22 results on '"Puhan, Milo A."'
Search Results
2. The German version of the Expanded Prostate Cancer Index Composite (EPIC): translation, validation and minimal important difference estimation
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Umbehr, Martin H., Bachmann, Lucas M., Poyet, Cedric, Hammerer, Peter, Steurer, Johann, Puhan, Milo A., and Frei, Anja
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- 2018
- Full Text
- View/download PDF
3. Patient-reported physical activity questionnaires: A systematic review of content and format
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Williams Kate, Frei Anja, Vetsch Anders, Dobbels Fabienne, Puhan Milo A, and Rüdell Katja
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Physical activity ,Chronic illness ,Patient-reported outcome questionnaires ,Systematic review ,Computer applications to medicine. Medical informatics ,R858-859.7 - Abstract
Abstract Background Many patients with chronic illness are limited in their physical activities. This systematic review evaluates the content and format of patient-reported outcome (PRO) questionnaires that measure physical activity in elderly and chronically ill populations. Methods Questionnaires were identified by a systematic literature search of electronic databases (Medline, Embase, PsychINFO & CINAHL), hand searches (reference sections and PROQOLID database) and expert input. A qualitative analysis was conducted to assess the content and format of the questionnaires and a Venn diagram was produced to illustrate this. Each stage of the review process was conducted by at least two independent reviewers. Results 104 questionnaires fulfilled our criteria. From these, 182 physical activity domains and 1965 items were extracted. Initial qualitative analysis of the domains found 11 categories. Further synthesis of the domains found 4 broad categories: 'physical activity related to general activities and mobility', 'physical activity related to activities of daily living', 'physical activity related to work, social or leisure time activities', and '(disease-specific) symptoms related to physical activity'. The Venn diagram showed that no questionnaires covered all 4 categories and that the '(disease-specific) symptoms related to physical activity' category was often not combined with the other categories. Conclusions A large number of questionnaires with a broad range of physical activity content were identified. Although the content could be broadly organised, there was no consensus on the content and format of physical activity PRO questionnaires in elderly and chronically ill populations. Nevertheless, this systematic review will help investigators to select a physical activity PRO questionnaire that best serves their research question and context.
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- 2012
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4. Discussing study limitations in reports of biomedical studies- the need for more transparency
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Puhan Milo A, Akl Elie A, Bryant Dianne, Xie Feng, Apolone Giovanni, and Riet Gerben
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Computer applications to medicine. Medical informatics ,R858-859.7 - Abstract
Abstract Unbiased and frank discussion of study limitations by authors represents a crucial part of the scientific discourse and progress. In today's culture of publishing many authors or scientific teams probably balance 'utter honesty' when discussing limitations of their research with the risk of being unable to publish their work. Currently, too few papers in the medical literature frankly discuss how limitations could have affected the study findings and interpretations. The goals of this commentary are to review how limitations are currently acknowledged in the medical literature, to discuss the implications of limitations in biomedical studies, and to make suggestions as to how to openly discuss limitations for scientists submitting their papers to journals. This commentary was developed through discussion and logical arguments by the authors who are doing research in the area of hedging (use of language to express uncertainty) and who have extensive experience as authors and editors of biomedical papers. We strongly encourage authors to report on all potentially important limitations that may have affected the quality and interpretation of the evidence being presented. This will not only benefit science but also offers incentives for authors: If not all important limitations are acknowledged readers and reviewers of scientific articles may perceive that the authors were unaware of them. Authors should take advantage of their content knowledge and familiarity with the study to prevent misinterpretations of the limitations by reviewers and readers. Articles discussing limitations help shape the future research agenda and are likely to be cited because they have informed the design and conduct of future studies. Instead of perceiving acknowledgment of limitations negatively, authors, reviewers and editors should recognize the potential of a frank and unbiased discussion of study limitations that should not jeopardize acceptance of manuscripts.
