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patient-reported Outcomes of Surgery of Non-Small Cell Lung Cancer: Evaluation Based on the Questionnaires of Anti-Aging Quality of Life and the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire

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Surgical Science 2017年第5期8卷 203-219页

作者： Takanori Ayabe Masaki Tomita Naohiro Nose Takashi Asada Kunihide Nakamura Division of Thoracic and Breast Surgery Department of SurgeryFaculty of MedicineUniversity of MiyazakiMiyazakiJapan Division of Cardiovascular Surgery Department of SurgeryFaculty of MedicineUniversity of MiyazakiMiyazakiJapan

Background: patient-reported outcomes of the quality of life (QOL) after an open thoracotomy have not been studied. To determine the physical and mental changes in surgical patients is very important for medical staffs. The surgical patient’s satisfaction and overall healthy changes were evaluated by the patient-self assessment questionnaires. Materials and Methods: From July 2007 to April 2008, 26 patients with non-small cell lung cancer (NSCLC) underwent surgical resection. The outcome of the QOL was evaluated by using two kinds of questionnaire surveys from the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and the anti-aging QOL assessment (AA-QOL). The EORTC QLQ-C30 consisted of five domains (physical, role, cognitive, emotional, and social functionings) and global QOL. The AA-QOL contained 51 items;30 physical and 21 mental symptoms regarding the elderly and the aging population. The patients replied to the two questionnaires at two different times, i.e., at pre-surgery (baseline) and at post-surgery (2 weeks after the operation). The obtained data of these scores were averaged and compared between the two points of the pre-surgery and post-surgery. Results: Regarding the outcomes of the EORTC QLQ-C30, the physical and social functioning became significantly worse after the surgery. In contrast, the global QOL significantly became better after the surgery. For the symptom at post-surgery, three of which were “nausea and vomiting”, “pain”, and “appetite loss”, became significantly worse compared to those at pre-surgery. Regarding the outcomes of the AA-QOL, the physical symptoms (muscular pain/stiffness, palpitations, dyspnea, no feeling of good health, anorexia, and coughing and sputum) became significantly worse after the surgery. Regarding the mental symptoms, there were no significant differences. Conclusions: Regarding the outcomes based on the changes in the QOL after surgery, the physical symp

关键词： patient-reported Outcome Surgery Quality of Life Non-Small Cell Lung Cancer

Establishing minimum clinically important difference values for the patient-reported Outcomes Measurement Information System Physical Function, hip disability and osteoarthritis outcome score for joint reconstruction, and knee injury and osteoarthritis out

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World Journal of Orthopedics 2018年第3期9卷 41-49页

作者： Man Hung Jerry Bounsanga Maren W Voss Charles L Saltzman Department of Orthopaedic Surgery Operations University of Utah Division of Public Health University of Utah Population Health Research Foundation University of Utah

AIM To establish minimum clinically important difference(MCID) for measurements in an orthopaedic patient population with joint *** Adult patients aged 18 years and older seeking care for joint conditions at an orthopaedic clinic took the patient-reported Outcomes Measurement Information System Physical Function(PROMIS~? PF) computerized adaptive test(CAT), hip disability and osteoarthritis outcome score for joint reconstruction(HOOS JR), and the knee injury and osteoarthritis outcome score for joint reconstruction(KOOS JR) from February 2014 to April 2017. MCIDs were calculated using anchorbased and distribution-based methods. patient reports of meaningful change in function since their first clinic encounter were used as an *** There were 2226 patients who participated with a mean age of 61.16(SD = 12.84) years, 41.6% male, and 89.7% Caucasian. Mean change ranged from 7.29 to 8.41 for the PROMIS~? PF CAT, from 14.81 to 19.68 for the HOOS JR, and from 14.51 to 18.85 for the KOOS JR. ROC cut-offs ranged from 1.97-8.18 for the PF CAT, 6.33-43.36 for the HOOS JR, and 2.21-8.16 for the KOOS JR. Distribution-based methods estimated MCID values ranging from 2.45 to 21.55 for the PROMIS~? PF CAT; from 3.90 to 43.61 for the HOOS JR, and from 3.98 to 40.67 for the KOOS JR. The median MCID value in the range was similar to the mean change score for each measure and was 7.9 for the PF CAT, 18.0 for the HOOS JR, and 15.1 for the KOOS *** This is the first comprehensive study providing a wide range of MCIDs for the PROMIS? PF, HOOS JR, and KOOS JR in orthopaedic patients with joint ailments.

