2023
Swan, J. Shannon; Langer, Michelle M.
Confirmatory Factor Analysis and Measurement Invariance of the Functional Assessment of Cancer Therapy Lung Cancer Utility Index (FACT-LUI) Journal Article
In: MDM Policy & Practice, vol. 8, no. 2, pp. 23814683231186992, 2023, ISSN: 2381-4683.
@article{Swan2023,
title = {Confirmatory Factor Analysis and Measurement Invariance of the Functional Assessment of Cancer Therapy Lung Cancer Utility Index (FACT-LUI)},
author = {J. Shannon Swan and Michelle M. Langer},
doi = {10.1177/23814683231186992},
issn = {2381-4683},
year = {2023},
date = {2023-08-27},
urldate = {2023-07-00},
journal = {MDM Policy \& Practice},
volume = {8},
number = {2},
pages = {23814683231186992},
publisher = {SAGE Publications},
abstract = {\<jats:p\> Background. A portion of the Functional Assessment of Cancer Therapy-Lung (FACT-L) instrument contributed to a previously published utility index, the FACT Lung Utility Index or FACT-LUI. Six FACT items representing lung cancer quality of life covered fatigue, pain, dyspnea, cough, anxiety, and depression. Two FACT items had been previously combined by the index authors into one for nausea and/or appetite loss, resulting in 7 final domains. Methods. The objective was to perform measurement invariance testing within a confirmatory factor analysis (CFA) framework to support the feasibility of using the FACT-LUI for non\textendashpreference-based psychometric applications. The original index patients comprised group 1, and similar FACT patient data ( n = 249) from another published study comprised group 2. One 2-factor model and two 1-factor CFA models were evaluated to assess measurement invariance across groups, using varying degrees of item parceling and a small number of residual covariances, all justified by the literature. Results. The 1-factor models were most optimal. A 1-factor model with 1 pair of items parceled showed invariance to the partial scalar level using usual fit criteria across groups, requiring 2 unconstrained intercepts. A 1-factor model with 3 pairs of justified parcels showed full configural, metric, and scalar invariance across groups. Conclusions. The FACT-LUI items fit a partially to fully invariant 1-factor model, suggesting feasibility for non\textendashpreference-based applications. Implications. Results suggest useful incorporation of the FACT-LUI into clinical trials with no substantial increased respondent burden, allowing preference-based and other psychometric applications from the same index items. \</jats:p\>\<jats:sec\>\<jats:title\>Highlights\</jats:title\>\<jats:p\> This work suggests that in addition to being originally designed for use as a utility index, the 7 FACT-LUI items together also fit simple CFA and measurement invariance models. This less expected result indicates that these items as a group are also potentially useful in non\textendashpreference-based applications. Clinical trials can make for challenging decisions concerning which patient-reported outcome measures to include without being burdensome. However, the literature suggests a need for improved reporting of quality of life in lung cancer in particular as well as cancer in general. Inclusion of more disease-specific items such as the FACT-LUI may allow for information gathering of both preference-based and non\textendashpreference-based data with less demand on patients, similar to what has been done with some generic instruments. \</jats:p\>\</jats:sec\>},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
<jats:p> Background. A portion of the Functional Assessment of Cancer Therapy-Lung (FACT-L) instrument contributed to a previously published utility index, the FACT Lung Utility Index or FACT-LUI. Six FACT items representing lung cancer quality of life covered fatigue, pain, dyspnea, cough, anxiety, and depression. Two FACT items had been previously combined by the index authors into one for nausea and/or appetite loss, resulting in 7 final domains. Methods. The objective was to perform measurement invariance testing within a confirmatory factor analysis (CFA) framework to support the feasibility of using the FACT-LUI for non–preference-based psychometric applications. The original index patients comprised group 1, and similar FACT patient data ( n = 249) from another published study comprised group 2. One 2-factor model and two 1-factor CFA models were evaluated to assess measurement invariance across groups, using varying degrees of item parceling and a small number of residual covariances, all justified by the literature. Results. The 1-factor models were most optimal. A 1-factor model with 1 pair of items parceled showed invariance to the partial scalar level using usual fit criteria across groups, requiring 2 unconstrained intercepts. A 1-factor model with 3 pairs of justified parcels showed full configural, metric, and scalar invariance across groups. Conclusions. The FACT-LUI items fit a partially to fully invariant 1-factor model, suggesting feasibility for non–preference-based applications. Implications. Results suggest useful incorporation of the FACT-LUI into clinical trials with no substantial increased respondent burden, allowing preference-based and other psychometric applications from the same index items. </jats:p><jats:sec><jats:title>Highlights</jats:title><jats:p> This work suggests that in addition to being originally designed for use as a utility index, the 7 FACT-LUI items together also fit simple CFA and measurement invariance models. This less expected result indicates that these items as a group are also potentially useful in non–preference-based applications. Clinical trials can make for challenging decisions concerning which patient-reported outcome measures to include without being burdensome. However, the literature suggests a need for improved reporting of quality of life in lung cancer in particular as well as cancer in general. Inclusion of more disease-specific items such as the FACT-LUI may allow for information gathering of both preference-based and non–preference-based data with less demand on patients, similar to what has been done with some generic instruments. </jats:p></jats:sec>
2020
Roth, Eve M.; Lubitz, Carrie C.; Swan, J. Shannon; James, Benjamin Christopher
Patient-reported quality of life outcome measures in the thyroid cancer population. Journal Article
In: Thyroid : official journal of the American Thyroid Association, vol. 30, no. 10, pp. 1414-1431, 2020, ISSN: 1557-9077, ().
@article{Roth2020,
title = {Patient-reported quality of life outcome measures in the thyroid cancer population.},
author = {Eve M. Roth and Carrie C. Lubitz and J. Shannon Swan and Benjamin Christopher James},
url = {https://www.ncbi.nlm.nih.gov/pubmed/32292128},
doi = {10.1089/thy.2020.0038},
issn = {1557-9077},
year = {2020},
date = {2020-10-01},
journal = {Thyroid : official journal of the American Thyroid Association},
volume = {30},
number = {10},
pages = {1414-1431},
abstract = {Background - There is an escalating worldwide population of thyroid cancer survivors. In addition to conventional metrics of quality of care, quality of life (QoL) assessment in thyroid cancer patients is imperative. Thyroid cancer survivors face unique impediments to health-related QoL (HRQoL), including thyroid-specific symptoms and exposure to disease-related stressors-including fear of recurrence and financial toxicity-over a prolonged survival period. Survey instruments currently used to assess HRQoL in TC survivors may be insufficient to accurately capture the burden of disease in this population. We aimed to identify the HRQoL instruments in the literature which have been applied in the thyroid cancer survivor population, and to present the psychometric properties of the scales and indexes that have been used. We hypothesize that few instruments have shown evidence of validity in this population. Summary - Of the 927 articles identified by search criteria, only 28 studies using 15 HRQoL instruments met inclusion criteria. Of the 15 HRQoL instruments identified, 9 were psychometric health status instruments and 6 were preference-based indexes, but none had been validated in the thyroid cancer survivor population. While the majority of reviewed studies demonstrated impaired psychological and emotional well-being in thyroid cancer survivors, these findings were not uniformly demonstrated across studies, and the longevity of the impact of thyroid cancer on HRQoL was variably reported. Conclusions -- Discrepancies in the literature regarding the impact of thyroid cancer survivorship on HRQoL emphasize the challenges of accurately assessing patient perspectives, reinforcing the importance of using well-constructed instruments to measure patient-reported outcomes in the target population. Care providers involved in the treatment of thyroid cancer survivors should be aware of longitudinal effects on HRQoL, especially pertaining to chronic psychological debilitation. Further development and rigorous validation of thyroid cancer-specific instruments will allow for better data gathering and understanding of the barriers to achieving high long-term HRQoL in thyroid cancer survivors throughout their long post-survival treatment course.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Background - There is an escalating worldwide population of thyroid cancer survivors. In addition to conventional metrics of quality of care, quality of life (QoL) assessment in thyroid cancer patients is imperative. Thyroid cancer survivors face unique impediments to health-related QoL (HRQoL), including thyroid-specific symptoms and exposure to disease-related stressors-including fear of recurrence and financial toxicity-over a prolonged survival period. Survey instruments currently used to assess HRQoL in TC survivors may be insufficient to accurately capture the burden of disease in this population. We aimed to identify the HRQoL instruments in the literature which have been applied in the thyroid cancer survivor population, and to present the psychometric properties of the scales and indexes that have been used. We hypothesize that few instruments have shown evidence of validity in this population. Summary - Of the 927 articles identified by search criteria, only 28 studies using 15 HRQoL instruments met inclusion criteria. Of the 15 HRQoL instruments identified, 9 were psychometric health status instruments and 6 were preference-based indexes, but none had been validated in the thyroid cancer survivor population. While the majority of reviewed studies demonstrated impaired psychological and emotional well-being in thyroid cancer survivors, these findings were not uniformly demonstrated across studies, and the longevity of the impact of thyroid cancer on HRQoL was variably reported. Conclusions -- Discrepancies in the literature regarding the impact of thyroid cancer survivorship on HRQoL emphasize the challenges of accurately assessing patient perspectives, reinforcing the importance of using well-constructed instruments to measure patient-reported outcomes in the target population. Care providers involved in the treatment of thyroid cancer survivors should be aware of longitudinal effects on HRQoL, especially pertaining to chronic psychological debilitation. Further development and rigorous validation of thyroid cancer-specific instruments will allow for better data gathering and understanding of the barriers to achieving high long-term HRQoL in thyroid cancer survivors throughout their long post-survival treatment course.
Bennett, Debbie L.; Swan, J. Shannon; Gazelle, G. Scott; Saksena, Mansi
Music during image-guided breast biopsy reduces patient anxiety levels. Journal Article
In: Clinical imaging, vol. 65, pp. 18–23, 2020, ISSN: 1873-4499, ().
@article{Bennett2020,
title = {Music during image-guided breast biopsy reduces patient anxiety levels.},
author = {Debbie L. Bennett and J. Shannon Swan and G. Scott Gazelle and Mansi Saksena},
url = {https://www.ncbi.nlm.nih.gov/pubmed/32353714},
doi = {10.1016/j.clinimag.2020.03.018},
issn = {1873-4499},
year = {2020},
date = {2020-09-01},
journal = {Clinical imaging},
volume = {65},
pages = {18--23},
abstract = {Interventions to decrease anxiety associated with image-guided breast biopsy are needed. Music intervention has been shown to be helpful in other outpatient procedural settings but data are limited regarding its effectiveness in the setting of breast biopsy. The purpose of this study was to determine whether listening to self-selected music during image-guided breast biopsy lowers anxiety. This randomized controlled trial was approved by the institutional review board and was HIPAA-compliant. 157 women between 18 and 75 (mean, 49.7 years) years of age, undergoing stereotactic or ultrasound-guided core biopsy, were enrolled in the study and were prospectively randomized to music or usual care. Patients in the music group listened to music of their choice during the biopsy. All patients completed the State Trait Anxiety Inventory (STAI) before and after the biopsy. Differences in pre-biopsy and post-biopsy anxiety levels were compared between the two groups using the Mann-Whitney U test. Baseline trait anxiety scores in the two groups were similar (34.0 music, 31.5 contro},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Interventions to decrease anxiety associated with image-guided breast biopsy are needed. Music intervention has been shown to be helpful in other outpatient procedural settings but data are limited regarding its effectiveness in the setting of breast biopsy. The purpose of this study was to determine whether listening to self-selected music during image-guided breast biopsy lowers anxiety. This randomized controlled trial was approved by the institutional review board and was HIPAA-compliant. 157 women between 18 and 75 (mean, 49.7 years) years of age, undergoing stereotactic or ultrasound-guided core biopsy, were enrolled in the study and were prospectively randomized to music or usual care. Patients in the music group listened to music of their choice during the biopsy. All patients completed the State Trait Anxiety Inventory (STAI) before and after the biopsy. Differences in pre-biopsy and post-biopsy anxiety levels were compared between the two groups using the Mann-Whitney U test. Baseline trait anxiety scores in the two groups were similar (34.0 music, 31.5 contro
Lee, Janie; Lowry, Kathryn; Chubiz, Jessica Cott; Swan, J. Shannon; Motazedi, Tina; Halpern, Elkan F.; Tosteson, Anna N A; Gazelle, G. Scott; Donelan, Karen
Breast cancer risk, worry, and anxiety: Effect on patient perceptions of false-positive screening results. Journal Article
In: Breast (Edinburgh, Scotland), vol. 50, pp. 104–112, 2020, ISSN: 1532-3080, ().
@article{JLee2020,
title = {Breast cancer risk, worry, and anxiety: Effect on patient perceptions of false-positive screening results.},
author = {Janie Lee and Kathryn Lowry and Jessica Cott Chubiz and J. Shannon Swan and Tina Motazedi and Elkan F. Halpern and Anna N A Tosteson and G. Scott Gazelle and Karen Donelan},
url = {https://www.ncbi.nlm.nih.gov/pubmed/32135458},
doi = {10.1016/j.breast.2020.02.004},
issn = {1532-3080},
year = {2020},
date = {2020-04-01},
journal = {Breast (Edinburgh, Scotland)},
volume = {50},
pages = {104--112},
abstract = {The impact of mammography screening recall on quality-of-life (QOL) has been studied in women at average risk for breast cancer, but it is unknown whether these effects differ by breast cancer risk level. We used a vignette-based survey to evaluate how women across the spectrum of breast cancer risk perceive the experience of screening recall. Women participating in mammography or breast MRI screening were recruited to complete a vignette-based survey. Using a numerical rating scale (0-100), women rated QOL for hypothetical scenarios of screening recall, both before and after benign results were known. Lifetime breast cancer risk was calculated using Gail and BRCAPRO risk models. Risk perception, trait anxiety, and breast cancer worry were assessed using validated instruments. The final study cohort included 162 women at low (n = 43, 26%), intermediate (n = 66, 41%), and high-risk (n = 53, 33%). Actual breast cancer risk was not a predictor of QOL for any of the presented scenarios. Across all risk levels, QOL ratings were significantly lower for the period during diagnostic uncertainty compared to after benign results were known (p 0.05). In multivariable regression analyses, breast cancer worry was a significant predictor of decreased QoL for all screening scenarios while awaiting results, including scenarios with non-invasive imaging alone or with biopsy. High trait anxiety and family history predicted lower QOL scores after receipt of benign test results (p 0.05). Women with high trait anxiety and family history may particularly benefit from discussions about the risk of recall when choosing a screening regimen.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
The impact of mammography screening recall on quality-of-life (QOL) has been studied in women at average risk for breast cancer, but it is unknown whether these effects differ by breast cancer risk level. We used a vignette-based survey to evaluate how women across the spectrum of breast cancer risk perceive the experience of screening recall. Women participating in mammography or breast MRI screening were recruited to complete a vignette-based survey. Using a numerical rating scale (0-100), women rated QOL for hypothetical scenarios of screening recall, both before and after benign results were known. Lifetime breast cancer risk was calculated using Gail and BRCAPRO risk models. Risk perception, trait anxiety, and breast cancer worry were assessed using validated instruments. The final study cohort included 162 women at low (n = 43, 26%), intermediate (n = 66, 41%), and high-risk (n = 53, 33%). Actual breast cancer risk was not a predictor of QOL for any of the presented scenarios. Across all risk levels, QOL ratings were significantly lower for the period during diagnostic uncertainty compared to after benign results were known (p 0.05). In multivariable regression analyses, breast cancer worry was a significant predictor of decreased QoL for all screening scenarios while awaiting results, including scenarios with non-invasive imaging alone or with biopsy. High trait anxiety and family history predicted lower QOL scores after receipt of benign test results (p 0.05). Women with high trait anxiety and family history may particularly benefit from discussions about the risk of recall when choosing a screening regimen.
2018
Swan, J. Shannon; Lennes, Inga; Stump, Natalie; Temel, Jennifer S; Wang, David; Keller, Lisa; Donelan, Karen
A Patient-Centered Utility Index for Non-Small Cell Lung Cancer in the United States. Journal Article
In: MDM policy & practice, vol. 3, pp. 2381468318801565, 2018, ISSN: 2381-4683, ().
