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Fang G, Yu W, Chen D, Ding X, Qiao L, Zhang L, Gao X, Yan Y, Huang Q, Ma J, Yin M. Development of a core outcome set of clinical research on the integration of traditional Chinese and Western medicine for spinal metastases: a study protocol. BMJ Open 2024; 14:e083315. [PMID: 39260838 PMCID: PMC11409365 DOI: 10.1136/bmjopen-2023-083315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/13/2024] Open
Abstract
BACKGROUND In recent years, the incidence of spinal metastasis (SM) has been increasing steadily. In response to this serious public health problem, researchers have made progress by using the integration of traditional Chinese and Western medicine. However, considerable heterogeneity in the definition and measurement of outcomes across clinical research studies, along with the lack of uniform measurement standards for study data, makes it difficult for researchers to compare different treatments. Therefore, it is crucial to accurately evaluate clinical research on the integration of traditional Chinese and Western medicine for SM. METHODS This study protocol outlines a comprehensive research programme based on the Core Outcome Set Standards Protocol Items. The study consists of four phases: a literature review, semistructured interviews, a two-round modified Delphi survey, a consensus meeting. Phase 1 involves a comprehensive literature review to extract outcomes used in current clinical studies of integrated traditional Chinese and Western medicine or Western medicine for the treatment of SM. A semistructured interview format will be used to survey patients and caregivers in phase 2 to collect suggestions from the patient perspective. Phase 3 involves a two-round modified Delphi survey to complete a prioritisation evaluation of outcomes to generate a candidate list for core outcome set (COS). Finally, phase 4 involves a face-to-face consensus meeting to review and establish the COS. ETHICS AND DISSEMINATION Conducted in response to the current dilemma of SM, the study was endorsed by the Spine Oncology Group of the Orthopaedic Surgeons Branch of the Chinese Physicians' Association. It will be developed and reported through a rigorous process, with the results of the study to be published in a peer-reviewed journal.Registration: COMET Registry: COMET 2938; https://www.comet-initiative.org/Studies/Details/2938.
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Affiliation(s)
| | - Wenlong Yu
- Department of Orthopedic, Longhua Hospital, Shanghai University of Traditional Chinese Medicinev, Shanghai, China
| | - Dingbang Chen
- Department of Orthopedic Oncology, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Xing Ding
- Department of Orthopedic, Longhua Hospital, Shanghai University of Traditional Chinese Medicinev, Shanghai, China
| | - Liang Qiao
- Department of Orthopedic, Longhua Hospital, Shanghai University of Traditional Chinese Medicinev, Shanghai, China
| | - Luosheng Zhang
- Department of Orthopedic Oncology, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Xin Gao
- Department of Orthopedic Oncology, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Yinjie Yan
- Department of Orthopedic, Longhua Hospital, Shanghai University of Traditional Chinese Medicinev, Shanghai, China
| | - Quan Huang
- Department of Orthopedic Oncology, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Junming Ma
- Department of Orthopedic, Longhua Hospital, Shanghai University of Traditional Chinese Medicinev, Shanghai, China
| | - Mengchen Yin
- Department of Orthopedic, Longhua Hospital, Shanghai University of Traditional Chinese Medicinev, Shanghai, China
- Department of Orthopedic Oncology, Changzheng Hospital, Naval Medical University, Shanghai, China
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Kowalski KL, Mistry J, Beilin A, Goodman M, Lukacs MJ, Rushton A. Physical functioning in the lumbar spinal surgery population: A systematic review and narrative synthesis of outcome measures and measurement properties of the physical measures. PLoS One 2024; 19:e0307004. [PMID: 39208263 PMCID: PMC11361614 DOI: 10.1371/journal.pone.0307004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 06/26/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND International agreement supports physical functioning as a key domain to measure interventions effectiveness for low back pain. Patient reported outcome measures (PROMs) are commonly used in the lumbar spinal surgery population but physical functioning is multidimensional and necessitates evaluation also with physical measures. OBJECTIVE 1) To identify outcome measures (PROMs and physical) used to evaluate physical functioning in the lumbar spinal surgery population. 2) To assess measurement properties and describe the feasibility and interpretability of physical measures of physical functioning in this population. STUDY DESIGN Two-staged systematic review and narrative synthesis. METHODS This systematic review was conducted according to a registered and published protocol. Two stages of searching were conducted in MEDLINE, EMBASE, Health & Psychosocial Instruments, CINAHL, Web of Science, PEDro and ProQuest Dissertations & Theses. Stage one included studies to identify physical functioning outcome measures (PROMs and physical) in the lumbar spinal surgery population. Stage two (inception to 10 July 2023) included studies assessing measurement properties of stage one physical measures. Two independent reviewers determined study eligibility, extracted data and assessed risk of bias (RoB) according to COSMIN guidelines. Measurement properties were rated according to COSMIN criteria. Level of evidence was determined using a modified GRADE approach. RESULTS Stage one included 1,101 reports using PROMs (n = 70 established in literature, n = 67 developed by study authors) and physical measures (n = 134). Stage two included 43 articles assessing measurement properties of 34 physical measures. Moderate-level evidence supported sufficient responsiveness of 1-minute stair climb and 50-foot walk tests, insufficient responsiveness of 5-minute walk and sufficient reliability of distance walked during the 6-minute walk. Very low/low-level evidence limits further understanding. CONCLUSIONS Many physical measures of physical functioning are used in lumbar spinal surgery populations. Few have investigations of measurement properties. Strongest evidence supports responsiveness of 1-minute stair climb and 50-foot walk tests and reliability of distance walked during the 6-minute walk. Further recommendations cannot be made because of very low/low-level evidence. Results highlight promise for a range of measures, but prospective, low RoB studies are required.
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Affiliation(s)
- Katie L. Kowalski
- School of Physical Therapy, Western University, London, Ontario, Canada
- Collaborative Specialization in Musculoskeletal Health Research, Bone and Joint Institute, Western University, London, Ontario, Canada
| | - Jai Mistry
- School of Physical Therapy, Western University, London, Ontario, Canada
- Physiotherapy, St George’s Hospital, London, United Kingdom
| | - Anthony Beilin
- School of Physical Therapy, Western University, London, Ontario, Canada
| | - Maren Goodman
- Western Libraries, Western University, London, Ontario, Canada
| | - Michael J. Lukacs
- School of Physical Therapy, Western University, London, Ontario, Canada
- Physiotherapy Department, London Health Sciences Centre, London, Ontario, Canada
| | - Alison Rushton
- School of Physical Therapy, Western University, London, Ontario, Canada
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Sherling N, Yilmaz M, Holm CE, Petersen MM, Fernandes L. Validity of the Musculoskeletal Tumor Society Score for lower extremity in patients with bone sarcoma or giant cell tumour of bone undergoing bone resection and reconstruction surgery in hip and knee. BMC Cancer 2024; 24:1019. [PMID: 39152389 PMCID: PMC11329989 DOI: 10.1186/s12885-024-12686-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 07/24/2024] [Indexed: 08/19/2024] Open
Abstract
BACKGROUND The Musculoskeletal Tumor Society Score (MSTS) is widely used to evaluate functioning following surgery for bone and soft-tissue sarcoma. However, concerns have been raised about its content validity due to the lack of patient involvement during item development. Additionally, literature reports inconsistent results regarding data quality and structural validity. This study aimed to evaluate content, structural and construct validity of the Danish version of the MSTS for lower extremity (MSTS-LE). METHODS The study included patients from three complete cohorts (n = 87) with bone sarcoma or giant cell tumour of bone who underwent bone resection and reconstruction surgery in hip and knee. Content validity was evaluated by linking MSTS items to frameworks of functioning, core outcome sets and semi-structured interviews. Data quality, internal consistency and factor analysis were used to assess the underlying structure of the MSTS. Construct validity was based on predefined hypotheses of correlation between the MSTS and concurrent measurements. RESULTS Content validity analysis revealed concerns regarding the MSTS. The MSTS did not sufficiently cover patient-important functions, the item Emotional acceptance could not be linked to the framework of functioning, the items Pain and Emotional acceptance pertained to domains beyond functioning and items' response options did not match items. A two-factor solution emerged, with the items Pain and Emotional acceptance loading highly on a second factor distinct from functioning. Internal consistency and construct validity showed values below accepted levels. CONCLUSION The Danish MSTS-LE demonstrated inadequate content validity, internal consistency, and construct validity. In addition, our analyses did not support unidimensionality of the MSTS. Consequently, the MSTS-LE is not a simple reflection of the construct of functioning and the interpretation of a sum score is problematic. Clinicians and researcher should exercise caution when relying solely on MSTS scores for assessing lower extremity function. Alternative outcome measurements of functioning should be considered for the evaluation of postoperative function in this patient group.
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Affiliation(s)
- Nikolai Sherling
- Department of Midwifery, Physiotherapy, Occupational Therapy, and Psychomotor Therapy, Faculty of Health, University College Copenhagen, Copenhagen, Denmark
| | - Müjgan Yilmaz
- Musculoskeletal Tumor Section, Department of Orthopedic Surgery, University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Christina Enciso Holm
- Musculoskeletal Tumor Section, Department of Orthopedic Surgery, University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Michael Mørk Petersen
- Musculoskeletal Tumor Section, Department of Orthopedic Surgery, University Hospital Rigshospitalet, Copenhagen, Denmark
- Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Linda Fernandes
- Department of Midwifery, Physiotherapy, Occupational Therapy, and Psychomotor Therapy, Faculty of Health, University College Copenhagen, Copenhagen, Denmark.
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Hill JE, Whitaker JC, Sharafi N, Hamer O, Chohan A, Harris C, Clegg A. The effectiveness and safety of heat/cold therapy in adults with lymphoedema: systematic review. Disabil Rehabil 2024; 46:2184-2195. [PMID: 37431170 PMCID: PMC11147455 DOI: 10.1080/09638288.2023.2231842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 06/27/2023] [Indexed: 07/12/2023]
Abstract
PURPOSE The aim of this review is to assess the efficacy and safety of using heat and cold therapy for adults with lymphoedema. METHODS A multi-database search was undertaken. Only studies which included adults with lymphoedema who were treated with heat or cold therapy reporting any outcome were included. Screening, data extraction, and assessment of bias were undertaken by a single reviewer and verified by a second. Due to the substantial heterogeneity, a descriptive synthesis was undertaken. RESULTS Eighteen studies were included. All nine studies which assessed the effects of heat-therapy on changes in limb circumference reported a point estimate indicating some reduction from baseline to end of study. Similarly, the five studies evaluating the use of heat-therapy on limb volume demonstrated a reduction in limb volume from baseline to end-of-study. Only four studies reported adverse events of which all were deemed to be minor. Only two studies explored the effects of cold therapy on lymphoedema. CONCLUSIONS Tentative evidence suggests heat-therapy may have some benefit in treating lymphoedema with minimal side effects. However, further high-quality randomised controlled trials are required, with a particular focus on moderating factors and assessment of adverse events.Implications for rehabilitationThis review highlights the potential benefit that heat therapy may have on reducing limb circumference and volume for adults with lymphoedema.There was no evidence that controlled localised heat therapy was unsafe.The current evidence-base is at a point where no specific clinical recommendations can be made.The use of heat therapy should only be applied as part of a methodologically robust study to treat lymphoedema.
