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Fisman D, Giglio N, Levin MJ, Nguyen VH, Pelton SI, Postma M, Ruiz-Aragón J, Urueña A, Mould-Quevedo JF. The economic rationale for cell-based influenza vaccines in children and adults: A review of cost-effectiveness analyses. Hum Vaccin Immunother 2024; 20:2351675. [PMID: 38835218 PMCID: PMC11155702 DOI: 10.1080/21645515.2024.2351675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 05/02/2024] [Indexed: 06/06/2024] Open
Abstract
Seasonal influenza significantly affects both health and economic costs in children and adults. This narrative review summarizes published cost-effectiveness analyses (CEAs) of cell-based influenza vaccines in children and adults <65 years of age, critically assesses the assumptions and approaches used in these analyses, and considers the role of cell-based influenza vaccines for children and adults. CEAs from multiple countries demonstrated the cost-effectiveness of cell-based quadrivalent influenza vaccines (QIVc) compared with egg-based trivalent/quadrivalent influenza vaccines (TIVe/QIVe). CEA findings were consistent across models relying on different relative vaccine effectiveness (rVE) estimate inputs, with the rVE of QIVc versus QIVe ranging from 8.1% to 36.2% in favor of QIVc. Across multiple scenarios and types of analyses, QIVc was consistently cost-effective compared with QIVe, including in children and adults across different regions of the world.
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Affiliation(s)
- David Fisman
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Norberto Giglio
- Servicio de Consultorios Externos de Pediatría. Hospital de Niños Ricardo Gutiérrez, Ciudad Autónoma de Buenos Aires, Argentina
| | - Myron J. Levin
- Departments of Pedatrics and Medicine, University of Colorado School of Medicine, Denver, Colorado, United States
| | | | - Stephen I. Pelton
- Department of Health Sciences, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Maarten Postma
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, Indonesia
- Faculty of Economics & Business, University of Groningen, Groningen, The Netherlands
- Department of Pharmacology and Therapy, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | | | - Analia Urueña
- Centro de Estudios para la Prevención y Control de Enfermedades Transmisibles, Universidad Isalud, Buenos Aires, Argentina
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Kasai H, Saito G, Takeda K, Tajima H, Kawame C, Hayama N, Shikino K, Shimizu I, Yamauchi K, Asahina M, Suzuki T, Ito S. Effect of a workplace-based learning program on clerkship students' behaviors and attitudes toward evidence-based medicine practice. MEDICAL EDUCATION ONLINE 2024; 29:2357411. [PMID: 38785167 PMCID: PMC11134098 DOI: 10.1080/10872981.2024.2357411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 05/15/2024] [Indexed: 05/25/2024]
Abstract
In clinical clerkship (CC), medical students can practice evidence-based medicine (EBM) with their assigned patients. Although CC can be a valuable opportunity for EBM education, the impact of EBM training, including long-term behavioral changes, remains unclear. One hundred and nine fourth- and fifth-year medical students undergoing CC at a medical school in Japan attended a workplace-based learning program for EBM during CC (WB-EBM), which included the practice of the five steps of EBM. The program's effect on the students' attitudes toward EBM in CC was assessed through questionnaires. A total of 88 medical students participated in the program. Responses to the questionnaire indicated high satisfaction with the WB-EBM program. The most common theme in students' clinical problems with their assigned patients was the choice of treatment, followed by its effect. Based on the responses in the post-survey for the long-term effects of the program, the frequency of problem formulation and article reading tended to increase in the 'within six months' group comprising 18 students who participated in the WB-EBM program, compared with the control group comprising 34 students who did not. Additionally, the ability to self-assess problem formulation was significantly higher, compared with the control group. However, among 52 students who participated in the WB-EBM program more than six months later, EBM-related behavioral habits in CC and self-assessments of the five steps of EBM were not significantly different from those in the control group. The WB-EBM program was acceptable for medical students in CC. It motivated them to formulate clinical questions and enhanced their critical thinking. Moreover, the WB-EBM program can improve habits and self-evaluations about EBM. However, as its effects may not last more than six months, it may need to be repeated across departments throughout CC to change behavior in EBM practice.
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Affiliation(s)
- Hajime Kasai
- Department of Medical Education, Graduate School of Medicine, Chiba University, Chiba, Japan
- Health Professional Development Center, Chiba University Hospital, Chiba, Japan
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Go Saito
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Kenichiro Takeda
- Health Professional Development Center, Chiba University Hospital, Chiba, Japan
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Hiroshi Tajima
- Department of Medical Education, Graduate School of Medicine, Chiba University, Chiba, Japan
- Health Professional Development Center, Chiba University Hospital, Chiba, Japan
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Chiaki Kawame
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Nami Hayama
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Kiyoshi Shikino
- Health Professional Development Center, Chiba University Hospital, Chiba, Japan
- Department of General Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
- Department of Community-Oriented Medical Education, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Ikuo Shimizu
- Department of Medical Education, Graduate School of Medicine, Chiba University, Chiba, Japan
- Health Professional Development Center, Chiba University Hospital, Chiba, Japan
| | - Kazuyo Yamauchi
- Health Professional Development Center, Chiba University Hospital, Chiba, Japan
- Department of Community-Oriented Medical Education, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Mayumi Asahina
- Health Professional Development Center, Chiba University Hospital, Chiba, Japan
| | - Takuji Suzuki
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Shoichi Ito
- Department of Medical Education, Graduate School of Medicine, Chiba University, Chiba, Japan
- Health Professional Development Center, Chiba University Hospital, Chiba, Japan
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Li M, Devane D, Beecher C, Dowling M, Duffy AG, Duggan C, Grimes DR, Kennan A, Kilty C, Nsangi A, Oxman AD, Stewart DC, Toomey E, Tierney M. Prioritising Key Concepts for informed health choices in cancer: An evidence-based online educational programme. PEC INNOVATION 2024; 5:100311. [PMID: 39027229 PMCID: PMC11254741 DOI: 10.1016/j.pecinn.2024.100311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 06/14/2024] [Accepted: 06/18/2024] [Indexed: 07/20/2024]
Abstract
Objective The overabundance of health misinformation has undermined people's capacity to make evidence-based, informed choices about their health. Using the Informed Health Choices (IHC) Key Concepts (KCs), we are developing a two-stage education programme, Informed Health Choices-Cancer (IHC-C), to provide those impacted by cancer with the knowledge and skills necessary to think critically about the reliability of health information and claims and make well-informed choices. Stage 1 seeks to prioritise the most relevant Key Concepts. Methods A project group and a patient and carer participation group completed a two-round prioritisation process. The process involved disseminating pre-reading materials, training sessions, and a structured judgement form to evaluate concepts for inclusion. Data from each round were analysed to reach a consensus on the concepts to include. Results Fourteen participants were recruited and completed the first-round prioritisation. Fifteen participants undertook the second-round prioritisation. Nine Key Concepts were selected for the programme across five training sessions and two consensus meetings. Conclusion The prioritised concepts identified represent the most pertinent aspects of cancer-related information for those impacted by the disease. By incorporating these concepts into educational materials and communication strategies, healthcare providers and organisations can potentially help cancer patients, survivors, and their loved ones to recognise and combat cancer-related misinformation more effectively. Innovation This study introduces a participatory prioritisation process, which integrates the expertise of healthcare professionals with the insights of patients and carers, thereby enhancing the programme's relevance and applicability.
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Affiliation(s)
- Mengqi Li
- School of Nursing & Midwifery, University of Galway, Galway, Ireland
- Health Research Board - Trials Methodology Research Network (HRB-TMRN), University of Galway, Galway, Ireland
| | - Declan Devane
- School of Nursing & Midwifery, University of Galway, Galway, Ireland
- Health Research Board - Trials Methodology Research Network (HRB-TMRN), University of Galway, Galway, Ireland
- Evidence Synthesis Ireland and Cochrane Ireland, Galway, Ireland
| | - Claire Beecher
- School of Nursing & Midwifery, University of Galway, Galway, Ireland
- Health Research Board - Trials Methodology Research Network (HRB-TMRN), University of Galway, Galway, Ireland
- Evidence Synthesis Ireland and Cochrane Ireland, Galway, Ireland
| | - Maura Dowling
- School of Nursing & Midwifery, University of Galway, Galway, Ireland
| | - Austin G. Duffy
- Department of Medical Oncology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Caitriona Duggan
- School of Nursing & Midwifery, University of Galway, Galway, Ireland
- Department of Oncology, Portiuncula University Hospital, Galway, Ireland
| | - David Robert Grimes
- School of Physical Sciences, Dublin City University, Dublin, Ireland
- Discipline of radiation therapy, Trinity College Dublin, Trinity Centre for Health Sciences, St. James's Hospital, Dublin, Ireland
| | - Avril Kennan
- Health Research Charities Ireland (HRCI), Dublin, Ireland
| | | | - Allen Nsangi
- Department of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Andrew D. Oxman
- Centre for Epidemic Interventions Research, Norwegian Institute of Public Health, Oslo, Norway
| | - Derek C. Stewart
- Evidence Synthesis Ireland and Cochrane Ireland, Galway, Ireland
- College of Medicine, Nursing & Health Sciences, University of Galway, Galway, Ireland
| | - Elaine Toomey
- School of Nursing & Midwifery, University of Galway, Galway, Ireland
| | - Marie Tierney
- School of Nursing & Midwifery, University of Galway, Galway, Ireland
- Health Research Board - Trials Methodology Research Network (HRB-TMRN), University of Galway, Galway, Ireland
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Antonio J, Newmire DE, Stout JR, Antonio B, Gibbons M, Lowery LM, Harper J, Willoughby D, Evans C, Anderson D, Goldstein E, Rojas J, Monsalves-Álvarez M, Forbes SC, Gomez Lopez J, Ziegenfuss T, Moulding BD, Candow D, Sagner M, Arent SM. Common questions and misconceptions about caffeine supplementation: what does the scientific evidence really show? J Int Soc Sports Nutr 2024; 21:2323919. [PMID: 38466174 DOI: 10.1080/15502783.2024.2323919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 02/17/2024] [Indexed: 03/12/2024] Open
Abstract
Caffeine is a popular ergogenic aid that has a plethora of evidence highlighting its positive effects. A Google Scholar search using the keywords "caffeine" and "exercise" yields over 200,000 results, emphasizing the extensive research on this topic. However, despite the vast amount of available data, it is intriguing that uncertainties persist regarding the effectiveness and safety of caffeine. These include but are not limited to: 1. Does caffeine dehydrate you at rest? 2. Does caffeine dehydrate you during exercise? 3. Does caffeine promote the loss of body fat? 4. Does habitual caffeine consumption influence the performance response to acute caffeine supplementation? 5. Does caffeine affect upper vs. lower body performance/strength differently? 6. Is there a relationship between caffeine and depression? 7. Can too much caffeine kill you? 8. Are there sex differences regarding caffeine's effects? 9. Does caffeine work for everyone? 10. Does caffeine cause heart problems? 11. Does caffeine promote the loss of bone mineral? 12. Should pregnant women avoid caffeine? 13. Is caffeine addictive? 14. Does waiting 1.5-2.0 hours after waking to consume caffeine help you avoid the afternoon "crash?" To answer these questions, we performed an evidence-based scientific evaluation of the literature regarding caffeine supplementation.
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Affiliation(s)
- Jose Antonio
- Nova Southeastern University, Department of Health and Human Performance, Davie, FL, USA
| | - Daniel E Newmire
- Texas Woman's University, Exercise Physiology and Biochemistry Laboratory, School of Health Promotion and Kinesiology, Denton, TX, USA
| | - Jeffrey R Stout
- University of Central Florida, College of Health Professions and Sciences, Orlando, FL, USA
| | - Brandi Antonio
- University of Central Florida, College of Health Professions and Sciences, Orlando, FL, USA
| | | | - Lonnie M Lowery
- Nutrition, Exercise and Wellness Associates, Cuyahoga Falls, OH, USA
- Walsh University, Department of Exercise Science, North Canton, OH, USA
| | - Joseph Harper
- Walsh University, Department of Exercise Science, North Canton, OH, USA
| | - Darryn Willoughby
- School of Exercise and Sport Science, University of Mary Hardin-Baylor, Belton, TX, USA
| | - Cassandra Evans
- Nova Southeastern University, Department of Health and Human Performance, Davie, FL, USA
| | - Dawn Anderson
- Indiana Tech, Exercise and Sport Performance Laboratory, Fort Wayne, IN, USA
| | - Erica Goldstein
- Stetson University, Department of Health Sciences, Deland, FL, USA
| | - Jose Rojas
- Keiser University, Fort Lauderdale, FL, USA
- Rocky Mountain University of Health Professions, Provo, UT, USA
| | - Matías Monsalves-Álvarez
- Universidad de O´Higgins, Exercise Metabolism and Nutrition Laboratory. Instituto de Ciencias de la Salud, Rancagua, Chile
- Motion Human Performance Laboratory, Lo Barnechea, Chile
| | - Scott C Forbes
- Brandon University, Department of Physical Education Studies, CBrandon, MB, Canada
| | | | - Tim Ziegenfuss
- The Center for Applied Health Sciences, Canfield, OH, USA
| | - Blake D Moulding
- University of Regina, Faculty of Kinesiology and Health Studies, Regina, SK, Canada
| | - Darren Candow
- University of Regina, Faculty of Kinesiology and Health Studies, Regina, SK, Canada
| | | | - Shawn M Arent
- University of South Carolina, Arnold School of Public Health, Columbia, SC, USA
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Grey A, Avenell A, Bolland MJ. Procrastination and inconsistency: Expressions of concern for publications with compromised integrity. Account Res 2024; 31:196-209. [PMID: 35952654 DOI: 10.1080/08989621.2022.2112572] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
Expressions of concern (EoC) can reduce the adverse effects of unreliable publications by alerting readers to concerns about publication integrity while assessment is undertaken. We investigated the use of EoC for 463 publications by two research groups for which we notified concerns about publication integrity to 142 journals and 44 publishers between March 2013 and February 2020. By December 2021, 95 papers had had an EoC, and 83 were retracted without an EoC. Median times from notification of concerns to EoC (10.4mo) or retraction without EoC (13.1mo) were similar. Among the 95 EoCs, 29 (30.5%) were followed by retraction after a median of 5.4mo, none was lifted, and 66 (69.5%) remained in place after a median of 18.1mo. Publishers with >10 notified publications issued EoCs for 0-81.8% of papers: for several publishers the proportions of notified papers for which EoCs were issued varied considerably between the 2 research groups. EoCs were issued for >30% of notified publications of randomized clinical trials and letters to the editor, and <20% of other types of research. These results demonstrate inconsistent application of EoCs between and within publishers, and prolonged times to issue and resolve EoCs.