@article{Swan2018,
title = {A Patient-Centered Utility Index for Non-Small Cell Lung Cancer in the United States.},
author = {J. Shannon Swan and Inga Lennes and Natalie Stump and Jennifer S Temel and David Wang and Lisa Keller and Karen Donelan},
url = {https://www.ncbi.nlm.nih.gov/pubmed/30349874},
doi = {10.1177/2381468318801565},
issn = {2381-4683},
year = {2018},
date = {2018-01-01},
journal = {MDM policy \& practice},
volume = {3},
pages = {2381468318801565},
abstract = {A preference-based quality-of-life index for non-small cell lung cancer was developed with a subset of Functional Assessment of Cancer Therapy (FACT)-General (G) and FACT-Lung (L) items, based on clinician input and the literature. A total of 236 non-small cell lung carcinoma patients contributed their preferences, randomly allocated among three survey groups to decrease burden. The FACT-L Utility Index (FACT-LUI) was constructed with two methods: 1) multiattribute utility theory (MAUT), where a visual analog scale (VAS)-based index was transformed to standard gamble (SG); and 2) an unweighted index, where items were summed, normalized to a 0 to 1.0 scale, and the result transformed to a scale length equivalent to the VAS or SG MAUT-based model on a Dead to Full Health scale. Agreement between patients' direct utility and the indexes for current health was assessed. The agreement of the unweighted index with direct SG was superior to the MAUT-based index (intraclass correlation for absolute agreement: 0.60 v. 0.35; mean difference: 0.03 v. 0.19; and mean absolute difference 0.09 v. 0.21, respectively). Mountain plots showed substantial differences, with the unweighted index demonstrating a median bias of 0.02 versus the MAUT model at 0.2. There was a significant difference ( = 0.0002) between early (I-II) and late stage (III-IV) patients, the mean difference for both indexes being greater than distribution-based estimates of minimal important difference. The population was limited to non-small cell lung cancer patients. However, most quality-of-life literature consulted and the FACT instruments do not differentiate between lung cancer cell types. Minorities were also limited in this sample. The FACT-LUI shows early evidence of validity for informing economic analysis of lung cancer treatments.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
A preference-based quality-of-life index for non-small cell lung cancer was developed with a subset of Functional Assessment of Cancer Therapy (FACT)-General (G) and FACT-Lung (L) items, based on clinician input and the literature. A total of 236 non-small cell lung carcinoma patients contributed their preferences, randomly allocated among three survey groups to decrease burden. The FACT-L Utility Index (FACT-LUI) was constructed with two methods: 1) multiattribute utility theory (MAUT), where a visual analog scale (VAS)-based index was transformed to standard gamble (SG); and 2) an unweighted index, where items were summed, normalized to a 0 to 1.0 scale, and the result transformed to a scale length equivalent to the VAS or SG MAUT-based model on a Dead to Full Health scale. Agreement between patients' direct utility and the indexes for current health was assessed. The agreement of the unweighted index with direct SG was superior to the MAUT-based index (intraclass correlation for absolute agreement: 0.60 v. 0.35; mean difference: 0.03 v. 0.19; and mean absolute difference 0.09 v. 0.21, respectively). Mountain plots showed substantial differences, with the unweighted index demonstrating a median bias of 0.02 versus the MAUT model at 0.2. There was a significant difference ( = 0.0002) between early (I-II) and late stage (III-IV) patients, the mean difference for both indexes being greater than distribution-based estimates of minimal important difference. The population was limited to non-small cell lung cancer patients. However, most quality-of-life literature consulted and the FACT instruments do not differentiate between lung cancer cell types. Minorities were also limited in this sample. The FACT-LUI shows early evidence of validity for informing economic analysis of lung cancer treatments.
2017
Swan, J. Shannon; Furtado, Vanessa F; Keller, Lisa A; Lotti, Judith Borsody; Saltalamacchia, Catherine A; Lennes, Inga; Salazar, Gloria M
Pilot Study of a Patient-Centered Radiology Process Model Journal Article
In: Journal of the American College of Radiology : JACR, vol. 14, no. 2, pp. 274-281, 2017, ISSN: 1558-349X, ().
@article{Swan2016a,
title = {Pilot Study of a Patient-Centered Radiology Process Model},
author = {J. Shannon Swan and Vanessa F Furtado and Lisa A Keller and Judith Borsody Lotti and Catherine A Saltalamacchia and Inga Lennes and Gloria M Salazar},
url = {https://www.ncbi.nlm.nih.gov/pubmed/27927589},
doi = {10.1016/j.jacr.2016.08.024},
issn = {1558-349X},
year = {2017},
date = {2017-02-01},
journal = {Journal of the American College of Radiology : JACR},
volume = {14},
number = {2},
pages = {274-281},
abstract = {The Radiology Process Model (RPM) was previously described in terms of its conceptual basis and proposed survey items. The current study describes the first pilot application of the RPM in the field and the results of initial psychometric analysis. We used an Institutional Review Board-approved pilot RPM survey in 100 patients having outpatient interventional radiology procedures. The 24 survey items had 4 or 5 levels of severity. We assessed for missing data, items that patients found confusing, any suggestions by patients for additional items and clarity of items from patient feedback. Factor analysis was performed and internal consistency measured. Construct validity was assessed by correlation of patient responses to the items as a summated scale with a visual analog scale (VAS) they completed indicating their interventional radiology experience. The visual analog scale and the RPM summated scale were strongly correlated (r = 0.7). Factor analysis showed four factors: interactions with facility and doctors/staff, time-sensitive aspects, pain, and anxiety. The items showed high internal consistency (alpha: 0.86) as a group and approximately 0.7 to 0.9 by the factors. Analysis shows that two items could be deleted (cost and communication between radiologist and referrers). Revision of two items and potential addition of others are discussed. The RPM shows initial evidence of psychometric validity and internal consistency reliability. Minor changes are anticipated before wider use.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
The Radiology Process Model (RPM) was previously described in terms of its conceptual basis and proposed survey items. The current study describes the first pilot application of the RPM in the field and the results of initial psychometric analysis. We used an Institutional Review Board-approved pilot RPM survey in 100 patients having outpatient interventional radiology procedures. The 24 survey items had 4 or 5 levels of severity. We assessed for missing data, items that patients found confusing, any suggestions by patients for additional items and clarity of items from patient feedback. Factor analysis was performed and internal consistency measured. Construct validity was assessed by correlation of patient responses to the items as a summated scale with a visual analog scale (VAS) they completed indicating their interventional radiology experience. The visual analog scale and the RPM summated scale were strongly correlated (r = 0.7). Factor analysis showed four factors: interactions with facility and doctors/staff, time-sensitive aspects, pain, and anxiety. The items showed high internal consistency (alpha: 0.86) as a group and approximately 0.7 to 0.9 by the factors. Analysis shows that two items could be deleted (cost and communication between radiologist and referrers). Revision of two items and potential addition of others are discussed. The RPM shows initial evidence of psychometric validity and internal consistency reliability. Minor changes are anticipated before wider use.
Lubitz, Carrie C.; Gregorio, Lucia De; Fingeret, Abbey L; Economopoulos, Konstantinos; Teremzawi, Diana; Hassan, Mursal; Parangi, Sareh; Stephen, Antonia; Halpern, Elkan F.; Donelan, Karen; Swan, J. Shannon
Measurement and Variation in Estimation of Quality of Life Effects of Patients Undergoing Treatment for Papillary Thyroid Carcinoma Journal Article
In: Thyroid : official journal of the American Thyroid Association, vol. 27, no. 2, pp. 197-206, 2017, ISSN: 1557-9077, ().
@article{Lubitz2016b,
title = {Measurement and Variation in Estimation of Quality of Life Effects of Patients Undergoing Treatment for Papillary Thyroid Carcinoma},
author = {Carrie C. Lubitz and Lucia De Gregorio and Abbey L Fingeret and Konstantinos Economopoulos and Diana Teremzawi and Mursal Hassan and Sareh Parangi and Antonia Stephen and Elkan F. Halpern and Karen Donelan and J. Shannon Swan},
url = {http://www.ncbi.nlm.nih.gov/pubmed/27824301},
doi = {10.1089/thy.2016.0260},
issn = {1557-9077},
year = {2017},
date = {2017-02-01},
journal = {Thyroid : official journal of the American Thyroid Association},
volume = {27},
number = {2},
pages = {197-206},
abstract = {Thyroid cancer incidence is increasing. The effect of diagnosis and treatment on health related quality of life (HRQoL) is an essential variable given no change in life span for the majority of patients. HRQoL instruments, with data useful for between-disease comparisons, are being increasingly used for health policy and outcomes evaluation. Variation exits among the instruments based on the impact of a specific disease. We assessed which of four well-validated preference-based surveys detect changes in health and clinical intervention in patients diagnosed with the papillary thyroid cancer (PTC). Four commonly used HRQoL questionnaires (Short Form-12v2® (SF6D), EuroQol-5D (EQ5D), and Health Utilities Index Mark 2 and 3 (HUI2, HUI3) were administered to patients with the diagnosis of PTC at three perioperative time points during the first year of treatment. Clinicopathological and treatment course data were assessed for HRQoL impact including complications from surgery, re-operation for persistence/early recurrence, and adjuvant radioactive iodine treatment. We compared standard metrics, including ceiling effect, intraclass correlation coefficient, effect sizes, and quality-adjusted life-years (QALYs) among the four instruments. Of 117 patients, 27% had a preoperative diagnosis of anxiety or depression, 41% had regional lymph node metastases, three had distant metastases and 49% underwent adjuvant radioactive iodine treatment. The ceiling effect (i.e. proportion with a perfect score) was greatest with the EQ5D and least with the SF6D. Index scores ranged from 0.77 (SF6D) to 0.90 (EQ5D). All scores declined at 2 weeks' post-op, and returned to pretreatment at six-months. The SF6D was the only instrument to exceed the conventional minimal-important difference between all three time points. QALYs were as follows: SF6D - 0.79, EQ5D - 0.90, HUI2 - 0.88, HUI3 - 0.86. Our results reflect the general good health of PTC patients. The effect on quality of life is primarily related to emotional and social impacts of treatment. The results support the measurement of a similar underlying construct, although variation in detecting changes in health exists between the instruments. Of the instruments assessed, the SF6D is the most responsive to treatment effects and should be utilized in future economic analyses in this patient population.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Thyroid cancer incidence is increasing. The effect of diagnosis and treatment on health related quality of life (HRQoL) is an essential variable given no change in life span for the majority of patients. HRQoL instruments, with data useful for between-disease comparisons, are being increasingly used for health policy and outcomes evaluation. Variation exits among the instruments based on the impact of a specific disease. We assessed which of four well-validated preference-based surveys detect changes in health and clinical intervention in patients diagnosed with the papillary thyroid cancer (PTC). Four commonly used HRQoL questionnaires (Short Form-12v2® (SF6D), EuroQol-5D (EQ5D), and Health Utilities Index Mark 2 and 3 (HUI2, HUI3) were administered to patients with the diagnosis of PTC at three perioperative time points during the first year of treatment. Clinicopathological and treatment course data were assessed for HRQoL impact including complications from surgery, re-operation for persistence/early recurrence, and adjuvant radioactive iodine treatment. We compared standard metrics, including ceiling effect, intraclass correlation coefficient, effect sizes, and quality-adjusted life-years (QALYs) among the four instruments. Of 117 patients, 27% had a preoperative diagnosis of anxiety or depression, 41% had regional lymph node metastases, three had distant metastases and 49% underwent adjuvant radioactive iodine treatment. The ceiling effect (i.e. proportion with a perfect score) was greatest with the EQ5D and least with the SF6D. Index scores ranged from 0.77 (SF6D) to 0.90 (EQ5D). All scores declined at 2 weeks' post-op, and returned to pretreatment at six-months. The SF6D was the only instrument to exceed the conventional minimal-important difference between all three time points. QALYs were as follows: SF6D - 0.79, EQ5D - 0.90, HUI2 - 0.88, HUI3 - 0.86. Our results reflect the general good health of PTC patients. The effect on quality of life is primarily related to emotional and social impacts of treatment. The results support the measurement of a similar underlying construct, although variation in detecting changes in health exists between the instruments. Of the instruments assessed, the SF6D is the most responsive to treatment effects and should be utilized in future economic analyses in this patient population.
2016
Swan, J. Shannon; Pandharipande, Pari; Salazar, Gloria M.
Developing a Patient-Centered Radiology Process Model Journal Article
In: J Am Coll Radiol, vol. 13, no. 5, pp. 510-6, 2016, ().
@article{Swan2016,
title = {Developing a Patient-Centered Radiology Process Model},
author = {J. Shannon Swan and Pari Pandharipande and Gloria M. Salazar},
url = {http://www.ncbi.nlm.nih.gov/pubmed/26833030},
doi = {10.1016/j.jacr.2015.11.022},
year = {2016},
date = {2016-05-01},
urldate = {2016-05-01},
journal = {J Am Coll Radiol},
volume = {13},
number = {5},
pages = {510-6},
institution = {Harvard Medical School, Boston, Massachusetts; Division of Interventional Radiology, Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts.},
abstract = {There has been increasing interest in the process of care that patients experience. To keep step with the rest of medicine, our specialty should be designing metrics that assess the overall experience of patients seeking care in radiology departments. A recent memo from the ACR chair calls for more work in this area. The aim of this study was to develop a patient-centered model for the experience of radiologic care, which may be helpful in addressing this need.Using principles of multiattribute utility theory and psychometric theory as well as recent literature, a model was developed for a patient-centered index that could be used in radiology facilities.A model was developed that concisely incorporates patient-centeredness of both radiologists and staff members (communication with patient and referrers, competence, and pain control) as well as patient- and process-related issues such as costs, procedural morbidity, access to care, appointment duration, waiting, timing of appointments, cleanliness of facility, and coordination with clinical services. The overall radiology process model was constructed as a set of nested models, which allow more integrated detail within the domains of patient experience.This model and others like it may help the ACR develop quality metrics to reasonably quantify the patient experience.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
There has been increasing interest in the process of care that patients experience. To keep step with the rest of medicine, our specialty should be designing metrics that assess the overall experience of patients seeking care in radiology departments. A recent memo from the ACR chair calls for more work in this area. The aim of this study was to develop a patient-centered model for the experience of radiologic care, which may be helpful in addressing this need.Using principles of multiattribute utility theory and psychometric theory as well as recent literature, a model was developed for a patient-centered index that could be used in radiology facilities.A model was developed that concisely incorporates patient-centeredness of both radiologists and staff members (communication with patient and referrers, competence, and pain control) as well as patient- and process-related issues such as costs, procedural morbidity, access to care, appointment duration, waiting, timing of appointments, cleanliness of facility, and coordination with clinical services. The overall radiology process model was constructed as a set of nested models, which allow more integrated detail within the domains of patient experience.This model and others like it may help the ACR develop quality metrics to reasonably quantify the patient experience.
2015
Daignault, Cory P.; Palmer, Edwin L.; Scott, James A.; Swan, J. Shannon; Daniels, Gilbert H.
Papillary Thyroid Carcinoma Metastasis to the Lumbar Spine Masquerading as a Schmorl's Node Journal Article
In: Nucl Med Mol Imaging, vol. 49, no. 3, pp. 217–222, 2015, ().
@article{Daignault2015,
title = {Papillary Thyroid Carcinoma Metastasis to the Lumbar Spine Masquerading as a Schmorl's Node},
author = {Cory P. Daignault and Edwin L. Palmer and James A. Scott and J. Shannon Swan and Gilbert H. Daniels},
url = {http://www.ncbi.nlm.nih.gov/pubmed/26279695},
doi = {10.1007/s13139-015-0320-x},
year = {2015},
date = {2015-09-01},
urldate = {2015-09-01},
journal = {Nucl Med Mol Imaging},
volume = {49},
number = {3},
pages = {217--222},
institution = {Thyroid Unit and Department of Medicine, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114 USA.},
abstract = {A Schmorl's node is a common incidental finding encountered during radiologic imaging. Despite the vertebral body being a common site of metastatic disease, a lytic lesion adjacent to an endplate with typical imaging features can often confidently be called a Schmorl's node. This is a case report of a patient with a single well-defined FDG-avid papillary thyroid carcinoma metastasis to the spine that had imaging findings characteristic of a Schmorl's node on CT and MRI. This case is important to consider as it demonstrates that the imaging characteristics of metastatic disease and Schmorl's nodes can overlap.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
A Schmorl's node is a common incidental finding encountered during radiologic imaging. Despite the vertebral body being a common site of metastatic disease, a lytic lesion adjacent to an endplate with typical imaging features can often confidently be called a Schmorl's node. This is a case report of a patient with a single well-defined FDG-avid papillary thyroid carcinoma metastasis to the spine that had imaging findings characteristic of a Schmorl's node on CT and MRI. This case is important to consider as it demonstrates that the imaging characteristics of metastatic disease and Schmorl's nodes can overlap.
Tramontano, Angela; Schrag, Deborah L.; Malin, Jennifer K.; Miller, Melecia; Weeks, Jane C.; Swan, J. Shannon; McMahon, Pamela M.
In: Med Decis Making, vol. 35, no. 3, pp. 371-87, 2015, ().
