A308 A PRACTICE AUDIT ON THE EFFECTIVENESS OF BIOFEEDBACK THERAPY IN A TERTIARY CARE CENTRE
Notice bibliographique
Résumé
Chronic constipation (CC) and fecal incontinence (FI) are common disorders that can often be related to pelvic floor neuromuscular sensory and motor dysfunction. These disorders have been shown to impair patients’ quality of life. Conventional therapies for both conditions include dietary changes, behavioural modification and pharmacologic therapies. However, these are frequently insufficient to achieve satisfactory outcomes in a subset of patients. Biofeedback therapy (BFT) involves training patients to improve the ano-rectal sensory, motor and coordination via verbal and visual feedback. BFT has been shown to be an effective treatment strategy in those patients who have failed conventional therapy with response rates often exceeding 50% of participants. To review the effectiveness of BFT as performed at a tertiary centre in Canada. A secondary aim was to determine the subset of patients who benefit most from BFT in our cohort. A retrospective chart review was performed on all patients who underwent BFT at our institution between January 1, 2008 and August 15, 2016. Demographic information, reason for referral, baseline and post-biofeedback ano-rectal manometry (ARM) data, and patient subjective report of changes in symptoms were collected. A positive response to BFT was defined as an improvement in the patient’s ARM profile (i.e. improvement in sphincter function, normalization of the balloon expulsion time, etc) and/or patient reported improvement of pre-BFT symptoms. Patients who completed a course of BFT were included. Descriptive statistics were used to analyze the data. 130 patients had a complete data set for the analysis. The average age of the patients was 56.1 ± 16.3 yr and 76.8% were female. The average number of completed biofeedback session was 2.9. 43.1% of patients were referred for CC, 37.7% for FI, 16.9% for both CC and FI, and 2.3% for rectal pain. 76.2% of the patients had a positive response to BFT. Amongst those, 27.3% had an improvement in their ARM profile alone, 7.1% reported symptomatic improvement alone, 65.6% demonstrated both manometric and symptomatic improvement. Patients, who responded to both symptom and ARM profile, were more likely to present with FI (65.3%) or both CC and FI (54.5%), as compared to those presenting with CC alone (37.5%). Examining the CC group (n=56), those with dyssynergic defecation (DD, n=53) were more likely to have ARM profile and symptom response than those without (39.6% vs. 0%). This practice audit illustrates that our BFT program achieves a similar overall response rate as compared with previously published reports. Our cohort demonstrates that patients presented with both FI and CC, FI, or CC with DD are more likely to respond. This data will be used to further examine our BFT program and to develop quality improvement initiatives within the program to improve patient outcomes. None
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».