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18. Mucositis in head and neck cancer: economic and quality-of-life outcomes

Author

Peterman, Amy, Cella, David, Glandon, Gerald, Dobrez, Deborah, and Yount, Susan

Subjects
Oral mucosa -- Injuries, Head and neck cancer -- Care and treatment, Medical care, Cost of -- Analysis, Chemotherapy -- Adverse and side effects, Radiotherapy -- Adverse and side effects, Health
Abstract

Outcomes research typically assesses three major health care outcomes, including quantity of life, quality of life (QOL), and health care cost. This article highlights the impact of treatment-associated mucositis on health care costs and QOL. After a background description of the economic analyses of overall cancer treatment costs and of the incremental costs associated with other treatment side effects, data from a retrospective study of mucositis-specific costs are presented. The second half of this article reviews current knowledge about the effect that mucositis has on QOL. Because the empirical work that specifically evaluates mucositis and QOL is quite limited, studies examining proxies for mucositis grading are described. These include studies comparing the QOL of patients currently undergoing treatment, in which symptoms likely to be associated with mucositis are worse, with that of patients who have completed treatment. Also discussed are investigations examining both the relationship between specific mucositis-associated symptoms, such as pain and difficulty swallowing, and QOL and the weighting of different domains of mucositis-associated problems. Finally, several future research directions are suggested, with the intent of expanding knowledge about the economic and QOL impact of mucositis in patients treated for head and neck cancer.

Published
2001

30. The talking touchscreen: A new approach to outcomes assessment in low literacy

Author

Hahn, Elizabeth A., primary, Cella, David, additional, Dobrez, Deborah, additional, Shiomoto, Gail, additional, Marcus, Elizabeth, additional, Taylor, Samuel G., additional, Vohra, Mala, additional, Chang, Chih‐Hung, additional, Wright, Benjamin D., additional, Linacre, John M., additional, Weiss, Barry D., additional, Valenzuela, Veronica, additional, Chiang, Hsaio‐Lin, additional, and Webster, Kimberly, additional

Published
2003
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32. The talking touchscreen: A new approach to outcomes assessment in low literacy.

Author

Hahn, Elizabeth A., Cella, David, Dobrez, Deborah, Shiomoto, Gail, Marcus, Elizabeth, Taylor, Samuel G., Vohra, Mala, Chih-Hung Chang, Wright, Benjamin D., Linacre, John M., Weiss, Barry D., Valenzuela, Veronica, Hsaio-Lin Chiang, Veronica, and Webster, Kimberly

Subjects
LITERACY, CANCER patients, PATIENTS, MEDICAL innovations, HIGH technology, MEDICINE
Abstract

Purpose . Cancer patients who are deficient in literacy skills are particularly vulnerable to experiencing different outcomes due to disparities in care or barriers to care. Outcomes measurement in low literacy patients may provide new insight into problems previously undetected due to the challenges of completing paper-and-pencil forms. Description of study . A multimedia program was developed to provide a quality of life assessment platform that would be acceptable to patients with varying literacy skills and computer experience. One item at a time is presented on the computer touchscreen, accompanied by a recorded reading of the question. Various colors, fonts and graphic images are used to enhance visibility, and a small picture icon appears near each text element allowing patients to replay the sound as many times as they wish. Evaluation questions are presented to assess patient burden and preferences. Results . An ethnically diverse group of 126 cancer patients with a range of literacy skills and computer experience reported that the ‘talking touchscreen’ (TT) was easy to use, and commented on the usefulness of the multimedia approach. Clinical implications . The TT is a practical, user-friendly data acquisition method that provides greater opportunities to measure self-reported outcomes in patients with a range of literacy skills. Copyright © 2003 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Published
2004
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33. In reply.

Author

Schmitt, Brian P., Dobrez, Deborah, Kyriacou, Demetrois N., and Parada, Jorge

Subjects
*LETTERS to the editor, *ANTHRAX
Abstract

A response by Brian P. Schmitt, Deborah Dobrez and Demetrios N. Kyriacou, among others to a letter to the editor about their article regarding the effect of preattack vaccination against anthrax on the expenditures in certain populations is presented.

Published
2008

34. Quality of life assessment for low literacy Latinos: a new multimedia program for self-administration.

Author

Hahn EA, Cellal D, Dobrez DG, Shiomoto G, Taylor SG, Galvez AG, Diaz P, Valenzuela V, Chiang HL, Khan S, Hudgens SA, and Du H

Subjects
Computer Literacy, Hispanic or Latino education, Humans, Interviews as Topic, Neoplasms psychology, Patient Satisfaction, United States, User-Computer Interface, Hispanic or Latino psychology, Language, Neoplasms ethnology, Quality of Life, Sickness Impact Profile, Surveys and Questionnaires standards
Abstract

Cancer patients who have limited literacy skills or English language proficiency are particularly vulnerable to receiving sub-optimal care. Outcome measurement in these patients may provide new insight into previously undetected problems. This report describes the development and testing of a Spanish language, multimedia program for quality of life (QOL) assessment. Pilot testing was conducted with 30 Latino cancer patients with a range of education levels and computer experience. Patients found the program easy to use and understand. The "Talking Touchscreen" is a practical, user-friendly method that provides greater opportunities to assess QOL in Spanish-speaking patients with a range of literacy skills.

Published
2003

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