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Affiliation(s)
- Andrew Grey
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Alison Avenell
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Mark J Bolland
- Department of Medicine, University of Auckland, Auckland, New Zealand
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Jørgensen AG, Dupont DM, Fjelstrup S, Bus C, Hansen CB, Benfield T, Garred P, Heegaard PM, Kjems J. Unbiased plasma profiling using pre-selected RNA aptamer pools predicts mortality in COVID-19 and identifies protein risk factors. MOLECULAR THERAPY. NUCLEIC ACIDS 2024; 35:102253. [PMID: 39049875 PMCID: PMC11268108 DOI: 10.1016/j.omtn.2024.102253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 06/13/2024] [Indexed: 07/27/2024]
Abstract
The impact of the COVID-19 pandemic demands effective prognostic tools for precise risk evaluation and timely intervention. This study utilized the APTASHAPE technology to profile plasma proteins in COVID-19 patient samples. Employing a highly diverse 2'-fluoro-protected RNA aptamer pool enriched toward proteins in the plasma samples from COVID-19 patients, we performed a single round of parallel selection on the derivation cohort and identified 93 discriminatory aptamers capable of distinguishing COVID-19 and healthy plasma samples. A subset of these aptamers was then used to predict 30-day mortality with high sensitivity and specificity in a validation cohort of 165 patients. We predicted 30-day mortality with areas under the curve (AUCs) of 0.91 in females and 0.68 in males. Affinity purification coupled with mass spectrometry analysis of the aptamer-targeted proteins identified potential biomarkers associated with disease severity, including complement system components. The study demonstrates the APTASHAPE technology as an unbiased approach that not only aids in predicting disease outcomes but also offers insights into gender-specific differences, shedding light on the nuanced aspects of COVID-19 pathophysiology. In conclusion, the findings highlight the promise of APTASHAPE as a valuable tool for estimating risk factors in COVID-19 patients and enabling stratification for personalized treatment management.
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Affiliation(s)
- Asger Givskov Jørgensen
- Interdisciplinary Nanoscience Center, Department of Molecular Biology and Genetics, Aarhus University, 8000 Aarhus C, Denmark
| | - Daniel Miotto Dupont
- Interdisciplinary Nanoscience Center, Department of Molecular Biology and Genetics, Aarhus University, 8000 Aarhus C, Denmark
| | - Søren Fjelstrup
- Interdisciplinary Nanoscience Center, Department of Molecular Biology and Genetics, Aarhus University, 8000 Aarhus C, Denmark
| | - Claus Bus
- Interdisciplinary Nanoscience Center, Department of Molecular Biology and Genetics, Aarhus University, 8000 Aarhus C, Denmark
| | - Cecilie Bo Hansen
- Laboratory of Molecular Medicine, Department of Clinical Immunology, Rigshospitalet, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen N, Denmark
| | - Thomas Benfield
- Department of Infectious Diseases, Copenhagen University Hospital – Amager and Hvidovre, 2650 Hvidovre, Denmark
| | - Peter Garred
- Laboratory of Molecular Medicine, Department of Clinical Immunology, Rigshospitalet, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen N, Denmark
| | - Peter M.H. Heegaard
- Department of Health Technology, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark
| | - Jørgen Kjems
- Interdisciplinary Nanoscience Center, Department of Molecular Biology and Genetics, Aarhus University, 8000 Aarhus C, Denmark
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Reinhart JP, Campbell EH, Proffer SL, Crum OM, Todd A, Gibson LE, Brewer JD, Demer AM. Incidence and mortality trends of primary cutaneous melanoma: A 50-year Rochester Epidemiologic Project study. JAAD Int 2024; 16:144-154. [PMID: 38957842 PMCID: PMC11217686 DOI: 10.1016/j.jdin.2024.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2024] [Indexed: 07/04/2024] Open
Abstract
Background National cancer reporting-based registry data, although robust, lacks granularity for incidence trends. Expert opinion remains conflicted regarding the possibility of melanoma overdiagnosis in the context of rising incidence without a corresponding rise in mortality. Objective To characterize 10- and 50-year trends in melanoma incidence and mortality. Methods Multicenter, population-based epidemiologic study utilizing the Rochester Epidemiology Project for Olmsted County, Minnesota residents diagnosed with melanoma from 01/01/1970 to 12/21/2020. Age- and sex-adjusted incidence and disease-specific mortality are calculated. Results Two thousand three hundred ten primary cutaneous melanomas were identified. Current age- and sex-adjusted incidence rates increased 11.1-fold since 1970s (P < .001). Over the last decade, there is an overall 1.21-fold (P < .002) increase, with a 1.36-fold increase (P < .002) among females and no significant increase among males (1.09-fold increase, P < .329). Melanoma-specific mortality decreased from 26.7% in 1970s to 1.5% in 2010s, with a hazard ratio (HR) reduction of 0.73 (P < .001) per 5-year period. Increased mortality was associated with Breslow thickness (HR 1.35, P < .001), age at diagnosis (HR 1.13, P = .001) left anatomic site (HR 1.98, P = .016), and nodular histogenic subtype (HR 3.08, P < .001). Limitations Retrospective nature and focused geographic investigation. Conclusion Melanoma incidence has continued to increase over the past decade, most significantly in females aged 40+. Trend variations among age and sex cohorts suggests external factors beyond overdiagnosis may be responsible. Disease-specific mortality of melanoma continues to decrease over the last 50 years.
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Affiliation(s)
- Jacob P. Reinhart
- Department of Dermatology, Mayo Clinic School of Graduate Medical Education, Rochester, Minnesota
| | - Elliott H. Campbell
- Department of Dermatology, Mayo Clinic School of Graduate Medical Education, Rochester, Minnesota
| | - Sydney L. Proffer
- Department of Dermatology, Mayo Clinic School of Graduate Medical Education, Rochester, Minnesota
| | - Olivia M. Crum
- Department of Dermatology, Mayo Clinic School of Graduate Medical Education, Rochester, Minnesota
| | - Austin Todd
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
| | - Lawrence E. Gibson
- Division of Dermatopathology, Department of Dermatology, Mayo Clinic, Rochester, Minnesota
| | - Jerry D. Brewer
- Division of Dermatologic Surgery, Department of Dermatology, Mayo Clinic, Rochester, Minnesota
| | - Addison M. Demer
- Division of Dermatologic Surgery, Department of Dermatology, Mayo Clinic, Rochester, Minnesota
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Romano L, Russo C, Gladwin TE, Panno A. Adolescents and Young Adults' Participation in Pro-Environmental Movements: A Systematic Review. J Genet Psychol 2024; 185:373-398. [PMID: 38373092 DOI: 10.1080/00221325.2024.2316804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 01/07/2024] [Indexed: 02/21/2024]
Abstract
Climate change is a reality that can no longer be ignored, so much so that combating climate change and its impact is one of the main goals of the UN Agenda 2030. Youths, albeit the main victims of climate change, are often excluded from decision-making processes on sustainable actions. More and more young people are joining collective pro-environmental movements, raising their voices against the current inadequate sustainable policies and claiming to be the main actors of change. However, pro-environmental collective actions are often judged negatively by public opinion, diminishing their effectiveness and potentially impacting youth participation. In light of this, it is critical to understand the individual, contextual and relational aspects that lead young people to engage with these movements. The present study aimed to systematically review the existing literature on factors that might promote youth participation in pro-environmental movements. According to the PRISMA guidelines, we conducted a literature search of three databases (PsycINFO, ProQuest, and SCOPUS). Moreover, we deepened our research by focusing on two relevant theoretical models on collective actions, the Social Identity Model of Collective Action and the Social Identity Model of Pro-Environmental Action. After the screening and the eligibility phases, 11 articles (12 studies) were included. Most of the selected studies adopted a cross-sectional quantitative design. The results revealed individual and relational factors involved in promoting youths' involvement in pro-environmental movements. To the aim of deepening young people's pro-environmental activism, findings highlighted the need to consider personal and social drivers together. Limitations of the study, future directions, and practical implications are discussed.
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Affiliation(s)
- Luciano Romano
- Experimental and Applied Psychology Laboratory, Department of Human Sciences, European University of Rome, Rome, Italy
| | - Claudia Russo
- Experimental and Applied Psychology Laboratory, Department of Human Sciences, European University of Rome, Rome, Italy
| | | | - Angelo Panno
- Experimental and Applied Psychology Laboratory, Department of Human Sciences, European University of Rome, Rome, Italy
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9
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Kidanemariam M, Graner MA, Bos WJW, Schroijen MA, de Koning EJP, Stiggelbout AM, Pieterse AH, Kunneman M. Patient-clinician collaboration in making care fit: A qualitative analysis of clinical consultations in diabetes care. PATIENT EDUCATION AND COUNSELING 2024; 125:108295. [PMID: 38749345 DOI: 10.1016/j.pec.2024.108295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 03/26/2024] [Accepted: 04/18/2024] [Indexed: 05/26/2024]
Abstract
OBJECTIVE To confirm described dimensions of making care fit and explore how patients and clinicians collaborate to make care fit in clinical practice. METHODS As part of an ongoing study, we audiotaped and transcribed patient-clinician consultations in diabetes care. We purposively selected consultations based on participants' demographical, biomedical and biographical characteristics. We analysed transcripts using reflexive thematic analysis. We combined a deductive and inductive approach, using the pre-described dimensions of making care fit and adding new (sub-)dimensions when pertinent. RESULTS We analysed 24 clinical consultations. Our data confirmed eight previously described dimensions and provided new sub-dimensions of making care fit with examples from clinical practice (problematic situation, influence of devices, sense of options, shared agenda setting, clinician context, adapting to changing organization of care, and possibility to reconsider). CONCLUSION Our study confirmed, specified and enriched the conceptualization of making care fit through practice examples. We observed patient-clinician collaboration in exploration of patients' context, and by responsively changing, adapting or maintaining care plans. PRACTICE IMPLICATIONS Our findings support clinicians and researchers with insights in important aspects of patient-clinician collaboration. Ultimately, this would lead to optimal design of care plans that fit well in each patient life.
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Affiliation(s)
- Martha Kidanemariam
- Medical Decision making, Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
| | | | - Willem Jan W Bos
- Department of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands; Department of Internal Medicine, Sint-Antonius Hospital, Nieuwegein, the Netherlands
| | - Marielle A Schroijen
- Department of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Eelco J P de Koning
- Department of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Anne M Stiggelbout
- Medical Decision making, Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands; Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Arwen H Pieterse
- Medical Decision making, Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
| | - Marleen Kunneman
- Medical Decision making, Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands; Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA.
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La Rosa GRM, Scapellato S, Cicciù M, Pedullà E. Antimicrobial Activity of Antibacterial Sutures in Oral Surgery: A Scoping Review. Int Dent J 2024; 74:688-695. [PMID: 38429145 DOI: 10.1016/j.identj.2024.01.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 01/24/2024] [Accepted: 01/28/2024] [Indexed: 03/03/2024] Open
Abstract
OBJECTIVE The aim of this scoping review was to explore and synthesise the current evidence on the antimicrobial activity of antibacterial suture materials used in oral surgery. METHODS The review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews. A bibliographic search was carried out in the PubMed and Scopus databases to retrieve all human clinical studies that investigated the antimicrobial efficacy of antibacterial-coated sutures used in oral surgery. Included studies were screened and extracted independently by 2 examiners. Data were tabulated and qualitatively described. RESULTS The search initially returned 150 articles and resulted in 5 included studies after the duplicates' removal and the full-text screening. Selected studies were published from 2014 to 2019. Three studies (60%) were randomised clinical trials, whilst the remaining studies did not report information on randomisation. The antimicrobial agents for coated sutures included triclosan and chlorhexidine. In almost all the studies, antibacterial-coated sutures exhibited lower bacterial retention compared to those without coating. CONCLUSIONS Within limitations, the antimicrobial-coated sutures employed in oral surgery exhibited good results in terms of their microbicidal activity when compared with sutures that were not coated. Considering the high variability and confounding factors identified in the included studies, more high-quality research is needed to confirm these results. Antimicrobial-coated sutures could represent a promising and clinically valid strategy to reduce microbial colonisation in oral surgery. The reduced bacterial adherence is likely to improve the clinical success of the surgical procedures. Yet, the cost-benefit ratio of antimicrobial-coated sutures should be assessed in larger clinical trials to confirm their efficacy over conventional noncoated sutures.
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Affiliation(s)
- Giusy Rita Maria La Rosa
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy.
| | - Simone Scapellato
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Marco Cicciù
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Eugenio Pedullà
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
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11
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Cracowski JL, Molimard M, Richard V, Roustit M, Khouri C. Assessing the benefit-risk balance of drugs. Some lessons from the COVID pandemic. Expert Opin Drug Saf 2024; 23:959-967. [PMID: 38898690 DOI: 10.1080/14740338.2024.2368811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 06/12/2024] [Indexed: 06/21/2024]
Abstract
INTRODUCTION Drug efficacy and effectiveness are assessed respectively through clinical trials and pharmaco-epidemiological studies. However, relative and absolute benefits of drugs are distinct measures that must be considered in relation to the baseline risk of disease incidence, complication or progression. On the other hand, adverse drug reactions are independent of the basic risk but depend on the characteristics of the population treated. Given these prerequisites, how can we balance the benefits and risks of drugs? AREAS COVERED We use the example of therapeutics evaluated during Covid to describe how assessing the benefit-risk balance of drugs is a complex process. EXPERT OPINION Clinical trials are not designed to identify rare adverse events, underscoring the necessity for a pharmacovigilance system. Evaluating the balance between the benefits and risks of drugs is an ongoing process, demanding the simultaneous analysis of data from clinical trials, potential drug-drug interactions, pharmacovigilance monitoring and pharmaco-epidemiological studies, to identify potential safety concerns. In addition, pharmacologists must play a major role in educating the general public about drugs, aiding in the accurate interpretation of the benefit-risk balance and preventing misinformation.
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Affiliation(s)
- Jean-Luc Cracowski
- Centre Régional de Pharmacovigilance de Grenoble, Université Grenoble Alpes, Inserm U1300, Grenoble, France
| | | | | | - Matthieu Roustit
- Centre d'Investigation Clinique de Grenoble, Université Grenoble Alpes, Inserm U1300, Grenoble, France
| | - Charles Khouri
- Centre Régional de Pharmacovigilance de Grenoble, Université Grenoble Alpes, Inserm U1300, Grenoble, France
- Centre d'Investigation Clinique de Grenoble, Université Grenoble Alpes, Inserm U1300, Grenoble, France
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12
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Izgu N, Metin ZG, Eroglu H, Semerci R, Pars H. Impact of spiritual interventions in individuals with cancer: A systematic review and meta-analysis. Eur J Oncol Nurs 2024; 71:102646. [PMID: 38943773 DOI: 10.1016/j.ejon.2024.102646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 06/05/2024] [Accepted: 06/14/2024] [Indexed: 07/01/2024]
Abstract
PURPOSE This meta-analysis aimed to determine how spiritual interventions affect cancer patients' physical, emotional, and spiritual outcomes and quality of life. METHODS Between 2012 and May 2024, the Cochrane Library, Scopus, PubMed, and Web of Science were searched considering the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Twenty-six randomized controlled trials were included, and 16 were synthesized in the meta-analysis. Bias risk was evaluated using the Cochrane risk-of-bias methodology for randomized studies. The Grading of Recommendations, Assessment, Development, and Evaluations tool was employed for evidence certainty. Heterogeneity was expressed through I2 and Q statistics. Hedge's g was calculated for effect sizes. Egger's and Kendall's Tau were used for publication bias. RESULTS Spiritual interventions yielded beneficial effects on fatigue (Hedges's g = 0.900, p < 0.001) and pain (Hedges's g = 0.670, p < 0.001) but not for overall symptom burden (Hedges's g = 0.208, p = 0.176). Significant effects were found for anxiety (Hedges's g = 0.301, p < 0.001), depression (Hedges's g = 0.175, p = 0.016), and psychological distress (Hedges's g = 0.178, p = 0.024), except for hopelessness (Hedges's g = 0.144, p = 0.091). Spiritual interventions enhanced faith (Hedges's g = 0.232, p = 0.035), the meaning of life (Hedges's g = 0.259, p = 0.002), spiritual well-being (Hedges's g = 0.268, p < 0.001), and quality of life (Hedges's g = 245, p < 0.001). Moderator analysis pointed out that cancer stage, total duration, delivery format, providers' qualification, content, and conceptual base of spiritual interventions significantly affect physical, emotional, and spiritual outcomes and quality of life. CONCLUSION This meta-analysis highlighted the benefits of spiritual interventions with varying effect sizes on patients' outcomes, as well as quality of life in cancer, and shed on how to incorporate these approaches into clinical practice.
