bluuebunny/crossref_metadata_2025_split huggingface dataset:
A General Population Utility Valuation Study for Metastatic Epidural Spinal Cord Compression Health States
Authors: Pahuta Markian A. , Wai Eugene K. , Werier Joel , van Walraven Carl , Coyle Doug 
Published: January 2019

Study Design.
General population utility valuation study.

Objective.
This study obtained utility valuations from a Canadian general population perspective for 31 unique metastatic epidural spinal cord compression (MESCC) health states and determined the relative importance of MESCC-related consequences on quality-of-life.

Summary of Background Data.
Few prospective studies on the treatment of MESCC have collected quality-adjusted-life-year weights (termed “utilities”). Utilities are an important summative measure which distills health outcomes to a single number that can assist healthcare providers, patients, and policy makers in decision making.

Methods.
We recruited a sample of 1138 adult Canadians using a market research company. Quota sampling was used to ensure that the participants were representative of the Canadian population in terms of age, sex, and province of residence. Using the validated MESCC module for the “Self-administered Online Assessment of Preferences” (SOAP) tool, participants were asked to rate six of the 31 MESCC health states, each of which presented varying severities of five MESCC-related dysfunctions (dependent; non-ambulatory; incontinent; pain; other symptoms).

Results.
Participants equally valued all MESCC-related dysfunctions which followed a pattern of diminishing marginal disutility (each additional consequence resulted in a smaller incremental decrease in utility than the previous). These results demonstrate that the general population values physical function equal to other facets of quality-of-life.

Conclusion.
We provide a comprehensive set of ex ante utility estimates for MESCC health states that can be used to help inform decision making. This is the first study reporting direct utility valuation for a spinal disorder. Our methodology offers a feasible solution for obtaining quality-of-life data without collecting generic health status questionnaire responses from patients.

Level of Evidence: 4
Cross-cultural Adaptation and Validation of the Norwegian Short-form McGill Pain Questionnaire-2 in Low Back-related Leg Pain
Authors: Hasvik Eivind , Haugen Anne Julsrud , Haukeland-Parker Stacey , Rimehaug Stein Arne , Gjerstad Johannes , Grøvle Lars 
Published: January 2019

Study Design.
A prospective observational study with translation and psychometric analyses of a questionnaire.

Objective.
Cross-cultural adaptation of the Short-Form McGill Pain Questionnaire-2 into Norwegian.

Summary of Background Data.
The different versions of the McGill Pain Questionnaire (MPQ) have been important and influential tools for pain assessment. To more reliably assess qualities of both neuropathic and non-neuropathic pain, the Short-Form MPQ was revised in 2009 (SF-MPQ-2), including seven additional descriptors. No Norwegian adaptation of the SF-MPQ-2 has been performed.

Methods.
A translation of the SF-MPQ-2 was performed based on established guidelines. Forward-translations were compared and discussed in an expert workgroup. A synthesis was achieved by consensus. A backward translation was reviewed and consolidated with the forward translations to confirm linguistic equivalence. A prefinal version was tested in eight patients, who were interviewed to evaluate acceptability and comprehension of the questionnaire. Minor changes were implemented. The questionnaire was externally proofread. The final Norwegian version (NSF-MPQ-2) was tested for content and construct validity and internal consistency reliability in a population with low back-related leg pain.

Results.
The backward translation was in good accordance with the original version. The prefinal version showed excellent acceptability and comprehension in initial patient-testing. The NSF-MPQ-2 showed satisfactory content and construct validity, including responsiveness to change, and acceptable internal consistency reliability as measured by Cronbach's alpha. A confirmatory factor analysis showed poor fit for the established four-factor structure, especially regarding the neuropathic subscale.

Conclusion.
The NSF-MPQ-2 showed excellent acceptability and comprehension, satisfactory content and construct validity, including responsiveness to change, and internal consistency reliability as measured by Cronbach's alpha. However, a confirmatory factor analysis raised concerns regarding the factor-structure in the present population. Until more evidence emerges for the four-factor solution we suggest the NSF-MPQ-2 should be used as a single measure.

Level of Evidence: 3
Estimating Health Utility in Patients Presenting for Spine Surgery Using Patient-reported Outcomes Measurement Information System (PROMIS) Health Domains
Authors: Raad Micheal , Neuman Brian J. , Kebaish Khaled M. , Riley Lee H. , Skolasky Richard L. 
Published: January 2019

Study Design.
Prospective cohort study.