@article{Tramontano2015,
title = {Catalog and Comparison of Societal Preferences (Utilities) for Lung Cancer Health States: Results from the Cancer Care Outcomes Research and Surveillance (CanCORS) Study},
author = {Angela Tramontano and Deborah L. Schrag and Jennifer K. Malin and Melecia Miller and Jane C. Weeks and J. Shannon Swan and Pamela M. McMahon},
url = {http://www.ncbi.nlm.nih.gov/pubmed/25670839},
doi = {10.1177/0272989X15570364},
year = {2015},
date = {2015-04-01},
urldate = {2015-04-01},
journal = {Med Decis Making},
volume = {35},
number = {3},
pages = {371-87},
institution = {Institute for Technology Assessment, Massachusetts General Hospital, Boston, MA (ACT, MCM, JSS, PMM)Dana-Farber Cancer Institute, Boston, MA (DLS, JCW)David Geffen School of Medicine at UCLA, Los Angeles, CA (JKM)Department of Radiology, Harvard Medical S},
abstract = {The EQ-5D and SF-6D are 2 health-related quality-of-life indexes that provide preference-weighted measures for use in cost-effectiveness analyses.The National Cancer Institute's Cancer Care Outcomes Research and Surveillance (CanCORS) Consortium included the EQ-5D and SF-12v2 in their survey of newly diagnosed lung cancer patients. Utilities were calculated from patient-provided scores for each domain of the EQ-5D or the SF-6D. Utilities were calculated for categories of cancer type, stage, and treatment.There were 5015 enrolled lung cancer patients with a baseline survey in CanCORS; 2396 (47.8%) completed the EQ-5D, and 2344 (46.7%) also completed the SF-12v2. The mean (standard deviation) utility from the EQ-5D was 0.78 (0.18), and from the SF-6D (derived from SF-12v2) was 0.68 (0.14). The EQ-5D demonstrated a ceiling effect, with 20% of patients reporting perfect scores, translating to a utility of 1.0. No substantial SF-6D floor effects were noted. Utilities increased with age and decreased with stage and comorbidities. Patient-reported (EQ-5D) visual analog scale scores for health status had a moderate (r = 0.48, p},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
The EQ-5D and SF-6D are 2 health-related quality-of-life indexes that provide preference-weighted measures for use in cost-effectiveness analyses.The National Cancer Institute's Cancer Care Outcomes Research and Surveillance (CanCORS) Consortium included the EQ-5D and SF-12v2 in their survey of newly diagnosed lung cancer patients. Utilities were calculated from patient-provided scores for each domain of the EQ-5D or the SF-6D. Utilities were calculated for categories of cancer type, stage, and treatment.There were 5015 enrolled lung cancer patients with a baseline survey in CanCORS; 2396 (47.8%) completed the EQ-5D, and 2344 (46.7%) also completed the SF-12v2. The mean (standard deviation) utility from the EQ-5D was 0.78 (0.18), and from the SF-6D (derived from SF-12v2) was 0.68 (0.14). The EQ-5D demonstrated a ceiling effect, with 20% of patients reporting perfect scores, translating to a utility of 1.0. No substantial SF-6D floor effects were noted. Utilities increased with age and decreased with stage and comorbidities. Patient-reported (EQ-5D) visual analog scale scores for health status had a moderate (r = 0.48, p
Swan, J. Shannon; Kong, Chung Yin; Hur, Chin; Halpern, Elkan F.; Itauma, Omosalewa; Williams, Olubunmi; Motazedi, Tina; Lee, Janie
Comparing Morbidities of Testing With a New Index: Screening Colonoscopy Versus Core-Needle Breast Biopsy Journal Article
In: J Am Coll Radiol, vol. 12, no. 3, pp. 295-301, 2015, ().
@article{Swan2014,
title = {Comparing Morbidities of Testing With a New Index: Screening Colonoscopy Versus Core-Needle Breast Biopsy},
author = {J. Shannon Swan and Chung Yin Kong and Chin Hur and Elkan F. Halpern and Omosalewa Itauma and Olubunmi Williams and Tina Motazedi and Janie Lee},
url = {http://www.ncbi.nlm.nih.gov/pubmed/25441485},
doi = {10.1016/j.jacr.2014.08.014},
year = {2015},
date = {2015-03-01},
urldate = {2015-03-01},
journal = {J Am Coll Radiol},
volume = {12},
number = {3},
pages = {295-301},
institution = {Institute for Technology Assessment, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Present address: Seattle Cancer Care Alliance, Seattle, Washington.},
abstract = {Focusing on outcomes of care alone may be too restrictive. Patients
can experience morbidity that is important to them from health care
processes themselves. However, many processes, such as testing and
screening, have been little evaluated. This study's purpose was to
assess the construct validity of a new preference-based index, the
Testing Morbidities Index (TMI), by comparing two common cancer-related
procedures in prior publications: screening colonoscopy and core-needle breast biopsy.Women evaluating their breast biopsies (n = 100) were
compared with men and women who had undergone screening colonoscopy (n = 109) after both groups completed the TMI. The TMI addresses
physical and mental or emotional quality of life affected by test-specific
aspects occurring before, during, or after any test. It has 7 domains
and survey items. TMI scores can be scaled in various ways, including
multi-attribute value theory-based patient or societal preferences, where 0 = dead and 1.0 = full health, as used here.There was significantly
greater morbidity from breast biopsy (mean, 0.84) than from screening
colonoscopy (mean, 0.88) comparing overall TMI preference scores
(P},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Focusing on outcomes of care alone may be too restrictive. Patients
can experience morbidity that is important to them from health care
processes themselves. However, many processes, such as testing and
screening, have been little evaluated. This study's purpose was to
assess the construct validity of a new preference-based index, the
Testing Morbidities Index (TMI), by comparing two common cancer-related
procedures in prior publications: screening colonoscopy and core-needle breast biopsy.Women evaluating their breast biopsies (n = 100) were
compared with men and women who had undergone screening colonoscopy (n = 109) after both groups completed the TMI. The TMI addresses
physical and mental or emotional quality of life affected by test-specific
aspects occurring before, during, or after any test. It has 7 domains
and survey items. TMI scores can be scaled in various ways, including
multi-attribute value theory-based patient or societal preferences, where 0 = dead and 1.0 = full health, as used here.There was significantly
greater morbidity from breast biopsy (mean, 0.84) than from screening
colonoscopy (mean, 0.88) comparing overall TMI preference scores
(P
can experience morbidity that is important to them from health care
processes themselves. However, many processes, such as testing and
screening, have been little evaluated. This study's purpose was to
assess the construct validity of a new preference-based index, the
Testing Morbidities Index (TMI), by comparing two common cancer-related
procedures in prior publications: screening colonoscopy and core-needle breast biopsy.Women evaluating their breast biopsies (n = 100) were
compared with men and women who had undergone screening colonoscopy (n = 109) after both groups completed the TMI. The TMI addresses
physical and mental or emotional quality of life affected by test-specific
aspects occurring before, during, or after any test. It has 7 domains
and survey items. TMI scores can be scaled in various ways, including
multi-attribute value theory-based patient or societal preferences, where 0 = dead and 1.0 = full health, as used here.There was significantly
greater morbidity from breast biopsy (mean, 0.84) than from screening
colonoscopy (mean, 0.88) comparing overall TMI preference scores
(P
2014
Kong, Chung Yin; Meng, Lesley; Omer, Zehra; Swan, J. Shannon; Srouji, Serene; Gazelle, G. Scott; Fennessy, Fiona M.
MRI-Guided Focused Ultrasound Surgery for Uterine Fibroid Treatment: A Cost-Effectiveness Analysis Journal Article
In: AJR Am J Roentgenol, vol. 203, no. 2, pp. 361–371, 2014, ().
@article{Kong2014a,
title = {MRI-Guided Focused Ultrasound Surgery for Uterine Fibroid Treatment: A Cost-Effectiveness Analysis},
author = {Chung Yin Kong and Lesley Meng and Zehra Omer and J. Shannon Swan and Serene Srouji and G. Scott Gazelle and Fiona M. Fennessy},
url = {http://www.ncbi.nlm.nih.gov/pubmed/25055272},
doi = {10.2214/AJR.13.11446},
year = {2014},
date = {2014-08-01},
urldate = {2014-08-01},
journal = {AJR Am J Roentgenol},
volume = {203},
number = {2},
pages = {361--371},
institution = {1 Department of Radiology, Massachusetts General Hospital, Institute for Technology Assessment, 101 Merrimac St, 10th Fl, Boston, MA 02114.},
abstract = {OBJECTIVE. The purpose of this article is to evaluate the cost effectiveness
of a treatment strategy for symptomatic uterine fibroids that uses
MRI-guided focused ultrasound as a first-line therapy relative to
uterine artery embolization (UAE) or hysterectomy. MATERIALS AND
METHODS. We developed a decision-analytic model to compare the cost
effectiveness of three first-line treatment strategies: MRI-guided
focused ultrasound, UAE, and hysterectomy. Treatment-specific short-
and long-term utilities, lifetime costs, and quality-adjusted life
years (QALYs) were incorporated, allowing us to conduct an incremental
cost-effectiveness analysis, using a societal willingness-to-pay
(WTP) threshold of $50,000/QALY to designate a strategy as cost effective.
Sensitivity analyses were subsequently performed on all key parameters.
RESULTS. In the base-case analysis, UAE as a first-line treatment
of symptomatic fibroids was the most effective and expensive strategy
(22.75 QALYs; $22,968), followed by MRI-guided focused ultrasound
(22.73 QALYs; $20,252) and hysterectomy (22.54 QALYs; $11,253). MRI-guided
focused ultrasound was cost effective relative to hysterectomy, with
an associated incremental cost-effectiveness ratio (ICER) of $47,891/QALY.
The ICER of UAE relative to MRI-guided focused ultrasound was $234,565/QALY,
exceeding the WTP threshold of $50,000/QALY, therefore rendering
MRI-guided focused ultrasound also cost effective relative to UAE.
In sensitivity analyses, results were robust to changes in most parameters
but were sensitive to changes in probabilities of recurrence, symptom
relief, and quality-of-life measures. CONCLUSION. First-line treatment
of eligible women with MRI-guided focused ultra-sound is a cost-effective
noninvasive strategy. For those not eligible for MRI-guided focused
ultra-sound, UAE remains a cost-effective option. These recommendations
integrate both the short- and long-term decrements in quality of
life associated with the specific treatment modalities.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVE. The purpose of this article is to evaluate the cost effectiveness
of a treatment strategy for symptomatic uterine fibroids that uses
MRI-guided focused ultrasound as a first-line therapy relative to
uterine artery embolization (UAE) or hysterectomy. MATERIALS AND
METHODS. We developed a decision-analytic model to compare the cost
effectiveness of three first-line treatment strategies: MRI-guided
focused ultrasound, UAE, and hysterectomy. Treatment-specific short-
and long-term utilities, lifetime costs, and quality-adjusted life
years (QALYs) were incorporated, allowing us to conduct an incremental
cost-effectiveness analysis, using a societal willingness-to-pay
(WTP) threshold of $50,000/QALY to designate a strategy as cost effective.
Sensitivity analyses were subsequently performed on all key parameters.
RESULTS. In the base-case analysis, UAE as a first-line treatment
of symptomatic fibroids was the most effective and expensive strategy
(22.75 QALYs; $22,968), followed by MRI-guided focused ultrasound
(22.73 QALYs; $20,252) and hysterectomy (22.54 QALYs; $11,253). MRI-guided
focused ultrasound was cost effective relative to hysterectomy, with
an associated incremental cost-effectiveness ratio (ICER) of $47,891/QALY.
The ICER of UAE relative to MRI-guided focused ultrasound was $234,565/QALY,
exceeding the WTP threshold of $50,000/QALY, therefore rendering
MRI-guided focused ultrasound also cost effective relative to UAE.
In sensitivity analyses, results were robust to changes in most parameters
but were sensitive to changes in probabilities of recurrence, symptom
relief, and quality-of-life measures. CONCLUSION. First-line treatment
of eligible women with MRI-guided focused ultra-sound is a cost-effective
noninvasive strategy. For those not eligible for MRI-guided focused
ultra-sound, UAE remains a cost-effective option. These recommendations
integrate both the short- and long-term decrements in quality of
life associated with the specific treatment modalities.
of a treatment strategy for symptomatic uterine fibroids that uses
MRI-guided focused ultrasound as a first-line therapy relative to
uterine artery embolization (UAE) or hysterectomy. MATERIALS AND
METHODS. We developed a decision-analytic model to compare the cost
effectiveness of three first-line treatment strategies: MRI-guided
focused ultrasound, UAE, and hysterectomy. Treatment-specific short-
and long-term utilities, lifetime costs, and quality-adjusted life
years (QALYs) were incorporated, allowing us to conduct an incremental
cost-effectiveness analysis, using a societal willingness-to-pay
(WTP) threshold of $50,000/QALY to designate a strategy as cost effective.
Sensitivity analyses were subsequently performed on all key parameters.
RESULTS. In the base-case analysis, UAE as a first-line treatment
of symptomatic fibroids was the most effective and expensive strategy
(22.75 QALYs; $22,968), followed by MRI-guided focused ultrasound
(22.73 QALYs; $20,252) and hysterectomy (22.54 QALYs; $11,253). MRI-guided
focused ultrasound was cost effective relative to hysterectomy, with
an associated incremental cost-effectiveness ratio (ICER) of $47,891/QALY.
The ICER of UAE relative to MRI-guided focused ultrasound was $234,565/QALY,
exceeding the WTP threshold of $50,000/QALY, therefore rendering
MRI-guided focused ultrasound also cost effective relative to UAE.
In sensitivity analyses, results were robust to changes in most parameters
but were sensitive to changes in probabilities of recurrence, symptom
relief, and quality-of-life measures. CONCLUSION. First-line treatment
of eligible women with MRI-guided focused ultra-sound is a cost-effective
noninvasive strategy. For those not eligible for MRI-guided focused
ultra-sound, UAE remains a cost-effective option. These recommendations
integrate both the short- and long-term decrements in quality of
life associated with the specific treatment modalities.
Humphrey, Kathryn L.; Lee, Janie; Donelan, Karen; Kong, Chung Yin; Williams, Olubunmi; Itauma, Omosalewa; Halpern, Elkan F.; Gerade, Beverly J.; Rafferty, Elizabeth A.; Swan, J. Shannon
Percutaneous Breast Biopsy: Effect on Short-term Quality of Life Journal Article
In: Radiology, vol. 270, no. 2, pp. 362–368, 2014, ().
@article{Humphrey2014,
title = {Percutaneous Breast Biopsy: Effect on Short-term Quality of Life},
author = {Kathryn L. Humphrey and Janie Lee and Karen Donelan and Chung Yin Kong and Olubunmi Williams and Omosalewa Itauma and Elkan F. Halpern and Beverly J. Gerade and Elizabeth A. Rafferty and J. Shannon Swan},
url = {http://www.ncbi.nlm.nih.gov/pubmed/24471385},
doi = {10.1148/radiol.13130865},
year = {2014},
date = {2014-02-01},
journal = {Radiology},
volume = {270},
number = {2},
pages = {362--368},
institution = {From the MGH Institute for Technology Assessment, Massachusetts General Hospital, Boston, Mass.},
abstract = {Purpose To examine the effects of percutaneous breast biopsy on short-term
quality of life. Materials and Methods The institutional review board
approved this HIPAA-compliant prospective study. From December 1,
2007, through February 28, 2010, women undergoing percutaneous breast
biopsy in an academic medical center were recruited to participate
in a mixed-mode survey 2-4 days after biopsy. Patients described
their biopsy experience by using the Testing Morbidities Index (TMI),
a validated instrument for assessing short-term quality of life related
to diagnostic testing. The scale ranged from 0 (worst possible experience)
to 100 (no adverse effects). Seven attributes were assessed: pain
or discomfort before and during testing, fear or anxiety before and
during testing, embarrassment during testing, and physical and mental
function after testing. Demographic and clinical information were
also collected. Univariate and multivariate linear regression analyses
were performed to identify significant predictors of TMI score. Results
In 188 women (mean age, 51.4 years; range, 22-80 years), the mean
TMI score (±standard deviation) was 82 ± 12. Univariate analysis
revealed age and race as significant predictors of the TMI score
(P},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Purpose To examine the effects of percutaneous breast biopsy on short-term
quality of life. Materials and Methods The institutional review board
approved this HIPAA-compliant prospective study. From December 1,
2007, through February 28, 2010, women undergoing percutaneous breast
biopsy in an academic medical center were recruited to participate
in a mixed-mode survey 2-4 days after biopsy. Patients described
their biopsy experience by using the Testing Morbidities Index (TMI),
a validated instrument for assessing short-term quality of life related
to diagnostic testing. The scale ranged from 0 (worst possible experience)
to 100 (no adverse effects). Seven attributes were assessed: pain
or discomfort before and during testing, fear or anxiety before and
during testing, embarrassment during testing, and physical and mental
function after testing. Demographic and clinical information were
also collected. Univariate and multivariate linear regression analyses
were performed to identify significant predictors of TMI score. Results
In 188 women (mean age, 51.4 years; range, 22-80 years), the mean
TMI score (±standard deviation) was 82 ± 12. Univariate analysis
revealed age and race as significant predictors of the TMI score
(P
quality of life. Materials and Methods The institutional review board
approved this HIPAA-compliant prospective study. From December 1,
2007, through February 28, 2010, women undergoing percutaneous breast
biopsy in an academic medical center were recruited to participate
in a mixed-mode survey 2-4 days after biopsy. Patients described
their biopsy experience by using the Testing Morbidities Index (TMI),
a validated instrument for assessing short-term quality of life related
to diagnostic testing. The scale ranged from 0 (worst possible experience)
to 100 (no adverse effects). Seven attributes were assessed: pain
or discomfort before and during testing, fear or anxiety before and
during testing, embarrassment during testing, and physical and mental
function after testing. Demographic and clinical information were
also collected. Univariate and multivariate linear regression analyses
were performed to identify significant predictors of TMI score. Results
In 188 women (mean age, 51.4 years; range, 22-80 years), the mean
TMI score (±standard deviation) was 82 ± 12. Univariate analysis
revealed age and race as significant predictors of the TMI score
(P
2013
Swan, J. Shannon; Kong, Chung Yin; Lee, Janie; Itauma, O.; Halpern, Elkan F.; Lee, Pablo; Vavinskiy, S.; Williams, O.; Zoltick, Emilie; Donelan, Karen
Patient and societal value functions for the testing morbidities index Journal Article
In: Med Decis Making, vol. 33, no. 6, pp. 819-38, 2013, ISSN: 1552-681X (Electronic) 0272-989, ().
