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Alanazi SA, Vicenzino B, van Bergen CJA, Hunter DJ, Wikstrom EA, Menz HB, Golightly YM, Smith MD. Protocol for the development of a core domain set for individuals with ankle osteoarthritis. Trials 2022; 23:748. [PMID: 36064628 PMCID: PMC9446870 DOI: 10.1186/s13063-022-06692-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 08/24/2022] [Indexed: 11/10/2022] Open
Abstract
Background Ankle osteoarthritis (OA) is a debilitating health condition that is increasing in prevalence. Currently, there are no evidence-based guidelines for managing ankle OA. One of the current challenges to establishing guidelines is the lack of a widely agreed-upon set of outcome measures that are consistently used in ankle OA research. Without a set of agreed-upon outcome measures, it is difficult to synthesise clinical trial outcomes through meta-analysis—an essential element of evidence-informed practice. In order to develop an appropriate set of outcome measures for ankle OA, it is important first to develop a core domain set. In this protocol, we describe the methodological approach that we will use to develop such a core domain set for ankle OA. Methods We established an international steering committee to guide the development of a core domain set for ankle OA. The core domain set development will follow a multi-staged approach consisting of three phases, involving participation by patients and clinicians/healthcare professionals. In phase 1, a list of candidate domains will be gleaned from (a) a scoping review of outcome measures used in ankle OA research, (b) qualitative interviews with individuals with ankle OA, and (c) qualitative interviews with healthcare professionals with expertise in ankle OA. In phase 2, the steering committee will review and generate a list of candidate domains from those gleaned in phase 1. In phase 3, this list of candidate domains will be considered in a Delphi process to reach a consensus on a core domain set. We anticipated this will involve 3 rounds of surveys. Conclusion This protocol describes the methods that will be used to develop a core domain set of health-related aspects for ankle OA. Importantly, it will include both healthcare professional and patient involvement. This is a prerequisite step to developing a core outcome set for ankle OA that should be reported in all clinical trials for ankle OA. The findings will be widely disseminated across peer-refereed publication(s) and national and international conferences, as well as via relevant professional societies, patient support group organisations, and social media platforms. Project registration This project is registered with the Core Outcome Measures in Effectiveness Trials (COMET) database on 17 March 2021. https://www.comet-initiative.org/Studies/Details/1837. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06692-0.
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Affiliation(s)
- Sultan Ayyadah Alanazi
- The University of Queensland, School of Health and Rehabilitation Sciences: Physiotherapy, Brisbane, Australia.,Department of Physical Therapy, College of Applied Medical Sciences, Majmaah University, Al-Majmaah, 11952, Saudi Arabia
| | - Bill Vicenzino
- The University of Queensland, School of Health and Rehabilitation Sciences: Physiotherapy, Brisbane, Australia
| | - Christiaan J A van Bergen
- Department of Orthopedic Surgery, Amphia, Breda, the Netherlands.,Department of Orthopedic Surgery and Sports Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - David J Hunter
- Sydney Musculoskeletal Health, Kolling Institute, The University of Sydney, Sydney, Australia.,Rheumatology Department, Royal North Shore Hospital, Sydney, Australia
| | - Erik A Wikstrom
- MOTION Science Institute, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Hylton B Menz
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Yvonne M Golightly
- College of Allied Health Professionals, University of Nebraska Medical Center, Omaha, NE, USA.,Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA
| | - Michelle D Smith
- The University of Queensland, School of Health and Rehabilitation Sciences: Physiotherapy, Brisbane, Australia.
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Karnik NS, Marsden J, McCluskey C, Boley RA, Bradley KA, Campbell CI, Curtis ME, Fiellin D, Ghitza U, Hefner K, Hser Y, McHugh RK, McPherson SM, Mooney LJ, Moran LM, Murphy SM, Schwartz RP, Shmueli‐Blumberg D, Shulman M, Stephens KA, Watkins KE, Weiss RD, Wu L. The opioid use disorder core outcomes set (OUD-COS) for treatment research: findings from a Delphi consensus study. Addiction 2022; 117:2438-2447. [PMID: 35293064 PMCID: PMC9543602 DOI: 10.1111/add.15875] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 02/23/2022] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND AIM There is no gold-standard and considerable heterogeneity in outcome measures used to evaluate treatments for opioid use disorder (OUD) along the opioid treatment cascade. The aim of this study was to develop the US National Institute on Drug Abuse (NIDA) National Drug Abuse Treatment Clinical Trials Network (CTN) opioid use disorder core outcomes set (OUD-COS). DESIGN Four-round, e-Delphi expert panel consensus study and plenary research group discussion and targeted consultation. SETTING United States. PARTICIPANTS A panel of 25 members including clinical practitioners, clinical researchers and administrative staff from the CTN, the network's affiliated clinical and community sites and the NIDA Centre for the CTN. MEASUREMENTS From a pool of 24 candidate items in four domains (biomedical/disease status; behaviors, symptoms and functioning; opioid treatment cascade; and morbidity and mortality), the panel completed an on-line questionnaire to rank items with defined specification on a 9-point scale for importance, with a standard 70% consensus criterion. FINDINGS After the fourth round of the questionnaire and subsequent discussion, consensus was reached for five outcomes: two patient-reported (global impression of improvement and incident non-fatal overdose); one clinician-reported (illicit/non-medical drug toxicology); and two from administrative records (duration of treatment and fatal opioid poisoning). CONCLUSIONS An e-Delphi consensus study has produced the US National Institute on Drug Abuse (NIDA) National Drug Abuse Treatment Clinical Trials Network opioid use disorder core outcomes set (version 1) for opioid use disorder treatment efficacy and effectiveness research.
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Affiliation(s)
- Niranjan S. Karnik
- Institute for Juvenile Research, Department of PsychiatryUniversity of Illinois ChicagoChicagoILUSA
| | - John Marsden
- Addictions Department, School of Academic Psychiatry, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Connor McCluskey
- Institute for Juvenile Research, Department of PsychiatryUniversity of Illinois ChicagoChicagoILUSA
| | - Randy A. Boley
- Institute for Juvenile Research, Department of PsychiatryUniversity of Illinois ChicagoChicagoILUSA
| | - Katharine A. Bradley
- Division of ResearchKaiser Permanente Washington Health Research InstituteSeattleWAUSA
| | | | - Megan E. Curtis
- Department of Psychiatry and Biobehavioral SciencesUniversity of CaliforniaLos AngelesCAUSA
| | - David Fiellin
- Yale School of Medicine, Internal MedicineProgram in Addiction MedicineNew HavenCTUSA
| | - Udi Ghitza
- National Institute on Drug Abuse, National Institutes of HealthNational Institute on Drug Abuse Center for Clinical Trials NetworkBethesdaMDUSA
| | - Kathryn Hefner
- Yale School of Medicine, Internal MedicineProgram in Addiction MedicineNew HavenCTUSA
- Emmes Company, LLCNational Institute on Drug Abuse Data and Statistics Center and Clinical Coordinating CenterRockvilleMDUSA
| | - Yih‐Ing Hser
- Department of Psychiatry and Biobehavioral SciencesUniversity of CaliforniaLos AngelesCAUSA
| | - R. Kathryn McHugh
- Division of Alcohol, Drugs and Addiction, McLean Hospital and Department of PsychiatryHarvard Medical School, McLean HospitalBelmontMAUSA
| | - Sterling M. McPherson
- Department of Community and Behavioral HealthWashington State University Elson S. Floyd College of MedicineSpokaneWAUSA
| | - Larissa J. Mooney
- Department of Psychiatry and Biobehavioral SciencesUniversity of CaliforniaLos AngelesCAUSA
| | - Landhing M. Moran
- National Institute on Drug Abuse, National Institutes of HealthNational Institute on Drug Abuse Center for Clinical Trials NetworkBethesdaMDUSA
| | - Sean M. Murphy
- Department of Population Health SciencesWeill Cornell Medical CollegeNew YorkNYUSA
| | | | - Dikla Shmueli‐Blumberg
- Emmes Company, LLCNational Institute on Drug Abuse Data and Statistics Center and Clinical Coordinating CenterRockvilleMDUSA
| | - Matisyahu Shulman
- Department of Psychiatry, Columbia University Irving Medical Center and Department of PsychiatryNew York State Psychiatric InstituteNew YorkNYUSA
| | - Kari A. Stephens
- Departments of Family Medicine, Biomedical Informatics and Medical EducationUniversity of WashingtonSeattleWAUSA
| | | | - Roger D. Weiss
- Emmes Company, LLCNational Institute on Drug Abuse Data and Statistics Center and Clinical Coordinating CenterRockvilleMDUSA
| | - Li‐Tzy Wu
- Duke University School of Medicine, Department of Psychiatry and Behavioral SciencesDuke University Medical CenterDurhamNCUSA
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Williamson PR, Barrington H, Blazeby JM, Clarke M, Gargon E, Gorst SL, Saldanha IJ, Tunis S. Review finds core outcome set uptake in new studies and systematic reviews needs improvement. J Clin Epidemiol 2022; 150:154-164. [PMID: 35779824 DOI: 10.1016/j.jclinepi.2022.06.016] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/24/2022] [Accepted: 06/24/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To review evidence about the uptake of core outcome sets (COS). A COS is an agreed standardized set of outcomes that should be measured and reported, as a minimum, in all clinical trials in a specific area of health or health care. STUDY DESIGN AND SETTING This article provides an analysis of what is known about the uptake of COS in research. Similarities between COS and outcomes recommended by stakeholders in the evidence ecosystem is reviewed, and actions taken by them to facilitate COS uptake described. RESULTS COS uptake is low in most research areas. Common facilitators relate to trialist awareness and understanding. Common barriers were not including in the development process all specialties who might use the COS, and the lack of recommendations for how to measure the outcomes. Increasingly, COS developers are considering strategies for promoting uptake earlier in the process, including actions beyond traditional dissemination approaches. Overlap between COS and outcomes in regulatory documents and health technology assessments is good. An increasing number and variety of organisations are recommending COS be considered. CONCLUSION We suggest actions for various stakeholders for improving COS uptake. Research is needed to assess the impact of these actions to identify effective evidence-based strategies.
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Affiliation(s)
- P R Williamson
- Department of Health Data Science, University of Liverpool (a member of Liverpool Health Partners), MRC/NIHR Trials Methodology Research Partnership, Liverpool, UK.
| | - H Barrington
- Department of Health Data Science, University of Liverpool (a member of Liverpool Health Partners), MRC/NIHR Trials Methodology Research Partnership, Liverpool, UK
| | - J M Blazeby
- NIHR Bristol Biomedical Research Centre at University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
| | - M Clarke
- Northern Ireland Methodology Hub, Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - E Gargon
- Department of Health Data Science, University of Liverpool (a member of Liverpool Health Partners), MRC/NIHR Trials Methodology Research Partnership, Liverpool, UK
| | - S L Gorst
- Department of Health Data Science, University of Liverpool (a member of Liverpool Health Partners), MRC/NIHR Trials Methodology Research Partnership, Liverpool, UK
| | - I J Saldanha
- Center for Evidence Synthesis in Health, Department of Health Services, Policy, and Practice (Primary), Department of Epidemiology (Secondary), Brown University School of Public Health, Providence, Rhode Island, USA
| | - S Tunis
- Center for Evaluation of Value and Risk in Health (CEVR), Tufts Medical Center, Boston Massachusetts, USA
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Zhang Y, Chen Y, Niu M, Li Y, Zhang J, Zhang L, Wu F, Chen Q, Yu H, Tian J. Establishing a core outcome set for neurogenic bladder trials: study protocol for a scoping review and Delphi surveys. Trials 2022; 23:485. [PMID: 35698096 PMCID: PMC9195205 DOI: 10.1186/s13063-022-06419-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Accepted: 05/20/2022] [Indexed: 11/23/2022] Open
Abstract
Background Neurogenic bladder (NGB) is a chronic and disabling condition with a high prevalence rate, which can cause economic burden on patients and their families and reduce the quality of life of patients. Researchers have carried out a large number of clinical trials on the effectiveness and safety of different interventions for the treatment of NGB. The published clinical trials of NGB generally suffered from inconsistent and irregular reporting of outcome indicators. To facilitate future research studies of NGB, a core outcome set (COS) is required, which helps translate the results into high-quality evidence. Methods and analysis This mixed-method project has four phases instrument: in phase 1, a scoping review of the literature to identify outcomes that have been reported in clinical trials and systematic reviews of clinical trials of interventions for NGB; in phase 2, a qualitative component using interviews to obtain the views of NGB patients, families, and their caregivers; in phase 3, Delphi survey among stakeholders to prioritize the core outcomes; and in phase 4, a face-to-face consensus meeting to discuss and agree on the final NBG COS. Conclusions We will develop a COS that should be reported in future clinical trials of NGB. Trial registration Core Outcome Measures in Effectiveness Trials (COMET) Initiative database registration: http://www.comet-initiative.org/studies/details/1985. Registered on 02 January 2022. INPLASY INPLASY202210007
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Affiliation(s)
- Yan Zhang
- Department of Spinal Cord Injury Rehabilitation, Gansu Province Hospital Rehabilitation Center, 53 Dingxi Road, Chengguan District, Lanzhou, 730000, Gansu, China
| | - Yamin Chen
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, No.199, Donggang West Road, Lanzhou City, 730000, Gansu Province, China
| | - Mingming Niu
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, No.199, Donggang West Road, Lanzhou City, 730000, Gansu Province, China
| | - Yuanyuan Li
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, No.199, Donggang West Road, Lanzhou City, 730000, Gansu Province, China
| | - Jiaoyan Zhang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, No.199, Donggang West Road, Lanzhou City, 730000, Gansu Province, China
| | - Li Zhang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, No.199, Donggang West Road, Lanzhou City, 730000, Gansu Province, China.,The Third Ward of Cardiovascular Clinical Medical Center, Affiliated Hospital of Gansu University of Chinese Medicine, Lanzhou, 730000, China
| | - Fangfang Wu
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, No.199, Donggang West Road, Lanzhou City, 730000, Gansu Province, China.,School of Nursing, Shangluo Vocational and Technical College, City, Shangluo, 726000, China
| | - Qingyun Chen
- Department of Clinical Laboratory, The Sixth People's Hospital of Chengdu City, Chengdu, 610000, Sichuan, China
| | - Huijin Yu
- Department of Spinal Cord Injury Rehabilitation, Gansu Province Hospital Rehabilitation Center, 53 Dingxi Road, Chengguan District, Lanzhou, 730000, Gansu, China.
| | - Jinhui Tian
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, No.199, Donggang West Road, Lanzhou City, 730000, Gansu Province, China. .,School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, Gansu, China. .,Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, Gansu, China.
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55
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Nasser A, Semciw A, Grimaldi A, Rio E, Pizzari T, Vicenzino B. Core outcome set development for proximal hamstring tendinopathy (COS-PHT): a study protocol. PHYSICAL THERAPY REVIEWS 2022. [DOI: 10.1080/10833196.2022.2077066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Anthony Nasser
- Department of Rehabilitation, Nutrition and Sport, La Trobe University, Melbourne, VIC, Australia
- Graduate School of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Adam Semciw
- Department of Rehabilitation, Nutrition and Sport, La Trobe University, Melbourne, VIC, Australia
- Allied Health, Northern Health, Melbourne, VIC, Australia
| | - Alison Grimaldi
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, QLD, Australia
| | - Ebonie Rio
- Department of Rehabilitation, Nutrition and Sport, La Trobe University, Melbourne, VIC, Australia
| | - Tania Pizzari
- Department of Rehabilitation, Nutrition and Sport, La Trobe University, Melbourne, VIC, Australia
| | - Bill Vicenzino
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, QLD, Australia
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Millward CP, Armstrong TS, Barrington H, Bell S, Brodbelt AR, Bulbeck H, Crofton A, Dirven L, Georgious T, Grundy PL, Islim AI, Javadpour M, Keshwara SM, Koszdin SD, Marson AG, McDermott MW, Meling TR, Oliver K, Plaha P, Preusser M, Santarius T, Srikandarajah N, Taphoorn MJB, Turner C, Watts C, Weller M, Williamson PR, Zadeh G, Zamanipoor Najafabadi AH, Jenkinson MD. Development of 'Core Outcome Sets' for Meningioma in Clinical Studies (The COSMIC Project): protocol for two systematic literature reviews, eDelphi surveys and online consensus meetings. BMJ Open 2022; 12:e057384. [PMID: 35534067 PMCID: PMC9086638 DOI: 10.1136/bmjopen-2021-057384] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Meningioma is the most common primary intracranial tumour in adults. The majority are non-malignant, but a proportion behave more aggressively. Incidental/minimally symptomatic meningioma are often managed by serial imaging. Symptomatic meningioma, those that threaten neurovascular structures, or demonstrate radiological growth, are usually resected as first-line management strategy. For patients in poor clinical condition, or with inoperable, residual or recurrent disease, radiotherapy is often used as primary or adjuvant treatment. Effective pharmacotherapy treatments do not currently exist. There is heterogeneity in the outcomes measured and reported in meningioma clinical studies. Two 'Core Outcome Sets' (COS) will be developed: (COSMIC: Intervention) for use in meningioma clinical effectiveness trials and (COSMIC: Observation) for use in clinical studies of incidental/untreated meningioma. METHODS AND ANALYSIS Two systematic literature reviews and trial registry searches will identify outcomes measured and reported in published and ongoing (1) meningioma clinical effectiveness trials, and (2) clinical studies of incidental/untreated meningioma. Outcomes include those that are clinician reported, patient reported, caregiver reported and based on objective tests (eg, neurocognitive tests), as well as measures of progression and survival. Outcomes will be deduplicated and categorised to generate two long lists. The two long lists will be prioritised through two, two-round, international, modified eDelphi surveys including patients with meningioma, healthcare professionals, researchers and those in caring/supporting roles. The two final COS will be ratified through two 1-day online consensus meetings, with representation from all stakeholder groups. ETHICS AND DISSEMINATION Institutional review board (University of Liverpool) approval was obtained for the conduct of this study. Participant eConsent will be obtained prior to participation in the eDelphi surveys and consensus meetings. The two systematic literature reviews and two final COS will be published and freely available. TRIAL REGISTRATION NUMBER COMET study ID 1508.
