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Biomedical subjects

O Sangha

Publications and source records attributed to O Sangha.

48 records · Page 3Linked to original sources
PubMed1997

[Patient-centered evaluation of illness outcome in musculoskeletal diseases: adaptation and revision of outcome instruments].

Assessment of disease consequences (outcome) requires reliable, valid, and sensitive instruments. Psychometrically sound generic health-status instruments such as the SF-36 have been validated for many languages and are available in German. Instead, most disease specific instruments have been developed in English and need to be adapted for the German language. To allow for cross-cultural comparisons and use of results across cultures, for instance, in international multicenter studies, instruments need to have both content and metric equivalence. Thus, adaptation of health-status instruments requires a standarized process including translation, backtranslation, review and assessment of metric properties (reliability, internal consistency, factors), and validity. Developments of new instruments from scratch are time and cost intensive and should only be considered if no current instrument is available. Ideally, newly developed instruments have interval-scale properties.

Activities of Daily Living↗
PubMed1997

[Patient-centered evaluation of the illness sequelae of musculoskeletal diseases: overview of important outcome instruments].

Quality of life and patient-centered health status has received increasing attention during the last decade. Simultaneously, there have been multiple instruments to assess quality of life in a standardized way. There are several possible approaches to assess health status in a more standardized way: (1) the judgement of a health professional, (2) performing standardized activities by the patient, and (3) self report of patients with standardized questionnaires. This paper presents a selection of health status instruments that have been used successfully to assess health-related quality of life in patients with musculoskeletal diseases. The description is restricted to instruments that have sound psychometric properties and that have been published in the scientific literature.

Activities of Daily Living↗
PubMed1997

Economic impact of rheumatologic disorders.

Universally, health care systems are currently undergoing tremendous change. It is not sufficient to demonstrate that specific medical interventions and services are effective, as third party payers have become increasingly interested in financial outcomes. Managed care has accelerated this movement and rheumatology is facing new challenges to position itself in a changing health care environment. Studies dealing with the economic burden of musculoskeletal diseases and the economic evaluation of particular services and interventions are reviewed. As the health care system shifts toward managed care, rheumatology is facing tremendous challenges to position itself in new markets.

Canada↗
PubMed1996

[Is misoprostol effective in NSAID-induced gastrointestinal complications?].

Misoprostol, a synthetic prostaglandin E1, has been shown to reduce both gastric lesions and clinically relevant gastrointestinal events in patients taking NSAIDs. In patients with multiple risk factors gain in quality of life by avoidance of gastric ulcers seems to offset the loss in quality of life due to diarrhea, the most important misoprostol side effect. From a clinical-epidemiological point of view misoprostol prophylaxis thus seems reasonable in patients with multiple risk factors. Since non-use due to diarrhea varies highly among patients, individual preferences should be considered in the decision making process. From an economic point of view misoprostol prophylaxis seems justified in patients with multiple risk factors. In such patients misoprostol prophylaxis may indeed be cost-saving. However, this needs to be confirmed in further economic evaluations based on newly available effectiveness data and better data on patient preferences from large and representative samples.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1996

Can comorbidity be measured by questionnaire rather than medical record review?

Comorbidity generally is measured by medical record abstraction, which is expensive and often impractical. The aim of this study was to assess the reproducibility and validity of a comorbidity questionnaire. The authors developed a brief comorbidity questionnaire that included items corresponding to each element of the medical record-based Charlson index. The questionnaire was administered to 170 inpatients. Charlson scores were abstracted from these patients' medical records. We assessed test-retest reliability of the questionnaire and the Charlson index, the correlation between the questionnaire and the Charlson index, and correlations between each comorbidity measure and indicators of health resource utilization including medication use, hospitalizations in the past year, and hospital charges. Test-retest reliability, assessed with the intraclass correlation coefficient, was 0.91 for the questionnaire and 0.92 for the chart-based Charlson index. The Spearman correlation between these two measures was 0.63. The correlation between comorbidity measures was weaker in less educated patients. Correlations with indicators of resource utilization were similar for the two comorbidity instruments. The authors found that a questionnaire version of the Charlson index is reproducible, valid, and offers practical advantages over medical record-based assessments.

Aged↗
PubMed1995

Assessment outcomes of clinical drug trials in osteoarthritis.

The management of osteoarthritis has been limited to symptomatic treatment to decrease pain and improve function without modifying the underlying disease process. New insights into the structure, physiology, and function of cartilage, however, have led to the development of promising approaches that might ultimately modify the underlying disease process. Over the past year, a number of therapeutic trials in osteoarthritis were reported in the literature. These studies provide an opportunity to review methodologic challenges in clinical trials of osteoarthritis.

Clinical Trials as Topic↗
PubMed1992

[The "Emmerich Arthritis Record", function and acceptance within the scope of an integrated treatment concept].