@article{Swan2013a,
title = {Patient and societal value functions for the testing morbidities index},
author = {J. Shannon Swan and Chung Yin Kong and Janie Lee and O. Itauma and Elkan F. Halpern and Pablo Lee and S. Vavinskiy and O. Williams and Emilie Zoltick and Karen Donelan},
url = {https://www.ncbi.nlm.nih.gov/pubmed/23689044},
doi = {10.1177/0272989X13487605},
issn = {1552-681X (Electronic)
0272-989},
year = {2013},
date = {2013-01-01},
journal = {Med Decis Making},
volume = {33},
number = {6},
pages = {819-38},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Swan, J. Shannon; Hur, Chin; Lee, Pablo; Motazedi, Tina; Donelan, Karen
Responsiveness of the testing morbidities index in colonoscopy Journal Article
In: Value Health, vol. 16, no. 6, pp. 1046–1053, 2013, ().
@article{Swan2013,
title = {Responsiveness of the testing morbidities index in colonoscopy},
author = {J. Shannon Swan and Chin Hur and Pablo Lee and Tina Motazedi and Karen Donelan},
url = {http://www.ncbi.nlm.nih.gov/pubmed/24041354},
doi = {10.1016/j.jval.2013.07.008},
year = {2013},
date = {2013-01-01},
journal = {Value Health},
volume = {16},
number = {6},
pages = {1046--1053},
institution = {Massachusetts General Hospital Institute for Technology Assessment, Boston, MA, USA; Harvard Medical School, Boston, MA, USA. Electronic address: .},
abstract = {The Testing Morbidities Index (TMI) was developed to measure the effects of any diagnostic or screening procedure on health-related quality of life (HRQOL); it includes seven domains incorporating mental and physical aspects before, during, and after testing. To add to prior work on the validity of the TMI classification, responsiveness of a summated scale version was evaluated in 71 colonoscopy patients. Further data on construct validity were also obtained.Patients enrolled in the study when scheduling colonoscopy days to weeks beforehand. The baseline survey included the EuroQol five-dimensional (EQ-5D) questionnaire with five levels in each attribute (EQ-5D-5L questionnaire) and its visual analogue scale (VAS) assessment (EQ-VAS), the Short Form 12 version 2 (SF-12v2) component summary scores and six-dimensional health state short-form (derived from the short-form 12v2 health survey [SF-6D] utilities), and an original construct-specific VAS (CS-VAS) for usual HRQOL using utility scale anchors. The TMI's highest possible summated score (all best levels) served as its baseline. Survey data were generally obtained by telephone interview. A postprocedure survey was given to patients after colonoscopy and interviews conducted as soon as possible after the day of the procedure. The postprocedure survey included the SF-12v2/SF-6D, EQ-5D questionnaire instruments, TMI items, and a CS-VAS incorporating the overall HRQOL effects of colonoscopy.Standardized response means showed greatest responsiveness by the TMI (-1.52) followed by the CS-VAS instruments (-0.42). The EQ-5D-5L questionnaire, the EQ-VAS, and the SF-12 component summaries were unresponsive, and the SF-6D was minimally responsive (-0.05). Correlation of the post-CS-VAS with the TMI was substantial (r = -0.52), suggesting TMI construct validity. Moderate to strong correlation of the baseline CS-VAS with standard indexes was observed (r = 0.54-0.81).The TMI appears responsive and exhibits further evidence of construct validity.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
The Testing Morbidities Index (TMI) was developed to measure the effects of any diagnostic or screening procedure on health-related quality of life (HRQOL); it includes seven domains incorporating mental and physical aspects before, during, and after testing. To add to prior work on the validity of the TMI classification, responsiveness of a summated scale version was evaluated in 71 colonoscopy patients. Further data on construct validity were also obtained.Patients enrolled in the study when scheduling colonoscopy days to weeks beforehand. The baseline survey included the EuroQol five-dimensional (EQ-5D) questionnaire with five levels in each attribute (EQ-5D-5L questionnaire) and its visual analogue scale (VAS) assessment (EQ-VAS), the Short Form 12 version 2 (SF-12v2) component summary scores and six-dimensional health state short-form (derived from the short-form 12v2 health survey [SF-6D] utilities), and an original construct-specific VAS (CS-VAS) for usual HRQOL using utility scale anchors. The TMI's highest possible summated score (all best levels) served as its baseline. Survey data were generally obtained by telephone interview. A postprocedure survey was given to patients after colonoscopy and interviews conducted as soon as possible after the day of the procedure. The postprocedure survey included the SF-12v2/SF-6D, EQ-5D questionnaire instruments, TMI items, and a CS-VAS incorporating the overall HRQOL effects of colonoscopy.Standardized response means showed greatest responsiveness by the TMI (-1.52) followed by the CS-VAS instruments (-0.42). The EQ-5D-5L questionnaire, the EQ-VAS, and the SF-12 component summaries were unresponsive, and the SF-6D was minimally responsive (-0.05). Correlation of the post-CS-VAS with the TMI was substantial (r = -0.52), suggesting TMI construct validity. Moderate to strong correlation of the baseline CS-VAS with standard indexes was observed (r = 0.54-0.81).The TMI appears responsive and exhibits further evidence of construct validity.
2012
Goyal, Rohit; Gazelle, G. Scott; Swan, J. Shannon
Expanding patient-reported outcomes to oral health complications from systemic cancer therapy Journal Article
In: Journal of clinical oncology : official journal of the American Society of Clinical Oncology, vol. 30, pp. 60, 2012, ISSN: 1527-7755, ().
@article{Goyal2012,
title = {Expanding patient-reported outcomes to oral health complications from systemic cancer therapy},
author = {Rohit Goyal and G. Scott Gazelle and J. Shannon Swan},
url = {http://www.ncbi.nlm.nih.gov/pubmed/28147102},
doi = {10.1200/jco.2012.30.34_suppl.60},
issn = {1527-7755},
year = {2012},
date = {2012-12-01},
urldate = {2012-12-01},
journal = {Journal of clinical oncology : official journal of the American Society of Clinical Oncology},
volume = {30},
pages = {60},
abstract = {60 Background: Cross-disciplinary patient reported outcomes (PROs) assess the full range of side effects from systemic cancer therapy. For oral health complications, however, the validity of oral-health specific and generic health-related quality-of-life (QoL) instruments is unknown for cancer patients. This study evaluates the performance, measurement, and prediction characteristics of the Oral Health Impact Profile (OHIP-14) and EQ-5D in cancer patients with bisphosphonate-associated Osteonecrosis of the Jaw (ONJ). 34 cancer patients assessed the QoL of their own ONJ with the OHIP-14 and evaluated the QoL of 4 standardized ONJ Health States with the EQ-5D, as previously published. For each instrument, the standard response mean (SRM), effect size (ES), and ability to distinguish minimally important differences (MID) were evaluated for ONJ compared to baseline (longitudinal responsiveness). Instrument MIDs (cross-sectional responsiveness) were also calculated. Performance of a published general dentistry algorithm to predict EQ-5D values from OHIP-14 results was tested. The OHIP-14 and EQ-5D instruments demonstrated moderate to large longitudinal and cross-sectional responsiveness. Pain was one of the most responsive domains for both instruments. Ceiling/floor effects were most prominent for OHIP-14. A general dentistry algorithm did not adequately predict EQ-5D values for cancer patients. This study provides the first empirical evidence for the performance, measurement, and prediction characteristics of oral-health specific and generic QoL instruments for the oral health side effects of systemic cancer treatment. Instrument validity is supported for oral health complications in cancer patients. These results provide benchmarks for PROs at the intersection of oral medicine and surgery, dentistry, and oncology. [Table: see text].},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
60 Background: Cross-disciplinary patient reported outcomes (PROs) assess the full range of side effects from systemic cancer therapy. For oral health complications, however, the validity of oral-health specific and generic health-related quality-of-life (QoL) instruments is unknown for cancer patients. This study evaluates the performance, measurement, and prediction characteristics of the Oral Health Impact Profile (OHIP-14) and EQ-5D in cancer patients with bisphosphonate-associated Osteonecrosis of the Jaw (ONJ). 34 cancer patients assessed the QoL of their own ONJ with the OHIP-14 and evaluated the QoL of 4 standardized ONJ Health States with the EQ-5D, as previously published. For each instrument, the standard response mean (SRM), effect size (ES), and ability to distinguish minimally important differences (MID) were evaluated for ONJ compared to baseline (longitudinal responsiveness). Instrument MIDs (cross-sectional responsiveness) were also calculated. Performance of a published general dentistry algorithm to predict EQ-5D values from OHIP-14 results was tested. The OHIP-14 and EQ-5D instruments demonstrated moderate to large longitudinal and cross-sectional responsiveness. Pain was one of the most responsive domains for both instruments. Ceiling/floor effects were most prominent for OHIP-14. A general dentistry algorithm did not adequately predict EQ-5D values for cancer patients. This study provides the first empirical evidence for the performance, measurement, and prediction characteristics of oral-health specific and generic QoL instruments for the oral health side effects of systemic cancer treatment. Instrument validity is supported for oral health complications in cancer patients. These results provide benchmarks for PROs at the intersection of oral medicine and surgery, dentistry, and oncology. [Table: see text].
Carlos, Ruth C.; Buist, Diana S M.; Wernli, Karen J.; Swan, J. Shannon
Patient-centered outcomes in imaging: quantifying value Journal Article
In: J Am Coll Radiol, vol. 9, no. 10, pp. 725–728, 2012, ().
@article{Carlos2012,
title = {Patient-centered outcomes in imaging: quantifying value},
author = {Ruth C. Carlos and Diana S M. Buist and Karen J. Wernli and J. Shannon Swan},
url = {http://www.ncbi.nlm.nih.gov/pubmed?term=23025867},
doi = {10.1016/j.jacr.2012.06.008},
year = {2012},
date = {2012-10-01},
journal = {J Am Coll Radiol},
volume = {9},
number = {10},
pages = {725--728},
institution = {Department of Radiology, University of Michigan, Ann Arbor, MI, USA. },
abstract = {The Patient-Centered Outcomes Research Institute was created in response
to a mandate to conduct comparative effectiveness research in clinical
care to inform decision making. The institute will be funded by the
Patient-Centered Outcomes Research Trust Fund, through congressional
set-asides, and by Medicare and private health insurers, through
a per beneficiary fee. The institute is governed by a board with
a broad stakeholder constitution. Key committees set the national
agenda for patient-centered outcomes research, the agenda for funding
priorities, and communication and dissemination of the evidence with
the goal of increasing the rate of implementation of the evidence
into policy. In imaging, patient-centered outcomes go beyond the
traditional metrics of patient satisfaction. Instead, these outcomes
need to encompass the benefits and harms, focus on outcomes relevant
to patients, and provide information to inform decision making. Therefore,
radiologists need to be involved as stakeholders in the design, conduct,
and dissemination of this research.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
The Patient-Centered Outcomes Research Institute was created in response
to a mandate to conduct comparative effectiveness research in clinical
care to inform decision making. The institute will be funded by the
Patient-Centered Outcomes Research Trust Fund, through congressional
set-asides, and by Medicare and private health insurers, through
a per beneficiary fee. The institute is governed by a board with
a broad stakeholder constitution. Key committees set the national
agenda for patient-centered outcomes research, the agenda for funding
priorities, and communication and dissemination of the evidence with
the goal of increasing the rate of implementation of the evidence
into policy. In imaging, patient-centered outcomes go beyond the
traditional metrics of patient satisfaction. Instead, these outcomes
need to encompass the benefits and harms, focus on outcomes relevant
to patients, and provide information to inform decision making. Therefore,
radiologists need to be involved as stakeholders in the design, conduct,
and dissemination of this research.
to a mandate to conduct comparative effectiveness research in clinical
care to inform decision making. The institute will be funded by the
Patient-Centered Outcomes Research Trust Fund, through congressional
set-asides, and by Medicare and private health insurers, through
a per beneficiary fee. The institute is governed by a board with
a broad stakeholder constitution. Key committees set the national
agenda for patient-centered outcomes research, the agenda for funding
priorities, and communication and dissemination of the evidence with
the goal of increasing the rate of implementation of the evidence
into policy. In imaging, patient-centered outcomes go beyond the
traditional metrics of patient satisfaction. Instead, these outcomes
need to encompass the benefits and harms, focus on outcomes relevant
to patients, and provide information to inform decision making. Therefore,
radiologists need to be involved as stakeholders in the design, conduct,
and dissemination of this research.
2011
Fennessy, F. M.; Kong, Chung Yin; Tempany, C. M.; Swan, J. Shannon
Quality-of-life assessment of fibroid treatment options and outcomes Journal Article
In: Radiology, vol. 259, no. 3, pp. 785-92, 2011, ISSN: 1527-1315 (Electronic) 0033-8419, ().
@article{Fennessy2011,
title = {Quality-of-life assessment of fibroid treatment options and outcomes},
author = {F. M. Fennessy and Chung Yin Kong and C. M. Tempany and J. Shannon Swan},
url = {http://www.ncbi.nlm.nih.gov/pubmed/21364084},
issn = {1527-1315 (Electronic) 0033-8419},
year = {2011},
date = {2011-06-01},
journal = {Radiology},
volume = {259},
number = {3},
pages = {785-92},
abstract = {PURPOSE: To obtain utilities (a unit of measure of a person's relative
preferences for different health states compared with death or worst
possible outcome) for uterine fibroids before and after treatment
and to measure short-term utilities for the following uterine fibroid
treatments: abdominal hysterectomy, magnetic resonance (MR) imaging-guided
focused ultrasound surgery, and uterine artery embolization (UAE).
MATERIALS AND METHODS: This retrospective study was approved by the
institutional review board and was HIPAA compliant. The waiting trade-off
(WTO) method, a variation on the time trade-off (TTO) method, is
used to obtain utilities for diagnostic procedures on the basis of
the fact that people wait longer to avoid noxious tests and/or procedures.
The WTO method provides short-term quality of life tolls in terms
of quality-adjusted life-weeks by scaling wait times with pre- and
posttreatment utilities. Utilities for uterine fibroids before and
after treatment were obtained with the TTO method and a visual analog
scale (VAS) by using a questionnaire administered by means of a phone
interview. WTO wait times were adjusted for quality of life with
VAS and TTO utilities and a transformation of VAS. Wait times were
compared by using nonparametric tests. The study participants included
62 patients who had undergone abdominal hysterectomy, 74 who had
undergone UAE, and 61 who had undergone MR imaging-guided focused
ultrasound surgery. RESULTS: Quality of life increased with all treatments.
The median WTO wait time was higher for hysterectomy (21.6 weeks)
than for UAE or MR imaging-guided focused ultrasound surgery (14.1
weeks for both) (P \< .05). Quality-adjusted life-week tolls were
smaller when scaled according to TTO than when scaled according to
VAS or transformation of VAS. CONCLUSION: Quality of life increased
after all fibroid treatments. WTO is feasible for assessing the quality-adjusted
morbidity of treatment procedures. SUPPLEMENTAL MATERIAL: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.11100704/-/DC1.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
PURPOSE: To obtain utilities (a unit of measure of a person's relative
preferences for different health states compared with death or worst
possible outcome) for uterine fibroids before and after treatment
and to measure short-term utilities for the following uterine fibroid
treatments: abdominal hysterectomy, magnetic resonance (MR) imaging-guided
focused ultrasound surgery, and uterine artery embolization (UAE).
MATERIALS AND METHODS: This retrospective study was approved by the
institutional review board and was HIPAA compliant. The waiting trade-off
(WTO) method, a variation on the time trade-off (TTO) method, is
used to obtain utilities for diagnostic procedures on the basis of
the fact that people wait longer to avoid noxious tests and/or procedures.