Objective.
To evaluate whether Patient-Reported Outcomes Measurement Information System (PROMIS) health domains can effectively estimate health utility index values for patients presenting for spine surgery.

Summary of Background Data.
Stable estimates of health utility are required to determine cost-effectiveness of spine surgery. There are no established methods to estimate health utility using PROMIS.

Methods.
We enrolled 439 patients with spine disease (mean age, 54 ± 18 yrs) presenting for surgery and assessed their health using the Medical Outcomes Study Short Form-12, version 2 (SF-12v2) and PROMIS domains. Standard health utility values were estimated from the SF-12v2. Participants were randomly assigned to derivation or validation cohort. In the derivation cohort, health utility values were estimated as a function of PROMIS domains using regression models. Model fit statistics determined the most parsimonious health utility estimation equation (HEE). In the validation cohort, values were calculated using the HEE. Estimated health utility values were correlated with SF-12v2-derived health utility values.

Results.
Mean preoperative health utility was 0.492 ± 0.008 and was similar between the two cohorts. All PROMIS health domains were significantly associated with health utility except Anxiety (P = 0.830) and Sleep Disturbance (P = 0.818). The final HEE was:
Health Utility (est) = 0.70742 – 0.00471 × Pain + 0.00647 × Physical function – 0.00316 × Fatigue – 0.00214 × Depression + 0.00317 × Satisfaction with Participation in Social Roles.
The estimation model accounted for 74% of observed variation in health utility. In the validation sample, mean health utility was 0.5033 ± 0.1684 and estimated health utility was 0.4966 ± 0.1342 (P = 0.401). These measures were strongly correlated (rho = 0.834).

Conclusion.
Our results indicate that PROMIS provides a reasonable estimate of health utility in adults presenting for lumbar or cervical spine surgery.

Level of Evidence: 1
The Effect of Core Stabilization Exercises on Trunk–Pelvis Three-Dimensional Kinematics During Gait in Non-Specific Chronic Low Back Pain
Authors: Bagheri Rasool , Parhampour Behrouz , Pourahmadi Mohammadreza , Fazeli Sayyed Hamed , Takamjani Ismail Ebrahimi , Akbari Mahmood , Dadgoo Mahdi 
Published: January 2019

Study Design.
Controlled clinical trial study.

Objective.
This study aimed to evaluate the effect of core stabilization exercise program (CSEP) on trunk–pelvis kinematics during gait in non-specific chronic low back pain (NCLBP).

Summary of Background Data.
NCLBP is a major public burden with variety of dysfunction including gait variability.

Methods.
Thirty participants (15 NCLBP and 15 healthy) were included in this study via the convenience sampling method. NCLBP group were intervened via the 16 sessions CSEP 3 days for 6 weeks and trunk–pelvis kinematics (angular displacement, waveform pattern [CVp], and offset variability [CVo]) during gait, pain, disability were evaluated before and after the intervention.

Results.
No significant differences in displacement and CVo in three planes were found between NCLBP and healthy groups. Independent t test was revealed that significant differences in CVp in the sagittal, frontal, and transverse planes were found between healthy and NCLBP in pre intervention. No significant changes in displacement and CVo were found as the result of intervention in NCLBP. Pain and disability decreased significantly after intervention. Paired t test revealed that the CSEP increased the frontal (P = 0.04) and transverse planes (P = 0.02) pattern variability significantly. However, there was a significant difference between groups in the sagittal plane CVp after intervention (sagittal plane CVp in healthy vs. NCLBP in post-CSE: mean difference = 14.1; P = 0.04).

Conclusion.
Considering the role of the deep trunk muscles in gait, and their common deconditioning in CLBP, a CSEP intervention may increase trunk–pelvis kinematic pattern variability. These results suggest CSEP may specifically increase transverse and frontal plane variability, indicating improved motor pattern replication through this movement planes.

Level of Evidence: 2
What Are the Costs of Cervical Radiculopathy Prior to Surgical Treatment?
Authors: Barton Cameron , Kalakoti Piyush , Bedard Nicholas A. , Hendrickson Nathan R. , Saifi Comron , Pugely Andrew J. 
Published: January 2019

Study Design.
Retrospective, observational study.

