Systematic review of the QoR-15 score, a patient- reported outcome measure measuring quality of recovery after surgery and anaesthesia

Kleif, Jakob; Waage, Johannes; Christensen, Karl Bang; Gögenur, Ismail

doi:10.1016/j.bja.2017.11.013

Cited by 187 publications

(189 citation statements)

References 29 publications

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“…[16][17][18][19] In a recent systematic review, the QoR-15 fulfilled the requirements for a patient-reported outcome questionnaire in the assessment of postoperative quality of recovery. 20 The province of KwaZulu Natal hosts the second largest population in South Africa and has an adult literacy rate of above There was no statistically significant difference in total QoR-15 scores and the VAS scores between male and female patients for both the English and isiZulu questionnaires. This was an interesting finding as previous studies reported worse postoperative quality of recovery scores for female patients when compared with their male counterparts.…”

Section: Patient Commentsmentioning

confidence: 89%

Development and validation of the isiZulu quality of recovery score

Sikhakhane

Küsel

Rodseth

2018

Southern African Journal of Anaesthesia and Analgesia

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Background: Recovery from anaesthesia and surgery is an important marker of the quality of perioperative care. One extensively validated score in assessing this is the Quality of Recovery-15 items (QoR-15) score. This study aimed to translate the QoR-15 score into isiZulu and validate both the original and translated version on an isiZulu speaking population. Methodology: A randomised quantitative observational study was performed testing the original and the translated version of the QoR-15 score. In a crossover format, patients were asked to complete both questionnaires with 40 minutes allowed between each questionnaire. A 100 mm visual analogue score (VAS) was completed by each participant as a comparative tool for overall quality of recovery. Results: There was good correlation between the English and isiZulu score 0.91 (p < 0.001) and substantial agreement between the scores (mean weighted kappa: 0.69). There was a negative correlation between duration of surgery and total QoR-15 scores for both the English (-0.3; p < 0.001) and isiZulu (-0.29; p < 0.001) questionnaires, and a positive correlation between VAS scores and total QoR-15 scores for both the English (0.38; p < 0.001) and isiZulu (0.38; p < 0.001) questionnaires. Conclusion: This study demonstrates that the QoR-15 score is suitable to use in an isiZulu speaking patient population. The translated isiZulu version is comparable to the English QoR-15 score and should be used to assess the QoR to improve patient care.

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Section: Patient Commentsmentioning

confidence: 89%

Development and validation of the isiZulu quality of recovery score

Sikhakhane

Küsel

Rodseth

2018

Southern African Journal of Anaesthesia and Analgesia

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“…In addition, patient-reported outcome measures (PROM) are increasingly relevant to health care providers and will influence clinical choices [ 5 ]. We have therefore undertaken a new exhaustive and comprehensive literature review representing a wide spectrum of clinical applications on key parameters relevant to patient outcome, in particular the influence of choice of anaesthetic technique on post-operative nausea and vomiting (PONV) [ 6 ]. Potential confounders and bias were minimised by strict adherence to Cochrane guidelines [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Propofol vs. inhalational agents to maintain general anaesthesia in ambulatory and in-patient surgery: a systematic review and meta-analysis

