Ckh Wong

Fish-oil supplement has neutral effects on vascular and metabolic function but improves renal function in patients with Type 2 diabetes mellitus.

Diabet. Med. 27, 54–60 (2010)

High-Intensity Focused Ultrasound for Treatment of Symptomatic Benign Thyroid Nodules: A Prospective Study

Purpose To evaluate first-year efficacy and changes in pressure symptoms and health-related quality of life (HRQOL) after ultrasonographically (US) guided high-intensity focused ultrasound (HIFU) ablation of symptomatic benign thyroid nodules. Materials and Methods After ethics approval and informed consent were obtained, a prospective trial was conducted. Patients with a symptomatic benign thyroid nodule were given a choice of HIFU treatment or active surveillance. Clinical and US examinations, pressure symptom scores (visual analog scale), and HRQOL questionnaires (short form-12 survey) were evaluated at baseline and at 3, 6, and 12 months. The primary outcome was change in nodule volume after 12 months. The percentage of change in nodule volume was defined as the baseline volume minus the volume at 12 months divided by the baseline volume times 100. Ablation success was defined as a reduction in volume of greater than 50%. Nodule volume was compared by using the paired t test. Continuous variables were compared by using the Mann-Whitney U test, and categorical variables were compared by using χ2 tests. Results Twenty-two patients underwent HIFU and 22 underwent active surveillance. Mean age was 53.11 years (range, 28-76 years) and 55.19 years (range, 41-70 years), respectively. The ratio of men to women was 2:20 and 1:21, respectively. The 12-month mean volume reduction ± standard deviation in the HIFU group was significant (68.87% ± 15.27 [range, 47.35%-94.89%], P < .001) but not in the surveillance group (-2.11% ± 6.29 [range, -15.64% to 12.70%], P > .05). Preablation nodule volume was the only determinant of ablation success (odds ratio, 1.877; 95% confidence interval [CI]: 1.085, 3.249; P = .024). At 12 months, patients in the HIFU group had less swelling (P < .001), lower pressure symptom scores (P < .001), and higher physical composite scores (P = .006). Physical composite scores significantly correlated with 6-month reduction in nodule size (r = 0.768; 95% CI: 0.660, 0.930; P < .001) and 12-month reduction in nodule size (r = 0.704; 95% CI: 0.680, 940; P < .001). Conclusion HIFU ablation of symptomatic benign thyroid nodules not only induced significant shrinkage but also improved pressure symptom scores and HRQOL throughout a 12-month period.

Increased dietary fruit intake was associated with lower burden of carotid atherosclerosis in Chinese patients with Type 2 diabetes mellitus.

Background  Previous studies demonstrated that high fruit consumption was associated with a lower risk of cardiovascular events in patients with Type 2 diabetes mellitus. However, the relationship between fruit intake and carotid atherosclerosis in these patients is unknown. We studied the relationship between dietary fruit intake and carotid intima‐media thickness in patients with Type 2 diabetes.

Hypertriglyceridaemic-waist phenotype and risk of diabetes in people with impaired fasting glucose in primary care: a cohort study

We aimed to determine the prospective association between baseline triglyceridaemic–waist phenotypes and diabetic mellitus incidence in individuals with impaired fasting glucose seen in primary care.

Effectiveness and cost-effectiveness of a two-year short messaging service (SMS) intervention for professional drivers with pre-diabetes

PHASE 2 OPEN-LABEL EXTENSION (OLE) STUDY OF PATISIRAN, AN INVESTIGATIONAL RNA INTERFERENCE (RNAI) THERAPEUTIC FOR THE TREATMENT OF HEREDITARY ATTR AMYLOIDOSIS WITH POLYNEUROPATHYOBJECTIVES Maturity onset diabetes of the young (MODY) is a genetic form of diabetes for which 13 genes are known to be responsible. Many subtypes of MODY can be treated with oral medication instead of insulin injections, which results in improved metabolic control, quality of life and cost savings. Massively parallel sequencing (MPS) enables the simultaneous sequencing of all 13 genes for a fraction of the cost of traditional Sanger sequencing. We conducted a cost utility analysis of genetic screening (targeted MPS) for MODY in a paediatric population presumed to have type 1 diabetes (T1D), where the underlying prevalence of MODY has been calculated as 2.6%. METHODS A Markov decision model was developed to estimate the incremental costs and quality-adjusted life years (QALYs) of genetic screening for MODY compared with standard care over 50 years’ follow up. The probabilities and quality of life weightings (utility) of long term diabetic complications were estimated from published data and population statistics. Costs were estimated from the perspective of the Australian health care system. RESULTS Genetic screening for MODY at diabetes diagnosis was more effective and less costly than standard care, with 1.39 QALYs gained and AU

