The Prostate Care Questionnaire for Carers (PCQ-C): reliability, validity and acceptability

<p>Abstract</p> <p>Background</p> <p>Patient experience is commonly monitored in evaluating and improving health care, but the experience of carers (partners/relatives/friends) is rarely monitored even though the role of carers can often be substantial. For carers to fulfil their role it is necessary to address their needs. This paper describes an evaluation of the reliability, validity and acceptability of the PCQ-C, a newly developed instrument designed to measure the experiences of carers of men with prostate cancer.</p> <p>Methods</p> <p>The reliability, acceptability and validity of the PCQ-C were tested through a postal survey and interviews with carers. The PCQ-C was posted to 1087 prostate cancer patients and patients were asked to pass the questionnaire on to their carer. Non-responders received one reminder. To assess test-retest reliability, 210 carers who had responded to the questionnaire were resent it a second time three weeks later. A subsample of nine carers from patients attending one hospital took part in qualitative interviews to assess validity and acceptability of the PCQ-C. Acceptability to service providers was evaluated based on four hospitals' experiences of running a survey using the PCQ-C.</p> <p>Results</p> <p>Questionnaires were returned by 514 carers (47.3%), and the majority of questions showed less than 10% missing data. Across the sections of the questionnaire internal consistency was high (Cronbach's alpha ranging from 0.80 to 0.89), and test-retest stability showed moderate to high stability (intraclass correlation coefficients ranging from 0.52 to 0.83). Interviews of carers indicated that the PCQ-C was valid and acceptable. Feedback from hospitals indicated that they found the questionnaire useful, and highlighted important considerations for its future use as part of quality improvement initiatives.</p> <p>Conclusions</p> <p>The PCQ-C has been found to be acceptable to carers and service providers having been used successfully in hospitals in England. It is ready for use to measure the aspects of care that need to be addressed to improve the quality of prostate cancer care, and for research.</p

The Prostate Care Questionnaire for Patients (PCQ-P): Reliability, validity and acceptability

<p>Abstract</p> <p>Background</p> <p>In England, prostate cancer patients report worse experience of care than patients with other cancers. However, no standard measure of patient experience of prostate cancer care is currently available. This paper describes an evaluation of the reliability, validity and acceptability of the PCQ-P, a newly developed instrument designed to measure patient experience of prostate cancer care.</p> <p>Methods</p> <p>The reliability, acceptability and validity of the PCQ-P were tested through a postal survey and interviews with patients. The PCQ-P was posted to 1087 prostate cancer patients varying in age, occupation, and overall health status, sampled from five hospitals in England. Nonresponders received one reminder. To assess criterion validity, 935 patients were also sent sections of the National Centre for Social Research Shortened Questionnaire; and to assess test-retest reliability, 296 patients who responded to the questionnaire were resent it a second time three weeks later. A subsample of 20 prostate cancer patients from one hospital took part in qualitative interviews to assess validity and acceptability of the PCQ-P. Acceptability to service providers was evaluated based on four hospitals' experiences of running a survey using the PCQ-P.</p> <p>Results</p> <p>Questionnaires were returned by 865 patients (69.2%). Missing data was low across the sections, with the proportion of patients completing less than 50% of each section ranging from 4.5% to 6.9%. Across the sections of the questionnaire, internal consistency was moderate to high (Cronbach's alpha ranging from 0.63 to 0.80), and test-retest stability was acceptable (intraclass correlation coefficients ranging from 0.57 to 0.73). Findings on criterion validity were significant. Patient interviews indicated that the PCQ-P had high face validity and acceptability. Feedback from hospitals indicated that they found the questionnaire useful, and highlighted important considerations for its future use as part of quality improvement initiatives.</p> <p>Conclusion</p> <p>The PCQ-P has been found to be acceptable to patients and service providers, and is ready for use for the measurement of patient experience in routine practice, service improvement programmes, and research.</p

Aplicación Forense de Tecnología Radiográfica Dental Portátil en Argentina. Estado Actual y Perspectivas Futuras

Fil: Briem Stamm, AD. Universidad de Buenos Aires. Facultad de Odontología. Unidad Académica Odontología Legal con Historia de la Odontología; Argentina.Fil: La Pasta, AA. Universidad de Buenos Aires. Ministerio de Salud de la Nación Área Técnica de Radiofísica Sanitaria; Argentina.Fil: Müller, AS. Universidad Abierta Interamericana Licenciatura en Producción de Bioimágenes Cátedra de Diagnóstico por Imágenes; Argentina.Fil: Rolón, Lara MC. Universidad Nacional de Asunción. Facultad de Odontología Paraguay; Argentina.Fil: Pujol, MH. Universidad de Buenos Aires. Facultad de Odontología. Cátedra de Diagnóstico por Imágenes; Argentina.Fil: Vázquez, DJ. Universidad de Buenos Aires. Facultad de Odontología. Cátedra de Diagnóstico por Imágenes; Argentina.Objetivos: Mensurar los niveles de radiación de fuga y dispersión emanada a través de los blindajes y estructuras plomadas del tubo de rayos X de la unidad dental portátil NOMAD, controlando la retrodispersión con el uso del escudo protector de acrílico plomado adaptado en el extremo final del tubo localizador plomado. Se midieron las tasas de exposición dispersadas mediante un detector tipo Geiger-Müller y una cámara de ionización con respuesta en el rango de energías aportadas en diagnóstico por imágenes para la medición de la exposición directa y determinación posterior de las dosis. Se utilizó un fantomas diseñado para diagnóstico odontológico, sopesando la radiación en diferentes angulaciones de operación del equipo NOMAD, simulando los gestos posturales de odontólogos, radiólogos y sujetos a identificar

Cost-effectiveness of lapatinib plus capecitabine in women with HER2+ metastatic breast cancer who have received prior therapy with trastuzumab

BACKGROUND: In a phase III trial of women with HER2+ metastatic breast cancer (MBC) previously treated with trastuzumab, an anthracycline, and taxanes (EGF100151), lapatinib plus capecitabine (L + C) improved time to progression (TTP) versus capecitabine monotherapy (C-only). In a trial including HER2? MBC patients who had received at least one prior course of trastuzumab and no more than one prior course of palliative chemotherapy (GBG 26/BIG 03-05), continued trastuzumab plus capecitabine (T + C) also improved TTP. METHODS: An economic model using patient-level data from EGF100151 and published results of GBG 26/BIG 03-05 as well as other literature were used to evaluate the incremental cost per quality-adjusted life-year [QALY] gained with L ? C versus C-only and versus T ? C in women with HER2? MBC previously treated with trastuzumab from the UK National Health Service (NHS) perspective. RESULTS: Expected costs were £28,816 with L ? C, £13,985 with C-only and £28,924 with T ? C. Corresponding QALYs were 0.927, 0.737 and 0.896. In the base case, L + C was estimated to provide more QALYs at a lower cost compared with T ? C; cost per QALY gained was £77,993 with L ? C versus C-only. In pairwise probabilistic sensitivity analyses, the probability that L + C is preferred to C-only was 0.03 given a threshold of £30,000. The probability that L + C is preferred to T + C was 0.54 regardless of the threshold. CONCLUSIONS: When compared against capecitabine alone, the addition of lapatinib has a cost-effectiveness ratio exceeding the threshold normally used by NICE. Compared with T + C, L + C is dominant in the base case and approximately equally likely to be cost-effective in probabilistic sensitivity analyses over a wide range of threshold values.Thomas E. Delea, Paul Tappenden, Oleg Sofrygin, Dominy Browning, Mayur M. Amonkar, Jon Karnon, Mel D. Walker, David Camero