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Affiliation(s)
- Nur Izgu
- Hacettepe University Faculty of Nursing, Internal Medicince Nursing Department, Ankara, Turkey.
| | - Zehra Gok Metin
- Hacettepe University Faculty of Nursing, Internal Medicince Nursing Department, Ankara, Turkey
| | - Hacer Eroglu
- Healthcare Vocational School, Lokman Hekim University, Ankara, Turkey
| | - Remziye Semerci
- Department of Pediatric Nursing, School of Nursing, Koç University, İstanbul, Turkey
| | - Hatice Pars
- Epidemiology MSc Program, The Institute of Health Sciences, Hacettepe University, Ankara, Turkey
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13
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Buijs GS, Kooijenga AC, Rikken QGH, Schafroth MU, Kievit AJ, Blankevoort L. MRI and SPECT/CT demonstrate, with low certainty of evidence, the highest diagnostic accuracy for aseptic knee arthroplasty loosening: A systematic comparative diagnostic test review and meta-analysis. Knee Surg Sports Traumatol Arthrosc 2024; 32:2061-2074. [PMID: 38769774 DOI: 10.1002/ksa.12206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 04/04/2024] [Accepted: 04/05/2024] [Indexed: 05/22/2024]
Abstract
PURPOSE The purpose of this study was to evaluate and compare the diagnostic accuracy of modalities used to aid the diagnosis of aseptic knee arthroplasty loosening. METHODS A comparative diagnostic test accuracy systematic review and meta-analysis was conducted following the Cochrane and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. PubMed, EMBASE and Cochrane databases were searched for original articles evaluating diagnostic modalities up to March 2024. Included studies compared the modality (index test) to the intraoperative finding as reference test. The QUADAS-C (Quality Assessment of Diagnostic Accuracy Studies-Comparative) tool was used to assess the quality of the included studies. The GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach was used to evaluate the certainty of evidence. Level of evidence was evaluated using the Oxford Levels of Evidence tool. The primary outcome was the summary of diagnostic accuracy metrics for each modality as demonstrated by a summary receiver-operating characteristic (SROC) curve. RESULTS The search yielded 467 articles. Of these, 14 articles were included. These 14 articles evaluated a total of five different diagnostic modalities: bone scintigraphy (three studies, 146 cases), 18-fluorodeoxyglucose positron emission tomography (two studies, 50 cases), single-photon emission computed tomography combined with computed tomography (SPECT/CT) (seven studies, 371 cases), radionuclide arthrogram (three studies, 196 cases) and magnetic resonance imaging (MRI) (one study, 116 cases). Nine studies exhibited a high risk of bias in patient selection, and all studies showed a high risk of bias related to the reference test. The majority of the included studies were classified as Level III evidence, leading to an overall low level of certainty in the evidence. The most accurate tests, as demonstrated by the SROC analysis, were MRI and SPECT/CT, with sensitivities ranging from 0.00 to 1.00 and 0.33 to 1.00 and specificities between 0.31-1.00 and 0.00-1.00, respectively. CONCLUSIONS This review and meta-analysis evaluated available diagnostic modalities to aid the diagnosis of knee arthroplasty loosening and based on a low certainty of evidence suggests that MRI and SPECT/CT are currently the most accurate modalities available to aid the diagnosis of aseptic loosening of knee arthroplasty components. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- George S Buijs
- Department of Orthopedic Surgery and Sport Medicine, Amsterdam UMC, location AMC, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Musculoskeletal Health, Amsterdam, The Netherlands
| | - Anne C Kooijenga
- Department of Orthopedic Surgery and Sport Medicine, Amsterdam UMC, location AMC, Amsterdam, The Netherlands
| | - Quinten G H Rikken
- Department of Orthopedic Surgery and Sport Medicine, Amsterdam UMC, location AMC, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Musculoskeletal Health, Amsterdam, The Netherlands
| | - Matthias U Schafroth
- Department of Orthopedic Surgery and Sport Medicine, Amsterdam UMC, location AMC, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Musculoskeletal Health, Amsterdam, The Netherlands
| | - Arthur J Kievit
- Department of Orthopedic Surgery and Sport Medicine, Amsterdam UMC, location AMC, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Musculoskeletal Health, Amsterdam, The Netherlands
| | - Leendert Blankevoort
- Department of Orthopedic Surgery and Sport Medicine, Amsterdam UMC, location AMC, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Musculoskeletal Health, Amsterdam, The Netherlands
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14
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Kenny KP, Chauhan A, Pavitt S, Foy R, Day PF. Qualitative research in dental traumatology-A narrative review. Dent Traumatol 2024; 40:357-365. [PMID: 38264961 DOI: 10.1111/edt.12935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 01/08/2024] [Indexed: 01/25/2024]
Abstract
This review highlights the recent contributions of qualitative research in advancing understanding of dental trauma injury and the barriers and enablers to guide policy for improved patient-centred care including transitional care. It summarises the common approaches and methods used and outlines the key factors that guide the appraisal of qualitative studies. It highlights the importance of the application of qualitative research methods in dental research to generate rich and detailed data to provide explanations and insights into people's experiences, beliefs and attitudes and the complexity of human decision-making and behaviour. In the past decade while there have been a growing number of publications of qualitative studies in dental journals, qualitative studies remain a small percentage of the published dental traumatology research. This may be because of limited understanding about the background, methods and rigour of qualitative research.
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Affiliation(s)
- Kate P Kenny
- School of Dentistry, University of Leeds, Leeds, UK
| | | | - Sue Pavitt
- School of Dentistry, University of Leeds, Leeds, UK
| | - Robbie Foy
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Peter F Day
- School of Dentistry, University of Leeds, Leeds, UK
- Community Dental Service, Bradford District Care NHS Foundation Trust, Bradford, UK
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15
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Pergolizzi JV, LeQuang JA, El-Tallawy SN, Wagner M, Ahmed RS, Varrassi G. An update on pharmacotherapy for trigeminal neuralgia. Expert Rev Neurother 2024; 24:773-786. [PMID: 38870050 DOI: 10.1080/14737175.2024.2365946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 06/05/2024] [Indexed: 06/15/2024]
Abstract
INTRODUCTION Trigeminal neuralgia is a rare condition that can be effectively treated by carbamazepine or oxcarbazepine but these older drugs are associated with dose-dependent and potentially treatment-limiting adverse effects. Third-generation anticonvulsants, new calcitonin gene-related peptide blockers for migraine, and older drugs such as ketamine and cannabinoids may be promising adjuvants or monotherapeutic options. AREAS COVERED The new drugs, their presumed mechanisms of action, safety and efficacy are discussed herein. There is a paucity of robust clinical evidence in support of these drugs for trigeminal neuralgia. New migraine agents are considered as well although migraines and trigeminal neuralgia are distinct, albeit similar, conditions. No new drugs have been released to market in recent years with the specific indication of trigeminal neuralgia. EXPERT OPINION In real-world clinical practice, about half of trigeminal neuralgia patients take more than one agent for prevention and combination therapy may be the optimal approach. Combination therapy might allow for lower doses of carbamazepine or oxcarbazepine, thus reducing the number and severity of potential adverse events but the potential for pharmacokinetic drug-drug interactions must be considered. Drug therapy for trigeminal neuralgia involves acute or abortive treatments, often administered in hospital versus long-term preventive therapy, usually involving oral agents.
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Affiliation(s)
| | | | - Salah N El-Tallawy
- Anesthesia and Pain Department, King Khalid University Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Anesthesia Department, Medicine, Minia University & NCI, Minia, Egypt
| | | | - Rania S Ahmed
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
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16
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Castanon A, Duffield S, Ramagopalan S, Reynolds R. Why is target trial emulation not being used in health technology assessment real-world data submissions? J Comp Eff Res 2024; 13:e240091. [PMID: 38850128 DOI: 10.57264/cer-2024-0091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2024] Open
Affiliation(s)
| | - Stephen Duffield
- National Institute of Health & Care Excellence, Manchester, M1 4BT, UK
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17
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Lawson McLean A, Lawson McLean AC. Integrating Shared Decision-Making into Undergraduate Oncology Education: A Pedagogical Framework. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2024; 39:374-382. [PMID: 38448671 PMCID: PMC11219368 DOI: 10.1007/s13187-024-02419-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/29/2024] [Indexed: 03/08/2024]
Abstract
The integration of shared decision-making (SDM) into undergraduate oncology education represents a critical evolution in medical pedagogy, reflecting the growing complexity and patient-centric focus of contemporary healthcare. This paper introduces a comprehensive pedagogical framework designed to embed SDM within the undergraduate medical curriculum, particularly in oncology, where the multiplicity of treatment options and their profound impact on patient life underscore the necessity of this approach. Grounded in a systematic literature review and aligned with established educational theories, this framework proposes twelve strategic approaches to cultivate future physicians proficient in both clinical acumen and patient-collaborative decision-making. The framework emphasizes real-world clinical experience, role-playing, case studies, and decision aids to deepen students' understanding of SDM. It advocates for the development of communication skills, ethical deliberation, and cultural competence, recognizing the multifaceted nature of patient care. The inclusion of patient narratives and evidence-based decision-making further enriches the curriculum, offering a holistic view of patient care. Additionally, the integration of digital tools within the SDM process acknowledges the evolving technological landscape in healthcare. The paper also addresses challenges in implementing this framework, such as curricular constraints and the need for educator training. It underscores the importance of continual evaluation and adaptation of these strategies to the dynamic field of medical education and practice. Overall, this comprehensive approach aims not only to enhance the quality of oncological care but also to prepare medical students for the complexities of modern medicine, where patient involvement in decision-making is both a necessity and an expectation.
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Affiliation(s)
- Aaron Lawson McLean
- Department of Neurosurgery, Jena University Hospital - Friedrich Schiller University Jena, Am Klinikum 1, 07747, Jena, Germany.
| | - Anna C Lawson McLean
- Department of Neurosurgery, Jena University Hospital - Friedrich Schiller University Jena, Am Klinikum 1, 07747, Jena, Germany
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Lopez DA, Cardenas-Iniguez C, Subramaniam P, Adise S, Bottenhorn KL, Badilla P, Mukwekwerere E, Tally L, Ahanmisi O, Bedichek IL, Matera SD, Perez-Tamayo GM, Sissons N, Winters O, Harkness A, Nakiyingi E, Encizo J, Xiang Z, Wilson IG, Smith AN, Hill AR, Adames AK, Robertson E, Boughter JR, Lopez-Flores A, Skoler ER, Dorholt L, Nagel BJ, Huber RS. Transparency and reproducibility in the Adolescent Brain Cognitive Development (ABCD) study. Dev Cogn Neurosci 2024; 68:101408. [PMID: 38924835 PMCID: PMC11254940 DOI: 10.1016/j.dcn.2024.101408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 05/27/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND Transparency can build trust in the scientific process, but scientific findings can be undermined by poor and obscure data use and reporting practices. The purpose of this work is to report how data from the Adolescent Brain Cognitive Development (ABCD) Study has been used to date, and to provide practical recommendations on how to improve the transparency and reproducibility of findings. METHODS Articles published from 2017 to 2023 that used ABCD Study data were reviewed using more than 30 data extraction items to gather information on data use practices. Total frequencies were reported for each extraction item, along with computation of a Level of Completeness (LOC) score that represented overall endorsement of extraction items. Univariate linear regression models were used to examine the correlation between LOC scores and individual extraction items. Post hoc analysis included examination of whether LOC scores were correlated with the logged 2-year journal impact factor. RESULTS There were 549 full-length articles included in the main analysis. Analytic scripts were shared in 30 % of full-length articles. The number of participants excluded due to missing data was reported in 60 % of articles, and information on missing data for individual variables (e.g., household income) was provided in 38 % of articles. A table describing the analytic sample was included in 83 % of articles. A race and/or ethnicity variable was included in 78 % of reviewed articles, while its inclusion was justified in only 41 % of these articles. LOC scores were highly correlated with extraction items related to examination of missing data. A bottom 10 % of LOC score was significantly correlated with a lower logged journal impact factor when compared to the top 10 % of LOC scores (β=-0.77, 95 % -1.02, -0.51; p-value < 0.0001). CONCLUSION These findings highlight opportunities for improvement in future papers using ABCD Study data to readily adapt analytic practices for better transparency and reproducibility efforts. A list of recommendations is provided to facilitate adherence in future research.
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Affiliation(s)
- Daniel A Lopez
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, United States; Center for Mental Health Innovation, Oregon Health & Science University, Portland, OR, United States
| | - Carlos Cardenas-Iniguez
- Department of Population and Public Health Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, CA, United States
| | - Punitha Subramaniam
- Department of Psychiatry, University of Utah, Salt Lake City, UT, United States
| | - Shana Adise
- Division of Endocrinology, Diabetes and Metabolism, Children's Hospital of Los Angeles, Los Angeles, CA, United States
| | - Katherine L Bottenhorn
- Department of Population and Public Health Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, CA, United States
| | - Paola Badilla
- Institute for Behavioral Genetics, University of Colorado, Boulder, CO, United States
| | - Ellen Mukwekwerere
- Department of Psychology, Psychiatry, and Radiology, Washington University in St. Louis, St. Louis, MO, United States
| | - Laila Tally
- Center for Children and Families and Department of Psychology, Florida International University, Miami, FL, United States
| | - Omoengheme Ahanmisi
- Department of Diagnostic Radiology & Nuclear Medicine, University of Maryland, Baltimore, MD, United States
| | - Isabelle L Bedichek
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA, United States
| | - Serena D Matera
- The Frederick J. and Marion A. Schindler Cognitive Neurophysiology Laboratory Department of Neuroscience and The Ernest J. Del Monte Institute for Neuroscience University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
| | | | - Nicholas Sissons
- Departments of Psychiatry and Radiology, University of Vermont, Burlington, VT, United States
| | - Owen Winters
- Department of Psychiatry, Medical University of South Carolina, Charleston, SC, United States
| | - Anya Harkness
- Center for Health Sciences, SRI International, Menlo Park, CS, United States
| | - Elizabeth Nakiyingi
- Department of Psychology, Psychiatry, and Radiology, Washington University in St. Louis, St. Louis, MO, United States
| | - Jennell Encizo
- Department of Psychology, Psychiatry, and Radiology, Washington University in St. Louis, St. Louis, MO, United States
| | - Zhuoran Xiang
- Department of Psychology, Yale University, New Haven, CT, United States
| | - Isabelle G Wilson
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
| | - Allison N Smith
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Anthony R Hill
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, United States
| | - Amanda K Adames
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States
| | - Elizabeth Robertson
- Department of Psychiatry, Medical University of South Carolina, Charleston, SC, United States
| | - Joseph R Boughter
- Department of Psychology, Psychiatry, and Radiology, Washington University in St. Louis, St. Louis, MO, United States
| | - Arturo Lopez-Flores
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, United States
| | - Emma R Skoler
- Institute for Behavioral Genetics, University of Colorado, Boulder, CO, United States
| | - Lyndsey Dorholt
- Department of Psychology, University of Minnesota, Minneapolis, MN, United States
| | - Bonnie J Nagel
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, United States; Center for Mental Health Innovation, Oregon Health & Science University, Portland, OR, United States
| | - Rebekah S Huber
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, United States; Department of Psychiatry, University of Utah, Salt Lake City, UT, United States; Center for Mental Health Innovation, Oregon Health & Science University, Portland, OR, United States.
