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Biomedical subjects

Sally Green

Publications and source records attributed to Sally Green.

At least 19 recordsLinked to original sources
PubMed2007

Screening for prostate cancer: a Cochrane systematic review.

OBJECTIVES: The objective of this systematic review was to determine whether screening for prostate cancer reduces prostate cancer mortality. METHODS: A systematic search for randomised controlled trials was conducted through electronic scientific databases and a specialist register of the Cochrane Prostatic Diseases and Urologic Cancers Group. Manual searching of specific journals was also conducted. Two authors independently reviewed studies that met the inclusion criteria. Studies were independently assessed for quality. Data from included studies was also extracted independently. RESULTS: Two randomised controlled trials were included however, both trials had methodological weaknesses. Re-analysis of the reported data using intention-to-screen and meta-analysis indicated no statistically significant difference in prostate cancer mortality between men randomized for prostate cancer screening and controls (RR 1.01, 95% CI: 0.80-1.29). CONCLUSIONS: Given that only two randomised controlled trials were included, and the high risk of bias of both trials, there is insufficient evidence to either support or refute the routine use of screening compared to no screening for reducing prostate cancer mortality. Currently, no robust evidence from randomised controlled trials is available regarding the impact of screening on quality of life, harms of screening, or its economic value. Results from two ongoing large scale multi-center randomised controlled trials, which will be available in the upcoming few years, will assist patients and health professionals in making an evidence-based decision regarding the effectiveness of screening for prostate cancer.

Humans↗
PubMed2006

Measures for assessing practice change in medical practitioners.

BACKGROUND: There are increasing numbers of randomised trials and systematic reviews examining the efficacy of interventions designed to bring about a change in clinical practice. The findings of this research are being used to guide strategies to increase the uptake of evidence into clinical practice. Knowledge of the outcomes measured by these trials is vital not only for the interpretation and application of the work done to date, but also to inform future research in this expanding area of endeavour and to assist in collation of results in systematic reviews and meta-analyses. METHODS: The objective of this review was to identify methods used to measure change in the clinical practices of health professionals following an intervention aimed at increasing the uptake of evidence into practice. All published trials included in a recent, comprehensive Health Technology Assessment of interventions to implement clinical practice guidelines and change clinical practice (n = 228) formed the sample for this study. Using a standardised data extraction form, one reviewer (SH), extracted the relevant information from the methods and/or results sections of the trials. RESULTS: Measures of a change of health practitioner behaviour were the most common, with 88.8% of trials using these as outcome measures. Measures that assessed change at a patient level, either actual measures of change or surrogate measures of change, were used in 28.8% and 36.7% of studies (respectively). Health practitioners' knowledge and attitudes were assessed in 22.8% of the studies and changes at an organisational level were assessed in 17.6%. CONCLUSION: Most trials of interventions aimed at changing clinical practice measured the effect of the intervention at the level of the practitioner, i.e. did the practitioner change what they do, or has their knowledge of and/or attitude toward that practice changed? Less than one-third of the trials measured, whether or not any change in practice, resulted in a change in the ultimate end-point of patient health status.

Journal Article↗
PubMed2005

The SEIQoL-DW is a valid method for measuring individual quality of life in stroke survivors attending a secondary prevention clinic.

OBJECTIVES: This paper examines the applicability and construct validity of the Schedule for the Evaluation of Individual Quality of Life-Direct Weight (SEIQoL-DW) for measuring quality of life in stroke survivors living at home that attend a secondary prevention clinic. PARTICIPANTS AND METHODS: Forty-six individuals attending a secondary prevention clinic following a stroke or transient ischaemic attack participated in a semi-structured interview to complete a range of outcome measures. Assessments of cognitive impairment, disability, and handicap were conducted using the Mini mental State Examination (MMSE), Barthel Index (BI), and Rankin Scale (RS). Measures to assess quality of life included perceived health status (PHS), Visual Analogue Mood Scale (VAMS), the Hospital Anxiety and Depression Scale (HADS), and the SEIQoL-DW. The construct validity of the SEIQoL-DW was assessed by correlation with the other measures. RESULTS: According to the cues elicited from the SEIQoL-DW, participants nominated 'relationships with family and friends' as the most important life domain, followed by 'social and leisure activities', and 'health'. Spearman's rho correlation coefficients demonstrated significant relationships between the SEIQoL-DW index scores, PHS (r = 0.35, p = 0.016), VAMS (r = 0.419, p = 0.004), and the HADS anxiety (r = -0.546, p < 0.0001) and depression (r = -0.701, p < 0.0001) subscale scores. CONCLUSIONS: The SEIQoL-DW demonstrated reasonable construct validity for use in assessing individual quality of life in a group of individuals following stroke or TIA that attend a secondary prevention clinic.