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Affiliation(s)
- Christopher P Millward
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
- Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Terri S Armstrong
- Neuro-Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, USA
| | | | | | - Andrew R Brodbelt
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
- Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | | | - Anna Crofton
- Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Linda Dirven
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Neurology, Haaglanden Medical Center, The Hague, The Netherlands
| | | | - Paul L Grundy
- Department of Neurosurgery, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Abdurrahman I Islim
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
- Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Mohsen Javadpour
- National Centre for Neurosurgery, Beaumont Hospital, Dublin, Ireland
| | - Sumirat M Keshwara
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
- Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Shelli D Koszdin
- Pharmacy, Veterans Affairs Healthcare System, Palo Alto, California, USA
| | - Anthony G Marson
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Michael W McDermott
- Division of Neuroscience, Florida International University, Miami, Florida, USA
| | - Torstein R Meling
- Department of Neurosurgery, Geneva University Hospitals, Geneva, Switzerland
| | - Kathy Oliver
- International Brain Tumour Alliance, Tadworth, UK
| | - Puneet Plaha
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Matthias Preusser
- Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Thomas Santarius
- Department of Neurosurgery, Addenbrooke's Hospital, Cambridge, UK
| | - Nisaharan Srikandarajah
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
- Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Martin J B Taphoorn
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Neurology, Haaglanden Medical Center, The Hague, The Netherlands
| | - Carole Turner
- Department of Neurosurgery, Addenbrooke's Hospital, Cambridge, UK
| | - Colin Watts
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Michael Weller
- Department of Neurology, University of Zurich, Zurich, Switzerland
| | | | - Gelareh Zadeh
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | | | - Michael D Jenkinson
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
- Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Liverpool, UK
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O'Malley N, Coote S, Clifford AM. Protocol for the development of a core outcome set for evaluating mixed-diagnosis falls prevention interventions for people with Multiple Sclerosis, Parkinson’s Disease and stroke. HRB Open Res 2022; 4:123. [PMID: 35633846 PMCID: PMC9123332 DOI: 10.12688/hrbopenres.13459.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2022] [Indexed: 01/07/2023] Open
Abstract
Background: Given the high incidence of falls and their associated negative effects, the development of effective falls prevention interventions for people with Multiple Sclerosis (MS), Parkinson's Disease (PD) and stroke is a priority. Currently the implementation of condition-specific falls prevention interventions is challenging in the community due to lack of participants and resources. Given the similarities in falls risk factors across stroke, PD and MS, the design of mixed-diagnosis interventions for groups comprising of people with these three neurological conditions may solve these implementation challenges. Having a core outcome set (COS) for evaluating these interventions would enable the comparison and combination of data, thereby facilitating progress in this research area. Therefore, the aim of this research study is to develop a COS for evaluating mixed-diagnosis falls prevention interventions for people with MS, PD and stroke. Methods: This will be a mixed-methods, international, multi-perspective Delphi consensus study with five stages. Stage one will involve the identification of potential outcomes through a systematic literature search, patient focus groups, and consultation with our stakeholder group. The second stage will be the development of the Delphi survey using the outcomes elicited from stage one. Stage three will be the prioritisation of outcomes using a two-round online Delphi survey involving patients, clinicians, researchers and policy-makers/service-planners. The fourth stage will be to identify and recommend outcome measures and definitions. The final stage will be a consensus meeting with representatives from each stakeholder group to agree upon the final COS. Discussion: Adoption of this COS in future trials investigating the effectiveness of mixed-diagnosis falls prevention interventions for people with MS, PD and stroke will facilitate the comparison and combination of research findings. This should translate into improved decision-making by service-planners/policy-makers and clinicians regarding the implementation of evidence-based falls prevention interventions into practice.
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Affiliation(s)
- Nicola O'Malley
- School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
- Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Susan Coote
- School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
- Centre of Physical Activity for Health, Health Research Institute, University of Limerick, Limerick, Ireland
- Multiple Sclerosis Society of Ireland, Limerick, Ireland
| | - Amanda M Clifford
- School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
- Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
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58
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O'Malley N, Coote S, Clifford AM. Protocol for the development of a core outcome set for evaluating mixed-diagnosis falls prevention interventions for people with Multiple Sclerosis, Parkinson's Disease and stroke. HRB Open Res 2022; 4:123. [PMID: 35633846 PMCID: PMC9123332 DOI: 10.12688/hrbopenres.13459.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2022] [Indexed: 11/15/2023] Open
Abstract
Background: Given the high incidence of falls and their associated negative effects, the development of effective falls prevention interventions for people with Multiple Sclerosis (MS), Parkinson's Disease (PD) and stroke is a priority. Currently the implementation of condition-specific falls prevention interventions is challenging in the community due to lack of participants and resources. Given the similarities in falls risk factors across stroke, PD and MS, the design of mixed-diagnosis interventions for groups comprising of people with these three neurological conditions may solve these implementation challenges. Having a core outcome set (COS) for evaluating these interventions would enable the comparison and combination of data, thereby facilitating progress in this research area. Therefore, the aim of this research study is to develop a COS for evaluating mixed-diagnosis falls prevention interventions for people with MS, PD and stroke. Methods: This will be a mixed-methods, international, multi-perspective Delphi consensus study with five stages. Stage one will involve the identification of potential outcomes through a systematic literature search, patient focus groups, and consultation with our stakeholder group. The second stage will be the development of the Delphi survey using the outcomes elicited from stage one. Stage three will be the prioritisation of outcomes using a two-round online Delphi survey involving patients, clinicians, researchers and policy-makers/service-planners. The fourth stage will be to identify and recommend outcome measures and definitions. The final stage will be a consensus meeting with representatives from each stakeholder group to agree upon the final COS. Discussion: Adoption of this COS in future trials investigating the effectiveness of mixed-diagnosis falls prevention interventions for people with MS, PD and stroke will facilitate the comparison and combination of research findings. This should translate into improved decision-making by service-planners/policy-makers and clinicians regarding the implementation of evidence-based falls prevention interventions into practice.
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Affiliation(s)
- Nicola O'Malley
- School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
- Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Susan Coote
- School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
- Centre of Physical Activity for Health, Health Research Institute, University of Limerick, Limerick, Ireland
- Multiple Sclerosis Society of Ireland, Limerick, Ireland
| | - Amanda M Clifford
- School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
- Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
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Ferreira NDR, Marto CMM, de Oliveira AT, Rodrigues MJ, DosSantos MF. Development of core outcome sets for clinical trials in temporomandibular disorders: A study protocol. PLoS One 2022; 17:e0267722. [PMID: 35482750 PMCID: PMC9049344 DOI: 10.1371/journal.pone.0267722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 04/13/2022] [Indexed: 12/02/2022] Open
Abstract
Background Temporomandibular Disorder (TMD) is a generic term applied to describe musculoskeletal disorders that affect the temporomandibular joint (TMJ), the masticatory muscles and the related structures. TMD comprises two groups of disorders, namely intra-articular TMD and masticatory muscle disorders. There is still difficulty in establishing the effectiveness of different therapeutic modalities for TMD with robust evidence, despite the large volume of publications in the area. The lack of outcomes standardization may represent a limiting factor in the search for scientific evidence. Objective This study aims to develop a core outcome sets (COS) for clinical trials in intra-articular TMD and masticatory muscle disorders. Methods The protocol for determining the COS-TMD will consist of three phases: 1. Synthesis of TMD Management Intervention Outcomes. The identification of outcomes will be carried out through a systematic review, which will include randomized clinical trials that evaluated the effectiveness of interventions used in TMD management. 2. Through a two-round international Delphi survey, the list of outcomes will be scored by three panels of stakeholders. 3. A representative sample of key stakeholders will be invited to participate in a face-to-face meeting where they can discuss the results of the Delphi survey and determine the final core set. Conclusions The implementation of this protocol will determine the COS-TMD, which will be made available for use in all TMD clinical studies. The use of COS when planning and reporting TMD clinical trials will reduce the risk of publication bias and enable proper comparison of results found by different studies.
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Affiliation(s)
- Natália dos Reis Ferreira
- Faculty of Medicine, Institute for Occlusion and Orofacial Pain, University of Coimbra, Coimbra, Portugal
- Postgraduate Program in Medicine (Radiology), Faculty of Medicine, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Carlos Miguel Machado Marto
- Faculty of Medicine, Institute of Experimental Pathology, University of Coimbra, Coimbra, Portugal
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), University of Coimbra, Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal
| | - Aleli Tôrres de Oliveira
- Postgraduate Program in Medicine (Radiology), Faculty of Medicine, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Maria João Rodrigues
- Faculty of Medicine, Institute for Occlusion and Orofacial Pain, University of Coimbra, Coimbra, Portugal
| | - Marcos Fabio DosSantos
- Postgraduate Program in Medicine (Radiology), Faculty of Medicine, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
- Laboratory of Mechanical Properties and Cell Biology (PropBio), Prosthodontics and Materials Sciences Department, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
- Postgraduate Program in Dentistry (PPGO), School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
- Postgraduate Program in Translational Neuroscience (PGNET), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
- * E-mail: ,
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Qiu R, Zhong C, Wan S, Zhang Y, Wei X, Li M, Hu J, Chen S, Zhao C, Chen Z, Chen J, Shang H. Developing a core outcome set for assessing clinical safety outcomes of cardiovascular diseases in clinical trials of integrated traditional Chinese medicine and Western medicine: study protocol. Trials 2022; 23:239. [PMID: 35346338 PMCID: PMC8962576 DOI: 10.1186/s13063-022-06166-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 03/10/2022] [Indexed: 11/10/2022] Open
Abstract
Background Integrative medicine is commonly used in China. Researchers prefer to report efficacy outcomes rather than safety outcomes in clinical trials; thus, evidence regarding safety in integrative medicine is unclear. Developing a core outcome set (COS) for safety outcomes is necessary. In this study, a representative example of the methodology for developing COS to assess safety outcomes of cardiovascular diseases in clinical trials investigating integrated medicine will be developed. Methods and analysis Safety information will be extracted from package inserts and through systematic reviews of treatments for cardiovascular diseases (including angina pectoris, myocardial infarction, heart failure, arrhythmia, and hypertension) to develop an extensive list of safety outcomes, which will then be categorized according to whether subjective or objective outcomes. Questionnaires for clinician-reported safety outcomes and patient-reported safety outcomes will be developed. Two rounds of the Delphi survey will then be conducted for different stakeholders (traditional Chinese medicine clinicians and researchers in cardiovascular diseases, Western medicine clinicians and researchers in cardiovascular diseases, integrated medicine clinicians and researchers of cardiovascular diseases, pharmacologists, methodologists of evidence-based medicine, and patients). After round 2 of the Delphi analysis, a face-to-face consensus meeting will be held to determine the final COS for assessing safety outcomes in cardiovascular diseases. Discussion A COS for safety outcomes in cardiovascular diseases may improve the consistency of reporting results and will help identify potential bias of selective reporting in the future. Trial registration This study was registered in the Core Outcome Measures in Effectiveness Trials database as study 1564. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06166-3.
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Affiliation(s)
- Ruijin Qiu
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Changming Zhong
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Siqi Wan
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Yao Zhang
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Xuxu Wei
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Min Li
- Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing, China
| | - Jiayuan Hu
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Shiqi Chen
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Chen Zhao
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Zhao Chen
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Jing Chen
- Baokang Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China.
| | - Hongcai Shang
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
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Zhang T, Li X, Zhao L, Zhang J, Tian J, Zhang J. Development of a Core Outcome Set in the Clinical Trials of Traditional Chinese Medicine for Stroke: A Study Protocol. Front Med (Lausanne) 2022; 9:753138. [PMID: 35308498 PMCID: PMC8927076 DOI: 10.3389/fmed.2022.753138] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 01/18/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Stroke, an acute cerebrovascular disease, is mainly caused by the sudden rupture or occlusion of blood vessels, and is subdivided into ischemic stroke and hemorrhagic stroke. It has become the second leading cause of death worldwide. In Chinese clinical practice, traditional Chinese medicine (TCM)/Integrative Medicine has been widely used for the treatment of stroke. Numerous randomized controlled trials (RCTs) of TCM/Integrative Medicine for stroke have been conducted to improve the efficacy and safety outcomes. However, their conclusions should be treated with caution because of the methodological quality defects in the clinical research. Pervasive inconsistencies are present in the outcomes collected and reported across these studies, which may lead to the pooling of discrepant data and preclude meta-analysis. The issue could be addressed by developing a core outcome set (COS). Aim The aim of this study is to develop a COS in the clinical trials of TCM/Integrative Medicine in the treatment of stroke. Method and Analysis A steering group will be set up to organize and guide the development of the COS. The study contains three phases: (I) development of an initial outcome list covering all relevant outcomes, via two steps: (i) systematic reviews of outcomes for clinical trials of TCM/ Integrative Medicine for stroke; (ii) semi-structured interviews with patients suffering from stroke; (II) conduction of three round of Delphi surveys with different stakeholder groups to prioritize important outcomes; (III) integration of outcomes into a core outcome set by a consensus meeting. Ethics and Dissemination This study has been granted by the Ethics Committee of Tianjin University of Traditional Chinese Medicine (TJUTCM-EC20210003). When the COS is completed, we will publish it in an appropriate journal to promote further widespread use. Registration This study has been registered at the Core Outcome Measures in Effectiveness Trials initiative, COMET database (Registration #1678).
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Affiliation(s)
- Ting Zhang
- Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Xuechao Li
- Clinical Research Center, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, China
| | - Liang Zhao
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China
| | - Jiaoyan Zhang
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China
| | - Jinhui Tian
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China.,Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Provinch, Lanzhou, China
| | - Junhua Zhang
- Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China
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Millward CP, Armstrong TS, Barrington H, Brodbelt AR, Bulbeck H, Byrne A, Dirven L, Gamble C, Grundy PL, Islim AI, Javadpour M, Keshwara SM, Krishna ST, Mallucci CL, Marson AG, McDermott MW, Meling TR, Oliver K, Pizer B, Plaha P, Preusser M, Santarius T, Srikandarajah N, Taphoorn MJB, Watts C, Weller M, Williamson PR, Zadeh G, Zamanipoor Najafabadi AH, Jenkinson MD. Opportunities and challenges for the development of "core outcome sets" in neuro-oncology. Neuro Oncol 2022; 24:1048-1055. [PMID: 35287168 PMCID: PMC9248398 DOI: 10.1093/neuonc/noac062] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Core Outcome Sets (COS) define minimum outcomes to be measured and reported in clinical effectiveness trials for a particular health condition/health area. Despite recognition as critical to clinical research design for other health areas, none have been developed for neuro-oncology. COS development projects should carefully consider: scope (how the COS should be used), stakeholders involved in development (including patients as both research partners and participants), and consensus methodologies used (typically a Delphi survey and consensus meeting), as well as dissemination plans. Developing COS for neuro-oncology is potentially challenging due to extensive tumor subclassification (including molecular stratification), different symptoms related to anatomical tumor location, and variation in treatment options. Development of a COS specific to tumor subtype, in a specific location, for a particular intervention may be too narrow and would be unlikely to be used. Equally, a COS that is applicable across a wider area of neuro-oncology may be too broad and therefore lack specificity. This review describes why and how a COS may be developed, and discusses challenges for their development, specific to neuro-oncology. The COS under development are briefly described, including: adult glioma, incidental/untreated meningioma, meningioma requiring intervention, and adverse events from surgical intervention for pediatric brain tumors.
