Browsing by Author "Mohtadi, Nicholas G. H."
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Item Open Access Assessing Validity and Responsiveness of the Rotator Cuff Quality of Life Index(2018-07-17) Campbell, Caitlin Dawn; Mohtadi, Nicholas G. H.; Wiley, James Preston; Bois, Aaron J.; Sabo, Marlis T.Background: The Rotator Cuff Quality of Life Index (RC-QOL) was developed to evaluate quality of life in patients with rotator cuff disease (RCD). This study provides additional validity and responsiveness testing over a 2-year period in accordance with the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines. Methods: Sixty-six patients (mean age, 59±10) with RCD were evaluated. Methodology testing included criterion (concurrent) and content validity, and responsiveness. Results: Content validity was confirmed with a Cronbach α of 0.91 (95% CI; range, 0.92-0.95) and an absence of floor and ceiling effects. Criterion (concurrent) validity was confirmed using the Western Ontario Rotator Cuff Index as a reference standard (r=0.85, p<0.001). The effect size of distribution-based methods of determining responsiveness were large (0.99-1.09) compared to mixed- and anchor-based methods (0.47-0.8). All responsiveness calculations met minimum requirements for acceptable thresholds. Conclusion: The RC-QOL is a valid and responsive measure of health-related quality of life in patients with chronic RCD. The results of this study added to the methodologic quality assessment of the RC-QOL, completing 7 of 10 COSMIN criteria.Item Open Access Development of a Clinical Pathway for Patients with Chronic Rotator Cuff Tears(2018-12-17) Eubank, Breda Hsiao Fon; Wiley, James Preston; Lafave, Mark R.; Mohtadi, Nicholas G. H.; Emery, John Charles HerbertClinical care pathways can be described as evidence-based best practice care that set out all of the decisions and services involved in treating a condition, are widely accepted, and are highly utilized. Clinical care pathways reduce unnecessary variations in patient care, improve quality of care, and reduce healthcare costs. Quality improvements in healthcare, however, cannot be achieved through the development of a clinical care pathway alone. In conjunction with the development of a clinical care pathway (i.e., the ideal pathway), the current pathway must be evaluated and compared to the ideal clinical care pathway in order to influence policy changes, identify and eliminate potential gaps in care, and to ensure equitable, seamless, and sustainable access to high-quality care for everyone. The purpose of this doctoral research, which comprises of a series of inter-related studies, was to execute the steps required to propose quality improvements in caring for patients presenting to the healthcare system with chronic rotator cuff tears. Specifically, the research questions examines what gaps in quality of care exist in the current system based on a comparison of the ideal and current standards of care for patients presenting to the healthcare system with chronic rotator cuff tears. Consequently, this thesis 1) reviewed the literature to provide context for chronic rotator cuff tears and to determine the need for a clinical care pathway; 2) proposed best practice care by establishing clinical consensus and patient flow algorithms for diagnosing and treating patients with rotator cuff pathology; 3) conducted further validity and reliability testing of two patient-reported outcome measures: the Rotator Cuff Quality-of-Life Index (RC-QOL) (Appendix A) and the Healthcare Access and Patient Satisfaction Questionnaire (HAPSQ) (Appendix B); 4) evaluated the current quality of care for patients with chronic rotator cuff tears using the RC-QOL and the HAPSQ; 5) compared current and ideal standards of care to identify gaps in the current healthcare system; and 6) explored the business case for best practice clinical care for patients in Alberta. Findings from this research demonstrated a need for healthcare reform for patients receiving care in the current system.Item Open Access Distribution of Injuries in Men's Canada West University Football(Sage Publications, 2000) Meeuwisse, Willem H.; Hagel, Brent E.; Mohtadi, Nicholas G. H.; Butterwick, Dale J.; Fick, Gordon H.Item Open Access Predicting patient outcome of non-operative treatment for a chronic rotator cuff tear(2009) More, Kristie Dawn; Mohtadi, Nicholas G. H.; Boorman, RichardItem Open Access The development and evaluation of a knee non-physician expert training curriculum(2008) Chan, Denise Siew Fong; Mohtadi, Nicholas G. H.Background The future implementation of a new health care delivery model, the "Knee Injury Clinic," will help to improve access to care for knee injuries by involving certified athletic therapists in an expanded role as "Non-Physician Experts" (NPE). Purpose and Methodology Two certified athletic therapists were trained to become Knee NPEs through a defined curriculum to safely assess, diagnose, investigate and manage soft tissue knee injuries under the supervision of a sport medicine physician. The program followed a six-step curriculum design. Pre- and post-test multiple choice question (MCQ) and objective structured clinical exams (OSCE) were used to evaluate improvement in knowledge and clinical skills. Conclusions Average improvement of the learners' knowledge on the MCQ exam was 12.0%. Clinical skills improvement ranged from 29.7 to 37.3% on the OSCE. The results support the role of NPEs in the new health care delivery model. Key resources contributing to the success of this curriculum were also identified.Item Open Access The development and implementation of a healthcare access and patient satisfaction questionnaire (hapsq) for measuring wait times, satisfaction, and costs with acute knee injury care in Alberta(2009) Lau, Breda Hsiao Fon; Mohtadi, Nicholas G. H.; Butterwick, Dale J.Item Open Access The inter-rater reliability of a diagnostic shoulder arthroscopy(2004) Sasyniuk, Treny Michele; Mohtadi, Nicholas G. H.