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1. Evolving and evaluating the OMERACT fellows program: insights and implications from OMERACT 2023 fellows

Author

Chapman, Lara S., Kelly, Ayano, Balay-Dustrude, Erin, Bekker, Charlotte, Berthelsen, Dorthe B., Ghosh, Nilasha, Gordon, Rachael A., Haas, Romi, Jones, Caitlin, Luquini, Andre, Weinbrecht-Mischkewitz, Max, Pickles, Tim, Saygin, Didem, Nielsen, Wils, Webers, Casper, Grosskleg, Shawna, Tugwell, Peter, D'Agostino, Maria Antonietta, Guillemin, Francis, and March, Lyn

Published
2024
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4. Measurement properties and interpretability of the Patient-Reported Impact of Dermatological Diseases (PRIDD) measure.

Author

Pattinson, Rachael, Trialonis-Suthakharan, Nirohshah, Pickles, Tim, Austin, Jennifer, FitzGerald, Allison, Augustin, Matthias, and Bundy, Christine

Subjects
MEASUREMENT errors, TEST validity, TRANSLATING & interpreting, LONGITUDINAL method, QUALITY of life
Abstract

Background Patient-reported outcome measures (PROMs) are crucial in assessing the impact of dermatological conditions on people's lives, but the existing dermatology-specific PROMs are not recommended for use, according to COSMIN. We developed the Patient-Reported Impact of Dermatological Diseases (PRIDD) measure in partnership with patients. It has strong evidence of content validity, structural validity, internal consistency, acceptability and feasibility. Objectives To test the remaining measurement properties of the PRIDD and establish the interpretability of scores against the COSMIN criteria, using classic and modern psychometric methods. Methods A global longitudinal study consisting of two online surveys administered 2–4 weeks apart was carried out. Adults (≥ 18 years of age) living with a dermatological condition were recruited via the International Alliance of Dermatology Patient Organizations' (GlobalSkin) membership network. Participants completed PRIDD, a demographics questionnaire and other related measures, including the Dermatology Life Quality Index. We tested the criterion validity, construct validity and responsiveness (Spearman's ρ, independent-samples t -tests and Anova); test–retest reliability [interclass correlation coefficient (ICC)]; measurement error [smallest detectable change or limits of agreement (LoA), distribution-based minimally important change (MIC)]; floor and ceiling effects (number of minimum and maximum scores and person–item location distribution maps), score bandings (κ coefficient of agreement) and the anchor-based MIC of the PRIDD. Results In total, 504 people with 35 dermatological conditions from 38 countries participated. Criterion validity (ρ = 0.79), construct validity (76% hypotheses met), test–retest validity (ICC = 0.93) and measurement error (LoA = 1.3 < MIC = 4.14) were sufficient. Floor and ceiling effects were in the acceptable range (< 15%). Score bandings were determined (κ = 0.47); however, the anchor-based MIC could not be calculated owing to an insufficient anchor. Conclusions PRIDD is a valid and reliable tool to evaluate the impact of dermatological disease on people's lives in research and clinical practice. It is the first dermatology-specific PROM to meet the COSMIN criteria. These results support the value of developing and validating PROMs with a patient-centred approach and using classic and modern psychometric methods. Further testing of responsiveness and MIC, cross-cultural translation, linguistic validation and global data collection are planned. [ABSTRACT FROM AUTHOR]

Published
2024
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6. Evolving and evaluating the OMERACT fellows program: insights and implications from OMERACT 2023 fellows

