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- Gangannagaripalli, J., et al.
(author)
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A Standard Set of Value-Based Patient-Centered Outcomes and Measures of Overall Health in Adults
- 2022
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In: Patient-Patient Centered Outcomes Research. - : Springer Science and Business Media LLC. - 1178-1653 .- 1178-1661. ; 15:3, s. 341-351
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Journal article (peer-reviewed)abstract
- Background The definition of population-specific outcomes is an essential precondition for the implementation of value-based health care. We developed a minimum standard outcome set for overall adult health (OAH) to facilitate the implementation of value-based health care in tracking, comparing, and improving overall health care outcomes of adults across multiple conditions, which would be of particular relevance for primary care and public health populations. Methods The International Consortium for Health Outcomes Measurement (ICHOM) convened an international panel (patients, clinicians, and topic experts). Following the development of a conceptual framework, a modified Delphi method (supported by public consultations) was implemented to identify, in sequence, the relevant domains, the best instruments for measuring them, the timing of measurement, and the relevant adjustment variables. Findings Outcomes were identified in relation to overall health status and the domains of physical, mental, and social health. Three instruments covering these domains were identified: PROMIS Scale v1.2-Global Health (10 items), WHO Wellbeing Index (5 items), and the WHO Disability Assessment Schedule 2.0 (12 items). Case-mix variables included a range of sociodemographic and biometric measures. Yearly measurement was proposed for all outcomes and most case-mix variables. Interpretation The ICHOM OAH Standard Set has been developed through consensus-based methods based on predefined criteria following high standards for the identification and selection of high-quality measures The involvements of a wide range of stakeholders supports the acceptability of the set, which is readily available for use and feasibility testing in clinical settings.
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- Haxen, Emma R., et al.
(author)
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“Hypoxic” Silurian oceans suggest early animals thrived in a low-O2 world
- 2023
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In: Earth and Planetary Science Letters. - 0012-821X. ; 622
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Journal article (peer-reviewed)abstract
- Atmospheric oxygen (O2) concentrations likely remained below modern levels until the Silurian–Devonian, as indicated by several recent studies. Yet, the background redox state of early Paleozoic oceans remains poorly constrained, hampering our understanding of the relationship between early animal evolution and O2. Here, we present a multi-proxy analysis of redox conditions in the Caledonian foreland basin to Baltica from the early to the mid-Silurian. Our results indicate that anoxic to severely hypoxic bottom waters dominated during deposition of the Silurian sediments cored in the Sommerodde-1 well (Bornholm, Denmark), and regional comparison suggests that these conditions persisted across the Baltoscandian foreland basin. Indeed, even during times of relative oxygenation, ichnological observations indicate that conditions were, at most, very weakly oxic. The results suggest that dissolved O2 was generally scarce in the bottom waters of the extensive Silurian seaway between Baltica and Avalonia, even between Paleozoic “Anoxic Events”. In light of delayed oxygenation of the atmosphere–hydrosphere system, it may be time to consider that early animals were adapted to “hypoxia” and thrived through ∼100 million years of low-O2 conditions after the Cambrian.
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