Health-related quality of life in facial palsy:translation and validation of the Dutch version Facial Disability Index

Contains fulltext : 229876.pdf (publisher's version ) (Open Access)PURPOSE: Patient-reported outcome measures are essential in the evaluation of facial palsy. Aim of this study was to translate and validate the Facial Disability Index (FDI) for use in the Netherlands. METHODS: The FDI was translated into Dutch according to a forward-backward method. Construct validity was assessed by formulating 22 hypotheses regarding associations of FDI scores with the Facial Clinimetric Evaluation scale, the Synkinesis Assessment Questionnaire, the Short Form-12 and the Sunnybrook Facial Grading System. Validity was considered adequate if at least 75% (i.e. 17 out of 22) of the hypotheses were confirmed. Additionally, confirmatory factor analysis was performed. Cronbach's α was calculated as a measure of internal consistency. Participants were asked to fill out the FDI a second time after 2 weeks to analyse test-retest reliability. Lastly, smallest detectable change was calculated. RESULTS: In total, 19 hypotheses (86.4%) were confirmed. Confirmatory factor analysis showed acceptable fit for the two factor structure of the original FDI (root mean square error of approximation = 0.064, standardized root mean square residual = 0.081, comparative fit index = 0.925, Chi-square = 50.22 with 34 degrees of freedom). Internal consistency for the FDI physical function scale was good (α > 0.720). Internal consistency for the FDI social/well-being scale was slightly less (α > 0.574). Test-retest reliability for both scales was good (intraclass correlation coefficients > 0.786). Smallest detectable change at the level of the individual was 17.6 points for the physical function and 17.7 points for the social/well-being function, and at group level 1.9 points for both scales. CONCLUSION: The Dutch version FDI shows good psychometric properties. The relatively large values for individual smallest detectable change may limit clinical use. The translation and widespread use of the FDI in multiple languages can help to compare treatment results internationally

Accuracy of a single measurement site for self-monitoring of patients with breast cancer at risk for lymphedema

Purpose: Early detection of breast cancer-related lymphedema through simple self-monitoring techniques may lead to early treatment and improved outcomes. Methods: Prospective study of circumference measurements at four time points before, during, and after adjuvant chemotherapy with docetaxel, doxorubicin, and cyclophosphamide. Volume was calculated using the 10-cm interval circumference measurement method (reference test) and percentage difference between arms, for volume and circumference, was determined. First, the most valid single measurement location was determined by calculating Pearson’s correlation coefficient relative to the reference test. Second, to evaluate the responsiveness to change over four time points, outcomes of the selected single measurement and the reference test were analyzed by repeated-measures ANOVA. Third, area under the curve (AUC) was used to determine the optimal sensitivity and specificity of the selected single measurement site (index test). Relationship between lymphedema (yes/no) and heaviness and swelling (yes/no) was analyzed using phi-coefficient. Results: The measurement point 30 cm proximal to the styloid process showed the highest correlation with percentage difference in total arm volume (r = 0.80) and detected increased percentage difference between arms after treatment. Analyses showed high accuracy (AUC = 0.94; 95% CI 0.90–0.99) and good sensitivity (0.85) and specificity (0.85) using a cutoff score of 4% circumference difference between arms at this location. A moderate correlation between feelings of heaviness and swelling to lymphedema was observed (rφ = 0.64). Conclusions: Circumference difference between arms of 4% measured at 30 cm proximal to the styloid process can be used as a surveillance site for further monitoring of patients at risk for lymphedema and may contribute to early diagnosis. Feelings of heaviness or swelling have moderate relationship with lymphedema, which needs to be confirmed in clinical practice

Adverse treatment effects in relation to impairments in upper extremities and thorax.

<p><u>Intervention</u>: ALND, axillary lymph node dissection; CEF, cyclophosphamide, epirubicin and fluorouracil; CE+T, cyclophosphamide, epirubicin + docetaxel; CT, chemotherapy; HT, hormonal therapy; LN, lymph node; MRM, modified radical mastectomy; RM, radical mastectomy; RT, radiotherapy; SC, supraclavicular; SNB, sentinel node biopsy; vs., versus.</p><p><u>Outcomes</u>: CTS, carpal tunnel syndrome; HR, hazard ratio; MSD, musculoskeletal disorder OR, odds ratio; RR, relative risk; ZOL, zoledronic acids; *, data extracted from included studies.</p

Outcome of the studies regarding breast cancer treatment and adverse effects.

