Papers by Jonathan Comins
Acta Orthopaedica, Jun 1, 2011
Sir-I thank Dr. Krogsgaard and colleagues for their interest in my Editorial on anterior cruciate... more Sir-I thank Dr. Krogsgaard and colleagues for their interest in my Editorial on anterior cruciate ligament (ACL) injuries. I have asked Drs Lohmander and Frobell to comment on the critique of their methods. I note that both Krogsgaard et al. and Lohmander et al. agree with the Cochrane review conclusion that there is no documented best treatment of acute ACL injuries. Considering this lack of evidence, I believe it justified to state that surgery in many cases might represent overtreatment.
DOAJ (DOAJ: Directory of Open Access Journals), Feb 1, 2022
Quality of Life Research, Sep 6, 2016
IntroductionMultidisciplinary rehabilitation has beneficial effects on health-related quality of ... more IntroductionMultidisciplinary rehabilitation has beneficial effects on health-related quality of life (HRQoL) in patients with chronic rheumatic diseases. However, whether this intervention benefits different age groups in women or men is largely unknown.PurposeTo investigate HRQoL in patients with chronic rheumatic disease after completion of a 3-week multidisciplinary treatment, with special focus on differences in effect between age and gender groups.MethodHRQoL was measured with SF-36. Mean scores for all SF-36 domains were compared before and after the 3-week regimen and again at 3-, 6-, and 12-month follow-ups. Multivariable linear regression models using generalized estimating equations to account for repeated measurement were employed. A weighting procedure to account for differential dropouts was applied.ResultsThree hundred fifty-six women and 74 men with chronic rheumatic disease were included. There were short-term improvements in all SF-36 domains irrespective of age or gender. These effects persisted for up to 1 year in the psychological, social, and energy domains for women under 50. We found no lasting effects for men; however, young men showed similar trends.ConclusionInpatient multidisciplinary rehabilitation improves short-term HRQoL in all patients. Younger women maintain these beneficial effects for up to 1 year. Additional intervention should be considered for elderly women and for men in order to sustain rehabilitation effects.
Diabetic Medicine, Nov 29, 2022
Producing a preference-based quality of LIFE measure to quantify the impact of HYPOGLYCAEMIA on p... more Producing a preference-based quality of LIFE measure to quantify the impact of HYPOGLYCAEMIA on people living with diabetes: A mixed-methods research protocol. Diabetic Medicine, 40(3), Article e15007.
Quality of Life Research, 2016
IntroductionMultidisciplinary rehabilitation has beneficial effects on health-related quality of ... more IntroductionMultidisciplinary rehabilitation has beneficial effects on health-related quality of life (HRQoL) in patients with chronic rheumatic diseases. However, whether this intervention benefits different age groups in women or men is largely unknown.PurposeTo investigate HRQoL in patients with chronic rheumatic disease after completion of a 3-week multidisciplinary treatment, with special focus on differences in effect between age and gender groups.MethodHRQoL was measured with SF-36. Mean scores for all SF-36 domains were compared before and after the 3-week regimen and again at 3-, 6-, and 12-month follow-ups. Multivariable linear regression models using generalized estimating equations to account for repeated measurement were employed. A weighting procedure to account for differential dropouts was applied.ResultsThree hundred fifty-six women and 74 men with chronic rheumatic disease were included. There were short-term improvements in all SF-36 domains irrespective of age or gender. These effects persisted for up to 1 year in the psychological, social, and energy domains for women under 50. We found no lasting effects for men; however, young men showed similar trends.ConclusionInpatient multidisciplinary rehabilitation improves short-term HRQoL in all patients. Younger women maintain these beneficial effects for up to 1 year. Additional intervention should be considered for elderly women and for men in order to sustain rehabilitation effects.
Translational Sports Medicine
Purpose. The objective of the current study was to conduct a rigorous assessment of the psychomet... more Purpose. The objective of the current study was to conduct a rigorous assessment of the psychometric properties of the Victorian Institute of Sports Assessment-patellar tendinopathy (VISA-P). Methods. Rasch analysis, confirmatory factor analysis (CFA), and multivariable linear regression were used to assess the psychometric properties of the VISA-P questionnaire in 184 Danish patients with patellar tendinopathy who had symptoms ranging from under 3 months to over 1 year. A group of 100 healthy Danish persons was included as a reference for known-group validation. Results. The analyses revealed that the 8-item VISA-P did not fit a unidimensional model, yielded at best a 3-factor model, and exhibited differential item functioning (DIF) across healthy subjects versus people with patellar tendinopathy. Conclusion. VISA-P in its present form does not satisfy a measurement model and is not a robust scale for measuring patellar tendinopathy. A new PROM for patellar tendinopathy should be d...
BMJ Open, 2019
IntroductionPreference-based measures (PBMs) of health-related quality of life (HRQoL) are used t... more IntroductionPreference-based measures (PBMs) of health-related quality of life (HRQoL) are used to generate quality-adjusted life years, which are necessary for cost-effectiveness evaluations of health interventions via cost–utility analysis. These measures of health can be generic (ie, pandiagnostic) or condition specific. No condition-specific PBM of HRQoL in Duchenne muscular dystrophy (DMD) exists, yet there are concerns that standard generic measures lack the specificity to assess aspects of HRQoL that are especially important to people with DMD. This study has been designed to produce a condition-specific PBM of HRQoL in DMD.Methods and analysisThis mixed-methods study proceeds through three stages. In the first stage (concept elicitation), semistructured interviews will be conducted with boys and men diagnosed with DMD, and analysed with framework to produce a draft health state descriptive system for HRQoL in DMD. In the second stage (refining the descriptive system), patien...
