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1. Exploring Chronic Pain and Pain Management Perspectives: Qualitative Pilot Analysis of Web-Based Health Community Posts

Author

Claire Harter, Marina Ness, Aleah Goldin, Christine Lee, Christine Merenda, Anne Riberdy, Anindita Saha, Richardae Araojo, and Michelle Tarver

Subjects
Computer applications to medicine. Medical informatics, R858-859.7
Abstract

BackgroundPatient perspectives are central to the US Food and Drug Administration’s benefit-risk decision-making process in the evaluation of medical products. Traditional channels of communication may not be feasible for all patients and consumers. Social media websites have increasingly been recognized by researchers as a means to gain insights into patients’ views about treatment and diagnostic options, the health care system, and their experiences living with their conditions. Consideration of multiple patient perspective data sources offers the Food and Drug Administration the opportunity to capture diverse patient voices and experiences with chronic pain. ObjectiveThis pilot study explores posts from a web-based patient platform to gain insights into the key challenges and barriers to treatment faced by patients with chronic pain and their caregivers. MethodsThis research compiles and analyzes unstructured patient data to draw out the key themes. To extract relevant posts for this study, predefined keywords were identified. Harvested posts were published between January 1, 2017, and October 22, 2019, and had to include #ChronicPain and at least one other relevant disease tag, a relevant chronic pain management tag, or a chronic pain management tag for a treatment or activity specific to chronic pain. ResultsThe most common topics discussed among persons living with chronic pain were related to disease burden, the need for support, advocacy, and proper diagnosis. Patients’ discussions focused on the negative impact chronic pain had on their emotions, playing sports, or exercising, work and school, sleep, social life, and other activities of daily life. The 2 most frequently discussed treatments were opioids or narcotics and devices such as transcutaneous electrical nerve stimulation machines and spinal cord stimulators. ConclusionsSocial listening data may provide valuable insights into patients’ and caregivers’ perspectives, preferences, and unmet needs, especially when conditions may be highly stigmatized.

Published
2023
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3. Integrating 4 Measures to Evaluate Physical Function in Patients with Cancer (In4M): Protocol for a prospective study

Author

Gita Thanarajasingam, Paul Kluetz, Vishal Bhatnagar, Abbie Brown, Elizabeth Cathcart-Rake, Matthew Diamond, Louis Faust, Mallorie Fiero, Scott Huntington, Molly Moore Jeffery, Lee Jones, Brie Noble, Jonas Paludo, Brad Powers, Joseph S. Ross, Jessica Ritchie, Kathryn Ruddy, Sarah Schellhorn, Michelle Tarver, Amylou Dueck, and Cary Gross

Subjects
Article
Abstract

Introduction Accurate, patient-centered evaluation of physical function in patients with cancer can provide important information on the functional impacts experienced by patients both from the disease and its treatment. Increasingly, digital health technology is facilitating and providing new ways to measure symptoms and function. There is a need to characterize the longitudinal measurement characteristics of physical function assessments, including clinician reported physical function (ClinRo), patient-reported physical function (PRO), performance outcome tests (PerfO) and wearable data, to inform regulatory and clinical decision making in cancer clinical trials and oncology practice. Methods and analysis In this prospective study, we are enrolling 200 English- and/or Spanish-speaking patients with breast cancer or lymphoma seen at Mayo Clinic or Yale University who will receive standard of care intravenous cytotoxic chemotherapy. Physical function assessments will be obtained longitudinally using multiple assessment modalities. Participants will be followed for 9 months using a patient-centered health data aggregating platform that consolidates study questionnaires, electronic health record data, and activity and sleep data from a wearable. Data analysis will focus on understanding variability, sensitivity, and meaningful changes across the included physical function assessments and evaluating their relationship to key clinical outcomes. Additionally, the feasibility of multi-modal physical function data collection in real world patients with cancer will be assessed, as will patient impressions of the usability and acceptability of the wearable sensor, data aggregation platform, and PROs. Ethics and dissemination This study has received approval from IRBs at Mayo Clinic, Yale University, and the U.S. Food & Drug Administration. Results will be made available to participants, funders, the research community, and the public.

Published
2023

4. Chronic Pain and Pain Management Posts in an Online Health Community: Qualitative Thematic and Content Analysis (Preprint)

Author

Claire Harter, Marina Ness, Aleah Goldin, Christine Lee, Christine Merenda, Anne Hammer, Anindita Saha, Richardae Araojo, and Michelle Tarver

Abstract

UNSTRUCTURED Patient perspectives are central to the U.S. Food and Drug Administration’s benefit-risk decision-making process in the evaluation of medical products. Traditional channels of communication may not be comfortable for all patients and consumers. Social media websites have increasingly been recognized by researchers as a means to gain insights on patients’ views about treatment and diagnostic options, the healthcare system, and their experiences living with their conditions. Utilizing multiple patient perspective data sources offers the FDA the opportunity to capture diverse patient voices and experiences with chronic pain. To explore diverse patients perspectives, a pilot study was conducted to examine posts from INSPIRE’s own patient platform and several social media platforms to gain insights into the key challenges and barriers faced by chronic pain patients (CPPs). The most common topics discussed among CPPs were disease burden, support and advocacy needs, and proper diagnosis. The two most frequently discussed treatments were opioids or narcotics, and devices such as transcutaneous electrical nerve stimulation (TENS) machines and spinal cord stimulators. Success in pain reduction was tempered by concerns of stigmatization regarding opioid addiction and dependency. The study illustrates how social listening data may provide valuable insights into diverse patient perspectives, preferences, and unmet needs, especially for conditions that may be perceived as stigmatizing.

