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ObjectivesIncorporating patient reported outcomes into health data linkage research ensures that the patient’s perspective is considered. We aimed to understand the use of patient reported outcomes across an entire healthcare organisation, to inform routine collection and integration of patient reported outcomes into hospital data systems for clinical practice and research. ApproachWe applied a mapping process consisting of 1) an audit of patient reported outcomes used in research projects and data registries, and 2) a survey of clinicians’ use of patient reported outcomes in their clinical practice from January 2015 to March 2021. Patient reported outcomes were then classified as ‘specific’ to a particular disease and/or conditions, or as a ‘generic’ measure that was applicable to a broader population. Patient reported outcomes were also mapped to the health domains they measured, using the World Health Organisation International Classification Framework. Data were described using frequency and proportion. ResultsPatient reported outcomes were used by 22% of research projects (n=144/666), 68% of clinical registries (n=13/19), and 76% of clinical specialties in their clinical care (n=16/21). Of the projects, registries and specialties that used patient reported outcomes, disease specific outcomes were most commonly used: 83% for research projects n=130/144), 69% for clinical registries (n=9/13), and 75% for clinical specialties (n=12/16). Greater than 80% of research projects, clinical registries and clinical specialties measured health domains relating to both body impairments and participation in daily life activities. The most commonly used generic patient reported outcome for research, data registries and clinical practice was the European Quality of Life Five Dimension Five Level (EQ-5D-5L) (research projects n=31/144, 22%; data registries n=2/13, 15%; clinical specialties n=3/16, 19%). ConclusionIn our setting, the EQ-5D-5L had broad applicability across a range of clinical specialties, collection systems and research studies, making it suitable for routine integration into health data systems with potential for linkage with other population data. Sufficient flexibility is required for the collection of population and disease specific measures.

Purpose Patient-reported outcome measures (PROMs) are valuable tools in evaluating the outcomes of surgical treatment health-related quality of life (HRQoL) of women with stress urinary incontinence (SUI) and may be incorporated into related clinical quality registries. The aim of this study was to assess the feasibility and acceptability of incorporating PROMs into the Australian Pelvic Floor Procedure Registry (APFPR). Methods Semi-structured qualitative interviews were conducted with women with SUI (N = 12) and their managing clinicians (N = 11) in Victoria, Australia. Interview topics covered content and face validity, appropriateness, and acceptability of three incontinence-specific, two pain, one anxiety and depression, one sexual function and one patient global impression of improvement instruments identified through the literature to determine their suitability and acceptability for the APFPR. We analysed interview data into topics using conventional content analysis. Results Study participants agreed that PROMs were needed for the APFPR. Both participant groups suggested that some of the instruments were ambiguous, therefore only three instruments (one incontinence-specific, sexual function and patient global impression of improvement) will be included in the APFPR. Both clinicians and women agreed it would be appropriate to answer PROMs at baseline and then at 6- and 12-month postsurgically. Email, phone call and mail-out of the instruments were the preferred options for administration. Conclusion Most women and clinicians supported the feasibility of incorporating PROMs in the APFPR. Participants believed the PROMs would demonstrate useful aggregate HRQoL data and have potential for use in individual care.

Background: Despite the high prevalence of depression among adult women, the proportion of reproductive-aged women with moderate or severe depressive symptoms is uncertain, as is the proportion tak...

Objective\ud \ud Numerous studies have proposed that smooth metal surfaces reduce initial bacterial attachment in the establishment of an early biofilm formation. However, these studies have largely examined single bacterial species, which are not always relevant as pathogens identified as initiators of inflammatory peri-implantitis. This study investigated the adherence of four periodontally-relevant bacterial species to implant and abutment surfaces in current clinical use.\ud Methods\ud \ud Discs of polished cobalt chromium (CoCr-polished) and milled titanium (Ti-milled), representing two clinically relevant surfaces, were prepared and surfaces were characterised. Bacterial species Porphyromonas gingivalis, Fusobacterium nucleatum, Prevotella intermedia and Aggregatibacter actinomycetemcomitans were cultured to mid-log or stationary growth phase. Co-cultures of P. gingivalis, F. nucleatum and P. gingivalis, F. nucleatum, Pr. intermedia were similarly prepared. Bacteria were inoculated onto discs for 2 h, stained with a live/dead fluorescent stain and percentage bacterial coverage was calculated by confocal microscopy and image analysis.\ud Results\ud \ud CoCr-polished discs had smooth surfaces with gentle valley structures, whilst Ti-milled discs had sharp edged peaks. Both discs demonstrated a partial wetting ability capable of initiating bacterial adhesion. P. gingivalis, F. nucleatum and co-cultures, at both mid-log and stationary concentrations, demonstrated equally high coverage of both the smooth CoCr-polished and the rougher Ti-milled metal surfaces. Pr. intermedia and A. actinomycetemcomitans demonstrated lower surface coverage which was slightly higher for Ti-milled.\ud Conclusion\ud \ud Variability was noted in the adherence potential for the respective periodontal pathogens examined. Particularly high adherence was noted for P. gingivalis and F. nucleatum, despite the manufacture of a smooth surface.\ud Clinical significance\ud \ud Both surfaces studied may be used at implant-abutment junctions and both possess an ability to establish a bacterial biofilm containing a periodontally-relevant species. These surfaces are thus able to facilitate the apical migration of bacteria associated with peri-implantitis.