Adult↗
PubMed2005

Guiding users to quality information about osteoarthritis on the Internet: a pilot study.

This pilot study explored the feasibility of and user satisfaction with an Internet User's Guide (IUG) to assist patients in sourcing relevant, valid information about osteoarthritis on the Internet. Twelve people with osteoarthritis participated in focus groups that involved searching the Internet for information relating to their condition with the aid of the IUG. Participants were asked to perform an initial search of the Internet for information on osteoarthritis, followed by a second search with the aid of the IUG. User satisfaction with the IUG and subsequent online searches was obtained during and following the Internet simulations. A total of 92% of all participants had previously used the Internet to search for health information in the past. However, only a third used the Internet to further source information on their condition. Prior to using the IUG, participants cited efficiently searching the Internet for relevant and credible information as the primary obstacle in their continued use of the Internet. All participants reported that the use of the IUG increased their ability to source quality online medical information. The provision of an IUG may support and increase user awareness about searching for relevant, quality medical information on the Internet. Further quantitative and qualitative research is required to identify how best to empower consumers who wish to use the Internet as a medical resource.

Aged↗
PubMed2004

Validity and internal consistency of a whiplash-specific disability measure.

STUDY DESIGN: Cross-sectional study of patients with whiplash-associated disorders investigating the internal consistency, factor structure, response rates, and presence of floor and ceiling effects of the Whiplash Disability Questionnaire (WDQ). OBJECTIVES: The aim of this study was to confirm the appropriateness of the proposed WDQ items. SUMMARY OF BACKGROUND DATA: Whiplash injuries are a common cause of pain and disability after motor vehicle accidents. Neck disability questionnaires are often used in whiplash studies to assess neck pain but lack content validity for patients with whiplash-associated disorders. The newly developed WDQ measures functional limitations associated with whiplash injury and was designed after interviews with 83 patients with whiplash in a previous study. METHODS: Researchers sought expert opinion on items of the WDQ, and items were then tested on a clinical whiplash population. Data were inspected to determine floor and ceiling effects, response rates, factor structure, and internal consistency. Packages of questionnaires were distributed to 55 clinicians, whose patients with whiplash completed and returned 101 questionnaires to researchers. RESULTS: No substantial floor or ceiling effects were identified on inspection of data. The overall floor effect was 12%, and the overall ceiling effect was 4%. Principal component analysis identified one broad factor that accounted for 65% of the variance in responses. Internal consistency was high; Cronbach's alpha = 0.96. CONCLUSIONS: Results of the study supported the retention of the 13 proposed items in a whiplash-specific disability questionnaire. Dependent on the results of further psychometric testing, the WDQ is likely to be an appropriate outcome measure for patients with whiplash.

Adult↗
PubMed2004

Reproducibility and responsiveness of the Whiplash Disability Questionnaire.

This study continued the validation of a Whiplash Specific Disability Questionnaire (WDQ) that was developed from the Neck Disability Index (NDI) using self-reported disabilities in a group of participants experiencing whiplash-associated disorders [J Manipulative Physiol Ther 14 (1991) 409]. Previous research has established the content, construct and face validity and internal consistency of the WDQ. The aim of this study was to establish the short-term and medium-term test-retest reliability and responsiveness of the WDQ. Participants (n = 63) receiving physiotherapy treatment for WAD were recruited from 30 private physiotherapy practices in Melbourne, Australia. Each participant completed three WDQ questionnaires over a 1-month period, the first two separated by 24 h. The third questionnaire contained an additional item that asked respondents to rate their perceived change in condition over the month. Reproducibility was determined using an intra-class correlation co-efficient. Responsiveness was assessed via correlation with participant perceived change, the effect size, standardised response mean (SRM) and the responsiveness statistic. Results demonstrated excellent short-term test-retest reliability (ICC 0.96). Reproducibility over 1 month was excellent (ICC 0.93). Correlation between change in WDQ score over 1 month and participant perceived change was r(s) = 0.64, the effect size was 0.03, the SRM was 0.08 and the responsiveness statistics were 0.90 (participants who improved) and -1.60 (participants who deteriorated). The minimal detectable change of the WDQ was established at 15 points. These results demonstrate that the WDQ has excellent short- and medium-term reproducibility and responsiveness in a population seeking treatment for WAD.

Adolescent↗
PubMed2004

Searching the Internet for information on prostate cancer screening: an assessment of quality.