Published
2022

6. Dissociations of the Fluocinolone Acetonide Implant: The Multicenter Uveitis Steroid Treatment (MUST) Trial and Follow-up Study

Author

Janet T. Holbrook, Elizabeth A. Sugar, Alyce E. Burke, Albert T. Vitale, Jennifer E. Thorne, Janet L. Davis, Douglas A. Jabs, Glenn J. Jaffe, Brenda Branchaud, Paul Hahn, Larry Koreen, Eleonora (Nora) M. Lad, Phoebe Lin, Joseph Nissim Martel, Neha (Shah) Serrano, Cindy Skalak, Lejla Vajzovic, Claxton Baer, Joyce Bryant, Sai Chavala, Michael Cusick, Shelley Day, Pouya Dayani, Justis Ehlers, Muge Kesen, Annie Lee, Alex Melamud, Jawad A. Qureshi, Adrienne Williams Scott, Robert F. See, Robert K. Shuler, Megan Wood, Steven Yeh, Alcides Fernandes, Deborah Gibbs, Donna Leef, Daniel F. Martin, Sunil Srivastava, James P. Dunn, Hosne Begum, Jeff Boring, Kristen L. Brotherson, Bryn Burkholder, Nicholas J. Butler, Dennis Cain, Mary A. Cook, David Emmert, Janis R. Graul, Mark Herring, Ashley Laing, Theresa G. Leung, Michael C. Mahon, Ahmafreza Moradi, Antonia Nwankwo, Trucian L. Ostheimer, Terry Reed, Ellen Arnold, Patricia M. Barnabie, Marie-Lynn Belair, Stephen G. Bolton, Joseph B. Brodine, Diane M. Brown, Lisa M. Brune, Anat Galor, Theresa Gan, Adam Jacobowitz, Meera Kapoor, Sanjay Kedhar, Stephen Kim, Henry A. Leder, Alison G. Livingston, Yavette Morton, Kisten Nolan, George B. Peters, Priscilla Soto, Ricardo Stevenson, Michelle Tarver-Carr, Yue Wang, C. Stephen Foster, Stephen D. Anesi, null Linda Bruner, Olga Ceron, David M. Hinkle, Nancy Persons, Bailey Wentworth, Sarah Acevedo, Fahd Anzaar, Tom Cesca, Angelica Contero, Kayleigh Fitzpatrick, Faith Goronga, Jyothir Johnson, Karina Q. Lebron, Danielle Marvell, Chandra Morgan, Nita Patel, Jennifer Pinto, Sana S. Siddique, Janet Sprague, Taygan Yilmaz, H. Nida Sen, Michael Bono, Denise Cunningham, Darryl Hayes, Dessie Koutsandreas, Robert B. Nussenblatt, Patti R. Sherry, Gregory L. Short, Wendy Smith, Alana Temple, Allison Bamji, Hanna Coleman, Geetaniali Davuluri, Lisa Faia, Chloe Gottlieb, Guy V. Jirawuthiworavong, Julie C. Lew, Richard Mercer, Dominic Obiyor, Cheryl H. Perry, Natalia Potapova, Eric Weichel, Keith J. Wroblewski, Paul A. Latkany, Corinne Coonan, Andrea Honda, Monica Lorenzo-Latkany, Robert Masini, Susan Morell, Angela Nguyen, Jason Badamo, Kenneth M. Boyd, Matthew Enos, Jenny Gallardo, Jacek Jarczynski, Ji Yun Lee, Mirjana McGrosky, Ann Nour, Meredith Sanchez, Kate Steinberg, Richard J. Stawell, Lisa Breayley, Carly D'Sylva, Elizabeth Glatz, Lauren Hodgson, Lyndell Lim, Cecilia Ling, Rachel McIntosh, Julie Morrison (Ewing), Andrew Newton, Sutha Sanmugasundram, Richard Smallwood, Ehud Zamir, Nicola Hunt, Lisa Jones, Ignatios Koukouras, Suzanne Williams, Pauline T. Merrill, Danielle Carns, Len Richine, Denise L. Voskuil-Marre, Kisung Woo, Bruce Gaynes, Christina Giannoulis, Pam Hulvey, Elaine Kernbauer, Heena S. Khan, Sarah J. Levine, Scott Toennessen, Eileen Tonner, Robert C. Wang, Hank Aguado, Sally Arceneaux, Karen Duignan, Gary E. Fish, Nick Hesse, Diana Jaramillo, Michael Mackens, Jean Arnwine, David Callanan, Kimberly Cummings, Keith Gray, Susie Howden, Karin Mutz, Brenda Sanchez, Susan Lightman, Filis Ismetova, Ashley Prytherch, Sophie Seguin-Greenstein, Oren Tomkins, Asat Bar, Kate Edwards, Lavanish Joshi, Jiten Moraji, Ahmed Samy, Timothy Stubbs, Simon Taylor, Hamish Towler, Rebecca Tronnberg, Gary N. Holland, Robert D. Almanzor, Jose Castellanos, Jean Pierre Hubschman, Ann K. Johiro, Alla Kukuyev, Ralph D. Levinson, Colin A. McCannel, Susan S. Ransome, Christine R. Gonzales, Anurag Gupta, Partho S. Kalyani, Michael A. Kapamajian, Peter J. Kappel, Cheryl Arcinue, Janne Chuang, Giulio Barteselli, Glenn Currie, Veronica Mendoza, Debbie Powell, Tom Clark, Denine E. Cochran, William R. Freeman, Joshua Hedaya, Tiara Kemper, Igor Kozak, Jacqueline M. LeMoine, Megan E. Loughran, Luzandra Magana, Francesca Mojana, Victoria Morrison, Vivian Nguyen, Stephen F. Oster, Nisha Acharya, David Clay, Salena Lee, Mary Lew, Todd P. Margolis, Jay Stewart, Ira G. Wong, Debra