1,721,048 research outputs found
Remote Monitoring of COVID-19 Patients Following Discharge from a Tertiary Care Center
No full textThe COVID-19 pandemic has affected people, healthcare systems and caregivers on a global scale causing bottlenecks in hospital resources and overload of healthcare systems. The presence of disease sequelae in
patients hospitalized due to COVID-19 warrants additional care and monitoring of these patients. Remote monitoring techniques have been implemented in several domains of healthcare such as cardiology, cardiac rehabilitation and nephrology. Monitoring of vital signs using these technologies has allowed the tracking of patients with more granularity, resulting in better clinical outcomes such as reduction in hospitalizations. Therefore, we hypothesize that remote monitoring is beneficial in managing COVID-19 patients post-hospitalization, enabling home-based patient follow-up. In this study, we investigated the use of remote
monitoring on a COVID-19 patient cohort discharged from a tertiary care center. A post-hoc division of patients into two groups (alert-generating patients and non-alert generating patients) was performed. The longitudinal progression of sensor and questionnaire data was studied using linear mixed-effect models. The measured heart rate values were statistically significant in terms of the intercept (p<0.001), indicating a difference between the two patient groups at baseline immediately post-discharge.The authors would like to acknowledge Dr. David Ruttens for his help in data collection for this project. The authors would like to thank the assistants and nurses at the Department of Pneumology, Ziekenhuis Oost-Limburg as well as the scientific researchers of Future Health for their help in the data collection procedure
Identifying Changes in Functional Capacity of Cardiorespiratory Patients Undergoing Exercise Rehabilitation
No full textHeart failure (HF) and chronic obstructive pulmonary disease (COPD) are two common complex multimorbid cardiorespiratory diseases. Due to their complex nature, it is challenging to identify changes in health status of affected patients. In this study, we analyse the progression of functional capacity as a first step in identifying changes in disease status of HF and COPD patients. 60 patients (NHF=35, NCOPD=25) undergoing cardiopulmonary rehabilitation were included in this study. A six-minute walk test (6MWT) assessing the sixminute walking distance (6MWD) was used to monitor the functional capacity of these patients. Patients performed five 6MWTs in total (1 baseline, 4 follow-up) with spotcheck HR and SpO2 values also being measured before and after each 6MWT. The progression of the 6MWDs was analysed using a two-way mixed ANOVA. To predict changes in functional capacity, patients were divided into two groups (“improved” vs “not improved”) based on a minimal clinically significant distance change. A decision tree classifier was trained on 6MWD, HR and SpO2 data features and evaluated using balanced accuracy. The mixed ANOVA showed a significant interaction effect as well as significant between-subjects and withinsubject effects. The classifier showed good performance in predicting improvement of functional capacity.The authors would like to thank Daimy Roebroek, Frauke Somers and Julie Deckers for their help in collecting data from patients for this study
Impact of Surgery on Functional and Patient-reported Outcomes in Patients With Early-stage Non-small Cell Lung Cancer
No full textRationale In patients with early-stage non-small cell lung cancer (NSCLC), the treatment of choice is surgical resection, with or without (neo)adjuvant chemotherapy. As a result of the disease and its treatment, patients have an increased risk for poor functional performances, decreased quality of life and high symptom burden. Current knowledge is mainly based on cross-sectional evaluations after treatment; longitudinal changes have been poorly characterized. Therefore, we aimed to investigate functional and patient-reported outcomes in patients with early-stage NSCLC before treatment and 12 weeks after treatment. Methods Patients with early-stage NSCLC (stage I-IIIB) were assessed before surgery and 12 weeks after treatment initiation. Functional outcome measures were a six-minute walk distance (6MWD), 1-minute sit-to-stand test (1-MSTST), quadriceps muscle strength (QMS; microFET), and handgrip strength (HGS; Jamar). Patient-reported outcome measures were the European Organization for the Research and Treatment of Cancer Questionnaire and lung cancer module (EORTC QLQ-C30-LC13), multidimensional fatigue inventory (MFI-20), and San Diego shortness of breath questionnaire (SOBQ). Analyses were performed using JMP PRO 