Changes in health-related quality of life among adults from low-income families in Hong Kong

1.4 million (US

Predicting SF-6D Preference-based Score based on the European Organization for Treatment and Research of Cancer Quality of Life Questionnaire in colorectal cancer

1.05 million) saved per 1,000 patients. The costs of the screening program were fully offset within four years. A sensitivity analysis revealed that genetic screening remained dominant until the MODY prevalence fell below 0.7%. CONCLUSIONS Screening for MODY in the paediatric diabetes population would reduce health system costs and improve patient quality of life. Our results were robust to assumptions around the underlying MODY prevalence and make a compelling argument for routine genetic screening in all children with presumed T1D.Poster Presentations Session IV - CCardiovascular Disorders - Clinical Outcomes Studies - no. PCV27OBJECTIVES: Traditionally, researchers relied on eliciting preferences through face-to-face interviews. Recently, there has been a shift towards using alternative modes, such as the internet, to gather such data. These different modes may be a source of variation in the results. In health services research, preferences are important as they provide an estimate of the value of each quality of life state, and can be used as weights to reflect the differential utility of each state. In this study, we compare the preferences elicited from two modes of administration (internet versus face-to-face) for the best-worst scaling (BWS) technique using the Adult Social Care Outcomes Toolkit service user measure (ASCOT-S). METHODS: Data were collected from a representative sample of the general population in England. The respondents (face-to-face: n=500; online: n=1,001) completed a survey which included the BWS experiment involving the ASCOT-S, consisted of 32 tasks which were blocked into 4 segments. Multinomial logistic regressions were undertaken to analyse the data. To allow for direct comparisons between the modes, model coefficients were standardised. RESULTS: Respondents in the face-to-face survey placed lower value on the lower levels of all ASCOT-S domains, except social participation, than those in the internet survey. The highest point difference of 0.12 was observed in Level 2 of the occupation domain. For the highest level of all ASCOT-S domains, except social participation, preference weights were higher in the face-to-face survey than the internet with point differences of up to 0.10. CONCLUSIONS: This study compared utility weights obtained from a BWS exercise using two modes of administration for the ASCOTS. The findings showed variation of responses between the two modes. Most differences were not significant and were low in absolute value. This suggests that preference weights are similar across the different modes of administration. We reflect on the implications of these findings for cost-effectiveness research.

Assessing the measurement invariance of the functional assessment of cancer therapy-colorectal quality of life instrument between self- and interviewer-administration

