Canadian English translation and linguistic validation of the 13-MD to measure global health-related quality of life

The 13-MD is a new instrument designed to measure more globally the various aspects of the health-related quality of life. Its structure is balanced around physical, mental, and social aspects of health. To translate the 13-MD into Canadian English and to ensure that it is conceptually equivalent to the original version in Canadian French. Forward and back translations were conducted. A linguistic validation was performed in both Canadian French and Canadian English following an iterative process. This validation was conducted with 15 participants in each group (French and English speakers) using face-to-face cognitive debriefing interviews. This process was done in accordance with academic standards. The two forward translations resulted in 35.8% of identical sentences (59/165). Back translation indicated that 83.6% of the sentences were identical or almost identical to the original Canadian French version. The review of the back translation led to a few changes in the reconciled forward translation (4/165) and the original version (11/165), while the linguistic validation process led to 24 changes over a possibility of 165 sentences in the Canadian English version and 6 over 165 in the Canadian French version. Most changes provided were minimal and were done to ensure a better understanding of the 13-MD. The translation and linguistic validation processes were successful in creating a valid 13-MD in Canadian English (13-MD-CE) that is conceptually equivalent to the original version.</p

Dimensions and sub-dimensions of IPC65 and IPC59.

<p>Dimensions and sub-dimensions of IPC65 and IPC59.</p

Descriptive statistics before and after validation of the questionnaire (n = 392).

<p>Descriptive statistics before and after validation of the questionnaire (n = 392).</p

Conceptual framework for the analysis of integration implementation in the healthcare process, taken from Roberge et al. [15] and adapted from the model by Contandriopoulos et al. [14].

<p>Conceptual framework for the analysis of integration implementation in the healthcare process, taken from Roberge et al. [<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0197484#pone.0197484.ref015" target="_blank">15</a>] and adapted from the model by Contandriopoulos et al. [<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0197484#pone.0197484.ref014" target="_blank">14</a>].</p

Measuring interdisciplinarity in clinical practice with IPC59, a modified and improved version of IPC65

<div><p>Rationale</p><p>Interdisciplinarity is considered a key concept in the management of complex cases in healthcare. However, working in interdisciplinary teams requires the integration of many concepts and a large amount of effort. To help healthcare managers and professionals identify the strengths and weaknesses of their interdisciplinary team and to ensure its continuous improvement, we developed a tool called the IPC65.</p><p>Objective</p><p>The purpose of this study was to test the reliability and validity of the IPC65.</p><p>Methods</p><p>Based on a comprehensive review of the literature and qualitative and quantitative assessments, the IPC65 was developed. In this study, the analysis was based on 392 healthcare professionals and managers from short-term care settings who provided valid responses throughout the province of Quebec in Canada. Descriptive statistics, Cronbach’s alpha values, and inter-item correlations were measured, and a principal component analysis (PCA) was conducted. Item discrimination was used to provide an improved version of the IPC65.</p><p>Results</p><p>The IPC65 showed good statistical results. The discriminant procedure provided the basis for shortening and improving the IPC65 to form the IPC59. Cronbach’s alpha values ranged from 0.857 to 0.967 in IPC59, demonstrating very good reliability for all four dimensions. The PCA showed good validity.</p><p>Conclusion</p><p>The IPC59 can be used to assess the degree of integration of key concepts leading to interdisciplinarity.</p></div

Graphical representation of principal component analysis for new sub-dimensions of clinical integration and integration of care.

<p>Graphical representation of principal component analysis for new sub-dimensions of clinical integration and integration of care.</p

Percutaneous coronary intervention with second-generation drug-eluting stent versus bare-metal stent: Systematic review and cost–benefit analysis

<div><p>Background</p><p>Drug-eluting stents (DESs) were considered as ground-breaking technology promising to eradicate restenosis and the necessity to perform multiple revascularization procedures subsequent to percutaneous coronary intervention. Soon after DESs were released on the market, however, there were reports of a potential increase in mortality and of early or late thrombosis. In addition, DESs are far more expensive than bare-metal stents (BMSs), which has led to their limited use in many countries. The technology has improved over the last few years with the second generation of DESs (DES-2). Moreover, costs have come down and an improved safety profile with decreased thrombosis has been reported.</p><p>Objective</p><p>Perform a cost–benefit analysis of DES-2s versus BMSs in the context of a publicly funded university hospital in Quebec, Canada.</p><p>Methods</p><p>A systematic review of meta-analyses was conducted between 2012 and 2016 to extract data on clinical effectiveness. The clinical outcome of interest for the cost–benefit analysis was target-vessel revascularization (TVR). Cost units are those used in the Quebec health-care system. The cost–benefit analysis was based on a 2-year perspective. Deterministic and stochastic models (discrete-event simulation) were used, and various risk factors of reintervention were considered.</p><p>Results</p><p>DES-2s are much more effective than BMSs with respect to TVR rate ratio (i.e., 0.29 to 0.62 in more recent meta-analyses). DES-2s seem to cause fewer deaths and in-stent thrombosis than BMSs, but results are rarely significant, with the exception of the cobalt–chromium everolimus DES. The rate ratio of myocardial infraction is systematically in favor of DES-2s and very often significant. Despite the higher cost of DES-2s, fewer reinterventions can lead to huge savings (i.e., -$479 to -$769 per patient). Moreover, the higher a patient’s risk of reintervention, the higher the savings associated with the use of DES-2s.</p><p>Conclusion</p><p>Despite the higher purchase cost of DES-2s compared to BMSs, generalizing their use, in particular for patients at high risk of reintervention, should enable significant savings.</p></div

Rate ratio of target-vessel revascularization (TVR).

<p>Rate ratio of target-vessel revascularization (TVR).</p

Rate ratio of definite or probable thrombosis.

<p>Rate ratio of definite or probable thrombosis.</p

Scenarios presented to respondents in the contingent choice survey.

<p>Scenarios presented to respondents in the contingent choice survey.</p