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Eryilmaz Polat S, Akyan Soydaş ŞS, Ocak E, Gençoğlu MY, Uytun S, Özkan Tabakci S, Kürtül M, Bilgiç I, Kaşikçi M, Ademhan Tural D, Tuğcu GD, Cinel G. Has the Coronavirus Disease 2019 Pandemic Played a Role in the Early Detection of Pulmonary Embolism in Children? J Pediatr Hematol Oncol 2024; 46:e412-e418. [PMID: 38968543 DOI: 10.1097/mph.0000000000002913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 05/31/2024] [Indexed: 07/07/2024]
Abstract
OBJECTIVE Pulmonary embolism (PE) poses a significant threat to children, and nonspecific symptoms lead to delayed diagnosis. The emergence of coronavirus disease 2019 (COVID-19) has increased the complexity as it is associated with similar symptoms and increased risk of thrombotic complications. This study aimed to assess the risk factors, clinical presentations, and diagnostic features of PE in pediatric patients and to examine the impact of the COVID-19 pandemic on children with PE. MATERIALS AND METHODS We conducted a retrospective descriptive study examining the clinical and diagnostic data of 44 pediatric patients with radiologically confirmed PE. The study compared and analyzed patients diagnosed before and during the COVID-19 pandemic. RESULTS In the study, 21 of 44 pediatric patients were diagnosed in the 4 years before the COVID-19 pandemic, and 23 were diagnosed with PE during the COVID-19 pandemic. The mean time to diagnosis was 8 (2 to 14) days before the pandemic and 1 (1 to 2) days during the pandemic ( P < 0.001). The most common associated condition in both groups was infection (65.9%). Dyspnea (65.9%) and tachypnea (50.0%) were common symptoms. Except for deep vein thrombosis, there were no significant differences according to associated conditions between the groups ( P = 0.001). Pulmonary emboli were anatomically detected using computed tomography angiography, showing bilateral involvement in 45.4% of patients, segmental artery involvement in 38.6%, and main artery involvement in 15.9%. CONCLUSION The COVID-19 pandemic heightened suspicion of pediatric PE and accelerated diagnosis. Standardized diagnostic guidelines are increasingly necessary to balance accurate diagnosis with avoiding excessive imaging.
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Affiliation(s)
| | | | - Ece Ocak
- Department of Pediatric Pulmonology, Ankara City Hospital
| | | | - Salih Uytun
- Department of Pediatric Pulmonology, Ankara City Hospital
| | | | - Meltem Kürtül
- Department of Pediatric Pulmonology, Ankara City Hospital
| | - Işil Bilgiç
- Department of Pediatric Pulmonology, Ankara City Hospital
| | - Merve Kaşikçi
- Department of Biostatistics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | | | | | - Güzin Cinel
- Department of Pediatric Pulmonology, Ankara City Hospital
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20
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da Silva GB, Manica D, da Silva AP, Valcarenghi E, Donassolo SR, Kosvoski GC, Mingoti MED, Gavioli J, Cassol JV, Hanauer MC, Hellmann MB, Marafon F, Bertollo AG, de Medeiros J, Cortez AD, Réus GZ, de Oliveira GG, Ignácio ZM, Bagatini MD. Peripheral biomarkers as a predictor of poor prognosis in severe cases of COVID-19. Am J Med Sci 2024; 368:122-135. [PMID: 38636654 DOI: 10.1016/j.amjms.2024.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/29/2023] [Accepted: 04/15/2024] [Indexed: 04/20/2024]
Abstract
We evaluated glycemia and triglyceride, hepatic, muscular, and renal damage markers, redox profile, and leptin and ghrelin hormone levels in COVID-19 patients. We also conducted statistical analysis to verify the potential of biomarkers to predict poor prognosis and the correlation between them in severe cases. We assessed glycemia and the levels of triglycerides, hepatic, muscular, and renal markers in automatized biochemical analyzer. The leptin and ghrelin hormones were assessed by the ELISA assay. Severe cases presented high glycemia and triglyceride levels. Hepatic, muscular, and renal biomarkers were altered in severe patients. Oxidative stress status was found in severe COVID-19 patients. Severe cases also had increased levels of leptin. The ROC curves indicated many biomarkers as poor prognosis predictors in severe cases. The Spearman analysis showed that biomarkers correlate between themselves. Patients with COVID-19 showed significant dysregulation in the levels of several peripheral biomarkers. We bring to light that a robust panel of peripheral biomarkers and hormones predict poor prognosis in severe cases of COVID-19 and biomarkers correlate with each other. Early monitoring of these biomarkers may lead to appropriate clinical interventions in patients infected by SARS-CoV2.
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Affiliation(s)
- Gilnei B da Silva
- Multicentric Postgraduate Program in Biochemistry and Molecular Biology, State University of Santa Catarina, Lages, SC, Brazil
| | - Daiane Manica
- Postgraduate Program in Biochemistry, Federal University of Santa Catarina, SC, Brazil
| | - Alana P da Silva
- Postgraduate Program in Biochemistry, Federal University of Santa Catarina, SC, Brazil
| | - Eduarda Valcarenghi
- Postgraduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó, SC, Brazil
| | - Sabine R Donassolo
- Postgraduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó, SC, Brazil
| | - Greicy C Kosvoski
- Postgraduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó, SC, Brazil
| | - Maiqueli E D Mingoti
- Postgraduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó, SC, Brazil
| | - Jullye Gavioli
- Postgraduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó, SC, Brazil
| | - Joana V Cassol
- Postgraduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó, SC, Brazil
| | - Marceli C Hanauer
- Postgraduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó, SC, Brazil
| | - Mariélly B Hellmann
- Postgraduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó, SC, Brazil
| | - Filomena Marafon
- Postgraduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó, SC, Brazil
| | - Amanda G Bertollo
- Postgraduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó, SC, Brazil
| | - Jesiel de Medeiros
- Postgraduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó, SC, Brazil
| | - Arthur D Cortez
- Postgraduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó, SC, Brazil
| | - Gislaine Z Réus
- Postgraduate Program in Health Sciences, Translational Psychiatry Laboratory, University of Southern Santa Catarina, Criciúma, SC, Brazil
| | - Gabriela G de Oliveira
- Postgraduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó, SC, Brazil
| | - Zuleide M Ignácio
- Postgraduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó, SC, Brazil
| | - Margarete D Bagatini
- Postgraduate Program in Biochemistry, Federal University of Santa Catarina, SC, Brazil; Postgraduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó, SC, Brazil.
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21
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Mariajoseph FP, Chung JX, Lai LT, Moore J, Goldschlager T, Chandra RV, Praeger A, Slater LA. Clinical management of contrast-induced neurotoxicity: a systematic review. Acta Neurol Belg 2024; 124:1141-1149. [PMID: 38329641 PMCID: PMC11266203 DOI: 10.1007/s13760-024-02474-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 01/04/2024] [Indexed: 02/09/2024]
Abstract
BACKGROUND Contrast-induced neurotoxicity (CIN) is an increasingly recognised complication following endovascular procedures utilising contrast. It remains poorly understood with heterogenous clinical management strategies. The aim of this review was to identify commonly employed treatments for CIN to enhance clinical decision making. METHODS A systematic search of Embase (1947-2022) and Medline (1946-2022) was conducted. Articles describing (i) patients with a clinical diagnosis of CIN, (ii) with radiological exclusion of other pathologies, (iii) detailed report of treatments, and (iv) discharge outcomes, were included. Data relating to demographics, procedure, symptoms, treatment and outcomes were extracted. RESULTS A total of 73 patients were included, with a median age of 64 years. The most common procedures were cerebral angiography (42.5%) and coronary angiography (42.5%), and the median volume of contrast administered was 150 ml. The most common symptoms were cortical blindness (38.4%) and reduced consciousness (28.8%), and 84.9% of patients experienced complete resolution at the time of discharge. Management included intravenous fluids to dilute contrast in the cerebrovasculature (54.8%), corticosteroids to reduce blood-brain barrier damage (47.9%), antiseizure (16.4%) and sedative (16.4%) medications. Mannitol (13.7%) was also utilised to reduce cerebral oedema. Intensive care admission was required for 19.2% of patients. No statistically significant differences were observed between treatment and discharge outcomes. CONCLUSIONS The clinical management of CIN should be considered on a patient-by-patient basis, but may consist of aggressive fluid therapy alongside corticosteroids, as well as other supportive therapy as required. Further examination of CIN management is required to define best practice.
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Affiliation(s)
- Frederick P Mariajoseph
- Department of Neurosurgery, Monash Health, Clayton, VIC, Australia.
- Department of Surgery, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia.
| | - Jia Xi Chung
- Department of Surgery, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia
| | - Leon T Lai
- Department of Neurosurgery, Monash Health, Clayton, VIC, Australia
- Department of Surgery, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia
| | - Justin Moore
- Department of Neurosurgery, Monash Health, Clayton, VIC, Australia
- Department of Surgery, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia
| | - Tony Goldschlager
- Department of Neurosurgery, Monash Health, Clayton, VIC, Australia
- Department of Surgery, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia
| | - Ronil V Chandra
- Monash Imaging, Monash Health, Clayton, Melbourne, Australia
- Department of Radiology, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia
| | - Adrian Praeger
- Department of Neurosurgery, Monash Health, Clayton, VIC, Australia
- Department of Surgery, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia
| | - Lee-Anne Slater
- Monash Imaging, Monash Health, Clayton, Melbourne, Australia
- Department of Radiology, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia
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22
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Goldenberg DL. How to understand the overlap of long COVID, chronic fatigue syndrome/myalgic encephalomyelitis, fibromyalgia and irritable bowel syndromes. Semin Arthritis Rheum 2024; 67:152455. [PMID: 38761526 DOI: 10.1016/j.semarthrit.2024.152455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 04/03/2024] [Accepted: 04/18/2024] [Indexed: 05/20/2024]
Abstract
Long COVID should be limited to patients with multiple, persistent symptoms not related to well-defined organ damage. Once redefined, a focused review of long COVID demonstrates striking similarity to chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME), fibromyalgia (FM) and irritable bowel syndrome (IBS). Research in long COVID has revealed similar findings to those noted in CFS/ME and FM, characterized by central nervous system organ dysfunction. Long COVID, like CFS/ME, FM and IBS, is best understood as a bidirectional mind-body, neuroimmune illness.
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Affiliation(s)
- Don L Goldenberg
- Emeritus Professor of Medicine, Tufts University School of Medicine, United States; Adjunct Faculty, Departments of Medicine and Nursing, Oregon Health Sciences University, United States.
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23
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Eder J, Pfeiffer L, Wichert SP, Keeser B, Simon MS, Popovic D, Glocker C, Brunoni AR, Schneider A, Gensichen J, Schmitt A, Musil R, Falkai P. Deconstructing depression by machine learning: the POKAL-PSY study. Eur Arch Psychiatry Clin Neurosci 2024; 274:1153-1165. [PMID: 38091084 PMCID: PMC11226486 DOI: 10.1007/s00406-023-01720-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 11/04/2023] [Indexed: 07/06/2024]
Abstract
Unipolar depression is a prevalent and disabling condition, often left untreated. In the outpatient setting, general practitioners fail to recognize depression in about 50% of cases mainly due to somatic comorbidities. Given the significant economic, social, and interpersonal impact of depression and its increasing prevalence, there is a need to improve its diagnosis and treatment in outpatient care. Various efforts have been made to isolate individual biological markers for depression to streamline diagnostic and therapeutic approaches. However, the intricate and dynamic interplay between neuroinflammation, metabolic abnormalities, and relevant neurobiological correlates of depression is not yet fully understood. To address this issue, we propose a naturalistic prospective study involving outpatients with unipolar depression, individuals without depression or comorbidities, and healthy controls. In addition to clinical assessments, cardiovascular parameters, metabolic factors, and inflammatory parameters are collected. For analysis we will use conventional statistics as well as machine learning algorithms. We aim to detect relevant participant subgroups by data-driven cluster algorithms and their impact on the subjects' long-term prognosis. The POKAL-PSY study is a subproject of the research network POKAL (Predictors and Clinical Outcomes in Depressive Disorders; GRK 2621).
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Affiliation(s)
- Julia Eder
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Nussbaumstrasse 7, 80336, Munich, Germany.
- Graduate Program "POKAL - Predictors and Outcomes in Primary Care" (DFG-GrK 2621, Munich, Germany.
| | - Lisa Pfeiffer
- Graduate Program "POKAL - Predictors and Outcomes in Primary Care" (DFG-GrK 2621, Munich, Germany
| | - Sven P Wichert
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Nussbaumstrasse 7, 80336, Munich, Germany
| | - Benjamin Keeser
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Nussbaumstrasse 7, 80336, Munich, Germany
| | - Maria S Simon
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Nussbaumstrasse 7, 80336, Munich, Germany
| | - David Popovic
- International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany
- Max-Planck Institute of Psychiatry, Munich, Germany
| | - Catherine Glocker
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Nussbaumstrasse 7, 80336, Munich, Germany
| | - Andre R Brunoni
- Department of Psychiatry, Faculty of Medicine, University of São Paulo (FMUSP), São Paulo, SP, Brasil
| | - Antonius Schneider
- Graduate Program "POKAL - Predictors and Outcomes in Primary Care" (DFG-GrK 2621, Munich, Germany
- Institute of General Practice and Health Services Research, School of Medicine, Technical University Munich, Munich, Germany
| | - Jochen Gensichen
- Graduate Program "POKAL - Predictors and Outcomes in Primary Care" (DFG-GrK 2621, Munich, Germany
- Institute of General Practice and Family Medicine, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Andrea Schmitt
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Nussbaumstrasse 7, 80336, Munich, Germany
- Laboratory of Neuroscience (LIM27), Institute of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Richard Musil
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Nussbaumstrasse 7, 80336, Munich, Germany
- Oberberg Specialist Clinic Bad Tölz, Bad Tölz, Germany
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Nussbaumstrasse 7, 80336, Munich, Germany
- Graduate Program "POKAL - Predictors and Outcomes in Primary Care" (DFG-GrK 2621, Munich, Germany
- International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany
- Max-Planck Institute of Psychiatry, Munich, Germany
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24
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Emadi Andani M, Barbiani D, Bonetto M, Menegaldo R, Villa-Sánchez B, Fiorio M. Preserving the placebo effect after disclosure: A new perspective on non-deceptive placebos. Br J Psychol 2024; 115:437-453. [PMID: 38226695 DOI: 10.1111/bjop.12696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 12/07/2023] [Accepted: 01/08/2024] [Indexed: 01/17/2024]
Abstract
The present study explores whether a particular style of placebo disclosure could serve as a tool to foster a renewed trust in one's own inherent resources and elicit a meaningful placebo effect. In a motor performance task, two placebo groups received inert transcutaneous electrical nerve stimulation (TENS) in each of four sessions along with information on its force-enhancing properties. Before the final session, one of the placebo groups was informed about the placebo, which was portrayed as a means to unleash an inherent potential. Along with force, we systematically monitored task-specific self-efficacy to test whether this variable would be differentially modulated in the two placebo groups. Compared to two control groups, placebo groups showed higher force and self-efficacy in the last session. No differences in self-efficacy were observed in the placebo groups even after revealing the placebo procedure, suggesting that the disclosure was effective in 'safeguarding' individuals' self-efficacy. These findings may have important implications, paving the way for the use of placebos that not only are ethically permissible but also support individuals' self-efficacy.