Background: The aim of this study is to examine the interest for relation between quality of life (QOL) and well being of an implementation of a program of physical activity, with patients of Multiple Sclerosis (MS). Methods: This is a correlation study. The study includes 27 patients with MS, mean age 44 years, 58,3 % women, 37,5% currently married, 67% retired, mean school level of 12,5 years. We use the questionnaire and the Multiple Sclerosis Quality of Life scale (MSQol-54) and sub scale psychological well-being (PWB) of Mental Health Inventory The program consists of an intervention to promote physical activity (IPPA) in a group of eight people, in once a week sessions of 90 minutes, during seven weeks. We analyze the results through the Spearman correlation tests between the dimensions of MSQOL-54 and Well-being. Findings: The Results the correlations between PWB and the domains of MSQOL-54 before application of IPPA and the end of the implementation of IPPA, showed that there were statistically significant correlations between all variables. Discussion: In this study, suggests that IPPA can play an important in the relation between the QOL and PWB of these patients.23rd Annual Conference of the International Society for Quality of Life Research Springer International Publishing Switzerland 2016 Cutting edge research plenary (1) Consensus-based standards and criteria for evaluating the content validity of patient-reported outcome measures: a COSMIN Delphi study Caroline B. Terwee, PhD, VU University Medical Center, Amsterdam, Netherlands; Cecilia A. Prinsen, PhD, VU University Medical Center, Amsterdam, Netherlands; Alessandro Chiarotto, MS (PhD Student), VU University Medical Center, Amsterdam, Netherlands; Marjan J. Westerman, PhD, VU University, Amsterdam, Netherlands; Henrica de Vet, PhD, VU University Medical Center, Amsterdam, Netherlands; Donald Patrick, PhD, University of Washington, Seattle, WA, United States; Jordi Alonso, PhD, IMIM (Hospital del Mar Medical Research Institute), Barcelona; CIBER en Epidemiologı́a y Salud Pública (CIBERESP), Madrid; Pompeu Fabra University (UPF), Barcelona, Spain; Lex M. Bouter, PhD, VU University Medical Center, Amsterdam, Netherlands; Lidwine B. Mokkink, PhD, VU University Medical Center, Amsterdam, Netherlands Aims: Content validity is considered to be the most important measurement property of a Patient-Reported Outcome Measure (PROM). Guidelines to evaluate content validity of PROMs are emerging, but there is a lack of a consensus-based checklist for assessing the quality of content validity studies. The current COSMIN standards only consider whether certain things have been done, but not how they were done, and the quality of the PROM development is not taken into account. Also consensus-based criteria for what constitutes good content validity of PROMs are lacking. The aim of this study was to reach consensus on standards and criteria for evaluating the content validity of PROMs. Standards refer to design requirements of studies and are used to evaluate the quality of studies on PROM development and content validity. Criteria refer to what constitutes good content validity and are used to evaluate the content validity of the PROM itself. Methods: A Delphi consensus study was performed in three email rounds among COSMIN users, authors of systematic reviews of PROMs and (methodological) papers on content validity. Potential standards and criteria were extracted from a systematic literature search. Participants were asked to rate the relevance of each proposed standard and criterion on a 5-point scale. In addition, they were invited to make comments. RESULTS: 158 experts from 21 countries participated. Consensus was reached on 28 standards for evaluating the quality of PROM development studies and 37 standards for evaluating the quality of studies evaluating the content validity of a PROM. Consensus was reached on 9 criteria for evaluating the content validity (i.e. relevance, comprehensiveness, and comprehensibility) of the PROM itself. The standards and criteria were pilot tested in a systematic review evaluating the content validity of PROMs for low back pain patients and slight adaptations were made. A user manual was developed with explanations and examples on how each item should be completed. Conclusions: The new COSMIN standards and criteria can be used in systematic reviews of PROMs to evaluate the content validity of PROMs for a given context and population in a standardized and transparent way. (2) Telling the interpretation story: the case for strong anchors and multiple methods Cheryl D. Coon, PhD, Outcometrix, Tucson, AZ, United States Aims: The patient-reported outcome (PRO) field continues to debate best practices for establishing thresholds for interpreting change on instruments. To gain insight into the value of common methods for determining thresholds, this simulation study intended to generate data with known properties against which the methods could be considered. Methods: Data were generated based on a t-score metric with half of the 1000-simulee sample (i.e., placebo) experiencing no change (centered at 0) and half (i.e., treatment) experiencing a 0.5standard deviation improvement (centered at 5). Five-category anchors were generated from the same distributions, with correlations between the PRO scores and the anchors ranging from 0.3 to 0.8. The ‘‘true’’ threshold for improvement was set at a score of 5. Methods evaluated included classification statistics (i.e., sensitivity, specificity, positive predictive value, negative predictive value), discriminant analysis, and regression. Results: Results for a correlation of 0.3 were difficult to interpret, which is consistent with the literature that proposes the correlation between the anchor and the PRO instrument be stronger than 0.3. The thresholds that might be considered from the 0.3 correlation results were deflated, which risks setting the bar for interpretation too low. A correlation of 0.5 produced more easily interpretable results, with thresholds ranging from approximately 4–9, depending on the method. A correlation of 0.8 produced more distinct inflection points, with thresholds ranging from approximately 4–8. Even with the strongest correlation, the PRO scores produced false positives and false negatives. Conclusions: This simulation study 123 Qual Life Res (2016) 25:1–196 DOI 10.1007/s11136-016-1390-7

Population norm of Chinese (HK) SF-12 health survey-version 2 of Chinese adults in Hong Kong

This journal suppl. contain abstracts presented at the 19th Annual Conference of the International Society for Quality of Life Research

Low circulating level of CD133+KDR+cells in patients with systemic sclerosis

This journal suppl. contain abstracts presented at the 19th Annual Conference of the International Society for Quality of Life Research