The contribution of psychological disorders to the burden of skin disease has been poorly explored, and this is a large-scale study to ascertain the association between depression, anxiety, and ...suicidal ideation with various dermatological diagnoses. This international multicenter observational cross-sectional study was conducted in 13 European countries. In each dermatology clinic, 250 consecutive adult out-patients were recruited to complete a questionnaire, reporting socio-demographic information, negative life events, and suicidal ideation; depression and anxiety were assessed with the Hospital Anxiety and Depression Scale. A clinical examination was performed. A control group was recruited among hospital employees. There were 4,994 participants––3,635 patients and 1,359 controls. Clinical depression was present in 10.1% patients (controls 4.3%, odds ratio (OR) 2.40 (1.67–3.47)). Clinical anxiety was present in 17.2% (controls 11.1%, OR 2.18 (1.68–2.82)). Suicidal ideation was reported by 12.7% of all patients (controls 8.3%, OR 1.94 (1.33–2.82)). For individual diagnoses, only patients with psoriasis had significant association with suicidal ideation. The association with depression and anxiety was highest for patients with psoriasis, atopic dermatitis, hand eczema, and leg ulcers. These results identify a major additional burden of skin disease and have important clinical implications.
Aim Electronic formats (ePROs) of paper-based patientreported outcomes (PROs) should be validated before they can be reliably used. This review aimed to examine studies investigating measurement ...equivalence between ePROs and their paper originals to identify methodologies used and to determine the extent of such validation. Methods Three databases (OvidSP, Web of Science and PubMed) were searched using a set of keywords. Results were examined for compliance with inclusion criteria. Articles or abstracts that directly compared screen-based electronic versions of PROs with their validated paperbased originals, with regard to their measurement equivalence, were included. Publications were excluded if the only instruments reported were stand-alone visual analogue scales or interactive voice response formats. Papers published before 2007 were excluded, as a previous metaanalysis examined papers published before this time. Results Fifty-five studies investigating 79 instruments met the inclusion criteria. 53 % of the 79 instruments studied were condition specific. Several instruments, such as the SF-36, were reported in more than one publication. The most frequently reported formats for ePROs were Web-based versions. In 78 % of the publications, there was evidence of equivalence or comparability between the two formats as judged by study authors. Of the 30 publications that provided preference data, 87 % found that overall participants preferred the electronic format. Conclusions When examining equivalence between paper and electronic versions of PROs, formats are usually judged by authors to be equivalent. Participants prefer electronic formats. This literature review gives encouragement to the further widespread development and use of ePROs.
CD8 + T Cell Exhaustion in Cancer Dolina, Joseph S; Van Braeckel-Budimir, Natalija; Thomas, Graham D ...
Frontiers in immunology,
07/2021, Letnik:
12
Journal Article
Recenzirano
Odprti dostop
A paradigm shift in the understanding of the exhausted CD8
T cell (T
) lineage is underway. Originally thought to be a uniform population that progressively loses effector function in response to ...persistent antigen, single-cell analysis has now revealed that CD8
T
is composed of multiple interconnected subpopulations. The heterogeneity within the CD8
T
lineage is comprised of immune checkpoint blockade (ICB) permissive and refractory subsets termed stem-like and terminally differentiated cells, respectively. These populations occupy distinct peripheral and intratumoral niches and are characterized by transcriptional processes that govern transitions between cell states. This review presents key findings in the field to construct an updated view of the spatial, transcriptional, and functional heterogeneity of anti-tumoral CD8
T
. These emerging insights broadly call for (re-)focusing cancer immunotherapies to center on the driver mechanism(s) underlying the CD8
T
developmental continuum aimed at stabilizing functional subsets.
This study's aim was to determine the relationship between Dermatology Life Quality Index (DLQI) scores and a Global Question (GQ) concerning patients' views of the overall impairment of their ...skin-related quality of life (QoL), and to express this relationship by identifying bands of DLQI scores equivalent to each GQ descriptor. A DLQI questionnaire and the GQ were mailed to 3834 adult general dermatology outpatients. There were 1993 (52%) responses: male 841; female 1152. Mean DLQI score=4.86 (range 0–30, standard deviation (SD)=5.83). Mean GQ score=1.22 (range 0–4, SD=1.20). The mean, mode, and median of the GQ scores for each DLQI score were used to devise several sets of bands of DLQI scores, and κ coefficients of agreement calculated. The set proposed for adoption is: DLQI scores 0–1=no effect on patient's life (GQ=0, n=754); DLQI scores 2–5=small effect on patient's life (GQ=1, n=611); DLQI scores 6–10=moderate effect on patient's life (GQ=2, n=327); DLQI scores 11–20=very large effect on patient's life (GQ=3, n=242); DLQI scores 21–30=extremely large effect on patient's life (GQ=4, n=59); κ coefficient 0.489. Banding of the DLQI will aid the clinical interpretation of an individual's DLQI score and allow DLQI scores to inform clinical decisions.
