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=> "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Ana Pilar" "apellidos" => "Millán Gómez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Marisa" "apellidos" => "Ribeiro González" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "Pilar" "apellidos" => "Martínez Piró" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "Juan" "apellidos" => "Jiménez Anula" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 5 => array:3 [ "nombre" => "María Belén" "apellidos" => "Sánchez Andújar" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "UGC de Aparato Locomotor, Servicio de Rehabilitación, Complejo Hospitalario de Jaén, Jaén, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Unidad de Cirugía de Mama, Complejo Hospitalario de Jaén, Jaén, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Validación del cuestionario FACT-B+4-MS y exploración de su capacidad predictora en mujeres intervenidas de cáncer de mama" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Lymph node surgery for breast cancer is associated with impaired upper limb such as lymphedema (less frequent after sentinel node biopsy than after lymphadenectomy), paresthesia, weakness and pain (9–68%).<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">1–5</span></a> Ute proposed to use validated self-completion tools systematically for early detection and postulated that a poor function of the upper limb within the first 3–6 months after surgery should be closely monitored.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">6</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The disability of upper limb is measured in various ways. The “Disabilities of the Arm, Shoulder and Hand” questionnaire (DASH; 0: maximum functionality; 100: maximum disability) is being widely used, especially its simplified version (“Quick DASH”), validated in Spanish.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">7</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The “Functional Assessment of Cancer Therapy-Breast” (FACT-B) questionnaire consists of 44 questions on the physical, social, emotional and functional dimensions of women. Every response is scored on a five-point Likert scale. Adding four questions, Coster<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">8</span></a> validated FACT-B+4 to include the upper limb functionality. Belmonte<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">9</span></a> validated the Spanish version in women coming from a screening. Women undergoing mastectomy and lymphadenectomy were underrepresented as the authors themselves acknowledge.</p><p id="par0020" class="elsevierStylePara elsevierViewall">The FACT-B+4 upper limb subscale (FACT-B+4-UL) includes five questions, one from the first FACT-B (B3: “One or both arms are swollen or sensitive”) and four from Coster (B10: “It hurts when I move my arm on this side”; B11: “I have less mobility on arm on this side”; B12: “Numb arm on this side”; B13: “My arm on this side is stiff”). The minimum and maximum disability would be represented by 0 and 20 points respectively.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Our goal is to validate the FACT-B+4-UL questionnaire in all women having undergone breast cancer surgery, not only after screening, as well as to explore their possibilities for predicting upper limb complications.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Patients and methodology</span><p id="par0030" class="elsevierStylePara elsevierViewall">We performed a prospective study with a cohort of women undergoing surgery plus radiation therapy for breast cancer in the Hospital Complex of Jaén. They were subsequently referred to the Rehabilitation Service from May 2010 to December 2014. The inclusion criteria were to be female and to have undergone lymph node surgery plus radiotherapy. Exclusion criteria were previous disabling changes in the upper limb and not being able to read and understand Spanish. The study was approved by the Hospital Ethics Committee. All patients signed an informed consent.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Patients completed FACT-B+4-UL one day after surgery and two months later, this time along with the “Quick DASH”; Then they were asked about their upper limb compared to the first day, being able to answer “better”, “same” or “worse.” The first sixty patients completed a third FACT-B+4-UL questionnaire in less than one week.</p><p id="par0040" class="elsevierStylePara elsevierViewall">Twenty-five women were also referred to Rehabilitation for treatment of breast cancer lymphedema prior to the study. FACT-B+4-UL and “Quick DASH” questionnaires were delivered to the patients.</p><p id="par0045" class="elsevierStylePara elsevierViewall">The following properties of FACT-B+4-UL were determined: (a) factor analysis (major components) 24<span class="elsevierStyleHsp" style=""></span>h and 2 months after surgery; (b) internal consistency (Cronbach's alpha) 24<span class="elsevierStyleHsp" style=""></span>h and 2 months after surgery; (c) test–retest reliability (intraclass correlation coefficient) between second and third administration; (d) construct validity (Pearson's R between FACT-B+4-UL and “Quick-DASH” after 2 months); (e) sensitivity to change, evaluated in three ways: comparing FACT-B+4-UL after 24<span class="elsevierStyleHsp" style=""></span>h and after 2 months, contrasting this comparison with the self-perceived difference, and comparing women in the cohort with those recruited for breast cancer lymphedema prior to the study.</p><p id="par0050" class="elsevierStylePara elsevierViewall">Follow-up to detect emerging cases of lymphedema and other disorders was completed in December 2015. Except for lymphedema, only the alterations occurring within the first year of surgery were considered.