Author

Chapman, Lara S, Kelly, Ayano, Balay-Dustrude, Erin, Bekker, Charlotte, Berthelsen, Dorthe B, Ghosh, Nilasha, Gordon, Rachael A, Haas, Romi, Jones, Caitlin, Luquini, Andre, Weinbrecht-Mischkewitz, Max, Pickles, Tim, Saygin, Didem, Nielsen, Wil, Webers, Casper, Grosskleg, Shawna, Tugwell, Peter, D'Agostino, Maria Antonietta, Guillemin, Franci, March, Lyn, D'Agostino, Maria Antonietta (ORCID:0000-0002-5347-0060), Chapman, Lara S, Kelly, Ayano, Balay-Dustrude, Erin, Bekker, Charlotte, Berthelsen, Dorthe B, Ghosh, Nilasha, Gordon, Rachael A, Haas, Romi, Jones, Caitlin, Luquini, Andre, Weinbrecht-Mischkewitz, Max, Pickles, Tim, Saygin, Didem, Nielsen, Wil, Webers, Casper, Grosskleg, Shawna, Tugwell, Peter, D'Agostino, Maria Antonietta, Guillemin, Franci, March, Lyn, and D'Agostino, Maria Antonietta (ORCID:0000-0002-5347-0060)

Abstract

Objective: To describe the evolution of the OMERACT Fellows Program (OM FP) and to evaluate the innovative changes implemented in the 2023 program. Methods: The OM FP, the first of its kind in global rheumatology, was developed in 2000 to mentor early career researchers in methods and processes for reaching evidence-driven consensus for outcome measures in clinical studies. The OM FP has evolved through continuing iterations of face to face and online feedback. Key new features delivered in 2023 included e-learning modules, virtual introductory pre-meetings, increased networking with Patient Research Partners (PRPs), learning opportunities to give and receive personal feedback, ongoing performance feedback during the meeting from Fellow peers, PRPs, senior OMERACTers (members of the OMERACT community) and Emerging Leader mentors, involvement in pitching promotions, two-minute Lightning Talks in a plenary session and an embedded poster tour. An online survey was distributed after the meeting to evaluate the program. Results: OM FP has included 208 fellows from 16 countries across 4 continents covering 47 different aspects of rheumatology outcomes since its inception. Over 50 % have remained engaged with OMERACT work. In 2023, 18 Fellows attended and 15 (83 %) completed the post-meeting survey. A dedicated OM FP was deemed important by all respondents, and 93 % would attend the meeting in future. The PRP/Fellow Connection Carousel and Lightning Talks were rated exceptional by 93 %. Key components to improve included clarification of expectations, overall workload, the Emerging Leaders Mentoring Program, and the content and duration of daily summary sessions. Conclusion: The innovations in the 2023 OM FP were well received by the majority of participants and supports early career rheumatology researchers to develop collaborations, skills and expertise in outcome measurement. Implementation of feedback from Fellows will enhance the program for future meetings, continuin

Published
2024

9. Pragmatic randomised controlled trial of guided self-help versus individual cognitive behavioural therapy with a trauma focus for post-traumatic stress disorder (RAPID)

Author

Bisson, Jonathan I, primary, Ariti, Cono, additional, Cullen, Katherine, additional, Kitchiner, Neil, additional, Lewis, Catrin, additional, Roberts, Neil P, additional, Simon, Natalie, additional, Smallman, Kim, additional, Addison, Katy, additional, Bell, Vicky, additional, Brookes-Howell, Lucy, additional, Cosgrove, Sarah, additional, Ehlers, Anke, additional, Fitzsimmons, Deborah, additional, Foscarini-Craggs, Paula, additional, Harris, Shaun R S, additional, Kelson, Mark, additional, Lovell, Karina, additional, McKenna, Maureen, additional, McNamara, Rachel, additional, Nollett, Claire, additional, Pickles, Tim, additional, and Williams-Thomas, Rhys, additional

Published
2023
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10. Further refinement of the Patient-Reported Impact of Dermatological Diseases (PRIDD) measure using classical test theory and item response theory.

