scholarly journals Validating the Transformation of PROMIS-GH to EQ-5D in Adult Spine Patients

2019 ◽  
Vol 8 (10) ◽  
pp. 1506 ◽  
Author(s):  
Panchagnula ◽  
Sun ◽  
Montejo ◽  
Nouri ◽  
Kolb ◽  
...  
Keyword(s):  
Goodness Of Fit ◽  
Mean Squared Error ◽  
The United States ◽  
Coefficient Of Determination ◽  
Categorical Variables ◽  
Measurement Information ◽  
Sample Population ◽  
Health Index ◽  
Patient Reported ◽  
Adult Spine

Spinal disorders and associated interventions are costly in the United States, putting them in the limelight of economic analyses. The Patient-Reported Outcomes Measurement Information System Global Health Survey (PROMIS-GHS) requires mapping to other surveys for economic investigation. Previous studies have proposed transformations of PROMIS-GHS to EuroQol 5-Dimension (EQ-5D) health index scores. These models require validation in adult spine patients. In our study, PROMIS-GHS and EQ-5D were randomly administered to 121 adult spine patients. The actual health index scores were calculated from the EQ-5D instrument and estimated scores were calculated from the PROMIS-GHS responses with six models. Goodness-of-fit for each model was determined using the coefficient of determination (R2), mean squared error (MSE), and mean absolute error (MAE). Among the models, the model treating the eight PROMIS-GHS items as categorical variables (CATReg) was the optimal model with the highest R2 (0.59) and lowest MSE (0.02) and MAE (0.11) in our spine sample population. Subgroup analysis showed good predictions of the mean EQ-5D by gender, age groups, education levels, etc. The transformation from PROMIS-GHS to EQ-5D had a high accuracy of mean estimate on a group level, but not at the individual level.

scholarly journals An Onsite Fitness Facility and Integrative Wellness Program Positively Impacted Health-Related Outcomes Among Teachers and Staff at an Urban Elementary/Middle School

2019 ◽  
Vol 8 ◽  
pp. 216495611987327
Author(s):  
Elizabeth A Parker ◽  
Patrick F McArdle ◽  
Debbie Gioia ◽  
Ariel Trilling ◽  
Mary Bahr-Robertson ◽  
...  
Keyword(s):  
Middle School ◽  
Sleep Disturbances ◽  
Qualitative Interviews ◽  
The United States ◽  
Measurement Information ◽  
Wellness Program ◽  
Patient Reported ◽  
Fitness Facility ◽  
Health Related ◽  
Improve Health

Background Given the large number of obesity-focused studies conducted in schools, there is a surprising lack of data regarding teacher workplace health behaviors in the United States. Objective To determine the feasibility and effectiveness of an onsite fitness facility with a structured integrative wellness program to improve health-related outcomes among teachers and staff at an urban elementary/middle school. Methods A 2-year mixed-methods analysis using Patient-Reported Outcomes Measurement Information System (PROMIS) measures and qualitative interviews included 39 teachers and staff employed at an urban elementary/middle school in Baltimore, Maryland. The fitness facility was dedicated exclusively to teachers and staff and the integrative wellness program included group exercise classes, yoga, mindfulness, and nutrition competitions. T tests were used to compare quantitative outcomes at baseline, the end of year 1, and the end of year 2. Results Compared to baseline, at year 1, there was a significant improvement in the PROMIS Sleep Disturbance score. From baseline to end of year 2, there were significant increases in the PROMIS Global Physical Health as well as significant decreases in Sleep Disturbances, Fatigue, and Social Isolation. Qualitative interviews conducted at the end of year 1 indicated that teachers who used the facility felt that it improved their mood, increased their energy, motivated them to eat healthily, and gave them opportunities to socialize with their colleagues in new ways. This impact was further enhanced in year 2. Conclusions An onsite fitness facility with an integrative wellness program may improve health-related outcomes among urban elementary school teachers and staff, with the greatest benefits seen after 2 years of implementation.

scholarly journals Mathematical Models for Tumor Growth and the Reduction of Overtreatment

