An International Collaborative Standardizing Patient-Centered Outcome Measures in Pediatric Facial Palsy.

IMPORTANCE: Standardization of outcome measurement using a patient-centered approach in pediatric facial palsy may help aid the advancement of clinical care in this population. OBJECTIVE: To develop a standardized outcome measurement set for pediatric patients with facial palsy through an international multidisciplinary group of health care professionals, researchers, and patients and patient representatives. DESIGN, SETTING, AND PARTICIPANTS: A working group of health care experts and patient representatives (n = 21), along with external reviewers, participated in the study. Seven teleconferences were conducted over a 9-month period between December 3, 2016, and September 23, 2017, under the guidance of the International Consortium for Health Outcomes Measurement, each followed with a 2-round Delphi process to develop consensus. This process defined the scope, outcome domains, measurement tools, time points for measurements, and case-mix variables deemed essential to a standardized outcome measurement set. Each teleconference was informed by a comprehensive review of literature and through communication with patient advisory groups. Literature review of PubMed was conducted for research published between January 1, 1981, and November 30, 2016. MAIN OUTCOMES AND MEASURES: The study aim was to develop the outcomes and measures relevant to children with facial palsy as opposed to studying the effect of a particular intervention. RESULTS: The 21 members of the working group included pediatric facial palsy experts from 9 countries. The literature review identified 1628 papers, of which 395 (24.3%) were screened and 83 (5.1%) were included for qualitative evaluation. A standard set of outcome measurements was designed by the working group to allow the recording of outcomes after all forms of surgical and nonsurgical facial palsy treatments among pediatric patients of all ages. Unilateral or bilateral, congenital or acquired, permanent or temporary, and single-territory or multiterritory facial palsy can be evaluated using this standard set. Functional, appearance, psychosocial, and administrative outcomes were selected for inclusion. Clinimetric and psychometric outcome measurement tools (clinician-, patient-, and patient proxy-reported) and time points for measuring patient outcomes were established. Eighty-six independent reviews of the standard set were completed, and 34 (85%) of the 40 patients and patient representatives and 44 (96%) of the 46 health care professionals who participated in the reviews agreed that the standard set would capture the outcomes that matter most to children with facial palsy. CONCLUSIONS AND RELEVANCE: This international collaborative study produced a free standardized set of outcome measures for evaluating the quality of care provided to pediatric patients with facial palsy, allowing benchmarking of clinicians, comparison of treatment pathways, and introduction of value-based reimbursement strategies in the field of pediatric facial palsy. LEVEL OF EVIDENCE: NA.

Evaluation of two Web-based alcohol interventions for mandated college students.

This study evaluated the efficacy of two Web-based interventions aimed at reducing heavy drinking in mandated college students. Mandated students were randomly assigned to one of two conditions: Web-based personalized normative feedback (WPNF) or Web-based education (WE). As predicted, results indicated that mandated students in the WPNF condition reported significantly greater reductions in weekly drinking quantity, peak alcohol consumption, and frequency of drinking to intoxication than students in the WE condition at a 30-day follow-up. Although not statistically significant, there was a similar trend for changes in alcohol-related problems. Mandated students in the WPNF group also reported significantly greater reductions in estimates of peer drinking from baseline to the follow-up assessment than students in the WE group. In addition, changes in estimates of peer drinking mediated the effect of the intervention on changes in drinking. Findings provide support for providing Web-based personalized normative feedback as an intervention program for mandated college students.

Adult attachment as a risk factor for intimate partner violence: the "mispairing" of partners' attachment styles.

This study examined the relationship between intimate partner violence and adult attachment in a sample of 70 couples. The attachment style of each partner and the interaction of the partners' attachment styles were examined as predictors of intimate partner violence. Additional analyses were conducted to examine violence reciprocity and to explore differences in the relationship between attachment and violence using continuous and dichotomous violence measures. Results of hierarchical regression analyses indicated the "mispairing" of an avoidant male partner with an anxious female partner was associated with both male and female violence. When controlling for partner violence, the relationship between attachment and violence was significant for males only. In addition, analyses using a dichotomized violence variable produced different results from analyses using a continuous violence measure. Clinical implications include focusing on the discrepancy between partners' needs for intimacy and distance within the couple as a strategy for treating intimate partner violence.