Biomedical subjects

Jin-Shei Lai

Publications and source records attributed to Jin-Shei Lai.

21 records · Page 2Linked to original sources

PubMed2002

Advances in quality of life measurements in oncology patients.

Accurate assessment of the quality of life (QOL) of patients can provide important clinical information to physicians, especially in the area of oncology. Changes in QOL are important indicators of the impact of a new cytotoxic therapy, can affect a patient's willingness to continue treatment, and may aid in defining response in the absence of quantifiable endpoints such as tumor regression. Because QOL is becoming an increasingly important aspect in the management of patients with malignant disease, it is vital that the instruments used to measure QOL are reliable and accurate. Assessment of QOL involves a multidimensional approach that includes physical, functional, social, and emotional well-being, and the most comprehensive instruments measure at least three of these domains. Instruments to measure QOL can be generic (eg, the Nottingham Health Profile), targeted toward specific illnesses (eg, Functional Assessment of Cancer Therapy - Lung), or be a combination of generic and targeted. Two of the most widely used examples of the combination, or hybrid, instruments are the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 Items and the Functional Assessment of Chronic Illness Therapy. A consequence of the increasing international collaboration in clinical trials has been the growing necessity for instruments that are valid across languages and cultures. To assure the continuing reliability and validity of QOL instruments in this regard, item response theory can be applied. Techniques such as item response theory may be used in the future to construct QOL item banks containing large sets of validated questions that represent various levels of QOL domains. As QOL becomes increasingly important in understanding and approaching the overall management of cancer patients, the tools available to clinicians and researchers to assess QOL will continue to evolve. While the instruments currently available provide reliable and valid measurement, further improvements in precision and application are anticipated.

Cross-Cultural Comparison↗

PubMed2002

Methods and progress in assessing the quality of life effects of supportive care with erythropoietin therapy.

Anemia is a common disorder in patients with cancer and can be caused by the disease itself or by cancer-related therapy. The cardinal symptom of anemia, fatigue, is the most commonly reported symptom in patients with cancer and has profound effects on patient well-being and quality of life. Until recently, blood transfusions were the mainstay of management of cancer-related anemia, despite attendant risks of transfusion-related reactions and transmission of infection. Recombinant human erythropoietin (epoetin-alpha), an effective alternative to blood transfusion, has been shown to improve hematologic parameters, including hemoglobin levels, Hematocrit, and transfusion requirements. Clinical trials have also suggested that this intervention has a positive impact on the quality of life of patients with cancer. The literature published between November 2000 and October 2001 continues to support a positive effect of epoetin-alpha therapy on the quality of life of patients with cancer and includes investigations of dosing schedules more convenient for patients and trials of longer-acting versions of epoetin-alpha, such as the novel erythropoiesis-stimulating protein. Future studies that incorporate measures of patient-reported outcomes and rigorous methodologic designs are needed to strengthen and elucidate this association between these pharmacologic therapies for cancer-related anemia and quality of life.

Anemia↗

PubMedDate not supplied

The impact of assistive technology and environmental interventions on function and living situation status with people who are ageing with developmental disabilities.

PURPOSE: A longitudinal study of 109 people with developmental disabilities, age 35 and older, was done to study the additive impact of mid to later life assistive technology and environmental interventions (AT-EI) on function and living situation status. All subjects were trying to transition out of institutional settings to community settings. METHOD: Functional status were measured at two times (Time I baseline and Time 2 an average of three years post intervention) on 32 functional activities under two conditions: without AT (person only) and with AT (environment adjusted). Rasch analysis was performed to convert ordinal functional scores to equal interval measures, with 95% confidence intervals computed to compare differences in function, with and without AT, across time. RESULTS: Results indicated that over 70% of subjects had better function with AT versus without AT at both time points. Over time, function did not change when rated without AT; however, when rated with AT, 13.6% had better function at Time 2. Subjects living in the community at Time 2 had significantly higher functional scores as compared to subjects in institutions, regardless of AT condition. Additional quantitative and qualitative data on AT-EI use, needs, and barriers and supports to its integration into everyday activities are reported. CONCLUSIONS: Results suggest a beneficial impact of later life AT-EI assessment and programming for people who are ageing with developmental disabilities, and qualitatively point to the influence of the social and physical living context upon AT-EI use and relationship to community living decisions long term.

Adult↗