关键词： Hhip disability and osteoarthritis outcome score for joint reconstruction patient-reported Outcomes Measurement Information System Physical Function Knee injury and osteoarthritis outcome score for joint reconstruction Minimum clinically important difference Joint Physical function Minimum detectable change Arthroplasty Orthopaedics Clinical outcomes

patient-reported Outcomes in Prostate Cancer: Prospective Changes Analysis for Prognosis Prediction

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Journal of Cancer Therapy 2015年第15期6卷 1238-1248页

作者： Teresa Sequeira Pedro Lopes Ferreira Joana Teixeira Isabel Peres Jorge Oliveira Augusta Silveira Fernando Pessoa University (UFP) Porto Portugal Centro de Estudos e Investigacao em Saúde da Universidade de Coimbra (CEISUC) Coimbra Portugal Coimbra University Coimbra Portugal Fernando Pessoa University Hospital School Porto Portugal Instituto Portugues de Oncologia do Porto (IPOP) Porto Portugal

Prostate cancer is affecting a higher proportion of male population. Health Related Quality of Life assessment can guide the development of an interdisciplinary and patient-centered care intervention. This study is aimed to assess Health Related Quality of Life in prostate cancer patients. Relationships between socio-demographic, clinical characteristics and patient-reported outcomes have been considered. Consecutive outpatients with prostate cancer, admitted at the Urology Clinic of the Instituto Português de Oncologia do Porto, were studied (n = 300). Health Related Quality of Life was assessed as part of the routine practice. The European Organisation for Research and Treatment of Cancer general questionnaire, QLQ-C30, and its specific module for prostate cancer patients, QLQ-PR25, were used. Evolution along time (elapsed since diagnosis, and up to 5 years) was considered in order to search for a prognosis prediction in prostate cancer patients. This study confirms the feasibility of a systematic Health Related Quality of Life assessment. Global Health Related Quality of Life was found to be higher 6 months after diagnosis, decreasing then until the second year after diagnosis and improving thereafter. A peak with better scores was identified at the fifth year after diagnosis. Social and physical dimensions revealed a similar pattern. Clinical significance was found 6 months and 5 years after diagnosis. The prospective analysis of Health Related Quality of Life changes is able to explore the patients’ outcomes in order to find patterns and relationships for prognosis prediction along the disease course. Such approach might promote patient confidence and thus a better cancer experience.

关键词： Oncology Prostate Cancer Health Related Quality of Life patient-reported Outcomes Prognosis Prediction

patient-reported Outcomes of Chemotherapy Involving Non-Small Cell Lung Cancer: Evaluation by Questionnaires of Quality of Life Regarding Anti-Aging and Anti-Cancer Drugs

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Advances in Lung Cancer 2017年第2期6卷 13-35页

作者： Takanori Ayabe Masaki Tomita Takashi Asada Kazuyo Tsuchiya Manabu Nemoto Kunihide Nakamura Division of Thoracic and Breast Surgery Department of Surgery Miyazaki Japan Department of Surgery Junwakai Memorial Hospital Miyazaki Japan Division of Cardiovascular Surgery Department of Surgery Faculty of Medicine University of Miyazaki Miyazaki Japan

Background: patient-reported outcomes (PROs) of quality of life (QOL) during chemotherapy involving lung cancer are very important for the medical staffs. patients’ satisfaction and healthy changes were evaluated by the patient-self assessment. Materials and Methods: From July 2007 to April 2008, a total of 19 patients received chemotherapy. The QOL data were collected by using the QOL questionnaire for cancer patients treated with anticancer drugs (QOL-ACD) and the anti-aging QOL assessment (AA-QOL). The AA-QOL contained 51 items: 30 of physical and 21 of mental symptoms of the elderly and the aging population. The patients replied to the questions at two different times, i.e., at pre-chemotherapy (baseline) and at post-chemotherapy (2 weeks after the chemotherapy). Results: Regarding the hematological toxicities, for the grade 3/4 toxicities, there were 12 neutropenia (12/19, 63.2%) and 3 thrombocytopenia (3/19, 15.8%). For the grade 3 febrile neutropenia, there were 5 cases (5/19, 26.3%). Regarding the non-hematological toxicities, there was no grade 3 and grade 4 toxicities. Based on the outcomes of the QOL-ACD, the three items (“physical condition”, “social attitude”, and “overall QOL”) at post-chemotherapy became significantly worse compared to the baseline. Regarding the outcomes of the AA-QOL, 4 items of physical symptoms (“thirst”, “anorexia”, “early satiety”, and “diarrhea”) became significantly worse compared to the baseline. Regarding the mental symptoms, 2 items (“nothing to look forward in life” and “a sense of uselessness”) became significantly worse compared to the baseline. Conclusion: Regarding the PROs of the QOL during the chemotherapy term, both the physical and mental symptoms had become worse. To clarify the changes in the QOL during chemotherapy is very important for multidisciplinary teamwork, which should play the role of providing the appropriate cares and treatment as patient-support.