Objective.
To examine the costs associated with nonoperative management (diagnosis and treatment) of cervical radiculopathy in the year prior to anterior cervical discectomy and fusion (ACDF).

Summary of Background Data.
While the costs of operative treatment have been previously described, less is known about nonoperative management costs of cervical radiculopathy leading up to surgery.

Methods.
The Humana claims dataset (2007–2015) was queried to identify adult patients with cervical radiculopathy that underwent ACDF. Outcome endpoint was assessment of cumulative and per-capita costs for nonoperative diagnostic (x-rays, computed tomographic [CT], magnetic resonance imaging [MRI], electromyogram/nerve conduction studies [EMG/NCS]) and treatment modalities (injections, physical therapy [PT], braces, medications, chiropractic services) in the year preceding surgical intervention.

Results.
Overall 12,514 patients (52% female) with cervical radiculopathy underwent ACDF. Cumulative costs and per-capita costs for nonoperative management, during the year prior to ACDF was $14.3 million and $1143, respectively. All patients underwent at least one diagnostic test (MRI: 86.7%; x-ray: 57.5%; CT: 35.2%) while 73.3% patients received a nonoperative treatment. Diagnostic testing comprised of over 62% of total nonoperative costs ($8.9 million) with MRI constituting the highest total relative spend ($5.3 million; per-capita: $489) followed by CT ($2.6 million; per-capita: $606), x-rays ($0.54 million; per-capita: $76), and EMG/NCS ($0.39 million; per-capita: $467). Conservative treatments comprised of 37.7% of the total nonoperative costs ($5.4 million) with injections costs constituting the highest relative spend ($3.01 million; per-capita: $988) followed by PT ($1.13 million; per-capita: $510) and medications (narcotics: $0.51 million, per-capita $101; gabapentin: $0.21 million, per-capita $93; NSAIDs: 0.107 million, per-capita $47), bracing ($0.25 million; per-capita: $193), and chiropractic services ($0.137 million; per-capita: $193).

Conclusion.
The study quantifies the cumulative and per-capital costs incurred 1-year prior to ACDF in patients with cervical radiculopathy for nonoperative diagnostic and treatment modalities. Approximately two-thirds of the costs associated with cervical radiculopathy are from diagnostic modalities. As institutions begin entering into bundled payments for cervical spine disease, understanding condition specific costs is a critical first step.

Level of Evidence: 3
Surgical Outcomes of Anterior Versus Posterior Fusion in Lenke Type 1 Adolescent Idiopathic Scoliosis
Authors: Vavruch Ludvig , Brink Rob C. , Malmqvist Marcus , Schlösser Tom P.C. , van Stralen Marijn , Abul-Kasim Kasim , Ohlin Acke , Castelein René M. , Tropp Hans 
Published: January 2019

Study Design.
Retrospective study.

Objective.
To describe surgical results in two and three dimensions and patient-reported outcomes of scoliosis treatment for Lenke type 1 idiopathic curves with an open anterior or posterior approach.

Summary of Background Data.
Different surgical techniques have been described to prevent curve progression and to restore spinal alignment in idiopathic scoliosis. The spine can be accessed via an anterior or a posterior approach. However, the surgical outcomes, especially in three dimensions, for different surgical approaches remain unclear.

Methods.
Cohorts of Lenke curve type 1 idiopathic scoliosis patients, after anterior or posterior spinal fusion were recruited, to measure curve characteristics on conventional radiographs, before and after surgery and after 2 years follow-up, whereas the vertebral axial rotation, true mid-sagittal anterior–posterior height ratio of individual structures, and spinal height differences were measured on 3D reconstructions of the pre- and postoperative supine low-dose computed tomography (CT) scans. Additionally, the intraoperative parameters were described and the patients completed the Scoliosis Research Society outcomes and the 3-level version of EuroQol Group questionnaires postoperatively.

Results.
Fifty-three patients with Lenke curve type 1 idiopathic scoliosis (26 in the anterior cohort and 27 in the posterior cohort) were analyzed. Fewer vertebrae were instrumented in the anterior cohort compared with the posterior cohort (P < 0.001), with less surgery time and lower intraoperative blood loss (P < 0.001). The Cobb angle correction of the primary thoracic curve directly after surgery was 57 ± 12% in the anterior cohort and 73 ± 12% in the posterior cohort (P < 0.001) and 55 ± 13% and 66 ± 12% (P = 0.001) at 2 years follow-up. Postoperative 3D alignment restoration and questionnaires showed no significant differences between the cohorts.