14.2.0. Paired t-tests and Wilcoxon Signed rank tests were used to compare differences between both timepoints. Results Fifteen patients were included (10 males; age 65±9yrs; 5 with COPD). Patients had NSCLC stage IA (n=10), IB (n=1), IIB (n=2) or IIIA (n=2) and were treated via VATS only (n=11) or VATS and adjuvant chemotherapy (n=4). Results are presented in Figure 1. Twelve weeks after treatment, a significant worsening was found for 1-MSTST (27reps vs. 23reps, p=0.008), HGS (36kg vs. 31kg, p=0.036), and SOBQ score (11 vs. 21, p=0.010). No significant differences were found for the other outcomes. Conclusion In early-stage NSCLC, the treatment mainly affected the performance on the 1-MSTST, peripheral muscle strength, and shortness of breath. In contrast to previous findings, we did not observe a significant decrease in 6MWD, quality of life, and fatigue levels
Functional and Patient-reported Outcomes at Diagnosis of Non-small Cell Lung Cancer
No full textRationale Poor functional performance and high symptom burden are frequently observed in patients undergoing treatment for non-small cell lung cancer (NSCLC). Little is known about their health status initiation therapy. We investigated functional and patient-reported outcomes at diagnosis in patients with early-and advanced-stage NSCLC, and compared them to age-matched healthy individuals. Methods A cross-sectional study was conducted in newly diagnosed patients with early-stage (stage IA-IIIA) and advanced-stage (stage IIIB-IVB) NSCLC-before starting treatment-and healthy individuals. Functional outcome measures were maximal inspiratory pressure (MIP; MicroRPM), quadriceps muscle strength (QMS; microFET), handgrip strength (HGS; Jamar), short physical performance battery (SPPB), one-minute sit-to-stand test (1-MSTST), and six-minute walk distance (6MWD). Patient-reported outcome measures were modified Baecke questionnaire, physical activity scale for the elderly questionnaire (PASE), multidimensional fatigue inventory (MFI-20), modified Medical Research Council dyspnea questionnaire (mMRC), San Diego shortness of breath questionnaire (SOBQ), hospital anxiety and depression scale (HADS), short-form health survey (SF-12), EuroQoL 5-dimensions (EQ-5D), and instrumental activities of daily living scale (IADLs). One-way ANOVAs and Kruskal-Wallis tests, followed by Tukey-Kramer or Steel-Dwass pairwise comparisons, were performed in JMP PRO 14.2.0 to explore differences between the three groups. Results We recruited 24 patients with early-stage NSCLC (70% male; age 66±9yrs; 33% COPD), 17 patients with advanced-stage NSCLC (65% male; age 64±7yrs; 6% COPD) and 18 healthy individuals (44% male; age 67±10yrs; 0% COPD). Patients with early-and advanced-stage NSCLC presented significant lower 1-MSTST (72%pred vs. 74%pred vs. 89%pred, p=0.010), 6MWD (97%pred vs. 106%pred vs. 128%pred, p<0.0001) and SF-12 mental component score (45 vs. 42 vs. 53, p=0.046) in comparison to healthy individuals. PASE and MFI-20 scores were significantly worse in patients with advanced-stage NSCLC than in healthy controls (56 vs. 108, p=0.005; 58 vs. 42, p=0.027). Compared to patients with early-stage NSCLC, patients with advanced-stage NSCLC had a significantly lower PASE score (88 vs. 56, p=0.049). Detailed results are presented in Table 1. Conclusion Patients with NSCLC scored lower on the 1-MSTST and SF-12 mental score at diagnosis compared to healthy individuals. Patients with advanced-stage NSCLC reported higher fatigue symptoms than healthy individuals, and lower self-reported physical activity levels than patients with early-stage NSCLC and healthy individuals. Although patients with NSCLC scored worse compared to healthy individuals, clinically relevant impairments were not found at diagnosis. To prevent a further decrease, it is important to implement individually tailored interventions to maintain their health status during and after treatment
Remote patient monitoring in COVID-19: a critical appraisal
No full textIs there any evidence for #telemonitoring in #COVID19? Read more: https://bit.ly/3p1YXBistatus: Publishe
Impact of Surgery on Functional and Patient-reported Outcomes in Patients With Early-stage Non-small Cell Lung Cancer