Author

Pattinson, Rachael, Trialonis-Suthakharan, Nirohshah, Pickles, Tim, Austin, Jennifer, FitzGerald, Allison, Augustin, Matthias, and Bundy, Christine

Subjects
CLASSICAL test theory, ITEM response theory, RASCH models, EXPLORATORY factor analysis, CONFIRMATORY factor analysis
Abstract

Background Existing dermatology-specific Patient-Reported Outcome Measures (PROMs) do not fully capture the substantial physical, psychological and social impact of dermatological conditions on patients' lives and are not recommended for use according to the COSMIN criteria. Most were developed with insufficient patient involvement and relied on classical psychometric methods. We are developing the new Patient-Reported Impact of Dermatological Diseases (PRIDD) measure for use in research and clinical practice in partnership with patients. Objectives To examine the factor structure of PRIDD, determine the definitive selection of items for each subscale, and establish structural validity and internal consistency through classical and modern psychometric methods. Methods Two cross-sectional online surveys were conducted. Adults (≥ 18 years) worldwide living with a dermatological condition were recruited through the membership network of the International Alliance of Dermatology Patient Organizations (GlobalSkin). They completed the PRIDD questionnaire and a demographics questionnaire via an online survey. We examined missing data and distribution of scores for each item. The factor structure was assessed using confirmatory and exploratory factor analysis (Survey 1). Internal consistency was examined using Cronbach's α. Rasch measurement theory analyses were conducted, including iterative assessment of rating scale function, fit to the Rasch model, unidimensionality, reliability, local dependence, targeting and differential item functioning (DIF) (Surveys 1 and 2). Results Participants in Surveys 1 and 2 numbered 483 and 504 people, respectively. All items had ≤ 3% missing scores and all five response options were used. A four-factor model showed the best fit. PRIDD and all four subscales were internally consistent but showed some misfit to the Rasch measurement model. Adjustments were made to rectify disordered thresholds, remove misfitting items, local dependency and DIF, and improve targeting. The resulting 16-item version and subscales fit the Rasch model, showed no local dependency or DIF at the test level, and were well targeted. Conclusions This field test study produced the final PRIDD measure, consisting of 16 items across four domains. The data triangulated and refined the conceptual framework of impact and provide evidence of PRIDD's structural validity and internal consistency. The final step in the development and validation of the PRIDD measure is to test the remaining measurement properties. [ABSTRACT FROM AUTHOR]

Published
2024
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16. The effect of the Talking Diabetes consulting skills intervention on glycaemic control and quality of life in children with type 1 diabetes: cluster randomised controlled trial (DEPICTED study)

Author

Robling, Mike, McNamara, Rachel, Bennert, Kristina, Butler, Christopher C, Channon, Sue, Cohen, David, Crowne, Elizabeth, Hambly, Helen, Hawthorne, Kamila, Hood, Kerenza, Longo, Mirella, Lowes, Lesley, Pickles, Tim, Playle, Rebecca, Rollnick, Stephen, Thomas-Jones, Emma, and Gregory, John W

Published
2012

17. Guided, internet based, cognitive behavioural therapy for post-traumatic stress disorder: pragmatic, multicentre, randomised controlled non-inferiority trial (RAPID)

Author

Bisson, Jonathan I, primary, Ariti, Cono, additional, Cullen, Katherine, additional, Kitchiner, Neil, additional, Lewis, Catrin, additional, Roberts, Neil P, additional, Simon, Natalie, additional, Smallman, Kim, additional, Addison, Katy, additional, Bell, Vicky, additional, Brookes-Howell, Lucy, additional, Cosgrove, Sarah, additional, Ehlers, Anke, additional, Fitzsimmons, Deborah, additional, Foscarini-Craggs, Paula, additional, Harris, Shaun R S, additional, Kelson, Mark, additional, Lovell, Karina, additional, McKenna, Maureen, additional, McNamara, Rachel, additional, Nollett, Claire, additional, Pickles, Tim, additional, and Williams-Thomas, Rhys, additional

Published
2022
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18. P089 Patient-reported outcome measures for rheumatoid arthritis disease activity: a systematic review following COSMIN guidelines

Author

Pickles, Tim, Horton, Mike, Bang Christensen, Karl, Phillips, Rhiannon, Gillespie, David, Macefield, Rhiannon, Aiyegbusi, Lee, Beecher, Claire, and Choy, Ernest

