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See detailFrench translation and validation of the AKPS questionnaire
Buckinx, Fanny ULiege; Remy, Gaël; Bornheim, Stephen ULiege et al

in British Journal of Sports Medicine (in press)

Introduction: The Anterior Knee Pain Scale (AKPS) is a questionnaire used to examine the subjective symptoms, such as the functional limitations and the anterior knee pain. First developed in English ... [more ▼]

Introduction: The Anterior Knee Pain Scale (AKPS) is a questionnaire used to examine the subjective symptoms, such as the functional limitations and the anterior knee pain. First developed in English, this questionnaire has since been translated and validated into several languages. The aims of the study were to translate and cross-culturally adapt the AKPS into French and to evaluate the reliability and validity of this translated version of the questionnaire. Methods: The translation part was articulated in six stages, according to international guidelines: (i) two initial translations from english to french; (ii) synthesis of the two translations; (iii) backward translations into the original language; (iv) expert committee to compare the backward translations with the original questionnaire (v) pre-final version testing and (VI) expert committee appraisal. To validate the French AKPS questionnaire, we assessed its validity, reliability and floor/ceiling effects. To do this, volunteer patients from Belgium and France, with patellofemoral pain syndrome were asked to answer the french version of the AKPS questionnaire at baseline and after 7 days, as well as the generic SF-36 questionnaire. Results: The AKPS questionnaire was translated without any major difficulties. A total of 101 subjects aged 34.49 ± 11.38 years on average were included in this study. Among them, 58.4% were women. Results indicated an excellent test-retest reliability (intraclass coefficient correlation of 0.97, 95% CI 0.96 - 0.98), a high internal consistency (Cronbach’s alpha of 0.87), a consistent construct validity (high correlations with the SF-36 questionnaire were found with domains related to physical function (r = 0.80), physical role (r = 0.70), pain (r = 0.64)) and low or moderate correlations with domains related to mental health (r = 0.26), vitality (r = 0.32), social function (r = 0.41)). Moreover, no floor/ceiling has been found. Conclusion: A valid AKPS french questionnaire is now available and can be used with confidence to better assess the disease burden associated with femoropatellar syndrom. It was successfully cross-culturally adapted into French. [less ▲]

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See detailFrench Translation and validation of the Exercise-Induced Leg Pain
Kaux, Jean-François ULiege; Hagelstein, Thibaut; Van Beveren, Julien et al

in British Journal of Sports Medicine (in press)

Objective: The « Exercise-Induced Leg Pain » (EILP) questionnaire has been developed (in German) to evaluate the severity of symptoms and sports ability in individuals with exercise-induced leg pain. The ... [more ▼]

Objective: The « Exercise-Induced Leg Pain » (EILP) questionnaire has been developed (in German) to evaluate the severity of symptoms and sports ability in individuals with exercise-induced leg pain. The purpose of the present study was to translate and cross-culturally adapt this questionnaire into French and to study the reliability and validity of the French-translated version (EILP-F). Methods: Translation and cross-culturally adaptation of the original EILP (EILP-G) was performed according to established guidelines. The translation part was articulated in six stages: (i) two initial translations from German to French; (ii) synthesis of the two translations; (iii) backward translations; (iv) expert committee to compare the backward translations with the original questionnaire; (v) pre-test; and (vi) approval of the final version of the EILP-F. To validate the EILP-F questionnaire, 84 subjects were recruited (28 pathological patients with a confirmed diagnosis of chronic leg pain, 28 asymptomatic sport students, 28 athletes healthy control). Discriminative power of the questionnaire was tested as well as reliability (internal consistency, test–retest reliability after a 7-10-day interval), construct validity and floor/ceiling effects. Results: the EILP-F version of the questionnaire has been generated without any major difficulties. The ability of the questionnaire to discriminate the three groups of subjects has been showed with a total score of 61.0 ± 18.5 for the pathologic group; 93.9 ± 7.57 for the asymptomatic group and 94.1 ± 9.79 for the control group (p-value adjusted on age = 0.008). A high internal consistency (Cronbach's alpha of 0.93) and an excellent test-retest radiality (ICC of 0.98 (95% CI 0.97-0.99, p<0.001)) indicated that the EILP-F is reliable. The EILP-F also demonstrated a good construct validity against different subscales of the Short Form-36 questionnaire, a generic quality of life questionnaire, with more than 87 % of prespecified hypotheses confirmed. Finally, no floor or ceiling effects were observed. Conclusion: The EILP-F questionnaire, a French version adapted from the original EILP-G, was successfully translated and cross-culturally adapted. The EILP-F questionnaire is consistent, valid and reliable for evaluating the French-speaking patients with chronic exercise-induced leg pain. [less ▲]