Summary
Background
Skin disease can affect the quality of life (QoL) of teenagers in a variety of different ways, some being unique to this age group.
Objectives
To develop and validate a ...dermatology‐specific QoL instrument for adolescents with skin diseases.
Methods
Qualitative semistructured interviews were conducted with adolescents with skin disease to gain in‐depth understanding of how skin diseases affect their QoL. A prototype instrument based on the themes identified from content analysis of interviews was tested in several stages, using classical test theory and item response theory models to develop this new tool and conduct its psychometric evaluation.
Results
Thirty‐three QoL issues were identified from semistructured interviews with 50 adolescents. A questionnaire based on items derived from content analysis of interviews was subjected to Rasch analysis: factor analysis identified three domains, therefore not supporting the validity of T‐QoL as a unidimensional measure. Psychometric evaluation of the final 18‐item questionnaire was carried out in a cohort of 203 adolescents. Convergent validity was demonstrated by significant correlation with Skindex‐Teen and Dermatology Life Quality Index (DLQI) or Children's DLQI. The T‐QoL showed excellent internal consistency reliability: Cronbach's α = 0·89 for total scale score and 0·85, 0·60 and 0·74, respectively, for domains 1, 2 and 3. Test–retest reliability was high in stable volunteers. T‐QoL showed sensitivity to change in two subgroups of patients who indicated change in their self‐assessed disease severity.
Conclusions
Built on rich qualitative data from patients, the T‐QoL is a simple and valid tool to quantify the impact of skin disease on adolescents’ QoL; it could be used as an outcome measure in both clinical practice and clinical research.
What's already known about this topic?
Skin disease can affect the quality of life (QoL) of teenagers in a variety of different ways, some being unique to this age group.
Dermatology‐specific QoL measures exist for adults and children.
Skindex‐Teen has been the only (21‐item) QoL measure for adolescents.
What does this study add?
T‐QoL is a new age‐specific measure to assess the QoL of teenagers with different skin diseases.
Items were generated using direct input from the target population.
T‐QoL was developed and psychometrically analysed using both traditional classical test theory and modern item response theory models.
What are the clinical implications of this work?
Data from T‐QoL may be able to influence treatment plans and care strategies for individuals and could be used in outcome research such as clinical trials.
Linked Comment: Prinsen. Br J Dermatol 2018; 178:23–25.
Respond to this article
Summary
Planners of interventional studies in psoriasis face the dilemma of selecting suitable quality‐of‐life (QoL) measures. Systematic reviews have the potential of identifying psychometrically ...sound measures in a given therapeutic area, while guiding the development of practice guidelines. The aim of this systematic review was to generate evidence of the use of QoL instruments in randomized controlled trials (RCTs) for interventions in psoriasis. The methodology followed the PRISMA guidelines. Six databases were searched with 388 search terms. s of articles were reviewed independently by two assessors, and a third adjudicator resolved any opinion differences. Risk of bias was assessed using the Jadad scale. Of 3646 screened publications, 99 articles (100 trials) met the eligibility criteria for inclusion, describing research on 33 215 patients. Thirty‐three trials tested topical therapy, 18 systemic, 39 biologics, nine phototherapy and 10 other interventions. The Dermatology Life Quality Index (DLQI) was the most commonly used QoL instrument (83 studies, 83%), followed by the 36‐Item Short Form Survey (SF‐36) (31, 31%), EuroQoL‐5D (EQ‐5D) (15, 15%), Psoriasis Disability Index (14, 14%) and Skindex (five, 5%). There was widespread inconsistency in the way that QoL data were reported. Of the 100 trials identified, 37 reported minimal clinically important difference (MCID): 32 for DLQI, 10 for SF‐36 and six for EQ‐5D. QoL measurement is increasingly being reported in RCTs of psoriasis. Formal guidelines are needed for assessment and publishing of QoL data. Researchers should consider whether MCID information is available, and development of MCID data should be encouraged.
What's already known about this topic?
Psoriasis significantly impacts quality of life (QoL) in patients.