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Affiliation(s)
- Christopher P Millward
- Corresponding Author: Christopher P. Millward, MRCS, MSc, MBBS, BSc, Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Lower Lane, Liverpool L9 7LJ, UK ()
| | - Terri S Armstrong
- Neuro-Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, USA
| | | | - Andrew R Brodbelt
- Institute of Systems, Molecular, & Integrative Biology, University of Liverpool, Liverpool, UK,Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | | | - Anthony Byrne
- Department of Palliative Care, Cardiff and Vale UHB, Cardiff, UK,Marie Curie Research Centre, Cardiff University, Cardiff, UK
| | - Linda Dirven
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands,Department of Neurology, Haaglanden Medical Center, The Hague, the Netherlands
| | - Carrol Gamble
- Institute of Population Health, University ofLiverpool, Liverpool, UK
| | - Paul L Grundy
- Department of Neurosurgery, University HospitalSouthampton, Southampton,UK
| | - Abdurrahman I Islim
- Institute of Systems, Molecular, & Integrative Biology, University of Liverpool, Liverpool, UK,Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Mohsen Javadpour
- National Centre for Neurosurgery, Beaumont Hospital, Dublin, Ireland
| | - Sumirat M Keshwara
- Institute of Systems, Molecular, & Integrative Biology, University of Liverpool, Liverpool, UK,Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Sandhya T Krishna
- Department of Neurosurgery. Alder Hey Children’s NHS Foundation Trust, Liverpool, UK
| | - Conor L Mallucci
- Department of Neurosurgery. Alder Hey Children’s NHS Foundation Trust, Liverpool, UK
| | - Anthony G Marson
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | | | - Torstein R Meling
- Department of Neurosurgery, Geneva University Hospital, Geneva, Switzerland
| | | | - Barry Pizer
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - Puneet Plaha
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Matthias Preusser
- Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Thomas Santarius
- Department of Neurosurgery, Addenbrooke’s Hospital & University of Cambridge, Cambridge, UK
| | - Nisaharan Srikandarajah
- Institute of Systems, Molecular, & Integrative Biology, University of Liverpool, Liverpool, UK,Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Martin J B Taphoorn
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands,Department of Neurology, Haaglanden Medical Center, The Hague, the Netherlands
| | - Colin Watts
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Michael Weller
- Department of Neurology, University Hospital and University of Zurich, Zürich, Switzerland
| | | | - Gelareh Zadeh
- Department of Surgery, University of Toronto, Toronto, Canada
| | - Amir H Zamanipoor Najafabadi
- University Neurosurgical Center Holland, Leiden University Medical Centre, Haaglanden Medical Center, Haga Teaching Hospitals, Leiden and The Hague, the Netherlands
| | - Michael D Jenkinson
- Institute of Systems, Molecular, & Integrative Biology, University of Liverpool, Liverpool, UK,Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Liverpool, UK
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Kjær MN, Granholm A, Vesterlund GK, Estrup S, Sivapalan P, Bruun CRL, Mortensen CB, Poulsen LM, Møller MH, Christensen S, Strøm T, Laerkner E, Brøchner AC, Rasmussen BS, Vestergaard SR, Barot E, Madsen MB, Egerod I, Perner A, Collet MO. Development of a core outcome set for general intensive care unit patients-A protocol. Acta Anaesthesiol Scand 2022; 66:415-424. [PMID: 34961916 DOI: 10.1111/aas.14024] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 12/19/2021] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Different outcomes are reported in randomised clinical trials (RCTs) in intensive care unit (ICU) patients, and no core outcome set (COS) is available for ICU patients in general. Accordingly, we aim to develop a COS for ICU patients in general. METHODS The COS will be developed in accordance with the Core Outcome Measures in Effectiveness Trials (COMET) Handbook, using a modified Delphi consensus process and semi-structured interviews involving adults who have survived acute admission to an ICU, family members, clinicians, researchers and other stakeholders. The modified Delphi process will include two steps. Step 1: conduction of a modified Delphi survey, developed and informed by combining the outputs of a literature search of outcomes in previous COSs and semi-structured interviews with key stakeholders. We plan at least two survey rounds to obtain consensus and refine the COS. Step 2: a consensus process regarding instruments or definitions to be recommended for the measurements of the outcomes selected in Step 1. A 'patient and public involvement panel' consisting of a smaller group of patients, family members, clinicians and researchers will be included in the development, analysis and interpretation of the COS. DISCUSSION The outlined multiple method studies will establish a COS for ICU patients in general, which may be used to increase the standardisation and comparability of results of RCTs conducted in patients in the ICU setting.
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Affiliation(s)
| | - Anders Granholm
- Department of Intensive Care Copenhagen University Hospital—Rigshospitalet Copenhagen Denmark
| | - Gitte Kingo Vesterlund
- Department of Intensive Care Copenhagen University Hospital—Rigshospitalet Copenhagen Denmark
| | - Stine Estrup
- Department of Anaesthesiology Zealand University Hospital Køge Denmark
| | - Praleene Sivapalan
- Department of Intensive Care Copenhagen University Hospital—Rigshospitalet Copenhagen Denmark
| | | | | | | | - Morten Hylander Møller
- Department of Intensive Care Copenhagen University Hospital—Rigshospitalet Copenhagen Denmark
| | | | - Thomas Strøm
- Department of Anaesthesiology and Intensive Care Odense University Hospital Odense Denmark
- Department of Anaesthesia and Critical Care Medicine Hospital Sønderjylland University Hospital of Southern Denmark Kolding Denmark
| | - Eva Laerkner
- Department of Anaesthesiology and Intensive Care Odense University Hospital Odense Denmark
| | | | - Bodil Steen Rasmussen
- Department of Anaesthesia and Intensive Care Aalborg University Hospital Aalborg Denmark
| | - Stine Rom Vestergaard
- Department of Anaesthesia and Intensive Care Aalborg University Hospital Aalborg Denmark
| | - Emily Barot
- Department of Intensive Care Copenhagen University Hospital—Rigshospitalet Copenhagen Denmark
| | - Martin Bruun Madsen
- Department of Intensive Care Copenhagen University Hospital—Rigshospitalet Copenhagen Denmark
| | - Ingrid Egerod
- Department of Intensive Care Copenhagen University Hospital—Rigshospitalet Copenhagen Denmark
| | - Anders Perner
- Department of Intensive Care Copenhagen University Hospital—Rigshospitalet Copenhagen Denmark
| | - Marie Oxenbøll Collet
- Department of Intensive Care Copenhagen University Hospital—Rigshospitalet Copenhagen Denmark
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Boehnke JR, Rana RZ, Kirkham JJ, Rose L, Agarwal G, Barbui C, Chase-Vilchez A, Churchill R, Flores-Flores O, Hurst JR, Levitt N, van Olmen J, Purgato M, Siddiqi K, Uphoff E, Vedanthan R, Wright J, Wright K, Zavala GA, Siddiqi N. Development of a core outcome set for multimorbidity trials in low/middle-income countries (COSMOS): study protocol. BMJ Open 2022; 12:e051810. [PMID: 35172996 PMCID: PMC8852662 DOI: 10.1136/bmjopen-2021-051810] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
INTRODUCTION 'Multimorbidity' describes the presence of two or more long-term conditions, which can include communicable, non-communicable diseases, and mental disorders. The rising global burden from multimorbidity is well documented, but trial evidence for effective interventions in low-/middle-income countries (LMICs) is limited. Selection of appropriate outcomes is fundamental to trial design to ensure cross-study comparability, but there is currently no agreement on a core outcome set (COS) to include in trials investigating multimorbidity specifically in LMICs. Our aim is to develop international consensus on two COSs for trials of interventions to prevent and treat multimorbidity in LMIC settings. METHODS AND ANALYSIS Following methods recommended by the Core Outcome Measures in Effectiveness Trials initiative, the development of these two COSs will occur in parallel in three stages: (1) generation of a long list of potential outcomes for inclusion; (2) two-round online Delphi surveys and (3) consensus meetings. First, to generate an initial list of outcomes, we will conduct a systematic review of multimorbidity intervention and prevention trials and interviews with people living with multimorbidity and their caregivers in LMICs. Outcomes will be classified using an outcome taxonomy. Two-round Delphi surveys will be used to elicit importance scores for these outcomes from people living with multimorbidity, caregivers, healthcare professionals, policy makers and researchers in LMICs. Finally, consensus meetings including all of these stakeholders will be held to agree outcomes for inclusion in the two COSs. ETHICS AND DISSEMINATION The study has been approved by the Research Governance Committee of the Department of Health Sciences, University of York, UK (HSRGC/2020/409/D:COSMOS). Each participating country/research group will obtain local ethics board approval. Informed consent will be obtained from all participants. We will disseminate findings through peer-reviewed open access publications, and presentations at global conferences selected to reach a wide range of LMIC stakeholders. PROSPERO REGISTATION NUMBER CRD42020197293.
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Affiliation(s)
- Jan R Boehnke
- School of Health Sciences, University of Dundee, Dundee, UK
- Department of Health Sciences, University of York, York, UK
| | - Rusham Zahra Rana
- Institute of Psychiatry, Rawalpindi Medical University, Rawalpindi, Pakistan
| | - Jamie J Kirkham
- Centre for Biostatistics, The University of Manchester, Manchester, UK
| | - Louise Rose
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Gina Agarwal
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Corrado Barbui
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
- Cochrane Global Mental Health, University of Verona, Verona, Italy
| | | | - Rachel Churchill
- Centre for Reviews and Dissemination and Cochrane Common Mental Disorders, University of York, York, UK
| | - Oscar Flores-Flores
- Facultad de Medicina Humana, Centro de Investigación del Envejecimiento (CIEN), Universidad San Martin de Porres, Lima, Peru
- Asociación Benéfica PRISMA, Lima, Peru
| | - John R Hurst
- UCL Respiratory, University College London, London, UK
| | - Naomi Levitt
- Chronic Disease Initiative for Africa and Division of Endocrinology, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Josefien van Olmen
- Department of Family Medicine and Population Health, University of Antwerp, Antwerpen, Belgium
| | - Marianna Purgato
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
- Cochrane Global Mental Health, University of Verona, Verona, Italy
| | - Kamran Siddiqi
- Department of Health Sciences, University of York, York, UK
- Hull York Medical School, York, UK
| | - Eleonora Uphoff
- Centre for Reviews and Dissemination and Cochrane Common Mental Disorders, University of York, York, UK
| | - Rajesh Vedanthan
- Department of Population Health, NYU Grossman School of Medicine, New York University, New York, New York, USA
| | - Judy Wright
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Kath Wright
- Centre for Reviews and Dissemination, University of York, York, UK
| | | | - Najma Siddiqi
- Department of Health Sciences, University of York, York, UK
- Hull York Medical School, York, UK
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Bakhbakhi D, Fraser A, Siasakos D, Hinton L, Davies A, Merriel A, Duffy JMN, Redshaw M, Lynch M, Timlin L, Flenady V, Heazell AE, Downe S, Slade P, Brookes S, Wojcieszek A, Murphy M, de Oliveira Salgado H, Pollock D, Aggarwal N, Attachie I, Leisher S, Kihusa W, Mulley K, Wimmer L, Burden C. Protocol for the development of a core outcome set for stillbirth care research (iCHOOSE Study). BMJ Open 2022; 12:e056629. [PMID: 35140161 PMCID: PMC8830254 DOI: 10.1136/bmjopen-2021-056629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Stillbirth is associated with significant physical, psychosocial and economic consequences for parents, families, wider society and the healthcare system. There is emerging momentum to design and evaluate interventions for care after stillbirth and in subsequent pregnancies. However, there is insufficient evidence to inform clinical practice compounded by inconsistent outcome reporting in research studies. To address this paucity of evidence, we plan to develop a core outcome set for stillbirth care research, through an international consensus process with key stakeholders including parents, healthcare professionals and researchers. METHODS AND ANALYSIS The development of this core outcome set will be divided into five distinct phases: (1) Identifying potential outcomes from a mixed-methods systematic review and analysis of interviews with parents who have experienced stillbirth; (2) Creating a comprehensive outcome long-list and piloting of a Delphi questionnaire using think-aloud interviews; (3) Choosing the most important outcomes by conducting an international two-round Delphi survey including high-income, middle-income and low-income countries; (4) Deciding the core outcome set by consensus meetings with key stakeholders and (5) Dissemination and promotion of the core outcome set. A parent and public involvement panel and international steering committee has been convened to coproduce every stage of the development of this core outcome set. ETHICS AND DISSEMINATION Ethical approval for the qualitative interviews has been approved by Berkshire Ethics Committee REC Reference 12/SC/0495. Ethical approval for the think-aloud interviews, Delphi survey and consensus meetings has been awarded from the University of Bristol Faculty of Health Sciences Research Ethics Committee (Reference number: 116535). The dissemination strategy is being developed with the parent and public involvement panel and steering committee. Results will be published in peer-reviewed specialty journals, shared at national and international conferences and promoted through parent organisations and charities. PROSPERO REGISTRATION NUMBER CRD42018087748.
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Affiliation(s)
- Danya Bakhbakhi
- Translational Health Sciences, University of Bristol Medical School, Bristol, UK
| | - Abigail Fraser
- Population Health Sciences, University of Bristol Medical School, Bristol, UK
| | | | - Lisa Hinton
- The Healthcare Improvement Studies Institute, University of Cambridge, Cambridge, UK
| | - Anna Davies
- Centre for Academic Child Health, University of Bristol, Bristol, UK
| | - Abi Merriel
- Population Health Sciences, University of Bristol Medical School, Bristol, UK
| | - James M N Duffy
- Obstetrics and Gynaecology Department, North Middlesex University Hospital NHS Trust, London, UK
| | | | - Mary Lynch
- Faculty of Health Sciences, University of Bristol, Bristol, UK
| | - Laura Timlin
- Women & Children's Health Department, North Bristol NHS Trust, Bristol, UK
| | - Vicki Flenady
- Centre of Research Excellence in Stillbirth, Mater Research Institute-University of Queensland, Brisbane, Queensland, Australia
| | | | - Soo Downe
- Research in Childbirth and Health, University of Central Lancashire, Preston, UK
| | - Pauline Slade
- Psychological Sciences, University of Liverpool, Liverpool, UK
| | - Sara Brookes
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Aleena Wojcieszek
- Centre of Research Excellence in Stillbirth, Mater Research Institute-University of Queensland, Brisbane, Queensland, Australia
| | - Margaret Murphy
- Nursing and Midwifery, University College Cork National University of Ireland, Cork, Ireland
| | | | - Danielle Pollock
- Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Neelam Aggarwal
- Department of Obstetrics and Gynaecology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Irene Attachie
- Department of Nursing and Midwifery, University of Health and Allied Sciences School of Public Health, Hohoe, Ghana
| | | | | | | | | | - Christy Burden
- Translational Health Sciences, University of Bristol Medical School, Bristol, UK
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Hamzeh H, Spencer S, Kelly C. Development of a core outcome set and outcome measurement set for physiotherapy trials in adults with Bronchiectasis (COS-PHyBE study): A protocol. PLoS One 2022; 17:e0263695. [PMID: 35134099 PMCID: PMC8824374 DOI: 10.1371/journal.pone.0263695] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 01/17/2022] [Indexed: 11/18/2022] Open
Abstract
Background Bronchiectasis is a chronic respiratory disease characterised by airways widening and recurrent infections, resulting in episodes of chronic cough, sputum expectoration, and dyspnoea. This leads to deterioration in daily function, repeated hospital admissions and poor quality of life. The prevalence and mortality related to bronchiectasis is increasing worldwide with growing economic burden on healthcare systems. Physiotherapy for bronchiectasis aims to decrease accumulation of sputum, dyspnoea, and improve exercise capacity and daily function. A robust evidence base to support physiotherapy in bronchiectasis is currently lacking. This is partly because of inconsistency and poor reporting of outcomes in available studies. A core outcome set is the minimum acceptable group of outcomes that should be used in clinical trials for a specific condition. This decreases research waste by improving consistency and reporting of key outcomes and facilitates the synthesis of study outcomes in systematic reviews and guidelines. The aim of the study is therefore to develop a core outcome set and outcome measurement set for physiotherapy research in adults with bronchiectasis. This will ensure outcomes important to key stakeholders are consistently used and reported in future research. Methods and analysis This project will use the COMET Initiative and COSMIN guidelines of core outcome set development and will include three phases. In the first phase, a comprehensive list of outcomes will be developed using systematic review of reported outcomes and qualitative interviews with patients and physiotherapists. Then consensus on key outcomes will be established in phase two using a Delphi survey and a consensus meeting. Finally, in phase three, we will identify appropriate instruments to measure the core outcomes by evaluating the psychometric properties of available instruments and a stakeholders’ meeting to establish consensus. Ethics The study was reviewed and has received ethical approval from the health-related Research Ethics Committee- Edge Hill University (ETH2021-0217). Registration This study is registered with the COMET database. https://www.comet-initiative.org/Studies/Details/1931. The full systematic review protocol is registered in PROSPERO under the number CRD42021266247.
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Affiliation(s)
- Hayat Hamzeh
- Faculty of Health, Social Care & Medicine, Edge Hill University, Ormskirk, United Kingdom
- * E-mail:
| | - Sally Spencer
- Faculty of Health, Social Care & Medicine, Edge Hill University, Ormskirk, United Kingdom
- Respiratory Research Centre, Edge Hill University, Ormskirk, Lancashire, United Kingdom
- Health Research Institute, Edge Hill University, Ormskirk, Lancashire, United Kingdom
| | - Carol Kelly
- Faculty of Health, Social Care & Medicine, Edge Hill University, Ormskirk, United Kingdom
- Respiratory Research Centre, Edge Hill University, Ormskirk, Lancashire, United Kingdom
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Thompson W, Teoh L, Pulcini C, Williams D, Pitkeathley C, Carter V, Sanderson S, Torres G, Walsh T. Dental antibiotic stewardship: study protocol for developing international consensus on a core outcome set. Trials 2022; 23:116. [PMID: 35120581 PMCID: PMC8817512 DOI: 10.1186/s13063-022-06038-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 01/17/2022] [Indexed: 11/18/2022] Open
Abstract
Background Antimicrobial resistance is both a global public health and patient safety problem driven by overprescribing of antibiotic and other antimicrobial drugs. To conserve the effectiveness of antibiotics for future generations, antibiotic stewardship approaches to using them only where appropriate and necessary are advocated. Dentistry accounts for about 10% of antibiotic prescriptions across global healthcare, with 80% not in accordance with guidance in some countries. Core outcome sets enable the results of studies to be compared in order to maximise the value which can be derived from them. The aim of this study is to develop an international consensus on a core outcome set for dental antibiotic stewardship. Methods Consensus on outcomes which are critical for inclusion in the core outcome set for dental antibiotic stewardship will be sought through two rounds of a Delphi survey (using the DelphiManager online system) followed by a final online consensus meeting. Thirty participants will be recruited to the Delphi Panel from across three stakeholder groups: ten dentists, ten academics and ten adults experienced with dental antibiotics as either a patient or parent/carer of a patient who has been prescribed them. Consensus will be achieved if more than 70% of the panel agree that an outcome is critical, with at least one from each stakeholder group in agreement. A long-list of candidate core outcomes has been developed from previously published studies with additions recommended by the steering group. The steering group will oversee development of the core outcome set and includes people from around the world with experience of dental antibiotics: clinicians, researchers and people with experience of being prescribed dental antibiotics and/or surviving an antibiotic resistant infection. Discussion To date, few studies of dental antibiotic stewardship have been published. Internationally, dental antibiotic guidelines and patterns of use vary widely, so a core outcome set is particularly important to facilitate meaningful comparisons between studies. This core outcome set will encompass antibiotic prescribing for both therapeutic indications, such as for people with acute infections, and for prophylactic indications, such as the prevention of distant site infections (like infective endocarditis) following dental procedures. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06038-w.
