Validation of the Asthma Severity Scoring System (ASSESS) in the ALLIANCE cohort.

BACKGROUND The Asthma Severity Scoring System (ASSESS) quantifies asthma severity in adolescents and adults. Scale performance in children < 12 years is unknown. OBJECTIVE To validate the ASSESS score in the All Age Asthma Cohort (ALLIANCE) and explore its use in children <12 years. METHODS Scale properties, responsiveness, and known-group validity were assessed in 247 children (median age 11 years, IQR: 8-13 years) and 206 adults (median age 52 years, IQR: 43-63 years). RESULTS Overall, measures of internal test consistency and test-retest reliability were similar to the original data of the Severe Asthma Research Program (SARP). Cronbach's α was 0.59 in children 12-18 years and 0.73 in adults, reflecting the inclusion of multiple and not always congruent dimensions to the ASSESS score especially in children. Analysis of known-group validity confirmed the discriminatory power, as the ASSESS score was significantly worse in patients with poor asthma control, exacerbations and increased salbutamol use. In children between 6-11 years test reliability was inferior compared to adults and adolescents (Cronbach's α 0.27) mostly due to a less lung function impairment in asthmatic children of this age group. Known-group validity however confirmed good discriminative power regarding severity-associated variables similar to adolescents and adults. CONCLUSION Test reliability and validity of the ASSESS score was confirmed in the ALLIANCE cohort. In children aged 6-11 years internal consistency was inferior compared to older asthma patients, however test validity was good and encourages age-spanning usage of the ASSESS score in all asthma patients ≥ 6 years

DataSheet_1_Optimizing the structure of interdisciplinary tumor boards for effective cancer care.pdf

IntroductionMulti-professional interdisciplinary tumor boards (ITB) are essential institutions to discuss all newly diagnosed, relapsed or complex cancer patients in a team of specialists to find an optimal cancer care plan for each individual patient with regard to national and international clinical practice guidelines, patient´s preference and comorbidities. In a high-volume cancer center, entity-specific ITBs take place at least once a week discussing a large number of patients. To a high level of expertise and dedication, this also requires an enormous amount of time for physicians, cancer specialists and administrative support colleagues, especially for radiologists, pathologists, medical oncologists and radiation oncologists, who must attend all cancer-specific boards according to certification requirements.MethodsIn this 15-month prospective German single-center analysis, we examined the established structures of 12 different cancer-specific ITBs at the certified Oncology Center and demonstrate tools helping to optimize processes before, during and after the boards for optimal, time-saving procedures.ResultsBy changing pathways, introducing revised registration protocols and new digital supports we could show that the workload of preparation by radiologists and pathologists could be reduced significantly by 22.9% (p=DiscussionThere are several ways to reduce the workload of all ITB team members while maintaining high quality recommendations and adherence to national and international guidelines.</p