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Affiliation(s)
- J. E. Hill
- Synthesis, Economic Evaluation and Decision Science (SEEDS) Group, University of Central Lancashire, Preston, UK
| | - J. C. Whitaker
- Allied Health Research Unit, University of Central Lancashire, Preston, UK
| | - N. Sharafi
- Allied Health Research Unit, University of Central Lancashire, Preston, UK
| | - O. Hamer
- Synthesis, Economic Evaluation and Decision Science (SEEDS) Group, University of Central Lancashire, Preston, UK
| | - A. Chohan
- Allied Health Research Unit, University of Central Lancashire, Preston, UK
| | - C. Harris
- Synthesis, Economic Evaluation and Decision Science (SEEDS) Group, University of Central Lancashire, Preston, UK
| | - A. Clegg
- Synthesis, Economic Evaluation and Decision Science (SEEDS) Group, University of Central Lancashire, Preston, UK
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Innes K, Ahmed I, Hudson J, Hernández R, Gillies K, Bruce R, Bell V, Avenell A, Blazeby J, Brazzelli M, Cotton S, Croal B, Forrest M, MacLennan G, Murchie P, Wileman S, Ramsay C. Laparoscopic cholecystectomy versus conservative management for adults with uncomplicated symptomatic gallstones: the C-GALL RCT. Health Technol Assess 2024; 28:1-151. [PMID: 38943314 PMCID: PMC11228691 DOI: 10.3310/mnby3104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2024] Open
Abstract
Background Gallstone disease is a common gastrointestinal disorder in industrialised societies. The prevalence of gallstones in the adult population is estimated to be approximately 10-15%, and around 80% remain asymptomatic. At present, cholecystectomy is the default option for people with symptomatic gallstone disease. Objectives To assess the clinical and cost-effectiveness of observation/conservative management compared with laparoscopic cholecystectomy for preventing recurrent symptoms and complications in adults presenting with uncomplicated symptomatic gallstones in secondary care. Design Parallel group, multicentre patient randomised superiority pragmatic trial with up to 24 months follow-up and embedded qualitative research. Within-trial cost-utility and 10-year Markov model analyses. Development of a core outcome set for uncomplicated symptomatic gallstone disease. Setting Secondary care elective settings. Participants Adults with symptomatic uncomplicated gallstone disease referred to a secondary care setting were considered for inclusion. Interventions Participants were randomised 1: 1 at clinic to receive either laparoscopic cholecystectomy or observation/conservative management. Main outcome measures The primary outcome was quality of life measured by area under the curve over 18 months using the Short Form-36 bodily pain domain. Secondary outcomes included the Otago gallstones' condition-specific questionnaire, Short Form-36 domains (excluding bodily pain), area under the curve over 24 months for Short Form-36 bodily pain domain, persistent symptoms, complications and need for further treatment. No outcomes were blinded to allocation. Results Between August 2016 and November 2019, 434 participants were randomised (217 in each group) from 20 United Kingdom centres. By 24 months, 64 (29.5%) in the observation/conservative management group and 153 (70.5%) in the laparoscopic cholecystectomy group had received surgery, median time to surgery of 9.0 months (interquartile range, 5.6-15.0) and 4.7 months (interquartile range 2.6-7.9), respectively. At 18 months, the mean Short Form-36 norm-based bodily pain score was 49.4 (standard deviation 11.7) in the observation/conservative management group and 50.4 (standard deviation 11.6) in the laparoscopic cholecystectomy group. The mean area under the curve over 18 months was 46.8 for both groups with no difference: mean difference -0.0, 95% confidence interval (-1.7 to 1.7); p-value 0.996; n = 203 observation/conservative, n = 205 cholecystectomy. There was no evidence of differences in quality of life, complications or need for further treatment at up to 24 months follow-up. Condition-specific quality of life at 24 months favoured cholecystectomy: mean difference 9.0, 95% confidence interval (4.1 to 14.0), p < 0.001 with a similar pattern for the persistent symptoms score. Within-trial cost-utility analysis found observation/conservative management over 24 months was less costly than cholecystectomy (mean difference -£1033). A non-significant quality-adjusted life-year difference of -0.019 favouring cholecystectomy resulted in an incremental cost-effectiveness ratio of £55,235. The Markov model continued to favour observation/conservative management, but some scenarios reversed the findings due to uncertainties in longer-term quality of life. The core outcome set included 11 critically important outcomes from both patients and healthcare professionals. Conclusions The results suggested that in the short term (up to 24 months) observation/conservative management may be a cost-effective use of National Health Service resources in selected patients, but subsequent surgeries in the randomised groups and differences in quality of life beyond 24 months could reverse this finding. Future research should focus on longer-term follow-up data and identification of the cohort of patients that should be routinely offered surgery. Trial registration This trial is registered as ISRCTN55215960. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 14/192/71) and is published in full in Health Technology Assessment; Vol. 28, No. 26. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
- Karen Innes
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Irfan Ahmed
- Department of Surgery, NHS Grampian, Aberdeen, UK
| | - Jemma Hudson
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Rodolfo Hernández
- Health Economics Research Unit, University of Aberdeen, Aberdeen, UK
| | - Katie Gillies
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Rebecca Bruce
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Victoria Bell
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Alison Avenell
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Jane Blazeby
- Center for Surgical Research, NIHR Bristol and Western Biomedical Research Centre, University of Bristol, Bristol, UK
| | - Miriam Brazzelli
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Seonaidh Cotton
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | | | - Mark Forrest
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Graeme MacLennan
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Peter Murchie
- Academic Primary Care, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Samantha Wileman
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Craig Ramsay
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
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Hughes A, Scholes-Robertson N, Ju A, Jauré A. Core Patient-Reported Outcomes for Trials in Nephrology. Semin Nephrol 2024; 44:151549. [PMID: 39289130 DOI: 10.1016/j.semnephrol.2024.151549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2024]
Abstract
The outcomes reported in trials across all stages of chronic kidney disease (CKD) are highly variable and often do not include outcomes that are directly relevant to patients and caregivers. Frequently, the outcomes reported in trials are often unvalidated surrogate biochemical end points. The omission of outcomes that are meaningful and important to patients can diminish the value of trials in supporting treatment decisions. In response, there have been increasing efforts across many health and medical disciplines to develop core outcome sets, defined as the minimum set of outcomes to be reported in all trials in a specific health area to improve the relevance and consistency of reporting trial outcomes. The international Standardized Outcomes in Nephrology (SONG) initiative was established in 2014 and has since developed seven core outcome sets for different diagnosis and treatment stages of CKD. The core outcomes were based on consensus among patients, caregivers, and health professionals. Each core outcome set includes at least one patient-reported outcome, including fatigue (hemodialysis), life participation (kidney transplantation, peritoneal dialysis, early CKD not yet requiring kidney replacement therapy, children and adolescents, and glomerular disease), and pain (polycystic kidney disease). This article outlines how patient-reported outcomes are currently reported in trials, discusses core patient-reported outcomes that have been established for trials in kidney disease, and outlines strategies for implementing core patient-reported outcomes in trials.
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Affiliation(s)
- Anastasia Hughes
- Sydney School of Public Health, University of Sydney, Sydney, Australia; Centre for Kidney Research, Children's Hospital at Westmead, Sydney, Australia.
| | - Nicole Scholes-Robertson
- Sydney School of Public Health, University of Sydney, Sydney, Australia; Centre for Kidney Research, Children's Hospital at Westmead, Sydney, Australia
| | - Angela Ju
- Sydney School of Public Health, University of Sydney, Sydney, Australia; Centre for Kidney Research, Children's Hospital at Westmead, Sydney, Australia
| | - Allison Jauré
- Sydney School of Public Health, University of Sydney, Sydney, Australia; Centre for Kidney Research, Children's Hospital at Westmead, Sydney, Australia
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Duggan C, Hernon O, Dunne R, McInerney V, Walsh SR, Lowery A, McCarthy M, Carr PJ. Vascular access device type for systemic anti-cancer therapies in cancer patients: A scoping review. Crit Rev Oncol Hematol 2024; 196:104277. [PMID: 38492760 DOI: 10.1016/j.critrevonc.2024.104277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 01/26/2024] [Accepted: 01/26/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Patients with cancer can expect to receive numerous invasive vascular access procedures for intravenous therapy and clinical diagnostics. Due to the increased incidence and prevalence of cancer globally there will be significantly more people who require first-line intravenous chemotherapy over the next ten years. METHODS Our objective was to determine the types of evidence that exist for the vascular access device (VAD) type for the delivery of systemic anti-cancer therapy (SACT) in cancer patients. We used JBI scoping review methodology to identify the types of VADs used for SACT and with a specific search strategy included articles from 2012-2022 published in the English language. We identify (i) type of VADs used for SACT delivery (ii) the type of insertion and post-insertion complications (iii) the geographical location and clinical environment (iv) and whether VAD choice impacts on quality of life (QOL). Findings were presented using the PAGER framework. MAIN FINDINGS Our search strategy identified 10,390 titles, of these, 5318 duplicates were removed. The remaining 5072 sources were screened for eligibility, 240 articles met the inclusion criteria. The most common design include retrospective study designs (n = 91) followed by prospective study designs (n = 31). We found 28 interventional studies with 21 registered in a clinical trial registry and identified no core outcome sets papers specific to VAD for SACT. The most prevalent publications were those that featured two or more VAD types (n = 70), followed by tunnelled intravenous VADs (n = 67). Of 38 unique complications identified, the most frequent catheter related complication was catheter related thrombosis (n = 178, 74%), followed by infection (n = 170, 71%). The county where the most publications originated from was China (n = 62) with one randomized controlled multicenter study from a comprehensive cancer centre. Of the thirty three studies that included QOL we found 4 which reported on body image. No QOL measurement tools specific to the process of SACT administration via VAD are available INTERPRETATION: Our findings suggest a systematic review and meta-analysis of VAD use for intravenous SACT can be considered. However, the development of a core outcome set for SACT should be prioritised. Funding for high quality programs of research for VAD in cancer are needed. Comprehensive cancer centres should lead this research agenda.