Subjects
Rheumatology, Pharmacology (medical)
Abstract

Background/Aims The standard measurement instruments for assessing Rheumatoid Arthritis (RA) disease activity (DA) are the Disease Activity Score with 28-Joint Count, Simple Disease Activity Index and Clinical Disease Activity Index, which all require a laboratory test and a joint count undertaken by a health care professional. The current standard of care in RA is “Treat-to-Target”, in which regular assessment of RA DA is an integral part. Few healthcare providers have the capacity to assess patients as frequently as stipulated by NICE or EULAR guidelines and thus treatment is not adjusted sufficiently. The SARS-COV-2 pandemic has made the problem more conspicuous with remote rather than face-to-face consultations. Previous research has suggested that Patient Reported Outcome Measures (PROMs) are the most informative way to assess RA DA, and that they allow for a more efficient use of NHS resource. We therefore aimed to assess all PROMs for RA DA against the internationally recognised COSMIN guidelines for rating PROMs. Methods PROSPERO registered as CRD42020176176. This review built on a previous systematic review in the same area, with the PubMed and EMBASE searches expanded to include all articles up to January 2019 (rather than the previous June 2014 date) and those before January 1994. Some articles from the previous review were excluded as they involved biomarker and/or healthcare professional assessments. All identified articles were rated by two independent researchers, where identified PROMs were assessed for Content validity, Quality of Measurement property and related Risk of bias following the COSMIN guidelines, leading to recommendations for use. Results 702 abstracts were retrieved: 310 from both PubMed and EMBASE, 230 from PubMed alone and 162 from EMBASE alone. 34 from the previous review were given full article review, of which 21 were included in the final selection. Of the remaining 668, 128 were selected for abstract review; 58 for full article review; and 10 for the final selection, giving 31 articles in total. 10 PROMs were identified: RADAI, RADAI-SF, RADAI5, PDAS2, PAS, PAS-II, RAPID3, RAPID4, PRO-CLARA and GAS. Following the application of COSMIN guidelines to these 31 articles, none of the identified PROMs could be recommended for use, as none had sufficient evidence for content validity. 5 PROMs had the potential to be recommended but the other five could not be recommended. Conclusion The lack of content validity is a major drawback for these PROMs, but it is worth noting that all of these were developed before the COSMIN guidelines were created, and COSMIN have only recently updated their guidelines to increase the relevance of content validity. A 2019 American College of Rheumatology review recommended two of the identified PROMs based on different criteria. Future research on PROMs for RA DA must look to evidence content validity. Disclosure T. Pickles: None. M. Horton: None. K. Christensen: None. R. Phillips: None. D. Gillespie: None. R. Macefield: None. O. Aiyegbusi: None. C. Beecher: None. E. Choy: None.

Published
2022
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19. Patient Reported Outcome Measures for Rheumatoid Arthritis Disease Activity:a systematic review following COSMIN guidelines

Author

Pickles, Tim, Macefield, Rhiannon, Aiyegbusi, Olalekan Lee, Beecher, Claire, Horton, Mike, Christensen, Karl Bang, Phillips, Rhiannon, Gillespie, David, Choy, Ernest, Pickles, Tim, Macefield, Rhiannon, Aiyegbusi, Olalekan Lee, Beecher, Claire, Horton, Mike, Christensen, Karl Bang, Phillips, Rhiannon, Gillespie, David, and Choy, Ernest