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Affiliation(s)
- Wendy Thompson
- Division of Dentistry, University of Manchester, Manchester, UK.
| | - Leanne Teoh
- Melbourne Dental School, University of Melbourne, Carlton, Victoria, Australia
| | | | - David Williams
- Institute of Dentistry, Queen Mary University of London, London, UK
| | | | | | | | | | - Tanya Walsh
- Division of Dentistry, University of Manchester, Manchester, UK
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Ibrahim SA, Kang BY, Schlessinger DI, Chiren SG, Tang JC, Kirkham JJ, Schmitt J, Poon E, Maher IA, Sobanko JF, Cartee TV, Alam M. Protocol for development of a core outcome set for clinical trials in melasma. BMJ Open 2022; 12:e046953. [PMID: 35121595 PMCID: PMC8819827 DOI: 10.1136/bmjopen-2020-046953] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION Melasma is a pigmentation disorder of the skin. Characterised by brown to gray-brown patches on the face and neck, the condition predominantly affects women and has been associated with pregnancy, hormonal variation and sun exposure. Melasma can be disfiguring and anxiety-provoking, and quality of life is often adversely impacted. Management includes sun protection, laser and energy device therapy, topical and oral skin-bleaching agents and chemical peels. While clinical trials of melasma exist, there is a lack of consistency in reported outcomes, which has been a barrier to the aggregation of data in systematic reviews and meta-analyses. This protocol describes a planned process for development of a minimum set of outcomes (ie, 'core outcome set') that should be measured in all clinical trials of melasma. METHODS AND ANALYSIS An exhaustive list of potential outcomes will be extracted from four sources: (1) systematic literature review of outcomes in clinical trials; (2) semistructured patient interviews; (3) brochures, pamphlets, clinical trial registries, and other published and unpublished sources and documentation; and (4) interviews with non-patient, non-physician stakeholders, including federal regulators, industry scientists and non-physician providers. An international two-round Delphi process will then be performed to identify the outcomes deemed most important to patients and physicians. Subsequently, a consensus meeting will be convened to review and process the results, and to vote on a final set of core outcomes. ETHICS AND DISSEMINATION Ethics approval was provided by the Northwestern University Institutional Review Board (protocol ID: STU00201637). This study is registered with both the Core Outcome Measures in Effectiveness Trials and Cochrane Skin-Core Outcome Set Initiative initiatives, and this protocol is in accordance with the guidelines for protocol development of both groups. All findings from the study described in this protocol will be disseminated to all stakeholders involved in the development process and will be submitted for publication in peer-reviewed journals. PROSPERO REGISTRATION NUMBER CRD42020214189.
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Affiliation(s)
- Sarah A Ibrahim
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Bianca Y Kang
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Daniel I Schlessinger
- Division of Dermatology, Department of Internal Medicine, Washington University in St Louis, St Louis, Missouri, USA
| | - Sarah G Chiren
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Jennifer C Tang
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Jamie J Kirkham
- Centre for Biostatistics, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Jochen Schmitt
- Centre for Evidence-Based Healthcare, Medical Faculty Carl Gustav Carus,Technical University Dresden, Dresden, Germany
| | - Emily Poon
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Ian A Maher
- Department of Dermatology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Joseph F Sobanko
- Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Division of Dermatologic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Todd V Cartee
- Department of Dermatology, Penn State Health, Hershey, Pennsylvania, USA
| | - Murad Alam
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Department of Otolaryngology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
- Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
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Bellucci C, Hughes K, Toomey E, Williamson PR, Matvienko-Sikar K. A survey of knowledge, perceptions and use of core outcome sets among clinical trialists. Trials 2021; 22:937. [PMID: 34924001 PMCID: PMC8684586 DOI: 10.1186/s13063-021-05891-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 11/28/2021] [Indexed: 12/16/2022] Open
Abstract
Background Core outcome sets (COS) are standardised sets of outcomes, which represent the minimum outcomes that should be measured and reported in clinical trials. COS can enhance comparability across health trials by reducing heterogeneity of outcome measurement and reporting and potentially minimising selective outcome reporting. Examining what researchers involved in trials know and think about COS is essential to increase awareness and promote COS uptake. The aim of this study is therefore to examine clinical trialists’ knowledge, perceptions and experiences of COS. Methods An online survey design was used. Participants were clinical trialists, operationalised for the current study as researchers named as the contact person on a trial registered on the International Standard Randomised Controlled Trial Number (ISRCTN) Trial repository between 1 January 2019 and 21 July 2020. Survey items assessed clinical trialists’ familiarity with and understanding of COS, along with experiences of COS use and development. Results Of 1913 clinical trialists contacted to participate, 62 (3%) completed the survey. Forty (65%) participants were familiar with COS and, of those familiar with COS, 21 (55%) had been involved in a trial that used a COS. Of clinical trialists who used COS in a trial(s), less than half (n = 9, 41%) reported that all COS outcomes were used. The main barriers to using COS are poor knowledge about COS (n = 43, 69%) and difficulties identifying relevant COS (n = 42, 68%). Clinical trialists also reported perceptions of COS as restrictive and often containing too many outcomes. The main enablers to using COS are clear understanding (n = 51, 82%) and perceived importance of COS (n = 44, 71%). Conclusions Enhancing clinical trialists’ use of all COS outcomes is needed to reduce outcome heterogeneity and enhance comparability across trial findings. Enhancing awareness of COS importance among researchers and funders is needed to ensure that COS are developed and used by clinical trialists. Education and training may further promote awareness and understanding of COS. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-021-05891-5.
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Affiliation(s)
- Chiara Bellucci
- School of Public Health, University College Cork, Cork, Ireland
| | - Karen Hughes
- MRC Hub for Trials Methodology Research Network, Department of Biostatistics, University of Liverpool, Liverpool, UK
| | - Elaine Toomey
- School of Allied Health, University of Limerick, Limerick, Ireland
| | - Paula R Williamson
- MRC/NIHR Trials Methodology Research Partnership, Department of Biostatistics, University of Liverpool, Liverpool, UK
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A protocol for developing a core outcome set for ectopic pregnancy. Trials 2021; 22:813. [PMID: 34789295 PMCID: PMC8596090 DOI: 10.1186/s13063-021-05772-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 10/29/2021] [Indexed: 11/23/2022] Open
Abstract
Background Randomised controlled trials (RCTs) evaluating ectopic pregnancy have reported many different outcomes, which are themselves often defined and measured in distinct ways. This level of variation results in an inability to compare results of individual RCTs. The development of a core outcome set to ensure outcomes important to key stakeholders are collected consistently will guide future research in ectopic pregnancy. Study aim To develop and implement a core outcome set to guide future research in ectopic pregnancy. Methods and analysis We have established an international steering group of key stakeholders, including healthcare professionals, researchers, and individuals with lived experience of ectopic pregnancy. We will identify potential outcomes from ectopic pregnancy from a comprehensive literature review of published randomised controlled trials. We will then utilise a modified Delphi method to prioritise outcomes. Subsequently, key stakeholders will be invited to score potential core outcomes on a nine-point Likert scale, ranging from 1 (not important) to 9 (critical). Repeated reflection and rescoring should promote whole and individual stakeholder group convergence towards consensus ‘core’ outcomes. We will also establish standardised definitions and recommend high-quality measurements for individual core outcomes. Trial registration COMET 1492. Registered in November 2019.
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Howie AH, Tingley K, Inbar-Feigenberg M, Mitchell JJ, Butcher NJ, Offringa M, Smith M, Angel K, Gentle J, Wyatt A, Campeau PM, Chan A, Chakraborty P, El Turk F, Mamak E, Mhanni A, Skidmore B, Sparkes R, Stockler S, Potter BK. Establishing a core outcome set for mucopolysaccharidoses (MPS) in children: study protocol for a rapid literature review, candidate outcomes survey, and Delphi surveys. Trials 2021; 22:816. [PMID: 34789302 PMCID: PMC8600749 DOI: 10.1186/s13063-021-05791-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 11/03/2021] [Indexed: 11/17/2022] Open
Abstract
Background Mucopolysaccharidoses (MPS) are a group of inherited metabolic diseases characterized by chronic, progressive multi-system manifestations with varying degrees of severity. Disease-modifying therapies exist to treat some types of MPS; however, they are not curative, underscoring the need to identify and evaluate co-interventions that optimize functioning, participation in preferred activities, and quality of life. A Canadian pediatric MPS registry is under development and may serve as a platform to launch randomized controlled trials to evaluate such interventions. To promote the standardized collection of patient/family-reported and clinical outcomes considered important to patients/families, health care providers (HCPs), and policymakers, the choice of outcomes to include in the registry will be informed by a core outcome set (COS). We aim to establish a patient-oriented COS for pediatric MPS using a multi-stakeholder approach. Methods In step 1 of the six-step process to develop the COS, we will identify relevant outcomes through a rapid literature review and candidate outcomes survey. A two-phase screening approach will be implemented to identify eligible publications, followed by extraction of outcomes and other pre-specified data elements. Simultaneously, we will conduct a candidate outcomes survey with children with MPS and their families to identify outcomes most important to them. In step 2, HCPs experienced in treating patients with MPS will be invited to review the list of outcomes generated in step 1 and identify additional clinically relevant outcomes. We will then ask patients/families, HCPs, and policymakers to rate the outcomes in a set of Delphi Surveys (step 3), and to participate in a subsequent consensus meeting to finalize the COS (step 4). Step 5 involves establishing a set of outcome measurement instruments for the COS. Finally, we will disseminate the COS to knowledge users (step 6). Discussion The proposed COS will inform the choice of outcomes to include in the MPS registry and, more broadly, promote the standardized collection of patient-oriented outcomes for pediatric MPS research. By involving patients/families from the earliest stage of the research, we will ensure that the COS will be relevant to those who will ultimately benefit from the research. Trial registration PROSPERO CRD42021267531, COMET Supplementary Information The online version contains supplementary material available at 10.1186/s13063-021-05791-8.
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Affiliation(s)
- Alison H Howie
- School of Epidemiology and Public Health, University of Ottawa, Room 101, 600 Peter Morand Crescent, Ottawa ON, Canada, Ottawa, ON, K1G 5Z3, Canada
| | - Kylie Tingley
- School of Epidemiology and Public Health, University of Ottawa, Room 101, 600 Peter Morand Crescent, Ottawa ON, Canada, Ottawa, ON, K1G 5Z3, Canada
| | | | | | - Nancy J Butcher
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Martin Offringa
- The Hospital for Sick Children, Toronto, ON, Canada.,Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, ON, Canada.,Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| | - Maureen Smith
- Patient Partner, Canadian Organization for Rare Disorders, Ottawa, ON, Canada
| | - Kim Angel
- Canadian MPS Society, Vancouver, BC, Canada
| | | | | | - Philippe M Campeau
- Department of Pediatrics, CHU Sainte-Justine and Université de Montréal, Montreal, QC, Canada
| | - Alicia Chan
- Department of Medical Genetics, University of Alberta, Edmonton, AB, Canada
| | - Pranesh Chakraborty
- Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.,Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada
| | - Farah El Turk
- McGill University Health Centre, Montreal, QC, Canada.,Department of Pediatrics, CHU Sainte-Justine and Université de Montréal, Montreal, QC, Canada
| | - Eva Mamak
- Department of Psychology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Aizeddin Mhanni
- Department of Pediatrics and Child Health, and Department of Biochemistry and Medical Genetics, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | | | - Rebecca Sparkes
- Department of Medical Genetics and Pediatrics, University of Calgary, Calgary, AB, Canada
| | - Sylvia Stockler
- Biochemical Diseases, BC Children's Hospital, Vancouver, BC, Canada
| | - Beth K Potter
- School of Epidemiology and Public Health, University of Ottawa, Room 101, 600 Peter Morand Crescent, Ottawa ON, Canada, Ottawa, ON, K1G 5Z3, Canada.
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The standards of obstetrics and gynecology core outcome sets: A scoping review. Integr Med Res 2021; 11:100776. [PMID: 34745879 PMCID: PMC8551850 DOI: 10.1016/j.imr.2021.100776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 09/07/2021] [Accepted: 09/09/2021] [Indexed: 11/23/2022] Open
Abstract
Background Core outcome sets (COSs) are the minimum outcomes which should be measured and reported by researchers investigating a specific condition. The definition of standards of COSs vary across different health-related areas. This investigated the characteristics of COSs regarding obstetrics and gynecology (OG) and examined the reports and designs of standards of OG COSs. Methods A comprehensive search was conduced on the COMET database on December 20, 2019 to identify systematic reviews on COSs. Two reviewers independently evaluated whether the reported OG COS met the reporting requirements as stipulated in the Core Outcome Set-STAndards for Reporting (COS-STAR) statement checklist and the minimum design recommendations as outlined in the Core Outcome Set-STAndards for Development (COS-STAD) checklist. Results Forty-four OG COSs related to 26 topics were identified. None of them met all the 25 standards of COS-STAR statement which representing 18 items considered essential for transparent and complete reporting list for all COS studies (range: 6.0-24.0, median: 14.0). The compliance rates to 16 standards of methods and result sections ranged from 27.3%–68.2%. Total COS-STAR compliance items for OG COSs with the prior protocol was significantly higher than without prior protocol (MD = 3.846, 95% CI: 0.835–6.858, P = 0.012). None of the OG COSs met all the 12 criteria in the COS-STAD minimum standards (range: 3.0-11.0, median: 5.0). The compliance rates for all three standards of stakeholders involved and all four standards of the consensus process were lower than 60%. Conclusions Methodological and reporting standards of OG COSs should be improved.
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Matvienko-Sikar K, Avery K, Blazeby JM, Devane D, Dodd S, Egan AM, Gorst SL, Hughes K, Jacobsen P, Kirkham JJ, Kottner J, Mellor K, Millward CP, Patel S, Quirke F, Saldanha IJ, Smith V, Terwee CB, Young AE, Williamson PR. Use of core outcome sets was low in clinical trials published in major medical journals. J Clin Epidemiol 2021; 142:19-28. [PMID: 34715310 DOI: 10.1016/j.jclinepi.2021.10.012] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 10/08/2021] [Accepted: 10/20/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To examine current practices in late-phase trials published in major medical journals and examine trialists' views about core outcome set (COS) use. STUDY DESIGN AND SETTING A sequential multi-methods study was conducted. We examined late-phase trials published between October 2019 and March 2020 in JAMA, NEJM, The Lancet, BMJ, and Annals of Internal Medicine. The COMET database was searched for COS potentially relevant to trials not reporting using a COS; overlap of trial and COS outcomes was examined. An online survey examined awareness of, and decisions to search for and use a COS. RESULTS Ninety-five trials were examined; 93 (98%) did not report using a COS. Relevant COS were identified for 31 trials (33%). Core outcomes were measured in 9 (23%) studies; all trials measured at least one core outcome. Thirty-one trialists (33%) completed our survey. The most common barrier to COS use was trialist's own outcome preferences and choice (68%). The most common perceived facilitator was awareness and knowledge about COS (90%). CONCLUSION COS use in this cohort of trials was low, even when relevant COS were available. Increased use of COS in clinical trials can improve evaluation of intervention effects and evidence synthesis and reduce research waste.
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Affiliation(s)
| | - Kerry Avery
- NIHR Bristol Biomedical Research Centre at University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
| | - Jane M Blazeby
- NIHR Bristol Biomedical Research Centre at University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
| | - Declan Devane
- Aras Moyola, School of Nursing and Midwifery, National University of Ireland, Galway, 26 Upper Newcastle, Galway, H91 E3YV, Ireland; Health Research Board Trials Methodology Research Network, National University of Ireland, Galway, Ireland
| | - Susanna Dodd
- Department of Health Data Science, University of Liverpool (a member of Liverpool Health Partners), MRC/NIHR Trials Methodology Research Partnership, Liverpool, UK
| | - Aoife M Egan
- Division of Endocrinology, Diabetes and Metabolism, Mayo Clinic School of Medicine, Rochester, MN, USA
| | - Sarah L Gorst
- Department of Health Data Science, University of Liverpool (a member of Liverpool Health Partners), MRC/NIHR Trials Methodology Research Partnership, Liverpool, UK
| | - Karen Hughes
- Department of Health Data Science, University of Liverpool (a member of Liverpool Health Partners), MRC/NIHR Trials Methodology Research Partnership, Liverpool, UK
| | | | - Jamie J Kirkham
- Centre for Biostatistics, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Jan Kottner
- Charité-Universitätsmedizin Berlin, Institute of Clinical Nursing Science, Berlin, Germany
| | - Katie Mellor
- Centre for Statistics in Medicine, Nuffield Department of Orthopedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Christopher P Millward
- Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Liverpool, UK; Institute of Systems, Molecular & Integrative Biology, University of Liverpool, Liverpool, UK
| | - Smitaa Patel
- Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, UK
| | - Fiona Quirke
- Health Research Board Trials Methodology Research Network, National University of Ireland, Galway, Ireland; College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - Ian J Saldanha
- Department of Health Services, Center for Evidence Synthesis in Health, Policy and Practice, and Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Valerie Smith
- School of Nursing and Midwifery, University of Dublin Trinity College, Ireland
| | - Caroline B Terwee
- Department of Epidemiology and Data Science, Amsterdam UMC, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Amber E Young
- Centre for Surgical Research, Population Health Sciences Bristol Medical School, Bristol, UK
| | - Paula R Williamson
- Department of Health Data Science, University of Liverpool (a member of Liverpool Health Partners), MRC/NIHR Trials Methodology Research Partnership, Liverpool, UK
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Lee SI, Eastwood KA, Moss N, Azcoaga-Lorenzo A, Subramanian A, Anand A, Taylor B, Nelson-Piercy C, Yau C, McCowan C, O'Reilly D, Hope H, Kennedy JI, Abel KM, Locock L, Brocklehurst P, Plachcinski R, Brophy S, Agrawal U, Thangaratinam S, Nirantharakumar K, Black M. Protocol for the development of a core outcome set for studies of pregnant women with pre-existing multimorbidity. BMJ Open 2021; 11:e044919. [PMID: 34716152 PMCID: PMC8559099 DOI: 10.1136/bmjopen-2020-044919] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Increasingly more pregnant women are living with pre-existing multimorbidity (≥two long-term physical or mental health conditions). This may adversely affect maternal and offspring outcomes. This study aims to develop a core outcome set (COS) for maternal and offspring outcomes in pregnant women with pre-existing multimorbidity. It is intended for use in observational and interventional studies in all pregnancy settings. METHODS AND ANALYSIS We propose a four stage study design: (1) systematic literature search, (2) focus groups, (3) Delphi surveys and (4) consensus group meeting. The study will be conducted from June 2021 to August 2022. First, an initial list of outcomes will be identified through a systematic literature search of reported outcomes in studies of pregnant women with multimorbidity. We will search the Cochrane library, Medline, EMBASE and CINAHL. This will be supplemented with relevant outcomes from published COS for pregnancies and childbirth in general, and multimorbidity. Second, focus groups will be conducted among (1) women with lived experience of managing pre-existing multimorbidity in pregnancy (and/or their partners) and (2) their healthcare/social care professionals to identify outcomes important to them. Third, these initial lists of outcomes will be prioritised through a three-round online Delphi survey using predefined score criteria for consensus. Participants will be invited to suggest additional outcomes that were not included in the initial list. Finally, a consensus meeting using the nominal group technique will be held to agree on the final COS. The stakeholders will include (1) women (and/or their partners) with lived experience of managing multimorbidity in pregnancy, (2) healthcare/social care professionals involved in their care and (3) researchers in this field. ETHICS AND DISSEMINATION This study has been approved by the University of Birmingham's ethical review committee. The final COS will be disseminated through peer-reviewed publication and conferences and to all stakeholders.