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Affiliation(s)
- C Duggan
- Department of Oncology, Portiuncula Hospital, Ballinasloe, Galway H53 T971, Ireland; School of Nursing and Midwifery, University of Galway, Ireland; Alliance for Vascular Access Teaching and Research (AVATAR) Group, Queensland, Australia.
| | - O Hernon
- School of Nursing and Midwifery, University of Galway, Ireland; Alliance for Vascular Access Teaching and Research (AVATAR) Group, Queensland, Australia
| | - R Dunne
- Library, University of Galway, Ireland
| | - V McInerney
- HRB Clinical Research Facility, University of Galway, Ireland
| | - S R Walsh
- Department of Vascular Surgery, Galway University Hospital, Ireland
| | - A Lowery
- School of Medicine, University of Galway, Ireland
| | - M McCarthy
- Department of Medical Oncology, Galway University Hospital, Ireland
| | - P J Carr
- School of Nursing and Midwifery, University of Galway, Ireland; Alliance for Vascular Access Teaching and Research (AVATAR) Group, Queensland, Australia
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Hopkins ZH, Chada LMP, Duffin KC. Defining what matters through core outcomes set development: uniting stakeholder perspectives, empowering patient voices. Br J Dermatol 2024; 190:301-302. [PMID: 38079199 DOI: 10.1093/bjd/ljad493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 12/08/2023] [Indexed: 02/18/2024]
Affiliation(s)
- Zachary H Hopkins
- Department of Dermatology, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT, USA
| | | | - Kristina C Duffin
- Department of Dermatology, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT, USA
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Robinson JL, Gatford KL, Bailey DN, Roff AJ, Clifton VL, Morrison JL, Stark MJ. Preclinical models of maternal asthma and progeny outcomes: a scoping review. Eur Respir Rev 2024; 33:230174. [PMID: 38417970 PMCID: PMC10900068 DOI: 10.1183/16000617.0174-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 12/09/2023] [Indexed: 03/01/2024] Open
Abstract
There is an increased risk of adverse perinatal outcomes in the ∼17% of women with asthma during pregnancy. The mechanisms linking maternal asthma and adverse outcomes are largely unknown, but reflect joint effects of genetics and prenatal exposure to maternal asthma. Animal models are essential to understand the underlying mechanisms independent of genetics and comorbidities, and enable safe testing of interventions. This scoping review aimed to explore the methodology, phenotype, characteristics, outcomes and quality of published studies using preclinical maternal asthma models. MEDLINE (PubMed), Embase (Elsevier) and Web of Science were systematically searched using previously validated search strings for maternal asthma and for animal models. Two reviewers independently screened titles and abstracts, full texts, and then extracted and assessed the quality of each study using the Animal Research: Reporting of In Vivo Experiments (ARRIVE) 2.0 guidelines. Out of 3618 studies identified, 39 were eligible for extraction. Most studies were in rodents (86%) and all were models of allergic asthma. Maternal and progeny outcomes included airway hyperresponsiveness, airway resistance, inflammation, lung immune cells, lung structure and serum immunoglobulins and cytokines. Experimental design (100%), procedural details (97%) and rationale (100%) were most often reported. Conversely, data exclusion (21%), blinding (18%) and adverse events (8%) were reported in a minority of studies. Species differences in physiology and timing of development, the use of allergens not relevant to humans and a lack of comparable outcome measures may impede clinical translation. Future studies exploring models of maternal asthma should adhere to the minimum core outcomes set presented in this review.
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Affiliation(s)
- Joshua L Robinson
- Robinson Research Institute, University of Adelaide, Adelaide, Australia
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
- Early Origins of Adult Health Research Group, Health and Biomedical Innovation, UniSA: Clinical and Health Sciences, University of South Australia, Adelaide, Australia
| | - Kathryn L Gatford
- Robinson Research Institute, University of Adelaide, Adelaide, Australia
- School of Biomedicine, University of Adelaide, Adelaide, Australia
| | - Danielle N Bailey
- Robinson Research Institute, University of Adelaide, Adelaide, Australia
| | - Andrea J Roff
- Robinson Research Institute, University of Adelaide, Adelaide, Australia
- School of Biomedicine, University of Adelaide, Adelaide, Australia
| | - Vicki L Clifton
- Mater Research Institute, University of Queensland, Brisbane, Australia
| | - Janna L Morrison
- Early Origins of Adult Health Research Group, Health and Biomedical Innovation, UniSA: Clinical and Health Sciences, University of South Australia, Adelaide, Australia
| | - Michael J Stark
- Robinson Research Institute, University of Adelaide, Adelaide, Australia
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
- Department of Neonatal Medicine, Women's & Children's Hospital, Adelaide, Australia
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Ahmed A, Koza E, Shi V, Ma M, Haq M, Kottner J, Garg A, Ingram JR, Ezzedine K, Spuls PI, Beeckman D, Wolkenstein P, Fransen F, Noe MH, Langbroek GB, Bauer A, Thorlacius L, Horbach SER, Layton A, Apfelbacher C, Cahn BA, Pearlman R, Schlessinger DI, Alam M. Clinical relevance and uptake of core outcome sets in dermatology. Arch Dermatol Res 2024; 316:78. [PMID: 38244063 DOI: 10.1007/s00403-023-02814-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 12/04/2023] [Accepted: 12/27/2023] [Indexed: 01/22/2024]
Affiliation(s)
- Areeba Ahmed
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Eric Koza
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Victoria Shi
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Melissa Ma
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Misha Haq
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Jan Kottner
- Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Amit Garg
- Department of Dermatology, Northwell Health, New York, USA
| | - John R Ingram
- Clinical Reader and Consultant Dermatologist, Division of Infection and Immunity, Cardiff University, Cardiff, UK
| | - Khaled Ezzedine
- Department of Dermatology, Hôpital Henri Mondor, Créteil, France
- Epidemiology in Dermatology and Evaluation of Therapeutics (EpiDermE)-EA 7379, Université Paris Est Créteil (UPEC), Créteil, France
| | | | - Dimitri Beeckman
- Skin Integrity Research Group (SKINT), Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium
- Swedish Centre for Skin and Wound Research (SCENTR), School of Health Sciences, Örebro University, Örebro, Sweden
| | - Pierre Wolkenstein
- Department of Dermatology, GHU Henri-Mondor, APHP, UPEC, Créteil, France
| | - Frederike Fransen
- Department of Dermatology, Amsterdam Public Health, Infection and Immunity, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Megan H Noe
- Harvard Medical School, Brigham and Women's Hospital, Boston, USA
| | - Ginger Beau Langbroek
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Andrea Bauer
- Department of Dermatology, University Hospital Carl Gustav Carus, Technical University, Dresden, Germany
| | - Linnea Thorlacius
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
| | - Sophie E R Horbach
- Department of Plastic and Reconstructive Surgery, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Alison Layton
- Skin Research Centre, University of York, Heslington Road, York, UK
| | - Christian Apfelbacher
- Institute of Social Medicine and Health Systems Research, Otto Von Guericke University Magdeburg, Leipziger Straße 44, 39120, Magdeburg, Germany
| | - Brian A Cahn
- Department of Dermatology, University of Illinois at Chicago, Chicago, IL, USA
| | - Ross Pearlman
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Daniel I Schlessinger
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Murad Alam
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
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11
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Kjærgaard C, Schmidt AM, Larsen JB, Laurberg TB, Mechlenburg I. Which patients with chronic low back pain respond favorably to multidisciplinary rehabilitation? A secondary analysis of a randomized controlled trial. Scand J Pain 2024; 24:sjpain-2023-0139. [PMID: 38733320 DOI: 10.1515/sjpain-2023-0139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 04/22/2024] [Indexed: 05/13/2024]
Abstract
OBJECTIVES The aim of this study was to identify prognostic variables at baseline associated with being responding favorably to multidisciplinary rehabilitation in patients with chronic low back pain (CLBP). METHODS A responder analysis was conducted based on data from a randomized controlled trial with 26-week follow-up including 165 patients with CLBP treated at a Danish multidisciplinary rehabilitation center. Patients were dichotomized into responders and non-responders based on the outcome of a minimal clinically important difference of six points on the Oswestry Disability Index. The associations between prognostic variables and responders were analyzed using logistic regression. RESULTS A total of 139 patients completed the study, of which 42% were classified as responders. Sex and employment status were statistically significant, with a decreased odds ratio (OR) of being a responder found for males compared to females (OR = 0.09, 95% CI = 0.02-0.48) and for being on temporary or permanent social benefits (OR = 0.28, 95% CI = 0.10-0.75) compared to being self-supporting or receiving retirement benefits. Statistically significant interaction (OR = 8.84, 95% CI = 1.11-70.12) was found between males and being on temporary or permanent social benefits. CONCLUSIONS In patients with CLBP, female patients as well as patients who were self-supporting or receiving retirement benefits were significantly more likely than male patients or patients on temporary or permanent social benefits to be a responder to multidisciplinary rehabilitation.
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Affiliation(s)
- Claus Kjærgaard
- Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 99, DK-8200 Aarhus N, Aarhus, Denmark
- Department of Orthopaedic Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, DK-8200 Aarhus N, Denmark
| | - Anne Mette Schmidt
- Medical Diagnostic Centre, University Research Clinic for Innovative Patient Pathways, Silkeborg Regional Hospital, Silkeborg, Denmark
| | - Josefine Beck Larsen
- Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 99, DK-8200 Aarhus N, Aarhus, Denmark
- Department of Orthopaedic Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, DK-8200 Aarhus N, Denmark
| | - Trine Bay Laurberg
- Department of Rheumatology, Aarhus University Hospital, Sano Aarhus, Aarhus, Denmark
| | - Inger Mechlenburg
- Department of Orthopedic Surgery, Aarhus University Hospital, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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12
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Hofstetter L, Mikhail J, Lalji R, Kurmann A, Rabold L, Côté P, Tricco AC, Pagé I, Hincapié CA. Minimal clinical datasets for spine-related musculoskeletal disorders in primary and outpatient care settings: a scoping review. J Clin Epidemiol 2024; 165:111217. [PMID: 37952699 DOI: 10.1016/j.jclinepi.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 11/02/2023] [Accepted: 11/07/2023] [Indexed: 11/14/2023]
Abstract
OBJECTIVES Effective measurement and monitoring of health status in patients with spine-related musculoskeletal (MSK) disorders are essential for providing appropriate care and improving outcomes. Minimal clinical datasets are standardized sets of key data elements and patient-centered outcomes that can be measured and recorded during routine clinical care. Our scoping review aimed to identify and map current evidence on minimal clinical datasets for measuring and monitoring health status in patients with spine-related MSK disorders in primary and outpatient healthcare settings. STUDY DESIGN AND SETTING We followed the JBI (formerly Joanna Briggs Institute) methodology for scoping reviews. MEDLINE, CINAHL, Cochrane Library, Index to Chiropractic Literature, MANTIS, ProQuest Dissertations and Theses Global, and medRxiv preprint repository were searched from database inception to August 1, 2021. Two reviewers independently screened titles and abstracts, full-text articles, and charted the evidence. Findings were synthesized and summarized descriptively. RESULTS After screening 5,583 citations and 301 full-text articles, 104 studies about 32 individual minimal clinical datasets were included. Most minimal clinical datasets were developed for patient populations with spine-involving inflammatory arthritis, nonspecific or degenerative spinal pain, and MSK disorders in general. The minimal clinical datasets varied substantially in terms of the author-reported time-to-complete (1-48 minutes) and the number of items (5-100 items). Fifty percent of the datasets involved healthcare professionals in their development process, and only 28% involved patients. Health domain items were most frequently linked to the components of activities and participation (43.9%) and body functions (28.6%), according to the International Classification of Functioning, Disability, and Health. There is no standardized definition of minimal clinical datasets to measure and monitor health status of patients with spine-related MSK disorders in routine clinical practice. Common core elements identified were practicality, feasibility in a busy routine practice, time efficiency, and the capability to be used across different healthcare settings. CONCLUSION Due to the absence of a standard definition for minimal clinical datasets for patients with spine-related MSK disorders, there is a lack of consistency in the selection of key data elements and patient-centered outcomes that should be included. More research on the implementation and feasibility of minimal clinical datasets in routine care settings is warranted and needed. It is essential to involve all relevant partners in the development process of minimal clinical datasets to ensure successful implementation and adoption in routine primary care.