Generic, skin‐specific and disease‐specific instruments are used in psoriasis interventional studies.
In psoriasis randomized controlled trials (RCTs), biologics are the most researched interventions for which QoL is reported.
What does this study add?
The most commonly used QoL instruments in psoriasis RCTs are the Dermatology Life Quality Index, 36‐Item Short Form Survey and EuroQol‐5D.
There is an increasing use of QoL instruments in RCTs in psoriasis.
The minimal clinically important difference of QoL measure scores is under‐reported.
There is inconsistent reporting of QoL data and a need for guidelines when reporting.
Linked Comment: Kivelevitch et al. Br J Dermatol 2017; 176:563.
In the present study, a highly sensitive and simple electrochemical (EC) aptasensor for the detection of serpin A12 as a novel biomarker of diabetes was developed on a platform where flower-like gold ...microstructures (FLGMs) are electrodeposited onto a disposable screen-printed carbon electrode. Meanwhile, serpin A12-specific thiolated aptamer was covalently immobilized on the FLGMs.
The electrochemical activity of a fabricated aptasensor under various conditions were examined by cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS). Aptamer concentration, deposition time, self-assembly time, and incubation time were optimized for assay of serpin A12. The differential pulse voltammetry (DPV) was implemented for quantitative detection of serpin A12 in K
Fe (CN)
/K
Fe (CN)
solution (redox probe).
The label-free aptasensor revealed a linear range of serpin A12 concentration (0.039-10 ng/mL), detection limit of 0.020 ng/mL (S/N=3), and 0.031 ng/mL in solution buffer and plasma, respectively.
The results indicate that this aptasensor has a high sensitivity, selectivity, stability, and acceptable reproducibility for detection of serpin A12 in diabetic patients.
The patient is the centre of a web of relationships, and the impact of his/her disease on family members and caregivers must be taken into account. The aim of this study was to identify the specific ...instruments that measure the impact of a dermatological disease on the quality of life (QoL) of family members, by performing a systematic search of the literature. Fifteen papers were identified, describing the creation and validation of nine instruments. Four of them concerned atopic dermatitis (Dermatitis Family Index, DFI; Parents’ Index QoL Atopic Dermatitis, PiQoL‐AD; QoL in primary caregivers of children with atopic dermatitis, QPCAD; Childhood Atopic Dermatitis Impact Scale, CADIS), two measured the impact of psoriasis in family members (Psoriasis Family Index, PFI; FamilyPso), one the impact of epidermolysis bullosa (Epidermolysis Bullosa Burden of Disease, EB‐BoD), one of ichthyosis (Family Burden Ichthyosis, FBI), and one was generic for dermatological conditions (Family Dermatology Life Quality Index, FDLQI). The European Academy of Dermatology and Venereology quality of life taskforce recommends that the impact of a skin disease on family and caregivers should be measured as part of any thorough evaluation of the burden of a disease. Guidelines are given to choose the most appropriate instruments.
Summary
This article reviews an aspect of daily clinical practice which is of critical
importance in virtually every clinical consultation, but which is seldom formally
considered. Non-clinical ...influences on clinical decision-making profoundly affect
medical decisions. These influences include patient-related factors such as
socioeconomic status, quality of life and patient's expectations and wishes,
physician-related factors such as personal characteristics and interaction with their
professional community, and features of clinical practice such as private versus
public practice as well as local management policies. This review brings together the
different strands of knowledge concerning non-clinical influences on clinical
decision-making. This aspect of decision-making may be the biggest obstacle to the
reality of practising evidence-based medicine. It needs to be understood in order to
develop clinical strategies that will facilitate the practice of evidence-based
medicine.
Abstract
Exposome-Explorer (http://exposome-explorer.iarc.fr) is a database of dietary and pollutant biomarkers measured in population studies. In its first release, Exposome-Explorer contained ...comprehensive information on 692 biomarkers of dietary and pollution exposures extracted from the analysis of 480 peer-reviewed publications. Today, Exposome-Explorer has been further expanded and contains a total of 908 biomarkers. Two additional types of information have been collected. First, 185 candidate dietary biomarkers having 403 associations with food intake (as measured by metabolomic studies) have been identified and added. Second, 1356 associations between dietary biomarkers and cancer risk in epidemiological studies, which were collected from 313 publications, have also been added to the database. Classifications for both foods and compounds have been revised, and new classifications for biospecimens, analytical methods and cancers have been implemented. Finally, the web interface has been redesigned to significantly improve the user experience.
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