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- 2012
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5. A comprehensive systematic review of the development process of 104 patient-reported outcomes (PROs) for physical activity in chronically ill and elderly people
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Frei Anja, Williams Kate, Vetsch Anders, Dobbels Fabienne, Jacobs Laura, Rüdell Katja, and Puhan Milo A
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Computer applications to medicine. Medical informatics ,R858-859.7 - Abstract
Abstract Background Capturing dimensions of physical activity relevant to patients may provide a unique perspective for clinical studies of chronically ill patients. However, the quality of the development of existing instruments is uncertain. The aim of this systematic review was to assess the development process of patient-reported outcome (PRO) instruments including their initial validation to measure physical activity in chronically ill or elderly patient populations. Methods We conducted a systematic literature search of electronic databases (Medline, Embase, Psychinfo, Cinahl) and hand searches. We included studies describing the original development of fully structured instruments measuring dimensions of physical activity or related constructs in chronically ills or elderly. We broadened the population to elderly because they are likely to share physical activity limitations. At least two reviewers independently conducted title and abstract screening and full text assessment. We evaluated instruments in terms of their aim, items identification and selection, domain development, test-retest reliability, internal consistency, validity and responsiveness. Results Of the 2542 references from the database search and 89 from the hand search, 103 full texts which covered 104 instruments met our inclusion criteria. For almost half of the instruments the authors clearly described the aim of the instruments before the scales were developed. For item identification, patient input was used in 38% of the instruments and in 32% adaptation of existing scales and/or unsystematic literature searches were the only sources for the generation of items. For item reduction, in 56% of the instruments patient input was used and in 33% the item reduction process was not clearly described. Test-retest reliability was assessed for 61%, validity for 85% and responsiveness to change for 19% of the instruments. Conclusions Many PRO instruments exist to measure dimensions of physical activity in chronically ill and elderly patient populations, which reflects the relevance of this outcome. However, the development processes often lacked definitions of the instruments' aims and patient input. If PROs for physical activity were to be used in clinical trials more attention needs to be paid to the establishment of content validity through patient input and to the assessment of their evaluative measurement properties.
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- 2011
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6. Validity of instruments to measure physical activity may be questionable due to a lack of conceptual frameworks: a systematic review
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Dobbels Fabienne, Frei Anja, Gimeno-Santos Elena, Rüdell Katja, Puhan Milo A, and Garcia-Aymerich Judith
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Chronic heart disease ,chronic respiratory disease ,conceptual framework ,elderly ,patient reported outcomes ,physical activity ,questionnaire ,systematic review ,Computer applications to medicine. Medical informatics ,R858-859.7 - Abstract
Abstract Background Guidance documents for the development and validation of patient-reported outcomes (PROs) advise the use of conceptual frameworks, which outline the structure of the concept that a PRO aims to measure. It is unknown whether currently available PROs are based on conceptual frameworks. This study, which was limited to a specific case, had the following aims: (i) to identify conceptual frameworks of physical activity in chronic respiratory patients or similar populations (chronic heart disease patients or the elderly) and (ii) to assess whether the development and validation of PROs to measure physical activity in these populations were based on a conceptual framework of physical activity. Methods Two systematic reviews were conducted through searches of the Medline, Embase, PsycINFO, and Cinahl databases prior to January 2010. Results In the first review, only 2 out of 581 references pertaining to physical activity in the defined populations provided a conceptual framework of physical activity in COPD patients. In the second review, out of 103 studies developing PROs to measure physical activity or related constructs, none were based on a conceptual framework of physical activity. Conclusions These findings raise concerns about how the large body of evidence from studies that use physical activity PRO instruments should be evaluated by health care providers, guideline developers, and regulatory agencies.
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- 2011
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7. Interviewer versus self-administered health-related quality of life questionnaires - Does it matter?