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Affiliation(s)
- Siang Ing Lee
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Kelly-Ann Eastwood
- Centre for Public Health, Queen's University Belfast, Belfast, UK
- St Michael's Hospital, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Ngawai Moss
- Patient and Public Representative, London, UK
| | | | | | - Astha Anand
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Beck Taylor
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | | | - Christopher Yau
- Division of Informatics, Imaging and Data Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Colin McCowan
- School of Medicine, University of St Andrews, St Andrews, UK
| | - Dermot O'Reilly
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Holly Hope
- Division of Psychology and Mental Health, Faculty of Biology Medicine and Health, Centre for Women's Mental Health, The University of Manchester, Manchester, UK
| | | | - Kathryn Mary Abel
- Division of Psychology and Mental Health, Faculty of Biology Medicine and Health, Centre for Women's Mental Health, The University of Manchester, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Louise Locock
- Health Service Research Unit, University of Aberdeen, Aberdeen, UK
| | - Peter Brocklehurst
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | | | - Sinead Brophy
- Data Science, Medical School, University of Swansea, Swansea, UK
| | - Utkarsh Agrawal
- School of Medicine, University of St Andrews, St Andrews, UK
| | - Shakila Thangaratinam
- WHO Collaborating Centre for Global Women's Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
- Department of Obstetrics and Gynaecology, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | | | - Mairead Black
- School of Medicine, Medical Science and Nutrition, University of Aberdeen, Aberdeen, UK
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McMullen CK, Sargeant JM, Kelton DF, O'Connor AM, Reedman CN, Hu D, Glanville J, Wood H, Winder CB. Relative Efficacy of Dry-Off Antimicrobial Treatments in Dairy Cattle to Cure Existing Intramammary Infections: A Systematic Review and Network Meta-Analysis. FRONTIERS IN ANIMAL SCIENCE 2021. [DOI: 10.3389/fanim.2021.726401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This systematic review and network meta-analysis aimed to estimate the relative efficacy of dry cow antimicrobial therapies, registered in Canada and/or the United States, to cure existing intramammary infections (IMI) in dairy cattle. The controlled trials examining all-cause cures of existing IMI present at dry-off were eligible. Five databases and four conference proceeding platforms were searched. The risk of bias at the level of the outcome was assessed using the Cochrane 2.0 risk of bias instrument (Cochrane, Denmark), and the overall confidence in the findings from the network meta-analysis was assessed using the Confidence in Network Meta-Analysis (CINeMA) platform. Of 3,743 articles screened for eligibility by the two independent reviewers, 58 trials were included in the Bayesian network meta-analysis for the all-cause cure of existing IMI from dry-off to calving. No antimicrobial treatment (non-active control) was associated with a decreased risk of a cure compared with all other currently labeled antimicrobials in Canada and the United States; however, lack of replication trials for some antimicrobial products created large credibility intervals and, therefore, we were unable to identify meaningful comparisons between the products. Poor reporting of trial features, heterogeneity in outcome measurements, and high risk of bias in some domains further contributed to this inability to compare antimicrobials. Continued improvement in the reporting of animal trials is required to make recommendations for antimicrobial products on the basis of efficacy.Systematic Review Registration:https://atrium.lib.uoguelph.ca/xmlui/bitstream/handle/10214/16236/Protocol_NMA_efficacy_dryoff_antibiotics_cure_IMI.pdf?sequence=3&isAllowed=y.
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Mateus T, Costa A, Viegas D, Marques A, Herdeiro MT, Rebelo S. Outcome measures frequently used to assess muscle strength in patients with myotonic dystrophy type 1: a systematic review. Neuromuscul Disord 2021; 32:99-115. [PMID: 35031191 DOI: 10.1016/j.nmd.2021.09.014] [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: 01/30/2021] [Revised: 09/29/2021] [Accepted: 09/30/2021] [Indexed: 10/20/2022]
Abstract
Measurement of muscle strength is fundamental for the management of patients with myotonic dystrophy type 1 (DM1). Nevertheless, guidance on this topic is somewhat limited due to heterogeneous outcome measures used. This systematic literature review aimed to summarize the most frequent outcome measures to assess muscle strength in patients with DM1. We searched on Pubmed, Web of Science and Embase databases. Observational studies using measures of muscle strength assessment in adult patients with DM1 were included. From a total of 80 included studies, 24 measured cardiac, 45 skeletal and 23 respiratory muscle strength. The most common method and outcome measures used to assess cardiac muscle strength were echocardiography and ejection fraction, for skeletal muscle strength were quantitative muscle test, manual muscle test and maximum isometric torque and medical research council and for respiratory muscle strength were manometry and maximal inspiratory and expiratory pressure. We successfully gathered the more consensual methods and measures to evaluate muscle strength in future clinical studies, particularly to test muscle strength response to treatments in patients with DM1. Future consensus on a set of measures to evaluate muscle strength (core outcome set), is important for these patients.
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Affiliation(s)
- Tiago Mateus
- Department of Medical Sciences, Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro 3810-193, Portugal
| | - Adriana Costa
- Department of Medical Sciences, Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro 3810-193, Portugal
| | - Diana Viegas
- Department of Medical Sciences, Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro 3810-193, Portugal
| | - Alda Marques
- Respiratory Research and Rehabilitation Laboratory - Lab3R, Institute of Biomedicine (iBiMED), School of Health Sciences (ESSUA), University of Aveiro, Aveiro, Portugal
| | - Maria Teresa Herdeiro
- Department of Medical Sciences, Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro 3810-193, Portugal
| | - Sandra Rebelo
- Department of Medical Sciences, Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro 3810-193, Portugal.
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Duncan HF, Nagendrababu V, El-Karim I, Dummer PMH. Outcome measures to assess the effectiveness of endodontic treatment for pulpitis and apical periodontitis for use in the development of European Society of Endodontology S3-level clinical practice guidelines: A consensus-based development. Int Endod J 2021; 54:2184-2194. [PMID: 34553383 DOI: 10.1111/iej.13627] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 09/03/2021] [Indexed: 12/20/2022]
Abstract
AIMS The European Society of Endodontology (ESE) is in the process of developing S3-level clinical practice guidelines for the treatment of pulpal and apical disease. In order to support robust systematic literature reviews, appropriate outcome measures (OMs) with minimum follow-up times must first be identified. Hence, the current project aimed to identify the appropriate OMs with minimum/maximum follow-up time to assess the effectiveness of endodontic treatment for pulpitis and apical periodontitis for use in the development of ESE S3-level guidelines through a standard consensus-based methodology. METHODOLOGY After a literature search, lists of relevant OMs were identified by the guideline development group (GDG) for the treatment of pulpitis (working group [WG] 1), the non-surgical treatment of apical periodontitis (WG 2), the surgical treatment of apical periodontitis (WG 3) and the regenerative treatment of apical periodontitis (WG 4). OMs relevant to each WG were ranked by the 43 members of the GDG in their importance to the patient using a 9-point Likert scale. Items with a score of 7-9 (critical importance) by more than 70% and items with a score of 1-3 (limited importance) by less than 30% of members were included, whereas the items with a score of 1-3 by more than 70% and items with a score of 7-9 by less than 30% were excluded. Several online Delphi meetings established an edited list of only important OMs. The ranked OMs were discussed by the GDG and harmonized to produce 'most critical', 'critical' and 'important' measures. After establishing the final ranked measures, the minimum and maximum length of follow-up related to each OM was defined by the guideline steering group. RESULTS The Delphi survey took place over two rounds. The patient-reported outcome measure (PROM) 'tooth survival' was rated the 'most critical measure' in all four WGs, while other PROMs including 'pain' and 'need for medication' were considered 'critical', alongside the clinician-reported outcome measures (CROM), 'radiographic assessment'. The PROMs 'The need for further intervention' and 'oral-health-related-quality-of-life' (OHRQoL) were included, but as 'important' not 'critical' measures. Differences occurred between WGs with 'vitality testing' defined as critical in WG1 and 'increased length and width of the root' defined as 'critical' in WG4. A minimum of 1-year and maximum of 'as long as possible' for all OMs were deemed necessary, except 'pain', 'swelling', 'medication' and 'OHRQoL', where shorter follow-up was accepted. CONCLUSIONS The GDG consensus process established the PROM "tooth survival" as the "most-critical". The identified OMs and length of follow-up will be applied to all the commissioned systematic reviews that will inform the subsequent process when developing the ESE S3-level clinical practice guidelines.
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Affiliation(s)
- Henry F Duncan
- Division of Restorative Dentistry & Periodontology, Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland
| | - Venkateshbabu Nagendrababu
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, UAE
| | - Ikhlas El-Karim
- School of Medicine Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Paul M H Dummer
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
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Tellum T, Naftalin J, Hirsch M, Saridogan E, Jurkovic D. A protocol for developing, disseminating, and implementing a core outcome set for adenomyosis research. Facts Views Vis Obgyn 2021; 13:203-208. [PMID: 34555874 PMCID: PMC8823268 DOI: 10.52054/fvvo.13.3.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Background Adenomyosis is a common benign gynaecological condition that has been associated with heavy and/or painful periods, subfertility and poor obstetric outcomes including miscarriage and preterm delivery. Studies evaluating treatments for adenomyosis have reported a wide range of outcomes and outcome measures. This variation in outcomes and outcome measures prevents effective data synthesis, thereby hampering the ability of meta-analyses to draw useful conclusions and inform clinical practice. Objectives Our aim is to develop a minimum set of outcomes to be reported in all future studies that investigate any uterus-sparing intervention for treating uterine adenomyosis. Wide adoption of 'core outcomes' into research on adenomyosis would reduce the heterogeneity of studies and make data synthesis easier. This will ultimately lead to comparable, prioritised, and patient-centred conclusions from meta-analyses and guidelines. Materials and Methods Outcomes identified from a systematic review of the literature will form a long list, agreed by an international steering group representing key stakeholders, including healthcare professionals, researchers, and public research partners. Through a modified Delphi process, key stakeholders will score outcomes from the agreed long list on a nine-point Likert scale that ranges from 1 (not important) to 9 (critical). Following the Delphi process, the refined outcome set will be finalised by the steering group. Finally, the steering group will develop recommendations for high-quality measures for each outcome. The study was prospectively registered with Core Outcome Measures in Effectiveness Trials Initiative; number 1649. Conclusion The implementation of the core outcome set for adenomyosis in future trials will enhance the availability of comparable data to facilitate more patient-centred evidence-based care. What is new? The core outcome set will facilitate the generation of clinically important and patient centred outcomes for studies evaluating treatments for adenomyosis.
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Hu Z, Liu X, Yang M. Evidence and Potential Mechanisms of Jin-Gui Shen-Qi Wan as a Treatment for Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis. Front Pharmacol 2021; 12:699932. [PMID: 34552482 PMCID: PMC8450514 DOI: 10.3389/fphar.2021.699932] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 07/29/2021] [Indexed: 01/08/2023] Open
Abstract
Background: Type 2 diabetes mellitus (T2DM) is a subtype of diabetes mellitus characterized by progressive dysfunction of β-cell insulin secretion and insulin resistance. Jīn-Guì Shèn-Qì Wán (JGSQW) has for many years been widely used in clinical practice as a treatment for T2DM. However, its effect remains unknown. Objectives: This study aims to summarize the clinical evidence of the effect of JGSQW on glucose and lipid metabolism in T2DM and the potential mechanisms underlying this effect. Methods: Six databases were searched without language or publication status restrictions. Data were extracted to a predefined template for synthesis. Results: Fourteen studies with 1586 participants were included in this meta-analysis. All 14 studies were judged to be at high risk of bias. JGSQW is safe for T2DM patients. Pooled results indicated that combination treatment results in a reduction in glycated hemoglobin (HbA1c) (mean difference (MD) −0.49%; 95% CI −0.67 to −0.31), fasting blood glucose (FBG) (MD −0.84; 95% CI −1.19 to −0.49), and 2-hour postprandial glucose 2hBG (MD −1.38; 95% CI −1.60 to −1.16). No significant difference in glucose metabolism was observed between JGSQW and hypoglycemic agents. The available evidence was insufficient to determine the effects on lipid metabolism. Sensitivity analyses indicated that these results were robust. Conclusion: By combining the available evidence, we found that JGSQW is safe for T2DM patients. Compared with hypoglycemic agents alone, combination treatment with JGSQW enhances the effect on glucose metabolism in patients with T2DM. We found no difference in the efficacy of JGSQW alone compared to hypoglycemic agents alone. In terms of lipid metabolism, the current evidence is insufficient and too inconsistent for us to draw firm conclusions, so further studies are needed.
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Affiliation(s)
- Zhipeng Hu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiaoke Liu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Maoyi Yang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Howarth E, Powell C, Woodman J, Walker E, Chesters H, Szilassy E, Gilbert R, Feder G. Protocol for developing core outcome sets for evaluation of psychosocial interventions for children and families with experience or at risk of child maltreatment or domestic abuse. BMJ Open 2021; 11:e044431. [PMID: 34426460 PMCID: PMC8383853 DOI: 10.1136/bmjopen-2020-044431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 07/31/2021] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Recognition that child maltreatment (CM) and domestic violence and abuse (DVA) are common and have serious and long-term adverse health consequences has resulted in policies and programmes to ensure that services respond to and safeguard children and their families. However, high-quality evidence about how services can effectively intervene is scant. The value of the current evidence base is limited partly because of the variety of outcomes and measures used in evaluative studies. One way of addressing this limitation is to develop a core outcome set (COS) which is measured and reported as a minimum standard in the context of trials and other types of evaluative research. The study described in this protocol aims to develop two discrete COSs for use in future evaluation of psychosocial interventions aimed at improving outcomes for children and families at risk or with experience of (1) CM or (2) DVA. METHODS AND ANALYSIS A two-phase mixed methods design: (1) rapid reviews of evidence, stakeholder workshops and semistructured interviews with adult survivors of CM/DVA and parents of children who have experienced CM/DVA and (2) a three panel adapted E-Delphi Study and consensus meeting. This study protocol adheres to reporting guidance for COS protocols and has been registered on the Core Outcome Measures for Effectiveness Trials (COMET) database. ETHICS AND DISSEMINATION We will disseminate our findings through peer-reviewed and open access publications, the COMET website and presentations at international conferences. We will engage with research networks, journal editors and funding agencies to promote awareness of the CM-COS and DVA-COS. We will work with advisory and survivor and public involvement groups to coproduce a range of survivor, policy and practice facing outputs.Approval for this study has been granted by the Research Ethics Committee at University College London.
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Affiliation(s)
- Emma Howarth
- School of Psychology, University of East London, London, UK
- Institute of Child Health, University College London, London, UK
| | - Claire Powell
- Institute of Child Health, University College London, London, UK
| | - Jenny Woodman
- Institute of Education, University College London, London, UK
| | - Erin Walker
- UCL Partners, University College London, London, UK
| | - Heather Chesters
- Institute of Child Health, University College London, London, UK
| | - Eszter Szilassy
- Centre for Academic Primary Care, Population Health Sciences, University of Bristol Medical School, Bristol, UK
| | - Ruth Gilbert
- Centre for Paediatric Epidemiology and Biostatistics, University College London Institute of Child Health, London, UK
| | - Gene Feder
- Community Based Medicine, University of Bristol Medical School, Bristol, UK
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de Blacam C, Baylis AL, Kirschner RE, Smith S, Sell D, Sie KCY, Harris HE, Orr DJA. Core Outcome Set for Reporting Outcomes of Interventions for Velopharyngeal Dysfunction: Final Results of the COS-VPD Initiative. Cleft Palate Craniofac J 2021; 59:S84-S96. [PMID: 34398725 DOI: 10.1177/10556656211035026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To date, the recording of outcomes of interventions for velopharyngeal dysfunction (VPD) has not been standardized. This makes a comparison of results between studies challenging. The aim of this study was to develop a core outcome set (COS) for reporting outcomes in studies examining the management of VPD. DESIGN A two-round Delphi consensus process was used to develop the COS. PATIENTS, PARTICIPANTS The expert Delphi panel comprised patients and caregivers of patients with VPD, surgeons and speech and language therapists specializing in cleft palate, and researchers with expertise in VPD. INTERVENTIONS A long list of outcomes was derived from the published literature. In each round of a Delphi survey, participants were asked to score outcomes using the Grading of Recommendations, Assessment, Development, and Evaluations scale of 1 to 9, with 1 to 3 labeled "not important," 4 to 6 labeled "important but not critical," and 7 to 9 labeled "critical." MAIN OUTCOME MEASURE Consensus criteria were specified a priori. Outcomes with a rating of 75% or more of the panel rating 7 to 9 and 25% or fewer rating 1 to 3 were included in the COS. RESULTS A total of 31 core outcomes were identified from the Delphi process. This list was condensed to combine topic areas to produce a final COS of 10 outcomes, including both processes of care and patient-reported outcomes that should be considered for reporting in future studies of VPD. CONCLUSIONS Implementation of the COS-VPD will facilitate consistency of outcomes data collection and comparison of results across studies.
