Exploring the integration of patient-reported outcome measures in clinical practice: A cross-sectional survey of EORTC healthcare professionals.

Using patient reported-outcome measures (PROMs) in routine care has significant potential to benefit patients with cancer, but it is unclear how widely they are used in practice. We conducted a cross-sectional survey (November 2023-April 2024) among healthcare professionals (HCPs) in the European Organisation for Research and Treatment of Cancer (EORTC). Descriptive statistics and chi-square tests assessed PROM use patterns, regional differences, and barriers. Binary regression models compared barriers between PROM users and non-users. Of the 3733 EORTC members contacted, 784 responded (21 % response rate), predominantly physicians. Among the 784 HCPs (50 % women), 338 (43 %) did not use PROMs, 214 (27 %) were occasional users, and 232 (30 %) used PROMs regularly. PROM use was significantly higher in Western Europe than in Central/Eastern Europe. PROMs were primarily used for monitoring health status and enhancing communication. PROM use was highest among HCPs treating bone, soft tissue, genito-urinary, and gynecological cancers, and lowest in lung cancer. Key barriers to PROM use included lack of time (reported by 70 % of respondents) and insufficient support on how to use PROMs (73 %). Compared to non-users, PROM users more frequently identified patient-level barriers, such as accessibility concerns, as relevant (Odds Ratio 3.5, 95 % Confidence Interval 2.4-5.3). PROM use varies by cancer type, setting, and region. Addressing time constraints, providing support, and overcoming patient barriers are key to broader integration. Ensuring equitable access to PROM tools across regions and settings is vital for promoting equity in cancer care

Application of the health assessment questionnaire disability index to various rheumatic diseases

Purpose\ud \ud To investigate whether the Stanford Health Assessment Questionnaire Disability Index (HAQ-DI) can serve as a generic instrument for measuring disability across different rheumatic diseases and to propose a scoring method based on item response theory (IRT) modeling to support this goal.\ud \ud Methods\ud \ud The HAQ-DI was administered to a cross-sectional sample of patients with confirmed rheumatoid arthritis (n = 619), osteoarthritis (n = 125), or gout (n = 102). The results were analyzed using the generalized partial credit model as an IRT model.\ud \ud Results\ud \ud It was found that 4 out of 8 item categories of the HAQ-DI displayed substantial differential item functioning (DIF) over the three diseases. Further, it was shown that this DIF could be modeled using an IRT model with disease-specific item parameters, which produces measures that are comparable for the three diseases.\ud \ud Conclusion\ud \ud Although the HAQ-DI partially functioned differently in the three disease groups, the measurement regarding the disability level of the patients can be made comparable using IRT methods\u

European Competition Policy in International Markets

International audienceChanges in the institutional, technological and economic environment raise new challenges to the European competition policy. In this context, it is timely for European authorities to appraise the external dimension of the European competition policy as well as its articulation with current internal reforms. Globalisation can increase the costs of monitoring and seriously reduce the ability of European authorities to tackle cross-border anti-competitive conducts. In addition, conflicts are exacerbated by industrial policy motivations. As it is unlikely that the sole application of the territoriality and extraterritoriality principles to competition rules could yield an optimal international competition system, globalisation calls for higher levels and types of cooperation. Given that bilateral cooperation and especially the implementation of comity principles could be of no value when laws or interests are sources of international conflicts, three main paths could be therefore encouraged: The continuous harmonization of rules through the joint action of OECD and ICN; the higher cooperation in the confidential information exchange; the establishment of global anti-trust institutions. Although WTO is legitimate in judging questions related market access and entry barriers, it is less equipped to assess international hard core cartels or M&A reviews. As a substitute for WTO, a multilevel system, like the EU system, could be promoted. For political and pragmatic reasons, it could be composed in a first step of a hard core of countries like the EU, Japan and the U.S. It could be associated with the creation of an international Court of Justice for competition. In addition to these external reforms, some internal reforms could be required. Competition authorities have to develop further competition advocacy to give a higher priority to competition issues in other EU policies and national regulation. A parallel and complementary reform could consist in making the European competition agency independent from State Members' interference

Investigating Linguistic Sources of Differential Item Functioning Using Expert Think-Aloud Protocols in Science Achievement Tests

ABSTRACT Even if national and international assessments are designed to be comparable, subsequent psychometric analyses often reveal differential item functioning (DIF). Central to achieving comparability is to examine the presence of DIF, and if DIF is found, to investigate its sources to ensure differentially functioning items do not lead to bias. In this study, sources of DIF were examined using think-aloud protocols. The think-aloud protocols of expert reviewers were conducted for comparing the English and French versions of 40 items previously identified as DIF (N = 20) and non-DIF (N = 20). Three highly trained and experienced experts in verifying and accepting/rejecting multi-lingual versions of curriculum and testing materials for government purposes participated in this study. Although there is a considerable amount of agreement in the identification of differentially functioning items, experts do not consistently identify and distinguish DIF and non-DIF items. Our analyses of the think-aloud protocols identified particular linguistic, general pedagogical, content-related, and cognitive factors related to sources of DIF. Implications are provided for the process of arriving at the identification of DIF prior to the actual administration of tests at national and international levels. Key words: think-aloud protocols; experts; translation; item [language] differences; performance differences

Charles Dumercy: Bibliographie des éditions originales

info:eu-repo/semantics/publishe

What are the main cross-national studies?

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