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See detailEarly Clinically Relevant Improvement in Quality of Life and Clinical Outcomes 1 Year Postsurgery in Patients with Knee and Hip Joint Arthroplasties.
Neuprez, Audrey ULiege; Neuprez, Arnaud ULiege; KAUX, Jean-François ULiege et al

in Cartilage (2018), 9(2), 127-139

Objective To measure and identify the determinants of the outcomes after hip/knee arthroplasty (HA/KA) in patients with osteoarthritis during the first postsurgical year. Design In this prospective ... [more ▼]

Objective To measure and identify the determinants of the outcomes after hip/knee arthroplasty (HA/KA) in patients with osteoarthritis during the first postsurgical year. Design In this prospective observational study, we evaluated the preoperative and postoperative (3, 6, and 12 months) outcomes of 626 patients who underwent HA (346 with median age 65 years, 59% female) or KA (280 with median age 66.5 years, 54% female) between 2008 and 2013. Generic and specific tools were used to measure health-related quality of life (HRQoL) and utility. Good outcome was defined as an improvement in WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) greater than or equal to the minimal important difference (MID). Regressions were performed to evaluate the relationship between preoperative and postoperative measures and evolution of WOMAC/good outcome. Results We observed an almost systematic improvement of all parameters for up to 12 months, but especially at the 3-month follow-up. The low number of comorbidities and the absence of postoperative complications were the common determinants of improvement of WOMAC total score after 12 months. Other parameters (background of the joint, preoperative function and length of hospital stay in KA group; place of discharge in HA group) affected the evolution of WOMAC scores. 87.09% of HA and 73.06% of KA patients experienced a good outcome. A small number of comorbidities, a worse preoperative function, a shortened hospital stay (KA only), and an absence of early postoperative complications (HA only) significantly predicted a good outcome. Conclusions Intermediate HRQoL following HA or KA improved quickly from preoperative levels for all instruments. More than 70% of patients achieved a good outcome defined as improved pain, stiffness and disability and the predictors are slightly close. [less ▲]

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See detailTraduction et validation du Exercise-Induced Leg Pain, questionnaire pour les patients francophones
Kaux, Jean-François ULiege; Hagelstein, Thibaut; Van Beveren, Julien et al

in Journal de Traumatologie du Sport (2018, March), 35(1), 62-63

Contexte : L’EILP-G a été développé afin d’évaluer la sévérité des symptômes affectant la fonction physique et les capacités sportives chez des patients présentant des douleurs de jambe à l’effort. Le ... [more ▼]

Contexte : L’EILP-G a été développé afin d’évaluer la sévérité des symptômes affectant la fonction physique et les capacités sportives chez des patients présentant des douleurs de jambe à l’effort. Le questionnaire a déjà été traduit en anglais et en grec. Objectifs : Le but de cette étude est de traduire et de réaliser une adaptation interculturelle du questionnaire EILP-G en français ainsi que d’en évaluer ses propriétés psychométriques. Matériel et Méthode : Le processus de traduction et d’adaptation interculturelle de l’exercise-induced leg pain questionnaire for German-speaking patients (EILP-G) a été guidé par les recommandations internationales d’adaptation interculturelle de questionnaires mesurant l’état de santé. Six étapes ont été respectées : (1) traduction française initiale, (2) synthèse de traduction française, (3) traduction inverse allemande, (4) comité d’expert, (5) test de la version pré-finale, (6) approbation du comité d’expert. 84 sujets furent recrutés et répartis en 3 groupes afin de tester l’EILP-FR : un groupe de sujets pathologiques (n=28), des sportifs à risque de développer ce type de pathologie (n=28) et des étudiants en sciences de la motricité asymptomatiques (n=28). Tous les sujets (n=84) ont rempli le questionnaire français à deux reprises avec un intervalle de 7 à 10 jours, parallèlement au Short Form Health Survey (SF-36) afin de pouvoir évaluer la fiabilité et la validité de l’EILP-FR. Résultats : L’EILP-FR indique une fidélité test-retest très bonne concernant le score total (ICC 0,96). Il en va de même pour le score total de chaque sous-groupe (ICC 0,88-0,94) ainsi que pour chaque item (0,75-0,92). Le questionnaire français présente une cohérence interne élevée (0,93). La corrélation entre l’EILP-FR et le SF-36 est modérée pour le score total (0,51;p<0.001). Une corrélation forte se présente entre le questionnaire et une partie des sous-échelles convergentes du SF-36 (PF, RP et BP ; chaque p<0.001). Les sous-échelles divergentes évaluant les propriétés psychologiques du SF-36 présentent toutes une corrélation faible et statistiquement non-significatives (RE, SF, VT), excepté MH (p<0.05). Aucun effet plancher ou plafond n’a été détecté. Conclusion : La version française, adaptée de la version originale EILP-G, a été traduite et adaptée interculturellement avec succès. L’EILP-FR est un questionnaire fiable et valide pour évaluer les patients francophones souffrant de douleurs chroniques de jambe à l’effort. [less ▲]