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Affiliation(s)
- Catherine de Blacam
- 575349Department of Plastic Surgery, 11595Children's Health Ireland at Crumlin, Dublin, Ireland.,8863Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Adriane L Baylis
- Plastic and Reconstructive Surgery, 2650Nationwide Children's Hospital, Columbus, OH, USA.,12305The Ohio State University College of Medicine, Columbus, OH, USA
| | - Richard E Kirschner
- Plastic and Reconstructive Surgery, 2650Nationwide Children's Hospital, Columbus, OH, USA.,12305The Ohio State University College of Medicine, Columbus, OH, USA
| | - Susan Smith
- 162839Department of General Practice, 8863Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Debbie Sell
- Speech and Language Therapy, 4956Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Kathleen C Y Sie
- Pediatric Otolaryngology, 7274Seattle Children's Hospital, Seattle, Washington, USA
| | | | - David J A Orr
- 575349Department of Plastic Surgery, 11595Children's Health Ireland at Crumlin, Dublin, Ireland.,8809Trinity College Dublin, Dublin, Ireland
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Qin D, Wang Y, Levey C, Ngan P, He H, Hua F. Protocol for the development of a Core Outcome Set for trials on the prevention and treatment of Orthodontically induced enamel White Spot Lesions (COS-OWSL). Trials 2021; 22:507. [PMID: 34332635 PMCID: PMC8325281 DOI: 10.1186/s13063-021-05371-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 06/12/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Enamel white spot lesions (WSLs), characterized by an opaque, matt, and chalky white appearance of enamel, are a sign of incipient caries. WSLs are common in orthodontic practice and can affect both the oral health and dental aesthetics of patients. Extensive studies have been conducted to evaluate the effectiveness of prevention or treatment for orthodontically induced enamel WSLs. However, substantial heterogeneity has been found in the outcomes used for the prevention and treatment of WSLs in literature, which prevents researchers from comparing and combining the results of different studies to draw more decisive conclusions. Therefore, we aim to develop a Core Outcome Set for trials on the prevention and treatment of Orthodontically induced enamel White Spot Lesions (COS-OWSL). METHODS The development of COS-OWSL comprises four phases: (1) a scoping review to identify and summarize all existing outcomes that have been used in trials on the prevention or treatment of orthodontically induced WSLs; (2) qualitative interviews with orthodontic patients without (for prevention) and with WSL-affected teeth (for treatment) and relevant dental professionals to identify additional outcomes relevant to them; (3) Delphi surveys to collect opinions from key stakeholders including patients, dental professionals, and researchers and to reach a preliminary consensus; and (4) a consensus meeting to develop the final COS-OWSL. DISCUSSION The COS-OWSL will be developed to facilitate the synthesis of evidence regarding the prevention and treatment of orthodontically induced WSLs and to promote the consistent use of relevant patient-important outcomes among future studies in this field. TRIAL REGISTRATION Core Outcome Measures in Effectiveness Trials (COMET) initiative (the COS-WSL project) 1399.
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Affiliation(s)
- Danchen Qin
- Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China.,Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Luoyu Rd. 237, Wuhan, 430079, China
| | - Yunlei Wang
- Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China.,Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Luoyu Rd. 237, Wuhan, 430079, China
| | - Colin Levey
- School of Dentistry, University of Dundee, Dundee, UK
| | - Peter Ngan
- Department of Orthodontics, West Virginia University, Morgantown, USA
| | - Hong He
- Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China. .,Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Luoyu Rd. 237, Wuhan, 430079, China.
| | - Fang Hua
- Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Luoyu Rd. 237, Wuhan, 430079, China. .,Centre for Evidence-Based Stomatology, School & Hospital of Stomatology, Wuhan University, Luoyu Rd. 237, Wuhan, 430079, China. .,Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
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Holl DC, Chari A, Iorio-Morin C, Dammers R, van der Gaag NA, Kolias AG, Hutchinson PJ, Edlmann E. Study Protocol on Defining Core Outcomes and Data Elements in Chronic Subdural Haematoma. Neurosurgery 2021; 89:720-725. [PMID: 34318894 PMCID: PMC8440066 DOI: 10.1093/neuros/nyab268] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 05/09/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Core Outcome Sets (COSs) are necessary to standardize reporting in research studies. This is urgently required in the field of chronic subdural hematoma (CSDH), one of the most common disease entities managed in neurosurgery and the topic of several recent trials. To complement the development of a COS, a standardized definition and baseline Data Elements (DEs) to be collected in CSDH patients, would further improve study quality and comparability in this heterogeneous population. OBJECTIVE To, first, define a standardized COS for reporting in all future CSDH studies; and, second, to identify a unified CSDH Definition and set of DEs for reporting in future CSDH studies. METHODS The overall study design includes a Delphi survey process among 150 respondents from 2 main stakeholder groups: healthcare professionals or researchers (HCPRs) and Patients or carers. HCPR, patients and carers will all be invited to complete the survey on the COS, only the HCPR survey will include questions on definition and DE. EXPECTED OUTCOMES It is expected that the COS, definition, and DE will be developed through this Delphi survey and that these can be applied in future CSDH studies. This is necessary to help align future research studies on CSDH and to understand the effects of different treatments on patient function and recovery. DISCUSSION This Delphi survey should result in consensus on a COS and a standardized CSDH Definition and DEs to be used in future CSDH studies.
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Affiliation(s)
- Dana C Holl
- Department of Neurosurgery, Erasmus Medical Centre, Erasmus MC Stroke Centre, Rotterdam, the Netherlands
| | - Aswin Chari
- Developmental Neurosciences, Great Ormond Street Institute of Child Health, University College London, London, UK.,Department of Neurosurgery, Great Ormond Street Hospital, London, UK
| | | | - Ruben Dammers
- Department of Neurosurgery, Erasmus Medical Centre, Erasmus MC Stroke Centre, Rotterdam, the Netherlands
| | - Niels A van der Gaag
- University Neurosurgical Centre Holland (UNCH), Leiden University Medical Centre, Haaglanden Medical Centre, Haga Teaching Hospital, the Netherlands
| | - Angelos G Kolias
- Division of Neurosurgery, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.,NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
| | - Peter J Hutchinson
- Division of Neurosurgery, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.,NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
| | - Ellie Edlmann
- Department of Neurosurgery, South West Neurosurgical Centre, University Hospitals Plymouth NHS Trust, Plymouth, UK.,Faculty of Health, Peninsula Medical School, University of Plymouth, Plymouth, UK
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Ooi CP, Yusof Khan AHK, Abdul Manaf R, Mustafa N, Sukor N, Williamson PR, Kamaruddin NA. Study protocol to develop a core outcome set for thyroid dysfunction to bridge the unmet needs of patient-centred care. BMJ Open 2021; 11:e050231. [PMID: 34321306 PMCID: PMC8319993 DOI: 10.1136/bmjopen-2021-050231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 07/13/2021] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Thyroid dysfunctions (TD) are common medical conditions affecting all global populations. Improved healthcare leading to increasing survival rates and delayed diagnosis rendered significant burden of the disease in the increasing number of patients with TD with comorbid illnesses. Therefore, reducing the burden of TD and improving the quality of care are crucial. Existing poor-quality data that guide evidence-based decisions only provide a fragmented picture of clinical care. The different outcomes across studies assessing the effectiveness of treatments impede our ability to synthesise results for determining the most efficient treatments. This project aims to produce a core outcome set (COS), which embeds the multiple complex dimensions of routine clinical care for the effectiveness studies and clinical care of adult patients with TD. METHODS AND ANALYSIS This mixed-method project has two phases. In phase 1, we will identify a list of patient-reported and clinical outcomes through qualitative research and systematic reviews. In phase 2, we will categorise the identified outcomes using the Core Outcome Measures in Effectiveness Trials taxonomy of core domains and the International Classification of Functioning, Disability and Health. We will develop questionnaires from the list of outcomes identified from each domain for the two-round online Delphi exercise, aiming to reach a consensus on the COS. The Delphi process will include patients, carers, researchers and healthcare participants. We will hold an online consensus meeting involving representatives of all key stakeholders to establish the final COS. ETHICS AND DISSEMINATION The study has been reviewed and approved by the Ethics Committee for Research Involving Human Subjects, Universiti Putra Malaysia and the Research Ethics Committee, National University of Malaysia. This proposed COS in TD will improve the value of data, facilitate high-quality evidence synthesis and evidence-based decision-making. Furthermore, we will present the results to participants, in peer-reviewed academic journals and conferences. REGISTRATION DETAILS Core Outcome Measures in Effectiveness Trials (COMET) Initiative database registration: http://www.comet-initiative.org/studies/details/1371.
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Affiliation(s)
- Cheow Peng Ooi
- Endocrine Unit, Department of Medicine, Universiti Putra Malaysia Faculty of Medicine and Health Sciences, Serdang, Selangor, Malaysia
- Endocrine Unit, Department of Medicine, Pusat Perubatan Universiti Kebangsaan Malaysia, Cheras, Malaysia
| | - Abdul Hanif Khan Yusof Khan
- Department of Neurology, Universiti Putra Malaysia Faculty of Medicine and Health Sciences, Serdang, Selangor, Malaysia
| | | | - Norlaila Mustafa
- Department of Medicine, Pusat Perubatan Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Norlela Sukor
- Department of Medicine, Pusat Perubatan Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | | | - Nor Azmi Kamaruddin
- Department of Medicine, Pusat Perubatan Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
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Qiu RJ, Li M, Hu JY, Chen J, Shang HC. Methods for development of a core outcome set for clinical trials integrating traditional Chinese medicine and Western medicine. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2021; 19:389-394. [PMID: 34384714 DOI: 10.1016/j.joim.2021.07.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 06/23/2021] [Indexed: 10/20/2022]
Abstract
Clinical trial outcome reporting differs between studies integrating traditional Chinese medicine (TCM) and Western medicine, so that some clinical trials are not eligible for inclusion in a systematic review. The excluded studies are therefore less widely disseminated, and even valid studies are less likely to yield impact. This problem may be addressed by developing core outcome sets (COSs) for integrative medicine in specific healthcare areas. The first stage of development is to define the scope of the COS for integrative medicine, the second stage is to establish the need for such a COS, and the third stage is to develop a protocol and register the COS. The final stage involves three steps: (i) development of a comprehensive list of outcomes (including efficacy outcomes and safety outcomes and TCM syndromes) using systematic review, qualitative or cross-sectional research, and reviews of package inserts and medical records; (ii) merging and grouping of outcomes within domains; (iii) conducting two rounds of Delphi survey and consensus meetings with a range of stakeholders. The final COS will include a general COS and core TCM syndrome- set. Development of COSs for clinical trials of integrative medicine may help to standardize outcome reporting and reduce publication bias in the future.
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Affiliation(s)
- Rui-Jin Qiu
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China
| | - Min Li
- The Third Affiliated Hospital, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Jia-Yuan Hu
- Dermatology Department, Beijing Hospital of Traditional Chinese Medicine, Beijing 100010, China
| | - Jing Chen
- Department of Health Care, Baokang Hospital, Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China.
| | - Hong-Cai Shang
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China.
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86
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Richardson E, McEwen A, Newton-John T, Manera K, Jacobs C. The Core Outcome DEvelopment for Carrier Screening (CODECS) study: protocol for development of a core outcome set. Trials 2021; 22:480. [PMID: 34294124 PMCID: PMC8296650 DOI: 10.1186/s13063-021-05439-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 07/09/2021] [Indexed: 11/22/2022] Open
Abstract
Background Reproductive genetic carrier screening is a type of genetic testing available to those planning a pregnancy, or during their first trimester, to understand their risk of having a child with a severe genetic condition. There is a lack of consensus for ‘what to measure’ in studies on this intervention, leading to heterogeneity in choice of outcomes and methods of measurement. Such outcome heterogeneity has implications for the quality and comparability of these studies and has led to a lack of robust research evidence in the literature to inform policy and decision-making around the offer of this screening. As reproductive genetic carrier screening becomes increasingly accessible within the general population, it is timely to investigate the outcomes of this intervention. Objectives The development of a core outcome set is an established methodology to address issues with outcome heterogeneity in research. We aim to develop a core outcome set for reproductive genetic carrier screening to clarify and standardise outcomes for research and practice. Methods In accordance with guidance from the COMET (Core Outcome Measures in Effectiveness Trials) Initiative, this study will consist of five steps: (i) a systematic review of quantitative studies, using narrative synthesis to identify previously reported outcomes, their definitions, and methods of measurement; (ii) a systematic review of qualitative studies using content analysis to identify excerpts related to patient experience and perspectives that can be interpreted as outcomes; (iii) semi-structured focus groups and interviews with patients who have undertaken reproductive genetic carrier screening to identify outcomes of importance to them; (iv) Delphi survey of key stakeholders, including patients, clinicians, and researchers, to refine and prioritise the list of outcomes generated from the previous steps; and (v) a virtual consensus meeting with a purposive sample of key stakeholders to finalise the core outcome set for reporting. Discussion This protocol outlines the core outcome set development process and its novel application in the setting of genetic testing. This core outcome set will support the standardisation of outcome reporting in reproductive carrier screening research and contribute to an evolving literature on outcomes to evaluate genetic testing and genetic counselling as health interventions. COMET core outcome set registration http://www.comet-initiative.org/Studies/Details/1381.
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Affiliation(s)
- Ebony Richardson
- Graduate School of Health, University of Technology Sydney, Building 20, 100 Broadway, Chippendale, Sydney, NSW, 2008, Australia.
| | - Alison McEwen
- Graduate School of Health, University of Technology Sydney, Building 20, 100 Broadway, Chippendale, Sydney, NSW, 2008, Australia
| | - Toby Newton-John
- Graduate School of Health, University of Technology Sydney, Building 20, 100 Broadway, Chippendale, Sydney, NSW, 2008, Australia
| | - Karine Manera
- Sydney School of Public Health, The University of Sydney, Edward Ford Building, A27 Fisher Rd, Sydney, NSW, 2006, Australia
| | - Chris Jacobs
- Graduate School of Health, University of Technology Sydney, Building 20, 100 Broadway, Chippendale, Sydney, NSW, 2008, Australia
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87
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Brown V, Moodie M, Tran HNQ, Sultana M, Hunter KE, Byrne R, Zarnowiecki D, Seidler AL, Golley R, Taylor R, Hesketh KD, Matvienko-Sikar K. Protocol for the development of Core Outcome Sets for Early intervention trials to Prevent Obesity in CHildren (COS-EPOCH). BMJ Open 2021; 11:e048104. [PMID: 34301658 PMCID: PMC8728369 DOI: 10.1136/bmjopen-2020-048104] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 06/21/2021] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Childhood overweight and obesity is prevalent in the first 5 years of life, and can result in significant health and economic consequences over the lifetime. The outcomes currently measured and reported in randomised controlled trials of early childhood obesity prevention interventions to reduce this burden of obesity are heterogeneous, and measured in a variety of ways. This variability limits the comparability of findings between studies, and contributes to research waste. This protocol presents the methodology for the development of two core outcome sets (COS) for obesity prevention interventions in children aged from 1 to 5 years from a singular development process: (1) a COS for interventions targeting physical activity and sedentary behaviour and (2) a COS for interventions targeting child feeding and dietary intake. Core outcomes related to physical activity and sedentary behaviour in children aged ≤1 year will also be identified to complement an existing COS for early feeding interventions, and provide a broader set of core outcomes in this age range. This will result in a suite of COS useful for measuring and reporting outcomes in early childhood obesity prevention studies, including multicomponent interventions. METHODS AND ANALYSIS Development of the COS will follow international best practice guidelines. A scoping review of trial registries will identify commonly reported outcomes and associated measurement instruments. Key stakeholders involved in obesity prevention, including policy-makers/funders, parents, researchers, health practitioners and community and organisational stakeholders will participate in an e-Delphi study and consensus meeting regarding inclusion of outcomes in the COS. Finally, recommended outcome measure instruments will be identified through literature review and group consensus. ETHICS AND DISSEMINATION Deakin University Human Research Ethics Committee (HEAG-H 231_2020). The COS will be disseminated through peer-reviewed publications and engagement with key stakeholders.
