Browsing by Subject "outcome assessment"

Now showing 1 - 7 of 7
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    Advanced Therapy in Traumatic Brain Injury Inpatient Rehabilitation: Effects on Outcomes During the First Year after Discharge
    (Elsevier, 2019) Timpson, Misti; Hade, Erinn M.; Beaulieu, Cynthia; Horn, Susan D.; Hammond, Flora M.; Peng, Juan; Montgomery, Erin; Giuffrida, Clare; Gilchrist, Kamie; Lash, Aubrey; Dijkers, Marcel; Corrigan, John D.; Bogner, Jennifer; Physical Medicine and Rehabilitation, School of Medicine
    Objective To use causal inference methods to determine if receipt of a greater proportion inpatient rehabilitation treatment focused on higher level functions, e.g. executive functions, ambulating over uneven surfaces (Advanced Therapy, AdvTx) results in better rehabilitation outcomes. Design A cohort study using propensity score methods applied to the TBI-Practice-Based Evidence (TBI-PBE) database, a database consisting of multi-site, prospective, longitudinal observational data. Setting Acute inpatient rehabilitation (IRF). Participants Patients enrolled in the TBI-PBE study (n=1843), aged 14 years or older, who sustained a severe, moderate, or complicated mild TBI, receiving their first IRF admission to one of 9 sites in the US, and consented to follow-up 3 and 9 months post discharge from inpatient rehabilitation. Interventions Not applicable. Main Outcome Measures: Participation Assessment with Recombined Tools-Objective-17, FIMTM Motor and Cognitive scores, Satisfaction with Life Scale, and Patient Health Questionnaire-9. Results Controlling for measured potential confounders, increasing the percentage of AdvTx during inpatient TBI rehabilitation was found to be associated with better community participation, functional independence, life satisfaction, and decreased likelihood of depression during the year following discharge from inpatient rehabilitation. Participants who began rehabilitation with greater disability experienced larger gains on some outcomes than those who began rehabilitation with more intact abilities. Conclusions Increasing the proportion of treatment targeting higher level functions appears to have no detrimental and a small, beneficial effect on outcome. Caution should be exercised when inferring causality given that a large number of potential confounders could not be completely controlled with propensity score methods. Further, the extent to which unmeasured confounders influenced the findings is not known and could be of particular concern due to the potential for the patient’s recovery trajectory to influence therapists’ decisions to provide a greater amount AdvTx.
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    Contextualized Treatment in Traumatic Brain Injury Inpatient Rehabilitation: Effects on Outcomes During the First Year after Discharge
    (Elsevier, 2019) Bogner, Jennifer; Dijkers, Marcel; Hade, Erinn M.; Beaulieu, Cynthia; Montgomery, Erin; Giuffrida, Clare; Timpson, Misti; Peng, Juan; Gilchrist, Kamie; Lash, Aubrey; Hammond, Flora M.; Horn, Susan; Corrigan, John; Physical Medicine and Rehabilitation, School of Medicine
    Objective To evaluate the effect of providing a greater percentage of therapy as contextualized treatment on acute traumatic brain injury (TBI) rehabilitation outcomes. Design Propensity score methods are applied to the TBI-Practice-Based Evidence (TBI-PBE) database, a database consisting of multi-site, prospective, longitudinal observational data. Setting Acute inpatient rehabilitation. Participants Patients enrolled in the TBI-PBE study (n=1843), aged 14 years or older, who sustained a severe, moderate, or complicated mild TBI, receiving their first IRF admission in the US, and consented to follow-up 3 and 9 months post discharge from inpatient rehabilitation. Interventions Not applicable. Main Outcome Measures Participation Assessment with Recombined Tools-Objective- -17, FIMTM Motor and Cognitive scores, Satisfaction with Life Scale and Patient Health Questionnaire-9. Results Increasing the percentage of contextualized treatment during inpatient TBI rehabilitation leads to better outcomes, specifically in regard to community participation. Conclusions Increasing the proportion of treatment provided in the context of real-life activities appears to have a beneficial impact on outcome. Although the effect sizes are small, the results are consistent with other studies supporting functional-based interventions effecting better outcomes. Furthermore, any positive findings, regardless of size or strength, are endorsed as important by consumers (survivors of TBI). While the findings do not imply that decontextualized treatment should not be used, when the therapy goal can be addressed with either approach, the findings suggest that better outcomes may result if the contextualized approach is used.