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See detailAdaptation interculturelle du questionnaire Kujala Anterior Knee Pain Scale pour les patients francophones
Kaux, Jean-François ULiege; Buckinx, Fanny ULiege; Bornheim, Stephen ULiege et al

in Journal de Traumatologie du Sport (2018, March), 35(1), 62

Introduction : Le syndrome fémoro-patellaire est l'un des problèmes du genou les plus fréquemment rencontrés. Il se caractérise par une douleur antérieure du genou dans les activités mettant en charge l ... [more ▼]

Introduction : Le syndrome fémoro-patellaire est l'un des problèmes du genou les plus fréquemment rencontrés. Il se caractérise par une douleur antérieure du genou dans les activités mettant en charge l'articulation fémoro-patellaire. Le Kujala Anterior Knee Pain Scale (Kujala AKPS) est un questionnaire utilisé pour évaluer les symptômes subjectifs, telles que les limitations fonctionnelles et la douleur antérieure du genou. Le questionnaire a déjà été traduit et validé en turc, en portugais brésilien, en persan, en chinois, et en néerlandais. Le but de cette étude est de traduire ce questionnaire en français afin d'en évaluer sa fiabilité et sa validité. Matériel et méthode : La traduction et l’adaptation interculturelle du questionnaire ont été réalisées selon les recommandations internationales comprenant 6 étapes : traduction initiale, synthèse des traductions, traduction de retour vers la langue d’origine, comité d'experts, test de la version pré-finale et approbation du comité d'experts. Une fois la version française obtenue, les participants (n=101) ont rempli 2 fois le Kujula AKPS à un intervalle de 7 jours, et le Short Form Health Survey (SF-36) afin d'en évaluer les propriétés psychométriques (la cohérence interne, la fidélité test-retest et la validité de construit). Résultats : Le Kujula AKPS montre une fidélité test-retest élevée pour le score total (ICC 0,97). La traduction française possède une cohérence interne élevée (0,87). Le Kujula AKPS possède une corrélation forte avec une partie des sous-échelles convergentes du SF-36 (PF, RP et BP). Il y a une corrélation faible ou modérée avec les sous-échelles divergentes du SF-36 (MH, SF et VT). Il n’y a pas d’effet plancher et plafond. Conclusion : La version française du questionnaire Kujula AKPS étant facilement compréhensible, elle semble avoir une bonne adaptation interculturelle. Cette étude a démontré que le Kujula AKPSF est fiable et valide pour les patients francophones souffrant d'un syndrome rotulien. [less ▲]

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See detailPharmaceutical-grade chondroitin sulfate in the management of knee osteoarthritis
Bruyère, Olivier ULiege

in Expert Opinion on Pharmacotherapy (2018), 19(4), 409-412

Introduction: Chondroitin Sulfate (CS) is a drug which is available as pharmaceutical-grade and nutriceutical-grade products, with important variations in preparation, composition, purity and therapeutic ... [more ▼]

Introduction: Chondroitin Sulfate (CS) is a drug which is available as pharmaceutical-grade and nutriceutical-grade products, with important variations in preparation, composition, purity and therapeutic effects. Previous studies using pharmaceutical-grade CS suggested that the compound improves pain and function and delays structural progression in knee osteoarthritis (OA), whereas discrepant results were observed when lower grade preparations were investigated. Areas covered: The recently published chondroitin versus celecoxib versus Placebo Trial (CONCEPT) assessed the symptomatic effect of pharmaceutical-grade CS 800 mg/day in symptomatic knee OA. Expert opinion: This prospective, randomized, 6-month, 3-arm, double-blind, double-dummy, placebo and celecoxib (200 mg/day) – controlled trial involved 604 patients aged above 50 years with primary knee OA. This study showed that CS is superior to placebo and similar to celecoxib in reducing pain and improving function in Kellgren-Lawrence grade 1–3 patients supporting the role of pharmaceuticalgrade CS as a potential first-line treatment for the management of patients with mild to moderate knee OA. [less ▲]