Brown, Claire M. Khouri, Debra A. Goldstein, Andrea Birnbaum, Andrea Degillio, Gemma De la Rosa, Carmen Ramirez, Evica Simjanowski, Mariner Skelly, Anna L. Castro-Malek, Catherine E. Crooke, Melody Huntley, Katrina Nash, Marcia Niec, Dimitry Pyatetsky, Misel Ramirez, Zuzanna Rozenbajgier, Howard H. Tessler, Thomas A. Albini, Marie Chin, Daniela Castaño, Ariana Elizondo, Macy Ho, Jaclyn L. Kovach, Richard C-S. Lin, Efrem Mandelcorn, Jackie K-D. Nguyen, Aura Pacini, Susan Pineda, David A. Pinto, Jose Rebimbas, Kimberly E. Stepien, Claudia Teran, Susan G. Elner, Hillary Bernard, Linda Fournier, Lindsay Godsey, Linda Goings, Richard Hackel, Moella Hesselgrave, K. Thiran Jayasundera, Robert Prusak, Pamela Titus, Melissa Bergeron, Reneé Blosser, Rebecca Brown, Carrie Chrisman-McClure, Julie R. Gothrup, Stephen J. Saxe, Deanna Sizemore, John H. Kempen, James Berger, Sheri Drossner, Joan C. DuPont, Albert M. Maguire, Janice Petner, Stephanie Engelhard, Tim Hopkins, Dawn McCall, Monique McRay, Daniel Will, Wei Xu, Jonathan Lo, Rebecca Salvo, Elizabeth Windsor, Laurel Weeney, Peter R. Pavan, Ken Albritton, JoAnn Leto, Brian Madow, Lori Mayor, Scott E. Pautler, Wyatt Saxon, Judy Soto, Burton Goldstein, Amy Klukoff, Lucy Lambright, Kim McDonald, Maria Ortiz, Susan Scymanky, Dee Dee Szalay, Narsing Rao, Tamara Davis, Jackie Douglass, Judith Linton, Margaret Padilla, Sylvia Ramos, Alexia Aguirre, Lawrence Chong, Lupe Cisneros, Elizabeth Corona, Dean Eliott, Amani Fawzi, Jesse Garcia, Rahul Khurana, Jennifer Lim, Rachel Mead, Julie H. Tsai, Albert Vitale, Paul S. Bernstein, Bonnie Carlstrom, James Gilman, Sandra Hanseen, Paula Morris, Diana Ramirez, Kimberley Wegner, John D. Sheppard, Brianne Anthony, Amber Casper, Lisa Felix-Kent, Jeanette Fernandez, Tari Johnson, Stephen V. Scoper, R. Denise Cole, Nancy Crawford, Lisa Franklin, Krista Hamelin, Jen Martin, Rebecca Marx, Gregory Schultz, Joseph Webb, Pamela Yeager, Rosa Y. Kim, Matthew S. Benz, David M. Brown, Eric Chen, Richard H. Fish, Eric Kegley, Laura Shawver, Tien P. Wong, Rebecca De La Garza, Shayla Friday (Hay), P. Kumar Rao, Eve Adcock, Rajendra S. Apte, Amy Baladenski, Rhonda Curtis, Sarah Gould, Amanda Hebden, Jamie Kambarian, Charla Meyer, Sam Pistorius, Melanie Quinn, Greg Rathert, Kevin J. Blinder, Ashley Hartz, Pam Light, Gaurav K. Shah, Russell VanGelder, Michael M. Altaweel, Natalie Kurinij, Diane Brown, Nancy Prusakowski, Larry Hubbard, Janet Wittes, William E. Barlow, Marc Hochberg, Alice T. Lyon, Alan G. Palestine, Lee S. Simon, James T. Rosenbaum, Harmon Smith, Janet Davis, Jennifer Thorne, Nisha R. Acharya, Jeffrey A. Boring, Judith Alexander, Wai Ping Ng, David S. Friedman, Anna Adler, Alyce Burke, Joanne Katz, Susan Reed, Husam Ansari, Nicholas Cohen, Sanjukta Modak, Lea T. Drye, Mark L. Van Natta, Kevin Frick, Thomas A. Louis, David Shade, Karen Pascual, Jill S. Slutsky-Sanon, Colby Glomp, Melissa A. Nieves, Maria Stevens, Amanda Allen, Yasmin Hilal, Francis Abreu, Anne Shanklin Casper, Cathleen Ewing, Adante Hart, Andrea Lears, Shirley Li, Jill Meinert, Vinnette Morrison, Deborah Nowakowski, Girlie Reyes, Dave M. Shade, Jacqueline Smith, Karen Steuernagle, Mark Van Natta, Vidya Venugopal, Tsung Yu, Paul Chen, Karen Collins, John Dodge, Kevin D. Frick, Rosetta Jackson, Christian Jimenez, Ariel Landers, Hope Livingston, Curtis L. Meinert, Sobharani Rayapudi, Weijiang Shen, Charles Shiflett, Rochelle Smith, Ada Tieman, James A. Tonascia, Richard Zheng, James Allan, Wendy K. Benz, Amitha Domalpally, Kristine A. Johnson, Dawn J. Myers, Jeong Won Pak, James L. Reimers, Debra J. Christianson, Geoffrey Chambers, Margaret A. Fleischli, Jacquelyn Freund, Kathleen E. Glander, Anne Goulding, Vonnie Gama, Sapna Gangaputra, Dennis Hafford, Susan E. Harris, Larry D. Hubbard, Jeffrey M. Joyce, Christina N. Kruse, Lauren Nagle, Amy Remm, Gwyn E. Padden-Lechten, Alyson Pohlman, Ruth A. Shaw, Peggy Sivesind, Dennis Thayer, Erika Treichel, Kelly J. Warren, Sheila M. Watson, Mary K. Webster, James K. White, Tara Wilhelmson, and Grace Zhang