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    Delivery of healthcare provider’s lifestyle advice and lifestyle behavioural change in adults who were overweight or obese in pre-diabetes management in the USA: NHANES (2013–2018)
    (BMJ, 2021) Davis-Ajami, Mary L.; Lu, Zhiqiang K.; Wu, Jun
    Objective: The purpose of this study is to examine the association between delivery of healthcare provider's advice about lifestyle management and lifestyle behavioural change in pre-diabetes management in adults who were overweight or obese. Design: This cross-sectional study included adults with body mass index (BMI) ≥25 kg/m2 and reporting pre-diabetes in USA. Outcomes included the prevalence of receiving provider's advice on lifestyle management and patterns of practicing lifestyle change. The association between delivery of provider's advice and lifestyle-related behavioural change in pre-diabetes management was examined. Setting: US Continuous National Health and Nutrition Examination Survey (2013-2018). Participants: A total of 1039 adults with BMI ≥25 kg/m2 reported pre-diabetes. Results: Of eligible adults with pre-diabetes, 76.8% received provider's advice about lifestyle change. The advice group showed higher proportions of ongoing lifestyle change than no advice group, including weight reduction/control (80.1% vs 70.9%, p=0.018), exercise (70.9% vs 60.9%, p=0.013) and diet modifications (83.8% vs 61.8%, p<0.001). After adjustment, those receiving provider's advice were more likely to increase exercise (OR 1.63, 95% CI 1.12 to 2.38) and modify diet (OR 3.0, 95% CI 1.82 to 4.96). Conclusion: Over 75% of US adults who were overweight or obese and reported pre-diabetes received healthcare provider's advice about reducing the risk of diabetes through lifestyle change. Provider's advice increased the likelihood of lifestyle-related behavioural change to exercise and diet.
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    Division of Undergraduate Education Honors College Institute for Engaged Learning University College Program Review and Assessment Committee (PRAC) Annual Report 2018-2019
    (IUPUI, 2019) Graunke, Steve
    The Division of Undergraduate Education (DUE) at IUPUI has a comprehensive range of programs, services, and policies designed to enhance student learning, academic achievement, and persistence. The focus on continuously improving student academic achievement and persistence has made a strong commitment to assessment and evaluation, an integral aspect of the DUE strategic plan. Assessing programs designed to enhance student educational outcomes during the first-year of college requires careful conceptualization of the processes and relationships involved before choosing measures and evaluation designs. As such, the DUE assessment strategy includes a three-phase approach to assessment including needs, process, and outcome assessment. In addition, we employ mix-method approaches that involve a combination of qualitative and quantitative methods as well as indirect and direct measures of student learning.
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    Division of Undergraduate Education Honors College Institute for Engaged Learning University College Program Review and Assessment Committee (PRAC) Annual Report 2019-2020
    (IUPUI, 2020) Graunke, Steve
    The Division of Undergraduate Education (DUE) at IUPUI has a comprehensive range of programs, services, and policies designed to enhance student learning, academic achievement, and persistence. The focus on continuously improving student academic achievement and persistence has made a strong commitment to assessment and evaluation, an integral aspect of the DUE strategic plan. Assessing programs designed to enhance student educational outcomes during the first-year of college requires careful conceptualization of the processes and relationships involved before choosing measures and evaluation designs. As such, the DUE assessment strategy includes a three-phase approach to assessment including needs, process, and outcome assessment. In addition, we employ mix-method approaches that involve a combination of qualitative and quantitative methods as well as indirect and direct measures of student learning.
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    Division of Undergraduate Education Honors College Institute for Engaged Learning University College Program Review and Assessment Committee (PRAC) Annual Report 2020-2021
    (IUPUI, 2021) Graunke, Steve
    The Division of Undergraduate Education (DUE) at IUPUI has a comprehensive range of programs, services, and policies designed to enhance student learning, academic achievement, and persistence. The focus on continuously improving student academic achievement and persistence has made a strong commitment to assessment and evaluation, an integral aspect of the DUE strategic plan. Assessing programs designed to enhance student educational outcomes during the first-year of college requires careful conceptualization of the processes and relationships involved before choosing measures and evaluation designs. As such, the DUE assessment strategy includes a three-phase approach to assessment including needs, process, and outcome assessment. In addition, we employ mix-method approaches that involve a combination of qualitative and quantitative methods as well as indirect and direct measures of student learning.
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    Validating the Postdischarge Surgical Recovery Scale 13 as a Measure of Perceived Postoperative Recovery After Laparoscopic Sacrocolpopexy
    (Wolters Kluwer, 2017-03) Carpenter, Janet S.; Heit, Michael; Chen, Chen X.; Stewart, Ryan; Hamner, Jennifer; Rand, Kevin L.; School of Nursing
    Objectives No postoperative recovery measurement tools have been validated among women undergoing laparoscopic sacrocolpopexy for pelvic organ prolapse, which impedes development and testing of strategies to improve recovery. The purpose of this study was to evaluate the performance of the Postdischarge Surgical Recovery Scale (PSR) as a measure of perceived recovery in laparoscopic sacrocolpopexy patients. Methods Women (N = 120) with stage 2 or higher pelvic organ prolapse undergoing laparoscopic sacrocolpopexy completed a 15-minute postoperative survey (days 7, 14, 42, and 90 [each ± 3 days]) which included the 15-item PSR. A confirmatory factor analysis was conducted using data from 14 days postsurgery, when patients would have begun to recover, but there was likely to be substantial variability in recovery across patients. We also assessed validity and explored sensitivity to change over time and minimally important difference values. Results Confirmatory factor analysis indicated a good fitting model for a reduced version of the PSR (ie, PSR13). Regressions showed that the PSR13 prospectively predicted single-item recovery scores. The PSR13 recovery significantly improved from days 7 to 42, suggesting the PSR13 is sensitive to change. Descriptive statistics including minimally important differences are reported. The minimally important difference was estimated to be around 5 points. Conclusions The PSR13 is a psychometrically sound tool for measuring recovery over time in this population. Its short length makes it an ideal postoperative recovery measure in clinical practice or research.