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See detailPrévalence de l’hypovitaminose D chez la femme enceinte : quelle est la situation en région liégeoise ?
VRANKEN, Laura ULiege; EMONTS, Patrick ULiege; Bruyère, Olivier ULiege et al

in Revue Médicale de Liège (2018), 73(1), 10-16

Summary : Vitamin D deficiency is a worldwide health problem, also during pregnancy. Inadequate maternal vitamin D status in pregnancy is associated with poor fetal growth, impaired bone development and ... [more ▼]

Summary : Vitamin D deficiency is a worldwide health problem, also during pregnancy. Inadequate maternal vitamin D status in pregnancy is associated with poor fetal growth, impaired bone development and rickets in infants after birth. Furthermore, higher rates of preeclampsia and gestational diabetes are associated with low maternal vitamin D status during pregnancy. Toxicity of vitamin D is rare. Most countries recommend vitamin D supplementation during pregnancy but guidelines are controversial and inadequate compared to real mother’s and child’s needs. Wath’s the best strategy to follow and supplement mother during pregnancy? In a study carried out at the maternity clinic Notre- Dame des Bruyères (CHU Liège), we studied for a year the vitamin D concentrations of young women at start of pregnancy and of others after delivery to evaluate the local situation and management of vitamin D status during pregnancy. We did not collect the cord blood samples in this study. However, this is a project we would like to achieve soon. This would allow us to compare the vitamin D results of the mother at the time of delivery, to those of the cord blood of their respective child. [less ▲]

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See detailValidity and reliability of the French translation of the VISA-A questionnaire
Kaux, Jean-François ULiege; Croisier, Jean-Louis ULiege; Bruyère, Olivier ULiege

in Journal of Rehabilitation Medicine (2018, January), 50(1), 121

Introduction: The Victorian Institute of Sport Assessment – Achilles tendinopathy questionnaire (VISA-A) evaluates the clinical severity of Achilles tendinopathy. The aim of this study was to translate ... [more ▼]

Introduction: The Victorian Institute of Sport Assessment – Achilles tendinopathy questionnaire (VISA-A) evaluates the clinical severity of Achilles tendinopathy. The aim of this study was to translate the VISA-A into French and to study the reliability and validity of this French version, the VISA-AF.Method: The VISA-A was translated into French to produce the VISA-AF using a validated methodology in six steps. Thereafter, several psychometric properties of this French version such as test–retest reliability, internal consistency, construct validity and floor and ceiling effects were evaluated. Therefore, we recruited 116 subjects, distributed into 3 groups: pathological patients (n=31), at-risk athletes (n=63) and healthy people (n=22). Results: The final version of the VISA-AF was approved by an expert committee. On a scale ranging from 0 to 100, the average scores of the VISA-AF obtained were 59 (± 18) for the pathological group, 99 (± 1) for the healthy group and 94 (± 7) for the at-risk group. The VISA-AF shows excellent reliability, low correlations with the discriminant subscales of the SF-36 and moderate correlations with the convergent subscales of the SF-36. Conclusions: The French version of the VISA-A is equivalent to its original version and is a reliable and valid questionnaire for French- speaking patients with Achilles tendinopathy. [less ▲]

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See detailTranslation and Validation of the VISA-P Questionnaire for French-Speaking Patients
Kaux, Jean-François ULiege; CROISIER, Jean-Louis ULiege; Bruyère, Olivier ULiege

in Journal of Rehabilitation Medicine (2018, January), 50(1), 110

Background: The Victorian Institute of Sport Assessment-Patella (VISA-P), originally developed in English, assesses the severity of patellar tendinopathy symptoms. To date, no French version of the ... [more ▼]

Background: The Victorian Institute of Sport Assessment-Patella (VISA-P), originally developed in English, assesses the severity of patellar tendinopathy symptoms. To date, no French version of the questionnaire exists. Objectives: The aim of our study was to translate the VISA-P into French and verify its psychometric properties. Methods: The translation and cultural adaptation were performed according to international recommendations in 6 steps: initial translation, translation merging, back translation to the original language, use of an expert committee to reach a prefinal version, test of the prefinal version, and expert committee appraisal of a final version. Afterward, the psychometric properties of the final French version (VISA-PF) were assessed in 92 subjects, divided into 3 groups: pathological subjects (n = 28), asymptomatic subjects (n = 22), and sports-risk subjects (n = 42). Results: All members of the expert committee agreed with the final version. On a scale ranging from 0 to 100, with 100 representing an asymptomatic subject, the average SD scores on the VISA-PF were 53 17 for the pathological group, 99 2 for the healthy group, and 86 14 for the sports-risk group. The test-retest reliability of the VISA-PF was excellent, with good internal consistency. Correlations between the VISA-PF and divergent validity of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) were low, and the correlation coefficient values measured between the VISA-PF scores and converged items of the SF-36 were higher. Conclusion: The VISA-PF is understandable, valid, and suitable for French-speaking patients with patellar tendinopathy. [less ▲]

