Development of a Disease-Specific Ureteral Calculus Patient Reported Outcome Measurement Instrument

Tran, Maxine; Sut, Michał; Collie, Jane; Neves, Joana B.; Al-Hayek, Samih; Armitage, James; Couturier, Dominique‐Laurent; Wiseman, Oliver

doi:10.1089/end.2017.0795

Cited by 20 publications

(10 citation statements)

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“…This is different for ureteric stones, where most patients are symptomatic , highlighting the need to assess the experience of the patients with renal stone separately from ureteric stones. In conjunction with developing a ureteric stone disease‐specific PROM tool (Cambridge Ureteric Stone PROM) , we allow for a sensitive, tailored approach to assess the experience of two clinically different phases of the disease. Studying the correlation between CReSP and WISQOL will guide on complimentary benefits of using both tools.…”

Section: Discussionmentioning

confidence: 99%

Qualitative exploration of the renal stone patients’ experience and development of the renal stone‐specific patient‐reported outcome measure

et al. 2019

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Objectives To investigate the experience of patients living with renal calculi via a qualitative methodology, aiming to develop and validate a disease‐specific patient‐reported outcome measure (PROM) for renal stones, the Cambridge Renal Stone PROM (CReSP). Patients, Subjects and Methods Patients with radiologically confirmed renal calculi who had undergone a range of management options were invited to focus groups or semi‐structured interviews to elicit patient input and generate the PROM content. The developed renal stone PROM underwent validity studies included Cronbach's α for internal consistency, Spearman's and Pearson's correlation coefficients for test–retest reliability. Discriminant validity was assessed by Pearson's correlation coefficients vs the EuroQol five‐dimensional five‐level questionnaire (EQ‐5D‐5L). Our project has Health and Social Care Research Ethics Committee approval. Results A total of 106 subjects participated in creating the newly developed PROM. In all, 36 patients were invited to 22 semi‐structured interviews and four focus groups, until reaching saturation. Major issues reported, and themes selected for the renal stone PROM included pain, anxiety, limitations to social life and tiredness, urinary symptoms, dietary changes’ impacts, and gastrointestinal tract symptoms. Reliability analysis for 30 patients to determine internal consistency using Cronbach's α with a mean (range) of 0.91 (0.90–0.93) within domains and Cronbach's α between domains was 0.92. Average inter‐item Pearson's and Spearman's correlation within domains was performed, with a Pearson's correlation mean (range) of 0.77 (0.73–0.85) and Spearman's correlation mean (range) of 0.72 (0.63–0.77). The test–retest Pearson's correlation mean (range) was 0.85 (0.57–0.95). Validity assessment was performed for 20 patients vs 20 controls. Pearson's correlation with EQ‐5D‐5L was −0.74, showing the newly developed PROM successfully discriminated patients with kidney stones. Our final renal stone PROM consists of 14 questions that are rated on a Likert scale; the higher the score, the worse the effect on a patient's quality of life. Conclusions Although pain was the most frequent symptom, other health‐related and social well‐being issues significantly impacted patients’ lives. Our validated patient‐derived CReSP is a new instrument, specifically tailored to measure renal stone disease health outcomes from the patient's point of view.

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Section: Discussionmentioning

confidence: 99%

Qualitative exploration of the renal stone patients’ experience and development of the renal stone‐specific patient‐reported outcome measure

et al. 2019

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“…Patient feedback data was not systematically collected in our study; however, Oderda et al 13 have previously demonstrated that Isiris ® stent removal is well-tolerated by patients. Ultimately, assessment of patients quality of life preoperatively would be a very interesting aspect to study, and this could be done using one of the specifically designed quality of life measures such as the Cambridge Ureteral Stone PROM (CUSP) 21 or the Cambridge Renal Stone PROM (CReSP) 22 for ureteric and renal stone treatments respectively, and then asking the patients to complete the questionnaires J Endolum Endourol Vol 4(1):e45-e53; April 14, 2021.This article is distributed under the terms of the Creative Commons Attribution-Non Commercial 4.0 International License. © Thakare, et al…”

Section: Discussionmentioning

confidence: 99%

A Prospective Evaluation of a Nurse-Led Stent Removal Service Using the Single-Use Isiris®in a Tertiary Referral Stone Unit and its Impact on Patient Waiting Times

Thakare

Collie

Shah

et al. 2021

Journal of Endoluminal Endourology

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Background and ObjectiveDouble J (JJ) ureteric stenting represents one of the most significant causes of patient discomfort and dissat-isfaction following endourological procedures. At our institution, a large tertiary referral centre for complex stones, standard JJ stent removal was previously undertaken with a flexible cystoscope (FC) in the endoscopy department by a doctor. The pathway was prone to delays through capacity constraints and prioritization being given to cancer investigations. The Isiris® is a single-use stent removal system consisting of a ‘camera on chip’ disposable FC with an integrated grasper. We examine the feasibility of a nurse-led stent removal service using Isiris®, performed as an office-based procedure, and its effect on waiting times. Material and MethodsA specialist stone nurse undertook training in FC approved by the British Association of Urological Surgeons (BAUS) and the British Association of Urological Nurses (BAUN). Once competency was reached, a nurse-led service was offered to patients in the outpatient setting. A prospective database from April 2018 to March 2020 was maintained to include patient data for stent removals in the nurse-led clinic using Isiris®. This was compared to a retrospective dataset of FC and stent removal between July 2016 and December 2016, per-formed by a doctor in the endoscopy department. The delays in stent removal compared to the ‘ideal’ stent removal date (planned date plus or minus 3 days tolerance allowed) were compared between the two pathways. ResultsThe specialist nurse undertook BAUS theory training and competency was reached using an approved BAUS/BAUN competency package. 414 stent removals were booked in the nurse group, of which 395 were undertaken. 291 of 395 (74%) patients in the nurse removal Isiris® group had their stent removed on time, whereas only 16 of 54 (30%) patients had their stents removed on time in the FC stent removal group. A delay of more than 21 days was seen in 22% of FC group vs only 2% in the nurse-led Isiris® group. Both planned removal and actual stent dwell time were longer in the FC group compared to Isiris® group (p < 0.0001). There were no major complications with the use of Isiris® for stent removal in the nurse-led clinic. ConclusionThis study has demonstrated that it is feasible to introduce a nurse-led stent removal service. The introduction of this service using the Isiris® system has led to a reduction in delays of stent removal, which is likely to trans-late into significant quality of life improvement for patients and economic benefits for the healthcare system.

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“… 39 There also exists a PROMs designed to specifically assess symptom burden associated with ureteric stones, the Cambridge Ureteral Stone PROM (CUSP). 40 …”

Section: Endourological Armamentariummentioning

confidence: 99%

Minimally Invasive Surgery for the Treatment of Ureteric Stones – State-of-the-Art Review

Bhanot

Jones²,

Somani³

2021

RRU

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Development of a Disease-Specific Ureteral Calculus Patient Reported Outcome Measurement Instrument

Abstract: CUSP is a patient-derived ureteral stone PROM, which can be used to measure ureteral stone disease health outcomes from the patient's point of view.

Cited by 20 publications

References 20 publications

Qualitative exploration of the renal stone patients’ experience and development of the renal stone‐specific patient‐reported outcome measure

Qualitative exploration of the renal stone patients’ experience and development of the renal stone‐specific patient‐reported outcome measure

A Prospective Evaluation of a Nurse-Led Stent Removal Service Using the Single-Use Isiris®in a Tertiary Referral Stone Unit and its Impact on Patient Waiting Times

Minimally Invasive Surgery for the Treatment of Ureteric Stones – State-of-the-Art Review

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