2018 ◽  
Vol 80 (01) ◽  
pp. 072-078 ◽  
Author(s):  
Berdine Heesterman ◽  
John-Melle Bokhorst ◽  
Lisa de Pont ◽  
Berit Verbist ◽  
Jean-Pierre Bayley ◽  
...  
Keyword(s):  
Tumor Growth ◽  
Mathematical Models ◽  
Goodness Of Fit ◽  
Mean Squared Error ◽  
Age At Onset ◽  
Growth Curves ◽  
Magnetic Resonance Images ◽  
Coefficient Of Determination ◽  
Growth Data ◽  
Significant Difference

Background To improve our understanding of the natural course of head and neck paragangliomas (HNPGL) and ultimately differentiate between cases that benefit from early treatment and those that are best left untreated, we studied the growth dynamics of 77 HNPGL managed with primary observation. Methods Using digitally available magnetic resonance images, tumor volume was estimated at three time points. Subsequently, nonlinear least squares regression was used to fit seven mathematical models to the observed growth data. Goodness of fit was assessed with the coefficient of determination (R 2) and root-mean-squared error. The models were compared with Kruskal–Wallis one-way analysis of variance and subsequent post-hoc tests. In addition, the credibility of predictions (age at onset of neoplastic growth and estimated volume at age 90) was evaluated. Results Equations generating sigmoidal-shaped growth curves (Gompertz, logistic, Spratt and Bertalanffy) provided a good fit (median R 2: 0.996–1.00) and better described the observed data compared with the linear, exponential, and Mendelsohn equations (p < 0.001). Although there was no statistically significant difference between the sigmoidal-shaped growth curves regarding the goodness of fit, a realistic age at onset and estimated volume at age 90 were most often predicted by the Bertalanffy model. Conclusions Growth of HNPGL is best described by decelerating tumor growth laws, with a preference for the Bertalanffy model. To the best of our knowledge, this is the first time that this often-neglected model has been successfully fitted to clinically obtained growth data.

scholarly journals A COMPARISON OF NONLINEAR MODELS FOR DESCRIBING WEIGHT-AGE DATA IN ANGLO-NUBIAN DOES

2019 ◽  
Vol 32 (1) ◽  
pp. 251-258 ◽  
Author(s):  
Francisco Arthur Arré ◽  
José Elivalto Guimarães Campelo ◽  
José Lindenberg Rocha Sarmento ◽  
Luiz Antônio Silva Figueiredo Filho ◽  
Diego Helcias Cavalcante
Keyword(s):  
Goodness Of Fit ◽  
Mean Squared Error ◽  
Nonlinear Models ◽  
Age Groups ◽  
Coefficient Of Determination ◽  
Group Model ◽  
Age Group ◽  
Von Bertalanffy ◽  
Absolute Deviation ◽  
Model Interaction

ABSTRACT The objective of this study was to determine the optimum age at last weighing and compare the goodness of fit of nonlinear models used to fit longitudinal weight-age data to describe the growth pattern of Anglo-Nubian does. Weights of 104 animals from birth to 60 months of age were grouped into 10 age groups at six-month intervals. In each age group, parameters A (asymptotic weight), B (integration constant), and K (maturity index) were estimated using the Brody, Gompertz, logistic, and von Bertalanffy models. Data were analyzed using analysis of variance in a factorial design (10 age groups × 4 nonlinear models). The age group × model interaction was not significant. Mean estimates of A, B, and K were significantly different between age groups up to 30 months (p < 0.05), indicating that the estimated curve is affected by weights taken before this age independent of the model. The values of mean squared error (MSE), mean absolute deviation (MAD), coefficient of determination (R2) and Rate of convergence (RC) at each age group up to 30 months were compared to determine the goodness of fit of nonlinear models. The ranking of fit was logistic, Brody, von Bertalanffy, and Gompertz. The logistic and Brody models respectively estimated the smallest and largest asymptotic weight. Longitudinal weight records taken until 30 months of age are most appropriate for estimating the growth of Anglo-Nubian does using nonlinear models.