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Affiliation(s)
- Vicki Brown
- Deakin Health Economics, Institute for Health Transformation, Global Obesity Centre (GLOBE), School of Health and Social Development, Deakin University, Geelong, Victoria, Australia
- Centre for Research Excellence in the Early Prevention of Obesity in Childhood, University of Sydney, Sydney, New South Wales, Australia
| | - Marj Moodie
- Deakin Health Economics, Institute for Health Transformation, Global Obesity Centre (GLOBE), School of Health and Social Development, Deakin University, Geelong, Victoria, Australia
- Centre for Research Excellence in the Early Prevention of Obesity in Childhood, University of Sydney, Sydney, New South Wales, Australia
| | - Huong Ngoc Quynh Tran
- Deakin Health Economics, Institute for Health Transformation, Global Obesity Centre (GLOBE), School of Health and Social Development, Deakin University, Geelong, Victoria, Australia
- Centre for Research Excellence in the Early Prevention of Obesity in Childhood, University of Sydney, Sydney, New South Wales, Australia
| | - Marufa Sultana
- Deakin Health Economics, Institute for Health Transformation, Global Obesity Centre (GLOBE), School of Health and Social Development, Deakin University, Geelong, Victoria, Australia
| | - Kylie Elizabeth Hunter
- Centre for Research Excellence in the Early Prevention of Obesity in Childhood, University of Sydney, Sydney, New South Wales, Australia
- NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Rebecca Byrne
- Centre for Research Excellence in the Early Prevention of Obesity in Childhood, University of Sydney, Sydney, New South Wales, Australia
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Dorota Zarnowiecki
- Centre for Research Excellence in the Early Prevention of Obesity in Childhood, University of Sydney, Sydney, New South Wales, Australia
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Anna Lene Seidler
- Centre for Research Excellence in the Early Prevention of Obesity in Childhood, University of Sydney, Sydney, New South Wales, Australia
- NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Rebecca Golley
- Centre for Research Excellence in the Early Prevention of Obesity in Childhood, University of Sydney, Sydney, New South Wales, Australia
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Rachael Taylor
- Centre for Research Excellence in the Early Prevention of Obesity in Childhood, University of Sydney, Sydney, New South Wales, Australia
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Kylie D Hesketh
- Centre for Research Excellence in the Early Prevention of Obesity in Childhood, University of Sydney, Sydney, New South Wales, Australia
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
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88
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Kersting C, Barzel A, Mortsiefer A. Mixed-methods approach to develop an agreed concept on patient relevance: study protocol for the 'PRO patients study'. BMJ Open 2021; 11:e047679. [PMID: 34244269 PMCID: PMC8273474 DOI: 10.1136/bmjopen-2020-047679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION With respect to patient-centred care and shared decision-making, measuring care effects based on outcomes relevant to patients is becoming increasingly important. Recently, a scoping review of the international literature revealed a wide range of supposedly patient-relevant outcomes and found that there is neither a sound definition of patient relevance nor a consistent set of outcomes relevant to patients. To close this gap, this study aims to develop an agreed concept on patient relevance including a set of outcomes relevant to patients irrespective of diseases, which grades outcomes according to their importance. METHODS AND ANALYSIS This prospective mixed-methods study will integrate the perspectives of patients across diseases, healthcare professionals and researchers. The consensus process will consist of four phases. Based on the results of the recent scoping review, a patient survey will be conducted first, followed by a multiprofessional group discussion. Finally, a two-round online Delphi approach based on data from the previous phases will be applied to agree on a concept. ETHICS AND DISSEMINATION Ethics approval for the study was granted on 26 August 2020 by the Ethics Commission of Witten/Herdecke University (reference number: 156/2020). In the long run, the implementation of an agreed concept on patient relevance will help improve the comparability of study results regarding the patient benefit and thereby strengthen the role of patients in the decision-making process. Also, the experiences regarding grading outcomes according to importance will help to develop a method on how to individualise clinical trial outcomes according to each patient's individual specifics and priorities in order to more adequately represent the patient perspective in clinical research. TRIAL REGISTRATION NUMBER Core Outcome Measures in Effectiveness Trials Initiative (registration number: 1685).
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Affiliation(s)
- Christine Kersting
- Chair of General Practice II and Patient-Centredness in Primary Care, Witten/Herdecke University, Witten, Germany
- Chair of General Practice I and Interprofessional Care, Witten/Herdecke University, Witten, Germany
| | - Anne Barzel
- Department of General Practice and Primary Care, Ulm University, Ulm, Germany
| | - Achim Mortsiefer
- Chair of General Practice II and Patient-Centredness in Primary Care, Witten/Herdecke University, Witten, Germany
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89
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Kgosidialwa O, Bogdanet D, Egan AM, O'Shea PM, Newman C, Griffin TP, McDonagh C, O'Shea C, Carmody L, Cooray SD, Anastasiou E, Wender-Ozegowska E, Clarson C, Spadola A, Alvarado F, Noctor E, Dempsey E, Napoli A, Crowther C, Galjaard S, Loeken MR, Maresh M, Gillespie P, de Valk H, Agostini A, Biesty L, Devane D, Dunne F. A core outcome set for the treatment of pregnant women with pregestational diabetes: an international consensus study. BJOG 2021; 128:1855-1868. [PMID: 34218508 PMCID: PMC9311326 DOI: 10.1111/1471-0528.16825] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2021] [Indexed: 12/21/2022]
Abstract
Objective To develop a core outcome set (COS) for randomised controlled trials (RCTs) evaluating the effectiveness of interventions for the treatment of pregnant women with pregestational diabetes mellitus (PGDM). Design A consensus developmental study. Setting International. Population Two hundred and five stakeholders completed the first round. Methods The study consisted of three components. (1) A systematic review of the literature to produce a list of outcomes reported in RCTs assessing the effectiveness of interventions for the treatment of pregnant women with PGDM. (2) A three-round, online eDelphi survey to prioritise these outcomes by international stakeholders (including healthcare professionals, researchers and women with PGDM). (3) A consensus meeting where stakeholders from each group decided on the final COS. Main outcome measures All outcomes were extracted from the literature. Results We extracted 131 unique outcomes from 67 records meeting the full inclusion criteria. Of the 205 stakeholders who completed the first round, 174/205 (85%) and 165/174 (95%) completed rounds 2 and 3, respectively. Participants at the subsequent consensus meeting chose 19 outcomes for inclusion into the COS: trimester-specific haemoglobin A1c, maternal weight gain during pregnancy, severe maternal hypoglycaemia, diabetic ketoacidosis, miscarriage, pregnancy-induced hypertension, pre-eclampsia, maternal death, birthweight, large for gestational age, small for gestational age, gestational age at birth, preterm birth, mode of birth, shoulder dystocia, neonatal hypoglycaemia, congenital malformations, stillbirth and neonatal death. Conclusions This COS will enable better comparison between RCTs to produce robust evidence synthesis, improve trial reporting and optimise research efficiency in studies assessing treatment of pregnant women with PGDM. 165 key stakeholders have developed #Treatment #CoreOutcomes in pregnant women with #diabetes existing before pregnancy.
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Affiliation(s)
- O Kgosidialwa
- College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - D Bogdanet
- College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - A M Egan
- Division of Endocrinology, Mayo Clinic, Rochester, MN, USA
| | - P M O'Shea
- College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - C Newman
- College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - T P Griffin
- College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - C McDonagh
- College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - C O'Shea
- College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - L Carmody
- College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - S D Cooray
- Diabetes and Endocrinology Units, Monash Health, Clayton, Vic., Australia.,Monash Centre for Health Research and Implementation, Monash University, Clayton, Vic., Australia
| | - E Anastasiou
- Department Diabetes & Pregnancy Outpatients, Mitera Hospital, Athens, Greece
| | - E Wender-Ozegowska
- Department of Reproduction, Poznan University of Medical Sciences, Poznan, Poland
| | - C Clarson
- Department of Paediatrics, University of Western Ontario, London, ON, Canada.,Lawson Health Research Institute, London, ON, Canada
| | - A Spadola
- Mother Infant Research Institute, Tufts Medical Center, Boston, MA, USA
| | - F Alvarado
- Mother Infant Research Institute, Tufts Medical Center, Boston, MA, USA
| | - E Noctor
- Division of Endocrinology, University Hospital Limerick, Limerick, Ireland
| | - E Dempsey
- INFANT Centre and Department of Paediatrics & Child Health, University College Cork, Cork, Ireland
| | - A Napoli
- Department of Clinical and Molecular Medicine, Sant'Andrea University Hospital, Sapienza, University of Rome, Rome, Italy
| | - C Crowther
- Liggins Institute, The University of Auckland, Auckland, New Zealand
| | - S Galjaard
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - M R Loeken
- Section of Islet Cell and Regenerative Biology, Joslin Diabetes Center, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Mja Maresh
- Department of Obstetrics, St Mary's Hospital, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - P Gillespie
- Health Economics and Policy Analysis Centre (HEPAC), National University of Ireland, Galway, Ireland
| | - H de Valk
- Department of Internal Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - A Agostini
- A.S.LViterbo Distretto A, Consultorio Montefiascone, Rome, Italy
| | - L Biesty
- School of Nursing & Midwifery, National University of Ireland Galway, Galway, Ireland
| | - D Devane
- School of Nursing & Midwifery, National University of Ireland Galway, Galway, Ireland.,HRB-Trials Methodology Research Network, National University of Ireland Galway, Galway, Ireland
| | - F Dunne
- College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
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90
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Zhang M, Chua HZ, Zhang J, Niu B, Zheng W, Li K, Zhang B. Developing a core outcome set on traditional Chinese medicine (COS-TCM) for chronic heart failure (CHF): a study protocol. BMJ Open 2021; 11:e047148. [PMID: 34215606 PMCID: PMC8256736 DOI: 10.1136/bmjopen-2020-047148] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Chronic heart failure (CHF) is a serious and advanced stage of various cardiovascular diseases and portends poor prognosis. An increase in clinical studies has reported the effectiveness of traditional Chinese medicine (TCM). For example, intravenous Chinese medicine can significantly improve cardiac function and biomarkers in patients with CHF. However, there exists inconsistency, lack of practicality and unclear reporting of outcomes in these clinical trials causing difficulty in the comparison of results across similar studies during data synthesis. A core outcome set (COS) can help in the standardisation of outcomes reported across studies from the same healthcare area. The aim of this study is to develop a COS on TCM for CHF (COS-TCM-CHF) to reduce heterogeneity in reporting and improve quality assessment in clinical trials to support data synthesis in addressing the effectiveness of TCM treatment. METHODS AND ANALYSIS This study will include constructing an outcome pool which will identify potential outcomes through systematic reviews of TCM randomised clinical trials, two clinical registry databases, semi-structured interviews of patients and the clinicians' questionnaire. According to the characteristics of TCM and a taxonomy recommended by the Core Outcome Measures in Effectiveness Trials (COMET) initiative, all outcomes in the outcome pool will be classified into different domains. A preliminary list of outcomes which will then be used in the Delphi survey is generated using a certain criteria based on the length of the pool. The Delphi survey will include two rounds with seven key stakeholder groups to select candidate items for a consensus meeting. A final COS-TCM-CHF will be developed at a face-to-face consensus meeting involving representatives from the different stakeholders. ETHICS AND DISSEMINATION Ethical approval of this study has been granted by Evidence-based Medicine Centre of Tianjin University of Traditional Chinese Medicine Research Ethics Committee (TJUTCMEC201200002). We will disseminate our research findings of the final COS on the website of Chinese Clinical Trials for Core Outcome Set, with open access publications and present at international conferences to reach a wide range of knowledge users. TRIAL REGISTRATION NUMBER http://www.comet-initiative.org/studies/details/1486.
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Affiliation(s)
- Mingyan Zhang
- Evidence-Based Medicine Centre, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Chinese Clinical Trials Core Outcome Set Research Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Hui Zi Chua
- Evidence-Based Medicine Centre, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Chinese Clinical Trials Core Outcome Set Research Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Junhua Zhang
- Evidence-Based Medicine Centre, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Chinese Clinical Trials Core Outcome Set Research Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Bohan Niu
- Evidence-Based Medicine Centre, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Chinese Clinical Trials Core Outcome Set Research Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Wenke Zheng
- Evidence-Based Medicine Centre, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Chinese Clinical Trials Core Outcome Set Research Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Kai Li
- Evidence-Based Medicine Centre, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Chinese Clinical Trials Core Outcome Set Research Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Boli Zhang
- Chinese Clinical Trials Core Outcome Set Research Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China
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91
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Veysey EC, Ingram JR, Apfelbacher CJ, Drucker AM. Core outcome set implementation supported by the BJD. Br J Dermatol 2021; 184:987-989. [PMID: 34091897 DOI: 10.1111/bjd.20050] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 03/09/2021] [Indexed: 12/17/2022]
Affiliation(s)
- E C Veysey
- Dermatology Department, St Vincent's Hospital, Melbourne, VIC, Australia
| | - J R Ingram
- Department of Dermatology and Wound Healing, Cardiff University, Cardiff, UK
| | - C J Apfelbacher
- Institute of Social Medicine and Health Systems Research, Otto von Guericke University of Magdeburg, Magdeburg, Germany
| | - A M Drucker
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, ON, Canada.,Women's College Research Institute and Department of Medicine, Women's College Hospital, Toronto, ON, Canada
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92
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McMullen CK, Sargeant JM, Kelton DF, Churchill KJ, Cousins KS, Winder CB. Modifiable management practices to improve udder health in dairy cattle during the dry period and early lactation: A scoping review. J Dairy Sci 2021; 104:10143-10157. [PMID: 34099288 DOI: 10.3168/jds.2020-19873] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 03/16/2021] [Indexed: 11/19/2022]
Abstract
The objective of this scoping review was to characterize all available literature on modifiable management practices used during the dry period that have been evaluated for their effects on udder health in dairy cattle during the dry period and the subsequent lactation. Five databases and two conference proceedings were searched for relevant literature. Articles published in or after 1990 were eligible for inclusion. Eligible interventions or exposures were restricted to modifiable management practices; however, antimicrobial and teat sealant products were enumerated but not further characterized, as systematic reviews have been published on this topic. Other modifiable management practices were reported in 229 articles. Nutrition (n = 79), which included ration formulation and delivery (n = 44) and vitamin and mineral additives (n = 35), was the most commonly reported practice, followed by vaccines (n = 40) and modification of dry period length (n = 27). Risk of clinical mastitis (CM) was the most commonly reported outcome (n = 151); however, reporting of outcome risk periods varied widely between articles. Cure of existing intramammary infections (IMI) over the dry period (n = 40) and prevention of new IMI over the dry period (n = 54) were most commonly reported with a risk period between calving and 30 d in milk. Future systematic reviews with meta-analyses could target management practices such as nutrition, vaccines, and dry period length to quantify their effects on improving udder health during the dry period and early lactation. However, the variation in reporting of time at risk for CM and other outcomes challenges the ability of future synthesis work to inform management decisions on the basis of efficacy to cure or prevent IMI and CM. Consensus on which core outcomes should be evaluated in mastitis research and the selection of consistent risk periods for specific outcomes in animal trials is imperative.
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Affiliation(s)
- Carrie K McMullen
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada, N1G 2W1
| | - Jan M Sargeant
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada, N1G 2W1
| | - David F Kelton
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada, N1G 2W1
| | - Katheryn J Churchill
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada, N1G 2W1
| | - Kineta S Cousins
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada, N1G 2W1
| | - Charlotte B Winder
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada, N1G 2W1.
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93
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MacLennan S, Williamson PR. The need for core outcome sets in urological cancer research. Transl Androl Urol 2021; 10:2832-2835. [PMID: 34295767 PMCID: PMC8261447 DOI: 10.21037/tau-20-1323] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 10/29/2020] [Indexed: 12/18/2022] Open
Affiliation(s)
- Steven MacLennan
- Academic Urology Unit, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.,European Association of Urology Guidelines Office Methodology Committee, Arnhem, The Netherlands
| | - Paula R Williamson
- MRC North West Hub for Trials Methodology Research, University of Liverpool and Liverpool Health Partners, Liverpool, UK
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94
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Bateman M, Evans JP, Vuvan V, Jones V, Watts AC, Phadnis J, Bisset L, Vicenzino B. Protocol for the development of a core outcome set for lateral elbow tendinopathy (COS-LET). Trials 2021; 22:339. [PMID: 33971941 PMCID: PMC8111763 DOI: 10.1186/s13063-021-05291-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 04/23/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Lateral elbow tendinopathy (LET) is a common condition that can cause significant disability and associated socioeconomic cost. Although it has been widely researched, outcome measures are highly variable which restricts evidence synthesis across studies. In 2019, a working group of international experts, health care professionals and patients, in the field of tendinopathy (International Scientific Tendinopathy Symposium Consensus (ICON) Group), published the results of a consensus exercise defining the nine core domains that should be measured in tendinopathy research. The aim of this study is to develop a core outcome set (COS) for LET mapping to these core domains. The primary output will provide a template for future outcome evaluation of LET. In this protocol, we detail the methodological approach to the COS-LET development. METHODS This study will employ a three-phase approach. (1) A systematic review of studies investigating LET will produce a comprehensive list of all instruments currently employed to quantify the treatment effect or outcome. (2) Instruments will be matched to the list of nine core tendinopathy outcome domains by a Steering Committee of clinicians and researchers with a specialist interest in LET resulting in a set of candidate instruments. (3) An international three-stage Delphi study will be conducted involving experienced clinicians, researchers and patients. Within this Delphi study, candidate instruments will be selected based upon screening using the Outcome Measures in Rheumatology (OMERACT) truth, feasibility and discrimination filters with a threshold of 70% agreement set for consensus. CONCLUSIONS There is currently no COS for the measurement or monitoring of LET in trials or clinical practice. The output from this project will be a minimum COS recommended for use in all future English language studies related to LET. The findings will be published in a high-quality journal and disseminated widely using professional networks, social media and via presentation at international conferences. TRIAL REGISTRATION Registered with the Core Outcome Measures in Effectiveness Trials (COMET) database, November 2019. https://www.comet-initiative.org/Studies/Details/1497 .
