2022 Eastern publications

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A summary list of all RD&E research outputs published or issued in 2022

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    Surviving rectal cancer at the cost of a colostomy: global survey of long-term health-related quality of life in 10 countries
    (Wiley, 2022-11-02) Kristensen, HØ; Thyø, A.; Emmertsen, K. J.; Smart, N. J.; Pinkney, T.; Warwick, A. M.; Pang, D.; Elfeki, H.; Shalaby, M.; Emile, S. H.; Abdelkhalek, M.; Zuhdy, M.; Poskus, T.; Dulskas, A.; Horesh, N.; Furnée, E. J. B.; Verkuijl, S. J.; Rama, N. J.; Domingos, H.; Maciel, J.; Solis-Peña, A.; Espín-Basany, E.; Hidalgo-Pujol, M.; Biondo, S.; Sjövall, A.; Christensen, P.
    BACKGROUND: Colorectal cancer management may require an ostomy formation; however, a stoma may negatively impact health-related quality of life (HRQoL). This study aimed to compare generic and stoma-specific HRQoL in patients with a permanent colostomy after rectal cancer across different countries. METHOD: A cross-sectional cohorts of patients with a colostomy after rectal cancer in Denmark, Sweden, Spain, the Netherlands, China, Portugal, Australia, Lithuania, Egypt, and Israel were invited to complete questionnaires regarding demographic and socioeconomic factors along with the Colostomy Impact (CI) score, European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ-C30) and five anchor questions assessing colostomy impact on HRQoL. The background characteristics of the cohorts from each country were compared and generic HRQoL was measured with the EORTC QLQ-C30 presented for the total cohort. Results were compared with normative data of reference European populations. The predictors of reduced HRQoL were investigated by multivariable logistic regression, including demographic and socioeconomic factors and stoma-related problems. RESULTS: A total of 2557 patients were included. Response rates varied between 51-93 per cent. Mean time from stoma creation was 2.5-6.2 (range 1.1-39.2) years. A total of 25.8 per cent of patients reported that their colostomy impairs their HRQoL 'some'/'a lot'. This group had significantly unfavourable scores across all EORTC subscales compared with patients reporting 'no'/'a little' impaired HRQoL. Generic HRQoL differed significantly between countries, but resembled the HRQoL of reference populations. Multivariable logistic regression showed that stoma dysfunction, including high CI score (OR 3.32), financial burden from the stoma (OR 1.98), unemployment (OR 2.74), being single/widowed (OR 1.35) and young age (OR 1.01 per year) predicted reduced stoma-related HRQoL. CONCLUSION: Overall HRQoL is preserved in patients with a colostomy after rectal cancer, but a quarter of the patients interviewed reported impaired HRQoL. Differences among several countries were reported and socioeconomic factors correlated with reduced quality of life.
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    Protocol to develop a core outcome set in incisional hernia surgery: the HarMoNY Project
    (BMJ, 2022-12-06) Harji, D.; Thomas, C.; Antoniou, S.; Chandraratan, H.; Griffiths, B.; Heniford, B. T.; Horgan, L.; Koeckerling, F.; Lopez-Cano, M.; Massey, L.; Miserez, M.; Montgomery, A.; Muysoms, F.; Poulose, B.; Reinpold, W.; Smart, N.
    INTRODUCTION: Incisional hernia has an incidence of up to 20% following laparotomy and is associated with significant morbidity and impairment of quality of life. A variety of surgical strategies including techniques and mesh types are available to manage patients with incisional hernia. Previous works have reported significant heterogeneity in outcome reporting for abdominal wall herniae, including ventral and inguinal hernia. This is coupled with under-reporting of important clinical and patient-reported outcomes. The lack of standardisation in outcome reporting contributes to reporting bias, hinders evidence synthesis and adequate data comparison between studies. This project aims to develop a core outcome set (COS) of clinically important, patient-oriented outcomes to be used to guide reporting of future research in incisional hernia. METHODS: This project has been designed as an international, multicentre, mixed-methods project. Phase I will be a systematic review of current literature to examine the current clinical and patient-reported outcomes for incisional hernia and abdominal wall reconstruction. Phase II will identify the outcomes of importance to all key stakeholders through in depth qualitative interviews. Phase III will achieve consensus on outcomes of most importance and for inclusion into a COS through a Delphi process. Phase IV will achieve consensus on the outcomes that should be included in a final COS. ETHICS AND DISSEMINATION: The adoption of this COS into clinical and academic practice will be endorsed by the American, British and European Hernia Societies. Its utilisation in future clinical research will enable appropriate data synthesis and comparison and will enable better clinical interpretation and application of the current evidence base. This study has been registered with the Core Outcome Measures in Effectiveness Trials initiative. PROSPERO REGISTRATION NUMBER: CRD42018090084.
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    Moving towards patient-centred outcomes: the Severe Asthma Questionnaire
    (European Respiratory Society, 2022-12-30) Davies, D.; Hyland, M. E.; Lanario, J. W.; Jones, R. C.; Masoli, M.
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    Out-of-hours task allocation: implications for foundation training and practice
    (HighWire, 2022-11-01) Bennett, R. A.; Fowler, G. E.
    INTRODUCTION: The role of foundation year-1 (FY1) doctors during the out-of-hours (OOHs) period was explored, identifying areas to improve their training. METHODS: Data were retrospectively collected for 1 year of foundation training (2018-2019) from an electronic task system between 17:00 to 08:00, Monday to Sunday, in a 798-bed teaching hospital in Exeter, UK. RESULTS: Thirty-two thousand, two hundred and sixty OOHs jobs were requested with 21,816 (67.6%) assigned to FY1 doctors and the clinical site practitioner. Jobs were distributed with 12,044 (55.2%) for FY1 medicine, 5,739 (26.3%) for FY1 surgery and 4,033 (18.5%) for the clinical site practitioner. The three most common jobs requested were prescribing (31.1%), patient reviews (17.9%), and interpreting or taking bloods (11.6%). Procedural jobs accounted for 22.2% of all jobs. Prescribing and patient review jobs were further categorised into commonly encountered themes. CONCLUSION: This study describes the nature of jobs performed by FY1 doctors working OOHs and identifies three areas to focus foundation doctor training. First, improving the preparedness of new graduates as guided by commonly identified jobs. Second, monitoring the appropriateness of performed jobs. Third, ensuring the evolving roles of allied health professionals and foundation doctors are clearly understood in relation to one another.