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Ackatz Lori E, Van Natta Mark L, Ahuja Alka, Puhan Milo A, and Meinert Curtis
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AIDS ,quality of life ,questionnaire ,administration ,Computer applications to medicine. Medical informatics ,R858-859.7 - Abstract
Abstract Background Patient-reported outcomes are measured in many epidemiologic studies using self- or interviewer-administered questionnaires. While in some studies differences between these administration formats were observed, other studies did not show statistically significant differences important to patients. Since the evidence about the effect of administration format is inconsistent and mainly available from cross-sectional studies our aim was to assess the effects of different administration formats on repeated measurements of patient-reported outcomes in participants with AIDS enrolled in the Longitudinal Study of Ocular Complications of AIDS. Methods We included participants enrolled in the Longitudinal Study of Ocular Complications in AIDS (LSOCA) who completed the Medical Outcome Study [MOS] -HIV questionnaire, the EuroQol, the Feeling Thermometer and the Visual Function Questionnaire (VFQ) 25 every six months thereafter using self- or interviewer-administration. A large print questionnaire was available for participants with visual impairment. Considering all measurements over time and adjusting for patient and study site characteristics we used linear models to compare HRQL scores (all scores from 0-100) between administration formats. We defined adjusted differences of ≥0.2 standard deviations [SD]) to be quantitatively meaningful. Results We included 2,261 participants (80.6% males) with a median of 43.1 years of age at enrolment who provided data on 23,420 study visits. The self-administered MOS-HIV, Feeling Thermometer and EuroQol were used in 70% of all visits and the VFQ-25 in 80%. For eight domains of the MOS-HIV differences between the interviewer- and self- administered format were < 0.1 SD. Differences in scores were highest for the social and role function domains but the adjusted differences were still < 0.2 SD. There was no quantitatively meaningful difference between administration formats for EuroQol, Feeling Thermometer and VFQ-25 domain scores. For ocular pain (VFQ-25), we found a statistically significant difference of 3.5 (95% CI 0.2, 6.8), which did, however, not exceed 0.2 SD. For all instruments scores were similar for the large and standard print formats with all adjusted differences < 0.2 SD. Conclusions Our large study provides evidence that administration formats do not have a meaningful effect on repeated measurements of patient-reported outcomes. As a consequence, longitudinal studies may not need to consider the effect of different administration formats in their analyses.
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- 2011
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8. Self-efficacy instruments for patients with chronic diseases suffer from methodological limitations - a systematic review
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Steurer-Stey Claudia, Svarin Anna, Frei Anja, and Puhan Milo A
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Computer applications to medicine. Medical informatics ,R858-859.7 - Abstract
Abstract Background Measurement of self-efficacy requires carefully developed and validated instruments. It is currently unclear whether available self-efficacy instruments for chronic diseases fulfill these requirements. Our aim was to systematically identify all existing self-efficacy scales for five major chronic diseases and to assess their development and validation process. Methods We conducted a systematic literature search in electronic databases (MEDLINE, PSYCHINFO, and EMBASE) to identify studies describing the development and/or validation process of self-efficacy instruments for the five chronic diseases diabetes, chronic obstructive pulmonary disease (COPD), asthma, arthritis, and heart failure. Two members of the review team independently selected articles meeting inclusion criteria. The self-efficacy instruments were evaluated in terms of their development (aim of instrument, a priori considerations, identification of items, selection of items, development of domains, answer options) and validation (test-retest reliability, internal consistency reliability, validity, responsiveness) process. Results Of 584 potentially eligible papers we included 25 (13 for diabetes, 5 for asthma, 4 for arthritis, 3 for COPD, 0 for heart failure) which covered 26 different self-efficacy instrument versions. For 8 instruments (30.8%), the authors described the aim before the scales were developed whereas for the other instruments the aim was unclear. In one study (3.8%) a priori considerations were specified. In none of the studies a systematic literature search was carried out to identify items. The item selection process was often not clearly described (38.5%). Test-retest reliability was assessed for 9 instruments (34.6%), validity using a correlational approach for 18 (69.2%), and responsiveness to change for 3 (11.5%) instruments. Conclusion The development and validation process of the majority of the self-efficacy instruments had major limitations. The aim of the instruments was often not specified and for most instruments, not all measurement properties that are important to support the specific aim of the instrument (for example responsiveness for evaluative instruments) were assessed. Researchers who develop and validate self-efficacy instruments should adhere more closely to important methodological concepts for development and validation of patient-reported outcomes and report their methods more transparently. We propose a systematic five step approach for the development and validation of self-efficacy instruments.