关键词： patient-reported Outcome Chemotherapy Quality of Life Non-Small Cell Lung Cancer

Whole breast ultrafractionation radiotherapy after breast-conserving surgery in early breast cancer: A single-center, prospective, observational study from China

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Malignancy Spectrum 2024年第2期1卷 113-122页

作者： Rui-Zhi Zhao Cheng Huang Tian-Lan Tang Gui-Qing Shi Si-Lin Chen Yu-Ping Lin Ying Wang Liu-Qing Jiang Jin-Hua Chen Chun-Sen Xu Fang-Meng Fu Zhong-Hua Han Shun-Guo Lin Chuan Wang Yong Yang Department of Radiation Oncology Fujian Medical University Union HospitalFujian Key Laboratory of Intelligent Imaging and Precision Radiotherapy for Tumors(Fujian Medical University)Clinical Research Center for Radiology and Radiotherapy of Fujian Province(DigestiveHematological and Breast Malignancies)FuzhouFujianChina Department of Follow-Up Center Fujian Medical University Union HospitalFuzhouFujianChina Department of Breast Surgery Fujian Medical University Union HospitalFuzhouFujianChina

Objective:This single-center,prospective,observational study was designed to investigate the toxicities,patient-reported outcome(PRO),and dosimetric analysis of whole breast ultrafractionation radiotherapy(RT)after breast-conserving surgery(BCS)in early breast cancer(BC).patients and methods:patients diagnosed with BC stage I,II and treated with BCS were enrolled.A dose of 26 Gray(Gy)in five fractions was prescribed to the whole breast and tumor *** endpoints included toxicities,PRO,and dosimetric *** was measured by the European Organization for Research and Treatment of Cancer general quality of life questionnaire(EORTC QLQ-C30)and the BC-specific questionnaire(EORTC QLQ-BR23)***:Between January 2022 and June 2023,62 female patients were *** median age was 45 *** patients(83.9%)were diagnosed with pathological stage I *** median planning target volume(PTV)was 456.4 *** minimum,maximum,and mean doses,and D95(dose of PTV irradiated volume more than 95%)to PTV were 20.2,28.8,27.2,and 26.3 Gy,*** median mean lung dose and percentage lung volume receiving 8 Gy(V8)were 3.6 Gy and 13.4%,*** median mean heart dose,V1.5(percentage of organ volume irradiated with 1.5 Gy or higher),and V7(percentage of organ volume irradiated with 7 Gy or higher)were 0.6 Gy,6.8%,and 0.4%,*** effects before RT showed no obvious differences compared to that post *** toxicities of grade 3 or higher *** patients had asymptomatic radiation pneumonia(grade 1),and 12 patients had radiation dermatitis(grade 1).No factor was significantly related to radiation dermatitis or radiation *** the EORTC QLQ-C30 and QLQ-BR23 questionnaires,all function and symptom scores before RT had no significant differences compared with that after RT,1−2 months after RT,and 3−4 months after *** RT did not worsen *** 1-year crude local control was 100%.Conclusion:Whole br

关键词： ultrafractionation radiotherapy breast cancer breast-conserving surgery toxicities patient-reported outcome

Management of gastroesophageal reflux disease: patient and physician communication challenges and shared decision making

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World Journal of Clinical Cases 2018年第15期6卷 892-900页

作者： Scott Klenzak Igor Danelisen Grace D Brannan Melissa A Holland Miranda AL van Tilburg Department of Psychiatry Cape Fear Valley Health System School of Osteopathic Medicine Campbell University College of Pharmacy and Health Sciences Campbell University Division of Gastroenterology and Hepatology School of Medicine University of North Carolina University of Washington