Abstract

BACKGROUND: The current standard of care in rheumatoid arthritis (RA) requires regular assessment of disease activity (DA). All standard RA DA measurement instruments require joint counts to be undertaken by a healthcare professional with/without a blood test. Few healthcare providers have the capacity to assess patients as frequently as stipulated by guidelines. Patient Reported Outcome Measures (PROMs) could be an efficient and informative way to assess RA DA, which is highlighted by the SARS-COV-2 pandemic, as most consultations are remote rather than face-to-face. We aimed to assess all PROMs for RA DA against the internationally recognised COSMIN guidelines to provide evidence-based recommendations to select the most suitable PROMs. METHODS: Review registered on PROSPERO as CRD42020176176. The search strategy was based on a previous similar systematic review and expanded to include all articles up to January 2019. All identified articles were rated by two independent assessors following the COSMIN guidelines. RESULTS: 668 abstracts were identified, with 10 articles included. A further 21 were identified from a previous review. Ten PROMs were identified. There was insufficient evidence to place any of the identified PROMs into recommendation for use category A due to lack of evidence for content validity, as stipulated by the COSMIN guidelines. CONCLUSION: Lack of evidence of content validity limits suitable PROM selection, therefore none can be recommended for use. It is acknowledged that all included PROMs were developed before the COSMIN guidelines were published. Future research on PROMs for RA DA must provide evidence of content validity.

Published
2022

26. Additional file 4: of Perineural local anaesthetic catheter after major lower limb amputation trial (PLACEMENT): study protocol for a randomised controlled pilot study

Author

Bosanquet, David, Ambler, Graeme, Cherry-Ann Waldron, Thomas-Jones, Emma, Brookes-Howell, Lucy, Kelson, Mark, Pickles, Tim, Harris, Debbie, Fitzsimmons, Deborah, Saxena, Neeraj, and Twine, Christopher

Abstract

Qualitative interview information sheet, healthcare professional (DOCX 1470 kb)

Published
2017
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28. Additional file 7: of Perineural local anaesthetic catheter after major lower limb amputation trial (PLACEMENT): study protocol for a randomised controlled pilot study

Author

Bosanquet, David, Ambler, Graeme, Cherry-Ann Waldron, Thomas-Jones, Emma, Brookes-Howell, Lucy, Kelson, Mark, Pickles, Tim, Harris, Debbie, Fitzsimmons, Deborah, Saxena, Neeraj, and Twine, Christopher

Subjects
humanities
Abstract

Qualitative interview consent form, patient (DOCX 1469 kb)

Published
2017
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30. Additional file 6: of Perineural local anaesthetic catheter after major lower limb amputation trial (PLACEMENT): study protocol for a randomised controlled pilot study

Author

Bosanquet, David, Ambler, Graeme, Cherry-Ann Waldron, Thomas-Jones, Emma, Brookes-Howell, Lucy, Kelson, Mark, Pickles, Tim, Harris, Debbie, Fitzsimmons, Deborah, Saxena, Neeraj, and Twine, Christopher

Abstract

Qualitative interview consent form, healthcare professional (DOCX 416 kb)

Published
2017
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33. Supporting shared decision making using an Option Grid for osteoarthritis of the knee in an interface musculoskeletal clinic: a stepped wedge trial

Author

Elwyn, Glyn, Pickles, Tim, Edwards, Adrian, Kinsey, Katharine, Brain, Kate, Newcombe, Robert G., Firth, Jill, Marrin, Katy, Nye, Alan, and Wood, Fiona

Subjects
Medicine(all), Patient decision aids, Collaborative deliberation, R1, Shared decision making, Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18], Option Grids
Abstract

Contains fulltext : 171568.pdf (Publisher’s version ) (Open Access) OBJECTIVE: To evaluate whether introducing tools, specifically designed for use in clinical encounters, namely Option Grids, into a clinical practice setting leads to higher levels of shared decision making. METHODS: A stepped wedge trial design where 6 physiotherapists at an interface clinic in Oldham, UK, were sequentially instructed in how to use an Option Grid for osteoarthritis of the knee. Patients with suspected or confirmed osteoarthritis of the knee were recruited, six per clinician prior to instruction, and six per clinician afterwards. We measured shared decision making, patient knowledge, and readiness to decide. RESULTS: A total of 72 patients were recruited; 36 were allocated to the intervention group. There was an 8.4 point (95% CI 4.4 to 12.2) increase in the Observer OPTION score (range 0-100) in the intervention group. The mean gain in knowledge was 0.9 points (score range 0-5, 95% CI, 0.3 to 1.5). There was no increase in encounter duration. CONCLUSION: Shared decision making increased when clinicians used the knee osteoarthritis Option Grid. PRACTICE IMPLICATIONS: Tools designed to support collaboration and deliberation about treatment options lead to increased levels of shared decision making.