Conclusion.
This study suggests that Lenke type 1 curves can be effectively managed surgically with either an open anterior or posterior approach. Each approach, however, has specific advantages and challenges, as described in this study, which must be considered before treating each patient.

Level of Evidence: 3
Failure of Pelvic Compensation in Patients With Severe Positive Sagittal Imbalance
Authors: Kim Ho-Joong , Shen Feng , Kang Kyoung-Tak , Chun Heoung-Jae , Kim Sung Taeck , Chang Bong-Soon , Lee Choon-Ki , Yeom Jin S. 
Published: January 2019

Study Design.
Case–control study for motion analysis.

Objective.
To compare spinopelvic parameters using static radiographs with the values obtained using motion analysis during gait between adult spinal deformity (ASD) or lumbar spinal stenosis (LSS).

Summary of Background Data.
It is still unclear whether measurement of radiological parameters using static radiographs can reflect natural sagittal balance during gait in the patients with severe positive sagittal imbalance.

Methods.
In this age- and sex-matched case control study, a total of 40 patients, each 20 subjects with either ASD or LSS who were scheduled to undergo surgery were included. Both clinical outcomes and sagittal spinopelvic parameters, including sagittal vertical axis (SVA), lumbar lordosis (LL), pelvic tilt (PT), sacral slope (SS), and pelvic incidence (PI) were measured. In motion analysis during walking, the angle of anterior pelvic tilt and the angles of the pelvis, hip, and knee were estimated. The correlation between variables was analyzed.

Results.
On standing lateral x-rays, SVA, PT, and PI – LL were significantly higher in the ASD group while SS and LL were significantly lower in the ASD group. However, on motion analysis, the average mean anterior pelvic tilt ± SD values in the ASD group were 8.3 ± 10.7 and 8.5 ± 10.7 on the right and left, respectively, and were not different from matched values in the LSS group. A Bland–Altman plot demonstrated a good agreement between the SS in the x-ray and anterior pelvic tilt in the motion analysis. In the ASD group, SS and SVA showed a significant positive correlation with mean anterior pelvic tilt in motion analysis during gait.

Conclusion.
The present study showed that the failure of pelvic compensation would likely occur in patients with severe positive sagittal imbalance during walking.

Level of Evidence: 3
Open Surgery for Trigger Finger Required Combined a1-a2 Pulley Release. A Retrospective Study on 1305 Case
Authors: Strigelli Vanni , Mingarelli Luigi , Fioravanti Giulio , Merendi Gianfranco , Merolli Antonio , Fanfani Francesco , Rocchi Lorenzo 
Published: January 2019

Objectives:
We retrospectively reviewed 1305 open-surgery for idiopathic trigger finger performed by 4 senior hand surgeons between 2014 and 2016.

Material and Methods:
Medical records and a telephone interview made with a minimum follow-up of 1 year were used to identify the recurrent rate of triggering and other complications.

Results:
This retrospective study let us note that 169 fingers (13%) required simultaneous release of the A1-A2 pulleys because the sectioning of the A1 pulley alone did not lead to complete free sliding of the tendons. We did not record any bowstring complication and we ascribe this to both surgery and bandaging technique. Overall rate of complication was 11.8% and relapse triggering or permanent proximal interphalangeal joint flexion (PPIJF) were among them; notably, however, they occurred only in patients where the A2 pulley was not sectioned.

Conclusions:
Is possible to reduce the percentage of relapse triggering or PPIJF after trigger finger surgery, by performing that combined A1-A2 pulley release.

Level of Evidence:
Level III.
Clinician Perspectives Regarding In-Hospital Cardiac Arrest Resuscitation: A Multicenter Survey
Authors: Peltan Ithan D. , Poll Justin , Sorensen Jeffrey , Guidry David , Chandler Marni , Beninati William , Brown Samuel M. 
Published: January 2019

Objectives:
Evaluate clinicians’ sentiments about participating in cardiac arrest resuscitations and identify factors associated with confidence in resuscitation of cardiac arrest.