Schraag

Pradelli²,

Alsaleh³

et al. 2018

BMC Anesthesiol

132

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BackgroundIt is unclear if anaesthesia maintenance with propofol is advantageous or beneficial over inhalational agents. This study is intended to compare the effects of propofol vs. inhalational agents in maintaining general anaesthesia on patient-relevant outcomes and patient satisfaction.MethodsStudies were identified by electronic database searches in PubMed™, EMBASE™ and the Cochrane™ library between 01/01/1985 and 01/08/2016. Randomized controlled trials (RCTs) of peer-reviewed journals were studied. Of 6688 studies identified, 229 RCTs were included with a total of 20,991 patients. Quality control, assessment of risk of bias, meta-bias, meta-regression and certainty in evidence were performed according to Cochrane. Common estimates were derived from fixed or random-effects models depending on the presence of heterogeneity. Post-operative nausea and vomiting (PONV) was the primary outcome. Post-operative pain, emergence agitation, time to recovery, hospital length of stay, post-anaesthetic shivering and haemodynamic instability were considered key secondary outcomes.ResultsThe risk for PONV was lower with propofol than with inhalational agents (relative risk (RR) 0.61 [0.53, 0.69], p < 0.00001). Additionally, pain score after extubation and time in the post-operative anaesthesia care unit (PACU) were reduced with propofol (mean difference (MD) − 0.51 [− 0.81, − 0.20], p = 0.001; MD − 2.91 min [− 5.47, − 0.35], p = 0.03). In turn, time to respiratory recovery and tracheal extubation were longer with propofol than with inhalational agents (MD 0.82 min [0.20, 1.45], p = 0.01; MD 0.70 min [0.03, 1.38], p = 0.04, respectively). Notably, patient satisfaction, as reported by the number of satisfied patients and scores, was higher with propofol (RR 1.06 [1.01, 1.10], p = 0.02; MD 0.13 [0.00, 0.26], p = 0.05). Secondary analyses supported the primary results.ConclusionsBased on the present meta-analysis there are several advantages of anaesthesia maintenance with propofol over inhalational agents. While these benefits result in an increased patient satisfaction, the clinical and economic relevance of these findings still need to be addressed in adequately powered prospective clinical trials.Electronic supplementary materialThe online version of this article (10.1186/s12871-018-0632-3) contains supplementary material, which is available to authorized users.

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“…Earlier studies have made use of a bifactor model in outcome assessment, especially in mental health and quality of life research [7][8][9][10][11][12][13][14]. To our knowledge, only Kleif et al applied a bifactor model to a surgical population [15]. An analysis using the bifactor model may have the potential to establish an overall domain score, potentially resulting in the aforementioned advantages.…”

Section: Introductionmentioning

confidence: 99%

Deriving an overall appearance domain score by applying bifactor IRT analysis to the BODY-Q appearance scales

et al. 2019

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Purpose With the BODY-Q, one can assess outcomes, such as satisfaction with appearance, in weight loss and body contouring patients using multiple scales. All scales can be used independently in any given combination or order. Currently, the BODY-Q cannot provide overall appearance scores across scales that measure a similar super-ordinate construct (i.e., overall appearance), which could improve the scales' usefulness as a benchmarking tool and improve the comprehensibility of patient feedback. We explored the possibility of establishing overall appearance scores, by applying a bifactor model to the BODY-Q appearance scales. Methods In a bifactor model, questionnaire items load onto both a primary specific factors and a general factor, such as satisfaction with appearance. The international BODY-Q validation patient sample (n = 734) was used to fit a bifactor model to the appearance domain. Factor loadings, fit indices, and correlation between bifactor appearance domain and satisfaction with body scale were assessed. Results All items loaded on the general factor of their corresponding domain. In the appearance domain, all items demonstrated adequate item fit to the model. All scales had satisfactory fit to the bifactor model (RMSEA 0.045, CFI 0.969, and TLI 0.964). The correlation between the appearance domain summary scores and satisfaction with body scale scores was found to be 0.77. Discussion We successfully applied a bifactor model to BODY-Q data with good item and model fit indices. With this method, we were able to produce reliable overall appearance scores which may improve the interpretability of the BODY-Q while increasing flexibility.

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Systematic review of the QoR-15 score, a patient- reported outcome measure measuring quality of recovery after surgery and anaesthesia

Abstract: The QoR-15 fulfils requirements for outcome measurement instruments in clinical trials and is the first measurement instrument of postoperative quality of recovery to undergo a systematic review according to the COSMIN checklist.

Cited by 187 publications

References 29 publications

Development and validation of the isiZulu quality of recovery score

Development and validation of the isiZulu quality of recovery score

Propofol vs. inhalational agents to maintain general anaesthesia in ambulatory and in-patient surgery: a systematic review and meta-analysis

Deriving an overall appearance domain score by applying bifactor IRT analysis to the BODY-Q appearance scales

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