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Aberdeen, United Kingdom

McNamara I.R.,University of East Anglia | Birmingham T.B.,University of Western Ontario | Marsh J.D.,Health Economics Research Unit | Chesworth B.M.,University of Western Ontario | And 2 more authors.
Knee | Year: 2014

Background: Improvements in generic and disease specific scores have been reported with medial opening wedge high tibial osteotomy (MOW HTO). However, meaningful comparisons between competing surgical interventions have been hampered by the lack of a preference based single index of health related quality of life (HRQoL). The primary aim of this study was to derive and report a single index measure of HRQoL for patients undergoing MOW HTO, preoperatively and at 12 and 24. postoperatively. Secondary aims were to evaluate changes in various additional measures of quality of life at these time points. Methods: The impact of MOW HTO was evaluated using generic and disease specific instruments. One hundred thirty eight patients completed the Medical Outcomes Study short form health survey (SF-12) and Knee Osteoarthritis Outcomes Score (KOOS) before, 12 and 24. months after surgery. A preference-based single index measure of HRQoL was calculated and changes were evaluated. Results: The mean change in the HRQoL suggested large, clinically significant improvements from 0.69 preoperatively to 0.82 (p. <. 0.001) and 0.8 at 12 and 24. months postoperatively respectively. All dimensions of the SF-12, except role mental health, and all dimensions of the KOOS also demonstrated statistically significant improvements between pre and postoperative measurements. Conclusions: The preoperative HRQoL of young patients with mechanical varus alignment and medial compartment knee osteoarthritis is similar to older patients with knee osteoarthritis. Medial opening wedge high tibial osteomoty results in significant improvements in HRQoL, the magnitude of which is comparable to other surgical interventions for knee osteoarthristis. © 2013.

Stein J.,Clinic of Psychiatry and Psychotherapy | Luppa M.,Clinic of Psychiatry and Psychotherapy | Konig H.-H.,Health Economics Research Unit | Riedel-Heller S.G.,Clinic of Psychiatry and Psychotherapy | Riedel-Heller S.G.,University of Leipzig
Dementia and Geriatric Cognitive Disorders | Year: 2010

Background/Aims: The determination of meaningful cognitive change over time is essential for the diagnosis of dementia in the elderly. Reliable change indices (RCIs) represent a suitable methodology to assess clinically significant cognitive change. The purpose of this paper is to provide a systematic review of RCI scores in elderly persons for neuropsychological tests currently available. Methods: A comprehensive literature search was conducted. Longitudinal studies dealing with the assessment of RCIs for cognitive instruments and cognitively healthy older participants were reviewed. Quality of studies was determined using a standardized system of evaluating methodical quality. Results: A total of 11 studies met the inclusion criteria; half of the studies rated highly for methodical quality. RCI scores were summarized for a number of neuropsychological instruments. Conclusion: RCIs have important implications regarding the interpretation of change in test scores in older adults. Further assessment and standardization is needed for many neuropsychological instruments. Copyright © 2010 S. Karger AG, Basel.

Alymani N.A.,Section of Translational Medical science | Alymani N.A.,Health Economics Research Unit | Smith M.D.,Health Economics Research Unit | Williams D.J.,Royal Infirmary | And 2 more authors.
European Journal of Cancer | Year: 2010

A priority translational research objective in cancer medicine is the discovery of novel therapeutic targets for solid tumours. Ideally, co-discovery of predictive biomarkers occurs in parallel to facilitate clinical development of agents and ultimately personalise clinical use. However, the identification of clinically useful predictive biomarkers for solid tumours has proven challenging with many initially promising biomarkers failing to translate into clinically useful applications. In particular, the 'failure' of a predictive biomarker has often only become apparent at a relatively late stage in investigation. Recently, the field has recognised the need to develop a robust clinical biomarker development methodology to facilitate the process. This review discusses the recent progress in this area focusing on the key stages in the biomarker development process: discovery, validation, qualification and implementation. Concentrating on predictive biomarkers for selecting systemic therapies for individual patients in the clinic, the advances and progress in each of these stages in biomarker development are outlined and the key remaining challenges are discussed. Specific examples are discussed to illustrate the challenges identified and how they have been addressed. Overall, we find that significant progress has been made towards a formalised biomarker developmental process. This holds considerable promise for facilitating the translation of predictive biomarkers from discovery to clinical implementation. Further enhancements could eventually be found through alignment with regulatory processes. © 2010 Elsevier Ltd.

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