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See detailCross-cultural adaptation and validation of the Patient-Rated Tennis Elbow Evaluation Questionnaire on lateral elbow tendinopathy for French-speaking patients
Kaux, Jean-François ULiege; Croisier, Jean-Louis ULiege; Bruyère, Olivier ULiege

in Journal of Rehabilitation Medicine (2018, January), 50(1), 122

Introduction: The lateral elbow tendinopathy is a common injury in tennis players and physical workers. The Patient- Rated Tennis Elbow Evaluation (PRTEE) Questionnaire was specifically designed to ... [more ▼]

Introduction: The lateral elbow tendinopathy is a common injury in tennis players and physical workers. The Patient- Rated Tennis Elbow Evaluation (PRTEE) Questionnaire was specifically designed to measure pain and functional limitations in patients with lateral epicondylitis. The aims were to adapt the PRTEE questionnaire into French (PRTEE-F) and to evaluate the reliability and validity of this translated version of the questionnaire . Methods: The PRTEE was translated and cross-culturally adapted into French according to international guidelines. To assess the reliability and validity of the PRTEE-F, 115 participants were asked twice to fill in the PRTEE-F, and once the DASH and the SF-36. Internal consistency (using Cronbach’s alpha), test-retest reliability (using intraclass correlation coefficient (ICC), standard error of measurement and minimal detectable change), and convergent and divergent validity (using the Spearman’s correlation coefficients respectively with the DASH and with some subscales of the SF-36) were assessed. Results: The PRTEE was translated into French without any problems. PRTEE-F showed a good test-retest reliability for the overall score (ICC 0.86) and for each item (ICC 0.8-0.96) and a high internal consistency (Cronbach’s alpha 1⁄4 0.98). The correlation analyses revealed high correlation coefficients between PRTEE-F and DASH (convergent validity) and, as expected, a low or moderate correlation with the divergent subscales of the SF-36 (discriminant validity). There was no floor or ceiling effect. Discussion and Conclusions: The PRTEE questionnaire was successfully cross-culturally adapted into French. The PRTEE-F is reliable and valid for evaluating French-speaking patients with lateral elbow tendinopathy. [less ▲]

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See detailCross-cultural adaptation and validation of the Kujala Anterior Knee Pain Scale (AKPS) questionnaire for French-speaking patients
Kaux, Jean-François ULiege; Buckinx, Fanny ULiege; Croisier, Jean-Louis ULiege et al

in Journal of Rehabilitation Medicine (2018, January), 50(1), 121-122

Introduction: The femoropatellar syndrom is one of the most common knee problem observable. The Kujala Anterior Knee Pain Scale (AKPS) is a questionnaire used to examine the subjective symptoms, such as ... [more ▼]

Introduction: The femoropatellar syndrom is one of the most common knee problem observable. The Kujala Anterior Knee Pain Scale (AKPS) is a questionnaire used to examine the subjective symptoms, such as the functional limitations and the anterior knee pain. Objective: The aims of the study were to translate and cross-culturally adapt the AKPS questionnaire into French and to evaluate the reliability and validity of this translated version of the questionnaire (AKPS- F). Patients : 101 patients with femoropatellar syndrom. Methods: The translation and the inter-cultural adaptation of the questionnaire has been adopted through the international recommendations highlighting 6 different steps : initial translation, translations synthesis, translation back to the original language, committee of experts, test of the pre-final version and the approval from the expert’s committee. Indeed the French version obtained, the participants have filled twice the AKPS with an interval of 7 days, and the Short Form Health in order to evaluate the psychometric properties (the internal coherence, the test-retest fidelity and the built validity). Results:The AKPS shows a high level of fidelity in the test-retest with a score of 0.97. The French translation also has a high internal coherence score with 0.87. The Kujula shows a great correlation with a part of the converging sub-scales from the SF36. There is a low/average correlation noticeable with the diverging sub-scales. There is no floor/ceiling effect. Discussion and conclusions: This study shows that AKPS-F is reliable and valid for the French patients suffering from a femoropatellar syndrom and can therefore be used. [less ▲]

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See detailPitfalls in the measurement of muscle mass; a need for a reference standard.
Buckinx, Fanny ULiege; Landi, Francesco; Cesari, francesco et al

in Journal of Cachexia, Sarcopenia and Muscle (2018)

Background: All proposed definitions of sarcopenia include the measurement of muscle mass, but the techniques and threshold values used vary. Indeed, the literature does not establish consensus on the ... [more ▼]