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- 2009
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9. The minimal important difference of the hospital anxiety and depression scale in patients with chronic obstructive pulmonary disease
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Büchi Stefan, Frey Martin, Puhan Milo A, and Schünemann Holger J
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Computer applications to medicine. Medical informatics ,R858-859.7 - Abstract
Abstract Background Interpretation of the Hospital Anxiety and Depression Scale (HADS), commonly used to assess anxiety and depression in COPD patients, is unclear. Since its minimal important difference has never been established, our aim was to determine it using several approaches. Methods 88 COPD patients with FEV1 ≤ 50% predicted completed the HADS and other patient-important outcome measures before and after an inpatient respiratory rehabilitation. For the anchor-based approach we determined the correlation between the HADS and the anchors that have an established minimal important difference (Chronic Respiratory Questionnaire [CRQ] and Feeling Thermometer). If correlations were ≥ 0.5 we performed linear regression analyses to predict the minimal important difference from the anchors. As distribution-based approach we used the Effect Size approach. Results Based on CRQ emotional function and mastery domain as well as on total scores, the minimal important difference was 1.41 (95% CI 1.18–1.63) and 1.57 (1.37–1.76) for the HADS anxiety score and 1.68 (1.48–1.87) and 1.60 (1.38–1.82) for the HADS total score. Correlations of the HADS depression score and CRQ domain and Feeling Thermometer scores were < 0.5. Based on the Effect Size approach the MID of the HADS anxiety and depression score was 1.32 and 1.40, respectively. Conclusion The minimal important difference of the HADS is around 1.5 in COPD patients corresponding to a change from baseline of around 20%. It can be used for the planning and interpretation of trials.
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- 2008
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10. Comparing a disease-specific and a generic health-related quality of life instrument in subjects with asthma from the general population
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Rochat Thierry, Ackermann-Liebrich Ursula, Schindler Christian, Bridevaux Pierre-Olivier, Gaspoz Jean-Michel, Puhan Milo A, and Gerbase Margaret W
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Computer applications to medicine. Medical informatics ,R858-859.7 - Abstract
Abstract Background Few epidemiologic studies have assessed health-related quality of life (HRQL) of asthma patients from a general population and it is unclear which instrument is best suitable for this purpose. We investigated the validity of the Asthma Quality of Life Questionnaire (AQLQ) and the SF-36 completed by individuals with asthma from the population-based SAPALDIA (Swiss study on air pollution and lung diseases in adults) cohort. Methods The study included 258 participants with a physician-diagnosed asthma who had completed the AQLQ and SF-36. We assessed floor and ceiling effects, internal consistency reliability and cross-sectional validity with a priori hypotheses that correlations between the specific HRQL domains (e.g. "symptoms" or "physical functioning") and the corresponding external validation measures (respiratory symptoms, need for doctor visits, limitation in activities due to asthma and lung function) would capture similar aspects and be correlated moderately (≥ 0.3) to strongly (≥ 0.5), whereas non-corresponding domains be correlated weakly with each other ( Results The AQLQ showed pronounced ceiling effects with all median domain scores above 6 (scores varied from 1–7). For the SF-36, ceiling effects were present in 5 out of 8 domains. Cronbach's alpha was >0.7 for all AQLQ and SF-36 domains. Correlations between the AQLQ domains "respiratory symptoms", "activity limitation" and "environmental exposure", and the validation measures ranged from 0.29–0.57. Correlations between the "emotional function" domain and the validation measures were also in this range (0.31–0.55) and not as low as we hypothesized. For the SF-36, correlations between "physical functioning" and "role physical", and the validation measures ranged from 0.25–0.56, whereas "role emotional" and "mental health" correlated with these measures from 0.01–0.23. Conclusion The AQLQ and the SF-36 showed fairly good internal consistency. Both instruments are limited by ceiling effects, but they appear less pronounced in the SF-36, which also shows a better discrimination between different aspects of HRQL. The SF-36 may therefore be a more valid measure of HRQL than the AQLQ when applied to individuals with asthma from the general population.
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- 2008
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11. Combining scores from different patient reported outcome measures in meta-analyses: when is it justified?
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Guyatt Gordon H, Soesilo Irene, Puhan Milo A, and Schünemann Holger J
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Computer applications to medicine. Medical informatics ,R858-859.7 - Abstract
Abstract Background Combining outcomes and the use of standardized effect measures such as effect size and standardized response mean across instruments allows more comprehensive meta-analyses and should avoid selection bias. However, such analysis ideally requires that the instruments correlate strongly and that the underlying assumption of similar responsiveness is fulfilled. The aim of the study was to assess the correlation between two widely used health-related quality of life instruments for patients with chronic obstructive pulmonary disease and to compare the instruments' responsiveness on a study level. Methods We systematically identified all longitudinal studies that used both the Chronic Respiratory Questionnaire (CRQ) and the St. George's Respiratory Questionnaire (SGRQ) through electronic searches of MEDLINE, EMBASE, CENTRAL and PubMed. We assessed the correlation between CRQ (scale 1 – 7) and SGRQ (scale 1 – 100) change scores and compared responsiveness of the two instruments by comparing standardized response means (change scores divided by their standard deviation). Results We identified 15 studies with 23 patient groups. CRQ change scores ranged from -0.19 to 1.87 (median 0.35, IQR 0.14–0.68) and from -16.00 to 3.00 (median -3.00, IQR -4.73–0.25) for SGRQ change scores. The correlation between CRQ and SGRQ change scores was 0.88. Standardized response means of the CRQ (median 0.51, IQR 0.19–0.98) were significantly higher (p < 0.001) than for the SGRQ (median 0.26, IQR -0.03–0.40). Conclusion Investigators should be cautious about pooling the results from different instruments in meta-analysis even if they appear to measure similar constructs. Despite high correlation in changes scores, responsiveness of instruments may differ substantially and could lead to important between-study heterogeneity and biased meta-analyses.