The WTO method provides short-term quality of life tolls in terms
of quality-adjusted life-weeks by scaling wait times with pre- and
posttreatment utilities. Utilities for uterine fibroids before and
after treatment were obtained with the TTO method and a visual analog
scale (VAS) by using a questionnaire administered by means of a phone
interview. WTO wait times were adjusted for quality of life with
VAS and TTO utilities and a transformation of VAS. Wait times were
compared by using nonparametric tests. The study participants included
62 patients who had undergone abdominal hysterectomy, 74 who had
undergone UAE, and 61 who had undergone MR imaging-guided focused
ultrasound surgery. RESULTS: Quality of life increased with all treatments.
The median WTO wait time was higher for hysterectomy (21.6 weeks)
than for UAE or MR imaging-guided focused ultrasound surgery (14.1
weeks for both) (P < .05). Quality-adjusted life-week tolls were
smaller when scaled according to TTO than when scaled according to
VAS or transformation of VAS. CONCLUSION: Quality of life increased
after all fibroid treatments. WTO is feasible for assessing the quality-adjusted
morbidity of treatment procedures. SUPPLEMENTAL MATERIAL: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.11100704/-/DC1.
preferences for different health states compared with death or worst
possible outcome) for uterine fibroids before and after treatment
and to measure short-term utilities for the following uterine fibroid
treatments: abdominal hysterectomy, magnetic resonance (MR) imaging-guided
focused ultrasound surgery, and uterine artery embolization (UAE).
MATERIALS AND METHODS: This retrospective study was approved by the
institutional review board and was HIPAA compliant. The waiting trade-off
(WTO) method, a variation on the time trade-off (TTO) method, is
used to obtain utilities for diagnostic procedures on the basis of
the fact that people wait longer to avoid noxious tests and/or procedures.
The WTO method provides short-term quality of life tolls in terms
of quality-adjusted life-weeks by scaling wait times with pre- and
posttreatment utilities. Utilities for uterine fibroids before and
after treatment were obtained with the TTO method and a visual analog
scale (VAS) by using a questionnaire administered by means of a phone
interview. WTO wait times were adjusted for quality of life with
VAS and TTO utilities and a transformation of VAS. Wait times were
compared by using nonparametric tests. The study participants included
62 patients who had undergone abdominal hysterectomy, 74 who had
undergone UAE, and 61 who had undergone MR imaging-guided focused
ultrasound surgery. RESULTS: Quality of life increased with all treatments.
The median WTO wait time was higher for hysterectomy (21.6 weeks)
than for UAE or MR imaging-guided focused ultrasound surgery (14.1
weeks for both) (P < .05). Quality-adjusted life-week tolls were
smaller when scaled according to TTO than when scaled according to
VAS or transformation of VAS. CONCLUSION: Quality of life increased
after all fibroid treatments. WTO is feasible for assessing the quality-adjusted
morbidity of treatment procedures. SUPPLEMENTAL MATERIAL: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.11100704/-/DC1.
Miksad, Rebecca; Lai, Kuan-Chi; Dodson, T. B.; Woo, S. B.; Treister, N. S.; Akinyemi, Omosalewa; Bihrle, Marian; Maytal, G.; August, M.; Gazelle, G. Scott; Swan, J. Shannon
Quality of life implications of bisphosphonate-associated osteonecrosis of the jaw Journal Article
In: Oncologist, vol. 16, no. 1, pp. 121-32, 2011, ISSN: 1549-490X (Electronic) 1083-7159, ().
@article{Miksad2011,
title = {Quality of life implications of bisphosphonate-associated osteonecrosis
of the jaw},
author = {Rebecca Miksad and Kuan-Chi Lai and T. B. Dodson and S. B. Woo and N. S. Treister and Omosalewa Akinyemi and Marian Bihrle and G. Maytal and M. August and G. Scott Gazelle and J. Shannon Swan},
url = {http://www.ncbi.nlm.nih.gov/pubmed/21212433},
issn = {1549-490X (Electronic) 1083-7159},
year = {2011},
date = {2011-01-01},
journal = {Oncologist},
volume = {16},
number = {1},
pages = {121-32},
abstract = {PURPOSE: Potentially debilitating, osteonecrosis of the jaw (ONJ)
is an emerging complication of bisphosphonates. However, its effect
on quality of life (QoL) is unknown. We determined the ONJ-related
QoL decline in a cancer patient cohort. PATIENTS AND METHODS: Thirty-four
cancer patients with bisphosphonate-associated ONJ completed a telephone
survey (October 2007 through May 2008). The Oral Health Impact Profile
14 (OHIP) retrospectively assessed participant oral health-related
QoL before and after ONJ. Standardized ONJ descriptions were developed
in a multidisciplinary, iterative process and were evaluated with
three frequently used preference-based QoL measurement methods on
a 0 (death) to 1 (perfect health) scale: Visual Analogue Scale (VAS),
Time Trade-Off (TTO), and EQ-5D. RESULTS: ONJ significantly (p \<
.001) increased OHIP scores (worse QoL) for additive (3.56-16.53)
and weighted (7.0-17.5) methods. Seven individual OHIP items significantly
increased (Bonferroni correction p \< .0035): pain, eating discomfort,
self-consciousness, unsatisfactory diet, interrupted meals, irritability,
and decreased life satisfaction. Mean preference-based QoL values
significantly decreased (p \< .001) with worsening ONJ stage (VAS,
TTO, and EQ-5D): no ONJ (0.76, 0.86, 0.82), ONJ stage 1 (0.69, 0.82,
0.78), ONJ stage 2 (0.51, 0.67, 0.55), and ONJ stage 3 (0.37, 0.61,
0.32). As ONJ worsened, EQ-5D domain scores significantly increased
(p \< .001). Pain/discomfort and anxiety/depression contributed most
to declining QoL. CONCLUSIONS: ONJ significantly affects QoL, a detriment
that increases with worsening ONJ. QoL impairments for ONJ stages
2 and 3 are similar to other treatment side effects that influence
decision-making. Bisphosphonate-associated ONJ QoL is an important
consideration for patients, clinicians, and policy makers.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
PURPOSE: Potentially debilitating, osteonecrosis of the jaw (ONJ)
is an emerging complication of bisphosphonates. However, its effect
on quality of life (QoL) is unknown. We determined the ONJ-related
QoL decline in a cancer patient cohort. PATIENTS AND METHODS: Thirty-four
cancer patients with bisphosphonate-associated ONJ completed a telephone
survey (October 2007 through May 2008). The Oral Health Impact Profile
14 (OHIP) retrospectively assessed participant oral health-related
QoL before and after ONJ. Standardized ONJ descriptions were developed
in a multidisciplinary, iterative process and were evaluated with
three frequently used preference-based QoL measurement methods on
a 0 (death) to 1 (perfect health) scale: Visual Analogue Scale (VAS),
Time Trade-Off (TTO), and EQ-5D. RESULTS: ONJ significantly (p <
.001) increased OHIP scores (worse QoL) for additive (3.56-16.53)
and weighted (7.0-17.5) methods. Seven individual OHIP items significantly
increased (Bonferroni correction p < .0035): pain, eating discomfort,
self-consciousness, unsatisfactory diet, interrupted meals, irritability,
and decreased life satisfaction. Mean preference-based QoL values
significantly decreased (p < .001) with worsening ONJ stage (VAS,
TTO, and EQ-5D): no ONJ (0.76, 0.86, 0.82), ONJ stage 1 (0.69, 0.82,
0.78), ONJ stage 2 (0.51, 0.67, 0.55), and ONJ stage 3 (0.37, 0.61,
0.32). As ONJ worsened, EQ-5D domain scores significantly increased
(p < .001). Pain/discomfort and anxiety/depression contributed most
to declining QoL. CONCLUSIONS: ONJ significantly affects QoL, a detriment
that increases with worsening ONJ. QoL impairments for ONJ stages
2 and 3 are similar to other treatment side effects that influence
decision-making. Bisphosphonate-associated ONJ QoL is an important
consideration for patients, clinicians, and policy makers.
is an emerging complication of bisphosphonates. However, its effect
on quality of life (QoL) is unknown. We determined the ONJ-related
QoL decline in a cancer patient cohort. PATIENTS AND METHODS: Thirty-four
cancer patients with bisphosphonate-associated ONJ completed a telephone
survey (October 2007 through May 2008). The Oral Health Impact Profile
14 (OHIP) retrospectively assessed participant oral health-related
QoL before and after ONJ. Standardized ONJ descriptions were developed
in a multidisciplinary, iterative process and were evaluated with
three frequently used preference-based QoL measurement methods on
a 0 (death) to 1 (perfect health) scale: Visual Analogue Scale (VAS),
Time Trade-Off (TTO), and EQ-5D. RESULTS: ONJ significantly (p <
.001) increased OHIP scores (worse QoL) for additive (3.56-16.53)
and weighted (7.0-17.5) methods. Seven individual OHIP items significantly
increased (Bonferroni correction p < .0035): pain, eating discomfort,
self-consciousness, unsatisfactory diet, interrupted meals, irritability,
and decreased life satisfaction. Mean preference-based QoL values
significantly decreased (p < .001) with worsening ONJ stage (VAS,
TTO, and EQ-5D): no ONJ (0.76, 0.86, 0.82), ONJ stage 1 (0.69, 0.82,
0.78), ONJ stage 2 (0.51, 0.67, 0.55), and ONJ stage 3 (0.37, 0.61,
0.32). As ONJ worsened, EQ-5D domain scores significantly increased
(p < .001). Pain/discomfort and anxiety/depression contributed most
to declining QoL. CONCLUSIONS: ONJ significantly affects QoL, a detriment
that increases with worsening ONJ. QoL impairments for ONJ stages
2 and 3 are similar to other treatment side effects that influence
decision-making. Bisphosphonate-associated ONJ QoL is an important
consideration for patients, clinicians, and policy makers.
2010
Swan, J. Shannon; Ying, J.; Stahl, James; Kong, Chung Yin; Moy, B.; Roy, J.; Halpern, Elkan F.
Initial development of the Temporary Utilities Index: a multiattribute system for classifying the functional health impact of diagnostic testing Journal Article
In: Qual Life Res, vol. 19, no. 3, pp. 401-12, 2010, ISSN: 1573-2649 (Electronic) 0962-9343, ().
@article{Swan2010,
title = {Initial development of the Temporary Utilities Index: a multiattribute system for classifying the functional health impact of diagnostic testing},
author = {J. Shannon Swan and J. Ying and James Stahl and Chung Yin Kong and B. Moy and J. Roy and Elkan F. Halpern},
url = {http://www.ncbi.nlm.nih.gov/pubmed/20084464},
issn = {1573-2649 (Electronic) 0962-9343},
year = {2010},
date = {2010-04-01},
urldate = {2010-04-01},
journal = {Qual Life Res},
volume = {19},
number = {3},
pages = {401-12},
abstract = {PURPOSE: The effects of testing and screening on quality of life may
influence the future behavior of society, but have not been quantified.
We derived a health classification and survey items for the morbidities
of testing and screening, to be the foundation of a multiattribute
utility instrument, the Temporary Utilities Index. METHODS: Seventy-six
women ranked the importance of attributes of the testing process
after breast biopsy. Seven survey items on the testing process were
subsequently developed and assessed for clarity by a second group
of 19 patients. The items cover attributes of mental and physical
well-being before, during, and after testing. A survey panel of 164
subjects accessed online used the items to endorse expected and experienced
effects of colon screening and mammography. They also endorsed items
from a colorectal benefits and barriers scale, a risk perception
scale, and EQ-5D, to utilize in the analyses of validity of the TUI
items. RESULTS: Based on criteria from the literature and limited
psychometric analysis, the items showed evidence of practicality,
validity, and a strong association with barriers. CONCLUSIONS: The
TUI health classification and survey items show evidence of validity,
and may inform economic analysis, once combined with utility weights.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
PURPOSE: The effects of testing and screening on quality of life may
influence the future behavior of society, but have not been quantified.
We derived a health classification and survey items for the morbidities
of testing and screening, to be the foundation of a multiattribute
utility instrument, the Temporary Utilities Index. METHODS: Seventy-six
women ranked the importance of attributes of the testing process
after breast biopsy. Seven survey items on the testing process were
subsequently developed and assessed for clarity by a second group
of 19 patients. The items cover attributes of mental and physical
well-being before, during, and after testing. A survey panel of 164
subjects accessed online used the items to endorse expected and experienced
effects of colon screening and mammography. They also endorsed items
from a colorectal benefits and barriers scale, a risk perception
scale, and EQ-5D, to utilize in the analyses of validity of the TUI
items. RESULTS: Based on criteria from the literature and limited
psychometric analysis, the items showed evidence of practicality,
validity, and a strong association with barriers. CONCLUSIONS: The
TUI health classification and survey items show evidence of validity,
and may inform economic analysis, once combined with utility weights.
influence the future behavior of society, but have not been quantified.
We derived a health classification and survey items for the morbidities
of testing and screening, to be the foundation of a multiattribute
utility instrument, the Temporary Utilities Index. METHODS: Seventy-six
women ranked the importance of attributes of the testing process
after breast biopsy. Seven survey items on the testing process were
subsequently developed and assessed for clarity by a second group
of 19 patients. The items cover attributes of mental and physical
well-being before, during, and after testing. A survey panel of 164
subjects accessed online used the items to endorse expected and experienced
effects of colon screening and mammography. They also endorsed items
from a colorectal benefits and barriers scale, a risk perception
scale, and EQ-5D, to utilize in the analyses of validity of the TUI
items. RESULTS: Based on criteria from the literature and limited
psychometric analysis, the items showed evidence of practicality,
validity, and a strong association with barriers. CONCLUSIONS: The
TUI health classification and survey items show evidence of validity,
and may inform economic analysis, once combined with utility weights.
2009
Johnson, Annette J.; Chen, Michael Y. M.; Swan, J. Shannon; Applegate, Kimberly E.; Littenberg, Benjamin
Cohort study of structured reporting compared with conventional dictation. Journal Article
In: Radiology, vol. 253, pp. 74–80, 2009, ISSN: 1527-1315, ().
@article{Johnson2009,
title = {Cohort study of structured reporting compared with conventional dictation.},
author = {Annette J. Johnson and Michael Y. M. Chen and J. Shannon Swan and Kimberly E. Applegate and Benjamin Littenberg},
url = {https://pubmed.ncbi.nlm.nih.gov/19709993/},
doi = {10.1148/radiol.2531090138},
issn = {1527-1315},
year = {2009},
date = {2009-10-01},
journal = {Radiology},
volume = {253},
pages = {74--80},
abstract = {To determine if radiology residents who used a structured reporting system (SRS) produced higher quality reports than residents who used conventional free-text dictation to report cranial magnetic resonance (MR) imaging in patients suspected of having a stroke. The study was approved by an institutional review board and was HIPAA compliant; informed consent was obtained. This study included residents, with 16 in the control group and 18 in the intervention group. For phase 1, each subject reviewed the same set of 25 brain MR imaging cases and dictated the cases by using free-text conventional dictation. For phase 2, 4 months later, the control group repeated the same process, whereas the intervention group reread the same MR imaging cases by using SRS to create reports. Resident-generated reports were graded for accuracy and completeness by a neuroradiologist on the basis of consensus interpretations and criterion standard diagnoses as established with at least 6 months of clinical follow-up, imaging follow-up, and/or histologic examination where appropriate. Accuracy and completeness scores were analyzed by using a Wilcoxon signed rank test for paired data and a Mann-Whitney U test for nonpaired data. Intervention group residents were surveyed regarding their opinions of SRS. For phase 1 reports, no significant difference in accuracy or completeness scores between control and intervention groups was found. Decreases in accuracy (91.5 to 88.7) and completeness (68.7 to 54.3) scores for phase 2 compared with phase 1 for the intervention group were found; increases in accuracy (91.4 to 92.4) and completeness (67.8 to 71.7) scores for phase 2 compared with phase 1 for the control group were found (all P values \< .001). The most common complaints were that the SRS was overly constraining with regard to report content and was time-consuming to use. While there are many potential benefits of structuring radiology reports, such changes cannot be assumed to improve report accuracy or completeness. Any SRS should be tested for effect on intrinsic report quality.},
keywords = {},
pubstate = {ppublish},
tppubtype = {article}
}
To determine if radiology residents who used a structured reporting system (SRS) produced higher quality reports than residents who used conventional free-text dictation to report cranial magnetic resonance (MR) imaging in patients suspected of having a stroke. The study was approved by an institutional review board and was HIPAA compliant; informed consent was obtained. This study included residents, with 16 in the control group and 18 in the intervention group. For phase 1, each subject reviewed the same set of 25 brain MR imaging cases and dictated the cases by using free-text conventional dictation. For phase 2, 4 months later, the control group repeated the same process, whereas the intervention group reread the same MR imaging cases by using SRS to create reports. Resident-generated reports were graded for accuracy and completeness by a neuroradiologist on the basis of consensus interpretations and criterion standard diagnoses as established with at least 6 months of clinical follow-up, imaging follow-up, and/or histologic examination where appropriate. Accuracy and completeness scores were analyzed by using a Wilcoxon signed rank test for paired data and a Mann-Whitney U test for nonpaired data. Intervention group residents were surveyed regarding their opinions of SRS. For phase 1 reports, no significant difference in accuracy or completeness scores between control and intervention groups was found. Decreases in accuracy (91.5 to 88.7) and completeness (68.7 to 54.3) scores for phase 2 compared with phase 1 for the intervention group were found; increases in accuracy (91.4 to 92.4) and completeness (67.8 to 71.7) scores for phase 2 compared with phase 1 for the control group were found (all P values < .001). The most common complaints were that the SRS was overly constraining with regard to report content and was time-consuming to use. While there are many potential benefits of structuring radiology reports, such changes cannot be assumed to improve report accuracy or completeness. Any SRS should be tested for effect on intrinsic report quality.