Subjects
Adult, Male, Reoperation, medicine.medical_specialty, Time Factors, Dissociation (neuropsychology), Visual acuity, Adolescent, genetic structures, Visual Acuity, Article, law.invention, Uveitis, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Foreign-Body Migration, Randomized controlled trial, Fluocinolone acetonide, Risk Factors, law, medicine, Humans, Glucocorticoids, Aged, Aged, 80 and over, Drug Implants, business.industry, 030503 health policy & services, Middle Aged, medicine.disease, Confidence interval, Surgery, Ophthalmology, Steroid therapy, Fluocinolone Acetonide, Anesthesia, Intravitreal Injections, 030221 ophthalmology & optometry, Equipment Failure, Female, Implant, medicine.symptom, 0305 other medical science, business, Follow-Up Studies, medicine.drug
Abstract

To describe fluocinolone acetonide implant dissociations in the Multicenter Uveitis Steroid Treatment (MUST) Trial.Randomized clinical trial with extended follow-up.Review of data collected on the first implant in the eye(s) of participants. Dissociation was defined as the drug pellet no longer being affixed to the strut and categorized as spontaneous or surgically related.A total of 250 eyes (146 patients) had at least 1 implant placed. Median follow-up time after implant placement was 6 years (range 0.5-9.2 years). Thirty-four dissociations were reported in 30 participants. There were 22 spontaneous events in 22 participants; 6-year cumulative risk of a spontaneous dissociation was 4.8% (95% confidence interval [CI]: 2.4%-9.1%). The earliest event occurred 4.8 years after placement. Nine of 22 eyes with data had a decline in visual acuity ≥5 letters temporally related to the dissociation. Thirty-nine implant removal surgeries were performed, 33 with replacement. Twelve dissociations were noted during implant removal surgeries in 10 participants (26%, 95% CI 15%-48%); 5 of these eyes had a decline in visual acuity ≥5 letters after surgery. The time from implant placement to removal surgery was longer for the surgeries at which dissociated implants were identified than for those without one (5.7 vs 3.7 years, P.001). Overall, visual acuity declined 15 or more letters from pre-implant values in 22% of affected eyes; declines were frequently associated with complications of uveitis or its treatment.There is an increasing risk of dissociation of Retisert implants during follow-up; the risk is greater with removal/exchange surgeries, but the risk of both spontaneous and surgically related events increases with longevity of the implants. In 22% of affected eyes visual acuity declined by 15 letters. In the context of eyes with moderate to severe uveitis for years, this rate is not unexpected.

Published
2016

7. Factors Predicting Visual Acuity Outcome in Intermediate, Posterior, and Panuveitis: The Multicenter Uveitis Steroid Treatment (MUST) Trial