Background: All proposed definitions of sarcopenia include the measurement of muscle mass, but the techniques and threshold values used vary. Indeed, the literature does not establish consensus on the best technique for measuring lean body mass. Thus, the objective measurement of sarcopenia is hampered by limitations intrinsic to assessment tools. The aim of this study was to review the methods to assess muscle mass and to reach consensus on the development of a reference standard. Methods: Literature reviews were performed by members of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis working group on frailty and sarcopenia. Face-to-face meetings were organized for the whole group to make amendments and discuss further recommendations. Results: A wide range of techniques can be used to assess muscle mass. Cost, availability, and ease of use can determine whether the techniques are better suited to clinical practice or are more useful for research. No one technique subserves all requirements but dual energy X-ray absorptiometry could be considered as a reference standard (but not a gold standard) for measuring muscle lean body mass. Conclusions: Based on the feasibility, accuracy, safety, and low cost, dual energy X-ray absorptiometry can be considered as the reference standard for measuring muscle mass. [less ▲]

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See detailFrench translation and validation of the sarcopenia screening tool SARC-F
Beaudart, Charlotte ULiege; Locquet, Médéa ULiege; Bornheim, Stephen ULiege et al

in European Geriatric Medicine (2018), (Online first),

Introduction The purpose of the present study is to translate and validate into French the SARC-F questionnaire, a simple and easy screening tool for sarcopenia. Materials and methods The translation ... [more ▼]

Introduction The purpose of the present study is to translate and validate into French the SARC-F questionnaire, a simple and easy screening tool for sarcopenia. Materials and methods The translation process has been divided into two consecutive parts: (1) the translation of the questionnaire from English to French and its language validation (inter-rater reliability and test–retest reliability); (2) the clinical validation of the French SARC-F to assess its performance (sensitivity, specificity, predictive positive value and predictive negative value) in a cohort of elderly Belgian subjects against 7 existing definitions of sarcopenia. Results The translated French version of the SARC-F demonstrated an excellent inter-rater reliability, with an intraclass correlation coefficient (ICC) of 0.90 (95% CI 0.76–0.96), as well as excellent test–retest reliability, with an ICC of 0.86 (95% CI 0.66–0.94). Afterwards, 306 subjects took part in the clinical validation of the French version of the SARC-F questionnaire. The results showed that sensitivity of the tool ranged from 22.1 to 75.0%, depending on the definition used for the diagnosis of sarcopenia, and the specificity ranged from 84.9 to 87.1%. Moreover, all positive predictive values were always below 50%; the lowest negative predictive value was 68.1%, and the best one reached approximately 99%. Conclusions The results are in line with the psychometric performance found in the initial English validation of the SARCF and seem to indicate that this screening tool can detect with precision the absence of sarcopenia, but seems less precise in affirming the presence of this geriatric syndrome. [less ▲]

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See detailCritical analysis of valuation and strategical orientation of merger and acquisition deals in the pharmaceutical industry
Dierks, Raphaela Marie Louisa ULiege; Bruyère, Olivier ULiege; Reginster, Jean-Yves ULiege

in Expert Reviews of Pharmacoeconomics & Outcomes Research (2018), 18(2), 147-60

Introduction: The pharmaceutical industry is undergoing major shifts due to changing macro and micro factors. As the industry is highly capital intensive and patents are expiring, the outlook is on ... [more ▼]

Introduction: The pharmaceutical industry is undergoing major shifts due to changing macro and micro factors. As the industry is highly capital intensive and patents are expiring, the outlook is on generating inorganic growth, mainly through M&A. Using the income valuation approach, one analyses two completed deals in 2016 above 1bn USD. Thereafter one outlines the main motives behind M&A deals and concluded by discussing whether M&A harms medical innovations. Areas covered: The paper is based on empirical study questioning existing literature in order to critically analyse valuation and the strategical orientation of pharmaceutical companies Expert commentary: Pharmaceutical companies understand the changing market conditions and favour their expertise. The restructuring of the industry moves to small niche companies (I.e. Biopharma or biotech companies) researching key innovations and big companies purchasing them to develop them, create clinical trials and distribute them as this is a costly manner Conclusion: One can expect more M&A deals during the next years focusing on value rather than volume. Pharmaceutical players resilient to the market changes may survive if they change their business model from a traditional vertical one to outsourcing and diversification including external players. [less ▲]

