research demonstrates that patients treated with certolizumab pegol benefit from meaningful and sustained HRQOL improvements. [source]

Interventions addressing transition difficulties for individuals with autism

Heather E. Sterling-Turner
Transitioning between activities can pose difficulties when working with students with autism. Individuals with autism may resist transitions by exhibiting a host of problem behaviors such as aggression and tantrums. Although scant, there is available research that provides sound recommendations for assessing and intervening for problem behaviors occurring during transition times. The present article presents a summary of the current transition literature, with a special emphasis on interventions for students with autism. Recommendations for the functional assessment and treatment evaluation of transitional difficulties are presented as well. © 2007 Wiley Periodicals, Inc. Psychol Schs 44: 681,690, 2007. [source]

Goal Attainment Scaling in paediatric rehabilitation: a report on the clinical training of an interdisciplinary team

D. Steenbeek
Abstract Background Goal Attainment Scaling (GAS) is a responsive method for individual goal setting and treatment evaluation. However, current knowledge about its reliability when used in paediatric rehabilitation treatment is insufficient and depends highly on standardization of the GAS method. A training programme was developed to introduce GAS to a team of 27 professionals from five disciplines. The purpose of the paper is to share the experiences of professionals and parents during this training. Methods The training consisted of three 2-h general discussion sessions and intensive individual feedback from the study leader (i.e. the first author). Feedback was given until the GAS scales met predetermined criteria of ordinality, described specific, measurable, acceptable, realistic abilities and activities in a single dimension, used the ,can-do' principle and could be scored within 10 min. Therapists and parents were asked to give their opinion by completing a questionnaire. Results One hundred and fifteen GAS scales were developed and scored by professionals. The development of a GAS scale remained a time-consuming procedure, despite the training: 45 (SD = 27) minutes per scale. The content criteria of GAS were found to be useful by all participants. Common issues requiring revision of the initial scales were equal scale intervals, specificity, measurability and selection of a single variable. After the training, 70% of the therapists and 60% of the parents regarded GAS as a suitable tool to improve the quality of rehabilitation treatment. Examples of GAS scales developed by the various disciplines are presented and discussed. Conclusions The experiences reported in this paper support the further development of training procedures for GAS before it can be used as an outcome measure in effect studies. The findings may be helpful in introducing GAS in the field of childhood disability. [source]

Comparing the solid phase and saline extract Microtox® assays for two polycyclic aromatic hydrocarbon-contaminated soils

Carolyn M. Acheson
Abstract The performance of remedial teatments is typically evaluated by measuring the concentration of specific chemicals. By adding toxicity bioassays to treatment evaluations, a fuller understanding of treatment performance is obtained. The solid phase Microtox® assay is a useful tool in characterizing the toxicity of contaminated soils and sediments. This study compares the performance of the solid phase and saline extract Microtox assays in two experiments using two soils contaminated with polycyclic aromatic hydrocarbons (PAHs). The first experiment, conducted to refine the solid phase assay procedures, evaluated sample holding times, sample replication, and reference toxicant controls. The effective concentration reducing light emission by 50% (EC50) of four samples was measured with eight replicates of each sample. Samples were stored for as long as two weeks without showing substantial changes in toxicity. For future studies, three replicates of each sample are recommended because that degree of replication yielded a statistical power of more than 95% in most samples. Phenol was a reliable reference toxicant with a mean EC50 of 21.76 and a 95% confidence interval of 15.6 to 27.9 mg/L. In a second experiment, the solid phase Microtox assay was compared to saline extract Microtox assays with mixing times ranging from 5 min to 16 h. The solid phase assay was more sensitive yielding EC50s 7 to 50 times lower than the extract EC50s. In addition, the saline extract assays displayed results that varied for mixing times of less than 2 h. Based on these two experiments, the solid phase Microtox test has proved to be a useful assay for measuring the toxicity of PAH-contaminated soils. [source]