Author

John H. Kempen, Mark L. Van Natta, Michael M. Altaweel, James P. Dunn, Douglas A. Jabs, Susan L. Lightman, Jennifer E. Thorne, Janet T. Holbrook, Glenn J. Jaffe, Brenda Branchaud, Paul Hahn, Larry Koreen, Eleonora (Nora) M. Lad, Phoebe Lin, Joseph Nissim Martel, Neha (Shah) Serrano, Cindy Skalak, Lejla Vajzovic, Claxton Baer, Joyce Bryant, Sai Chavala, Michael Cusick, Shelley Day, Pouya Dayani, Justis Ehlers, Muge Kesen, Annie Lee, Alex Melamud, Jawad A. Qureshi, Adrienne Williams Scott, Robert F. See, Robert K. Shuler, Megan Wood, Steven Yeh, Alcides Fernandes, Deborah Gibbs, Donna Leef, Daniel F. Martin, Sunil Srivastava, Hosne Begum, Jeff Boring, Kristen L. Brotherson, Bryn Burkholder, Nicholas J. Butler, Dennis Cain, Mary A. Cook, David Emmert, Janis R. Graul, Mark Herring, Ashley Laing, Theresa G. Leung, Michael C. Mahon, Ahmafreza Moradi, Antonia Nwankwo, Trucian L. Ostheimer, Terry Reed, Ellen Arnold, Patricia M. Barnabie, Marie-Lynn Belair, Stephen G. Bolton, Joseph B. Brodine, Diane M. Brown, Lisa M. Brune, Anat Galor, Theresa Gan, Adam Jacobowitz, Meera Kapoor, Sanjay Kedhar, Stephen Kim, Henry A. Leder, Alison G. Livingston, Yavette Morton, Kisten Nolan, George B. Peters, Priscilla Soto, Ricardo Stevenson, Michelle Tarver-Carr, Yue Wang, C. Stephen Foster, Stephen D. Anesi, Linda Bruner, Olga Ceron, David M. Hinkle, Nancy Persons, Bailey Wentworth, Sarah Acevedo, Fahd Anzaar, Tom Cesca, Angelica Contero, Kayleigh Fitzpatrick, Faith Goronga, Jyothir Johnson, Karina Q. Lebron, Danielle Marvell, Chandra Morgan, Nita Patel, Jennifer Pinto, Sana S. Siddique, Janet Sprague, Taygan Yilmaz, H. Nida Sen, Michael Bono, Denise Cunningham, Darryl Hayes, Dessie Koutsandreas, Robert B. Nussenblatt, Patti R. Sherry, Gregory L. Short, Wendy Smith, Alana Temple, Allison Bamji, Hanna Coleman, Geetaniali Davuluri, Lisa Faia, Chloe Gottlieb, Guy V. Jirawuthiworavong, Julie C. Lew, Richard Mercer, Dominic Obiyor, Cheryl H. Perry, Natalia Potapova, Eric Weichel, Keith J. Wroblewski, Paul A. Latkany, Corinne Coonan, Andrea Honda, Monica Lorenzo-Latkany, Robert Masini, Susan Morell, Angela Nguyen, Jason Badamo, Kenneth M. Boyd, Matthew Enos, Jenny Gallardo, Jacek Jarczynski, Ji Yun Lee, Mirjana McGrosky, Ann Nour, Meredith Sanchez, Kate Steinberg, Richard J. Stawell, Lisa Breayley, Carly D'Sylva, Elizabeth Glatz, Lauren Hodgson, Lyndell Lim, Cecilia Ling, Rachel McIntosh, Julie Morrison (Ewing), Andrew Newton, Sutha Sanmugasundram, Richard Smallwood, Ehud Zamir, Nicola Hunt, Lisa Jones, Ignatios Koukouras, Suzanne Williams, Pauline T. Merrill, Danielle Carns, Len Richine, Denise L. Voskuil-Marre, Kisung Woo, Bruce Gaynes, Christina Giannoulis, Pam Hulvey, Elaine Kernbauer, Heena S. Khan, Sarah J. Levine, Scott Toennessen, Eileen Tonner, Robert C. Wang, Hank Aguado, Sally Arceneaux, Karen Duignan, Gary E. Fish, Nick Hesse, Diana Jaramillo, Michael Mackens, Jean Arnwine, David Callanan, Kimberly Cummings, Keith Gray, Susie Howden, Karin Mutz, Brenda Sanchez, Susan Lightman, Filis Ismetova, Ashley Prytherch, Sophie Seguin-Greenstein, Oren Tomkins, Asat Bar, Kate Edwards, Lavanish Joshi, Jiten Moraji, Ahmed Samy, Timothy Stubbs, Simon Taylor, Hamish Towler, Rebecca Tronnberg, Gary N. Holland, Robert D. Almanzor, Jose Castellanos, Jean Pierre Hubschman, Ann K. Johiro, Alla Kukuyev, Ralph D. Levinson, Colin A. McCannel, Susan S. Ransome, Christine R. Gonzales, Anurag Gupta, Partho S. Kalyani, Michael A. Kapamajian, Peter J. Kappel, Cheryl Arcinue, Janne Chuang, Giulio Barteselli, Glenn Currie, Veronica Mendoza, Debbie Powell, Tom Clark, Denine E. Cochran, William R. Freeman, Joshua Hedaya, Tiara Kemper, Igor Kozak, Jacqueline M. LeMoine, Megan E. Loughran, Luzandra Magana, Francesca Mojana, Victoria Morrison, Vivian Nguyen, Stephen F. Oster, Nisha Acharya, David Clay, Salena Lee, Mary Lew, Todd P. Margolis, Jay Stewart, Ira G. Wong, Debra Brown, Claire M. Khouri, Debra A. Goldstein, Andrea Birnbaum, Andrea Degillio, Gemma De la Rosa, Carmen Ramirez, Evica Simjanowski, Mariner Skelly, Anna L. Castro-Malek, Catherine E. Crooke, Melody Huntley, Katrina Nash, Marcia Niec, Dimitry Pyatetsky, Misel Ramirez, Zuzanna Rozenbajgier, Howard H. Tessler, Janet L. Davis, Thomas A. Albini, Marie Chin, Daniela Castaño, Ariana Elizondo, Macy Ho, Jaclyn L. Kovach, Richard C-S. Lin, Efrem Mandelcorn, Jackie K-D. Nguyen, Aura Pacini, Susan Pineda, David A. Pinto, Jose Rebimbas, Kimberly E. Stepien, Claudia Teran, Susan G. Elner, Hillary Bernard, Linda Fournier, Lindsay Godsey, Linda Goings, Richard Hackel, Moella Hesselgrave, K. Thiran Jayasundera, Robert Prusak, Pamela Titus, Melissa Bergeron, Reneé Blosser, Rebecca Brown, Carrie Chrisman-McClure, Julie R. Gothrup, Stephen J. Saxe, Deanna Sizemore, James Berger, Sheri Drossner, Joan C. DuPont, Albert M. Maguire, Janice Petner, Stephanie Engelhard, Tim Hopkins, Jonathan Lo, Dawn McCall, Monique McRay, Rebecca Salvo, Daniel Will, Wei Xu, Elizabeth Windsor, Laurel Weeney, Peter R. Pavan, Ken Albritton, JoAnn Leto, Brian Madow, Lori Mayor, Scott E. Pautler, Wyatt Saxon, Judy Soto, Burton Goldstein, Amy Klukoff, Lucy Lambright, Kim McDonald, Maria Ortiz, Susan Scymanky, Dee Dee Szalay, Narsing Rao, Tamara Davis, Jackie Douglass, Judith Linton, Margaret Padilla, Sylvia Ramos, Narsing A. Rao, Alexia Aguirre, Lawrence Chong, Lupe Cisneros, Elizabeth Corona, Dean Eliott, Amani Fawzi, Jesse Garcia, Rahul Khurana, Jennifer Lim, Rachel Mead, Julie H. Tsai, Albert Vitale, Paul S. Bernstein, Bonnie Carlstrom, James Gilman, Sandra Hanseen, Paula Morris, Diana Ramirez, Kimberley Wegner, John D. Sheppard, Brianne Anthony, Amber Casper, Lisa Felix-Kent, Jeanette Fernandez, Tari Johnson, Stephen V. Scoper, R. Denise Cole, Nancy Crawford, Lisa Franklin, Krista Hamelin, Jen Martin, Rebecca Marx, Gregory Schultz, Joseph Webb, Pamela Yeager, Rosa Y. Kim, Matthew S. Benz, David M. Brown, Eric Chen, Richard H. Fish, Eric Kegley, Laura Shawver, Tien P. Wong, Rebecca De La Garza, Shayla Friday (Hay), P. Kumar Rao, Eve Adcock, Rajendra S. Apte, Amy Baladenski, Rhonda Curtis, Sarah Gould, Amanda Hebden, Jamie Kambarian, Charla Meyer, Sam Pistorius, Melanie Quinn, Greg Rathert, Kevin J. Blinder, Ashley Hartz, Pam Light, Gaurav K. Shah, Russell VanGelder, Natalie Kurinij, Diane Brown, Nancy Prusakowski, Larry Hubbard, Janet Wittes, William E. Barlow, Marc Hochberg, Alice T. Lyon, Alan G. Palestine, Lee S. Simon, James T. Rosenbaum, Harmon Smith, Janet Davis, Jennifer Thorne, Nisha R. Acharya, Albert T. Vitale, Jeffrey A. Boring, Judith Alexander, Wai Ping Ng, David S. Friedman, Anna Adler, Alyce Burke, Joanne Katz, Susan Reed, Husam Ansari, Nicholas Cohen, Sanjukta Modak, Elizabeth A. Sugar, Alyce E. Burke, Lea T. Drye, Kevin Frick, JoAnn Katz, Thomas A. Louis, David Shade, Karen Pascual, Jill S. Slutsky-Sanon, Amanda Allen, Colby Glomp, Yasmin Hilal, Melissa A. Nieves, Maria Stevens, Francis Abreu, Anne Shanklin Casper, Cathleen Ewing, Adante Hart, Andrea Lears, Shirley Li, Jill Meinert, Vinnette Morrison, Deborah Nowakowski, Girlie Reyes, Dave M. Shade, Jacqueline Smith, Karen Steuernagle, Mark Van Natta, Vidya Venugopal, Tsung Yu, Paul Chen, Karen Collins, John Dodge, Kevin D. Frick, Rosetta Jackson, Christian Jimenez, Ariel Landers, Hope Livingston, Curtis L. Meinert, Sobharani Rayapudi, Weijiang Shen, Charles Shiflett, Rochelle Smith, Ada Tieman, James A. Tonascia, Richard Zheng, James Allan, Wendy K. Benz, Amitha Domalpally, Kristine A. Johnson, Dawn J. Myers, Jeong Won Pak, James L. Reimers, Geoffrey Chambers, Debra J. Christianson, Margaret A. Fleischli, Jacquelyn Freund, Vonnie Gama, Sapna Gangaputra, Kathleen E. Glander, Anne Goulding, Dennis Hafford, Susan E. Harris, Larry D. Hubbard, Jeffrey M. Joyce, Christina N. Kruse, Lauren Nagle, Gwyn E. Padden-Lechten, Alyson Pohlman, Amy Remm, Ruth A. Shaw, Peggy Sivesind, Dennis Thayer, Erika Treichel, Kelly J. Warren, Sheila M. Watson, Mary K. Webster, James K. White, Tara Wilhelmson, and Grace Zhang