Published
2016

35. Perineural local anaesthetic catheter after major lower limb amputation trial (PLACEMENT): study protocol for a randomised controlled pilot study

Author

Bosanquet, David C., primary, Ambler, Graeme K., additional, Waldron, Cherry-Ann, additional, Thomas-Jones, Emma, additional, Brookes-Howell, Lucy, additional, Kelson, Mark, additional, Pickles, Tim, additional, Harris, Debbie, additional, Fitzsimmons, Deborah, additional, Saxena, Neeraj, additional, and Twine, Christopher P., additional

Published
2017
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36. Abstracts from The College of Podiatry Annual Conference 2016

Author

Ingram, John, primary, Cawley, Scott, additional, Jones, Angela, additional, Coulman, Elinor, additional, Gregory, Clive, additional, Pickles, Tim, additional, Kei, Him Shun Hinson, additional, Fletcher, Paul, additional, Curran, Mike, additional, Prior, Trevor, additional, Formosa, Cynthia, additional, Otter, Simon, additional, Rome, Keith, additional, Gow, Peter, additional, Dalbeth, Nicola, additional, Rohan, Maheswaran, additional, Stewart, Sarah, additional, Aiyer, Ashok, additional, Glasser, Sam, additional, Paton, Joanne, additional, Collings, Richard, additional, Marsden, Jonathan, additional, Torgerson, David, additional, Cockayne, Sarah, additional, Rodgers, Sara, additional, Green, Lorraine, additional, Fairhurst, Caroline, additional, Adamson, Joy, additional, Clark, Arabella, additional, Corbacho, Belen, additional, Hewitt, Catherine, additional, Hicks, Kate, additional, Hull, Robin, additional, Keenan, Anne-Maree, additional, Lamb, Sarah, additional, Menz, Hylton, additional, Redmond, Anthony, additional, Richardson, Zoe, additional, Vernon, Wesley, additional, Watson, Judith, additional, Farndon, Lisa, additional, Clarke, Arabella, additional, McIntosh, Caroline, additional, Mizzi, Stephen, additional, Cutajar, Lucianne, additional, Mizzi, Annabelle, additional, Falzon, Owen, additional, Swaine, Ian, additional, Springett, Kate, additional, Bachand, Andrea, additional, Avison, Ben, additional, Leitch, Jessica, additional, Scott, Jennifer, additional, Hendry, Gordon, additional, Locke, Jackie, additional, McArdle, Carla, additional, Lagan, Katie, additional, McDowell, David, additional, Kaminski, Michelle, additional, Raspovic, Anita, additional, McMahon, Lawrence, additional, Lambert, Katrina, additional, Erbas, Bircan, additional, Mount, Peter, additional, Kerr, Peter, additional, Landorf, Karl, additional, Mamode, Louis, additional, Bowen, Catherine, additional, Burnett, Malcolm, additional, Gates, Lucy, additional, Ashburn, Ann, additional, Cole, Mark, additional, Donovan-Hall, Margaret, additional, Pickering, Ruth, additional, Bader, Dan, additional, Robison, Judy, additional, Kunkel, Dorit, additional, Al Bimani, Saed, additional, Warner, Martin, additional, Murchie, Jane, additional, Hannigan, Rachel, additional, Ellis, Mairghread, additional, Patience, Aimie, additional, Slater, Sophie, additional, Wallace, Kirsten, additional, Edwards, Katherine, additional, Borthwick, Alan M., additional, McCulloch, Louise, additional, Redmond, Anthony C., additional, Pinedo-Villanueva, Rafael, additional, Arden, Nigel K., additional, Bowen, Catherine J., additional, Siddle, Heidi, additional, Mandl, Peter, additional, Aletaha, Daniel, additional, Vlieland, Thea Vliet, additional, Backhaus, Marina, additional, Cornell, Patricia, additional, D’Agostino, Maria Antonietta, additional, Ellegaard, Karen, additional, Iagnocco, Annamaria, additional, Jakobsen, Bente, additional, Jasinski, Tiina, additional, Kildal, Nina, additional, Lehner, Michaela, additional, Moller, Ingrid, additional, Supp, Gabriela, additional, O’Connor, Philip, additional, Naredo, Esperanza, additional, and Wakefield, Richard, additional