Characteristics of Clients Seeking Yoga Therapy in a University-Based Student Clinic

2020 ◽  
Author(s):  
Steffany Moonaz ◽  
Marlysa Sullivan ◽  
Daryl Nault ◽  
Irene Bright-Dumm ◽  
Ryan Bradley
Keyword(s):  
Mental Health ◽  
Patient Reported Outcomes ◽  
The United States ◽  
Study Data ◽  
Measurement Information ◽  
Physical And Mental Health ◽  
Yoga Therapy ◽  
Highly Educated ◽  
Clinical Encounters ◽  
Patient Reported

Abstract Yoga therapy is an emerging profession with recent development of educational competencies, training program accreditation, and practitioner certification. In the United States, most yoga therapy training programs are studio-based and data on mentored clinical encounters are lacking. This study aimed to characterize the client population in a university-based mentored student clinic. As part of a larger feasibility study, data were collected at all clinic visits for 70 consenting clients. Data collected included demographic characteristics, reasons for pursuing care, use of other healthcare approaches, and the Patient-Reported Outcomes Measurement Information System (PROMIS) for physical and mental health. Participants were mostly middle-aged, White, and highly educated. Common reasons for pursuing care were pain and mental health. Most used multiple healthcare approaches. Average scores for most patient-reported outcomes fell within normal range at baseline. Future studies are needed to better characterize yoga therapy users and to expand access for populations in whom the modality is underutilized despite emerging evidence of relevance.

scholarly journals A hydrological model skill score and revised R-squared

2021 ◽  
Author(s):  
Charles Onyutha
Keyword(s):  
Mathematical Modeling ◽  
Goodness Of Fit ◽  
Hydrological Model ◽  
Mean Squared Error ◽  
Skill Score ◽  
Coefficient Of Determination ◽  
Model Skill ◽  
Squared Error ◽  
Quality Coefficient ◽  
Correlation Term

Abstract Despite the advances in methods of statistical and mathematical modeling, there is considerable lack of focus on improving how to judge models’ quality. Coefficient of determination (R2) is arguably the most widely applied ‘goodness-of-fit’ metric in modelling and prediction of environmental systems. However, known issues of R2 are that it: (i) can be low and high for an accurate and imperfect model, respectively; (ii) yields the same value when we regress observed on modelled series and vice versa; and (iii) does not quantify a model's bias (B). A new model skill score E and revised R-squared (RRS) are presented to combine correlation, term B and capacity to capture variability. Differences between E and RRS lie in the forms of correlation and the term B used for each metric. Acceptability of E and RRS was demonstrated through comparison of results from a large number of hydrological simulations. By applying E and RRS, the modeller can diagnostically identify and expose systematic issues behind model optimizations based on other ‘goodness-of-fits’ such as Nash–Sutcliffe efficiency (NSE) and mean squared error. Unlike NSE, which varies from −∞ to 1, E and RRS occur over the range 0–1. MATLAB codes for computing E and RRS are provided.

QOLP-02. HEALTH-RELATED QUALITY OF LIFE (HRQOL) AMONG PEDIATRIC PATIENTS WITH NEUROFIBROMATOSIS TYPE 1 (NF1) AND PLEXIFORM NEUROFIBROMA (PN) IN THE UNITED STATES: PERSPECTIVES OF THE PATIENTS AND CAREGIVERS

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi182-vi183
Author(s):  
Xiaoqin Yang ◽  
Hyun Kyoo Yoo ◽  
Suvina Amin ◽  
Wendy Cheng ◽  
Heather Sipsma ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Upper Extremity ◽  
Pediatric Patients ◽  
Plexiform Neurofibroma ◽  
The United States ◽  
Measurement Information ◽  
Patient Reports ◽  
Patient Reported ◽  
Treatment Naïve