</p><p id="par0055" class="elsevierStylePara elsevierViewall">Statistical analysis was performed with the R-Commander software. In addition to the methods mentioned for FACT-B+4-UL, we calculated the mean and standard deviation (SD) of the quantitative variables, whose normality had been previously verified (Kolmogorov–Smirnov). The means were compared, depending on the case, through the Student test or the variance analysis (ANOVA). The predictive capacity of FACT-B+4-UL was explored using two logistic regression models, the dependent variable being the lymphedema in one, and the remaining upper limb impairments in the other (adjustment variables: age, type of surgery and FACT-B+4 levels after 24<span class="elsevierStyleHsp" style=""></span>h and after 2 months). The accepted significance level was 0.05. With data from the Coster study,<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">9</span></a> the minimum sample size was 126.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><p id="par0060" class="elsevierStylePara elsevierViewall">201 women were recruited. Thirty-two could not be monitored, 8 because it was not possible to contact them and 24 because they preferred to be monitored in the nearest local hospitals. Thus, the sample consisted of 169 women (mean age: 53.1 years, SD: 12). 51.2% had undergone lumpectomy plus lymphadenectomy, 36.5% lumpectomy plus sentinel node biopsy, and 12.3% mastectomy plus lymphadenectomy. Eighteen women presented lymphedema throughout the study (10.6%) and 16 (9.5%) suffered one or more changes within the first year after surgery (pain in 12 cases, limited mobility in 5 and sensory impairment in 6).</p><p id="par0065" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> shows the FACT-B+4-UL levels, Cronbach's alpha and factor analysis 24<span class="elsevierStyleHsp" style=""></span>h and 2 months after surgery.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">Fifty-seven of the 60 women who received a third FACT-B+4-UL questionnaire, completed it. The intraclass correlation coefficient between the second and third completions was 0.98.</p><p id="par0075" class="elsevierStylePara elsevierViewall">The mean “Quick DASH” after two months was 20.31 (SD: 20.8); Pearson's R coefficient with FACT-B+4-UL was 0.81 (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.01).</p><p id="par0080" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows the difference between FACT-B+4-UL after 24<span class="elsevierStyleHsp" style=""></span>h and after 2 months with respect to the self-perceived variation.</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">In the 25 cases of lymphedema associated with breast surgery prior to study, the mean FACT-B+4-UL was 8.68 (SD: 4.33), and the “Quick DASH” 40.38 (DE: 23.17). The Pearson coefficient was 0.71 (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.01).</p><p id="par0090" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> shows both logistic regression models. Only the type of surgery explained lymphedema occurrence (almost nine times more frequent after partial or total lymphadenectomy than after sentinel node biopsy), although the model only explained 10% of the variability. For complications other than lymphedema, only FACT-B+ 4-UL after 2 months had explanatory value with a more solid model than the previous model, but also weak (14% of the variability).</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discussion</span><p id="par0095" class="elsevierStylePara elsevierViewall">Two major findings arise from our study. First, FACT-B+4-UL is single-factorial and has internal consistency, test–retest reliability, construct validity and sensitivity to change, particularly if given some time after surgery, two months in our case. Second, applied some time after surgery, it does not predict the occurrence of lymphedema, but, albeit poorly, other complications of the upper limb.</p><p id="par0100" class="elsevierStylePara elsevierViewall">Our Cronbach's alpha is comparable to those of Coster<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">8</span></a> (0.83) or Belmonte<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">9</span></a> (0.89), meaning excellent internal consistency. Test–retest reliability is unquestionable given the high intraclass correlation coefficient. Less than one week after the second assessment ensures sufficient clinical stability to measure this property. The validity of the idea is supported by the high degree of correlation between FACT-B+4-UL and “Quick DASH”. Sensitivity to change has been clearly established in the three forms proposed in the methodology section.</p><p id="par0105" class="elsevierStylePara elsevierViewall">Our results corroborate the known relationship between the type of surgery and lymphedema.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">4</span></a></p><p id="par0110" class="elsevierStylePara elsevierViewall">FACT-B+4-UL is not shown to be a useful lymphedema predictor, although it is poorly associated with other complications. To our knowledge, no study has been published on the ability of any tool to predict complications of the upper limb after breast cancer surgery. Further studies would be necessary on the early and accurate identification of women at risk of these complications.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conclusions</span><p id="par0115" class="elsevierStylePara elsevierViewall">The Spanish version of FACT-B+4-UL is useful for measuring upper limb disability in women undergoing breast cancer surgery. It does not predict the occurrence of lymphedema and its predictive capacity for other complications is low.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conflict of interest</span><p id="par0120" class="elsevierStylePara elsevierViewall">The authors report no conflict of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:3 [ "identificador" => "xres860153" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction and objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Patients and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec854252" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres860152" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción y objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Pacientes y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec854251" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Patients and methodology" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Conclusions" ] 9 => array:2 [ "identificador" => "sec0030" "titulo" => "Conflict of interest" ] 10 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2017-01-16" "fechaAceptado" => "2017-03-02" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec854252" "palabras" => array:4 [ 0 => "Disability evaluation" 1 => "Lymphoedema" 2 => "Breast cancer" 3 => "Upper limb disorder" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec854251" "palabras" => array:4 [ 0 => "Evaluación de la discapacidad" 1 => "Linfedema" 2 => "Cáncer de mama" 3 => "Alteraciones del miembro superior" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction and objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The early detection of upper limb complications is important in women operated on for breast cancer. The “FACT-B+4-UL” questionnaire, a specific variant of the Functional Assessment of Cancer Therapy-Breast (FACT-B) is available among others to measure the upper limb function.