Gastroesophageal reflux disease(GERD) is a common upper esophageal condition and typical symptoms can include heartburn and sensation of regurgitation while atypical symptoms include chronic cough, asthma, hoarseness, dyspepsia and nausea. Typically, diag-nosis is presumptive given the presence of typical and atypical symptoms and is an indication for empiric therapy. Treatment management can include lifestyle modifications and/or medication therapy with proton pump inhibitor(PPI) class being the preferred and most effective. Complete symptom resolution is not always achieved and long-term PPI therapy can put patients at risk for serious side effects and needless expense. The brain-gut connection and hypervigilance plays an important role in symptom resolution and treatment success, especially in the case of non-PPI responders. Hypervigilance is a combination of increased esophageal sensory sensitivity in combination with exaggerated threat perception surrounding esophageal symptoms. Hypervigilance requires a different approach to GERD managements, where continued PPI therapy and surgery are usually not recommended. Rather, helping physicians and patients understand the brain-gut connection can guide and improve *** and reassurance should be the main pillars or treatment. However, it is important not to suggest the symptoms are due to anxiety alone, this often leads to patient dissatisfaction. patient dissatisfaction with treatment reveals the need for a more patient-centered approach to GERD management and better communication between patients and providers. Shared decision making(SDM) with the incorporation of patient-reported outcomes(PRO) promotes patient adherence and satisfaction. SDM is a joint discussion between clinician and patient in which a mutually shared solution is explored for GERD symptoms. For SDM to work the physician needs to capture patients' perceptions which may not be obtained in the standard interview. This can be done through the

关键词： Gastroesophageal reflux disease Psychosocial patient-physician communication Shared decision making patient-reported outcomes patient satisfaction

Hepatitis C virus cure with direct acting antivirals: Clinical,economic, societal and patient value for China

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World Journal of Hepatology 2019年第5期11卷 421-441页

作者： Qing Xie Jian-Wei Xuan Hong Tang Xiao-Guang Ye Peng Xu I-Heng Lee Shan-Lian Hu Department of Infectious Diseases Ruijin HospitalShanghai Jiaotong University School of MedicineShanghai 200025China Health Economic Research Institute School of PharmacySun Yat-Sen UniversityGuangzhou 510006Guangdong ProvinceChina Center of Infectious Diseases West China Hospital of Sichuan UniversityChengdu 610041Sichuan ProvinceChina Second Affiliated Hospital of Guangzhou Medical University Guangzhou 510260Guangdong ProvinceChina Gilead Sciences Inc Shanghai 200122China Gilead Sciences Inc Foster CityCA 94404United States School of Public Health Fudan UniversityShanghai 200032China Shanghai Health Development Research Center Shanghai 200032China

About 10 million people in China are infected with hepatitis C virus(HCV),with the seroprevalence of anti-HCV in the general population estimated at 0.6%.Delaying effective treatment of chronic hepatitis C(CHC)is associated with liver disease progression,cirrhosis,hepatocellular carcinoma,and liver-related *** extrahepatic manifestations of CHC further add to the disease burden of *** CHC-related advanced liver diseases and systemic manifestations are costly for both the healthcare system and *** of work productivity due to reduced well-being and quality of life in CHC patients further compounds the economic burden of the ***,pegylatedinterferon plus ribavirin(PR)was the standard of ***,a substantial number of patients are ineligible for PR treatment,and only 40%–75%achieved sustained virologic ***,PR is associated with impairment of patient-reported outcomes(PROs),high rates of adverse events,and poor *** the advent of direct acting antivirals(DAAs),the treatment of CHC patients has been *** have broader eligible patient populations,higher efficacy,better PRO profiles,fewer adverse events,and better adherence rates,thereby making it possible to cure a large proportion of all CHC *** article aims to provide a comprehensive evaluation on the value of effective,curative hepatitis C treatment from the clinical,economic,societal,and patient experience perspectives,with a focus on recent data from China,supplemented with other Asian and international experiences where China data are not available.

关键词： Hepatitis C Value of cure Sustained virologic response End stage liver disease Prevention of transmission Cost-effectiveness Productivity Societal value patient-reported outcomes

Efficacy and Safety of Tofacitinib in Chinese patients with Rheumatoid Arthritis

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Chinese Medical Journal 2018年第22期131卷 2683-2692页