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Affiliation(s)
- Léonie Hofstetter
- EBPI-UWZH Musculoskeletal Epidemiology Research Group, University of Zurich and Balgrist University Hospital, Zurich, Switzerland; Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland; University Spine Centre Zurich (UWZH), Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Jérémie Mikhail
- Department of Chiropractic, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | - Rahim Lalji
- EBPI-UWZH Musculoskeletal Epidemiology Research Group, University of Zurich and Balgrist University Hospital, Zurich, Switzerland; Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland; University Spine Centre Zurich (UWZH), Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Astrid Kurmann
- EBPI-UWZH Musculoskeletal Epidemiology Research Group, University of Zurich and Balgrist University Hospital, Zurich, Switzerland
| | - Lorene Rabold
- EBPI-UWZH Musculoskeletal Epidemiology Research Group, University of Zurich and Balgrist University Hospital, Zurich, Switzerland
| | - Pierre Côté
- Institute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada; Division of Epidemiology and Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Andrea C Tricco
- Division of Epidemiology and Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; Queen's Collaboration for Health Care Quality Joanna Briggs Institute Centre of Excellence, School of Nursing, Queen's University, Kingston, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Canada
| | - Isabelle Pagé
- Department of Chiropractic, Université du Québec à Trois-Rivières, Trois-Rivières, Canada; Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS) - Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale (CIUSSS-CN), Quebec City, Canada
| | - Cesar A Hincapié
- EBPI-UWZH Musculoskeletal Epidemiology Research Group, University of Zurich and Balgrist University Hospital, Zurich, Switzerland; Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland; University Spine Centre Zurich (UWZH), Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
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13
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Kari K, Thayani Z, Ward S, Magee T, Jones G, Fitzgerald K, Magana K, Modi J, Hughes G, Ito Ford A, Vassar M. Assessing the uptake of the type 1 diabetes core outcome set in randomized controlled trials: A Cross-Sectional study. Diabetes Res Clin Pract 2024; 207:111085. [PMID: 38195041 DOI: 10.1016/j.diabres.2023.111085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 11/04/2023] [Accepted: 12/27/2023] [Indexed: 01/11/2024]
Abstract
AIMS This study analyzed uptake of the core outcome set (COS) for type 1 diabetes (T1D) and trends in its use before and after its development in December 2017. METHODS On June 26, 2023, ClinicalTrials.gov was systematically searched for T1D randomized controlled trials. The Core Outcome Measures in Effectiveness Trials (COMET) database provided a COS of eight key outcomes for analysis. Included trials were analyzed for COS uptake before and after its release in December 2017 in a masked, duplicate fashion by independent reviewers. We also calculated the proportion of trials that measured the complete COS and assessed the most frequently reported COS outcomes. RESULTS Of 3,792 originally screened articles, 144 RCTs were included in the final sample. Following COS publication, its use steadily decreased. Within the COS, HbA1c and severe hypoglycemia were most frequently implemented as endpoints; other recommended outcomes were rarely used in the published trials. CONCLUSION Despite the 2017 T1D COS publication, use has decreased over time. This inconsistency negatively influences evidence-based practices and care. Educating researchers on COS and promoting uptake is crucial. Wider COS adoption in T1D trials could enhance clinical research overall. Further study of barriers and facilitators influencing uptake is essential to support consistent use and reporting.
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Affiliation(s)
- Karim Kari
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States.
| | - Zohaib Thayani
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
| | - Shaelyn Ward
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States.
| | - Trevor Magee
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States.
| | - Garrett Jones
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States.
| | - Kyle Fitzgerald
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States.
| | - Kimberly Magana
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States.
| | - Jay Modi
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States.
| | - Griffin Hughes
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
| | - Alicia Ito Ford
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States; Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States.
| | - Matt Vassar
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States; Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States.
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Gallagher K, Chant K, Mancini A, Bluebond-Langner M, Marlow N. The NeoPACE study: study protocol for the development of a core outcome set for neonatal palliative care. BMC Palliat Care 2023; 22:203. [PMID: 38114987 PMCID: PMC10729357 DOI: 10.1186/s12904-023-01326-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 12/08/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Neonatal death is the leading category of death in children under the age of 5 in the UK. Many babies die following decisions between parents and the neonatal team; when a baby is critically unwell, with the support of healthcare professionals, parents may make the decision to stop active treatment and focus on ensuring their baby has a 'good' death. There is very little evidence to support the clinical application of neonatal palliative care and/or end-of-life care, resulting in variation in clinical provision between neonatal units. Developing core outcomes for neonatal palliative care would enable the development of measures of good practice and enhance our care of families. The aim of this study is to develop a core outcome set with associated tools for measuring neonatal palliative care. METHOD This study has four phases: (1) identification of potential outcomes through systematic review and qualitative interviews with key stakeholders, including parents and healthcare professionals (2) an online Delphi process with key stakeholders to determine core outcomes (3) identification of outcome measures to support clinical application of outcome use (4) dissemination of the core outcome set for use across neonatal units in the UK. Key stakeholders include parents, healthcare professionals, and researchers with a background in neonatal palliative care. DISCUSSION Developing a core outcome set will standardise minimum reported outcomes for future research and quality improvement projects designed to determine the effectiveness of interventions and clinical care during neonatal palliative and/or end-of-life care. The core outcome set will provide healthcare professionals working in neonatal palliative and/or end-of-life support with an increased and consistent evidence base to enhance practice in this area. TRIAL REGISTRATION The study has been registered with the COMET initiative ( https://www.comet-initiative.org/Studies/Details/1470 ) and the systematic review is registered with the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42023451068).
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Affiliation(s)
- Katie Gallagher
- UCL Elizabeth Garrett Anderson Institute for Women's Health, University College London, 74 Huntley Street, WC1E 6AU, London, UK.
| | - Kathy Chant
- UCL Elizabeth Garrett Anderson Institute for Women's Health, University College London, 74 Huntley Street, WC1E 6AU, London, UK
| | - Alex Mancini
- Chelsea and Westminster Hospitals NHS Foundation Trust, London, UK
| | | | - Neil Marlow
- UCL Elizabeth Garrett Anderson Institute for Women's Health, University College London, 74 Huntley Street, WC1E 6AU, London, UK
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15
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Karumbi J, Gathara D, Young B, Williamson P. To adopt or adapt an existing neonatal core outcome set in Kenya: a study protocol. Trials 2023; 24:806. [PMID: 38102720 PMCID: PMC10722714 DOI: 10.1186/s13063-023-07821-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 11/22/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Development and use of core outcome set(s) (COS) in research can reduce research wastage by ensuring that a minimum set of outcomes are always reported on. Neonatal morbidity and mortality are a big burden in low- and middle-income countries (LMICs). Research is continuously being undertaken to reduce this burden. Currently, there is no COS for neonatal research in LMICs but there exists one for neonatal research in high-income countries (HICs). OBJECTIVES To determine outcomes that are useful for neonatal care in Kenya to inform whether an existing COS should be adopted or adapted. To assess the feasibility of a routine data collection system to collect data of the agreed-on COS. METHODS A review of existing literature on neonatal research in LMICs followed by a qualitative study of key stakeholders in neonatal care. To explore whether to adapt or adopt, in two hospitals, two focus group discussions with 6-8 parents/caregivers will be undertaken (one each in two hospitals). Key informant interviews will also be conducted with 6 health care providers in each of the hospitals. At the policy-making level, we will conduct 10 key informant interviews. Qualitative data will be analyzed thematically. A consensus meeting will be undertaken with key stakeholders, who will be presented with an overview of the COS developed for HICs, key findings from the literature, and the qualitative study to determine context-appropriate COS. The agreed-on outcomes will be counterchecked against the case records in the two hospitals. The feasibility of collecting the outcomes on a routine electronic research database, the Clinical Information Network that collects standardized data at admission and discharge, will be explored. The congruence (or not) of the outcomes will be documented and be used to enrich the discussion and provide a snapshot of the feasibility of the health information system to collect routine data on the COS. CONCLUSIONS A COS for use in neonatal care in Kenya will help enhance outcome measurements and reporting not just in research but also in routine practice. This will enhance the comparability of interventions in trials and routine settings leading to reduced research wastage and likely improved quality of care. Additionally, the methodology used for this work can be adopted in other settings as a means of adopting or adapting an existing COS.
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Affiliation(s)
- Jamlick Karumbi
- Department of Health Data Science, University of Liverpool, Liverpool, UK.
- Health Systems Research, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.
| | - David Gathara
- Health Systems Research, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Centre for Maternal, Adolescent, Reproductive & Child Health (MARCH), London School of Hygiene and Tropical Medicine, London, UK
| | - Bridget Young
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | - Paula Williamson
- Department of Health Data Science, University of Liverpool, Liverpool, UK
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16
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Vidyasagaran AL, McDaid D, Faisal MR, Nasir M, Muliyala KP, Thekkumkara S, Wright J, Huque R, Benkalkar S, Siddiqi N. Prevalence of mental disorders in South Asia: A systematic review of reviews. Glob Ment Health (Camb) 2023; 10:e78. [PMID: 38161740 PMCID: PMC10755414 DOI: 10.1017/gmh.2023.72] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 08/24/2023] [Accepted: 11/02/2023] [Indexed: 01/03/2024] Open
Abstract
Mental disorders are increasing in South Asia (SA), but their epidemiological burden is under-researched. We carried out a systematic umbrella review to estimate the prevalence of mental disorders and intentional self-harm in the region. Multiple databases were searched and systematic reviews reporting the prevalence of at least one mental disorder from countries in SA were included. Review data were narratively synthesised; primary studies of common mental disorders (CMDs) among adults were identified from a selected subset of reviews and pooled. We included 124 reviews. The majority (n = 65) reported on mood disorders, followed by anxiety disorders (n = 45). High prevalence of mental disorders and intentional self-harm was found in general adult and vulnerable populations. Two reviews met our pre-defined criteria for identifying primary studies of CMDs. Meta-analysis of 25 primary studies showed a pooled prevalence of 16.0% (95% CI = 11.0-22.0%, I 2 = 99.9%) for depression, 12.0% (5.0-21.0%, I 2 = 99.9%) for anxiety, and 14.0% (10.0-19.0, I 2 = 99.9%) for both among the general adult population; pooled estimates varied by country and assessment tool used. Overall, reviews suggest high prevalence for mental disorders in SA, but evidence is limited on conditions other than CMDs.
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Affiliation(s)
| | - David McDaid
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
| | | | - Muhammad Nasir
- Department of Economics, Institute of Business Administration (IBA), Karachi, Pakistan
| | - Krishna P. Muliyala
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bengaluru, India
| | | | - Judy Wright
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | | | | | - Najma Siddiqi
- Department of Health Sciences, University of York, Heslington, UK
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17
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Waithira N, Kestelyn E, Chotthanawathit K, Osterrieder A, Mukaka M, Lang T, Cheah PY. Investigating the Secondary Use of Clinical Research Data: Protocol for a Mixed Methods Study. JMIR Res Protoc 2023; 12:e44875. [PMID: 36877564 PMCID: PMC10028503 DOI: 10.2196/44875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 02/10/2023] [Accepted: 02/14/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND The increasing emphasis to share patient data from clinical research has resulted in substantial investments in data repositories and infrastructure. However, it is unclear how shared data are used and whether anticipated benefits are being realized. OBJECTIVE The purpose of our study is to examine the current utilization of shared clinical research data sets and assess the effects on both scientific research and public health outcomes. Additionally, the study seeks to identify the factors that hinder or facilitate the ethical and efficient use of existing data based on the perspectives of data users. METHODS The study will utilize a mixed methods design, incorporating a cross-sectional survey and in-depth interviews. The survey will involve at least 400 clinical researchers, while the in-depth interviews will include 20 to 40 participants who have utilized data from repositories or institutional data access committees. The survey will target a global sample, while the in-depth interviews will focus on individuals who have used data collected from low- and middle-income countries. Quantitative data will be summarized by using descriptive statistics, while multivariable analyses will be used to assess the relationships between variables. Qualitative data will be analyzed through thematic analysis, and the findings will be reported in accordance with the COREQ (Consolidated Criteria for Reporting Qualitative Research) guidelines. The study received ethical approval from the Oxford Tropical Research Ethics Committee in 2020 (reference number: 568-20). RESULTS The results of the analysis, including both quantitative data and qualitative data, will be available in 2023. CONCLUSIONS The outcomes of our study will offer crucial understanding into the current status of data reuse in clinical research, serving as a basis for guiding future endeavors to enhance the utilization of shared data for the betterment of public health outcomes and for scientific progress. TRIAL REGISTRATION Thai Clinical Trials Registry TCTR20210301006; https://tinyurl.com/2p9atzhr. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/44875.
