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- Berglund, Malin, 1970, et al.
(författare)
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Hearing outcome after myringoplasty in Sweden: A nationwide registry-based cohort study
- 2020
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Ingår i: Clinical Otolaryngology. - : Wiley. - 1749-4478 .- 1749-4486 .- 1365-2273. ; 45:3, s. 357-363
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Tidskriftsartikel (refereegranskat)abstract
- Objectives To present hearing results after successful primary myringoplasty surgeries registered in the Swedish Quality Registry for Myringoplasty and to evaluate the chance of hearing improvement and the risk of hearing loss. Design A retrospective nationwide cohort study based on prospectively collected registry data between 2002 and 2012. Settings Registry data from secondary and tertiary hospitals performing myringoplasty. Participants Patients with healed tympanic membrane after primary myringoplasty surgery performed from 2002 to 2012 in Sweden. Main outcome measures Postoperative hearing results, hearing gain and air-bone gap (ABG). Results In 2226 myringoplasties, air conduction audiograms were recorded, and the average preoperative pure tone average (PTA(4)) of the group was 28.5 dB, which improved postoperatively to 19.6 dB with an average of 8.8 dB improvement. Bone conduction was measured for 1476 procedures. Closure of the ABG to 10 dB or less was achieved in 51% of the ears and to less than 20 dB in 89% of the ears. Sixty-one percent of patients with preoperatively deteriorated hearing experienced improved hearing, but 3% of all patients experienced deteriorated hearing. After the surgery, 93% of the patients were satisfied. Conclusions Hearing results after successful myringoplasty surgery are often favourable, but although the tympanic membrane is healed, hearing improvement is not guaranteed, and hearing deterioration can also occur.
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| 2. |
- Berglund, Malin, 1970, et al.
(författare)
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Validation of the Swedish Quality Register for Ear Surgery - SwedEar
- 2023
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Ingår i: BMC Medical Informatics and Decision Making. - : BioMed Central (BMC). - 1472-6947. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The Swedish Quality Register for Ear Surgery (SwedEar) is a national register monitoring surgical procedures and outcomes of ear surgery to facilitate quality improvement. The value of the register is dependent on the quality of its data. SwedEar has never been validated regarding data quality or missing entries. Therefor, the purpose of this study was to assess coverage, completeness and response rate in the register and validate the physicians' reported data accuracy.METHODS: In this validation study, the completeness, response rate and missing registrations were analysed. Data in SwedEar were compared with the yearly collected statistics of otosurgical procedures in The Swedish Otosurgical Society and the comparison of rates between groups was calculated with Fisher's exact test. Validation of registered data accuracy was performed on every 20th registered case during a five-year period. Data were reabstracted from medical records and compared with the original registration. Interrater agreement, reliability measures, Cohen's kappa, Gwet's AC1 and positive predictive value were calculated.RESULTS: SwedEar has a coverage of 100%. The completeness of registered cases was 84% and the response rate was 74%. The validation of data accuracy assessed 13 530 variables, including audiograms. Less than 3% of incorrect or missing variables were identified. For most of the pre- and postoperative variables the Kappa and Gwet´s AC1 results show an almost perfect agreement (> 0.80). For audiogram data the ICC shows an excellent reliability (> 0.9) for all but one value.CONCLUSION: This validation shows that SwedEar has excellent coverage, high completeness, and that the data in the register have almost perfect reliability. The data are suitable for both clinical and research purposes. Further efforts to improve completeness are warranted.
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| 4. |
- Olaison, Sara, 1976-, et al.