For a comprehensive model of rheumatoid arthritis treatment, we designed an arthritis manual for continuous treatment of chronic illness. One goal of introducing the manual to the patients was the improvement of communication between patient and different doctors and therapists. The first part includes of a doctor's documentation sheet and a patient calendar (6 months each) for daily self-documentation of drug compliance. The second part is a daily pain-rating scale. The 3-year evaluation of 655 patient manuals for 286 patients was analyzed to estimate the compliance in using the manual. Overall, 87% of diagnoses, 83% of disease-modifying anti-rheumatic drugs (DMARDs), 87% of non-steroidal anti-rheumatic drugs (NSAIDs) had been documented in the manual. Data indicates that the general practitioner and the rheumatologist accepted the manual form. In addition, 85% of the documented patients used the DMARDs, 74% used the daily pain score, and 43% the daily physiotherapy. Subgroup data (n = 130 RA patients) suggest additional results: 1) there was no difference in sociodemographic data between the patient manual user group and the non-user group; 2) the user group consisted of patients with higher disease activity (ARA-criteria), higher pain score, and negative mood pattern. Furthermore, the user group was more active in daily physiotherapy, ergotherapy, and balneotherapy.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1992

[Special problems of young rheumatic patients with occupational placement].

In a study initiated by the German League against Rheumatism, 433 young patients with rheumatic disorders (mean age 27 years, disease duration 7.5 years, 60% female, 40% male) were questioned in 1989 for the first time to ascertain disease-related problems encountered at school or during professional training. Their self-reported diagnoses were 68.2% chronic arthritis and 23.6% Ankylosing spondylitis (definite or probable diagnosis). From 181 patients who had been affected at school age, 84.5% reported the following main problems: absence related to illness, exclusion from excursions and school-related activities. Nevertheless, a majority of the patients (60.5%) reached a qualified graduation. 25.3% of the study sample was still attending school, 50.3% were employed, 8.6% were unemployed, and 4.5% had been retired early. Only 37.7% of the Arthritis patients and 22.3% of the Spondylitis patients had sought advice and help from the labour exchange services; 26.9% of the arthritis patients and 21.9% of the Spondylitis patients assessed this advice to be helpful. Regarding vocational guidance, the patients main criticism was a lack of knowledge about rheumatic disorders. There is a demand for an adjustment of the individual physical abilities and the requirements of the respective jobs, and continuous supervision by a rheumatologist is necessary.

Adolescent↗
PubMedDate not supplied

[Evaluation of the North American Spine Society Instrument for assessment of health status in patients with chronic backache].

PURPOSE OF THE STUDY: The translation/back and translation and validation of the North American Spine Society (NASS) Instrument in German was published recently. This contribution aims at describing the scoring of this questionnaire. METHOD: The scoring is oriented on the recommendations of the developing scientists of the US-American original, with whom we cooperated during the German validation. RESULTS: The scoring algorithm is described, a program for computerized scoring in SPSS was written. Program syntax and the questionnaire are reproduced. CONCLUSION: The contribution enables interested researchers to apply and score the NASS questionnaire in German-speaking countries.

Back Pain↗
PubMedDate not supplied

[Validation of the North American Spine Society Instrument for assessment of health status in patients with chronic backache].

BACKGROUND: Pain and functional limitations are the chief symptoms in patients with back pain. However, standardized assessment of these domains are still not commonplace in clinical practice. The objective of this study was the cultural adaptation and validation of the North American Spine Society (NASS) Lumbar Spine Outcome Assessment Instrument for German speaking patients with back pain. METHODS: Translation and backtranslation of the NASS instrument was performed according to international recommendations. 56 consecutive inpatients with a confirmed diagnosis of dorsopathia completed a German version of the NASS instrument, the SF-36 and an established German instrument for back patients (FFbH-R). All patients completed the questionnaires 48 hours apart to assess test-retest reliability. Validity was assessed through correlation with corresponding subscales of the SF-36, the FFbH-R and a 0-10 pain numeric rating scale. Internal consistency and item-to-scale correlation served as statistics of reliability. RESULTS: The two subscales of the NASS Instrument for cervical and lumbar problems correlate significantly with the corresponding subscales of the FFbH-R and the SF-36 (r = 0.28-0.83, p < 0.05) and 0.39-0.68 (p < 0.05) with a pain numeric rating scale. Test-retest reliability demonstrated intraclass correlation coefficients between 0.82 to 0.89. CONCLUSION: The German version of the NASS Cervical and Lumbar Spine Outcome Assessment Instrument allows the standardized assessment of pain, functional limitations and neurogenic symptoms in patients with back pain and the international comparison of health states and therapeutic outcomes.

Activities of Daily Living↗
PubMedDate not supplied

[Critical evaluation of economic analysis exemplified by preventive misoprostol administration in antirheumatic drug-induced gastropathy].

Public and professional concern about the limited resources and increasing costs of medical care in absolute and relative terms have stimulated research on the costs and benefits of health care programs and interventions. The identification of cost-effective alternatives requires the choice of the type of analysis, definition of the perspective, comprehensive assessment of the costs as well as the effects and the critical interpretation of the results. These aspects are illustrated with the example of misoprostol-prophylaxis for NSAID-induced gastropathy. A summary of relevant criteria for an economic analysis in clinical practice is provided.

Anti-Inflammatory Agents, Non-Steroidal↗