<p><u>Study design</u>: CCT, clinical controlled trial; Cos, cohort study; CSS, cross sectional study; pts, patients; RCT, randomized controlled trial; SR, systematic review.</p><p>Intervention: ALND, axillary lymph node dissection; art, article; CE, cyclophosphamide, epirubicin; CEF, cyclophosphamide, epirubicin and fluorouracil; CT, chemotherapy; FU, follow up; Gy, Grey; HT, hormonal therapy; IMB, internal mammarial boost; IM-MS, internal mammary and medial supraclavicular lymph node chain; IORT, intra operative radiotherapy; LRRT, locoregional radiotherapy corresponding to periclavicular, axillary level 3, and for right-side breast cancers, the internal mammary nodes; LN, lymph node; M, metastasis; N, nodal status; PAB, posterior axillary boost; RT, radiotherapy; SC, supra scapular; SNB, sentinel node biopsy; T, docetaxel; T, tumor; TAM, tamoxifen; vs., versus; wks, weeks; ZOL, Zoledronic Acid.</p><p><u>Measurement instruments</u>: BIS, bio impedance spectroscopy; BMI, body mass index; BSI, Brief Symptom Inventory; CPAQ, Chronic Pain Acceptance Questionnaire; CES-D, center for epidemiologic studies – depression scale; CTCAE, Common Terminology Criteria for Adverse Events ; DASH, disabilities of arm, shoulder and hand; EORTC-QLQ-C30-BR23, European organization for research and treatment of cancer – quality of life questionnaire- breast; FACT-G-B, functional assessment of cancer therapy – general – breast; FLIC, Functional living index – cancer; FQ, fatigue questionnaire; FPACQ, Flemish Physical Activity Computerized Questionnaire; GCQ, general coping questionnaire; HADS, hospital anxiety and depression scale; ICD, international classification of diseases; IOC, impact of cancer scale; KAPS, Kwan’s arm problem scale; LANSS, Leeds Assessment of Neuropathic Symptoms and Signs; LBCQ, lymphedema breast cancer questionnaire; LEFT-BC, Lymphedema Evaluation Following Treatment for Breast Cancer; LENT-SOMA, late effects normal tissue – subjective objective management analytic; Li-Sat, life satisfaction; MASS, measure of arm symptoms survey; MET, metabolic equivalent ; MOS, medical outcomes study; MPQ, McGill pain questionnaire; MRC-scale, medical research council scale; MSPQ, Modified Somatic Perception Questionnaire; NPRS, numeric pain rating scale; PAISSR, Psychological Adjustment to Illness Scale-Self-Report; PAQ, physical activity questionnaire; PSI-B, Problem solving inventory-brief; ROM, range of motion; SF-36, short form-36; SPADI, shoulder pain and disability index; ULDQ, upper limb disability questionnaire; v, version; VAS, visual analogue scale; WHR, Waist-Hip ratio.</p><p><u>Outcomes</u>: ADL, activities in daily living; AWS, axillary web syndrome; CHF, cardiac heart failure; CTS, carpal tunnel syndrome; HR, Hazard Ratio; LE, lymphedema; LVEF, left ventricular ejection fraction; ns, non-significant; OR, odds ratio; MPS, myofascial pain syndrome; MSD, musculoskeletal disorders; PA, physical activity; PMPS, Post Mastectomy Pain Syndrome; RR, relative risk; sign, significant; *, data extracted from included studies.</p

Flow diagram literature search adverse effects of breast cancer treatment.

<p>Flow diagram literature search adverse effects of breast cancer treatment.</p

Quality test of methodology of the included studies based on the critical appraisal sheets of the Centre of Evidence Based Medicine.

<p>CCS-Case-Control Study; CCT, Clinical Controlled Trial ; CI, confidential interval; CoS, cohort study; CSS, Cross Sectional Study; RCT, Randomized Controlled Trial.</p

Quality test of methodology of the included systematic reviews based on the critical appraisal sheets of the Centre of Evidence Based Medicine.

<p>Quality test of methodology of the included systematic reviews based on the critical appraisal sheets of the Centre of Evidence Based Medicine.</p

Search string adverse effects.

<p>Search string adverse effects.</p