Journal of Bone and Joint Surgery
Archives of Physical Medicine and Rehabilitation, 2017
This paper presents the methods of synthesis for speed systems control of induction motor drives,... more This paper presents the methods of synthesis for speed systems control of induction motor drives, which in accordance with the principles of vector control are represented as a dynamic multi-input/multi-output object. Under the influence of uncontrolled signal and parametric disturbances, the synthesized speed control systems should ensure the proximity of processes to the desired, as well as the static accuracy of performance. Results can be obtained using special methods of structural and parametrical synthesis, such as methods of localization and high gains, which allow one to purposefully organize slow and fast movement loops, by establishing deep feedbacks, thereby ensuring a low sensitivity of the speed control system of induction motor drives to the influence of perturbations of various kinds.
Scandinavian Journal of Medicine & Science in Sports, 2020
To use an inadequate patient reported outcome measure (PROM) or use a PROM in an inappropriate wa... more To use an inadequate patient reported outcome measure (PROM) or use a PROM in an inappropriate way potentially influences the quality of measurement. The objectives of this study were to define potential inadequate uses of PROMs in sports research studies and estimate how often they occur. A consensus group consisting of medical researchers, statisticians, and psychometricians identified and defined potentially irregular applications of PROMs. Occurrence of these in 349 consecutive articles in sports medicine in which PROMs were used as primary outcomes was reviewed. In all, 14 different potential problems were defined, and one or several occurred in 172 of the articles (49%). These were as follows: using a PROM that was developed for a different patient group (100 cases), using two or more PROMs with identical questions (94), aggregation of domain sum scores (82), combinations of subjective and objective measures (27), using a PROM to diagnose or evaluate the individual patient (7), using a PROM for a single limb (3), recall bias (3), exclusion of domains or items (3), construction of a PROM for a specific occasion (2), categorization of the scale (2), and mixing different versions of a PROM (1). Adaption of scale scores (e. g., to percentage) when results are reported (144) carries a risk of miscalculation and distorted impression of results. Data related to uncertainty about completing the PROM and the handling of missing data were not provided in the manuscripts. In conclusion, potential problems in the use and reporting of PROMs are common in sports research, and this can influence the validity of reported results.
Foot and Ankle Surgery, 2021
BACKGROUND Patient reported outcome measures (PROMs) are essential for evaluating treatment of an... more BACKGROUND Patient reported outcome measures (PROMs) are essential for evaluating treatment of ankle instability (AI). The aim was to assess the content validity and the measurement properties of all relevant PROMs for AI. METHODS Relevant PROMs were identified from PubMed and SCOPUS. The development and validation quality of the PROMs was assessed according to established scientific standards. RESULTS Seventeen PROMs and 56 validation studies were analyzed. Content validity, which ensures the PROM measures what is relevant, is obtained by involving target patients in the development process. Only three PROMs identified had some degree of patient involvement (Cumberland Ankle Instability Tool (CAIT), Lower Extremity Function Scale (LEFS), and the Foot and Ankle Ability Measure (FAAM)). Of these, only FAAM was somewhat rigorously validated using modern psychometric validation methods, and exhibited superior measurement properties (construct validity). CONCLUSION No existing PROM is completely adequate to evaluate AI. However, FAAM is the best choice.
Foot and Ankle Surgery, 2021
BACKGROUND The Foot and Ankle Ability Measure (FAAM) was developed by involvement of patients wit... more BACKGROUND The Foot and Ankle Ability Measure (FAAM) was developed by involvement of patients with chronic ankle instability (CAI) and has acceptable measurement properties, but is not available in Danish. METHODS FAAM was translated and culturally adapted into Danish, and its measurement properties were assessed using Rasch analyses. RESULTS A Danish version was produced with small adaptations, and content relevance was confirmed by Danish patients. The 21-item ADL domain showed misfit to the Rasch model, but after removing six items, the resulting 15-item scale displayed adequate fit. The Sports domain also exhibited misfit, but after removing one item and adjusting due to differential item functioning related to age for another item, a 7-item scale showed good fit. This resulted in a 22-item 2-dimensional Danish version of FAAM. CONCLUSION The 22-item Danish FAAM exhibits robust measurement properties for patients with various conditions of the lower leg, ankle, and foot, including CAI.
Scandinavian Journal of Medicine & Science in Sports, 2020
How to translate and locally adapt a PROM. Assessment of cross-cultural differential item functio... more How to translate and locally adapt a PROM. Assessment of cross-cultural differential item functioning.
Scandinavian Journal of Medicine & Science in Sports, 2021
Choosing the most appropriate patient‐reported outcome measure (PROM) for a clinical study is ess... more Choosing the most appropriate patient‐reported outcome measure (PROM) for a clinical study is essential in order to achieve trustworthy results. This choice will depend on (a) the objective of the study and hence the research question; (b) the choice of a theoretical framework, such as the World Health Organization's International Classification of Functioning, Disability, and Health (ICF); (c) whether there currently is a PROM that possesses high content validity and high construct validity for the specific patient group and objective, and if not; (d) the decision on whether to use a suboptimal PROM or develop and validate a new PROM. This paper presents the steps that should be followed in order to assess the relevance of PROMs and suggests ways to enhance the choice depending on the goal of the study.
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Papers by Jonathan Comins