Patient reported outcomes | Andrew Vallance-Owen

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A presentation by Andrew Vallance-Owen on Patient Reported Outcomes at the diagnosis Salon on 28th April.

Santé & Médecine Spirituel Business

PATIENT REPORTED OUTCOMES International Forum on Quality and Safety in Healthcare Breakfast Session Andrew Vallance-Owen Group Medical Director 7 April 2011

Generic questionnaire used by NHS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

EQ-5D Kind, P. et al. BMJ 1998;316:736-741

Disease-specific vs. generic tools ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

VF-14 (Visual Function) – extract from 14 questions

Baseline data can be interesting in their own right: VF-14 pre-op scores, where 100 = no visual problems 0 10 20 30 40 50 60 70 80 90 100 0 3 5 8 11 13 16 19 21 24 27 29 32 35 38 40 43 46 48 51 54 56 59 62 64 67 70 72 75 78 80 83 86 88 91 94 96 99 Percentage of patients (N=824) VF-14 score (100 = no visual problems)

PROMS - NHS ,[object Object],[object Object],[object Object],[object Object]

Recruitment varies by procedure % of patients completing baseline questionnaire, NHS data Hips and knees – 70 to 80% Hernia – 50 to 60% Varicose vein – 40 to 50%

EQ-5D responsiveness? Note number “Same” and “Unknown” … compared with condition-specific tools:

How NHS data have been presented (as experimental statistics) http://www.hesonline.nhs.uk/Ease/servlet/ContentServer?siteID=1937&categoryID=1295

How the NHS data can be shown - funnel plot Oxford Hip change scores by hospital, April ’09 to April ’10 data NHS Experimental Statistics

The future of PROMS? The ‘howRu’ howRu 35 words EQ-5D 230 words SF-12 451 words SF-36 779 words

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Dr. Faiza delivers an insightful lecture on the distinguishing characteristics of skeletal, smooth, and cardiac muscles, offering a comprehensive understanding of their histology, physiological anatomy, electrophysiological properties, and contractile mechanisms. Through meticulous tabulation and comparison, she aims to equip learners with a detailed comprehension of the unique features and functionalities of each muscle type. Beginning with a detailed exploration of histological differences, Dr. Faiza outlines key distinctions such as multinucleation in skeletal muscle, mononucleation in smooth and cardiac muscles, and the presence of striations in skeletal and cardiac muscles. She meticulously elucidates the structural arrangement of each muscle type, highlighting their cellular morphology and organization within tissues. Transitioning to physiological anatomy, Dr. Faiza navigates through various aspects including innervation, level of control, initiation of contraction, and modification by hormones. By delineating the role of the somatic nervous system in skeletal muscle control, and contrasting it with the autonomic nervous system's influence on smooth and cardiac muscles, she offers a nuanced understanding of neural regulation in muscle physiology. Furthermore, Dr. Faiza delves into electrophysiological properties, elucidating the mechanisms underlying action potential generation, duration, and ionic basis in each muscle type. Through insightful analysis, she reveals how differences in action potential characteristics contribute to variations in muscle contraction speed, duration, and resistance to fatigue. Finally, Dr. Faiza meticulously examines the contractile mechanisms of skeletal, smooth, and cardiac muscles, shedding light on the sliding filament theory, mechanisms of calcium action, and speed of contraction. By comprehensively comparing these mechanisms, she provides learners with a deep understanding of the intricate processes governing muscle contraction and function. Through engaging presentation and meticulous analysis, Dr. Faiza's lecture serves as a valuable resource for students seeking a thorough understanding of the fundamental differences between skeletal, smooth, and cardiac muscles.

Difference Between Skeletal Smooth and Cardiac Muscles

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