Grants Funded

Abstract

Impact Statement: The development of the NERVE-Q will provide researchers, healthcare providers, administrators and payers with meaningful, precise and reliable feedback on important peripheral nerve injured patient-centred outcomes. Moreover, it will provide a standardized, universal language for the presentation of peripheral nerve outcomes. The NERVE-Q can be used to document the outcomes of patients in clinical audit projects for quality improvement and in local, national, and international research efforts. Furthermore, using the NERVE-Q in clinical practice will provide patients with the opportunity to report their concerns directly to their healthcare providers, who can use patients' results in conjunction with objective measures to make real-time clinical decisions and improve overall outcomes.

Project Summary: Peripheral nerve injuries result in devastating loss of function and persistent chronic pain, which leads to long-term disruptions in daily living, leisure, professional development, and education. Advances in our understanding of nerve topography, injury pathophysiology, nerve regeneration and neuropathic pain have led to a paradigm shift in the treatment of nerve injuries over the last 50 years. New treatment options are available to restore motor and sensory function and alleviate pain. Until recently, outcome assessments in healthcare have focused on traditional measures (such as complications, readmission rates, survival) over more patient-centered measures. Now, policymakers, administrators, and clinicians worldwide seek to improve health services and patient outcomes by including the patient voice using patient-reported outcome instruments (PROs). A comprehensive patient-centred outcome tool that measures the unique issues that matter to patients with nerve injuries does not exist. Moreover, a standardized, universal language for the presentation of peripheral nerve outcomes is currently lacking. Our overarching goal is to develop a PRO specific to patients with nerve injuries: the NERVE-Q. Our specific aim for the current project is to carry out the first phase of this work, which involves developing a set of PRO scales that can be used to measure treatments for nerve injuries. We will accomplish this through semi-structured interviews with a variety of patients affected by nerve injuries, both adult and pediatric. These interviews will probe participants about existing scales from other PROs within the Q measures that may be relevant to the nerve-injured population, and develop new scales for concepts that are unique to this population. Clinicians who treat patients with nerve injuries will also be asked for their input to ensure the final scales reflect all clinically important issues. Throughout the study, our team will employ modern psychometric methods and follow international best practice guidelines to maximize the clinical applicability and scientific quality of the NERVE-Q. Once we have completed this phase of the study, we will carry out international field-testing to refine and validate the scales. We anticipate the NERVE-Q to be broadly applicable to nerve-injured patients worldwide, both in clinical and research settings.

Biography
Dr. Jana Dengler graduated from the University of Toronto Faculty of Medicine in 2013 and subsequently completed her residency training in Plastic and Reconstructive Surgery at the University of Toronto in 2018. Following this, she pursued additional fellowship training in hand, peripheral nerve and microsurgery at the Washington University of St. Louis under the mentorship of Drs. Susan Mackinnon and Amy Moore. Dr. Dengler is presently an Assistant Professor and Surgeon at Sunnybrook Health Science Center in Toronto, which is the major Level I Trauma hospital for the Greater Toronto Area. She is an Affiliate Scientist at the Institute for Clinical Evaluative Sciences, at Sunnybrook Research Institute, and the clinical lead for the multidisciplinary Complex Combined Upper Extremity Clinic and the Peripheral Nerve Pain Clinic. In addition to her clinical training, Dr. Dengler has an undergraduate degree and graduate degree in Biomedical Engineering and recently completed a Masters of Health Science in Translational Research. Her clinical and research interests are in access to care, processes of care and clinical outcomes in patients with peripheral nerve injuries. She has both qualitative and quantitative research expertise.