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- 2006
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12. Internal consistency reliability is a poor predictor of responsiveness
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Heels-Ansdell Diane, Guyatt Gordon H, Bryant Dianne, Puhan Milo A, and Schünemann Holger J
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Computer applications to medicine. Medical informatics ,R858-859.7 - Abstract
Abstract Background Whether responsiveness represents a measurement property of health-related quality of life (HRQL) instruments that is distinct from reliability and validity is an issue of debate. We addressed the claims of a recent study, which suggested that investigators could rely on internal consistency to reflect instrument responsiveness. Methods 516 patients with chronic obstructive pulmonary disease or knee injury participating in four longitudinal studies completed generic and disease-specific HRQL questionnaires before and after an intervention that impacted on HRQL. We used Pearson correlation coefficients and linear regression to assess the relationship between internal consistency reliability (expressed as Cronbach's alpha), instrument type (generic and disease-specific) and responsiveness (expressed as the standardised response mean, SRM). Results Mean Cronbach's alpha was 0.83 (SD 0.08) and mean SRM was 0.59 (SD 0.33). The correlation between Cronbach's alpha and SRMs was 0.10 (95% CI -0.12 to 0.32) across all studies. Cronbach's alpha alone did not explain variability in SRMs (p = 0.59, r2 = 0.01) whereas the type of instrument was a strong predictor of the SRM (p = 0.012, r2 = 0.37). In multivariable models applied to individual studies Cronbach's alpha consistently failed to predict SRMs (regression coefficients between -0.45 and 1.58, p-values between 0.15 and 0.98) whereas the type of instrument did predict SRMs (regression coefficients between -0.25 to -0.59, p-values between Conclusion Investigators must look to data other than internal consistency reliability to select a responsive instrument for use as an outcome in clinical trials.
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- 2005
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13. Self-administration and interviewer-administration of the German Chronic Respiratory Questionnaire: instrument development and assessment of validity and reliability in two randomised studies
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Lichtenschopf Alfred, Brandli Otto, Grueter Thomas, Frey Martin, Behnke Michaela, Puhan Milo A, Guyatt Gordon H, and Schunemann Holger J
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COPD ,Health Related Quality of Life ,Chronic Respiratory Questionnaire ,Standardisation ,Self-Administration ,Computer applications to medicine. Medical informatics ,R858-859.7 - Abstract
Abstract Background Assessment of health-related quality of life (HRQL) is important in patients with chronic obstructive pulmonary disease (COPD). Despite the high prevalence of COPD in Germany, Switzerland and Austria there is no validated disease-specific instrument available. The objective of this study was to translate the Chronic Respiratory Questionnaire (CRQ), one of the most widely used respiratory HRQL questionnaires, into German, develop an interviewer- and self-administered version including both standardised and individualised dyspnoea questions, and validate these versions in two randomised studies. Methods We recruited three groups of patients with COPD in Switzerland, Germany and Austria. The 44 patients of the first group completed the CRQ during pilot testing to adapt the CRQ to German-speaking patients. We then recruited 80 patients participating in pulmonary rehabilitation programs to assess internal consistency reliability and cross-sectional validity of the CRQ. The third group consisted of 38 patients with stable COPD without an intervention to assess test-retest reliability. To compare the interviewer- and self-administered versions, we randomised patients in groups 2 and 3 to the interviewer- or self-administered CRQ. Patients completed both the standardised and individualised dyspnoea questions. Results For both administration formats and all domains, we found good internal consistency reliability (Crohnbach's alpha between 0.73 and 0.89). Cross-sectional validity tended to be better for the standardised compared to the individualised dyspnoea questions and cross-sectional validity was slightly better for the self-administered format. Test-retest reliability was good for both the interviewer-administered CRQ (intraclass correlation coefficients for different domains between 0.81 and 0.95) and the self-administered format (intraclass correlation coefficients between 0.78 and 0.86). Lower within-person variability was responsible for the higher test-retest reliability of the interviewer-administered format while between person variability was similar for both formats. Conclusions Investigators in German-speaking countries can choose between valid and reliable self-and interviewer-administered CRQ formats.
