Browsing by Author "Jetté, Nathalie"

Now showing 1 - 6 of 6
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    Discriminative ability of quality of life measures in multiple sclerosis
    (2017-12-21) Fiest, Kirsten M; Greenfield, Jamie; Metz, Luanne M; Patten, Scott B; Jetté, Nathalie; Marrie, Ruth Ann
    Abstract Background Though many people with multiple sclerosis (MS) have comorbidities, the use of generic and disease-specific health related quality of life (HRQOL) scales to discriminate the effects of comorbidity has not been established. The utility of these scales to discriminate differences between persons with varying levels of disability is also unknown. Methods Using online questionnaires, a convenience sample of Albertans with MS was recruited between July 2011 and March 2013. Participants completed demographic questions, a validated comorbidity questionnaire, a self-reported disability scale, and the following HRQOL scales: the Short Form (SF)-36, SF-6D, Health Utilities Index-Mark III (HUI-III), and Multiple Sclerosis Quality of Life-54 (MSQOL-54). The ability of each HRQOL scale to distinguish between comorbidity groups was assessed using a one-way analysis of covariance, adjusting for age, sex, disease course, and disability level. Results Five hundred sixty three participants completed all relevant questionnaires. All HRQOL measures distinguished between persons with or without depression, while none were able to distinguish between participants with or without hypertension, thyroid disease, irritable bowel syndrome, or osteoporosis. The SF-36 physical scale, SF-6D, HUI-III, and MSQOL-54 physical scales were able to distinguish between all disability groups, though the HUI-III was better able to distinguish between individuals with moderate versus severe disability. Conclusions Disease-specific measures would discriminate better between those with and without comorbidities than generic-specific measures and the HUI-III would discriminate best between persons with differing severities of disability. Generic or disease-specific measures may be useful in future studies examining the effects of comorbidity in MS and the effects of treatment of comorbidities in MS.
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    Perspectives on neurological patient registries: a literature review and focus group study
    (BioMed Central, 2013-11-09) Korngut, Lawrence; MacKean, Gail; Casselman, Lisa; Johnston, Megan; Day, Lundy; Lam, Darren; Lorenzetti, Diane; Warner, Janet; Jetté, Nathalie; Pringsheim, Tamara
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    Predicting poor postoperative pain control after elective spine surgery
    (2019-06-26) Yang, Min-Han Michael; Riva-Cambrin, Jay; Casha, Steven; Sajobi, Tolulope; Jetté, Nathalie
    Background: Inadequate postoperative pain control after spine surgery is common and can lead to patient dissatisfaction and poor outcomes. Predictors for poorly controlled pain after spine surgery are unknown and preoperative prognostic tools are not available to aid in the identification of high-risk patients to help facilitate the development of personalized treatments. In this thesis, we performed (1) a systematic review on the predictors associated with poor pain control in surgical patients; (2) performed a retrospective cohort study evaluating predictors of poor postoperative pain control following spine surgery; and (3) developed and validated a clinical prediction score to identify patients at high-risk for developing poor pain control. Methods: (1) A random-effects model was used to meta-analyze the predictors for poor pain control after surgery in the systematic review. (2) Adults from the Canadian Spine Outcomes and Research Network registry who underwent elective cervical or thoracolumbar surgery were included. Preoperative predictors for poor pain control (mean numeric rating scale for pain>4 at rest during the first 24 hours after surgery) were identified using a multivariable logistic regression model. (3) The prediction score was developed and internally validated using a 70:30 split-sample method. Results: (1) Thirty-three studies representing 53,362 patients were included in the systematic review. Nine significant predictors for poor postoperative pain control were identified across surgical disciplines. (2) The retrospective cohort study included 1,300 patients, of which 56.7% had poor pain control after surgery. The multivariable model identified that younger age, female sex, preoperative daily opioid use, higher preoperative neck/back pain, higher depression scores on patient health questionnaire-9, ≥3 motion segment surgery, and fusion surgery were associated with poor pain control. (3) Patients identified as low-, high-, and extreme-risk by the score had 32.0%, 63.0%, and 85.0% probability of developing poor pain control, respectively. Conclusion: Seven significant predictors for poorly controlled pain after spine surgery were identified and incorporated into a prediction score. The score can discriminate patients at higher risk for, and accurately predict the probability of, developing poor pain control after surgery.
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    Suicidal ideation in persons with neurological conditions
    (2014-12-05) Altura, Kristianne Chelsea; Fiest, Kirsten; Jetté, Nathalie
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    Use of complementary and alternative medicine by those with a chronic disease and the general population - results of a national population based survey
    (BioMed Central, 2010-10-18) Metcalfe, Amy; Williams, Jeanne V.A.; McChesney, Jane; Patten, Scott B.; Jetté, Nathalie
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    Validation of a case definition for depression in administrative data against primary chart data as a reference standard
    (2019-01-07) Doktorchik, Chelsea; Patten, Scott; Eastwood, Cathy; Peng, Mingkai; Chen, Guanmin; Beck, Cynthia A; Jetté, Nathalie; Williamson, Tyler; Quan, Hude
    Abstract Background Because the collection of mental health information through interviews is expensive and time consuming, interest in using population-based administrative health data to conduct research on depression has increased. However, there is concern that misclassification of disease diagnosis in the underlying data might bias the results. Our objective was to determine the validity of International Classification of Disease (ICD)-9 and ICD-10 administrative health data case definitions for depression using review of family physician (FP) charts as the reference standard. Methods Trained chart reviewers reviewed 3362 randomly selected charts from years 2001 and 2004 at 64 FP clinics in Alberta (AB) and British Columbia (BC), Canada. Depression was defined as presence of either: 1) documentation of major depressive episode, or 2) documentation of specific antidepressant medication prescription plus recorded depressed mood. The charts were linked to administrative data (hospital discharge abstracts and physician claims data) using personal health numbers. Validity indices were estimated for six administrative data definitions of depression using three years of administrative data. Results Depression prevalence by chart review was 15.9–19.2% depending on year, region, and province. An ICD administrative data definition of ‘2 depression claims with depression ICD codes within a one-year window OR 1 discharge abstract data (DAD) depression diagnosis’ had the highest overall validity, with estimates being 61.4% for sensitivity, 94.3% for specificity, 69.7% for positive predictive value, and 92.0% for negative predictive value. Stratification of the validity parameters for this case definition showed that sensitivity was fairly consistent across groups, however the positive predictive value was significantly higher in 2004 data compared to 2001 data (78.8 and 59.6%, respectively), and in AB data compared to BC data (79.8 and 61.7%, respectively). Conclusions Sensitivity of the case definition is often moderate, and specificity is often high, possibly due to undercoding of depression. Limitations to this study include the use of FP charts data as the reference standard, given the potential for missed or incorrect depression diagnoses. These results suggest that that administrative data can be used as a source of information for both research and surveillance purposes, while remaining aware of these limitations.