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Affiliation(s)
- Naomi Waithira
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, Thailand
| | - Evelyne Kestelyn
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | | | - Anne Osterrieder
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Mavuto Mukaka
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, Thailand
| | - Trudie Lang
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Phaik Yeong Cheah
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, Thailand
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Wood L, Foster NE, Lewis M, Bronfort G, Groessl EJ, Hewitt C, Miyamoto GC, Reme SE, Bishop A. Matching the Outcomes to Treatment Targets of Exercise for Low Back Pain: Does it Make a Difference? Results of Secondary Analyses From Individual Patient Data of Randomised Controlled Trials and Pooling of Results Across Trials in Comparative Meta-analysis. Arch Phys Med Rehabil 2023; 104:218-228. [PMID: 35934047 DOI: 10.1016/j.apmr.2022.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 07/19/2022] [Accepted: 07/21/2022] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To explore whether using a single matched or composite outcome might affect the results of previous randomized controlled trials (RCTs) testing exercise for non-specific low back pain (NSLBP). The first objective was to explore whether a single matched outcome generated greater standardized mean differences (SMDs) when compared with the original unmatched primary outcome SMD. The second objective was to explore whether a composite measure, composed of matched outcomes, generated a greater SMD when compared with the original primary outcome SMD. DESIGN We conducted exploratory secondary analyses of data. SETTING Seven RCTs were included, of which 2 were based in the USA (University research clinic, Veterans Affairs medical center) and the UK (primary care clinics, nonmedical centers). One each were based in Norway (clinics), Brazil (primary care), and Japan (outpatient clinics). PARTICIPANTS The first analysis comprised 1) 5 RCTs (n=1033) that used an unmatched primary outcome but included (some) matched outcomes as secondary outcomes, and the second analysis comprised 2) 4 RCTs (n=864) that included multiple matched outcomes by developing composite outcomes (N=1897). INTERVENTION Exercise compared with no exercise. MAIN OUTCOME MEASURES The composite consisted of standardized averaged matched outcomes. All analyses replicated the RCTs' primary outcome analyses. RESULTS Of 5 RCTs, 3 had greater SMDs with matched outcomes (pooled effect SMD 0.30 [95% confidence interval {CI} 0.04, 0.56], P=.02) compared with an unmatched primary outcome (pooled effect SMD 0.19 [95% CI -0.03, 0.40] P=.09). Of 4 composite outcome analyses, 3 RCTs had greater SMDs in the composite outcome (pooled effect SMD 0.28 [95% CI 0.05, 0.51] P=.02) compared with the primary outcome (pooled effect SMD 0.24 [95% CI -0.04, 0.53] P=.10). CONCLUSIONS These exploratory analyses suggest that using an outcome matched to exercise treatment targets in NSLBP RCTs may produce greater SMDs than an unmatched primary outcome. Composite outcomes could offer a meaningful way of investigating superiority of exercise than single domain outcomes.
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Affiliation(s)
- Lianne Wood
- Primary Care Centre Versus Arthritis, School of Medicine, Faculty of Medicine, Keele University, Newcastle-under-Lyme, UK; Nottingham University Hospitals NHS Trust, Queens Medical Centre, Derby Road, Nottingham, UK.
| | - Nadine E Foster
- Primary Care Centre Versus Arthritis, School of Medicine, Faculty of Medicine, Keele University, Newcastle-under-Lyme, UK
| | - Martyn Lewis
- Primary Care Centre Versus Arthritis, School of Medicine, Faculty of Medicine, Keele University, Newcastle-under-Lyme, UK
| | - Gert Bronfort
- Earl E Bakken Centre for Spirituality and Healing, University of Minnesota, Minneapolis, MN, USA
| | - Erik J Groessl
- University of California San Diego, Herbert Wertheim School of Public Health and UCSD Health Services Research Centre, La Jolla, CA, USA
| | - Catherine Hewitt
- York Trials Unit, Department of Health Sciences, University of York, UK
| | - Gisela C Miyamoto
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
| | - Silje E Reme
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Annette Bishop
- Primary Care Centre Versus Arthritis, School of Medicine, Faculty of Medicine, Keele University, Newcastle-under-Lyme, UK
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Langbroek GB, Wolkerstorfer A, Horbach SE, Spuls PI, Kelly KM, Robertson SJ, van Raath MI, Al‐Niaimi F, Kono T, Boixeda P, Laubach HJ, Badawi AM, Rubin AT, Haedersdal M, Manuskiatti W, van der Horst CM, Ubbink D. A core outcome domain set for clinical research on capillary malformations (the COSCAM project): an e-Delphi process and consensus meeting. Br J Dermatol 2022; 187:730-742. [PMID: 35762296 PMCID: PMC9796083 DOI: 10.1111/bjd.21723] [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] [Received: 12/14/2021] [Revised: 06/16/2022] [Accepted: 06/26/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND There is limited evidence on the best available treatment options for capillary malformations (CMs), mainly due to the absence of uniform outcome measures in trials on therapies. A core outcome set (COS) enables standard reporting of trial outcomes, which facilitates comparison of treatment results. OBJECTIVES To develop a core outcome domain set (CDS), as part of a core outcome set (COS), for clinical research on CMs. METHODS Sixty-seven potentially relevant outcome subdomains were recognized based on the literature, focus group sessions, and input from the COSCAM working group. These outcome subdomains were presented in an online Delphi study to CM experts (medical specialists and authors of relevant literature) and (parents of) patients with CM (international patient associations). During three e-Delphi study rounds, the participants repeatedly scored the importance of these outcome subdomains on a seven-point Likert scale. Participants could also propose other relevant outcome subdomains. Consensus was defined as ≥ 80% agreement as to the importance of an outcome subdomain among both stakeholder groups. The CDS was finalized during an online consensus meeting. RESULTS In total 269 participants from 45 countries participated in the first e-Delphi study round. Of these, 106 were CM experts from 32 countries, made up predominantly of dermatologists (59%) and plastic surgeons (18%). Moreover, 163 (parents of) patients with CM from 28 countries participated, of whom 58% had Sturge-Weber syndrome. During the two subsequent e-Delphi study rounds, 189 and 148 participants participated, respectively. After the entire consensus process, consensus was reached on 11 outcome subdomains: colour/redness, thickness, noticeability, distortion of anatomical structures, glaucoma, overall health-related quality of life, emotional functioning, social functioning, tolerability of intervention, patient satisfaction with treatment results, and recurrence. CONCLUSIONS We recommend the CDS to be used as a minimum reporting standard in all future trials of CM therapy. Our next step will be to select suitable outcome measurement instruments to score the core outcome subdomains. What is already known about this topic? Besides physical and functional sequelae, capillary malformations (CMs) often cause emotional and social burden. The lack of uniform outcome measures obstructs proper evaluation and comparison of treatment strategies. As a result, there is limited evidence on the best available treatment options. The development of a core outcome set (COS) may improve standardized reporting of trial outcomes. What does this study add? A core outcome domain set (CDS), as part of a COS, was developed for clinical research on CMs. International consensus was reached on the recommended core outcome subdomains to be measured in CM trials: colour/redness, thickness, noticeability, distortion of anatomical structures, glaucoma, overall health-related quality of life, emotional functioning, social functioning, tolerability of intervention, patient satisfaction with treatment results, and recurrence. This CDS enables the next step in the development of a COS, namely to reach consensus on the core outcome measurement instruments to score the core outcome subdomains. What are the clinical implications of this work? The obtained CDS will facilitate standardized reporting of treatment outcomes, thereby enabling proper comparison of treatment results. This comparison is likely to provide more reliable information for patients about the best available treatment options.
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Affiliation(s)
- Ginger Beau Langbroek
- Department of SurgeryAmsterdam University Medical Centers, location AMC, University of AmsterdamAmsterdamthe Netherlands,Department of Plastic, Reconstructive and Hand SurgeryAmsterdam University Medical Centers, University of AmsterdamAmsterdamthe Netherlands
| | - Albert Wolkerstorfer
- Department of DermatologyAmsterdam University Medical Centers, Amsterdam Public Health, Immunity and Infections, University of AmsterdamAmsterdamthe Netherlands
| | - Sophie E.R. Horbach
- Department of Plastic, Reconstructive and Hand SurgeryAmsterdam University Medical Centers, University of AmsterdamAmsterdamthe Netherlands
| | - Phyllis I. Spuls
- Department of DermatologyAmsterdam University Medical Centers, Amsterdam Public Health, Immunity and Infections, University of AmsterdamAmsterdamthe Netherlands
| | - Kristen M. Kelly
- Department of DermatologyUniversity of California IrvineIrvineCAUSA
| | - Susan J. Robertson
- Department of DermatologyMurdoch Children’s Research Institute, The Royal Children’s HospitalMelbourneVICAustralia
| | - M. Ingmar van Raath
- Department of Plastic, Reconstructive, and Hand SurgeryMaastricht University Medical Center, Maastricht UniversityMaastrichtthe Netherlands
| | - Firas Al‐Niaimi
- Private dermatological practiceLondonUK,Department of DermatologyUniversity of AalborgAalborgDenmark
| | - Taro Kono
- Department of Plastic SurgeryTokai University School of MedicineShimokasuyaIseharaKanagawaJapan
| | - Pablo Boixeda
- Department of DermatologyHospital Ramon y CajalMadridSpain
| | - Hans J. Laubach
- Department of DermatologyGeneva University Hospitals (HUG)GenevaSwitzerland
| | - Ashraf M. Badawi
- Department of DermatologySzeged UniversitySzegedHungary,Department of Medical Laser ApplicationsNational Institute of Laser Enhanced Sciences, Cairo UniversityGizaEgypt
| | | | - Merete Haedersdal
- Department of DermatologyUniversity of Copenhagen, Bispebjerg HospitalCopenhagenNVDenmark
| | - Woraphong Manuskiatti
- Department of Dermatology, Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
| | - Chantal M.A.M. van der Horst
- Department of Plastic, Reconstructive and Hand SurgeryAmsterdam University Medical Centers, University of AmsterdamAmsterdamthe Netherlands
| | - D.T. Ubbink
- Department of SurgeryAmsterdam University Medical Centers, location AMC, University of AmsterdamAmsterdamthe Netherlands
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20
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Hu T, Long Y, Chen R, Yang Z, Liu L, Huang L, Huang J, Liao G, Du L. Core outcomes were rarely reported overall in systematic reviews on acupuncture for osteoarthritis: a cross-sectional meta-epidemiological study. Acupunct Med 2022:9645284221108215. [PMID: 35983785 DOI: 10.1177/09645284221108215] [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: 11/17/2022]
Abstract
OBJECTIVE To identify a comprehensive list of outcomes and explore the reporting rate of core outcome sets (COS) and related factors in systematic reviews (SRs) of acupuncture for osteoarthritis (OA). STUDY DESIGN AND SETTING Databases were searched for the relative SRs. Descriptive statistics were calculated as frequencies and percentages. Binary logistic regression was used to explore the factors affecting the reporting rate of COS. RESULTS We included 59 SRs. Outcome measures reported in the SRs were classified into 11 domains and 67 unique outcomes. No SR completely reported COS. In COS released in 2016, 75% of outcomes (6/8) were only reported by ⩽5% SRs. In COS released in 2019, the reporting rate was very low (from 0% to 17%) for 73.3% of outcomes (11/15). SRs published in the most recent 5 years had a significantly greater possibility of reporting COS (odds ratio (OR) = 4.74, 95% confidence interval (CI) = 1.33 to 16.88, p = 0.016). CONCLUSION Core outcomes were rarely reported in systematic reviews of acupuncture for OA, with considerable heterogeneity in the use of outcomes. The publication of COS in the COMET (Core Outcome Measures in Effectiveness Trials) database may help promote the reporting of COS. We encourage systematic reviewers to use relevant COS.