Swan, J. Shannon; Miksad, Rebecca
Measuring the quality-of-life effects of diagnostic and screening tests Journal Article
In: J Am Coll Radiol, vol. 6, no. 8, pp. 567-75, 2009, ISSN: 1558-349X (Electronic) 1546-1440, ().
@article{Swan2009,
title = {Measuring the quality-of-life effects of diagnostic and screening
tests},
author = {J. Shannon Swan and Rebecca Miksad},
url = {http://www.ncbi.nlm.nih.gov/pubmed/19643385},
issn = {1558-349X (Electronic) 1546-1440},
year = {2009},
date = {2009-08-01},
journal = {J Am Coll Radiol},
volume = {6},
number = {8},
pages = {567-75},
abstract = {Health-related quality of life (HRQL) is a central concept for understanding
the outcomes of medical care. When used in cost-effectiveness analysis,
HRQL is typically measured for conditions persisting over long time
frames (years), and quality-adjusted life year (QALY) values are
generated. Consequently, years are the basic unit of time for cost-effectiveness
analysis results: dollars spent per QALY gained. However, shorter
term components of health care may also affect HRQL, and there is
increased interest in measuring and accounting for these events.
In radiology, the short-term HRQL effects of screening and diagnostic
testing may affect a test's cost-effectiveness, even though they
may only last for days. The unique challenge in radiology HRQL assessment
is to realistically tap into the testing and screening experience
while remaining consistent with QALY theory. The authors review HRQL
assessment and highlight methods developed to specifically address
the short-term effects of radiologic screening and testing.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Health-related quality of life (HRQL) is a central concept for understanding
the outcomes of medical care. When used in cost-effectiveness analysis,
HRQL is typically measured for conditions persisting over long time
frames (years), and quality-adjusted life year (QALY) values are
generated. Consequently, years are the basic unit of time for cost-effectiveness
analysis results: dollars spent per QALY gained. However, shorter
term components of health care may also affect HRQL, and there is
increased interest in measuring and accounting for these events.
In radiology, the short-term HRQL effects of screening and diagnostic
testing may affect a test's cost-effectiveness, even though they
may only last for days. The unique challenge in radiology HRQL assessment
is to realistically tap into the testing and screening experience
while remaining consistent with QALY theory. The authors review HRQL
assessment and highlight methods developed to specifically address
the short-term effects of radiologic screening and testing.
the outcomes of medical care. When used in cost-effectiveness analysis,
HRQL is typically measured for conditions persisting over long time
frames (years), and quality-adjusted life year (QALY) values are
generated. Consequently, years are the basic unit of time for cost-effectiveness
analysis results: dollars spent per QALY gained. However, shorter
term components of health care may also affect HRQL, and there is
increased interest in measuring and accounting for these events.
In radiology, the short-term HRQL effects of screening and diagnostic
testing may affect a test's cost-effectiveness, even though they
may only last for days. The unique challenge in radiology HRQL assessment
is to realistically tap into the testing and screening experience
while remaining consistent with QALY theory. The authors review HRQL
assessment and highlight methods developed to specifically address
the short-term effects of radiologic screening and testing.
Swan, J. Shannon
Multiattribute Utility Ŧheory Book Chapter
In: Kattan, M. W. (Ed.): Encyclopedia of Medical Decision Making, vol. 2, pp. 795-799, Sage, Thousand Oaks, CA, 2009, ().
@inbook{Swan2009a,
title = {Multiattribute Utility {T}heory},
author = {J. Shannon Swan},
editor = {M. W. Kattan},
year = {2009},
date = {2009-01-01},
booktitle = {Encyclopedia of Medical Decision Making},
volume = {2},
pages = {795-799},
publisher = {Sage},
address = {Thousand Oaks, CA},
keywords = {},
pubstate = {published},
tppubtype = {inbook}
}
Wright, Davene; Wittenberg, Eve; Swan, J. Shannon; Miksad, Rebecca; Prosser, L. A.
Methods for measuring temporary health States for cost-utility analyses Journal Article
In: PharmacoEconomics, vol. 27, no. 9, pp. 713-23, 2009, ISSN: 1170-7690 (Print) 1170-7690 (Lin, ().
@article{Wright2009,
title = {Methods for measuring temporary health States for cost-utility analyses},
author = {Davene Wright and Eve Wittenberg and J. Shannon Swan and Rebecca Miksad and L. A. Prosser},
url = {http://www.ncbi.nlm.nih.gov/pubmed/19757865},
issn = {1170-7690 (Print) 1170-7690 (Lin},
year = {2009},
date = {2009-01-01},
journal = {PharmacoEconomics},
volume = {27},
number = {9},
pages = {713-23},
abstract = {A variety of methods are available to measure preferences for temporary
health states for cost-utility analyses. The objectives of this review
were to summarize the available temporary health-state valuation
methods, identify advantages and disadvantages of each, and identify
areas for future research. We describe the key aspects of each method
and summarize advantages and disadvantages of each method in terms
of consistency with QALY theory, relevance to temporary health-state-specific
domains, ease of use, time preference, and performance in validation
studies. Two broad categories of methods were identified: traditional
and adapted. Traditional methods were health status instruments,
time trade-off (TTO), and the standard gamble (SG). Methods adapted
specifically for temporary health-state valuation were TTO with specified
duration of the health state, TTO with a lifespan modification, waiting
trade-off, chained approaches for TTO and SG, and sleep trade-off.
Advantages and disadvantages vary by method and no 'gold standard'
method emerged. Selection of a method to value temporary health states
will depend on the relative importance of the following considerations:
ability to accurately capture the unique characteristics of the temporary
health state, level of respondent burden and cognition, theoretical
consistency of elicited preference values with the overall purpose
of the study, and resources available for study development and data
collection. Further research should focus on evaluating validity,
reliability and feasibility of temporary health-state valuation methods.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
A variety of methods are available to measure preferences for temporary
health states for cost-utility analyses. The objectives of this review
were to summarize the available temporary health-state valuation
methods, identify advantages and disadvantages of each, and identify
areas for future research. We describe the key aspects of each method
and summarize advantages and disadvantages of each method in terms
of consistency with QALY theory, relevance to temporary health-state-specific
domains, ease of use, time preference, and performance in validation
studies. Two broad categories of methods were identified: traditional
and adapted. Traditional methods were health status instruments,
time trade-off (TTO), and the standard gamble (SG). Methods adapted
specifically for temporary health-state valuation were TTO with specified
duration of the health state, TTO with a lifespan modification, waiting
trade-off, chained approaches for TTO and SG, and sleep trade-off.
Advantages and disadvantages vary by method and no 'gold standard'
method emerged. Selection of a method to value temporary health states
will depend on the relative importance of the following considerations:
ability to accurately capture the unique characteristics of the temporary
health state, level of respondent burden and cognition, theoretical
consistency of elicited preference values with the overall purpose
of the study, and resources available for study development and data
collection. Further research should focus on evaluating validity,
reliability and feasibility of temporary health-state valuation methods.
health states for cost-utility analyses. The objectives of this review
were to summarize the available temporary health-state valuation
methods, identify advantages and disadvantages of each, and identify
areas for future research. We describe the key aspects of each method
and summarize advantages and disadvantages of each method in terms
of consistency with QALY theory, relevance to temporary health-state-specific
domains, ease of use, time preference, and performance in validation
studies. Two broad categories of methods were identified: traditional
and adapted. Traditional methods were health status instruments,
time trade-off (TTO), and the standard gamble (SG). Methods adapted
specifically for temporary health-state valuation were TTO with specified
duration of the health state, TTO with a lifespan modification, waiting
trade-off, chained approaches for TTO and SG, and sleep trade-off.
Advantages and disadvantages vary by method and no 'gold standard'
method emerged. Selection of a method to value temporary health states
will depend on the relative importance of the following considerations:
ability to accurately capture the unique characteristics of the temporary
health state, level of respondent burden and cognition, theoretical
consistency of elicited preference values with the overall purpose
of the study, and resources available for study development and data
collection. Further research should focus on evaluating validity,
reliability and feasibility of temporary health-state valuation methods.
2008
Fennessy, F. F.; Tempany, C. M. C.; Kong, Chung Yin; Swan, J. Shannon
Short-term analysis of fibroid treatment options and utility analysis of fibroid treatment outcomes Conference
RSNA Proceedings, 2008.
@conference{Fennessy2008a,
title = {Short-term analysis of fibroid treatment options and utility analysis of fibroid treatment outcomes},
author = {F. F. Fennessy and C. M. C. Tempany and Chung Yin Kong and J. Shannon Swan},
url = {https://www.researchgate.net/publication/266118681_Short-term_Utility_Analysis_of_Fibroid_Treatment_Options_and_Utility_Analysis_of_Fibroid_Treatment_Outcomes},
year = {2008},
date = {2008-12-02},
urldate = {2011-01-01},
booktitle = {RSNA Proceedings},
pages = {433-434},
keywords = {},
pubstate = {published},
tppubtype = {conference}
}
Stahl, James; Tramontano, Angela; Swan, J. Shannon; Cohen, B. J.
Balancing urgency, age and quality of life in organ allocation decisions--what would you do? A survey Journal Article
In: J Med Ethics, vol. 34, pp. 109-15, 2008, ().
@article{Stahl2008,
title = {Balancing urgency, age and quality of life in organ allocation decisions--what
would you do? A survey},
author = {James Stahl and Angela Tramontano and J. Shannon Swan and B. J. Cohen},
url = {http://www.ncbi.nlm.nih.gov/pubmed/18234950},
year = {2008},
date = {2008-01-01},
journal = {J Med Ethics},
volume = {34},
pages = {109-15},
abstract = {PURPOSE: Explore public attitudes towards the trade-offs between justice
and medical outcome inherent in organ allocation decisions. BACKGROUND:
The US Task Force on Organ Transplantation recommended that considerations
of justice, autonomy and medical outcome be part of all organ allocation
decisions. Justice in this context may be modeled as a function of
three types of need, related to age, clinical urgency, and quality
of life. METHODS: A web-based survey was conducted in which respondents
were asked to choose between two hypothetical patients who differed
in clinical urgency (time to death textless1 year), age, pretransplant
and post-transplant quality of life, and life expectancy. RESULTS:
A pool of 1600 people were notified via email about the survey; 623
(39 responded. Respondents preferred giving organs to younger people
up to an age difference of textless15.4 years (SD 18) and more clinically
urgent people up to a difference in urgency of textless2.54 months
(SD 3). Priority varied with the quality of life of the worst-off
patient and the relative status of the patients. If both had worse
than average quality of life, respondents preferred the better-off
patient. When both had better than average quality of life, they
preferred the worse-off patient. In analysis according to age versus
clinical urgency, the older the patient, the more urgency needed
to receive priority. In quality of life versus clinical urgency,
the better the control's quality of life, the more urgency the competing
patient required. The worse the patient's post-transplant outcome,
the more urgency needed to receive priority. CONCLUSIONS: It appears
that clinical urgency is only one of many factors influencing attitudes
about allocation decisions and that respondents may invoke different
principles of fairness depending the relative clinical status of
patients.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
PURPOSE: Explore public attitudes towards the trade-offs between justice
and medical outcome inherent in organ allocation decisions. BACKGROUND:
The US Task Force on Organ Transplantation recommended that considerations
of justice, autonomy and medical outcome be part of all organ allocation
decisions. Justice in this context may be modeled as a function of
three types of need, related to age, clinical urgency, and quality
of life. METHODS: A web-based survey was conducted in which respondents
were asked to choose between two hypothetical patients who differed
in clinical urgency (time to death textless1 year), age, pretransplant
and post-transplant quality of life, and life expectancy. RESULTS:
A pool of 1600 people were notified via email about the survey; 623
(39 responded. Respondents preferred giving organs to younger people
up to an age difference of textless15.4 years (SD 18) and more clinically
urgent people up to a difference in urgency of textless2.54 months
(SD 3). Priority varied with the quality of life of the worst-off
patient and the relative status of the patients. If both had worse
than average quality of life, respondents preferred the better-off
patient. When both had better than average quality of life, they
preferred the worse-off patient. In analysis according to age versus
clinical urgency, the older the patient, the more urgency needed
to receive priority. In quality of life versus clinical urgency,
the better the control's quality of life, the more urgency the competing
patient required. The worse the patient's post-transplant outcome,
the more urgency needed to receive priority. CONCLUSIONS: It appears
that clinical urgency is only one of many factors influencing attitudes
about allocation decisions and that respondents may invoke different
principles of fairness depending the relative clinical status of
patients.
and medical outcome inherent in organ allocation decisions. BACKGROUND:
The US Task Force on Organ Transplantation recommended that considerations
of justice, autonomy and medical outcome be part of all organ allocation
decisions. Justice in this context may be modeled as a function of
three types of need, related to age, clinical urgency, and quality
of life. METHODS: A web-based survey was conducted in which respondents
were asked to choose between two hypothetical patients who differed
in clinical urgency (time to death textless1 year), age, pretransplant
and post-transplant quality of life, and life expectancy. RESULTS:
A pool of 1600 people were notified via email about the survey; 623
(39 responded. Respondents preferred giving organs to younger people
up to an age difference of textless15.4 years (SD 18) and more clinically
urgent people up to a difference in urgency of textless2.54 months
(SD 3). Priority varied with the quality of life of the worst-off
patient and the relative status of the patients. If both had worse
than average quality of life, respondents preferred the better-off
patient. When both had better than average quality of life, they
preferred the worse-off patient. In analysis according to age versus
clinical urgency, the older the patient, the more urgency needed
to receive priority. In quality of life versus clinical urgency,
the better the control's quality of life, the more urgency the competing
patient required. The worse the patient's post-transplant outcome,
the more urgency needed to receive priority. CONCLUSIONS: It appears
that clinical urgency is only one of many factors influencing attitudes
about allocation decisions and that respondents may invoke different
principles of fairness depending the relative clinical status of
patients.
Wright, Davene; Wittenberg, Eve; Swan, J. Shannon; Miksad, Rebecca; Prosser, L. A.
A review and critique of methods for measuring temporary health states in cost-utility analysis Journal Article
In: Value in Health: Proceedings of the International Society for Pharmacoeconomics and Outcomes Research, vol. 11, no. 3, pp. A177, 2008, ().
@article{DWright2008,
title = {A review and critique of methods for measuring temporary health states in cost-utility analysis},
author = {Davene Wright and Eve Wittenberg and J. Shannon Swan and Rebecca Miksad and L. A. Prosser},
year = {2008},
date = {2008-01-01},
urldate = {2008-01-01},
journal = {Value in Health: Proceedings of the International Society for Pharmacoeconomics and Outcomes Research},
volume = {11},
number = {3},
pages = {A177},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
2006
Swan, J. Shannon; Lawrence, W. F.; Roy, J.
Process utility in breast biopsy Journal Article
In: Med Decis Making, vol. 26, no. 4, pp. 347-59, 2006, ISSN: 0272-989X (Print) 0272-989X (Lin, ().
@article{Swan2006,
title = {Process utility in breast biopsy},
author = {J. Shannon Swan and W. F. Lawrence and J. Roy},
url = {http://www.ncbi.nlm.nih.gov/pubmed/16855124},
issn = {0272-989X (Print) 0272-989X (Lin},
year = {2006},
date = {2006-00-01},
journal = {Med Decis Making},
volume = {26},
number = {4},
pages = {347-59},
abstract = {PURPOSE: To determine whether the waiting trade-off (WTO) is feasible
for differentiating short-term biopsy preferences in an acute situation
where anxiety is the symptomatic disease state. METHODS: 75 women
with past experience of either breast core-needle biopsy (CNB), more
invasive excisional surgical biopsy (EXB), or both, had telephone
WTO assessments. Patients' baseline and test-related anxiety were
valued by time trade-off (TTO) used to scale the WTO. Rating scales
(RS) were obtained for convergent validity assessment with WTO and
TTO. RESULTS: Data were obtained in 38 women who had both CNB and
EXB ("paired") and 20 who had CNB only and 16 who had EXB only ("unpaired").
