Journal of clinical epidemiology
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Whereas pain is frequently measured using a visual analog scale (VAS) that can examine change over short time intervals in the same subject, such ratings are not useful in analyzing differences across subjects. We created a method for normalizing VAS pain reporting to control for the variation between different populations due to the differences in subjective perception or objective evaluation of pain. ⋯ It is possible to standardize VAS pain ratings to compare pain between different populations.
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Multicenter Study
Local and national electronic databases in Norway demonstrate a varying degree of validity.
The aim of the present study was to examine the validity of local and national electronic databases using medical records as gold Standard. ⋯ The present findings question the validity of electronic databases and thus have implications for epidemiologic studies.
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Cancer-related fatigue (CRF) is one of the most common unrelieved symptoms experienced by patients. CRF is underrecognized and undertreated due to a lack of clinically sensitive instruments that integrate easily into clinics. Modern computerized adaptive testing (CAT) can overcome these obstacles by enabling precise assessment of fatigue without requiring the administration of a large number of questions. A working item bank is essential for development of a CAT platform. The present report describes the building of an operational item bank for use in clinical settings with the ultimate goal of improving CRF identification and treatment. ⋯ The final bank includes 72 items. These 72 unidimensional items explained 57.5% of the variance, based on factor analysis results. Excellent internal consistency (alpha=0.99) and acceptable item-total correlation were found (range: 0.51-0.85). The 72 items covered a reasonable range of the fatigue continuum. No significant ceiling effects, floor effects, or gaps were found. A sample short form was created for demonstration purposes. The resulting bank is amenable to the development of a CAT platform.
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Multicenter Study Comparative Study Clinical Trial
Assessment of functional status, low back disability, and use of diagnostic imaging in patients with low back pain and radiating leg pain.
We analyzed data from outpatients with chronic low back pain (LBP) in the Veterans Health Study (n = 563) to examine the relationship between localized LBP intensity and radiating leg pain in assessing patient functional status, low back disability, and use of diagnostic imaging. Based on the localized LBP intensity, the study subjects were divided into tertiles (low, moderate, and high intensity). The study subjects were also stratified by the extent of radiating leg pain. ⋯ The results of the study indicate that measures of localized LBP intensity and radiating leg pain contribute separately to the assessment of patient functional status, low back disability, and use of diagnostic imaging. These results suggest that localized LBP intensity and radiating leg pain may represent two different approaches in assessing back pain severity. Future epidemiological and health services research should consider both measures in assessing the impact of LBP on patient functional status, low back disability, and use of diagnostic imaging.
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Multicenter Study
Chronic comorbidity and outcomes of hospital care: length of stay, mortality, and readmission at 30 and 365 days.
This article evaluates the behavior of an adaptation of the Charlson Index (CHI) applied to administrative databases to measure the relationship between chronic comorbidity and the hospital care outcomes of length of stay (LOS), in-hospital mortality, and emergency readmissions at 30 and 365 days. These outcomes were analyzed in 106,673 hospitalization episodes whose records are registered in a minimum basic data set maintained by the public health authorities of the community of Valencia, Spain. ⋯ While comorbidity does appear to increase the risk of adverse outcomes in general and mortality and readmission specifically, the second outcome is only possible if the first has not occurred. For this reason, information and selection biases derived from administrative databases, or from the CHI itself, should be taken into account when using and interpreting the index.