(författare)
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Hearing Outcomes After Ossiculoplasty With Bone or Titanium Prostheses : A Nationwide Register-Based Study
- 2024
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Ingår i: Clinical Otolaryngology. - : John Wiley & Sons. - 1749-4478 .- 1365-2273 .- 1749-4486. ; 49:5, s. 660-669
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: This study compares hearing outcomes of two prosthesis materials, bone and titanium, used in ossiculoplasty.DESIGN: This retrospective nationwide registry-based study uses data systematically collected by the Swedish Quality Registry for Ear Surgery (SwedEar). SETTING: The data were obtained from clinics in Sweden that perform ossiculoplasty.PARTICIPANTS: Patients who underwent ossiculoplasty using either bone or titanium prostheses were registered in SwedEar between 2013 and 2019.MAIN OUTCOME MEASURES: Hearing outcome expressed as air-bone gap (ABG) gain.RESULTS: The study found no differences between bone and titanium for ABG or air conduction (AC) for either partial ossicular replacement prostheses (PORP) or total ossicular replacement prostheses (TORP). In a comparison between PORP and TORP for ABG and AC outcomes, regardless of the material used, PORP showed a small advantage, with an additional improvement of 3.3 dB (95% CI [confidence interval], 0.1-4.4) in ABG and 2.2 dB (95% CI, 1.7-4.8) in AC. In secondary surgery using TORP, titanium produced slightly better results for high-frequency pure tone average. The success rate, a postoperative ABG ≤20 dB, was achieved in 62% of the operations for the whole group.CONCLUSION: Both bone and titanium used to reconstruct the ossicular chain produce similar hearing outcomes for both PORP and TORP procedures. However, titanium may be a preferable option for secondary surgeries involving TORP. The success rate, a postoperative ABG ≤20 dB, is consistent with other studies, but there is room for improvement in patient selection criteria and surgical techniques.
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| 5. |
- Redfors, Ylva Dahlin, et al.
(författare)
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Hearing-related, health-related quality of life in patients who have undergone otosclerosis surgery : a long-term follow-up study
- 2015
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Ingår i: International Journal of Audiology. - : Informa UK Limited. - 1499-2027 .- 1708-8186. ; 54:2, s. 63-69
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aims of the study were to assess health-related quality of life and hearing-related disability in subjects with otosclerosis 30 years after surgery.Design: An observational study was performed. Medical records were reviewed, a clinical examination as well as audiometric assessments were performed. Generic health-related quality of life was assessed by the SF-36v2 and hearing disability by a shortened version of SSQ (speech spatial and qualities of hearing scale).Study sample: Sixty-fi ve individuals, who had undergone stapedectomy in 1977-79 at a tertiary referral center.Results: Generic health-related quality of life according to SF-36 subscale scores was comparable to that of an age- and sex-matched reference population. The SF-36 mental component summary score (MCS) was, however, significantly better than that of the reference population. The mental and physical summary component scores correlated significantly to hearing disability measured by the SSQ but not to hearing impairment. Hearing disability was displayed in all SSQ sub-scores, especially in more complex listening situations and in the localization of sounds.Conclusions: This study shows that individuals with otosclerosis, 30 years after surgery, have a good generic health-related quality of life, despite moderate to severe hearing loss and significant hearing disabilities.
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| 6. |
- Wittberg, Sara, 1987-, et al.
(författare)
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The quest for standardisation in adult social work: Municipal guidelines and premises for professional discretion
- 2024
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Ingår i: International Journal of Social Welfare. - : John Wiley & Sons. - 1369-6866 .- 1468-2397.
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Tidskriftsartikel (refereegranskat)abstract
- Little is known about how the tools and guidelines, which are central to current social work practice, are designed. The purpose of this article is to improve understanding of the conditions for social workers' discretion by analysing how the municipal responsibility to meet individual needs is circumscribed in local guidelines for needs assessment in Swedish elder care. The paper applies framing theory to the analysis of guidelines in 51 municipalities and maps the prevalence of guidelines. Framing theory highlights how different designs of local guidelines can create varying premises for the discretion of social workers. By illustrating how the guidelines provide social workers with the necessary guidance on how to interpret the law by circumscribing their discretion in standardised, and varying, ways, the findings point to the importance of further research on how the quest for standardisation in adult social work through local guidelines influences social workers' assessments in practice.
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