Subjects
Male, medicine.medical_specialty, Time Factors, Triamcinolone acetonide, Visual acuity, genetic structures, Visual Acuity, Article, law.invention, Fluocinolone acetonide, Randomized controlled trial, law, Ophthalmology, Panuveitis, medicine, Humans, Glucocorticoids, Macular edema, Aged, Drug Implants, business.industry, Middle Aged, medicine.disease, eye diseases, Treatment Outcome, Female, sense organs, medicine.symptom, business, Tomography, Optical Coherence, Uveitis, Follow-Up Studies, medicine.drug, Cohort study
Abstract

To identify factors associated with best-corrected visual acuity (BCVA) presentation and 2-year outcome in 479 intermediate, posterior, and panuveitic eyes.Cohort study using randomized controlled trial data.Multicenter Uveitis Steroid Treatment (MUST) Trial masked BCVA measurements at baseline and at 2 years follow-up used gold-standard methods. Twenty-three clinical centers documented characteristics per protocol, which were evaluated as potential predictive factors for baseline BCVA and 2-year change in BCVA.Baseline factors significantly associated with reduced BCVA included age ≥50 vs50 years; posterior vs intermediate uveitis; uveitis duration10 vs6 years; anterior chamber (AC) flaregrade 0; cataract; macular thickening; and exudative retinal detachment. Over 2 years, eyes better than 20/50 and 20/50 or worse at baseline improved, on average, by 1 letter (P = .52) and 10 letters (P.001), respectively. Both treatment groups and all sites of uveitis improved similarly. Factors associated with improved BCVA included resolution of active AC cells, resolution of macular thickening, and cataract surgery in an initially cataractous eye. Factors associated with worsening BCVA included longer duration of uveitis (6-10 or10 vs6 years), incident AC flare, cataract at both baseline and follow-up, pseudophakia at baseline, persistence or incidence of vitreous haze, and incidence of macular thickening.Intermediate, posterior, and panuveitis have a similarly favorable prognosis with both systemic and fluocinolone acetonide implant treatment. Eyes with more prolonged/severe inflammatory damage and/or inflammatory findings initially or during follow-up have a worse visual acuity prognosis. The results indicate the value of implementing best practices in managing inflammation.