Patients rated only the procedure(s) they experienced. Median paired
and mean unpaired WTO scores indicated patients were willing to wait significantly longer to avoid EXB (P = 0.000},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
PURPOSE: To determine whether the waiting trade-off (WTO) is feasible
for differentiating short-term biopsy preferences in an acute situation
where anxiety is the symptomatic disease state. METHODS: 75 women
with past experience of either breast core-needle biopsy (CNB), more
invasive excisional surgical biopsy (EXB), or both, had telephone
WTO assessments. Patients' baseline and test-related anxiety were
valued by time trade-off (TTO) used to scale the WTO. Rating scales
(RS) were obtained for convergent validity assessment with WTO and
TTO. RESULTS: Data were obtained in 38 women who had both CNB and
EXB ("paired") and 20 who had CNB only and 16 who had EXB only ("unpaired").
Patients rated only the procedure(s) they experienced. Median paired
and mean unpaired WTO scores indicated patients were willing to wait significantly longer to avoid EXB (P = 0.000
for differentiating short-term biopsy preferences in an acute situation
where anxiety is the symptomatic disease state. METHODS: 75 women
with past experience of either breast core-needle biopsy (CNB), more
invasive excisional surgical biopsy (EXB), or both, had telephone
WTO assessments. Patients' baseline and test-related anxiety were
valued by time trade-off (TTO) used to scale the WTO. Rating scales
(RS) were obtained for convergent validity assessment with WTO and
TTO. RESULTS: Data were obtained in 38 women who had both CNB and
EXB ("paired") and 20 who had CNB only and 16 who had EXB only ("unpaired").
Patients rated only the procedure(s) they experienced. Median paired
and mean unpaired WTO scores indicated patients were willing to wait significantly longer to avoid EXB (P = 0.000
2004
Kongnakorn, T.; Swan, J. Shannon; Sainfort, F.
Empirical Ŧest and Validation of the Waiting Ŧradeoff Method Journal Article
In: Medical Decision Making (26th Annual Meeting SMDM Abstracts), vol. 25, no. 1, pp. E34, 2004, ().
@article{Kongnakorn2004,
title = {Empirical {T}est and Validation of the Waiting {T}radeoff Method},
author = {T. Kongnakorn and J. Shannon Swan and F. Sainfort},
year = {2004},
date = {2004-01-01},
journal = {Medical Decision Making (26th Annual Meeting SMDM Abstracts)},
volume = {25},
number = {1},
pages = {E34},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Rosen, M. P.; Jarvik, J. G.; Swan, J. Shannon
Expect the unexpected: thoughts, insights and musing about research in radiology Journal Article
In: Acad Radiol, vol. 11, pp. 206–12, 2004, ().
@article{Rosen2004,
title = {Expect the unexpected: thoughts, insights and musing about research in radiology},
author = {M. P. Rosen and J. G. Jarvik and J. Shannon Swan},
url = {http://www.ncbi.nlm.nih.gov/pubmed/14974595},
year = {2004},
date = {2004-01-01},
journal = {Acad Radiol},
volume = {11},
pages = {206--12},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
2003
Swan, J. Shannon; Sainfort, F.; Lawrence, W. F.; Kuruchittham, V.; Kongnakorn, T.; Heisey, D. M.
Process utility for imaging in cerebrovascular disease Journal Article
In: vol. 10, pp. 266–74, 2003, ().
@article{Swan2003,
title = {Process utility for imaging in cerebrovascular disease},
author = {J. Shannon Swan and F. Sainfort and W. F. Lawrence and V. Kuruchittham and T. Kongnakorn and D. M. Heisey},
url = {http://www.ncbi.nlm.nih.gov/pubmed/12643553},
year = {2003},
date = {2003-01-01},
volume = {10},
pages = {266--74},
abstract = {RATIONALE AND OBJECTIVES: The morbidity associated with a diagnostic
test can influence its cost-effectiveness, but the quantification
of that morbidity is controversial. Accounting for pain and invasiveness
requires the measurement of "process utility" in addition to the
expected value of testing. An original time trade-off variant was
applied to the imaging evaluation of cerebrovascular disease, for
which differences in morbidity are important to patients. MATERIALS
AND METHODS: A "waiting trade-off" (WTO) was used to evaluate the
preferences of 89 patients for magnetic resonance (MR) angiography
and conventional x-ray angiography. Patients were experienced with
both tests. A weighted difference was calculated between the period
a patient was willing to wait for a test result and treatment after
a hypothetical "ideal" test and the choice to undergo conventional
angiography or MR angiography with immediate treatment. A rating
scale was used to check the convergent validity of the WTO. RESULTS: Paired data showed a highly significant difference (P = .0001) between
the mean preference for conventional and MR angiography, favoring
the latter and translating into a difference of 5 quality-adjusted
life days. The more negatively patients judged their conventional
angiographic experience, the longer they were willing to wait for
the ideal test result. CONCLUSION: The WTO provides a reasonable
estimate of the relative morbidity of more invasive conventional
angiographic procedures and provides a quality-adjustment term for
economic analysis. Such an approach may enable more complete evaluation
of the effects of other processes on medical care.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
RATIONALE AND OBJECTIVES: The morbidity associated with a diagnostic
test can influence its cost-effectiveness, but the quantification
of that morbidity is controversial. Accounting for pain and invasiveness
requires the measurement of "process utility" in addition to the
expected value of testing. An original time trade-off variant was
applied to the imaging evaluation of cerebrovascular disease, for
which differences in morbidity are important to patients. MATERIALS
AND METHODS: A "waiting trade-off" (WTO) was used to evaluate the
preferences of 89 patients for magnetic resonance (MR) angiography
and conventional x-ray angiography. Patients were experienced with
both tests. A weighted difference was calculated between the period
a patient was willing to wait for a test result and treatment after
a hypothetical "ideal" test and the choice to undergo conventional
angiography or MR angiography with immediate treatment. A rating
scale was used to check the convergent validity of the WTO. RESULTS: Paired data showed a highly significant difference (P = .0001) between
the mean preference for conventional and MR angiography, favoring
the latter and translating into a difference of 5 quality-adjusted
life days. The more negatively patients judged their conventional
angiographic experience, the longer they were willing to wait for
the ideal test result. CONCLUSION: The WTO provides a reasonable
estimate of the relative morbidity of more invasive conventional
angiographic procedures and provides a quality-adjustment term for
economic analysis. Such an approach may enable more complete evaluation
of the effects of other processes on medical care.
test can influence its cost-effectiveness, but the quantification
of that morbidity is controversial. Accounting for pain and invasiveness
requires the measurement of "process utility" in addition to the
expected value of testing. An original time trade-off variant was
applied to the imaging evaluation of cerebrovascular disease, for
which differences in morbidity are important to patients. MATERIALS
AND METHODS: A "waiting trade-off" (WTO) was used to evaluate the
preferences of 89 patients for magnetic resonance (MR) angiography
and conventional x-ray angiography. Patients were experienced with
both tests. A weighted difference was calculated between the period
a patient was willing to wait for a test result and treatment after
a hypothetical "ideal" test and the choice to undergo conventional
angiography or MR angiography with immediate treatment. A rating
scale was used to check the convergent validity of the WTO. RESULTS: Paired data showed a highly significant difference (P = .0001) between
the mean preference for conventional and MR angiography, favoring
the latter and translating into a difference of 5 quality-adjusted
life days. The more negatively patients judged their conventional
angiographic experience, the longer they were willing to wait for
the ideal test result. CONCLUSION: The WTO provides a reasonable
estimate of the relative morbidity of more invasive conventional
angiographic procedures and provides a quality-adjustment term for
economic analysis. Such an approach may enable more complete evaluation
of the effects of other processes on medical care.
2002
Wieben, O.; Carroll, T. J.; Swan, J. Shannon; Frayn, R.
Rapid generation of preview images for real-time 3Đ MR angiography Journal Article
In: Phys Med Biol, vol. 47, no. 1, pp. N17-24, 2002, ISSN: 0031-9155 (Print) 0031-9155 (Li, ().
@article{Wieben2002,
title = {Rapid generation of preview images for real-time 3{D} MR angiography},
author = {O. Wieben and T. J. Carroll and J. Shannon Swan and R. Frayn},
url = {https://www.ncbi.nlm.nih.gov/pubmed/11814233},
doi = {10.1088/0031-9155/47/1/403},
issn = {0031-9155 (Print)
0031-9155 (Li},
year = {2002},
date = {2002-01-01},
journal = {Phys Med Biol},
volume = {47},
number = {1},
pages = {N17-24},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Swan, J. Shannon; Carroll, T. J.; Kennell, T. W.; Heisey, D. M.; Korosec, F. R.; Frayne, R.; Mistretta, C. A.; Grist, T. M.
Time-resolved three-dimensional contrast-enhanced MR angiography of the peripheral vessels Journal Article
In: Radiology, vol. 225, no. 1, pp. 43-52, 2002, ISSN: 0033-8419 (Print) 0033-8419 (Li, ().
@article{Swan2002,
title = {Time-resolved three-dimensional contrast-enhanced MR angiography of the peripheral vessels},
author = {J. Shannon Swan and T. J. Carroll and T. W. Kennell and D. M. Heisey and F. R. Korosec and R. Frayne and C. A. Mistretta and T. M. Grist},
url = {https://www.ncbi.nlm.nih.gov/pubmed/12354982},
doi = {10.1148/radiol.2251011292},
issn = {0033-8419 (Print) 0033-8419 (Li},
year = {2002},
date = {2002-01-01},
urldate = {2002-01-01},
journal = {Radiology},
volume = {225},
number = {1},
pages = {43-52},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
2001
Carroll, T. J.; Korosec, F. R.; Swan, J. Shannon; Hany, T. F.; Grist, T. M.; Mistretta, C. A.
The effect of injection rate on time-resolved contrast-enhanced peripheral MRA Journal Article
In: J Magn Reson Imaging, vol. 14, no. 4, pp. 401-10, 2001, ISSN: 1053-1807 (Print) 1053-1807 (Li, ().
@article{Carroll2001,
title = {The effect of injection rate on time-resolved contrast-enhanced peripheral MRA},
author = {T. J. Carroll and F. R. Korosec and J. Shannon Swan and T. F. Hany and T. M. Grist and C. A. Mistretta},
url = {https://www.ncbi.nlm.nih.gov/pubmed/11599064},
doi = {10.1002/jmri.1200},
issn = {1053-1807 (Print) 1053-1807 (Li},
year = {2001},
date = {2001-01-01},
urldate = {2001-01-01},
journal = {J Magn Reson Imaging},
volume = {14},
number = {4},
pages = {401-10},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
2000
Swan, J. Shannon; Kennell, T. W.; Acher, C. W.; Heisey, D. M.; Grist, T. M.; Korosec, F. R.; Hagenauer, M. E.
Magnetic resonance angiography of aorto-iliac disease Journal Article
In: Am J Surg, vol. 180, no. 1, pp. 6-12, 2000, ISSN: 0002-9610 (Print) 0002-9610 (Li, ().
@article{Swan2000a,
title = {Magnetic resonance angiography of aorto-iliac disease},
author = {J. Shannon Swan and T. W. Kennell and C. W. Acher and D. M. Heisey and T. M. Grist and F. R. Korosec and M. E. Hagenauer},
url = {https://www.ncbi.nlm.nih.gov/pubmed/11036131},
doi = {10.1016/s0002-9610(00)00412-8},
issn = {0002-9610 (Print)
0002-9610 (Li},
year = {2000},
date = {2000-01-01},
journal = {Am J Surg},
volume = {180},
number = {1},
pages = {6-12},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Carroll, T. J.; Korosec, F. R.; Swan, J. Shannon; Grist, T. M.; Frayne, R.; Mistretta, C. A.
Method for rapidly determining and reconstructing the peak arterial frame from a time-resolved CE-MRA exam Journal Article
In: Magn Reson Med, vol. 44, no. 5, pp. 817-20, 2000, ISSN: 0740-3194 (Print) 0740-3194 (Li, ().
@article{Carroll2000,
title = {Method for rapidly determining and reconstructing the peak arterial frame from a time-resolved CE-MRA exam},
author = {T. J. Carroll and F. R. Korosec and J. Shannon Swan and T. M. Grist and R. Frayne and C. A. Mistretta},
url = {https://www.ncbi.nlm.nih.gov/pubmed/11064419},
doi = {10.1002/1522-2594(200011)44:5\<817::aid-mrm22\>3.0.co;2-x},
issn = {0740-3194 (Print)
0740-3194 (Li},
year = {2000},
date = {2000-01-01},
journal = {Magn Reson Med},
volume = {44},
number = {5},
pages = {817-20},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Frayne, R.; Grist, T. M.; Swan, J. Shannon; Peters, D. C.; Korosec, F. R.; Mistretta, C. A.
3D MR DSA: effects of injection protocol and image masking Journal Article
In: J Magn Reson Imaging, vol. 12, no. 3, pp. 476-87, 2000, ISSN: 1053-1807 (Print) 1053-1807 (Li, ().
@article{Frayne2000,
title = {3D MR DSA: effects of injection protocol and image masking},
author = {R. Frayne and T. M. Grist and J. Shannon Swan and D. C. Peters and F. R. Korosec and C. A. Mistretta},
url = {https://www.ncbi.nlm.nih.gov/pubmed/10992316},
doi = {10.1002/1522-2586(200009)12:3\<476::aid-jmri14\>3.0.co;2-f},
issn = {1053-1807 (Print) 1053-1807 (Li},
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Swan, J. Shannon; Fryback, D. G.; Lawrence, W. F.; Sainfort, F.; Hagenauer, M. E.; Heisey, D. M.
A time-tradeoff method for cost-effectiveness models applied to radiology Journal Article
In: Med Decis Making, vol. 20, no. 1, pp. 79-88, 2000, ISSN: 0272-989X (Print) 0272-989X (Li, ().
@article{Swan2000,
title = {A time-tradeoff method for cost-effectiveness models applied to radiology},
author = {J. Shannon Swan and D. G. Fryback and W. F. Lawrence and F. Sainfort and M. E. Hagenauer and D. M. Heisey},
url = {https://www.ncbi.nlm.nih.gov/pubmed/10638540},
doi = {10.1177/0272989X0002000110},
issn = {0272-989X (Print) 0272-989X (Li},
year = {2000},
date = {2000-01-01},
urldate = {2000-01-01},
journal = {Med Decis Making},
volume = {20},
number = {1},
pages = {79-88},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
1999
Hoch, J. R.; Kennell, T. W.; Hollister, M. S.; Sproat, I. A.; Swan, J. Shannon; Acher, C. W.; Burks, J.; Heisey, D. M.
Comparison of treatment plans for lower extremity arterial occlusive disease made with electrocardiography-triggered two-dimensional time-of- flight magnetic resonance angiography and digital subtraction angiography Journal Article
In: Am J Surg, vol. 178, no. 2, pp. 166-72., 1999, ().
@article{Hoch1999,
title = {Comparison of treatment plans for lower extremity arterial occlusive disease made with electrocardiography-triggered two-dimensional time-of- flight magnetic resonance angiography and digital subtraction angiography},
author = {J. R. Hoch and T. W. Kennell and M. S. Hollister and I. A. Sproat and J. Shannon Swan and C. W. Acher and J. Burks and D. M. Heisey},
year = {1999},
date = {1999-01-01},
journal = {Am J Surg},
volume = {178},
number = {2},
pages = {166-72.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
1998
Swan, J. Shannon; Langlotz, C. P.
In: Invest Radiol, vol. 33, no. 9, pp. 553-9, 1998, ISSN: 0020-9996 (Print) 0020-9996 (Li, ().
@article{Swan1998,
title = {Patient preference for magnetic resonance versus conventional angiography. Assessment methods and implications for cost-effectiveness analysis: an overview},
author = {J. Shannon Swan and C. P. Langlotz},
url = {https://www.ncbi.nlm.nih.gov/pubmed/9766040},
doi = {10.1097/00004424-199809000-00011},
issn = {0020-9996 (Print)
0020-9996 (Li},
year = {1998},
date = {1998-01-01},
journal = {Invest Radiol},
volume = {33},
number = {9},
pages = {553-9},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Willig, D. S.; Turski, P. A.; Frayne, R.; Graves, V. B.; Korosec, F. R.; Swan, J. Shannon; Mistretta, C. A.; Grist, T. M.
In: Radiology, vol. 208, no. 2, pp. 447-51, 1998, ISSN: 0033-8419 (Print) 0033-8419 (Li, ().
@article{Willig1998,
title = {Contrast-enhanced 3D MR DSA of the carotid artery bifurcation: preliminary study of comparison with unenhanced 2D and 3D time-of-flight MR angiography},
author = {D. S. Willig and P. A. Turski and R. Frayne and V. B. Graves and F. R. Korosec and J. Shannon Swan and C. A. Mistretta and T. M. Grist},
url = {https://www.ncbi.nlm.nih.gov/pubmed/9680574},
doi = {10.1148/radiology.208.2.9680574},
issn = {0033-8419 (Print) 0033-8419 (Li},
year = {1998},
date = {1998-01-01},
urldate = {1998-01-01},
journal = {Radiology},
volume = {208},
number = {2},
pages = {447-51},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
1997
Swan, J. Shannon; Fryback, D. G.; Lawrence, W. F.; Katz, D. A.; Heisey, D. M.; Hagenauer, M. E.; Selzer, P. M.; Jacobson, B. K.