Published
2017
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38. Steal your neighbor's trash for fun and profit

Author

Pickles, Tim

Subjects
Home appliances -- Maintenance and repair, Lawn and garden equipment -- Maintenance and repair, Recycling (Waste, etc.) -- Methods, Home and garden
Published
2001

40. Effects of an optimised POCT guided diagnostic and treatment strategy for symptoms of uncomplicated UTI on use of appropriate antibiotics and uptake into primary care practice

Author

Bates, Janine, primary, Thomas-Jones, Emma, additional, Kirby, Nigel, additional, Pickles, Tim, additional, Thomas, Rhys, additional, Bongard, Emily, additional, Gal, Micaela, additional, Little, Paul, additional, Verheij, Theo, additional, Llor, Carlos, additional, Cohen, David, additional, Francis, Nick, additional, Hood, Kerry, additional, and Butler, Christopher, additional

Published
2013
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41. Pragmatic randomised controlled trial of guided self-help versus individual cognitive behavioural therapy with a trauma focus for post-traumatic stress disorder (RAPID)

Author

Bisson, Jonathan, Ariti, Cono, Cullen, Katherine, Kitchiner, Neil, Lewis, Catrin, Roberts, Neil P., Simon, Natalie, Smallman, Kim, Addison, Katy, Bell, Vicky, Brooks-Howell, Lucy, Cosgrove, Sarah, Ehlers, Anke, Fitzsimmons, Deborah, Foscarini-Craggs, Paula, Harris, Shaun R. S., Kelson, Mark, Lovell, Karina, McKenna, Maureen, McNamara, Rachel, Nollett, Claire, Pickles, Tim, and Williams-Thomas, Rhys

42. Sand islands.

Author

Pickles, Tim

Subjects
*SHADES & shadows
Abstract

A question is presented regarding patterns cast on the seabed by patches of floating sand.

Published
2007
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43. P089 Patient-reported outcome measures for rheumatoid arthritis disease activity: a systematic review following COSMIN guidelines

Author

Pickles, Tim, Horton, Mike, Bang Christensen, Karl, Phillips, Rhiannon, Gillespie, David, Macefield, Rhiannon, Aiyegbusi, Lee, Beecher, Claire, Choy, Ernest, Pickles, Tim, Horton, Mike, Bang Christensen, Karl, Phillips, Rhiannon, Gillespie, David, Macefield, Rhiannon, Aiyegbusi, Lee, Beecher, Claire, and Choy, Ernest

Abstract

Background/Aims The standard measurement instruments for assessing Rheumatoid Arthritis (RA) disease activity (DA) are the Disease Activity Score with 28-Joint Count, Simple Disease Activity Index and Clinical Disease Activity Index, which all require a laboratory test and a joint count undertaken by a health care professional. The current standard of care in RA is “Treat-to-Target”, in which regular assessment of RA DA is an integral part. Few healthcare providers have the capacity to assess patients as frequently as stipulated by NICE or EULAR guidelines and thus treatment is not adjusted sufficiently. The SARS-COV-2 pandemic has made the problem more conspicuous with remote rather than face-to-face consultations. Previous research has suggested that Patient Reported Outcome Measures (PROMs) are the most informative way to assess RA DA, and that they allow for a more efficient use of NHS resource. We therefore aimed to assess all PROMs for RA DA against the internationally recognised COSMIN guidelines for rating PROMs. Methods PROSPERO registered as CRD42020176176. This review built on a previous systematic review in the same area, with the PubMed and EMBASE searches expanded to include all articles up to January 2019 (rather than the previous June 2014 date) and those before January 1994. Some articles from the previous review were excluded as they involved biomarker and/or healthcare professional assessments. All identified articles were rated by two independent researchers, where identified PROMs were assessed for Content validity, Quality of Measurement property and related Risk of bias following the COSMIN guidelines, leading to recommendations for use. Results 702 abstracts were retrieved: 310 from both PubMed and EMBASE, 230 from PubMed alone and 162 from EMBASE alone. 34 from the previous review were given full article review, of which 21 were included in the final selection. Of the remaining 668, 128 were selected for abstract review; 58 for full article

