Creation and validation of a new tool for the monitoring efficacy of neurogenic bowel dysfunction treatment on response: the MENTOR tool.


Journal

Spinal cord
ISSN: 1476-5624
Titre abrégé: Spinal Cord
Pays: England
ID NLM: 9609749

Informations de publication

Date de publication:
Jul 2020
Historique:
received: 21 09 2019
accepted: 16 01 2020
revised: 13 01 2020
pubmed: 29 1 2020
medline: 28 5 2021
entrez: 29 1 2020
Statut: ppublish

Résumé

Prospective observational study. A tool to help decision-making tool for Neurogenic Bowel Dysfunction (NBD) in individuals with SCI is needed. We present a project to create and validate a new tool, the Monitoring Efficacy of NBD Treatment On Response (MENTOR), and to determine its level of concordance with decisions made by experienced clinicians in the field. UK, Denmark, USA, Italy, The Netherlands, Germany. The first phase was creation of the tool through a modified Delphi process. The second phase was the validation, wherein individuals with spinal cord injury with NBD were asked to complete the MENTOR tool immediately prior to clinic consultation. From the responses to the questionnaire of the tool, each participant was allocated into one of three categories reflecting the possible therapeutic recommendations ("recommend change", "further discussion" and "monitoring"). An expert clinician then assessed the participant, blinded to MENTOR results, and made an independent treatment decision. A total of 248 MENTOR forms were completed. Strong agreement was found when the MENTOR tool recommended monitoring (92%) or treatment change (83%); the lowest concordance when the decision was for the "further discussion" option (59%). Patient acceptability was reported by 97% of individuals. MENTOR is an easy to use tool to monitor the treatment of NBD and determinate progression through the clinical pathway. This validation study shows good correspondence between expert clinician opinion and MENTOR result. The tool has potential to be used in other patient groups, following further studies.

Identifiants

pubmed: 31988365
doi: 10.1038/s41393-020-0424-8
pii: 10.1038/s41393-020-0424-8
pmc: PMC7340621
doi:

Types de publication

Journal Article Multicenter Study Observational Study Validation Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

795-802

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Auteurs

Anton Emmanuel (A)

GI Physiology Unit, University College Hospital, London, UK. anton.emmanuel@nhs.net.

Klaus Krogh (K)

Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.

Steven Kirshblum (S)

Kessler Institute for Rehabilitation, Rutgers New Jersey Medical School, New Jersey, USA.

Peter Christensen (P)

Pelvic Floor Unit, Aarhus University Hospital, Aarhus, Denmark.

Michele Spinelli (M)

Spinal Unit, Niguarda Hospital, Milan, Italy.

Dirk van Kuppevelt (D)

Sint Maartensclinic Rehabilitation Center, Nijmegen, Netherlands.

Rainer Abel (R)

Department of Orthopedic Surgery, Kinikum Bayreuth, Bayreuth, Germany.

Dietrich Leder (D)

Department Of Proctology and Endoscopy, Viszera Chirugie Zentrum, Munich, Germany.

Bruno Gallo Santacruz (BG)

Department of Clinical Development, Coloplast A/S, Humlebæk, Denmark.

Kimberly Bain (K)

Certified Facilitator, BaingGroup Consulting, Ontario, Canada.

Valentina Passananti (V)

GI Physiology Unit, University College Hospital, London, UK.

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