Published
2015

8. List of Contributors

Author

Juan-Carlos Abad, Mark B Abelson, David H Abramson, Martin A Acquadro, Anthony P Adamis, Wesley H Adams, Natalie A Afshari, Everett Ai, Lloyd M Aiello, Lloyd P Aiello, Levent Akduman, Marissa L Albano, Daniel M. Albert, Terry J Alexandrou, Eduardo C Alfonso, Jorge L Alié, Hassan Alizadeh, Ibrahim A Al Jadaan, Sabah Al-Jastaneiah, Calliope E Allen, David Allen, Robert C Allen, Albert Alm, Samar Al-Swailem, Abigail K Alt, Michael M Altaweel, Russell Anderson, Christopher M Andreoli, Sofia Androudi, Leonard PK Ang, Fahd Anzaar, David J Apple, Claudia A Arrigg, Pablo Artal, Penny Asbell, George K Asdourian, Neal Atebara, Pelin Atmaca-Sonmez, Isabelle Audo, Gerd U Auffarth, Robin K Avery, Dimitri T Azar, Ann S Baker, Mark Balles, Scott D Barnes, Donald M Barnett, Neal P Barney, Fina C Barouch, George B Bartley, Jason JS Barton, Irmgard Behlau, Jose I Belda, Jeffrey L Bennett, Timothy J Bennett, Gregg J Berdy, Carlo Roberto Bernardino, Vitaliano Bernardino, Eliot L Berson, Amitabh Bharadwaj, Robert Bhisitkul, Ravinder D Bhui, Jurij Bilyk, Valérie Biousse, Alan C Bird, Norman Paul Blair, Barbara A Blodi, Mark S Blumenkranz, H Culver Boldt, Mark S Borchert, Luigi Borrillo, Gary E Borodic, S Arthur Boruchoff, Swaraj Bose, Michael E Boulton, RW Bowman, Elizabeth A Bradley, Periklis D Brazitikos, Robert Breeze, Neil M Bressler, Susan B Bressler, Alfred Brini, Donald L Budenz, Angela N Buffenn, Scott E Burk, Salim Butrus, David Callanan, J Douglas Cameron, Louis B Cantor, William A Cantore, Jorge Cantu-Dibildox, Victoria Casas, Miriam Casper, Robin J Casten, Yara P Catoira, Jerry Cavallerano, Samantha J Chai, Maria R Chalita, Sherman M Chamberlain, Audrey S Chan, Chi-Chao Chan, Paul Chan, Matthew J Chapin, Karen L Chapman, Eric Chen, Joe Chen, Julie A Chen, Teresa C Chen, Zhou Chen, Patricia Chévez-Barrios, Emily Y Chew, Mark Chiang, James Chodosh, Eva-Marie Chong, Denise Chun, Leo T Chylack, Antonio P Ciardella, Mortimer Civan, Liane Clamen, John I Clark, Glenn Cockerham, Andre Cohen, Elisabeth J Cohen, Kathryn A Colby, Anne L Coleman, Hanna R Coleman, Joseph Colin, J Michael Collier, Grant M Comer, M Ronan Conlon, Kim E Cooper, James J Corbett, Miguel C Coma, Marshall N Cyrlin, Linda R Dagi, Matthew A Dahlgren, Timothy J Daley, Andrea P Da Mata, Bertil Damato, Donald J D'Amico, Reza Dana, Aude Danan-Husson, Helen B Danesh-Meyer, Ronald P Danis, Jason K Darlington, Stefanie L Davidson, Janet L Davis, Elizabeth A Davis, Jose J de la Cruz, Adam G de la Garza, Margaret M DeAngelis, Sheri L DeMartelaere, Joseph L Demer, Avninder Dhaliwal, J Paul Dieckert, Diana V Do, Marshall G Doane, Christopher Dodds, Claes H Dohlman, Guy Donati, Eric D Donnenfeld, Arlene Drack, Thaddeus P Dryja, David Dueker, Jay S Duker, Jennifer A Dunbar, James P Dunn, William J Dupps, Marlene L Durand, Jonathan J Dutton, Chiara M Eandi, Deepak P Edward, Robert A Egan, David A Eichenbaum, Susan E Eklund, Elizabeth C Engle, Kristine Erickson, Bita Esmaeli, Aaron Fay, Leonard Feiner, Sharon Fekrat, Frederick L Ferris, Howard F Fine, Donald C Fletcher, Paul Flikier, Richard P Floyd, Harry W Flynn, Donald S Fong, Ramon L Font, Brian JR Forbes, Rod Foroozan, Bradley S Foster, C Stephen Foster, Jill A Foster, Gary N Foulks, Tamara R Fountain, Gregory M Fox, Thomas F Freddo, Sharon F Freedman, K Bailey Freund, Thomas R Friberg, Alan H Friedman, David Friedman, Deborah I Friedman, Ephraim Friedman, Arthur D Fu, Anne B Fulton, Ahmed Galal, Steven Galetta, Mark Gallardo, Brenda Gallie, Alec Garner, James A Garrity, Damien Gatinel, Steven J Gedde, Craig E Geist, Steve Gerber, Ramon C Ghanem, Jon P Gieser, Michael S Gilmore, Howard V Gimbel, Ilene K Gipson, Tyrone Glover, Robert A Goldberg, Mordechai Goldenfeld, Scott M Goldstein, Cintia F Gomi, Haiyan Gong, John A Gonzales, John Goosey, Justin L Gottlieb, Joshua Gould, Evangelos S Gragoudas, David B Granet, Michael J Greaney, Daniel G Green, Franz Grehn, Jack V Greiner, Craig M Greven, Gregory J Griepentrog, Carl Groenewald, Cynthia L Grosskreutz, Lori Latowski Grover, Vamsi K Gullapalli, Padma Gulur, Jonathan Gunther, Manish Gupta, Mayank Gupta, David R Guyer, Darin R Haivala, Julia A Haller, GM Halmagyi, Lawrence S Halperin, Islam M Hamdi, Steven R Hamilton, Kristin M Hammersmith, Dennis P Han, Ronald M Hansen, J William Harbour, Seenu M Hariprasad, Mona Harissi-Dagher, Shirin E. Hassan, Mark P Hatton, Pamela Hawley, Yasutaka Hayashida, John R Heckenlively, Thomas R Hedges, Alfred D Heggie, Katrinka L Heher, Jeffrey S Heier, J Fielding Hejtmancik, Bonnie A Henderson, Peter S Hersh, Ahmed A Hidayat, Eva Juliet Higginbotham, Tatsuo Hirose, Allen C Ho, ThucAnh T Ho, R Nick Hogan, David E Holck, Nancy M Holekamp, Peter G Hovland, Thomas C Hsu, William C Hsu, Andrew JW Huang, Mark S Hughes, Jennifer Hui, David G Hunter, Laryssa A Huryn, Deeba Husain, Robert A Hyndiuk, Michael Ip, Brian J Jacobs, Frederick A Jakobiec, Lee M Jampol, Harold G Jensen, Fei Ji, David L Johnson, Douglas H Johnson, Mark W Johnson, R Paul Johnson, Robert N Johnson, Karen M Joos, Nancy C Joyce, J Michael Jumper, Ula V. Jurkunas, Alon Kahana, Malik Y Kahook, Elliott Kanner, Kevin Kalwerisky, Henry J Kaplan, Ekaterini C Karatza, Randy Kardon, James A Katowitz, William R Katowitz, Melanie Kazlas, Kelly S Keefe, Lara Kelley, Charles J Kent, Kenneth R Kenyon, Bilal F Khan, Jemshed A Khan, Naheed W Khan, Peng Tee Khaw, Femida Kherani, Eva C Kim, Hee Joon Kim, Ivana K Kim, Jonathan W Kim, Rosa Y Kim, Stella K Kim, Tae-Im Kim, Christina M Klais, Stephen R Klapper, Barbara EK Klein, Guy Kleinmann, Thomas Klink, Dino D Klisovic, Stephen D Klyce, Tolga Kocaturk, Thomas Kohnen, Takeshi Kojima, Tobias Koller, David A Kostick, Joel A Kraut, Chandrasekharan Krishnan, Ronald R Krueger, Joseph H Krug, Sara