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See detailPrediction of the Incidence of Falls and Deaths Among Elderly Nursing Home Residents: The SENIOR Study.
Buckinx, Fanny ULiege; Croisier, Jean-Louis ULiege; Reginster, Jean-Yves ULiege et al

in Journal of the American Medical Directors Association (2018), 19(1), 18-24

OBJECTIVE: The objective of this study was to evaluate, among nursing home residents, the extent to which the various operational definitions of frailty predict mortality and falls at 1 year. METHODS: We ... [more ▼]

OBJECTIVE: The objective of this study was to evaluate, among nursing home residents, the extent to which the various operational definitions of frailty predict mortality and falls at 1 year. METHODS: We studied 662 participants from the Sample of Elderly Nursing home Individuals: An Observational Research (SENIOR) cohort aged 83.2 ± 8.99 years, including 484 (72.5%) women and living in nursing homes. Among this cohort, 584 and 565 participants, respectively, were monitored over 12 months for mortality assessment and for occurrence of falls (ie, by mean of their medical records). Each patient was subjected to a clinical examination at baseline, during which many original clinical characteristics were collected. Stepwise regression analyses were carried out to predict mortality and falls. RESULTS: Among the participants included in the study, 93 (15.9%) died and 211 (37.3%) experienced a fall during the 1-year of follow-up. After adjustment, none of the definitions of frailty assessed predicted the 1-year occurrence of negative health outcomes. When comparing the clinical characteristics of deceased participants and those still alive, being a man (OR = 1.89; 95% CI: 1.19-3.01; P = .002) and being diagnosed with sarcopenia (OR = 1.7; 95% CI: 1.1-2.92; P = .03) were independent factors associated with 1-year mortality. Other independent factors that were significantly associated with the 1-year occurrence of falls were the results obtained with the Tinetti test (OR = 0.93; 95% CI: 0.87-0.98; P = .04), with the grip strength test (OR = 0.95; 95% CI: 0.90-0.98, P = .03), and with the isometric strength test of elbow extensors (OR = 0.93; 95%CI: 0.87-0.97; P = .04). CONCLUSIONS: Within the operational definitions of frailty assessed, none is sufficiently sensitive to predict the occurrence of falls and deaths at 1 year among nursing home residents. Globally, the frequency of undesirable health outcomes seems to be higher among participants with lower muscle strength and mobility. Medical strategy or adapted physical activity, with the aim of improving specific isometric muscle strength and mobility could potentially, but significantly, reduce the occurrence of falls and even deaths. [less ▲]

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See detailInappropriate claims from non-equivalent medications in osteoarthritis: a position paper endorsed by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO)
Bruyère, Olivier ULiege; Cooper, Cyrus ULiege; Al-Daghri, Nasser ULiege et al

in Aging Clinical and Experimental Research (2018), 30

Osteoarthritis (OA) is a progressive joint disease, that occurs frequently in the aging population and is a major cause of disability worldwide. Both glucosamine and chondroitin are biologically active ... [more ▼]

Osteoarthritis (OA) is a progressive joint disease, that occurs frequently in the aging population and is a major cause of disability worldwide. Both glucosamine and chondroitin are biologically active molecules that are substrates for proteoglycan, an essential component of the cartilage matrix. Evidence supports the use of glucosamine and chondroitin as symptomatic slow-acting drugs for osteoarthritis (SYSADOAs) with impact on OA symptoms and disease-modifying effects in the long term. Glucosamine and chondroitin are administered in exogenous form as a sulfate salt and multiple formulations of these agents are available, both as prescription-grade products and nutritional supplements. However, while all preparations may claim to deliver a therapeutic level of glucosamine or chondroitin not all are supported by clinical evidence. Only patented crystalline glucosamine sulfate (pCGS) is shown to deliver consistently high glucosamine bioavailability and plasma concentration in humans, which corresponds to demonstrated clinical efficacy. Similarly, clinical evidence supports only the pharmaceutical-grade chondroitin sulfate. The European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) advocates, through careful consideration of the evidence base, that judicious choice of glucosamine and chondroitin formulation is essential to maximize clinical benefit, patient adherence and satisfaction with treatment. In future, the ESCEO recommends that complex molecules with biological activity such as pCGS may be treated as “biosimilars” akin to the European Medicines Agency guidance on biological medicinal products. It seems likely that for all other complex molecules classed as SYSADOAs, the recommendation to use only formulations clearly supported by the evidence-base should apply. [less ▲]

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See detailBone health assessment in older people with or without muscle health impairment.
Locquet, Médéa ULiege; Beaudart, Charlotte ULiege; Bruyère, Olivier ULiege et al

in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA (2018)

This study investigated the relationship between muscle and bone status in elderly individuals. Our results suggested links between sarcopenia and osteoporosis; impairment in muscle status (i.e., muscle ... [more ▼]