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- 2004
14. Validity of instruments to measure physical activity may be questionable due to a lack of conceptual frameworks
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Gimeno Santos, Elena, 1980, Frei, Anja, Dobbels, Fabienne, Rüdell, Katja, Puhan, Milo A., García Aymerich, Judith, PROactive consortium, University of Zurich, Garcia-Aymerich, J, and Groningen Research Institute for Asthma and COPD (GRIAC)
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Questionnaires ,DYSPNEA QUESTIONNAIRE PFSDQ ,Applied psychology ,POPULATION-BASED COHORT ,physical activity ,INVENTORY ,Review ,PsycINFO ,patient reported outcomes ,Pulmonary Disease, Chronic Obstructive ,Elderly ,systematic review ,QUALITY-OF-LIFE ,Surveys and Questionnaires ,Outcome Assessment, Health Care ,Health care ,Activities of Daily Living ,Malalties cròniques ,Patient reported outcomes ,SCALE ,General Environmental Science ,Motricitat ,HEALTH-STATUS ,General Medicine ,Chronic respiratory disease ,Systematic review ,FUNCTIONAL STATUS ,Scale (social sciences) ,Chronic heart disease ,lcsh:R858-859.7 ,11035 Institute of General Practice ,medicine.medical_specialty ,Chronic Obstructive ,Heart Diseases ,Psychometrics ,MEDLINE ,610 Medicine & health ,CINAHL ,Motor Activity ,lcsh:Computer applications to medicine. Medical informatics ,elderly ,OBSTRUCTIVE PULMONARY-DISEASE ,VALIDATION ,Pulmonary Disease ,Outcome Assessment (Health Care) ,Physical medicine and rehabilitation ,Quality of life (healthcare) ,Conceptual framework ,Cor -- Malalties ,medicine ,Humans ,business.industry ,Physical activity ,Questionnaire ,questionnaire ,Public Health, Environmental and Occupational Health ,Pulmons -- Malalties ,2739 Public Health, Environmental and Occupational Health ,chronic respiratory disease ,Chronic Disease ,PATIENT-REPORTED OUTCOMES ,General Earth and Planetary Sciences ,conceptual framework ,10029 Clinic and Policlinic for Internal Medicine ,business - Abstract
Background Guidance documents for the development and validation of patient-reported outcomes (PROs) advise the use of conceptual frameworks, which outline the structure of the concept that a PRO aims to measure. It is unknown whether currently available PROs are based on conceptual frameworks. This study, which was limited to a specific case, had the following aims: (i) to identify conceptual frameworks of physical activity in chronic respiratory patients or similar populations (chronic heart disease patients or the elderly) and (ii) to assess whether the development and validation of PROs to measure physical activity in these populations were based on a conceptual framework of physical activity. Methods Two systematic reviews were conducted through searches of the Medline, Embase, PsycINFO, and Cinahl databases prior to January 2010. Results In the first review, only 2 out of 581 references pertaining to physical activity in the defined populations provided a conceptual framework of physical activity in COPD patients. In the second review, out of 103 studies developing PROs to measure physical activity or related constructs, none were based on a conceptual framework of physical activity. Conclusions These findings raise concerns about how the large body of evidence from studies that use physical activity PRO instruments should be evaluated by health care providers, guideline developers, and regulatory agencies.