44. The effect of the Talking Diabetes consulting skills intervention on glycaemic control and quality of life in children with type 1 diabetes: cluster randomised controlled trial (DEPICTED study)

Author

Robling, Mike, McNamara, Rachel, Bennert, Kristina, Butler, Christopher C, Channon, Sue, Cohen, David, Crowne, Elizabeth, Hambly, Helen, Hawthorne, Kamila, Hood, Kerenza, Longo, Mirella, Lowes, Lesley, Pickles, Tim, Playle, Rebecca, Rollnick, Stephen, Thomas-Jones, Emma, and Gregory, John W

Abstract

OBJECTIVE: To evaluate the effectiveness on glycaemic control of a training programme in consultation skills for paediatric diabetes teams. Design Pragmatic cluster randomised controlled trial. Setting 26 UK secondary and tertiary care paediatric diabetes services. Participants 79 healthcare practitioners (13 teams) trained in the intervention (359 young people with type 1 diabetes aged 4-15 years and their main carers) and 13 teams allocated to the control group (334 children and their main carers). Intervention Talking Diabetes programme, which promotes shared agenda setting and guiding communication style, through flexible menu of consultation strategies to support patient led behaviour change. MAIN OUTCOME MEASURES: The primary outcome was glycated haemoglobin (HbA1c) level one year after training. Secondary outcomes were clinical measures (hypoglycaemic episodes, body mass index, insulin regimen), general and diabetes specific quality of life, self reported and proxy reported self care and enablement, perceptions of the diabetes team, self reported and carer reported importance of, and confidence in, undertaking diabetes self management measured over one year. Analysis was by intention to treat. An integrated process evaluation included audio recording a sample of 86 routine consultations to assess skills shortly after training (intervention group) and at one year follow-up (intervention and control group). Two key domains of skill assessment were use of the guiding communication style and shared agenda setting. RESULTS: 660/693 patients (95.2%) provided blood samples at follow-up. Training diabetes care teams had no effect on HbA1clevels (intervention effect 0.01, 95% confidence interval –0.02 to 0.04, P=0.5), even after adjusting for age and sex of the participants. At follow-up, trained staff (n=29) were more capable than controls (n=29) in guiding (difference in means 1.14, P<0.001) and agenda setting (difference in proportions 0.45, 95% confidence interval 0.22 to 0.62). Although skills waned over time for the trained practitioners, the reduction was not significant for either guiding (difference in means –0.33, P=0.128) or use of agenda setting (difference in proportions –0.20, –0.42 to 0.05). 390 patients (56%) and 441 carers (64%) completed follow-up questionnaires. Some aspects of diabetes specific quality of life improved in controls: reduced problems with treatment barriers (mean difference –4.6, 95% confidence interval –8.5 to –0.6, P=0.03) and with treatment adherence (–3.1, –6.3 to –0.01, P=0.05). Short term ability to cope with diabetes increased in patients in intervention clinics (10.4, 0.5 to 20.4, P=0.04). Carers in the intervention arm reported greater excitement about clinic visits (1.9, 1.05 to 3.43, P=0.03) and improved continuity of care (0.2, 0.1 to 0.3, P=0.01). CONCLUSIONS: Improving glycaemic control in children attending specialist diabetes clinics may not be possible through brief, team-wide training in consultation skills. Trial registration Current Controlled Trials ISRCTN61568050.

Published
2011
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