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Patients and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The Spanish version of the upper limb subscale of the FACT-B+4 was validated in a prospective cohort of 201 women operated on for breast cancer (factor analysis, internal consistency, test–retest reliability, construct validity and sensitivity to change were determined). Its predictive capacity of subsequent lymphoedema and other complications in the upper limb was explored using logistic regression.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">This subscale is unifactorial and has a great internal consistency (Cronbach's alpha: 0.87), its test–retest reliability and construct validity are strong (intraclass correlation coefficient: 0.986; Pearson's R with “Quick DASH”: 0.81) as is its sensitivity to change. It didn’t predict the onset of lymphedema. Its predictive capacity for other upper limb complications is low.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">FACT-B+4-UL is useful in measuring upper limb disability in women surgically treated for breast cancer; but it does not predict the onset of lymphoedema and its predictive capacity for others complications in the upper limb is low.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction and objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Patients and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducción y objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">La detección precoz de las complicaciones del miembro superior en mujeres intervenidas de cáncer de mama es importante. El cuestionario FACT-B+4-MS, variante del <span class="elsevierStyleItalic">Functional Assessment of Cancer Therapy-Breast</span> (FACT-B) es una escala específica de la función del miembro superior en estas pacientes.</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Pacientes y métodos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Se valida el FACT-B+4-MS en una cohorte prospectiva de 201 mujeres intervenidas por cáncer de mama (análisis factorial, consistencia interna, fiabilidad test-retest, validez del constructo y sensibilidad al cambio) y se explora mediante regresión logística su capacidad predictora de linfedema y otras complicaciones.</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">El FACT-B+4-MS es unifactorial y goza de gran consistencia interna (alfa de Cronbach: 0,87), alta fiabilidad test-retest (coeficiente de correlación intraclase: 0,98), validez de constructo (R de Pearson con el “<span class="elsevierStyleItalic">Quick</span> DASH”: 0,81) y sensibilidad al cambio. En los modelos de regresión, no aparece como variable explicatoria de linfedema, pero sí de otras complicaciones del miembro superior.</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">El FACT-B+4-MS es útil para medir la discapacidad del miembro superior en mujeres operadas por cáncer de mama. No predice el establecimiento de linfedema, pero sí, aunque débilmente, otras alteraciones.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción y objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Pacientes y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Please cite this article as: Andrade Ortega JA, Millán Gómez AP, Ribeiro González M, Martínez Piró P, Jiménez Anula J, Sánchez Andújar MB. Validación del cuestionario FACT-B+4-MS y exploración de su capacidad predictora en mujeres intervenidas de cáncer de mama. Med Clin (Barc). 2017;148:555–558.</p>" ] ] "multimedia" => array:3 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">FACT-B+4-UL: FACT-B+4 upper limb subscale; 24<span class="elsevierStyleHsp" style=""></span>h: 24<span class="elsevierStyleHsp" style=""></span>h; 2<span class="elsevierStyleHsp" style=""></span>m: 2 months.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">n \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Mean (standard deviation) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Cronbach's alpha \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Factor analysis (percentage of variance explained by a factor) \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">FACT-B+4-MS<span class="elsevierStyleInf">24<span class="elsevierStyleHsp" style=""></span>h</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">201 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7.1 (3.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.74 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">50.2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">FACT-B+4-MS<span class="elsevierStyleInf">2<span class="elsevierStyleHsp" style=""></span>m</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">169 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4.9 (4.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.87 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">65.8 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">p</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">*</span></a><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span><0.0001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1453832.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "*" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Student's <span class="elsevierStyleItalic">t</span> (related samples).