Abstract BACKGROUND PNs occur in 30-50% of pediatric patients with NF1, often resulting in debilitating pain, mobility limitations, significant disfigurement, and may be life-threatening. Real-world evidence on the HRQoL of pediatric NF1 PN patients is limited. METHODS Patients ages 8-18 years with NF1 PN (treatment-naïve/new on selumetinib [≤ 1 month of use]) and their caregivers were recruited through Children’s Tumor Foundation to participate in an online cross-sectional survey (12/2020-1/2021). HRQoL measures included Pediatric Quality of Life Inventory (PedsQL; Acute version), Pain Interference Index (PII), and Patient-Reported Outcomes Measurement Information System (PROMIS) mobility and upper extremity functioning subscales. Patients provided self-reported responses; caregivers provided proxy responses and patient characteristics. Agreement between patient-reports and caregiver proxies was assessed using intra-class correlation coefficients (ICCs). RESULTS 61 patient-caregiver dyads participated in the survey. Patients were mostly white/Caucasian (90.2%), 50.8% female, with a median (range) age of 13.0 (11-16) years. Most were treatment-naïve (96.7%), with NF1 and PN diagnosis for &gt; 5 years (91.8%, 82.0%). On the PedsQL (range: 0-100; higher=better; healthy patient mean scores typically &gt; 80), patient-reported mean scores were 50.3, 56.1, 60.7, and 63.7 for school, emotional, social, and physical functioning; mean total score= 58.5. Caregiver-proxy mean scores ranged from 49.9-61.5 across subscales; mean total score= 55.4. Among patients reporting pain in the last 7 days, PII mean scores (range: 0-6; higher=more interference) were 3.0 (patient-reports) and 2.9 (caregiver proxies). Among patients with movement difficulty in the past 7 days, mean PROMIS scales t-scores (distribution mean= 50; higher=better) were 40.2 and 39.5 (patient-reports), and 35.6 and 30.1 (caregiver proxies), for mobility and upper extremity functioning. ICCs were very good, ranging from 0.85-0.93 across HRQoL measures. CONCLUSION NF1 PN can have substantial negative impact on pediatric patients, as demonstrated across various HRQoL domains, highlighting the importance of collecting patient-centered outcomes to guide treatment decisions.

scholarly journals An Evaluation of PROMIS Health Domains in Sarcoma Patients Compared to the United States Population

Sarcoma ◽  
2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Benjamin Wilke ◽  
Anna Cooper ◽  
Mark Scarborough ◽  
C. Parker Gibbs ◽  
Andre Spiguel
Keyword(s):  
United States ◽  
General Population ◽  
Physical Function ◽  
The United States ◽  
Successful Outcome ◽  
Measurement Information ◽  
Patient Reported ◽  
The Us ◽  
Health Domains

Background. The Patient Reported Outcomes Measurement Information System (PROMIS) is a patient-directed system that allows comparisons across medical conditions. With this tool, comparisons can now be made between rare conditions, such as sarcomas, and more common ailments, of the United States general population. This allows comparisons between rare conditions, such as sarcomas, to more common ailments, or even the United States (US) general population. Objectives. Our purpose was to use PROMIS to compare outcomes in patients that had undergone resection of a nonmetastatic sarcoma to the US population. Methods. One hundred thirty-eight patients were included in the analysis. These patients were divided into early (<2 years) and late follow-up (>2 years). Results. We evaluated results from seven health domains and found significantly lower scores in the physical function and depression domains. These differences were present in both the early and late cohorts when compared to the US population. Conclusion. While physical function was found to be worse in the sarcoma cohorts, we observed significantly improved levels of depression in these patients when compared to the US population. This finding was maintained over time and is an important reminder that a patient’s goals and desires change following a cancer diagnosis and must be taken into consideration when planning treatment and determining a successful outcome.

scholarly journals Use of Mental Health Apps by Patients With Breast Cancer in the United States: Pilot Pre-Post Study (Preprint)

2019 ◽  
Author(s):  
Philip I Chow ◽  
Shayna L Showalter ◽  
Matthew Gerber ◽  
Erin M Kennedy ◽  
David Brenin ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Mental Health ◽  
Mobile Phone ◽  
The United States ◽  
Cancer Center ◽  
Measurement Information ◽  
Depression And Anxiety ◽  
Health Apps ◽  
Distress Symptoms ◽  
Patient Reported

BACKGROUND Nearly half of the patients with breast cancer experience clinically significant mental distress within the first year of receiving their cancer diagnosis. There is an urgent need to identify scalable and cost-efficient ways of delivering empirically supported mental health interventions to patients with breast cancer. OBJECTIVE The aim of this study was to evaluate the feasibility of in-clinic recruitment for a mobile phone app study and to evaluate the usability and preliminary impact of a suite of mental health apps (IntelliCare) with phone coaching on psychosocial distress symptoms in patients recently diagnosed with breast cancer. METHODS This pilot study adopted a within-subject, 7-week pre-post study design. A total of 40 patients with breast cancer were recruited at a US National Cancer Institute–designated clinical cancer center. Self-reported distress (Patient Health Questionnaire-4) and mood symptoms (Patient-Reported Outcomes Measurement Information System depression and anxiety scales) were assessed at baseline and postintervention. App usability was assessed at postintervention. RESULTS The minimum recruitment threshold was met. There was a significant decrease in general distress symptoms, as well as symptoms of depression and anxiety, from baseline to postintervention. Overall, participants reported high levels of ease of app use and learning. Scores for app usefulness and satisfaction were reinforced by some qualitative feedback suggesting that tailoring the apps more for patients with breast cancer could enhance engagement. CONCLUSIONS There is a dire need for scalable, supportive interventions in cancer. The results from this study inform how scalable mobile phone–delivered programs with additional phone support can be used to support patients with breast cancer. INTERNATIONAL REGISTERED REPORT RR2-10.2196/11452