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Affiliation(s)
- Marcus Bateman
- Derby Shoulder Unit, Royal Derby Hospital, University Hospitals of Derby & Burton NHS Foundation Trust, Uttoxeter Road, Derby, UK.
| | - Jonathan P Evans
- Health Services and Policy Research, Smeall Building, JS03, St Lukes Campus, Exeter, UK
| | - Viana Vuvan
- School of Health and Rehabilitation Sciences: Physiotherapy, The University of Queensland, St Lucia, Brisbane, Australia
| | - Val Jones
- Sheffield Shoulder and Elbow Unit, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Adam C Watts
- Wrightington, Wigan and Leigh Teaching Hospitals NHS Foundation Trust, Wrightington Hospital, Hill Lane, Wigan, UK
| | - Joideep Phadnis
- University Hospitals Sussex NHS Foundation Trust, Royal Sussex County Hospital, Eastern Road, Brighton, UK
- Brighton & Sussex Medical School, University of Sussex, 94 N - S Rd, Falmer, Brighton, UK
| | - Leanne Bisset
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| | - Bill Vicenzino
- School of Health and Rehabilitation Sciences: Physiotherapy, The University of Queensland, St Lucia, Brisbane, Australia
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95
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Qiu R, Han S, Wei X, Zhong C, Li M, Hu J, Wang P, Zhao C, Chen J, Shang H. Development of a Core Outcome Set for the Benefits and Adverse Events of Acute Heart Failure in Clinical Trials of Traditional Chinese Medicine and Western Medicine: A Study Protocol. Front Med (Lausanne) 2021; 8:677068. [PMID: 34026800 PMCID: PMC8137966 DOI: 10.3389/fmed.2021.677068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 04/06/2021] [Indexed: 01/11/2023] Open
Abstract
Aims: To identify a minimum set of efficacy and adverse events for patients with acute heart failure (AHF) among different stakeholders in clinical trials of traditional Chinese medicine and Western medicine. Methods and Analysis: First, we will develop a preliminary long list of outcomes that includes efficacy and adverse events/reactions via three steps: (i) systematic reviews of efficacy and safety outcomes for clinical trials of AHF; (ii) drugs included in the National Medical Insurance Catalog, the National Essential Medicines Catalog, and the WHO Essential Medicines List will be collected and safety outcomes extracted from the package inserts; and (iii) patients' or caregivers' semi-structured interviews will be carried out to add new viewpoints to the list. Second, after merging outcomes and grouping them under different outcome domains, questionnaires for health professionals and patients will be separately developed. Further, two rounds of Delphi survey for health professionals and a survey for patients and the public will be carried out. Third, different stakeholders will discuss and determine the final core outcome set (COS) for AHF in a consensus meeting. Ethics and Dissemination: The entire project has been approved by the Ethics Committee of the main institution. After the final COS is developed, it will be published and discussed widely in conferences. Clinical Trial Registration: This study is registered with the Core Outcome Measures in Effectiveness Trials database as study 1566 (available at: https://www.cometinitiative.org/Studies/Details/1566).
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Affiliation(s)
- Ruijin Qiu
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China
| | - Songjie Han
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China
| | - Xuxu Wei
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China
| | - Changming Zhong
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China
| | - Min Li
- Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing, China
| | - Jiayuan Hu
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China
| | - Pengqian Wang
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China.,Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
| | - Chen Zhao
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jing Chen
- Baokang Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Hongcai Shang
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China
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96
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Treatment of Chronic Pulmonary Heart Disease with Traditional Chinese Medicine: A Protocol for the Development of a Core Outcome Set (COS-TCM-CPHD). EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:5559883. [PMID: 33953782 PMCID: PMC8057871 DOI: 10.1155/2021/5559883] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 03/12/2021] [Accepted: 03/31/2021] [Indexed: 11/18/2022]
Abstract
Background Treatment of chronic pulmonary heart disease (CPHD), a common disease, has over recent years been studied using traditional Chinese medicine (TCM) due to many high-profile benefits. These can be evaluated by the measurement and analysis of related outcomes. Because of selective reporting bias and the heterogeneity of study outcomes, it is not possible to combine similar studies in a meta-analysis. Consequently, not only does the low quality of original studies fails to support evidence-based decision-making, but also the value of those clinical studies cannot be evaluated. To solve these problems, the development of a core outcome set for traditional Chinese medicines for the treatment of chronic pulmonary heart disease (COS-TCM-CPHD) is required. Methods The development is conducted in five steps: (1) a library of outcomes through systematic review, the retrieval of libraries from two clinical trials registries, and semistructured interviews is established; (2) following data extraction and analysis of the library of outcomes, each outcome can be classified into seven outcome domains, including TCM disease, symptoms/signs, physical and chemical testing, quality of life, long-term prognosis, economic evaluation, and adverse events to form a preliminary list of outcomes; (3) stakeholder groups for participation are selected; (4) stakeholder groups are invited to participate in two rounds of Delphi surveys to score outcomes and provide additional outcomes; (5) a consensus meeting is organized to produce the final COS-TCM-CPHD. Discussion. The protocol is consistent with the guidelines defined by the Core Outcome Set-STAndardised Protocol (COS-STAP) statement and formulated with reference to Core Outcome Set-STAndards for development (COS-STAD). The COS-TCM-CPHD will improve the consistency of study reports and reduce publication bias, thereby improving the quality of TCM clinical trials and decision-making for evidence-based medicine. The study has been registered on the COMET website (http://www.comet-initiative.org/Studies/Details/1677).
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97
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Liu M, Gao Y, Yuan Y, Shi S, Yang K, Shi J, Wu J, Zhang J, Tian J. Sjogren's syndrome in clinical trials of traditional Chinese medicine: protocol for the development of a core outcome set. Trials 2021; 22:233. [PMID: 33771203 PMCID: PMC7999517 DOI: 10.1186/s13063-021-05187-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 03/11/2021] [Indexed: 12/04/2022] Open
Abstract
Background Sjogren’s syndrome (SS) is a chronic autoimmune rheumatic disease with an incidence of 0.03 to 0.3%. In recent years, there are an increasing number of randomized controlled trials of traditional Chinese medicine (TCM) for SS. However, there are generally some problems in these published clinical trials: lack of reporting primary or long-term outcomes and the heterogeneous in different clinical trials’ outcome. Our study aims to determine the priority outcomes and standard TCM syndromes for all stakeholders and reach agreement on the COS and syndromes to be measured and reported in all future TCM trials in patients with SS. Methods and analysis A phase-wise refinement approach will be used, consisting of three phases, yet complementary, sub-work phases, whereby each phase will inform the next coming phases. The following are the three phases: (I-a) identifying of a long initial list of outcomes through systematic literature review and semi-structured qualitative interviews and (I-b) identifying an initial list of TCM syndromes through (1) systematic literature review, (2) referencing ancient Chinese medical books, and (3) retrospective studies of medical records; (II) prioritization of outcomes using Delphi survey with different stakeholders, such as health professionals and patients; and (III) through consensus meetings with patients and professionals to agree on the final COS and TCM syndromes. Discussion We summarized the actions of COS into three points: direct action, indirect action, and final action. After the final COSs is completed, we will publish this research in a journal to promote communication. Trial registration Core Outcome Measures in Effectiveness Trials Initiative (COMET) number 1429. Registered on 01 December 2019. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-021-05187-8.
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Affiliation(s)
- Ming Liu
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, No.199, Donggang West Road, Chengguan District, Lanzhou City, Gansu Province, China.,Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Ya Gao
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, No.199, Donggang West Road, Chengguan District, Lanzhou City, Gansu Province, China.,Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Yuan Yuan
- Gansu University of Chinese Medicine, Lanzhou, China
| | - Shuzhen Shi
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, No.199, Donggang West Road, Chengguan District, Lanzhou City, Gansu Province, China.,Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Kelu Yang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, No.199, Donggang West Road, Chengguan District, Lanzhou City, Gansu Province, China.,Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China
| | - Jiyuan Shi
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, No.199, Donggang West Road, Chengguan District, Lanzhou City, Gansu Province, China.,Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China
| | - Jiarui Wu
- Department of Clinical Chinese Pharmacy, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, China
| | - Junhua Zhang
- Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, No.312 Anshanxi Street, Nankai District, Tianjin City, China.
| | - Jinhui Tian
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, No.199, Donggang West Road, Chengguan District, Lanzhou City, Gansu Province, China. .,Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China.
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98
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Clark E, Maguire H, Cannon P, Leung EY. The effects of physical activity, fast-mimicking diet and psychological interventions on cancer survival: A systematic review and meta-analysis of randomized controlled trials. Complement Ther Med 2021; 57:102654. [PMID: 33359756 PMCID: PMC8047871 DOI: 10.1016/j.ctim.2020.102654] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 12/16/2020] [Accepted: 12/18/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Health professionals are often asked if non-pharmacological interventions prolong life. This review aims to evaluate the effects of physical activity, fast-mimicking diet (FMD) and psychological interventions on survival in all cancers. METHODS A systematic review and meta-analysis of randomized controlled trials (RCTs). Only RCTs of physical activity, FMD and psychological interventions (including counselling, cognitive and other psychotherapies) in cancer patients that reported survival outcomes were included. DATA SOURCES CENTRAL, MEDLINE, Embase, CINAHL, APA PsycINFO, Web of Science, ICTRP and ClinicalTrials.gov from inception to January 2020 were searched without language restrictions. The protocol was prospectively registered at PROSPERO (CRD42019160944). RESULTS Thirty-one RCTs (9 on physical activity and 22 on psychological interventions) were included in the final analysis after evaluation of 60,207 records from our initial search. No eligible RCT on FMD was reported. RCTs on group psychological interventions (41.9 %) and in patients with breast cancer (38.7 %) were the most common. Most evaluated short-term interventions and in primary or adjuvant settings. Only one of 9 (11 %) RCTs on physical activity and 8 of 22 (36 %) RCTs on psychological interventions were associated with improved overall survival. Only group psychological interventions in breast cancer had adequate number of RCTs to allow a meta-analysis to be performed. It demonstrated a trend towards improved overall survival (HR -0.20, 95 %CI -0.49 to 0.10), particularly in RCTs that evaluated long-term (>6 months) therapies (HR -0.29, 95 %CI -0.59 to 0.01). CONCLUSION Longer term interventions starting early in the patients' care journey in primary and adjuvant settings have shown the most promise for improving survival. Better designed RCTs including survival outcomes are particularly needed in non-breast cancers.
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Affiliation(s)
- Emma Clark
- Institute of Infection, Immunity and Inflammation, Sir Graeme Davies Building, 120 University Place, University of Glasgow, Glasgow G12 8TA, United Kingdom
| | - Hannah Maguire
- Institute of Infection, Immunity and Inflammation, Sir Graeme Davies Building, 120 University Place, University of Glasgow, Glasgow G12 8TA, United Kingdom
| | - Paul Cannon
- University of Glasgow Library, University of Glasgow, Hillhead St, Glasgow G12 8QE, United Kingdom
| | - Elaine Yl Leung
- Institute of Infection, Immunity and Inflammation, Sir Graeme Davies Building, 120 University Place, University of Glasgow, Glasgow G12 8TA, United Kingdom; Institute of Cancer and Genomic Sciences, 6 Mindelsohn Way, Birmingham B15 2SY, United Kingdom.
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99
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Slavin V, Creedy DK, Gamble J. Core Outcome Sets Relevant to Maternity Service Users: A Scoping Review. J Midwifery Womens Health 2021; 66:185-202. [PMID: 33565682 DOI: 10.1111/jmwh.13195] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 10/27/2020] [Accepted: 10/30/2020] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Variation in outcomes reported in maternity-related clinical trials and practice stifles data synthesis and contributes to ineffective or harmful treatments and interventions. Variation can be addressed using core outcome sets (COSs), minimum agreed sets of outcomes that should be measured and reported in all clinical trials in a specific area of health or health care. This scoping review identified studies that developed maternity-related COSs; evaluated the extent, scope, quality, and consistency of outcomes across similar COSs; and identified current gaps in evidence. METHODS A multifaceted search of 2 COS registers (Core Outcome Measures in Effectiveness Trials, Core Outcomes in Women's and Newborn Health), the International Consortium for Health Outcomes Measurement website, electronic databases (MEDLINE, Embase, CINAHL), and hand search was conducted. Published, English-language studies describing maternal and neonatal COSs for any health condition and published from inception to January 2020 were included. COS development process was evaluated against recently published COS Standards for Development: scope, stakeholder involvement, and consensus process. RESULTS Thirty-two articles relating to 26 COSs were included (maternal: 18 articles that addressed 17 COSs; neonatal: 14 articles that addressed 9 COSs) and covered a range of obstetric and neonatal conditions. COSs were published between 2006 and 2020, 58% since 2017. Maternal COSs included more outcomes (median, 17; range, 50) than neonatal COSs (median, 8; range, 20). Overlap in COSs was seen for maternity care and gestational diabetes. Overlap in outcomes was seen across similar COSs, which were mostly inconsistent or poorly defined. No included COS met all minimum standards for development. Two COSs extended recommendations for how and when to measure outcomes. DISCUSSION Growth in COS development in the last 3 years signifies increasing commitment to address variation and improve data synthesis. Although the quality of the development process has improved in the last 3 years, there is a need for improvement. This article presents an urgent need to minimize overlap in outcomes and standardize outcome measurement, case definitions, and timing of measurement between COSs.
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Affiliation(s)
- Valerie Slavin
- Transforming Maternity Care Collaborative, Griffith University, Logan Campus, Meadowbrook, Australia.,Women, Newborn, and Children's Services, Gold Coast University Hospital, Southport, Australia
| | - Debra K Creedy
- Transforming Maternity Care Collaborative, Griffith University, Logan Campus, Meadowbrook, Australia
| | - Jenny Gamble
- Transforming Maternity Care Collaborative, Griffith University, Logan Campus, Meadowbrook, Australia
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100
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Quirke FA, Healy P, Bhraonáin EN, Daly M, Biesty L, Hurley T, Walker K, Meher S, Haas DM, Bloomfield FH, Kirkham JJ, Molloy EJ, Devane D. COHESION: core outcomes in neonatal encephalopathy (protocol). Trials 2021; 22:125. [PMID: 33557892 PMCID: PMC7871638 DOI: 10.1186/s13063-021-05030-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 01/06/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Neonatal encephalopathy is a complex syndrome in infants that predominantly affects the brain and other organs. The leading cause is a lack of oxygen in the blood reaching the brain. Neonatal encephalopathy can result in mortality or complications later in life, including seizures, movement disorders and cerebral palsy. Treatment options for neonatal encephalopathy are limited mainly to therapeutic hypothermia, although other potential treatments are emerging. However, evaluations of the effectiveness of treatments are challenging because of heterogeneity and inconsistency in outcomes measured and reported between trials. In this paper, we detail how we will develop a core outcome set to standardise outcomes measured and reported upon for interventions for the treatment of neonatal encephalopathy. METHODS We will systematically review the literature to identify outcomes reported previously in randomised trials and systematic reviews of randomised trials. We will identify outcomes important to parents or caregivers of infants diagnosed with and who have received treatment for neonatal encephalopathy. We will do this by conducting in person or by video teleconferencing interviews with parents or caregivers in high-income and low- to middle-income countries. Stakeholders with expertise in neonatal encephalopathy (parents/caregivers, healthcare providers and researchers) will rate the importance of identified outcomes in an online Delphi survey using either a three-round Delphi survey or a "Real-Time" Delphi survey to which stakeholders will be allocated at random. Consensus meetings will take place by video conference to allow for an international group of stakeholder representatives to discuss and vote on the outcomes to include in the final core outcome set (COS). DISCUSSION More research is needed on treatments for neonatal encephalopathy. Standardising outcomes measured and reported in evaluations of the effectiveness of interventions for the treatment of neonatal encephalopathy will improve evidence synthesis and improve results reported in systematic reviews and meta-analysis in this area. Overall, this COS will allow for improved treatments to be identified, heterogeneity in research to be reduced, and overall patient care to be enhanced. TRIAL REGISTRATION This study is registered in the Core Outcome Measures for Effectiveness (COMET) database http://www.comet-initiative.org/Studies/Details/1270 .
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Affiliation(s)
- Fiona A. Quirke
- Health Research Board Neonatal Encephalopathy PhD Training Network (NEPTuNE), Galway, Ireland
- Health Research Board – Trials Methodology Research Network (HRB-TMRN), Galway, Ireland
- College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - Patricia Healy
- College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
- School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland
| | | | - Mandy Daly
- Advocacy and Policymaking, Irish Neonatal Health Alliance, Wicklow, Ireland
| | - Linda Biesty
- College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
- School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland
- Qualitative Research in Trials Centre (QUESTS), National University of Ireland Galway, Galway, Ireland
| | - Tim Hurley
- Health Research Board Neonatal Encephalopathy PhD Training Network (NEPTuNE), Galway, Ireland
- Paediatrics and Child Health, Trinity College Dublin, Dublin, Ireland
| | - Karen Walker
- RPA Newborn Care, Sydney Local Health District, Sydney, Australia
| | - Shireen Meher
- Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham, UK
| | - David M. Haas
- Department of Obstetrics and Gynaecology, Indiana University School of Medicine, Indianapolis, USA
| | | | - Jamie J. Kirkham
- Centre for Biostatistics, University of Manchester, Manchester, UK
| | - Eleanor J. Molloy
- Paediatrics and Child Health, Trinity College Dublin, Dublin, Ireland
- Department of Neonatology, Children’s Hospital Ireland at Crumlin and Tallaght, Coombe Women and Infants University Hospital, Dublin, Ireland
| | - Declan Devane
- Health Research Board – Trials Methodology Research Network (HRB-TMRN), Galway, Ireland
- College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
- School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland
- Evidence Synthesis Ireland, National University of Ireland Galway, Galway, Ireland
- Cochrane Ireland, National University of Ireland Galway, Galway, Ireland
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