MR and conventional angiography: work in progress toward assessing utility in radiology Journal Article
In: Acad Radiol, vol. 4, no. 7, pp. 475-82, 1997, ISSN: 1076-6332 (Print) 1076-6332 (Li, ().
@article{Swan1997,
title = {MR and conventional angiography: work in progress toward assessing utility in radiology},
author = {J. Shannon Swan and D. G. Fryback and W. F. Lawrence and D. A. Katz and D. M. Heisey and M. E. Hagenauer and P. M. Selzer and B. K. Jacobson},
url = {https://www.ncbi.nlm.nih.gov/pubmed/9232166},
doi = {10.1016/s1076-6332(97)80231-0},
issn = {1076-6332 (Print)
1076-6332 (Li},
year = {1997},
date = {1997-01-01},
journal = {Acad Radiol},
volume = {4},
number = {7},
pages = {475-82},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
1996
Frayne, R.; Grist, T. M.; Korosec, F. R.; Willig, D. S.; Swan, J. Shannon; Turski, P. A.; Mistretta, C. A.
MR angiography with three-dimensional MR digital subtraction angiography Journal Article
In: Top Magn Reson Imaging, vol. 8, no. 6, pp. 366-88, 1996, ISSN: 0899-3459 (Print) 0899-3459 (Li, ().
@article{Frayne1996,
title = {MR angiography with three-dimensional MR digital subtraction angiography},
author = {R. Frayne and T. M. Grist and F. R. Korosec and D. S. Willig and J. Shannon Swan and P. A. Turski and C. A. Mistretta},
url = {https://www.ncbi.nlm.nih.gov/pubmed/9402678},
issn = {0899-3459 (Print)
0899-3459 (Li},
year = {1996},
date = {1996-01-01},
journal = {Top Magn Reson Imaging},
volume = {8},
number = {6},
pages = {366-88},
keywords = {},
pubstate = {published},
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}
Grist, T. M.; Swan, J. Shannon; Korosec, F. R.
Investigators refine MR angio methods Journal Article
In: Diagn Imaging (San Franc), vol. 18, no. 4, pp. 45-50, 1996, ISSN: 0194-2514 (Print) 0194-2514 (Li, ().
@article{Grist1996,
title = {Investigators refine MR angio methods},
author = {T. M. Grist and J. Shannon Swan and F. R. Korosec},
url = {https://www.ncbi.nlm.nih.gov/pubmed/10159857},
issn = {0194-2514 (Print)
0194-2514 (Li},
year = {1996},
date = {1996-01-01},
journal = {Diagn Imaging (San Franc)},
volume = {18},
number = {4},
pages = {45-50},
keywords = {},
pubstate = {published},
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}
Swan, J. Shannon
Intrapelvic two-dimensional time-of-flight magnetic resonance angiography in healthy and diseased subjects Journal Article
In: Acad Radiol, vol. 3, no. 7, pp. 607-9; discussion 60, 1996, ISSN: 1076-6332 (Print) 1076-6332 (Li, ().
@article{Swan1996,
title = {Intrapelvic two-dimensional time-of-flight magnetic resonance angiography in healthy and diseased subjects},
author = {J. Shannon Swan},
url = {https://www.ncbi.nlm.nih.gov/pubmed/8796723},
doi = {10.1016/s1076-6332(96)80227-3},
issn = {1076-6332 (Print)
1076-6332 (Li},
year = {1996},
date = {1996-01-01},
journal = {Acad Radiol},
volume = {3},
number = {7},
pages = {607-9; discussion 60},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
1995
Alley, M. T.; Grist, T. M.; Swan, J. Shannon
Development of a phased-array coil for the lower extremities Journal Article
In: Magn Reson Med, vol. 34, no. 2, pp. 260-7, 1995, ISSN: 0740-3194 (Print) 0740-3194 (Li, ().
@article{Alley1995,
title = {Development of a phased-array coil for the lower extremities},
author = {M. T. Alley and T. M. Grist and J. Shannon Swan},
url = {https://www.ncbi.nlm.nih.gov/pubmed/7476086},
doi = {10.1002/mrm.1910340218},
issn = {0740-3194 (Print)
0740-3194 (Li},
year = {1995},
date = {1995-01-01},
journal = {Magn Reson Med},
volume = {34},
number = {2},
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keywords = {},
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}
Swan, J. Shannon; Grist, T. M.; Sproat, I. A.; Heiner, J. P.; Wiersma, S. R.; Heisey, D. M.
Musculoskeletal neoplasms: preoperative evaluation with MR angiography Journal Article
In: Radiology, vol. 194, no. 2, pp. 519-24, 1995, ISSN: 0033-8419 (Print) 0033-8419 (Li, ().
@article{Swan1995,
title = {Musculoskeletal neoplasms: preoperative evaluation with MR angiography},
author = {J. Shannon Swan and T. M. Grist and I. A. Sproat and J. P. Heiner and S. R. Wiersma and D. M. Heisey},
url = {https://www.ncbi.nlm.nih.gov/pubmed/7529935},
doi = {10.1148/radiology.194.2.7529935},
issn = {0033-8419 (Print)
0033-8419 (Li},
year = {1995},
date = {1995-01-01},
journal = {Radiology},
volume = {194},
number = {2},
pages = {519-24},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Swan, J. Shannon; Korosec, F. R.; Heisey, D. M.; Grist, T. M.
In: J Vasc Interv Radiol, vol. 6, no. 6, pp. 965-70, 1995, ISSN: 1051-0443 (Print) 1051-0443 (Li, ().
@article{Swan1995a,
title = {Evaluation of presaturation pulse thickness and gap for lower extremity peripheral two-dimensional time-of-flight MR angiography with a signa 1.5-T unit},
author = {J. Shannon Swan and F. R. Korosec and D. M. Heisey and T. M. Grist},
url = {https://www.ncbi.nlm.nih.gov/pubmed/8850678},
doi = {10.1016/s1051-0443(95)71223-4},
issn = {1051-0443 (Print)
1051-0443 (Li},
year = {1995},
date = {1995-01-01},
journal = {J Vasc Interv Radiol},
volume = {6},
number = {6},
pages = {965-70},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Tuite, M. J.; Smet, A. A. De; Swan, J. Shannon; Keene, J. S.
MR imaging of a meniscal ossicle Journal Article
In: Skeletal Radiol, vol. 24, no. 7, pp. 543-5, 1995, ISSN: 0364-2348 (Print)0364-2348 (Li, ().
@article{Tuite1995,
title = {MR imaging of a meniscal ossicle},
author = {M. J. Tuite and A. A. De Smet and J. Shannon Swan and J. S. Keene},
url = {https://www.ncbi.nlm.nih.gov/pubmed/8545656},
doi = {10.1007/BF00202157},
issn = {0364-2348 (Print)0364-2348 (Li},
year = {1995},
date = {1995-01-01},
journal = {Skeletal Radiol},
volume = {24},
number = {7},
pages = {543-5},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
1994
Smet, A. A. De; Tuite, M. J.; Norris, M. A.; Swan, J. Shannon
MR diagnosis of meniscal tears: analysis of causes of errors Journal Article
In: AJR Am J Roentgenol, vol. 163, no. 6, pp. 1419-23, 1994, ISSN: 0361-803X (Print) 0361-803X (Li, ().
@article{DeSmet1994,
title = {MR diagnosis of meniscal tears: analysis of causes of errors},
author = {A. A. De Smet and M. J. Tuite and M. A. Norris and J. Shannon Swan},
url = {https://www.ncbi.nlm.nih.gov/pubmed/7992739},
doi = {10.2214/ajr.163.6.7992739},
issn = {0361-803X (Print)
0361-803X (Li},
year = {1994},
date = {1994-01-01},
journal = {AJR Am J Roentgenol},
volume = {163},
number = {6},
pages = {1419-23},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
1993
Damron, T. A.; Brodke, D. S.; Heiner, J. P.; Swan, J. Shannon; DeSouky, S.
Case report 803: Gorham's disease (Gorham-Stout syndrome) of scapula Journal Article
In: Skeletal Radiol, vol. 22, no. 6, pp. 464-7, 1993, ISSN: 0364-2348 (Print) 0364-2348 (Li, ().
@article{Damron1993,
title = {Case report 803: Gorham's disease (Gorham-Stout syndrome) of scapula},
author = {T. A. Damron and D. S. Brodke and J. P. Heiner and J. Shannon Swan and S. DeSouky},
url = {https://www.ncbi.nlm.nih.gov/pubmed/8248825},
doi = {10.1007/BF00538454},
issn = {0364-2348 (Print)
0364-2348 (Li},
year = {1993},
date = {1993-01-01},
journal = {Skeletal Radiol},
volume = {22},
number = {6},
pages = {464-7},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Swan, J. Shannon; Heiner, J. P.; Rao, V. K.; Weber, D. M.
Preoperative evaluation of giant cell tumors of the radius with magnetic resonance angiography Journal Article
In: J Hand Surg Am, vol. 18, no. 3, pp. 499-503, 1993, ISSN: 0363-5023 (Print) 0363-5023 (Li, ().
@article{Swan1993,
title = {Preoperative evaluation of giant cell tumors of the radius with magnetic resonance angiography},
author = {J. Shannon Swan and J. P. Heiner and V. K. Rao and D. M. Weber},
url = {https://www.ncbi.nlm.nih.gov/pubmed/8515023},
doi = {10.1016/0363-5023(93)90099-o},
issn = {0363-5023 (Print)
0363-5023 (Li},
year = {1993},
date = {1993-01-01},
journal = {J Hand Surg Am},
volume = {18},
number = {3},
pages = {499-503},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Swan, J. Shannon; Kennel, T. W.; Wojtowycz, M. M.; Grist, T. M.
Increased presaturation pulse gaps in two-dimensional time-of-flight MR angiography: a pitfall in diseased lower extremities Journal Article
In: J Vasc Interv Radiol, vol. 4, no. 4, pp. 569-71, 1993, ISSN: 1051-0443 (Print) 1051-0443 (Li, ().
@article{Swan1993a,
title = {Increased presaturation pulse gaps in two-dimensional time-of-flight MR angiography: a pitfall in diseased lower extremities},
author = {J. Shannon Swan and T. W. Kennel and M. M. Wojtowycz and T. M. Grist},
url = {https://www.ncbi.nlm.nih.gov/pubmed/8353357},
doi = {10.1016/s1051-0443(93)71924-7},
issn = {1051-0443 (Print)
1051-0443 (Li},
year = {1993},
date = {1993-01-01},
journal = {J Vasc Interv Radiol},
volume = {4},
number = {4},
pages = {569-71},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Swan, J. Shannon; Weber, D. M.; Korosec, F. R.; Grist, T. M.; Heiner, J. P.
Combined MRI and MRA for limb salvage planning Journal Article
In: J Comput Assist Tomogr, vol. 17, no. 2, pp. 339-42, 1993, ISSN: 0363-8715 (Print) 0363-8715 (Li, ().
@article{Swan1993b,
title = {Combined MRI and MRA for limb salvage planning},
author = {J. Shannon Swan and D. M. Weber and F. R. Korosec and T. M. Grist and J. P. Heiner},
url = {https://www.ncbi.nlm.nih.gov/pubmed/8454767},
doi = {10.1097/00004728-199303000-00033},
issn = {0363-8715 (Print)
0363-8715 (Li},
year = {1993},
date = {1993-01-01},
journal = {J Comput Assist Tomogr},
volume = {17},
number = {2},
pages = {339-42},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Wang, Y.; Weber, D. M.; Korosec, F. R.; Mistretta, C. A.; Grist, T. M.; Swan, J. Shannon; Turski, P. A.
Generalized matched filtering for time-resolved MR angiography of pulsatile flow Journal Article
In: Magn Reson Med, vol. 30, no. 5, pp. 600-8, 1993, ISSN: 0740-3194 (Print) 0740-3194 (Li, ().
@article{Wang1993,
title = {Generalized matched filtering for time-resolved MR angiography of pulsatile flow},
author = {Y. Wang and D. M. Weber and F. R. Korosec and C. A. Mistretta and T. M. Grist and J. Shannon Swan and P. A. Turski},
url = {https://www.ncbi.nlm.nih.gov/pubmed/8259060},
doi = {10.1002/mrm.1910300511},
issn = {0740-3194 (Print)
0740-3194 (Li},
year = {1993},
date = {1993-01-01},
journal = {Magn Reson Med},
volume = {30},
number = {5},
pages = {600-8},
keywords = {},
pubstate = {published},
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}
1992
Swan, J. Shannon; Weber, D. M.; Grist, T. M.; Wojtowycz, M. M.; Korosec, F. R.; Mistretta, C. A.
Peripheral MR angiography with variable velocity encoding. Work in progress Journal Article
In: Radiology, vol. 184, no. 3, pp. 813-7, 1992, ISSN: 0033-8419 (Print) 0033-8419 (Li, ().
@article{Swan1992,
title = {Peripheral MR angiography with variable velocity encoding. Work in progress},
author = {J. Shannon Swan and D. M. Weber and T. M. Grist and M. M. Wojtowycz and F. R. Korosec and C. A. Mistretta},
url = {https://www.ncbi.nlm.nih.gov/pubmed/1509072},
doi = {10.1148/radiology.184.3.1509072},
issn = {0033-8419 (Print)
0033-8419 (Li},
year = {1992},
date = {1992-01-01},
journal = {Radiology},
volume = {184},
number = {3},
pages = {813-7},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
1991
Buckwalter, K. A.; Swan, J. Shannon; Braunstein, E. M.
Evaluation of joint disease in the adult hand and wrist Journal Article
In: Hand Clin, vol. 7, no. 1, pp. 135-51, 1991, ().
@article{Buckwalter1991,
title = {Evaluation of joint disease in the adult hand and wrist},
author = {K. A. Buckwalter and J. Shannon Swan and E. M. Braunstein},
url = {http://www.ncbi.nlm.nih.gov/pubmed/2037631},
year = {1991},
date = {1991-01-01},
journal = {Hand Clin},
volume = {7},
number = {1},
pages = {135-51},
keywords = {},
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Swan, J. Shannon; Braunstein, E. M.; Capello, W.
Aspiration of the hip in patients treated with Girdlestone arthroplasty Journal Article
In: AJR Am J Roentgenol, vol. 156, no. 3, pp. 545-6, 1991, ISSN: 0361-803X (Print) 0361-803X (Li, ().
@article{Swan1991,
title = {Aspiration of the hip in patients treated with Girdlestone arthroplasty},
author = {J. Shannon Swan and E. M. Braunstein and W. Capello},
url = {https://www.ncbi.nlm.nih.gov/pubmed/1899754},
doi = {10.2214/ajr.156.3.1899754},
issn = {0361-803X (Print)
0361-803X (Li},
year = {1991},
date = {1991-01-01},
journal = {AJR Am J Roentgenol},
volume = {156},
number = {3},
pages = {545-6},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Swan, J. Shannon; Braunstein, E. M.; Wellman, H. N.; Capello, W.
Contrast and nuclear arthrography in loosening of the uncemented hip prosthesis Journal Article
In: Skeletal Radiol, vol. 20, no. 1, pp. 15-9, 1991, ISSN: 0364-2348 (Print) 0364-2348 (Li, ().
@article{Swan1991a,
title = {Contrast and nuclear arthrography in loosening of the uncemented hip prosthesis},
author = {J. Shannon Swan and E. M. Braunstein and H. N. Wellman and W. Capello},
url = {https://www.ncbi.nlm.nih.gov/pubmed/2000499},
doi = {10.1007/BF00243715},
issn = {0364-2348 (Print)
0364-2348 (Li},
year = {1991},
date = {1991-01-01},
journal = {Skeletal Radiol},
volume = {20},
number = {1},
pages = {15-9},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
1988
Swan, J. Shannon; Braunstein, E. M.
Radiology clinic. Abnormal clavicle in a patient with renal failure Journal Article
In: Indiana Med, vol. 81, no. 4, pp. 317-8, 1988, ISSN: 0746-8288 (Print) 0746-8288 (Li, ().
@article{Swan1988,
title = {Radiology clinic. Abnormal clavicle in a patient with renal failure},
author = {J. Shannon Swan and E. M. Braunstein},
url = {https://www.ncbi.nlm.nih.gov/pubmed/3361112},
issn = {0746-8288 (Print)
0746-8288 (Li},
year = {1988},
date = {1988-01-01},
journal = {Indiana Med},
volume = {81},
number = {4},
pages = {317-8},
keywords = {},
pubstate = {published},
tppubtype = {article}
}