scholarly journals Performance Evaluation of ANFIS and GA-ANFIS for Predicting Stock Market Indices

2021 ◽  
Vol 13 (7) ◽  
pp. 1
Author(s):  
Farnaz Ghashami ◽  
Kamyar Kamyar
Keyword(s):  
Genetic Algorithm ◽  
Stock Market ◽  
Mean Squared Error ◽  
Fuzzy Inference ◽  
The United States ◽  
Coefficient Of Determination ◽  
Improve Performance ◽  
Inference System ◽  
Squared Error ◽  
Neuro Fuzzy

A model of Adaptive Neuro-Fuzzy Inference System (ANFIS) trained with an evolutionary algorithm, namely Genetic Algorithm (GA) is presented in this paper. Further, the model is tested on the NASDAQ stock market indices which is among the most widely followed indices in the United States. Empirical results show that by determining the parameters of ANFIS (premise and consequent parameters) using GA, we can improve performance in terms of Mean Squared Error (MSE), Root Mean Squared Error (RMSE), coefficient of determination (R-Squared) in comparison with using solely ANFIS.

360 Evaluating Quality of Life and Cost-Effectiveness in Adult Spine Surgery: Prospective Validation of Measurement Tools in a Local Adult Spine Patient Population

Neurosurgery ◽  
2017 ◽  
Vol 64 (CN_suppl_1) ◽  
pp. 283-283
Author(s):  
Julio D Montejo ◽  
Shreyas Panchagnula ◽  
Aria Nouri ◽  
Luis Kolb ◽  
Justin Virojanapa ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cost Effectiveness ◽  
Linear Regression ◽  
Spine Surgery ◽  
Linear Models ◽  
Random Order ◽  
Measurement Information ◽  
Patient Reported ◽  
Adult Spine

Abstract INTRODUCTION Quality of life and cost-effectiveness are important outcome measures in adult spine surgery. The patient-reported outcomes measurement information system (PROMIS) Global Health Scale (GHS) questionnaire is widely utilized but cannot be factored into cost-effectiveness, creating a barrier to improvement. Previous studies have proposed transformations of PROMIS-GHS to EuroQol (EQ-5D-3L) questionnaire data, which can be utilized to assess cost-effectiveness. However, such methods were not developed specifically in adult spine patients and thus may not be valid. METHODS PROMIS-GHS and EQ-5D-3L were administered in random order to 52 consecutive adult spine patients, 46 of which were unambiguously completed and thus included. Demographics were also collected. EQ-5D-3L index values were calculated according to a validated United States value set. Our dataset was randomly partitioned into a training (n = 40) and a testing (n = 6) subset. Linear regression was utilized to develop a transformation and Bland-Altman agreement analysis was utilized to assess comparability between our model, previously reported models, and the observed EQ-5D-3L index values. RESULTS >The average age of our cohort was 60 +/− 14 years (range 21–85), 70% were female, and 95% completed at least high school. Linear regression produced a novel model in which three out of ten PROMIS-GHS items (general health, quality of life, and physical activities) were statistically significant indicators of EQ-5D-3L index values. Bland-Altman agreement analysis between our model, previously reported models, and the observed EQ-5D-3L index values revealed a substantial range of agreement. CONCLUSION To our knowledge, this study represents the first prospective validation study of transformations between PROMIS-GHS and EQ-5D-3L index values in adult spine patients. Our analysis suggests the existence of alternative linear models that appear to demonstrate agreement with previously established models. However, further studies with larger samples sizes are needed.

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