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Affiliation(s)
- Mehran Emadi Andani
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Diletta Barbiani
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Marco Bonetto
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Rudy Menegaldo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | | | - Mirta Fiorio
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
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25
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Laniece Delaunay C, Melo A, Maurel M, Mazagatos C, Goerlitz L, O'Donnell J, Oroszi B, Sève N, Rodrigues AP, Martínez-Baz I, Meijer A, Mlinarić I, Latorre-Margalef N, Lazăr M, Pérez-Gimeno G, Dürrwald R, Bennett C, Túri G, Rameix-Welti MA, Guiomar R, Castilla J, Hooiveld M, Kurečić Filipović S, Samuelsson Hagey T, Dijkstra F, Borges V, Ramos Marín V, Bacci S, Kaczmarek M, Kissling E. Effectiveness of COVID-19 vaccines administered in the 2023 autumnal campaigns in Europe: Results from the VEBIS primary care test-negative design study, September 2023-January 2024. Vaccine 2024; 42:3931-3937. [PMID: 38839521 PMCID: PMC11252666 DOI: 10.1016/j.vaccine.2024.05.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 05/20/2024] [Accepted: 05/28/2024] [Indexed: 06/07/2024]
Abstract
In autumn 2023, European vaccination campaigns predominantly administered XBB.1.5 vaccine. In a European multicentre study, we estimated 2023 COVID-19 vaccine effectiveness (VE) against laboratory-confirmed symptomatic infection at primary care level between September 2023 and January 2024. Using a test-negative case-control design, we estimated VE in the target group for COVID-19 vaccination overall and by time since vaccination. We included 1057 cases and 4397 controls. Vaccine effectiveness was 40 % (95 % CI: 26-53 %) overall, 48 % (95 % CI: 31-61 %) among those vaccinated < 6 weeks of onset and 29 % (95 % CI: 3-49 %) at 6-14 weeks. Our results suggest that COVID-19 vaccines administered to target groups during the autumn 2023 campaigns showed clinically significant effectiveness against laboratory-confirmed, medically attended symptomatic SARS-CoV-2 infection in the 3 months following vaccination. A longer study period will allow for further variant-specific COVID-19 VE estimates, better understanding decline in VE and informing booster administration policies.
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Affiliation(s)
| | - Aryse Melo
- National Reference Laboratory for Influenza Virus and Other Respiratory Visuses, Infectious disease department - National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
| | | | - Clara Mazagatos
- National Centre of Epidemiology, CIBERESP, Carlos III Health Institute, Madrid, Spain
| | | | - Joan O'Donnell
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | - Beatrix Oroszi
- National Laboratory for Health Security, Epidemiology and Surveillance Centre, Semmelweis University, Budapest, Hungary
| | - Noémie Sève
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | - Ana Paula Rodrigues
- Epidemiology department, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
| | - Iván Martínez-Baz
- Instituto de Salud Pública de Navarra - IdiSNA - CIBERESP, Pamplona, Spain
| | - Adam Meijer
- National Institute for Public Health and the Environment, Centre for Infectious Diseases Control, Bilthoven, the Netherlands
| | - Ivan Mlinarić
- Croatian Institute of Public Health, Zagreb, Croatia
| | | | - Mihaela Lazăr
- Cantacuzino National Military Medical Institute for Research and Development, Bucharest, Romania
| | - Gloria Pérez-Gimeno
- National Centre of Epidemiology, CIBERESP, Carlos III Health Institute, Madrid, Spain
| | - Ralf Dürrwald
- National Reference Centre for Influenza, Robert Koch Institute, Berlin, Germany
| | - Charlene Bennett
- UCD-National Virus Reference Laboratory, University College Dublin, Dublin, Ireland
| | - Gergő Túri
- National Laboratory for Health Security, Epidemiology and Surveillance Centre, Semmelweis University, Budapest, Hungary
| | - Marie-Anne Rameix-Welti
- Centre National de Référence Virus des Infections Respiratoire (CNR VIR), Institut Pasteur, Université Paris Cité, Paris, France; Institut Pasteur, Université Paris-Saclay, Université de Versailles St. Quentin, Université Paris Cité, UMR 1173 (2I), INSERM, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Raquel Guiomar
- National Reference Laboratory for Influenza Virus and Other Respiratory Visuses, Infectious disease department - National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
| | - Jesús Castilla
- Instituto de Salud Pública de Navarra - IdiSNA - CIBERESP, Pamplona, Spain
| | | | | | | | - Frederika Dijkstra
- National Institute for Public Health and the Environment, Centre for Infectious Diseases Control, Bilthoven, the Netherlands
| | - Vitor Borges
- Bioinformatics Unit, Infectious Diseases Department, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
| | - Violeta Ramos Marín
- Servicio de Epidemiología de la Consejería de Sanidad y Servicios Sociales de Ceuta, Ceuta, Spain
| | - Sabrina Bacci
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Marlena Kaczmarek
- European Centre for Disease Prevention and Control, Stockholm, Sweden
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26
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Solberg RB, Fretheim A, Elgersma IH, Fagernes M, Iversen BG, Hemkens LG, Rose CJ, Elstrøm P. Personal protective effect of wearing surgical face masks in public spaces on self-reported respiratory symptoms in adults: pragmatic randomised superiority trial. BMJ 2024; 386:e078918. [PMID: 39048132 DOI: 10.1136/bmj-2023-078918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/27/2024]
Abstract
OBJECTIVE To evaluate the personal protective effects of wearing versus not wearing surgical face masks in public spaces on self-reported respiratory symptoms over a 14 day period. DESIGN Pragmatic randomised superiority trial. SETTING Norway. PARTICIPANTS 4647 adults aged ≥18 years: 2371 were assigned to the intervention arm and 2276 to the control arm. INTERVENTIONS Participants in the intervention arm were assigned to wear a surgical face mask in public spaces (eg, shopping centres, streets, public transport) over a 14 day period (mask wearing at home or work was not mentioned). Participants in the control arm were assigned to not wear a surgical face mask in public places. MAIN OUTCOME MEASURES The primary outcome was self-reported respiratory symptoms consistent with a respiratory infection. Secondary outcomes included self-reported and registered covid-19 infection. RESULTS Between 10 February 2023 and 27 April 2023, 4647 participants were randomised of whom 4575 (2788 women (60.9%); mean age 51.0 (standard deviation 15.0) years) were included in the intention-to-treat analysis: 2313 (50.6%) in the intervention arm and 2262 (49.4%) in the control arm. 163 events (8.9%) of self-reported symptoms consistent with respiratory infection were reported in the intervention arm and 239 (12.2%) in the control arm. The marginal odds ratio was 0.71 (95% confidence interval (CI) 0.58 to 0.87; P=0.001) favouring the face mask intervention. The absolute risk difference was -3.2% (95% CI -5.2% to -1.3%; P<0.001). No statistically significant effect was found on self- reported (marginal odds ratio 1.07, 95% CI 0.58 to 1.98; P=0.82) or registered covid-19 infection (effect estimate and 95% CI not estimable owing to lack of events in the intervention arm). CONCLUSION Wearing a surgical face mask in public spaces over 14 days reduces the risk of self-reported symptoms consistent with a respiratory infection, compared with not wearing a surgical face mask. TRIAL REGISTRATION ClinicalTrials.gov NCT05690516.
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Affiliation(s)
- Runar Barstad Solberg
- Centre for Epidemic Interventions Research (CEIR), Norwegian Institute of Public Health, Oslo, Norway
| | - Atle Fretheim
- Centre for Epidemic Interventions Research (CEIR), Norwegian Institute of Public Health, Oslo, Norway
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Ingeborg Hess Elgersma
- Centre for Epidemic Interventions Research (CEIR), Norwegian Institute of Public Health, Oslo, Norway
| | - Mette Fagernes
- Division of Infection Control, Norwegian Institute of Public Health, Oslo, Norway
| | - Bjørn Gunnar Iversen
- Division of Infection Control, Norwegian Institute of Public Health, Oslo, Norway
| | - Lars G Hemkens
- Pragmatic Evidence Lab, Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), Basel, Switzerland
- Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland
- Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, USA
| | - Christopher James Rose
- Centre for Epidemic Interventions Research (CEIR), Norwegian Institute of Public Health, Oslo, Norway
- Cluster for Reviews and Health Technology Assessments, Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | - Petter Elstrøm
- Centre for Epidemic Interventions Research (CEIR), Norwegian Institute of Public Health, Oslo, Norway
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27
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Abogunrin S, Adelakun A, Akinola T, Bashir U, Fagbohungbe B, Mueller E, Neeser K, Ogunnubi O, Parekh K. Challenges of consolidating evidence collected during a pandemic and lessons for the future. Curr Med Res Opin 2024:1-12. [PMID: 38975733 DOI: 10.1080/03007995.2024.2377676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 07/02/2024] [Indexed: 07/09/2024]
Abstract
OBJECTIVE To illustrate the challenges encountered when gathering rapidly synthesized evidence in response to the coronavirus disease 2019 (COVID-19) pandemic. METHODS In this article, we describe the challenges encountered when we performed a systematic literature review (SLR) of randomized controlled trials (RCTs) on the efficacy and safety of treatments for severe COVID-19. The methods of the SLR are described in full, to show the context of our objectives. Then we use the results of the SLR to demonstrate the problems of producing synthesized evidence in this setting. RESULTS Various challenges were identified during this SLR. These were primarily a result of heterogeneity in the study methodology of eligible studies. Definitions of the patient populations and outcome measurements were highly variable and the majority of studies demonstrated a high risk of bias, preventing quantitative synthesis of the collated evidence. CONCLUSION Consolidating evidence from RCTs evaluating COVID-19 interventions was problematic. Guidance is needed for scenarios with high rapid output in primary research.
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Affiliation(s)
| | - Alex Adelakun
- Manchester University Foundation Trust, Manchester, UK
| | | | - Usman Bashir
- Community Medicine Department, Bayero University Kano, Kano, Nigeria
| | | | | | | | - Oluseun Ogunnubi
- Department of Psychiatry, College of Medicine of the University of Lagos, Lagos, Nigeria
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28
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Wieringa S, McGuire H, Wang Q, van der Wees P, Shaw B. Making sustainable healthcare decisions: three turns towards sustainable guidelines. BMJ Evid Based Med 2024; 29:219-222. [PMID: 37816591 DOI: 10.1136/bmjebm-2023-112352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/28/2023] [Indexed: 10/12/2023]
Affiliation(s)
- Sietse Wieringa
- Centre for Sustainable Healthcare Education, University of Oslo, Oslo, Norway
- Interdisciplinary Research in Health Sciences, University of Oxford, Oxford, UK
| | - Hugh McGuire
- National Institute for Health and Clinical Excellence Manchester Office, Manchester, UK
| | - Qi Wang
- Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- McMaster Health Forum, McMaster University, Hamilton, Ontario, Canada
| | - Philip van der Wees
- Department of IQ Healthcare, Radboud University Medical Centre, Nijmegen, Nederland
| | - Beth Shaw
- Center for Evidence-based Policy, Oregon Health and Science University, Portland, Oregon, USA
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29
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Mohebbi Z, Ghaemmaghami P, Rajaei M, Keshtkar MM, Ghanbarzadeh S, Khoram B. The association between potential predictors and death of patients during the COVID-19 pandemic in Shiraz: a hierarchical multiple regression analysis. BMC Public Health 2024; 24:1975. [PMID: 39044209 PMCID: PMC11267688 DOI: 10.1186/s12889-024-19372-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 07/04/2024] [Indexed: 07/25/2024] Open
Abstract
INTRODUCTION Identifying clinical factors that increase the risk of mortality in COVID-19 patients is crucial. This enables targeted screening, optimizing treatment, and prevention of severe complications, ultimately reducing death rates. This study aimed to develop prediction models for the death of patients (i.e., survival or death) during the COVID-19 pandemic in Shiraz, exploring the main influencing factors. METHOD We conducted a retrospective cohort study using hospital-based records of 1030 individuals diagnosed with COVID-19, who were hospitalized for treatment between March 21, 2021, and March 21, 2022, in Shiraz, Iran. Variables related to the final outcome were selected based on criteria and univariate logistic regression. Hierarchical multiple logistic regression and classification and regression tree (CART) models were utilized to explore the relationships between potential influencing factors and the final outcome. Additionally, methods were employed to identify the high-risk population for increased mortality rates during COVID-19. Finally, accuracy was evaluated the performance of the models, with the area under the receiver operator characteristic curve(AUC), sensitivity, and specificity metrics. RESULTS In this study, 558 (54.2%) individuals infected with COVID-19 died. The final model showed that the type of medicine antiviral (OR: 11.10, p = 0.038) than reference (antiviral and corticosteroid), and discharge oxygen saturation(O2) (OR: 1.10, p < 0.001) had a positive association with the chance of survival, but other variables were not considered as predictive variables. Predictive models for the final outcome(death) achieved accuracies ranging from 81 to 87% for hierarchical multiple logistic regression and from 87 to 94% for the CART model. Therefore, the CART model performed better than the hirerical multiple logistic regression model. CONCLUSION These findings firstly elucidate the incidence and associated factors of the outcome (death) among patients in Shiraz, Iran. Furthermore, we demonstrated that antiviral medication alone (without corticosteroids) and high O2 increase the survival chances of COVID patients.
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Affiliation(s)
- Zinat Mohebbi
- Community Based Psychiatric Care Research Center, Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Parvin Ghaemmaghami
- School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Melika Rajaei
- Nurse, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Sina Ghanbarzadeh
- Medical Student, Student Research Committee, Medical College, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Bagher Khoram
- Instructor of Critical-Care Nursing, MSN, Department of Anesthesia, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
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Affengruber L, Nussbaumer-Streit B, Hamel C, Van der Maten M, Thomas J, Mavergames C, Spijker R, Gartlehner G. Rapid review methods series: Guidance on the use of supportive software. BMJ Evid Based Med 2024; 29:264-271. [PMID: 38242566 DOI: 10.1136/bmjebm-2023-112530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/22/2023] [Indexed: 01/21/2024]
Abstract
This paper is part of a series of methodological guidance from the Cochrane Rapid Reviews Methods Group. Rapid reviews (RRs) use modified systematic review methods to accelerate the review process while maintaining systematic, transparent and reproducible methods. This paper guides how to use supportive software for RRs.We strongly encourage the use of supportive software throughout RR production. Specifically, we recommend (1) using collaborative online platforms that enable working in parallel, allow for real-time project management and centralise review details; (2) using automation software to support, but not entirely replace a human reviewer and human judgement and (3) being transparent in reporting the methodology and potential risk for bias due to the use of supportive software.