No full textRationale In patients with early-stage non-small cell lung cancer (NSCLC), the treatment of choice is surgical resection, with or without (neo)adjuvant chemotherapy. As a result of the disease and its treatment, patients have an increased risk for poor functional performances, decreased quality of life and high symptom burden. Current knowledge is mainly based on cross-sectional evaluations after treatment; longitudinal changes have been poorly characterized. Therefore, we aimed to investigate functional and patient-reported outcomes in patients with early-stage NSCLC before treatment and 12 weeks after treatment. Methods Patients with early-stage NSCLC (stage I-IIIB) were assessed before surgery and 12 weeks after treatment initiation. Functional outcome measures were a six-minute walk distance (6MWD), 1-minute sit-to-stand test (1-MSTST), quadriceps muscle strength (QMS; microFET), and handgrip strength (HGS; Jamar). Patient-reported outcome measures were the European Organization for the Research and Treatment of Cancer Questionnaire and lung cancer module (EORTC QLQ-C30-LC13), multidimensional fatigue inventory (MFI-20), and San Diego shortness of breath questionnaire (SOBQ). Analyses were performed using JMP PRO 14.2.0. Paired t-tests and Wilcoxon Signed rank tests were used to compare differences between both timepoints. Results Fifteen patients were included (10 males; age 65±9yrs; 5 with COPD). Patients had NSCLC stage IA (n=10), IB (n=1), IIB (n=2) or IIIA (n=2) and were treated via VATS only (n=11) or VATS and adjuvant chemotherapy (n=4). Results are presented in Figure 1. Twelve weeks after treatment, a significant worsening was found for 1-MSTST (27reps vs. 23reps, p=0.008), HGS (36kg vs. 31kg, p=0.036), and SOBQ score (11 vs. 21, p=0.010). No significant differences were found for the other outcomes. Conclusion In early-stage NSCLC, the treatment mainly affected the performance on the 1-MSTST, peripheral muscle strength, and shortness of breath. In contrast to previous findings, we did not observe a significant decrease in 6MWD, quality of life, and fatigue levels
Functional and Patient-reported Outcomes at Diagnosis of Non-small Cell Lung Cancer
No full textRationale Poor functional performance and high symptom burden are frequently observed in patients undergoing treatment for non-small cell lung cancer (NSCLC). Little is known about their health status initiation therapy. We investigated functional and patient-reported outcomes at diagnosis in patients with early-and advanced-stage NSCLC, and compared them to age-matched healthy individuals. Methods A cross-sectional study was conducted in newly diagnosed patients with early-stage (stage IA-IIIA) and advanced-stage (stage IIIB-IVB) NSCLC-before starting treatment-and healthy individuals. Functional outcome measures were maximal inspiratory pressure (MIP; MicroRPM), quadriceps muscle strength (QMS; microFET), handgrip strength (HGS; Jamar), short physical performance battery (SPPB), one-minute sit-to-stand test (1-MSTST), and six-minute walk distance (6MWD). Patient-reported outcome measures were modified Baecke questionnaire, physical activity scale for the elderly questionnaire (PASE), multidimensional fatigue inventory (MFI-20), modified Medical Research Council dyspnea questionnaire (mMRC), San Diego shortness of breath questionnaire (SOBQ), hospital anxiety and depression scale (HADS), short-form health survey (SF-12), EuroQoL 5-dimensions (EQ-5D), and instrumental activities of daily living scale (IADLs). One-way ANOVAs and Kruskal-Wallis tests, followed by Tukey-Kramer or Steel-Dwass pairwise comparisons, were performed in JMP PRO 14.2.0 to explore differences between the three groups. Results We recruited 24 patients with early-stage NSCLC (70% male; age 66±9yrs; 33% COPD), 17 patients with advanced-stage NSCLC (65% male; age 64±7yrs; 6% COPD) and 18 healthy individuals (44% male; age 67±10yrs; 0% COPD). Patients with early-and advanced-stage NSCLC presented significant lower 1-MSTST (72%pred vs. 74%pred vs. 89%pred, p=0.010), 6MWD (97%pred vs. 106%pred vs. 128%pred, p<0.0001) and SF-12 mental component score (45 vs. 42 vs. 53, p=0.046) in comparison to healthy individuals. PASE and MFI-20 scores were significantly worse in patients with advanced-stage NSCLC than in healthy controls (56 vs. 108, p=0.005; 58 vs. 42, p=0.027). Compared to patients with early-stage NSCLC, patients with advanced-stage NSCLC had a significantly lower PASE score (88 vs. 56, p=0.049). Detailed results are presented in Table 1. Conclusion Patients with NSCLC scored lower on the 1-MSTST and SF-12 mental score at diagnosis compared to healthy individuals. Patients with advanced-stage NSCLC reported higher fatigue symptoms than healthy individuals, and lower self-reported physical activity levels than patients with early-stage NSCLC and healthy individuals. Although patients with NSCLC scored worse compared to healthy individuals, clinically relevant impairments were not found at diagnosis. To prevent a further decrease, it is important to implement individually tailored interventions to maintain their health status during and after treatment
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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