Design:
Electronic survey.

Setting:
Twenty-one hospitals in Utah and Idaho.

Subjects:
All attending physicians, residents, and nurses in a multilevel healthcare system likely to participate in an in-hospital cardiac arrest resuscitation at least once every 2 years.

Interventions:
None.

Measurements and Methods:
A survey instrument evaluating clinician perceptions of in-hospital cardiac arrest resuscitation participation was developed after literature review and iteratively revised based on expert input and cognitive pretesting. Survey responses were collected anonymously. Sixty percent of 1,642 contacted clinicians (n = 977) submitted complete responses, of whom 874 met study inclusion criteria (190 attending physicians, 576 nurses, and 110 residents). Most respondents (74%) participated in less than or equal to six in-hospital cardiac arrest events per year, and 41% of respondents were most likely to participate in in-hospital cardiac arrest resuscitation at a community, rural, or critical access hospital. Confidence in in-hospital cardiac arrest participation was high overall (92%), but lower among residents (86%) than nurses (91%) or attending physicians (96%; p = 0.008). Fewer residents (52%) than nurses (73%) or attending physicians (95%; p < 0.001) reported feeling confident leading in-hospital cardiac arrest teams. Residents (63%) and attending physicians (36%) were more likely to worry about making errors during an in-hospital cardiac arrest event than nurses (18%; p < 0.001). Only 15% of residents and 50% of respondents overall reported they were both confident participating in in-hospital cardiac arrest resuscitation and did not worry about making errors. In-hospital cardiac arrest participation frequency was the dominant predictor of respondents’ confidence leading or participating in an in-hospital cardiac arrest resuscitation.

Conclusions:
Many clinicians, especially residents, who participate in or lead in-hospital cardiac arrest resuscitation events lack confidence or worry about management errors. Hospitals—particularly smaller hospitals—should consider methods to provide in-hospital cardiac arrest teams additional “effective experience,” potentially using simulation or telemedicine consultation.
Being Convinced and Taking Responsibility: A Qualitative Study of Family Members’ Experience of Organ Donation Decision and Bereavement After Brain Death*
Authors: Kentish-Barnes Nancy , Cohen-Solal Zoé , Souppart Virginie , Cheisson Gaëlle , Joseph Liliane , Martin-Lefèvre Laurent , Si Larbi Anne Gaelle , Viquesnel Gérald , Marqué Sophie , Donati Stéphane , Charpentier Julien , Pichon Nicolas , Zuber Benjamin , Lesieur Olivier , Ouendo Martial , Renault Anne , Le Maguet Pascale , Kandelman Stanislas , Thuong Marie , Floccard Bernard , Mezher Chaouki , Duranteau Jacques , Azoulay Elie 
Published: January 2019

Objectives:
Family members of brain dead patients experience an unprecedented situation in which not only they are told that their loved one is dead but are also asked to consider organ donation. The objective of this qualitative study was to determine 1) what it means for family members to make the decision and to take responsibility, 2) how they interact with the deceased patient in the ICU, 3) how family members describe the impact of the process and of the decision on their bereavement process.

Design:
Qualitative study using interviews with bereaved family members who were approached for organ donation after the death of their relative in the ICU (brain death).

Setting:
Family members from 13 ICUs in France.

Subjects:
Bereaved family members who were approached for organ donation after the death of their relative in the ICU (brain death).

Intervention:
None.

Measurements and Results:
Twenty-four interviews were conducted with 16 relatives of organ donor patients and with eight relatives of nonorgan donor patients. Three themes emerged: 1) taking responsibility—relatives explain how they endorse decisional responsibility but do not experience it as a burden, on the contrary; 2) ambiguous perceptions of death—two groups of relatives emerge: those for whom ambiguity hinders their acceptance of the patient’s death; those for whom ambiguity is an opportunity to accept the death and say goodbye; and 3) donation as a comfort during bereavement.

Conclusions:
In spite of caregivers’ efforts to focus organ donation discussions and decision on the patient, family members feel a strong decisional responsibility that is not experienced as a burden but a proof of their strong connection to the patient. Brain death however creates ambivalent experiences that some family members endure whereas others use as an opportunity to perform separation rituals. Last, organ donation can be experienced as a form of comfort during bereavement provided family members remain convinced their decision was right.