OBJECTIVES: To identify how on-line information relating to prostate cancer screening (PCS) is best sourced, whether through general, medical, or meta-search engines, and to assess the quality of that information. METHODS: Websites providing information about PCS were searched across 15 search engines representing three distinct types: general, medical, and meta-search engines. The quality of on-line information was assessed using the DISCERN quality assessment tool. Quality performance characteristics were analyzed by performing Mann-Whitney U tests. Search engine efficiency was measured by each search query as a percentage of the relevant websites included for analysis from the total returned and analyzed by performing Kruskal-Wallis analysis of variance. RESULTS: Of 6690 websites reviewed, 84 unique websites were identified as providing information relevant to PCS. General and meta-search engines were significantly more efficient at retrieving relevant information on PCS compared with medical search engines. The quality of information was variable, with most of a poor standard. Websites that provided referral links to other resources and a citation of evidence provided a significantly better quality of information. In contrast, websites offering a direct service were more likely to provide a significantly poorer quality of information. CONCLUSIONS: The current lack of a clear consensus on guidelines and recommendation in published data is also reflected by the variable quality of information found on-line. Specialized medical search engines were no more likely to retrieve relevant, high-quality information than general or meta-search engines.

Adenocarcinoma↗
PubMed2004

Analysis of outcome measures for persons with patellofemoral pain: which are reliable and valid?

OBJECTIVE: To examine the test-retest reliability, validity, and responsiveness of several outcome measures in the treatment of patellofemoral pain. DESIGN: Evaluation of the clinimetric properties of individual outcome measures for patellofemoral pain treatment, using data collected from a previously published randomized controlled trial (RCT). SETTING: General community and private practice. PARTICIPANTS: The data from 71 persons enrolled in an RCT of a conservative intervention for patellofemoral pain were used to evaluate the measures' validity and responsiveness. A subset of this cohort (n=20) was used to assess reliability. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Three 10-cm visual analog scales (VASs) for usual pain (VAS-U), worst pain (VAS-W), and pain on 6 aggravating activities (walking, running, squatting, sitting, ascending and descending stairs) (VAS-activity); the Functional Index Questionnaire (FIQ); the Anterior Knee Pain Scale (AKPS); and the global rating of change. RESULTS: The test-retest reliability ranged from poor (intraclass correlation coefficient [ICC]=.49) to good (ICC=.83), and the measures correlated moderately with each other (r range,.56-.72). Median change scores differed significantly between improved and unimproved persons for all measures. The effect sizes for VAS-U (.79), VAS-W (.88), and the AKPS (.98) were large, indicating greater responsiveness than the FIQ (.37) and VAS-activity (.66). Similarly, the AKPS and VAS-W were the most efficient measures for detecting a treatment effect when compared with a reference measure (VAS-U, which was assigned a value of 1). The minimal difference that patients or clinicians consider clinically important for the AKPS is 10 (out of 100) points and for the VAS it is 2cm (out of 10cm). CONCLUSIONS: The AKPS and VAS for usual or worst pain are reliable, valid, and responsive and are therefore recommended for future clinical trials or clinical practice in assessing treatment outcome in persons with patellofemoral pain.

Adolescent↗
PubMed2004

Is the Human Activity Profile a useful measure in people with knee osteoarthritis?

This study evaluated the usefulness of the Human Activity Profile (HAP) in people with knee osteoarthritis (OA). People with OA (N = 226) completed the HAP and a battery of pain and physical function measures. Healthy elderly controls (N = 33) also completed the HAP, and 20 OA participants underwent repeat testing 2 to 7 days later. Test-retest reliability was excellent (intraclass correlation coefficients 0.96 and 0.95). The HAP was sensitive enough to detect differences in physical activity between people with (N = 33) and without OA (N = 33) (p < 0.01). When OA individuals were classified as impaired, moderately active, or active based on HAP score, differences in pain and physical function were detected (p < 0.05). Correlations between HAP and commonly used pain and physical function measures were weak to moderate (r = 0.18-0.63, all p < 0.01), indicating that the HAP measures additional information not gained by other assessment tools. The HAP is a reliable measure, and it is sensitive enough to discriminate between people with and without knee OA, and within an OA cohort. The HAP appears to have greater applicability in osteoarthritic women than men.

Aged↗
PubMed2004

Tennis elbow.

Explore the source record for details and available documents.

Acupuncture↗
PubMed2003

Tennis elbow.

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Acupuncture Therapy↗
PubMed2003

Converting systematic reviews to Cochrane format: a cross-sectional survey of Australian authors of systematic reviews.