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Affiliation(s)
- Lisa Affengruber
- Department for Evidence-based Medicine and Evaluation, Cochrane Austria, University for Continuing Education Krems, Krems, Austria
- Department of Family Medicine, Maastricht University, Maastricht, The Netherlands
| | - Barbara Nussbaumer-Streit
- Department for Evidence-based Medicine and Evaluation, Cochrane Austria, University for Continuing Education Krems, Krems, Austria
| | - Candyce Hamel
- Canadian Association of Radiologists, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Miriam Van der Maten
- Knowledge Institute, Dutch Association of Medical Specialists, Utrecht, The Netherlands
| | - James Thomas
- University College London, UCL Social Research Institute, London, UK
| | | | - Rene Spijker
- Cochrane Netherlands, Julius Center for Health Sciences and Primary Care, UMC Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Gerald Gartlehner
- Department for Evidence-based Medicine and Evaluation, Cochrane Austria, University for Continuing Education Krems, Krems, Austria
- Center for Public Health Methods, RTI International, Research Triangle Park, North Carolina, USA
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Theriault G, Grad R. Preventing overdiagnosis and overuse: proposed guidance for guideline panels. BMJ Evid Based Med 2024; 29:272-274. [PMID: 38237953 DOI: 10.1136/bmjebm-2023-112608] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/05/2024] [Indexed: 07/25/2024]
Affiliation(s)
| | - Roland Grad
- Family Medicine, McGill University, Montreal, Quebec, Canada
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Grimshaw JM, Levinson W. Reducing low value care: opportunities and challenges for Choosing Wisely campaigns. BMJ Evid Based Med 2024; 29:215-218. [PMID: 37586873 DOI: 10.1136/bmjebm-2023-112271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/18/2023] [Indexed: 08/18/2023]
Affiliation(s)
- Jeremy M Grimshaw
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Wendy Levinson
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- St. Michael's Hospital, Toronto, Ontario, Canada
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Veroniki AA, Thirugnanasampanthar SS, Konstantinidis M, Dourka J, Ghassemi M, Neupane D, Khan P, Nincic V, Corry M, Robson R, Parker A, Soobiah C, Sinilaite A, Doyon-Plourde P, Gil A, Siu W, Moqueet N, Stevens A, English K, Florez ID, Yepes-Nuñez JJ, Hutton B, Muller M, Moja L, Straus S, Tricco AC. Trivalent and quadrivalent seasonal influenza vaccine in adults aged 60 and older: a systematic review and network meta-analysis. BMJ Evid Based Med 2024; 29:239-254. [PMID: 38604619 DOI: 10.1136/bmjebm-2023-112767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/02/2024] [Indexed: 04/13/2024]
Abstract
OBJECTIVES To compare the efficacy of influenza vaccines of any valency for adults 60 years and older. DESIGN AND SETTING Systematic review with network meta-analysis (NMA) of randomised controlled trials (RCTs). MEDLINE, EMBASE, JBI Evidence-Based Practice (EBP) Database, PsycINFO, and Cochrane Evidence -Based Medicine database were searched from inception to 20 June 20, 2022. Two reviewers screened, abstracted, and appraised articles (Cochrane Risk of Bias (ROB) 2.0 tool) independently. We assessed certainty of findings using Confidence in Network Meta-Analysis and Grading of Recommendations, Assessment, Development and Evaluations approaches. We performed random-effects meta-analysis and network meta-analysis (NMA), and estimated odds ratios (ORs) for dichotomous outcomes and incidence rate ratios (IRRs) for count outcomes along with their corresponding 95% confidence intervals (CIs) and prediction intervals. PARTICIPANTS Older adults (≥60 years old) receiving an influenza vaccine licensed in Canada or the USA (vs placebo, no vaccine, or any other licensed vaccine), at any dose. MAIN OUTCOME MEASURES Laboratory-confirmed influenza (LCI) and influenza-like illness (ILI). Secondary outcomes were the number of vascular adverse events, hospitalisation for acute respiratory infection (ARI) and ILI, inpatient hospitalisation, emergency room (ER) visit for ILI, outpatient visit, and mortality, among others. RESULTS We included 41 RCTs and 15 companion reports comprising 8 vaccine types and 206 032 participants. Vaccines may prevent LCI compared with placebo, with high-dose trivalent inactivated influenza vaccine (IIV3-HD) (NMA: 9 RCTs, 52 202 participants, OR 0.23, 95% confidence interval (CI) (0.11 to 0.51), low certainty of evidence) and recombinant influenza vaccine (RIV) (OR 0.25, 95%CI (0.08 to 0.73), low certainty of evidence) among the most efficacious vaccines. Standard dose trivalent IIV3 (IIV3-SD) may prevent ILI compared with placebo, but the result was imprecise (meta-analysis: 2 RCTs, 854 participants, OR 0.39, 95%CI (0.15 to 1.02), low certainty of evidence). Any HD was associated with prevention of ILI compared with placebo (NMA: 9 RCTs, 65 658 participants, OR 0.38, 95%CI (0.15 to 0.93)). Adjuvanted quadrivalent IIV (IIV4-Adj) may be associated with the least vascular adverse events, but the results were very uncertain (NMA: eight 8 RCTs, 57 677 participants, IRR 0.18, 95%CI (0.07 to 0.43), very low certainty of evidence). RIV on all-cause mortality may be comparable to placebo (NMA: 20 RCTs, 140 577 participants, OR 1.01, 95%CI (0.23 to 4.49), low certainty of evidence). CONCLUSIONS This systematic review demonstrated efficacy associated with IIV3-HD and RIV vaccines in protecting older persons against LCI. RIV vaccine may reduce all-cause mortality when compared with other vaccines, but the evidence is uncertain. Differences in efficacy between influenza vaccines remain uncertain with very low to moderate certainty of evidence. PROSPERO REGISTRATION NUMBER CRD42020177357.
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Affiliation(s)
- Areti Angeliki Veroniki
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Sai Surabi Thirugnanasampanthar
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Menelaos Konstantinidis
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Jasmeen Dourka
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Marco Ghassemi
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Dipika Neupane
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Paul Khan
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Vera Nincic
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Margarita Corry
- Trinity College Dublin School of Nursing and Midwifery, Dublin, Ireland
| | - Reid Robson
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Amanda Parker
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Charlene Soobiah
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | | | | | - Anabel Gil
- Public Health Agency, Ottawa, Ontario, Canada
| | - Winnie Siu
- Public Health Agency, Ottawa, Ontario, Canada
| | | | | | - Kelly English
- Patient Partner, Strategy for Patient Oriented-Research Evidence Alliance (SPOR EA), St Michael's Hospital, Toronto, Ontario, Canada
| | - Ivan D Florez
- Department of Pediatrics, University of Antioquia Faculty of Medicine, Medellin, Colombia
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
- Pediatric Intensive Care Unit, Clinica Las Américas-AUNA, Medellin, Colombia
| | - Juan J Yepes-Nuñez
- University of los Andes Faculty of Medicine, Bogota, Cundinamarca, Colombia
- Pulmonology Service, Internal Medicine Section, University Hospital of the Fundacion Santa Fe de Bogota, Bogota, Colombia
| | - Brian Hutton
- Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Matthew Muller
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Department of Medicine, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Lorenzo Moja
- Department of Biomedical Sciences and Technologies, University of Milan, Milano, Lombardia, Italy
| | - Sharon Straus
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
- Department of Geriatric Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Andrea C Tricco
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
- Epidemiology Division & Institute of Health Policy, Management, and Evaluation, University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada
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Wu Y, Lin C. Ethical implications of AI-driven bias assessment in medicine. BMJ Evid Based Med 2024; 29:282. [PMID: 38918061 DOI: 10.1136/bmjebm-2024-113095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/14/2024] [Indexed: 06/27/2024]
Affiliation(s)
- Yanyi Wu
- School of Public Affairs, Zhejiang University, Hangzhou, China
- Institute of China's Science, Technology and Policy, Zhejiang University, Hangzhou, China
| | - Chenghua Lin
- School of Public Affairs, Zhejiang University, Hangzhou, China
- Institute of China's Science, Technology and Policy, Zhejiang University, Hangzhou, China
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Affiliation(s)
- Natalie Edmiston
- Lismore Rural Clinical School, Western Sydney University, Lismore, New South Wales, Australia
| | - Iman Hegazi
- School of Medicine, Western Sydney University, Penrith South, New South Wales, Australia
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Logullo P, de Beyer JA, Kirtley S, Schlüssel MM, Collins GS. Open access journal publication in health and medical research and open science: benefits, challenges and limitations. BMJ Evid Based Med 2024; 29:223-228. [PMID: 37770125 DOI: 10.1136/bmjebm-2022-112126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/11/2023] [Indexed: 10/03/2023]
Affiliation(s)
- Patricia Logullo
- UK EQUATOR Centre, Centre for Statistics in Medicine (CSM), NDORMS (Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Diseases), University of Oxford, Oxford, UK
- Oxford-Brazil EBM Alliance, Oxford, UK
| | - Jennifer A de Beyer
- UK EQUATOR Centre, Centre for Statistics in Medicine (CSM), NDORMS (Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Diseases), University of Oxford, Oxford, UK
| | - Shona Kirtley
- UK EQUATOR Centre, Centre for Statistics in Medicine (CSM), NDORMS (Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Diseases), University of Oxford, Oxford, UK
| | - Michael Maia Schlüssel
- UK EQUATOR Centre, Centre for Statistics in Medicine (CSM), NDORMS (Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Diseases), University of Oxford, Oxford, UK
| | - Gary S Collins
- UK EQUATOR Centre, Centre for Statistics in Medicine (CSM), NDORMS (Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Diseases), University of Oxford, Oxford, UK
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Lee M, Sathe M, Moshiree B, Vu PT, Heltshe SL, Schwarzenberg SJ, Freedman SD, Freeman AJ. Estimating minimal clinically important difference (MCID) for gastrointestinal symptoms in cystic fibrosis. J Cyst Fibros 2024:S1569-1993(24)00798-7. [PMID: 39048465 DOI: 10.1016/j.jcf.2024.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 05/05/2024] [Accepted: 07/17/2024] [Indexed: 07/27/2024]
Abstract
BACKGROUND Minimal clinically important difference (MCID) is important to establish as a meaningful outcome in research when using patient reported outcome measures (PROMs). We determined the MCID using the distribution-based approach for three measurements used as part of the GALAXY study, which is an observational prospective study on gastrointestinal (GI) symptoms in cystic fibrosis (CF). METHODS Four hundred and two persons with cystic fibrosis (PwCF) participated in the GALAXY study, all with baseline values available for all questionnaires. Mean age was 20.9 years (2.1- 61.1) with 75 females and 94 males under the age of 18 (42.04 %) and 118 females and 115 males aged 18 or older (57.99 %). MCID was measured for Patient Assessment of Constipation Symptoms (PAC-SYM), Patient Assessment of Upper Gastrointestinal Symptoms (PAGI-SYM), Patient Assessment of Constipation-Quality of Life (PAC-QOL) and their subscales. Two distribution-based approaches, defined as multiplications of the standard deviation (SD) or standard error of the mean (SEM), were used to approximate the MCID. RESULTS The two distribution-based approaches for determining the MCID estimates produced comparable results in trends in MCIDs across the subscales and total scores. In general, MCID estimates of subscales for all three measurements were higher than their total score MCIDs. The one-half SD- and SEM-based MCID estimates for total scores of each questionnaire are as follows: PAC-SYM: 0.26 and 0.14; PAGI-SYM: 0.32 and 0.15; PAC-QOL: 0.27 and 0.18, respectively. CONCLUSION This paper establishes initial MCIDs estimated by the distribution-based approach for the PAC-SYM, PAGI-SYM and PAC-QOL that can now be used to evaluate interventional studies that may impact gastrointestinal symptoms in PwCF.
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Affiliation(s)
- MinJae Lee
- Peter O'Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX
| | - Meghana Sathe
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, University of Texas Southwestern/Children's Health, Dallas, TX.
| | - Baha Moshiree
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, Atrium Health, Wake Forest Medical University, Charlotte, NC
| | - Phuong T Vu
- Cystic Fibrosis Foundation Therapeutics Development Network Coordinating Center, Seattle Children's Research Institute, Seattle WA
| | - Sonya L Heltshe
- Cystic Fibrosis Foundation Therapeutics Development Network Coordinating Center, Seattle Children's Research Institute, Seattle WA; Department of Pediatrics, University of Washington School of Medicine, Seattle, WA
| | - Sarah Jane Schwarzenberg
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, University of Minnesota Masonic Children's Hospital, Minneapolis, MN
| | - Steven D Freedman
- Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, MA
| | - A Jay Freeman
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Nationwide Children's Hospital, The Ohio State University COM
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Alhajahjeh A, Hmeidan M, Abdulelah AA, Al-Nezaa I, Al-Abbadi F, Dobbs RW, Sater ZA, Al Awamlh BAH, Lee DI, Shahait M. Factors affecting the non-publication of clinical trials of prevalent urological cancer. World J Urol 2024; 42:426. [PMID: 39037516 DOI: 10.1007/s00345-024-05135-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 06/20/2024] [Indexed: 07/23/2024] Open
Abstract
OBJECTIVES Clinical trials (CTs) are critical in understanding and managing cancer. However, despite being completed, CT results are often unpublished, compromising the ability to glean useful information from them. This study aimed to evaluate factors influencing the non-publication of urological oncology clinical trials. METHODOLOGY We conducted a comprehensive search of ClinicalTrials.gov to identify CTs focused on urological cancers completed between 2000 and 2020. We used the National Clinical Trial (NCT) identifier number to check whether the trial was published. RESULTS 9,145 oncology CTs were conducted between 2000 and 2020, of which 8.39% (n = 767) focused on urological cancers, and 47.2% (n = 362) of these trials remained unpublished. Univariable analysis revealed that trials with a sample size of less than 50 and phase 4 were significantly associated with non-publication p < 0.001. In contrast, trials involving triple masking, a higher number of agents, and those conducted in High-Income Countries were associated with a higher likelihood of publication p < 0.05. Multivariable analysis demonstrated that trials enrolling more than 50 patients and employing three or more agents, along with triple and quadruple masking, had higher odds of being published (OR = 1.62; 95%CI (1.22-2.16), 1.89; 95%CI (1.10-3.27), 3.04; 95%CI (1.44-6.44), 5.62; 95%CI (1.72-18.37), and 5.41; 95%CI (1.76-16.67), p < 0.05, respectively). However, trials conducted in low-middle-income Countries had lower odds of publication (OR = 0.26; 95%CI (0.08-0.87), p = 0.02). CONCLUSION We found that almost one-half (47.2%) of all completed urologic oncology clinical trials are not published in a PubMed-indexed journal. This non-publication rate represents a significant loss of scientific knowledge and progress. We identified several key variables including sample size.