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Affiliation(s)
- Tengyue Hu
- West China School of Medicine, Sichuan University, Chengdu, P.R. China
| | - Youlin Long
- Medical Device Regulatory Research and Evaluation Center, West China Hospital, Sichuan University, Chengdu, P.R. China.,Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, P.R. China
| | - Rui Chen
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, P.R. China
| | - Zixin Yang
- West China School of Medicine, Sichuan University, Chengdu, P.R. China
| | - Liqin Liu
- West China School of Medicine, Sichuan University, Chengdu, P.R. China
| | - Litao Huang
- Department of Clinical Research Management, West China Hospital, Sichuan University, Chengdu, P.R. China
| | - Jin Huang
- Medical Device Regulatory Research and Evaluation Center, West China Hospital, Sichuan University, Chengdu, P.R. China
| | - Ga Liao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, P.R. China.,Medical Big Data Center, Sichuan University, Chengdu, P.R. China.,Departments of Information Management and Stomatology Informatics, West China Hospital of Stomatology, Sichuan University, Chengdu, P.R. China
| | - Liang Du
- Medical Device Regulatory Research and Evaluation Center, West China Hospital, Sichuan University, Chengdu, P.R. China.,Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, P.R. China
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21
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Henrotin JB, Petit-Gelin V. Rasch analysis of the Oxford shoulder score in a non-surgical occupational population. Work 2022; 72:1239-1248. [DOI: 10.3233/wor-205334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: The Oxford shoulder score (OSS) questionnaire for measuring patient perception of shoulder disability, has not tested specifically in a non-surgical population and no study has assessed the OSS with modern psychometrics based on Rasch model (RM). OBJECTIVE: To assess the psychometric properties of the OSS using RM among health-care workers with shoulder disorders and to verify its interest in a non-surgical population. METHODS: In an occupational health department of a French hospital center, a retrospective review was performed of the medical records from June 2019 to October 2020. Responses to 110 questionnaires were examined from 55 subjects (97% of women). A polytomous Rasch model based on the Partial Credit Model was used. RESULTS: Overall fit was satisfactory, the reliability coefficient was high and an ascending order was observed with the 5 categories of the scale. Analysis of the residuals supports unidimensionality and the local independence assumption. Item performance remained stable across the subgroup examined (DIF measures). Scale to-sample targeting indicated a substantial floor effect, and the mildest impairments were not well discriminated. CONCLUSIONS: OSS presents good psychometric qualities. However, it does not clearly discriminate subjects presenting the lowest levels of impairment. Its use in a non-surgical population is questionable.
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22
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Outcome Domain and Measurement Instrument Reporting in Randomized Controlled Trials of Interventions for Lumbar Spinal Stenosis: A Systematic Review. J Orthop Sports Phys Ther 2022; 52:446-A2. [PMID: 35584024 DOI: 10.2519/jospt.2022.10879] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To describe outcome measurement instruments and outcome domains in randomized controlled trials of any interventions for lumbar spinal stenosis (LSS). DESIGN Systematic review. LITERATURE SEARCH The Cochrane Central Register of Controlled Trials (CENTRAL) and PubMed were searched from inception to May 2020. STUDY SELECTION CRITERIA Trials were eligible if patients were diagnosed with LSS, with or without neurogenic claudication. Trials were eligible if they used at least 1 outcome measurement instrument. DATA SYNTHESIS Measurement instruments used in trials were extracted and then classified into outcome domains. We described the frequency of measurement instruments and outcome domains. RESULTS After study screening, 29 trials were included. In total, 54 different individual outcome measurement instruments were used. The Visual Analogue Scale (59%; n = 17) and the Oswestry Disability Index (52%; n = 15) were the most frequently used outcome measurement instruments in trials; function (90%; n = 26) and pain (62%; n = 18) were the most common outcome domains. CONCLUSION In total, 54 different measurement instruments were used in trials of interventions for LSS. This diverse range of observations contributes to outcome instrument heterogeneity between trials and impedes the analysis of data due to lack of comparability. The most common outcome domains assessed were pain and function, which will help inform a core outcome measure set for symptomatic LSS. J Orthop Sports Phys Ther 2022;52(7):446-456. Epub: 18 May 2022. doi:10.2519/jospt.2022.10879.
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23
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Innes K, Hudson J, Banister K, Croal B, Ramsay C, Ahmed I, Blazeby J, Gillies K. Core outcome set for symptomatic uncomplicated gallstone disease. Br J Surg 2022; 109:539-544. [PMID: 35576389 PMCID: PMC10364745 DOI: 10.1093/bjs/znac095] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 02/04/2022] [Accepted: 03/08/2022] [Indexed: 11/14/2022]
Abstract
BACKGROUND Heterogeneity of outcomes is a problem for assessing intervention effectiveness when considering treatments for uncomplicated symptomatic gallstone disease. The value to all stakeholders of outcomes that have been measured and reported to date is also unclear. The aim of this study was to develop a core outcome set for symptomatic uncomplicated gallstone disease. METHODS An in person-meeting was held with patients to prioritize potentially important outcomes from a previously developed longlist of outcomes. This was followed by an online three-round Delphi survey that was conducted with healthcare professionals. The results of each consensus process were compared and combined to produce the final core outcome set. RESULTS A total of 82 participants enrolled in round 1 of the Delphi survey, with a final sample of 40 participants contributing to round 3. Five patients contributed to the in-person group meeting. Following the consensus processes, 11 outcomes were considered to be core by patients and healthcare professionals, and included in the core outcome set. These were: quality of life; overall health state; overall satisfaction; overall pain; common bile duct injury; biliary leak; haemorrhage; need for endoscopic retrograde cholangiopancreatography; intra-abdominal collections; admission/readmission for problems; and reoperation. CONCLUSION A core outcome set for symptomatic uncomplicated gallstone disease has been developed with patients and healthcare professionals. Eleven outcomes across four key domains have been identified. These represent the minimum set of outcomes that should be reported in trials evaluating interventions for gallstone disease.
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Affiliation(s)
- Karen Innes
- Health Services Research Unit, University of Aberdeen Institute of Applied Health Sciences, Aberdeen, UK
| | - Jemma Hudson
- Health Services Research Unit, University of Aberdeen Institute of Applied Health Sciences, Aberdeen, UK
| | - Katie Banister
- Health Services Research Unit, University of Aberdeen Institute of Applied Health Sciences, Aberdeen, UK
| | - Bernard Croal
- Clinical Biochemistry, Grampian University Hospitals NHS Trust, Aberdeen, UK
| | - Craig Ramsay
- Health Services Research Unit, University of Aberdeen Institute of Applied Health Sciences, Aberdeen, UK
| | - Irfan Ahmed
- Department of Surgery, NHS Grampian, Aberdeen, UK
| | - Jane Blazeby
- Department of Social Medicine, University of Bristol, Bristol, UK
| | - Katie Gillies
- Health Services Research Unit, University of Aberdeen Institute of Applied Health Sciences, Aberdeen, UK
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24
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Doumouchtsis SK, Nama V, Falconi G, Rada MP, Manonai J, Iancu G, Haddad JM, Betschart C. Developing Core Outcome Sets (COS) and Core Outcome Measures Sets (COMS) in Cosmetic Gynecological Interventions: Protocol for a Development and Usability Study. JMIR Res Protoc 2021; 10:e28032. [PMID: 34779787 PMCID: PMC8663614 DOI: 10.2196/28032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 05/31/2021] [Accepted: 09/28/2021] [Indexed: 11/17/2022] Open
Abstract
Background Studies evaluating cosmetic gynecological interventions have followed variable methodology and reported a diversity of outcomes. Such variations limit the comparability of studies and the value of research-based evidence. The development of core outcome sets (COS) and core outcome measures sets (COMS) would help address these issues, ensuring a minimum of outcomes important to all stakeholders, primarily women requesting or having experienced cosmetic gynecological interventions. Objective This protocol describes the methods used in developing a COS and COMS for cosmetic gynecological interventions. Methods An international steering group within CHORUS, including health care professionals, researchers, and women with experience in cosmetic gynecological interventions from 4 continents, will guide the development of COS and COMS. Potential outcome measures and outcomes will be identified through comprehensive literature reviews. These potential COS and COMS will be entered into an international, multi-perspective web-based Delphi survey where Delphi participants judge which domains will be core. A priori thresholds for consensus will get established before each Delphi round. The Delphi survey results will be evaluated quantitatively and qualitatively in subsequent stakeholder group consensus meetings in the process of establishing “core” outcomes. Results Dissemination and implementation of the resulting COS and COMS within an international context will be promoted and reviewed. Conclusions This protocol presents the steps in developing a COS and COMS for cosmetic gynecological interventions. Embedding the COS and COMS for cosmetic gynecological interventions within future clinical trials, systematic reviews, and practice guidelines could contribute to enhancing the value of research and improving overall patient care. Trial Registration Core Outcome Measures in Effectiveness Trials (COMET) 1592; https://tinyurl.com/n8faysuh International Registered Report Identifier (IRRID) PRR1-10.2196/28032
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Affiliation(s)
- Stergios K Doumouchtsis
- Department of Obstetrics and Gynecology, Epsom & St Helier University Hospital NHS Trust, London, United Kingdom.,Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, Athens, Greece.,Institute of Medical and Biomedical Education, St George's University of London, London, United Kingdom.,School of Medicine, American University of the Caribbean, Coral Gables, FL, United States.,School of Medicine, Ross University, Miramar, FL, United States.,CHORUS: An International Collaboration for Harmonising Outcomes, Research and Standards in Urogynaecology and Women's Health, Epsom, United Kingdom
| | - Vivek Nama
- CHORUS: An International Collaboration for Harmonising Outcomes, Research and Standards in Urogynaecology and Women's Health, Epsom, United Kingdom.,Department of Obstetrics and Gynecology, Croydon University Hospital, London, United Kingdom
| | - Gabriele Falconi
- CHORUS: An International Collaboration for Harmonising Outcomes, Research and Standards in Urogynaecology and Women's Health, Epsom, United Kingdom.,Department of Surgical Sciences, Complex Operative Unit of Gynecology, Fondazione PTV Policlinico Tor Vergata, University Hospital, Rome, Italy
| | - Maria Patricia Rada
- CHORUS: An International Collaboration for Harmonising Outcomes, Research and Standards in Urogynaecology and Women's Health, Epsom, United Kingdom.,Department of Obstetrics and Gynecology, Universitatea de Medicina si Farmacie Iuliu Hatieganu din Cluj-Napoca, Cluj-Napoca, Romania
| | - Jittima Manonai
- CHORUS: An International Collaboration for Harmonising Outcomes, Research and Standards in Urogynaecology and Women's Health, Epsom, United Kingdom.,Department of Obstetrics and Gynecology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - George Iancu
- CHORUS: An International Collaboration for Harmonising Outcomes, Research and Standards in Urogynaecology and Women's Health, Epsom, United Kingdom.,Department of Obstetrics and Gynecology, Universitatea de Medicina si Farmacie Carol Davila din Bucuresti, Bukarest, Romania
| | - Jorge Milhem Haddad
- CHORUS: An International Collaboration for Harmonising Outcomes, Research and Standards in Urogynaecology and Women's Health, Epsom, United Kingdom.,Urogynecology Division, Department of Obstetrics and Gynecology, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Cornelia Betschart
- CHORUS: An International Collaboration for Harmonising Outcomes, Research and Standards in Urogynaecology and Women's Health, Epsom, United Kingdom.,Department of Gynecology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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25
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Rodrigues M, Sanger N, Dufort A, Sanger S, Panesar B, D'Elia A, Parpia S, Samaan Z, Thabane L. Outcomes reported in randomised controlled trials of major depressive disorder in older adults: protocol for a methodological review. BMJ Open 2021; 11:e054777. [PMID: 34725082 PMCID: PMC8562520 DOI: 10.1136/bmjopen-2021-054777] [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: 11/03/2022] Open
Abstract
INTRODUCTION Major depressive disorder (MDD or depression) is prevalent among adults aged 65 years and older. The effectiveness and safety of interventions used to treat depression is often assessed through randomised controlled trials (RCTs). However, heterogeneity in the selection, measurement and reporting of outcomes in RCTs renders comparisons between trial results, interpretability and generalisability of findings challenging. There is presently no core outcome set (COS) for use in RCTs that assess interventions for older adults with MDD. We will conduct a methodological review of the literature for outcomes reported in trials for adults 65 years and older with depression to assess the heterogeneity of outcome measures. METHODS AND ANALYSIS RCTs evaluating pharmacotherapy, psychotherapy, or any other treatment intervention for older adults with MDD published in the last 10 years will be located using electronic database searches (MEDLINE, Embase, PsycINFO and the Cochrane Central Register of Controlled Trials). Reviewers will conduct title and abstract screening, full-text screening and data extraction of trials eligible for inclusion independently and in duplicate. Outcomes will be synthesised and mapped to core outcome-domain frameworks. We will summarise characteristics associated with trials and outcomes. ETHICS AND DISSEMINATION We hope that findings from our methodological review will reduce variability in outcome selection, measurement and reporting and facilitate the development of a COS for older adults with MDD. Our review will also inform evidence synthesis efforts in identifying the best treatment practices for this clinical population. Ethics approval is not required, as this study is a literature review. PROSPERO REGISTRATION NUMBER CRD42021244753.