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- 2011
15. Self-efficacy instruments for patients with chronic diseases suffer from methodological limitations - a systematic review
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Frei, Anja, primary, Svarin, Anna, additional, Steurer-Stey, Claudia, additional, and Puhan, Milo A, additional
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- 2009
- Full Text
- View/download PDF
16. Comparing a disease-specific and a generic health-related quality of life instrument in subjects with asthma from the general population
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Puhan, Milo A, primary, Gaspoz, Jean-Michel, additional, Bridevaux, Pierre-Olivier, additional, Schindler, Christian, additional, Ackermann-Liebrich, Ursula, additional, Rochat, Thierry, additional, and Gerbase, Margaret W, additional
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- 2008
- Full Text
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17. The minimal important difference of the hospital anxiety and depression scale in patients with chronic obstructive pulmonary disease
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Puhan, Milo A, primary, Frey, Martin, additional, Büchi, Stefan, additional, and Schünemann, Holger J, additional
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- 2008
- Full Text
- View/download PDF
18. Combining scores from different patient reported outcome measures in meta-analyses: when is it justified?
- Author
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Puhan, Milo A, primary, Soesilo, Irene, additional, Guyatt, Gordon H, additional, and Schünemann, Holger J, additional
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- 2006
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19. Internal consistency reliability is a poor predictor of responsiveness
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Puhan, Milo A, primary, Bryant, Dianne, additional, Guyatt, Gordon H, additional, Heels-Ansdell, Diane, additional, and Schünemann, Holger J, additional
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- 2005
- Full Text
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20. The minimal important difference of the hospital anxiety and depression scale in patients with chronic obstructive pulmonary disease
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Stefan Büchi, Holger J. Schünemann, Milo A. Puhan, Martin Frey, University of Zurich, and Puhan, Milo A
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medicine.medical_specialty ,medicine.medical_treatment ,media_common.quotation_subject ,610 Medicine & health ,lcsh:Computer applications to medicine. Medical informatics ,Hospital Anxiety and Depression Scale ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Linear regression ,Medicine ,In patient ,030212 general & internal medicine ,Psychiatry ,Depression (differential diagnoses) ,media_common ,Rehabilitation ,business.industry ,Research ,Public Health, Environmental and Occupational Health ,2739 Public Health, Environmental and Occupational Health ,General Medicine ,10057 Klinik für Konsiliarpsychiatrie und Psychosomatik ,030228 respiratory system ,Feeling ,Physical therapy ,lcsh:R858-859.7 ,Anxiety ,10029 Clinic and Policlinic for Internal Medicine ,medicine.symptom ,business - Abstract
Background Interpretation of the Hospital Anxiety and Depression Scale (HADS), commonly used to assess anxiety and depression in COPD patients, is unclear. Since its minimal important difference has never been established, our aim was to determine it using several approaches. Methods 88 COPD patients with FEV1 ≤ 50% predicted completed the HADS and other patient-important outcome measures before and after an inpatient respiratory rehabilitation. For the anchor-based approach we determined the correlation between the HADS and the anchors that have an established minimal important difference (Chronic Respiratory Questionnaire [CRQ] and Feeling Thermometer). If correlations were ≥ 0.5 we performed linear regression analyses to predict the minimal important difference from the anchors. As distribution-based approach we used the Effect Size approach. Results Based on CRQ emotional function and mastery domain as well as on total scores, the minimal important difference was 1.41 (95% CI 1.18–1.63) and 1.57 (1.37–1.76) for the HADS anxiety score and 1.68 (1.48–1.87) and 1.60 (1.38–1.82) for the HADS total score. Correlations of the HADS depression score and CRQ domain and Feeling Thermometer scores were < 0.5. Based on the Effect Size approach the MID of the HADS anxiety and depression score was 1.32 and 1.40, respectively. Conclusion The minimal important difference of the HADS is around 1.5 in COPD patients corresponding to a change from baseline of around 20%. It can be used for the planning and interpretation of trials.