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Affiliation(s)
- Abdulrahman Alhajahjeh
- Department of Internal Medicine, King Hussein Cancer Center (KHCC), Amman, Jordan
- School of Medicine, University of Jordan, Amman, Jordan
| | | | - Ahmed A Abdulelah
- Edinburgh Medical School, The University of Edinburgh, Edinburgh, UK
| | | | - Faris Al-Abbadi
- Edinburgh Medical School, The University of Edinburgh, Edinburgh, UK
| | | | - Zahi Abdul Sater
- Global Health Institute, American University of Beirut, Beirut, Lebanon
- College of Public Health, Phoenicia University, Mazraat El Daoudiyeh, Lebanon
| | | | - David I Lee
- Department of Urology, University of California, Irvine Medical Center, Irvine, CA, UK
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Providencia R. Preoperative statins in cardiac surgery: a tale of small study bias or 'the truth, and nothing but the truth'. Cochrane Database Syst Rev 2024; 7:ED000167. [PMID: 39037830 PMCID: PMC11262553 DOI: 10.1002/14651858.ed000167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/24/2024]
Affiliation(s)
- Rui Providencia
- GENEs health and social care evidence SYnthesiS unit, Institute of Health InformaticsUniversity College LondonUnited Kingdom
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Riganti P, Hoffmann TC. Shared decision-making and evidence-based medicine series: exploring contemporary challenges and future directions. BMJ Evid Based Med 2024:bmjebm-2024-113024. [PMID: 39038925 DOI: 10.1136/bmjebm-2024-113024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/06/2024] [Indexed: 07/24/2024]
Affiliation(s)
- Paula Riganti
- Family and Community Medicine Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Tammy C Hoffmann
- Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
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Stevens A, Hersi M, Garritty C, Hartling L, Shea BJ, Stewart LA, Welch VA, Tricco AC. Rapid review method series: interim guidance for the reporting of rapid reviews. BMJ Evid Based Med 2024:bmjebm-2024-112899. [PMID: 39038926 DOI: 10.1136/bmjebm-2024-112899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/30/2024] [Indexed: 07/24/2024]
Abstract
Rapid reviews (RRs) are produced using abbreviated methods compared with standard systematic reviews (SR) to expedite the process for decision-making. This paper provides interim guidance to support the complete reporting of RRs. Recommendations emerged from a survey informed by empirical studies of RR reporting, in addition to collective experience. RR producers should use existing, robustly developed reporting guidelines as the foundation for writing RRs: notably Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 (PRISMA 2020; reporting for SRs), but also preferred reporting items for overviews of reviews (PRIOR) items (reporting for overviews of SRs) where SRs are included in the RR. In addition, a minimum set of six items were identified for RRs: three items pertaining to methods and three addressing publication ethics. Authors should be reporting what a priori-defined iterative methods were used during conduct, what distinguishes their RR from an SR, and knowledge user (eg, policymaker) involvement in the process. Explicitly reporting deviations from standard SR methods, including omitted steps, is important. The inclusion of publication ethics items reflects the predominance of non-journal published RRs: reporting an authorship byline and corresponding author, acknowledging other contributors, and reporting the use of expert peer review. As various formats may be used when packaging and presenting information to decision-makers, it is practical to think of complete reporting as across a set of explicitly linked documents made available in an open-access journal or repository that is barrier-free. We encourage feedback from the RR community of the use of these items as we look to develop a consolidated list in the development of PRISMA-RR.
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Affiliation(s)
- Adrienne Stevens
- Centre for Immunization Programs, Infectious Diseases & Vaccination Programs Branch, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Mona Hersi
- Centre for Immunization Programs, Infectious Diseases & Vaccination Programs Branch, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Chantelle Garritty
- School of Epidemiology and Public Health, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
- Global Health and Guidelines Division, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Lisa Hartling
- Alberta Research Centre for Health Evidence, University of Alberta, Edmonton, Alberta, Canada
| | - Beverley J Shea
- School of Epidemiology and Public Health, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
| | - Lesley A Stewart
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Vivian Andrea Welch
- Bruyere Research Institute, University of Ottawa, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Andrea C Tricco
- Epidemiology Division and Institute of Health Policy, Management, and Evaluation, University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada
- Li Ka Shing Knowledge Institute of St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
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Callum J, Putowski Z, Alhazzani W, Belley-Cote E, Møller MH, Curry N, Al Duhailib Z, Fung M, Giocobbo L, Granholm A, Louw V, Maybohm P, Muller M, Nielsen N, Oleschuk C, Raza S, Scruth E, Siegal D, Stanworth SJ, Vlaar APJ, White M, Oczkowski S. Small-volume blood sample collection tubes in adult intensive care units: A rapid practice guideline. Acta Anaesthesiol Scand 2024. [PMID: 39034625 DOI: 10.1111/aas.14497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Accepted: 06/27/2024] [Indexed: 07/23/2024]
Abstract
BACKGROUND This Intensive Care Medicine Rapid Practice Guideline (ICM-RPG) provides an evidence-based recommendation to address the question: in adult patients in intensive care units (ICUs), should we use small-volume or conventional blood collection tubes? METHODS We included 23 panelists in 8 countries and assessed and managed financial and intellectual conflicts of interest. Methodological support was provided by the Guidelines in Intensive Care, Development, and Evaluation (GUIDE) group. We conducted a systematic review, including evidence from observational and randomized studies. Using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach, we evaluated the certainty of evidence and developed recommendations using the Evidence-to-Decision framework. RESULTS We identified 8 studies (1 cluster and 2 patient-level randomized trials; 5 observational studies) comparing small-volume to conventional tubes. We had high certainty evidence that small-volume tubes reduce daily and cumulative blood sampling volume; and moderate certainty evidence that they reduce the risk of transfusion and mean number of red blood cell units transfused, but these estimates were limited by imprecision. We had high certainty that small-volume tubes have a similar rate of specimens with insufficient quantity. The panel considered that the desirable effects of small-volume tubes outweigh the undesirable effects, are less wasteful of resources, and are feasible, as demonstrated by successful implementation across multiple countries, although there are upfront implementation costs to validate small-volume tubes on laboratory instrumentation. CONCLUSION This ICM-RPG panel made a strong recommendation for the use of small-volume sample collection tubes in adult ICUs based on overall moderate certainty evidence.
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Affiliation(s)
- Jeannie Callum
- Pathology and Molecular Medicine, Queen's University and Kingston Health Sciences Centre, Kingston, Ontario, Canada
| | - Zbignew Putowski
- Center for Intensive Care and Perioperative Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Waleed Alhazzani
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Critical Care, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Research Institute of St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
- GUIDE Group, Hamilton, Ontario, Canada
| | - Emilie Belley-Cote
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- GUIDE Group, Hamilton, Ontario, Canada
- Population Health Research Institute, Hamilton, Ontario, Canada
| | - Morten Hylander Møller
- GUIDE Group, Hamilton, Ontario, Canada
- Department of Intensive Care, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Nicola Curry
- Department of Clinical Haematology, Haemophilia & Thrombosis Centre, Oxford University Hospitals National Health Service Foundation Trust, Oxford, UK
- John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Zainab Al Duhailib
- Critical Care Medicine Department, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
- Department of Medicine, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Mark Fung
- University of Vermont Medical Center, Burlington, Vermont, USA
| | - Louise Giocobbo
- Halton Healthcare, Oakville Trafalgar Memorial Hospital, Oakville, Ontario, Canada
| | - Anders Granholm
- GUIDE Group, Hamilton, Ontario, Canada
- Department of Intensive Care, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Vernon Louw
- Division Clinical Haematology, Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
| | - Patrick Maybohm
- Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Würzburg, Würzburg, Germany
| | - Marcella Muller
- Department of Intensive Care, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Nathan Nielsen
- Division of Pulmonary, Critical Care and Sleep Medicine, and Section of Transfusion Medicine and Therapeutic Pathology, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA
| | - Curtis Oleschuk
- Pathology and Molecular Medicine, Queen's University and Kingston Health Sciences Centre, Kingston, Ontario, Canada
| | - Sheharyar Raza
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Elizabeth Scruth
- NCAL Quality, Safety, Risk Department, Kaiser Permanente, Oakland, California, USA
| | - Deborah Siegal
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Ottawa Hospital Resarch Institute, Ottawa, Ontario, Canada
| | - Simon J Stanworth
- John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Radcliffe Department of Medicine, University of Oxford, Oxford, UK
- Systematic Review Initiative, NHS Blood and Transplant, Oxford, UK
| | - Alexander P J Vlaar
- Department of Intensive Care, Amsterdam University Medical Centers, Amsterdam, the Netherlands
- Laboratory of Experimental Intensive Care and Anesthesiology, Amsterdam University Medical Centers - Location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Micheline White
- College of the Humanities and the Department of English, Carleton University, Ottawa, Ontario, Canada
| | - Simon Oczkowski
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Research Institute of St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
- GUIDE Group, Hamilton, Ontario, Canada
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Nanji K, Xie J, Hatamnejad A, Pur DR, Phillips M, Zeraatkar D, Wong TY, Guymer RH, Kaiser PK, Sivaprasad S, Bhandari M, Steel DH, Wykoff CC, Chaudhary V. Exploring the fragility of meta-analyses in ophthalmology: a systematic review. Eye (Lond) 2024:10.1038/s41433-024-03255-2. [PMID: 39033242 DOI: 10.1038/s41433-024-03255-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 06/13/2024] [Accepted: 07/15/2024] [Indexed: 07/23/2024] Open
Abstract
OBJECTIVE The fragility index (FI) of a meta-analysis evaluates the extent that the statistical significance can be changed by modifying the event status of individuals from included trials. Understanding the FI improves the interpretation of the results of meta-analyses and can help to inform changes to clinical practice. This review determined the fragility of ophthalmology-related meta-analyses. METHODS Meta-analyses of randomized controlled trials with binary outcomes published in a journal classified as 'Ophthalmology' according to the Journal Citation Report or an Ophthalmology-related Cochrane Review were included. An iterative process determined the FI of each meta-analysis. Multivariable linear regression modeling evaluated the relationship between the FI and potential predictive factors in statistically significant and non-significant meta-analyses. RESULTS 175 meta-analyses were included. The median FI was 6 (Q1-Q3: 3-12). This meant that moving 6 outcomes from one group to another would reverse the study's findings. The FI was 1 for 18 (10.2%) of the included meta-analyses and was ≤5 for 75 (42.4%) of the included meta-analyses. The number of events (p < 0.001) and the p-value (p < 0.001) were the best predictors of the FI in both significant and non-significant meta-analyses. CONCLUSION The statistical significance of meta-analyses in ophthalmology often hinges on the outcome of a few patients. The number of events and the p-value are the most important factors in determining the fragility of the evidence. The FI is an easily interpretable measure that can supplement the reader's understanding of the strength of the evidence being presented. PROSPERO REGISTRATION CRD42022377589.
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Affiliation(s)
- Keean Nanji
- Department of Surgery, Division of Ophthalmology, McMaster University, Hamilton, ON, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Jim Xie
- Department of Surgery, Division of Ophthalmology, McMaster University, Hamilton, ON, Canada
| | - Amin Hatamnejad
- Department of Surgery, Division of Ophthalmology, McMaster University, Hamilton, ON, Canada
| | - Daiana R Pur
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Mark Phillips
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Dena Zeraatkar
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
- Department of Anesthesia, McMaster University, Hamilton, ON, Canada
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Tsinghua Medicine, Tsinghua University, Beijing, China
| | - Robyn H Guymer
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia
- Department of Surgery (Ophthalmology), The University of Melbourne, Melbourne, Australia
| | - Peter K Kaiser
- Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Sobha Sivaprasad
- NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital, London, UK
| | - Mohit Bhandari
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
- Department of Surgery, Division of Orthopedic Surgery, McMaster University, Hamilton, ON, Canada
| | - David H Steel
- Bioscience Institute, Newcastle University, Newcastle Upon Tyne, UK
- Sunderland Eye Infirmary, Sunderland, UK
| | - Charles C Wykoff
- Retina Consultants of Texas, Houston, TX, USA
- Blanton Eye Institute, Houston Methodist Hospital, Houston, TX, USA
| | - Varun Chaudhary
- Department of Surgery, Division of Ophthalmology, McMaster University, Hamilton, ON, Canada.
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Julian GS, Shau WY, Chou HW, Setia S. Bridging Real-World Data Gaps: Connecting Dots across Ten Asian Countries. JMIR Med Inform 2024. [PMID: 39026427 DOI: 10.2196/58548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2024] Open
Abstract
UNSTRUCTURED he economic trend and the healthcare landscape are rapidly evolving across Asia. Effective Real-World Data (RWD) for regulatory and clinical decision-making is a crucial milestone associated with this evolution. This necessitates a critical evaluation of Real-World Data (RWD) generation within distinct nations for utilization of various RWD warehouses in the generation of Real-World Evidence (RWE). In this article, we outline the RWD generation trends for two contrasting nation archetypes, 'Solo Scholars'-nations with relatively self-sufficient RWD research systems-and 'Global Collaborators'-countries largely reliant on international infrastructures for RWD generation. The key trends and patterns in RWD generation, country-specific insights into the predominant databases used in each country to produce RWE, and insights into the broader landscape of RWD database utilization across these countries are discussed. Conclusively, the data points out the heterogeneous nature of RWD generation practices across 10 different Asian nations and advocates for strategic enhancements in data harmonization. The evidence highlights the imperative for improved database integration and the establishment of standardized protocols and infrastructure for leveraging Electronic Medical Records (EMR) in streamlining RWD acquisition. The Clinical Data Analysis and Reporting System (CDARS) of Hong Kong is an excellent example of a successful EMR system that showcases the capacity of integrated robust EMR platforms to consolidate and produce diverse RWE. This, in turn, can potentially reduce the necessity for reliance on numerous condition-specific local and global registries or limited and largely unavailable medical insurance or claims databases in most Asian nations. Linking Health Technology Assessment (HTA) processes with open data initiatives like the Observational Medical Outcomes Partnership Common Data Model and the Observational Health Data Sciences and Informatics could enable the leveraging of global data resources to inform local decision-making. Advancing such initiatives is crucial for reinforcing healthcare frameworks in resource-limited settings and advancing towards cohesive, evidence-driven healthcare policy and improved patient outcomes in the region.
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Affiliation(s)
| | - Wen-Yi Shau
- Pfizer Corporation Hong Kong Limited, Hong Kong, HK
| | | | - Sajita Setia
- Transform Medical Communications Limited, Sajita Setia42 Kilkenny Drive, Auckland, NZ
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Prentice KR, Williams BA, True JM, Jones CH. Advancing health equity in the aftermath of COVID-19: Confronting intensifying racial disparities. iScience 2024; 27:110257. [PMID: 39027376 PMCID: PMC11255839 DOI: 10.1016/j.isci.2024.110257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2024] Open
Abstract
The COVID-19 pandemic has exposed and exacerbated the persistent racial and ethnic health disparities in the United States. The pandemic has also had profound spillover effects on other aspects of health and wellbeing, such as mental health, chronic diseases, education, and income, for marginalized groups. In this article, we provide a thorough analysis of the pandemic's impact on racial and ethnic health disproportionalities, highlighting the multifaceted and interrelated factors that contribute to these inequities. We also argue for a renewed focus on health equity in healthcare policy and practice, emphasizing the need for systemic changes that address both the immediate and long-term consequences of these imbalances. We propose a framework for achieving health equity that involves creating equitable systems, care, and outcomes for all individuals, regardless of their race or ethnicity.
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Affiliation(s)
| | | | - Jane M. True
- Pfizer Inc, 66 Hudson Boulevard, New York, NY 10001, USA
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Pal B, Atem TD, Kumari S, Murti K, Kumar R, Pandey K, Siddiqui NA, Dhingra S, Chaudhary V. Ophthalmic adverse effects of miltefosine in the treatment of leishmaniasis: a systematic review. Cutan Ocul Toxicol 2024:1-8. [PMID: 39023122 DOI: 10.1080/15569527.2024.2380311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 07/10/2024] [Indexed: 07/20/2024]
Abstract
OBJECTIVE Miltefosine stands as the sole oral medication approved for the treatment of leishmaniasis. The appearance of severe ophthalmic toxicities induced by miltefosine in the context of leishmaniasis treatment is a matter of significant concern. The main objective of this study is to present a comprehensive summary of the ophthalmic adverse effects associated with miltefosine when used in the treatment of leishmaniasis. METHODS A systematic search was performed on PubMed, ScienceDirect, Embase, Scopus, and Google Scholar, covering articles from inception up to June 2023, without language restrictions, to identify relevant studies documenting ocular toxicity following miltefosine treatment for leishmaniasis. RESULTS A total of eight studies involving 31 leishmaniasis patients who developed ocular toxicities while undergoing miltefosine treatment were included in the analysis. These studies were conducted in various regions, with five originating from India, two from Bangladesh, and one from Nepal. Patients presented a spectrum of ophthalmic complications, including uveitis, keratitis, scleritis, and Mooren's ulcer. Commonly reported symptoms included pain, redness, excessive tearing, partial vision impairment, permanent blindness, light sensitivity, and the appearance of white spots on the eye. On average, patients received miltefosine treatment for a duration of 47 days before experiencing the onset of ocular problems. It is important to note that the risk of ocular toxicities increases with prolonged use of miltefosine. CONCLUSIONS Therefore, to mitigate the potential for irreversible damage to the eyes, it is imperative that all individuals undergoing miltefosine therapy undergo regular eye examinations.