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Affiliation(s)
- Myanca Rodrigues
- Health Research Methodology Graduate Program, Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Nitika Sanger
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Alexander Dufort
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Stephanie Sanger
- Health Sciences Library, McMaster University, Hamilton, Ontario, Canada
| | - Balpreet Panesar
- Neuroscience Graduate Program, McMaster University, Hamilton, Ontario, Canada
| | - Alessia D'Elia
- Neuroscience Graduate Program, McMaster University, Hamilton, Ontario, Canada
| | - Sameer Parpia
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Oncology, McMaster University, Hamilton, Ontario, Canada
| | - Zainab Samaan
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Mood Disorders Program, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Population Health Research Institute, Hamilton, Ontario, Canada
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26
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Almeida LV, Fukuchi CA, Sakanaka TE, Cliquet A. A low-cost easily implementable physiotherapy intervention clinically improves gait implying better adaptation to lower limb prosthesis: a randomized clinical trial. Sci Rep 2021; 11:21228. [PMID: 34707169 PMCID: PMC8551177 DOI: 10.1038/s41598-021-00686-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 10/15/2021] [Indexed: 11/13/2022] Open
Abstract
Lower limb amputation highly impacts the lives of individuals. The inability to walk due to difficulties in adapting to wearing prosthesis can potentially result in physical degeneration and comorbidity in this population. In this randomized clinical trial study, we investigated if a low-cost and easily implementable physiotherapy intervention was effective in improving gait performance and adaptation to lower limb prosthesis in individuals with an amputation. A total of 26 individuals participated in the study, 16 with lower limb amputation and 10 without amputation. Participants with amputation were further divided in intervention and control groups. The intervention group underwent a rehabilitation protocol aimed at strengthening muscles and improving prosthesis adaptation. Muscle strengthening targeted the hip segment, prioritizing the abdominal muscles, hip flexors, extensors, adductors and abductors, followed by cicatricial mobilization and weight-bearing on the stump for desensitization. Assessment and measures were performed across the kinetic and kinematic parameters of gait. In the comparison between pre-and post-intervention, a significant increase in gait speed (0.68—2.98, 95% CI, 1.83, effect size ES) and cadence (0.56—2.69, 95% CI, 1.63, ES) was found between groups and time points. Step (0.73—3.11, 95% CI, 1.92, ES) and stride length (0.62—2.84, 95% CI, 1.73) increased between pre- and post-intervention, while in the control group both variables remained smaller. The intervention group decreased stance phase as a percentage of gait cycle between pre- and post-intervention (− 1.33—0.62, 95% CI, − 36, ES), while it increased in the control group. Improvement in a combination of important gait parameters indicates that the intervention protocol promoted the adaptation to prosthesis and the functional independence of individuals with lower limb amputation. It is recommended that the participants continue receiving follow-up assessments and rehabilitation interventions.
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Affiliation(s)
- Leticia Vargas Almeida
- Department of Orthopedics and Traumatology, Faculty of Medical Sciences, State University of Campinas, São Paulo, Brazil.
| | - Claudiane Arakaki Fukuchi
- Department of Orthopedics and Traumatology, Faculty of Medical Sciences, State University of Campinas, São Paulo, Brazil
| | - Tania Emi Sakanaka
- Department of Orthopedics and Traumatology, Faculty of Medical Sciences, State University of Campinas, São Paulo, Brazil
| | - Alberto Cliquet
- Department of Orthopedics and Traumatology, Faculty of Medical Sciences, State University of Campinas, São Paulo, Brazil.,Biocybernetics and Rehabilitation Engineering Lab., Department of Electrical Engineering, University of São Paulo, São Paulo, Brazil
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Miyamoto GC, Ben ÂJ, Bosmans JE, van Tulder MW, Lin CWC, Cabral CMN, van Dongen JM. Interpretation of trial-based economic evaluations of musculoskeletal physical therapy interventions. Braz J Phys Ther 2021; 25:514-529. [PMID: 34340933 DOI: 10.1016/j.bjpt.2021.06.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 06/21/2021] [Accepted: 06/30/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND As resources for healthcare are scarce, decision-makers increasingly rely on economic evaluations when making reimbursement decisions about new health technologies, such as drugs, procedures, devices, and equipment. Economic evaluations compare the costs and effects of two or more interventions. Musculoskeletal disorders have a high prevalence and result in high levels of disability and high costs worldwide. Because physical therapy interventions are usually the first line of treatment for musculoskeletal disorders, economic evaluations of such interventions are becoming increasingly important for stakeholders in the field of physical therapy, including physical therapists, decision-makers, and reseachers. However, economic evaluations are relatively difficult to interpret for the majority of stakeholders. OBJECTIVE To support physical therapists, decision-makers, and researchers in the field of physical therapy interpreting trial-based economic evaluations and translating the results of such studies to clinical practice. METHODS The design, analysis, and interpretation of economic evaluations performed alongside randomized controlled trials are discussed. To further illustrate and explain these concepts, we use a case study assessing the cost-effectiveness of exercise therapy compared to standard advice in patients with musculoskeletal disorders. CONCLUSIONS Economic evaluations are increasingly being used in healthcare decision-making. Therefore, it is of utmost importance that their design, conduct, and analysis are state-of-the-art and that their interpretation is adequate. This masterclass will help physical therapists, decision-makers, and researchers in the field of physical therapy to critically appraise the quality and results of trial-based economic evaluations and to apply the results of such studies to their own clinical practice and setting.
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Affiliation(s)
- Gisela Cristiane Miyamoto
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil; Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health, Amsterdam, The Netherlands.
| | - Ângela Jornada Ben
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Judith E Bosmans
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Maurits W van Tulder
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Chung-Wei Christine Lin
- Institute for Musculoskeletal Health Sydney, School of Public Healthy, The University of Sydney, Sydney, New South Wales, Australia
| | | | - Johanna Maria van Dongen
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health, Amsterdam, The Netherlands
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Langbroek GB, Wolkerstorfer A, Horbach SER, Spuls PI, Kelly KM, Robertson SJ, van Raath MI, Al-Niaimi F, Kono T, Boixeda P, Laubach HJ, Badawi AM, Troilius Rubin A, Haedersdal M, Manuskiatti W, van der Horst CMAM, Ubbink DT. Development of a core outcome domain set for clinical research on capillary malformations (the COSCAM project). J Eur Acad Dermatol Venereol 2021; 35:1888-1895. [PMID: 34014582 PMCID: PMC8453952 DOI: 10.1111/jdv.17376] [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] [Received: 02/15/2021] [Accepted: 04/21/2021] [Indexed: 01/19/2023]
Abstract
Background Due to a large variety in treatment outcomes reported in therapeutic trials and lacking patient‐relevant outcomes, it is hard to adequately compare and improve current therapies for patients with capillary malformations (CMs). The Core Outcome Set for Capillary Malformations (COSCAM) project aims to develop a core outcome set (COS) for use in future CM trials, in which we will first develop a core outcome (sub)domain set (CDS). Here, we describe the methods for the development of a CDS and present the results of the first development stage. Methods The COSCAM project is carried out according to the recommendations of the Cochrane Skin Core OUtcomes Set INitiative (CS‐COUSIN) and the Core Outcome Measures in Effectiveness Trials (COMET) initiative. During the first stage, we identified all potentially relevant outcome subdomains based on a systematic review, two focus group sessions and input from patient representatives of Dutch patient organizations and the COSCAM‐founding group. In stage two, we will present the subdomains in a three‐round e‐Delphi study and online consensus meeting, in which CM patients, parents/caregivers and CM experts worldwide rate the importance of the proposed subdomains, hereby finalizing the core outcome (sub)domains of the CDS. Results A total of 67 potential outcome subdomains were included; sixteen were previously used in the literature, 20 were proposed by Dutch patients and their parents/caregivers (n = 13) in focus group sessions and 38 were suggested by the experts of the COSCAM‐founding group. Seven were excluded because of overlap. Conclusion The final CDS may serve as a minimum standard in future CM trials, thereby facilitating adequate comparison of treatment outcomes. After this CDS development, we will select appropriate outcome measurement instruments to measure the core outcome subdomains.