作者： Zhan-Guo Li Yi Liu Hu-Ji Xu Zhi-Wei Chen Chun-De Bao Jie-Ruo Gu Dong-Bao Zhao Yuan An Lie-Ju Hwang Lisy Wang Joel Kremer Qi-Zhe Wu Department of Rheumatology and Immunology Peking University People's HospitalBeijing 100044China Center for Rheumatology Albany Medical CollegeAlbanyNY 12208USA Medical Pfizer IncBeijing 100010China Department of Rheumatology and Immunology West China Hospital of Sichuan UniversityChengduSichuan 610041China Department of Rheumatology and Immunology Shanghai Changzheng HospitalThe Second Military Medical UniversityShanghai 200003China Department of Rheumatology First Affiliated Hospital of Soochow UniversitySuzhouJiangsu 215006China Department of Rheumatology Shanghai Renji HospitalShanghai 200000China Department of Rheumatology The Third Affiliated Hospital of Sun Yat-Sen UniversityGuangzhouGuangdong 510630China Department of Rheumatology and Immunology Changhai Hospital of ShanghaiShanghai 200433China Statistician Pfizer IncNew YorkNY 10017USA(at the time of analysis) Clinician Pfizer IncCrotonCT 06340USA

Background: Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis(RA). This study assessed the efficacy and safety of tofacitinib in Chinese patients with RA enrolled in Phase 3 and long?term extension(LTE) ***: ORAL Sync was a 1?year, randomized, placebo?controlled, Phase 3 trial. patients received tofacitinib 5 or 10 mg twice daily(BID) or placebo advanced to tofacitinib 5 or 10 mg BID at 3 or 6 months. All patients remained on ≥1 background conventional synthetic disease?modifying antirheumatic drug. ORAL Sequel is an open?label LTE study(data?cut: March 2015; data collection and analyses were ongoing, and study database was not locked at the time of analysis; study was closed in 2017). Efficacy outcomes: American College of Rheumatology(ACR) 20/50/70 response rates and Disease Activity Score in 28 joints using erythrocyte sedimentation rate(DAS28?4 [ESR]). patient? and physician?reported outcomes: Health Assessment Questionnaire?Disability Index(HAQ?DI), patient and Physician Global Assessment of Arthritis, and pain(visual analog scale). Safety was assessed ***: ORAL Sync included 218 patients; 192 were subsequently enrolled into ORAL Sequel. In ORAL Sync, more patients achieved ACR20(tofacitinib 5 mg BID, 67.4%; 10 mg BID, 70.6%; placebo, 34.1%) and DAS28?4(ESR) patients were similar to the global ***: Tofacitinib significantly reduced signs/symptoms and improved physical function and quality of life in Chinese patients with moderate?to?severely active RA up to Month 48. The safety profile was consistent with the global *** Trial Identifie

关键词： Clinical Efficacy patient-reported Outcomes Rheumatoid Arthritis Safety Tofacitinib

Importance of fatigue and its measurement in chronic liver disease

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World Journal of Gastroenterology 2019年第28期25卷 3669-3683页

作者： Lynn H Gerber Ali A Weinstein Rohini Mehta Zobair M Younossi Department of Medicine Beatty Center for Liver and Obesity Research Inova Health System Falls Church VA 22042 United States Center for the Study of Chronic Illness and Disability George Mason University Fairfax VA 22030 United States Beatty Center for Liver and Obesity Research Inova Health System Falls Church VA 22042 United States

The mechanisms of fatigue in the group of people with non-alcoholic fatty liver disease and non-alcoholic steatohepatitis are protean. The liver is central in the pathogenesis of fatigue because it uniquely regulates much of the storage, release and production of substrate for energy generation. It is exquisitely sensitive to the feedback controlling the uptake and release of these energy generation substrates. Metabolic contributors to fatigue, beginning with the uptake of substrate from the gut, the passage through the portal system to hepatic storage and release of energy to target organs (muscle and brain) are central to understanding fatigue in patients with chronic liver disease. Inflammation either causing or resulting from chronic liver disease contributes to fatigue, although inflammation has not been demonstrated to be causal. It is this unique combination of factors, the nexus of metabolic abnormality and the inflammatory burden of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis that creates pathways to different types of fatigue. Many use the terms central and peripheral fatigue. Central fatigue is characterized by a lack of self-motivation and can manifest both in physical and mental activities. Peripheral fatigue is classically manifested by neuromuscular dysfunction and muscle weakness. Therefore, the distinction is often seen as a difference between intention (central fatigue) versus ability (peripheral fatigue). New approaches to measuring fatigue include the use of objective measures as well as patient reported outcomes. These measures have improved the precision with which we are able to describe fatigue. The measures of fatigue severity and its impact on usual daily routines in this population have also been improved, and they are more generally accepted as reliable and sensitive. Several approaches to evaluating fatigue and developing endpoints for treatment have relied of biosignatures associated with fatigue. These have bee

关键词： Fatigue Chronic liver disease Non-alcoholic fatty liver diseases Nonalcoholic steatohepatitis Measurement patient-reported outcomes