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Affiliation(s)
- Biplab Pal
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, India
| | - Tambe Daniel Atem
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, India
| | - Sweta Kumari
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, India
| | - Krishna Murti
- National Institute of Pharmaceutical Education and Research, Hajipur, Bihar, India
| | - Rishikesh Kumar
- Rajendra Memorial Research Institute of Medical Sciences (Indian Council of Medical Research), Agamkuan, Patna, Bihar, IndiaConsultant (Biostatistics)
| | - Krishna Pandey
- Rajendra Memorial Research Institute of Medical Sciences (Indian Council of Medical Research), Agamkuan, Patna, Bihar, IndiaConsultant (Biostatistics)
| | - Niyamat Ali Siddiqui
- Rajendra Memorial Research Institute of Medical Sciences (Indian Council of Medical Research), Agamkuan, Patna, Bihar, IndiaConsultant (Biostatistics)
| | - Sameer Dhingra
- National Institute of Pharmaceutical Education and Research, Hajipur, Bihar, India
| | - Vaibhav Chaudhary
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, India
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Wang X, Yanna LI, Rui LI, Yuan L, Hua Y, Cai Y, Liu X. Low-Frequency RTMS Attenuates Social Impairment in the VPA-induced Mouse Model. Behav Brain Res 2024:115156. [PMID: 39032867 DOI: 10.1016/j.bbr.2024.115156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 07/16/2024] [Accepted: 07/17/2024] [Indexed: 07/23/2024]
Abstract
BACKGROUND Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impaired social interactions and repetitive behaviors. Despite its prevalence, effective treatments remain elusive. Recent studies have highlighted the importance of the balance between GABAergic and glutamatergic neuronal synaptic functions in ASD development. Repetitive transcranial magnetic stimulation (RTMS) is a painless and effective treatment allowed for use in depression and obsessive-compulsive disorder. However, its efficacy in treating autism is still under investigation. Low-frequency RTMS (LF-RTMS), which shows promise in reducing autism-like behaviors, is considered to regulate synaptic function. OBJECTIVE We observed and recorded the behaviors of mice to assess the impact of RTMS on their social interactions and repetitive activities. Subsequently, we examined GABAergic and glutamatergic neuronal markers along with synaptic marker proteins to understand the underlying changes associated with these behaviors. METHODS To evaluate behaviors associated with autism spectrum disorder (ASD), several behavioral tests were conducted, focusing on sociability, repetitive behaviors, locomotion, anxiety, and depression. Additionally, Western blot and immunofluorescence staining were employed to investigate the activity of GABAergic and glutamatergic neurons in the hippocampus, aiming to understand the synaptic mechanisms underlying these behaviors. RESULTS LF-RTMS treatment effectively relieved the social disability and normalized synaptic function in the hippocampus of ASD mice model induced by valproate (VPA). Importantly, this treatment did not lead to any adverse effects on repetitive behavior, locomotion, anxiety, or depression. CONCLUSION LF-RTMS attenuated social disability without affecting repetitive behavior, locomotion, anxiety, or depression. Changes in the expression of GABAergic and glutamatergic neuronal synaptic proteins in the hippocampus were also observed.
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Affiliation(s)
- Xinyi Wang
- Department of Neurology, Affiliated Jinling Hospital, Medical School, Nanjing University, Nanjing, Jiangsu 210000, China
| | - L I Yanna
- Department of Neurology, Affiliated Jinling Hospital, Medical School, Nanjing University, Nanjing, Jiangsu 210000, China
| | - L I Rui
- Department of Neurology, Jinling Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Linying Yuan
- Department of Neurology, Affiliated Jinling Hospital, Medical School, Nanjing University, Nanjing, Jiangsu 210000, China
| | - Yanfan Hua
- Department of Neurology, Affiliated Jinling Hospital, Medical School, Nanjing University, Nanjing, Jiangsu 210000, China
| | - Yulong Cai
- Department of Neurology, Jinling Hospital, Nanjing Medical University, Nanjing, Jiangsu, China.
| | - Xinfeng Liu
- Department of Neurology, Affiliated Jinling Hospital, Medical School, Nanjing University, Nanjing, Jiangsu 210000, China.
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Ledda RE, Funk GC, Sverzellati N. The pros and cons of lung cancer screening. Eur Radiol 2024:10.1007/s00330-024-10939-6. [PMID: 39014085 DOI: 10.1007/s00330-024-10939-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 06/10/2024] [Accepted: 06/14/2024] [Indexed: 07/18/2024]
Abstract
Several trials have shown that low-dose computed tomography-based lung cancer screening (LCS) allows a substantial reduction in lung cancer-related mortality, carrying the potential for other clinical benefits. There are, however, some uncertainties to be clarified and several aspects to be implemented to optimize advantages and minimize the potential harms of LCS. This review summarizes current evidence on LCS, discussing some of the well-established and potential benefits, including lung cancer (LC)-related mortality reduction and opportunity for smoking cessation interventions, as well as the disadvantages of LCS, such as overdiagnosis and overtreatment. CLINICAL RELEVANCE STATEMENT: Different perspectives are provided on LCS based on the updated literature. KEY POINTS: Lung cancer is a leading cancer-related cause of death and screening should reduce associated mortality. This review summarizes current evidence related to LCS. Several aspects need to be implemented to optimize benefits and minimize potential drawbacks of LCS.
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Affiliation(s)
| | - Georg-Christian Funk
- Department of Medicine II with Pneumology, Karl Landsteiner Institute for Lung Research and Pulmonary Oncology, Klinik Ottakring, Vienna, Austria
| | - Nicola Sverzellati
- Department of Medicine and Surgery (DiMeC), University of Parma, Parma, Italy
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Porter JC, Inshaw J, Solis VJ, Denneny E, Evans R, Temkin MI, De Vasconcelos N, Aramburu IV, Hoving D, Basire D, Crissell T, Guinto J, Webb A, Esmail H, Johnston V, Last A, Rampling T, Lippert L, Helbig ET, Kurth F, Williams B, Flynn A, Lukey PT, Birault V, Papayannopoulos V. Anti-inflammatory therapy with nebulized dornase alfa for severe COVID-19 pneumonia: a randomized unblinded trial. eLife 2024; 12:RP87030. [PMID: 39009040 PMCID: PMC11251720 DOI: 10.7554/elife.87030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/17/2024] Open
Abstract
Background Prinflammatory extracellular chromatin from neutrophil extracellular traps (NETs) and other cellular sources is found in COVID-19 patients and may promote pathology. We determined whether pulmonary administration of the endonuclease dornase alfa reduced systemic inflammation by clearing extracellular chromatin. Methods Eligible patients were randomized (3:1) to the best available care including dexamethasone (R-BAC) or to BAC with twice-daily nebulized dornase alfa (R-BAC + DA) for seven days or until discharge. A 2:1 ratio of matched contemporary controls (CC-BAC) provided additional comparators. The primary endpoint was the improvement in C-reactive protein (CRP) over time, analyzed using a repeated-measures mixed model, adjusted for baseline factors. Results We recruited 39 evaluable participants: 30 randomized to dornase alfa (R-BAC +DA), 9 randomized to BAC (R-BAC), and included 60 CC-BAC participants. Dornase alfa was well tolerated and reduced CRP by 33% compared to the combined BAC groups (T-BAC). Least squares (LS) mean post-dexamethasone CRP fell from 101.9 mg/L to 23.23 mg/L in R-BAC +DA participants versus a 99.5 mg/L to 34.82 mg/L reduction in the T-BAC group at 7 days; p=0.01. The anti-inflammatory effect of dornase alfa was further confirmed with subgroup and sensitivity analyses on randomised participants only, mitigating potential biases associated with the use of CC-BAC participants. Dornase alfa increased live discharge rates by 63% (HR 1.63, 95% CI 1.01-2.61, p=0.03), increased lymphocyte counts (LS mean: 1.08 vs 0.87, p=0.02) and reduced circulating cf-DNA and the coagulopathy marker D-dimer (LS mean: 570.78 vs 1656.96 μg/mL, p=0.004). Conclusions Dornase alfa reduces pathogenic inflammation in COVID-19 pneumonia, demonstrating the benefit of cost-effective therapies that target extracellular chromatin. Funding LifeArc, Breathing Matters, The Francis Crick Institute (CRUK, Medical Research Council, Wellcome Trust). Clinical trial number NCT04359654.
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Affiliation(s)
- Joanna C Porter
- UCL Respiratory, University College LondonLondonUnited Kingdom
- University College London Hospitals NHS TrustLondonUnited Kingdom
| | | | | | - Emma Denneny
- UCL Respiratory, University College LondonLondonUnited Kingdom
- University College London Hospitals NHS TrustLondonUnited Kingdom
| | - Rebecca Evans
- University College London Hospitals NHS TrustLondonUnited Kingdom
| | - Mia I Temkin
- Antimicrobial Defence Lab, The Francis Crick InstituteLondonUnited Kingdom
| | | | | | - Dennis Hoving
- Antimicrobial Defence Lab, The Francis Crick InstituteLondonUnited Kingdom
| | - Donna Basire
- UCL Respiratory, University College LondonLondonUnited Kingdom
| | - Tracey Crissell
- University College London Hospitals NHS TrustLondonUnited Kingdom
| | - Jesusa Guinto
- University College London Hospitals NHS TrustLondonUnited Kingdom
| | - Alison Webb
- University College London Hospitals NHS TrustLondonUnited Kingdom
| | - Hanif Esmail
- University College London Hospitals NHS TrustLondonUnited Kingdom
- National Institute for Health Research, University College London Hospital Biomedical Research CentreLondonUnited Kingdom
| | - Victoria Johnston
- University College London Hospitals NHS TrustLondonUnited Kingdom
- National Institute for Health Research, University College London Hospital Biomedical Research CentreLondonUnited Kingdom
| | - Anna Last
- University College London Hospitals NHS TrustLondonUnited Kingdom
- Clinical Research Department, London School of Hygiene and Tropical MedicineLondonUnited Kingdom
| | - Thomas Rampling
- University College London Hospitals NHS TrustLondonUnited Kingdom
- National Institute for Health Research, University College London Hospital Biomedical Research CentreLondonUnited Kingdom
| | - Lena Lippert
- Charité – Universitätsmedizin Berlin, Department of Infectious Diseases and Respiratory MedicineBerlinGermany
| | - Elisa Theresa Helbig
- Charité – Universitätsmedizin Berlin, Department of Infectious Diseases and Respiratory MedicineBerlinGermany
| | - Florian Kurth
- Charité – Universitätsmedizin Berlin, Department of Infectious Diseases and Respiratory MedicineBerlinGermany
| | - Bryan Williams
- University College London Hospitals NHS TrustLondonUnited Kingdom
- National Institute for Health Research, University College London Hospital Biomedical Research CentreLondonUnited Kingdom
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50
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d'Entremont MA, Tiong D, Sadeghirad B, McGrath BP, Cioffi GM, Garni TA, Cheema ZM, Layland J, Revaiah PC, Serruys PW, Stone GW, Jolly SS. Assessment of Coronary Stenoses for Percutaneous Coronary Intervention: A Systematic Review and Network Meta-Analysis of Randomized Trials. Am J Cardiol 2024; 223:29-39. [PMID: 38768846 DOI: 10.1016/j.amjcard.2024.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 05/14/2024] [Accepted: 05/15/2024] [Indexed: 05/22/2024]
Abstract
Evidence regarding the comparative efficacy of the different methods to determine the significance of coronary stenoses in the catheterization laboratory is lacking. We aimed to compare all available methods guiding the decision to perform percutaneous coronary intervention (PCI). We searched Medline, Embase, and CENTRAL until October 5, 2023. We included trials that randomized patients with greater than 30% stenoses who were considered for PCI and reported major adverse cardiovascular events (MACE). We performed a frequentist random-effects network meta-analysis and assessed the certainty of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. We included 15 trials with 16,333 participants with a mean weighted follow-up of 34 months. The trials contained a median of 49.3% (interquartile range: 32.6%, 100%) acute coronary syndrome participants. Quantitative flow ratio (QFR) was associated with a decreased risk of MACE compared with coronary angiography (CA) (risk ratio [RR] 0.68, 95% confidence interval [CI] 0.56 to 0.82, high certainty), fractional flow reserve (FFR) (RR 0.73, 95% CI 0.58 to 0.92, moderate certainty), and instantaneous wave-free ratio (iFR) (RR 0.63, 95% CI 0.49 to 0.82, moderate certainty), and ranked first for MACE (88.1% probability of being the best). FFR (RR 0.93, 95% CI 0.82 to 1.06, moderate certainty) and iFR (RR 1.07, 95% CI 0.90 to 1.28, moderate certainty) likely did not decrease the risk of MACE compared with CA. Intravascular imaging may not be associated with a significant decrease in MACE compared with CA (RR 0.85, 95% CI 0.62 to 1.17, low certainty) when used to guide the decision to perform PCI. In conclusion, a decision to perform PCI based on QFR was associated with a decreased risk of MACE compared with CA, FFR, and iFR in a mixed stable coronary disease and acute coronary syndrome population. These hypothesis-generating findings should be validated in large, randomized, head-to-head trials.
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Affiliation(s)
- Marc-André d'Entremont
- Population Health Research Institute, Hamilton, Ontario, Canada; Hamilton Health Sciences, Hamilton, Ontario, Canada; Department of Medicine, McMaster University, Hamilton, Ontario, Canada; Centre Hospitalier Universitaire de Sherbrooke (CHUS), Sherbrooke, Quebec, Canada
| | - Denise Tiong
- Hamilton Health Sciences, Hamilton, Ontario, Canada; Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Behnam Sadeghirad
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada
| | - Brian P McGrath
- Hamilton Health Sciences, Hamilton, Ontario, Canada; Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Giacomo Maria Cioffi
- Hamilton Health Sciences, Hamilton, Ontario, Canada; Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Turki Al Garni
- Hamilton Health Sciences, Hamilton, Ontario, Canada; Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Zain M Cheema
- Hamilton Health Sciences, Hamilton, Ontario, Canada; Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | | | - Pruthvi C Revaiah
- CORRIB Research Centre for Advanced Imaging and Core Laboratory, University of Galway, Galway, Ireland
| | - Patrick W Serruys
- CORRIB Research Centre for Advanced Imaging and Core Laboratory, University of Galway, Galway, Ireland
| | - Gregg W Stone
- The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York
| | - Sanjit S Jolly
- Population Health Research Institute, Hamilton, Ontario, Canada; Hamilton Health Sciences, Hamilton, Ontario, Canada; Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
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