This study investigated the relationship between muscle and bone status in elderly individuals. Our results suggested links between sarcopenia and osteoporosis; impairment in muscle status (i.e., muscle mass, muscle strength, and physical performance) is associated with deterioration in bone mass and texture subsequently leading to an increased risk of fracture. INTRODUCTION: Accumulating evidence has shown associations between sarcopenia and osteoporosis, but existing studies face inconsistencies in the clinical definition of both conditions. Thus, we sought to investigate bone health among older individuals with or without muscle health impairment. METHODS: We conducted an analysis of cross-sectional data available from the Sarcopenia and Physical Impairment with Advancing Age (SarcoPhAge) study. Sarcopenia was diagnosed according to the European Working Group on Sarcopenia in Older People (EWGSOP) (i.e., a low muscle mass plus either low muscle strength or low physical performance). Muscle mass and areal bone mineral density (aBMD) were determined using dual-energy X-ray absorptiometry (DEXA). Muscle strength was assessed using a hand dynamometer, and physical performance was assessed with the Short Physical Performance Battery test. Using the cutoff limits proposed by the EWGSOP, we have classified women in the "low SMI group" when its value was < 5.50 kg/m(2), in the "low muscle strength group" when strength was < 20 kg, and in the "low physical performance group" when SPPB < 8 points. The thresholds of < 7.26 kg/m(2) (for SMI), < 30 kg (for muscle strength), and SPPB < 8 points were used for men. The 10-year fracture risk was obtained using the FRAX(R) tool. Moreover, bone texture was determined using the trabecular bone score (TBS) method. RESULTS: The study sample consisted of 288 older subjects aged 74.7 +/- 5.7 years, and 59.0% of the subjects were women. Sarcopenia was diagnosed in 43 individuals (14.9%), and osteoporosis was diagnosed in 36 subjects (12.5%). Moreover, aBMD values were, most of the time, lower in older men and women with muscle impairment (i.e., low muscle mass, low muscle strength, and low physical performance). For these subjects, we also noted a higher probability of fracture. When comparing bone quality, there were no significant differences in the TBS values between sarcopenic and non-sarcopenic older men and women or between those with low and high muscle mass. However, when controlling for confounders (i.e., age, BMI, number of co-morbidities, smoking status, and nutritional status), TBS values were lower in older women with low muscle strength (p = 0.04) and in older men with low physical performance (p = 0.01). CONCLUSIONS: Our study showed interrelationships between components of sarcopenia and osteoporosis, with older subjects with muscle impairment having poorer bone health. [less ▲]

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See detailComparison of the performance of five screening methods for sarcopenia.
Locquet, Médéa ULiege; Beaudart, Charlotte ULiege; Reginster, Jean-Yves ULiege et al

in Clinical Epidemiology (2018), 10

Background: Sarcopenia leads to serious adverse health consequences. There is a dearth of screening tools for this condition, and performances of these instruments have rarely been evaluated. Our aim was ... [more ▼]

Background: Sarcopenia leads to serious adverse health consequences. There is a dearth of screening tools for this condition, and performances of these instruments have rarely been evaluated. Our aim was to compare the performance of five screening tools for identifying elders at risk of sarcopenia against five diagnostic definitions. Subjects and methods: We gathered cross-sectional data of elders from the SarcoPhAge (“Sarco”penia and “Ph”ysical Impairment with Advancing “Age”) study. Lean mass was measured with X-ray absorptiometry, muscle strength with a dynamometer and physical performance with the Short Physical Performance Battery (SPPB) test. Performances of screening methods were described using sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and area under the curve (AUC), according to five diagnostic definitions of sarcopenia. For each screening tool, optimal cutoff points were computed using two methods. Results: A total of 306 subjects (74.8±5.9 years, 59.5% women) were included. The prevalence of sarcopenia varied from 5.7% to 16.7% depending on the definition. The best sensitivity (up to 100%) and the best NPV (up to 99.1%) were obtained with the screening test of Ishii et al, regardless of the definition applied. The highest AUC (up to 0.914) was also demonstrated by the instrument of Ishii et al. The most specific tool was the algorithm of the European Working Group on Sarcopenia in Older People (EWGSOP; up to 91.1%). All NPVs were above 87.0%, and all PPVs were below 51.0%. New cutoffs related to each screening instrument were also proposed to better discriminate sarcopenic individuals from non-sarcopenic individuals. Conclusion: Screening instruments for sarcopenia can be relevantly used in clinical practice to make sure to identify individuals who do not suffer from the syndrome. The screening test of Ishii et al showed better properties in terms of distinguishing those at risk of sarcopenia from those who were not at risk. [less ▲]

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