A positive association was established between dental decay and the presence of a fistula. Although not proven as causative, possible reasons for this include nasal mucus retaining sugary food in the mouth and an overall prolonged food-clearance time. The known association between severity of cleft and an increased likelihood of a fistula and severity of cleft and increased dental decay were again demonstrated but were not found to be the exclusive explanation for the new finding of an association between fistulae and higher dental decay rates.
282 Background: Clinical trials and international registries assess outcomes considered relevant to men with advanced prostate cancer (CaP). However, we lack a single standardized set of outcomes, making direct comparisons between populations and quality of care assessments challenging. We sought to create a minimum standardized set of outcomes relevant to men with advanced CaP. Methods: The International Consortium for Health Outcomes Measurement assembled a multi-disciplinary working group to create a minimum set of measures to collect for men with advanced CaP. We used a modified Delphi method to establish pertinent measures and case-mix characteristics. Results: Approximately 24 experts, including clinicians and patient advocates, from North America, Europe, and Australia participated. We defined the included population as men with metastatic prostate cancer or biochemical recurrence who failed or were ineligible for salvage therapy. Outcomes important to all men with advanced CaP, such as overall survival, and measures specific to subgroups, such as time to metastasis, were identified. Measures gathered from clinical data include risk-stratification characteristics and measures of disease control. Patient-reported outcome measures, like pain control, depression, and erectile, urinary, and bowel dysfunction, were also identified. Conclusions: Standardized outcome measures are necessary to assess quality of care across different populations, and are critical to ensure value in health care. Our international, multi-disciplinary team identified clinical data and patient-reported outcomes to provide a basis for international health outcome comparisons and future assessments of quality of care for men with advanced CaP.
Introduction: Evaluation of hand function has traditionally focused on objective measurements involving strength and range of movement measurements. The World Health Organisation International Classification of Disability, Functioning and Health (ICF) framework has introduced a more patient-orientated approach to assessment, incorporating four distinct areas of body structures, body functions, environment and activity limitation. These can be evaluated with both questionnaires and functional tests. Whereas there seems to be agreement over adult hand assessment, children's hand assessment leaves involved therapists and clinician often wondering, which test to perform. The objective of this review was to evaluate the currently available childrens' hand and upper limb assessment tools within the framework of the ICF. Method: A review of 19 of the most commonly used paediatric hand and upper limb assessment tools in the context of the components of the ICF. The International Classification of Disability, Functioning and Health linking rules composed by Cieza et al. were used in order to map each of the meaningful concepts in these assessment tools to the domains of the ICF. Results: The activities domain of the ICF was found to be well represented in all assessment tools. Four out of 19 assessment tools had items that mapped to the environment domain. The highest number of different concepts mapped was found in musculoskeletal questionnaires. The lowest number of concepts was found in the pegboard tests. Conclusion: Tests are often combined to attempt to cover as many aspects of the ICF yet our findings show that this may not always be achieved. Clinicians and therapists must be aware that in order to get a more complete overview of a child's hand and upper limb functioning sometimes time-and resource-consuming tests have to be combined.
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