BACKGROUND: Despite the growing reputation and subject coverage of the Cochrane Database of Systematic Reviews, many systematic reviews continue to be published solely in paper-based health care journals. This study was designed to determine why authors choose to publish their systematic reviews outside of the Cochrane Collaboration and if they might be interested in converting their reviews to Cochrane format for publication in the Cochrane Database of Systematic Reviews. METHODS: Cross-sectional survey of Australian primary authors of systematic reviews not published on the Cochrane Database of Systematic Reviews identified from the Database of Abstracts of Reviews of Effectiveness. RESULTS: We identified 88 systematic reviews from the Database of Abstracts of Reviews of Effectiveness with an Australian as the primary author. We surveyed 52 authors for whom valid contact information was available. The response rate was 88 per cent (46/52). Ten authors replied without completing the survey, leaving 36 valid surveys for analysis. The most frequently cited reasons for not undertaking a Cochrane review were: lack of time (78%), the need to undergo specific Cochrane training (46%), unwillingness to update reviews (36%), difficulties with the Cochrane process (26%) and the review topic already registered with the Cochrane Collaboration (21%). (Percentages based on completed responses to individual questions.) Nearly half the respondents would consider converting their review to Cochrane format. Dedicated time emerged as the most important factor in facilitating the potential conversion process. Other factors included navigating the Cochrane system, assistance with updating and financial support. Eighty-six per cent were willing to have their review converted to Cochrane format by another author. CONCLUSION: Time required to complete a Cochrane review and the need for specific training are the primary reasons why some authors publish systematic reviews outside of the Cochrane Collaboration. Encouragingly, almost half of the authors would consider converting their review to Cochrane format. Based on the current number of reviews in the Database of Abstracts of Reviews of Effectiveness, this could result in more than 700 additional Cochrane reviews. Ways of supporting these authors and how to provide dedicated time to convert systematic reviews needs further consideration.

Attitude↗
PubMed2003

Validity of the neck disability index, Northwick Park neck pain questionnaire, and problem elicitation technique for measuring disability associated with whiplash-associated disorders.

The Neck Disability Index (NDI) and Northwick Park Neck Pain Questionnaire (NPQ) were developed to measure self-perceived disability from neck pain, including that which may arise from whiplash injury. However, there is little data specifically concerning their validity for whiplash-associated disorders (WAD). The aim of this study was to assess the validity of the NDI and NPQ as measures of outcome in WAD by comparing them to a patient preference questionnaire, the problem elicitation technique (PET), which identifies problems that are of most importance to the individual patient. A cross-sectional study of 71 patients with varying severity and duration of WAD were recruited from a private physiotherapy practice. All patients completed a standardized self-administered questionnaire that included demographic and clinical details as well as self-perceived pain and severity of symptoms, NDI and NPQ. A trained interviewer administered the PET. Construct validity of the disability measures was examined by determining their correlation with each other and with pain and severity of symptoms by calculating Pearson's correlation coefficients. Content validity of the NDI and NPQ was assessed by comparing the items of both questionnaires to the problems identified by the PET. Participants' mean age was 40.1 years (SD=14.3) and 59 were women (83.1%). Most patients were in WAD category I (n=23, 32.1%), or II (n=42, 59.2%). Mean NDI, NPQ, and PET scores were 40.7 (SD=17.0), 38.7 (SD=15.8), and 160.2 (SD=92.0, range 6.0-509.5), respectively. Correlations between the NDI and PET, NPQ and PET, and NDI and NPQ were r=0.57, 0.56 and 0.88, respectively. The PET identified an average of 7.7 problems per patient (SD=4.2, range 1-17 problems). Problems most commonly identified were work for wages (52.1%), fatigued during the day (50.7%), participation in sports (47.9%), depression (43.7%), drive a car (43.7%), socialize with friends (33.8%), sleep through the night (31.0%), frustration (31.0%), and anger (28.2%). Only three of these problems are included in the NDI (work, driving, and sleeping) and only four are included in the NPQ (work, driving, sleeping, and social activities). While both the NDI and NPQ include some problems that are common in patients with WAD, frequently identified problems, such as emotional and social items are absent. In contrast to the PET, neither instrument captures the full spectrum of disabilities judged to be important by the patient.

Adult↗
PubMed2002

Training practitioners in preparing systematic reviews: a cross-sectional survey of participants in the Australasian Cochrane Centre training program.

BACKGROUND: Although systematic reviews of health care interventions are an invaluable tool for health care providers and researchers, many potential authors never publish reviews. This study attempts to determine why some people with interest in performing systematic reviews do not subsequently publish a review; and what steps could possibly increase review completion. METHODS: Cross-sectional survey by email and facsimile of the 179 participants in Australasian Cochrane Centre training events between 1998 and 2000. RESULTS: Ninety-two participants responded to the survey (51 percent). Response rate of deliverable surveys was 82 percent (92/112). The remainder of the participants had invalid or no contact information on file. More than 75 percent of respondents felt that the current workshops met their needs for training. The most critical barriers to completion of a Cochrane review were: lack of time (80 percent), lack of financial support (36 percent), methodological problems (23 percent) and problems with group dynamics (10 percent). CONCLUSIONS: Strategies to protect reviewer time and increase the efficiency of the review process may increase the numbers of trained reviewers completing a systematic review.

Attitude of Health Personnel↗