</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Values of FACT-B+4-UL, Cronbach's alpha and factor analysis 24<span class="elsevierStyleHsp" style=""></span>h and 2 months after surgery.</p>" ] ] 1 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">FACT-B+4-UL: FACT-B+4 upper limb subscale; 24<span class="elsevierStyleHsp" style=""></span>h: 24<span class="elsevierStyleHsp" style=""></span>h; 2<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>2 months.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Patient's self-perceived difference \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">FACT-B+4-MS<span class="elsevierStyleInf">24<span class="elsevierStyleHsp" style=""></span>h</span> – FACT-B+4-MS<span class="elsevierStyleInf">2<span class="elsevierStyleHsp" style=""></span>m</span> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span><a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">*</span></a> \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Better (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>101) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.5 (4.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><0.0001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">The same (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>49) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.9 (3.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Worse (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>19) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−2.8 (3.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1453833.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "*" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Variance analysis (ANOVA).</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Variation of FACT-B+4-UL between one day and 2 months after surgery and patient's self-perceived difference regarding her upper limb.</p>" ] ] 2 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at3" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">B: constant; SE: standard error; FACT-B+4-UL: FACT-B+4 upper limb subscale; CI: confidence interval; OR: odds ratios; 24<span class="elsevierStyleHsp" style=""></span>h: 24<span class="elsevierStyleHsp" style=""></span>h; 2<span class="elsevierStyleHsp" style=""></span>m: 2 months.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">Variable explained \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Lymphedema</th><th class="td" title="table-head " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Other upper limb impairments</th></tr><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Explanatory variables \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">B</span> (SE) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OR (CI 95%) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">B</span> (SE) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OR (CI 95%) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span> \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Interception \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−3.88 (1.56) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.02 (0.00–0.36) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.0129 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−2.92 (0.63) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.05 (0.01–0.17) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.13316 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Surgery (partial or total lymphadenectomy) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.12 (1.07) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8.38 (1.52–156.30) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.0470 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.01 (0.62) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.01 (0.30–3.57) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.99048 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">FACT-B+4-MS<span class="elsevierStyleInf">24<span class="elsevierStyleHsp" style=""></span>h</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.04 (0.07) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.04 (0.91–1.20) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.5549 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−0.07 (0.09) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.93 (0.78–1.10) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.60507 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">FACT-B+4-MS<span class="elsevierStyleInf">2<span class="elsevierStyleHsp" style=""></span>m</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−0.03 (0.06) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.97 (0.85–1.09) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.5904 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.21 (0.06) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.23 (1.09–1.39) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.00195 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−0.01 (0.02) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.99 (0.95–1.03) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.7500 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−0.01 (0.02) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.98 (0.93–1.03) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.63143 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " colspan="3" align="left" valign="top">Nagelkerke's <span class="elsevierStyleItalic">R</span><span class="elsevierStyleSup">2</span>: 0.094</td><td class="td" title="table-entry " colspan="3" align="left" valign="top">Nagelkerke's <span class="elsevierStyleItalic">R</span><span class="elsevierStyleSup">2</span>: 0.139</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1453831.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Logistic regression models to explain the occurrence of lymphedema and other upper limb abnormalities.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:9 [ 0 => array:3 [ "identificador" => "bib0050" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Late morbidity associated with a tumour-negative sentinel lymph node biopsy in primary breast cancer patients: a systematic review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "C.Q. 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