Krupsky, Rachel W Kuchtey, Ramsay S Kurban, Paul A Kurz, JR Kuszak, Young H Kwon, Thad A Labbe, Deborah L Lam, Jeffrey C Lamkin, Kathleen A Lamping, Anne Marie Lane, Katherine A Lane, Keith J Lane, Jonathan H Lass, Mary G Lawrence, Andrew G Lee, Carol M Lee, Michael S Lee, Paul P Lee, William B Lee, Igal Leibovitch, Bradley N Lemke, Craig A Lemley, Andrea Leonardi, Simmons Lessell, Leonard A Levin, Grace A Levy-Clarke, Julie C Lew, Craig Lewis, Wei Li, Laurence S Lim, Lyndell L Lim, Wee-Kiak Lim, Grant T Liu, John I Loewenstein, McGregor N Lott, Jonathan C Lowry, David B Lyon, Robert E Lytle, Mathew MacCumber, Bonnie T Mackool, Nalini A Madiwale, Francis Mah, Martin A Mainster, Michael H Manning, Steven L Mansberger, Robert E Marc, Mellone Marchong, Dennis M Marcus, Julie A Mares, Brian P Marr, Carlos E Martinez, Robert W Massof, Yukihiro Matsumoto, Cynthia Mattox, Marlon Maus, Cathleen M McCabe, Steven A McCormick, Michael McCrakken, James P McCulley, John A McDermott, H Richard McDonald, Marguerite B McDonald, Peter J McDonnell, Robert McGillivray, Craig A McKeown, James McLaughlin, W Wynn McMullen, Shlomo Melamed, George Meligonis, Efstratios Mendrinos, Dale R Meyer, Catherine B Meyerle, William F Mieler, Michael Migliori, Martin C Mihm, Darlene Miller, David Miller, Joan W Miller, Neil R Miller, David M Mills, Monte D Mills, Tatyana Milman, Lylas Mogk, Marja Mogk, Jordi Monés, Robert Montes-Micó, Christie L Morse, Asa D Morton, Anne Moskowitz, Shizuo Mukai, A Linn Murphree, Robert P Murphy, Timothy G Murray, Philip I Murray, Karina Nagao, Jay Neitz, Maureen Neitz, Peter A Netland, Arthur H Neufeld, Nancy J Newman, Eugene WM Ng, Quan Dong Nguyen, Jerry Y Niederkorn, Robert J Noecker, Robert B Nussenblatt, Joan M O'Brien, Paul D O'Brien, Terrence P O'Brien, Denis O'Day, R Joseph Olk, Karl R Olsen, Sumru Onal, Yen Hoong Ooi, E Mitchel Opremcak, George Ousler, Randall R Ozment, Samuel Packer, Millicent L Palmer, George N Papaliodis, DJ John Park, David W Parke, Cameron F Parsa, M Andrew Parsons, Louis R Pasquale, Neha N Patel, Sayjal J Patel, Thomas D Patrianakos, James R Patrinely, Deborah Pavan-Langston, Eli Peli, Susan M Pepin, Victor L Perez, Juan J Pérez-Santonja, John R Perfect, Henry D Perry, Joram Piatigorsky, Dante Pieramici, Eric A Pierce, Roberto Pineda, Misha L Pless, Howard D Pomeranz, Constantin J Pournaras, William Power, Manvi Prakash, Anita G Prasad, Valerie Purvin, David A Quillen, Graham E Quinn, Melvin D Rabena, James L Rae, Michael B Raizman, Alessandro Randazzo, Narsing A Rao, Christopher J Rapuano, Sherman W Reeves, Carl D Regillo, Elias Reichel, Martin H Reinke, Douglas Rhee, Claudia U Richter, Joseph F Rizzo, Richard M Robb, Anja C Roden, I Rand Rodgers, Merlyn M Rodrigues, Yonina Ron, Geoffrey E Rose, Emanuel S Rosen, James T Rosenbaum, Perry Rosenthal, Strutha C Rouse, Barry W Rovner, Malgorzata Rozanowska, Michael P Rubin, Peter AD Rubin, Shimon Rumelt, Anil K Rustgi, Tina Rutar, Mark S Ruttum, Allan R Rutzen, Edward T Ryan, Alfredo A Sadun, José-Alain Sahel, Leorey Saligan, Sarwat Salim, John F Salmon, Diva R Salomão, David Sami, Michael A Sandberg, Virender S Sangwan, Maria A Saornil, Joseph W Sassani, Rony R Sayegh, Andrew P Schachat, Wiley A Schell, Amy C Schefler, Tina Scheufele, Vivian Schiedler, Gretchen Schneider, Alison Schroeder, Ronald A Schuchard, Joel S Schuman, Ivan R Schwab, Adrienne Scott, Ingrid U Scott, Marvin L Sears, Johanna M Seddon, Theo Seiler, Robert P Selkin, Richard D Semba, Irina Serbanescu, Briar Sexton, Tarek M Shaarawy, Peter Shah, Aron Shapiro, Savitri Sharma, Jean Shein, Debra J Shetlar, M Bruce Shields, Carol L Shields, Jerry A Shields, Bradford J Shingleton, John W Shore, Lesya M Shuba, Guy J Ben Simon, Richard J Simmons, Michael Simpson, Arun D Singh, Omah S Singh, Karen Sisley, Arthur J Sit, David Smerdon, William E Smiddy, Ronald E Smith, Terry J Smith, Neal G Snebold, Lucia Sobrin, John A Sorenson, Sarkis H Soukiasian, George L Spaeth, Richard F Spaide, Monika Srivastava, Sunil K Srivastava, Alexandros N Stangos, Tomy Starck, Walter J Stark, Joshua D Stein, Roger F Steinert, Leon Strauss, Barbara W Streeten, J Wayne Streilein, James D Strong, Ilene K Sugino, Eric B Suhler, Timothy J Sullivan, Jennifer K Sun, Janet S Sunness, Francis C Sutula, Nasreen A Syed, Christopher N Ta, Hidehiro Takei, Jonathan H Talamo, Richard R Tamesis, Madhura Tamhankar, Kristen J Tarbet, Michelle Tarver-Carr, Mark A Terry, Joseph M Thomas, Vance Thompson, Jennifer E Thorne, Matthew J Thurtell, David P Tingey, King W To, Faisal M Tobaigy, Michael J Tolentino, Melissa G Tong, Gail Torkildsen, Cynthia A Toth, Elias I Traboulsi, Michele Trucksis, James C Tsai, Julie H Tsai, David T Tse, Scheffer CG Tseng, Elmer Y Tu, Ira J Udell, Alejandra A Valenzuela, Russell N Van Gelder, Gregory P Van Stavern, Deborah K Vander Veen, Demetrios Vavvas, David H Verity, Paolo Vinciguerra, Paul F Vinger, Nicholas J Volpe, Werner Wackernagel, Sonal Desai Wadhwa, Michael D Wagoner, Nadia K Waheed, David S Walton, Martin Wand, Jie Jin Wang, Scott M Warden, Lennox Webb, David Weber, Daniel Wee, Corey B Westerfeld, Christopher T Westfall, Scott M Whitcup, Valerie A White, William L White, Jason Wickens, Janey L Wiggs, Jacob T Wilensky, Charles P Wilkinson, Patrick D Williams, David J Wilson, M Roy Wilson, Steven E Wilson, Jules Winokur, William J Wirostko, Gadi Wollstein, Albert Chak Ming Wong, Tien Y Wong, John J Woog, Michael Wride, Carolyn S Wu, Darrell WuDunn, Jean Yang, Lawrence A Yannuzzi, Michael J Yaremchuk, R Patrick Yeatts, Richard W Yee, Steven Yeh, Lucy HY Young, Jenny Y Yu, Beatrice YJT Yue, Charles M Zacks, Bruce M Zagelbaum, Maryam Zamani, Marco Zarbin, Leonidas Zografos, and Christopher I Zoumalan

Published
2008

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