- Full Text
- View/download PDF
21. Interviewer versus self-administered health-related quality of life questionnaires - does it matter?
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Puhan MA, Ahuja A, Van Natta ML, Ackatz LE, and Meinert C
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- Adult, Female, Health Surveys, Humans, Male, Middle Aged, Patient Satisfaction, Sickness Impact Profile, Treatment Outcome, Young Adult, HIV Infections psychology, Health Status, Interviews as Topic methods, Psychometrics instrumentation, Quality of Life, Surveys and Questionnaires standards
- Abstract
Background: Patient-reported outcomes are measured in many epidemiologic studies using self- or interviewer-administered questionnaires. While in some studies differences between these administration formats were observed, other studies did not show statistically significant differences important to patients. Since the evidence about the effect of administration format is inconsistent and mainly available from cross-sectional studies our aim was to assess the effects of different administration formats on repeated measurements of patient-reported outcomes in participants with AIDS enrolled in the Longitudinal Study of Ocular Complications of AIDS., Methods: We included participants enrolled in the Longitudinal Study of Ocular Complications in AIDS (LSOCA) who completed the Medical Outcome Study [MOS] -HIV questionnaire, the EuroQol, the Feeling Thermometer and the Visual Function Questionnaire (VFQ) 25 every six months thereafter using self- or interviewer-administration. A large print questionnaire was available for participants with visual impairment. Considering all measurements over time and adjusting for patient and study site characteristics we used linear models to compare HRQL scores (all scores from 0-100) between administration formats. We defined adjusted differences of ≥0.2 standard deviations [SD]) to be quantitatively meaningful., Results: We included 2,261 participants (80.6% males) with a median of 43.1 years of age at enrollment who provided data on 23,420 study visits. The self-administered MOS-HIV, Feeling Thermometer and EuroQol were used in 70% of all visits and the VFQ-25 in 80%. For eight domains of the MOS-HIV differences between the interviewer- and self- administered format were < 0.1 SD. Differences in scores were highest for the social and role function domains but the adjusted differences were still < 0.2 SD. There was no quantitatively meaningful difference between administration formats for EuroQol, Feeling Thermometer and VFQ-25 domain scores. For ocular pain (VFQ-25), we found a statistically significant difference of 3.5 (95% CI 0.2, 6.8), which did, however, not exceed 0.2 SD. For all instruments scores were similar for the large and standard print formats with all adjusted differences < 0.2 SD., Conclusions: Our large study provides evidence that administration formats do not have a meaningful effect on repeated measurements of patient-reported outcomes. As a consequence, longitudinal studies may not need to consider the effect of different administration formats in their analyses.
- Published
- 2011
- Full Text
- View/download PDF
22. Self-administration and interviewer-administration of the German Chronic Respiratory Questionnaire: instrument development and assessment of validity and reliability in two randomised studies.
- Author
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Puhan MA, Behnke M, Frey M, Grueter T, Brandli O, Lichtenschopf A, Guyatt GH, and Schunemann HJ
- Subjects
- Adult, Aged, Austria, Female, Germany, Humans, Interviews as Topic, Male, Middle Aged, Pilot Projects, Pulmonary Disease, Chronic Obstructive rehabilitation, Switzerland, Translations, Psychometrics instrumentation, Pulmonary Disease, Chronic Obstructive physiopathology, Sickness Impact Profile, Surveys and Questionnaires standards
- Abstract
Background: Assessment of health-related quality of life (HRQL) is important in patients with chronic obstructive pulmonary disease (COPD). Despite the high prevalence of COPD in Germany, Switzerland and Austria there is no validated disease-specific instrument available. The objective of this study was to translate the Chronic Respiratory Questionnaire (CRQ), one of the most widely used respiratory HRQL questionnaires, into German, develop an interviewer- and self-administered version including both standardised and individualised dyspnoea questions, and validate these versions in two randomised studies., Methods: We recruited three groups of patients with COPD in Switzerland, Germany and Austria. The 44 patients of the first group completed the CRQ during pilot testing to adapt the CRQ to German-speaking patients. We then recruited 80 patients participating in pulmonary rehabilitation programs to assess internal consistency reliability and cross-sectional validity of the CRQ. The third group consisted of 38 patients with stable COPD without an intervention to assess test-retest reliability. To compare the interviewer- and self-administered versions, we randomised patients in groups 2 and 3 to the interviewer- or self-administered CRQ. Patients completed both the standardised and individualised dyspnoea questions., Results: For both administration formats and all domains, we found good internal consistency reliability (Crohnbach's alpha between 0.73 and 0.89). Cross-sectional validity tended to be better for the standardised compared to the individualised dyspnoea questions and cross-sectional validity was slightly better for the self-administered format. Test-retest reliability was good for both the interviewer-administered CRQ (intraclass correlation coefficients for different domains between 0.81 and 0.95) and the self-administered format (intraclass correlation coefficients between 0.78 and 0.86). Lower within-person variability was responsible for the higher test-retest reliability of the interviewer-administered format while between person variability was similar for both formats., Conclusions: Investigators in German-speaking countries can choose between valid and reliable self-and interviewer-administered CRQ formats.
- Published
- 2004
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