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Affiliation(s)
- G B Langbroek
- Department of Surgery, Amsterdam University Medical Center (UMC) Location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - A Wolkerstorfer
- Department of Dermatology, Amsterdam University Medical Center UMC, Amsterdam Public Health, Immunity and Infections, University of Amsterdam, Amsterdam, The Netherlands
| | - S E R Horbach
- Department of Plastic-, Reconstructive- and Hand Surgery, Amsterdam University Medical Center (UMC), University of Amsterdam, Amsterdam, The Netherlands
| | - P I Spuls
- Department of Dermatology, Amsterdam University Medical Center UMC, Amsterdam Public Health, Immunity and Infections, University of Amsterdam, Amsterdam, The Netherlands
| | - K M Kelly
- Department of Dermatology, University of California Irvine, Irvine, CA, USA
| | - S J Robertson
- Department of Dermatology and Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, VIC, Australia
| | - M I van Raath
- Department of Plastic, Reconstructive, and Hand Surgery, Maastricht University Medical Center, Maastricht University, Maastricht, The Netherlands
| | - F Al-Niaimi
- Private Dermatological Practice, London, UK.,Department of Dermatology, University of Aalborg, Aalborg, Denmark
| | - T Kono
- Department of Plastic Surgery, Tokai University School of Medicine, Shimokasuya Isehara Kanagawa, Kanagawa, Japan
| | - P Boixeda
- Department of Dermatology, Hospital Ramon y Cajal, Madrid, Spain
| | - H J Laubach
- Department of Dermatology, Geneva University Hospitals (HUG), Geneva, Switzerland
| | - A M Badawi
- Department of Dermatology, Szeged University, Szeged, Hungary.,Department of Medical Laser Applications, National Institute of Laser Enhanced Sciences, Cairo University, Giza, Egypt
| | - A Troilius Rubin
- Department of Dermatology, Skåne University Hospital, Malmö, Sweden
| | - M Haedersdal
- Department of Dermatology, University of Copenhagen, Bispebjerg Hospital, Copenhagen NV, Denmark
| | - W Manuskiatti
- Department of Dermatology, Siriraj Skin Laser Center Department of Dermatology, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
| | - C M A M van der Horst
- Department of Plastic-, Reconstructive- and Hand Surgery, Amsterdam University Medical Center (UMC), University of Amsterdam, Amsterdam, The Netherlands
| | - D T Ubbink
- Department of Surgery, Amsterdam University Medical Center (UMC) Location AMC, University of Amsterdam, Amsterdam, The Netherlands
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Rose L, Burry L, Blackwood B. Core outcome sets in intensive care–what are they and why do we need them? An example for delirium. Nurs Crit Care 2021; 26:144-146. [DOI: 10.1111/nicc.12627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 03/26/2021] [Indexed: 12/14/2022]
Affiliation(s)
- Louise Rose
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care King's College London London UK
| | - Lisa Burry
- Department of Pharmacy & Medicine, Sinai Health System, Leslie Dan Faculty of Pharmacy University of Toronto Toronto Canada
| | - Bronagh Blackwood
- Wellcome‐Wolfson Institute for Experimental Research Faculty of Medicine Health and Life Sciences, Queen's University Belfast Belfast UK
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Ramsey I, Corsini N, Hutchinson AD, Marker J, Eckert M. A core set of patient-reported outcomes for population-based cancer survivorship research: a consensus study. J Cancer Surviv 2021; 15:201-212. [PMID: 32865766 PMCID: PMC7966135 DOI: 10.1007/s11764-020-00924-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 07/31/2020] [Indexed: 12/28/2022]
Abstract
PURPOSE Core outcome sets aim to improve the consistency and quality of research by providing agreed-upon recommendations regarding what outcomes should be measured as a minimum for a population and setting. This study aimed to identify a core set of patient-reported outcomes (PROs) representing the most important issues impacting on cancer survivors' long-term health, functioning, and quality of life, to inform population-based research on cancer survivorship. METHODS In phase I, a list of 46 outcomes was generated through focus groups (n = 5) with cancer survivors (n = 40) and a review of instruments for assessing quality of life in cancer survivorship. In phase II, 69 national experts in cancer survivorship practice, research, policy, and lived experience participated in a two-round Delphi survey to refine and prioritise the listed outcomes into a core outcome set. A consensus meeting was held with a sub-sample of participants to discuss and finalise the included outcomes. RESULTS Twelve outcome domains were agreed upon for inclusion in the core outcome set: depression, anxiety, pain, fatigue, cognitive problems, fear of cancer recurrence or progression, functioning in everyday activities and roles, financial toxicity, coping with cancer, overall bother from side effects, overall quality of life, and overall health status. CONCLUSIONS We established a core set of PROs to standardise assessment of cancer survivorship concerns at a population level. IMPLICATIONS FOR CANCER SURVIVORS Adoption of the core outcome set will ensure that survivorship outcomes considered important by cancer survivors are assessed as a minimum in future studies. Furthermore, its routine use will optimise the comparability, quality, and usefulness of the data cancer survivors provide in population-based research.
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Affiliation(s)
- Imogen Ramsey
- Rosemary Bryant AO Research Centre, UniSA Clinical & Health Sciences, University of South Australia, City East Campus, GPO Box 2471, Adelaide, South Australia, 5001, Australia.
| | - Nadia Corsini
- Rosemary Bryant AO Research Centre, UniSA Clinical & Health Sciences, University of South Australia, City East Campus, GPO Box 2471, Adelaide, South Australia, 5001, Australia
| | - Amanda D Hutchinson
- UniSA Justice & Society, University of South Australia, Adelaide, South Australia, Australia
| | - Julie Marker
- Cancer Voices South Australia, Adelaide, Australia
| | - Marion Eckert
- Rosemary Bryant AO Research Centre, UniSA Clinical & Health Sciences, University of South Australia, City East Campus, GPO Box 2471, Adelaide, South Australia, 5001, Australia
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Franchignoni F, Giordano A, Monticone M. Construct validity of the Quebec Back Pain Disability Scale: a factor analytic and Rasch study. Eur J Phys Rehabil Med 2021; 57:600-606. [PMID: 33666389 DOI: 10.23736/s1973-9087.21.06502-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Studies on structural validity of the Quebec Back Pain Disability Scale (QBPDS) showed uncertain unidimensionality. AIM To investigate dimensionality and internal construct validity of the QBPDS, using advanced psychometric methods. DESIGN Secondary analysis of data from a cross-sectional observational study, SETTING: Outpatient rehabilitation hospital. POPULATION 201 patients with chronic Low Back Pain (40% men; mean age 48±12 years). METHODS Confirmatory (CFA) and then Exploratory Factor Analysis (EFA), and Rasch analysis were used. RESULTS CFA could not provide a satisfactory one-factor solution. Thus, according to a preliminary parallel analysis, two factor structures were examined: i) a single-factor solution, that showed good model fit according to Goodness of Fit Index and Comparative Fit Index, acceptable fit according to Root Mean Square Error of Approximation, and poor fit according to Standardized Root Mean Square of Residuals; ii) a bi-factor solution, both showing a good fit in all 4 indices. The Explained Common Variance index was 0.87. Thus, it was considered appropriate to apply Rasch analysis to our QBPDS data. Four items underfit the Rasch model and showed (two by two) local dependency. Removing these 4 misfitting items resulted in an acceptable fit to the Rasch model of the 16 remaining items. CONCLUSIONS All results pointed towards an essential unidimensionality of the QBPDS. Thus, we suggest to provisionally use the full QBPDS and its global score, pending further research on scale's construct validity. If the suboptimal performance of 4 items would be confirmed, the deletion of some of them could improve the metric quality of the scale. CLINICAL REHABILITATION IMPACT This study fills an evidence gap on important measurement properties of the QBPDS (namely, dimensionality and internal construct validity), thus representing a useful step towards the definition of the more suitable outcome measures for research and clinical practice in nonspecific chronic LBP.
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Affiliation(s)
- Franco Franchignoni
- Physical and Rehabilitation Medicine Unit, Istituti Clinici Scientifici Maugeri, IRCCS, Institute of Tradate, Tradate, Varese, Italy
| | - Andrea Giordano
- Bioengineering Unit, Istituti Clinici Scientifici Maugeri IRCCS, Institute of Veruno, Veruno, Novara, Italy
| | - Marco Monticone
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy - .,Neurorehabilitation Unit, Department of Neuroscience and Rehabilitation, G. Brotzu Hospital, Cagliari, Italy
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Wolfenden L, Movsisyan A, McCrabb S, Stratil JM, Yoong SL. Selecting Review Outcomes for Systematic Reviews of Public Health Interventions. Am J Public Health 2021; 111:465-470. [PMID: 33476230 PMCID: PMC7893343 DOI: 10.2105/ajph.2020.306061] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2020] [Indexed: 11/04/2022]
Abstract
For systematic reviews to have an impact on public health, they must report outcomes that are important for decision-making. Systematic reviews of public health interventions, however, have a range of potential end users, and identifying and prioritizing the most important and relevant outcomes represents a considerable challenge.In this commentary, we describe potentially useful approaches that systematic review teams can use to identify review outcomes to best inform public health decision-making. Specifically, we discuss the importance of stakeholder engagement, the use of logic models, consideration of core outcome sets, reviews of the literature on end users' needs and preferences, and the use of decision-making frameworks in the selection and prioritization of outcomes included in reviews.The selection of review outcomes is a critical step in the production of public health reviews that are relevant to those who use them. Utilizing the suggested strategies may help the review teams better achieve this.
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Affiliation(s)
- Luke Wolfenden
- Luke Wolfenden and Sam McCrabb are with the School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia. Ani Movsisyan and Jan M. Stratil are with the Institute for Medical Information Processing, Biometry and Epidemiology and the Pettenkofer School of Public Health, Ludwig Maximilian University of Munich, Munich, Germany. Sze Lin Yoong is with the Faculty of Health, Arts and Design, Swinburne University of Technology, Melbourne, Australia
| | - Ani Movsisyan
- Luke Wolfenden and Sam McCrabb are with the School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia. Ani Movsisyan and Jan M. Stratil are with the Institute for Medical Information Processing, Biometry and Epidemiology and the Pettenkofer School of Public Health, Ludwig Maximilian University of Munich, Munich, Germany. Sze Lin Yoong is with the Faculty of Health, Arts and Design, Swinburne University of Technology, Melbourne, Australia
| | - Sam McCrabb
- Luke Wolfenden and Sam McCrabb are with the School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia. Ani Movsisyan and Jan M. Stratil are with the Institute for Medical Information Processing, Biometry and Epidemiology and the Pettenkofer School of Public Health, Ludwig Maximilian University of Munich, Munich, Germany. Sze Lin Yoong is with the Faculty of Health, Arts and Design, Swinburne University of Technology, Melbourne, Australia
| | - Jan M Stratil
- Luke Wolfenden and Sam McCrabb are with the School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia. Ani Movsisyan and Jan M. Stratil are with the Institute for Medical Information Processing, Biometry and Epidemiology and the Pettenkofer School of Public Health, Ludwig Maximilian University of Munich, Munich, Germany. Sze Lin Yoong is with the Faculty of Health, Arts and Design, Swinburne University of Technology, Melbourne, Australia
| | - Sze Lin Yoong
- Luke Wolfenden and Sam McCrabb are with the School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia. Ani Movsisyan and Jan M. Stratil are with the Institute for Medical Information Processing, Biometry and Epidemiology and the Pettenkofer School of Public Health, Ludwig Maximilian University of Munich, Munich, Germany. Sze Lin Yoong is with the Faculty of Health, Arts and Design, Swinburne University of Technology, Melbourne, Australia
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Wang M, Chen Z, Wong M, Thabane L, Mbuagbaw L, Siegal D, Le Gal G, Holbrook A. Are the correct outcomes being measured in studies of oral anticoagulants? A systematic survey. Thromb Res 2021; 201:30-49. [PMID: 33631520 DOI: 10.1016/j.thromres.2021.02.016] [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: 11/06/2020] [Revised: 01/26/2021] [Accepted: 02/08/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Oral anticoagulant (OAC) intervention trials have typically included clinical event outcomes. However, there is no standard list of outcomes to be used in OAC research. This study aimed to describe and classify the outcomes used in recent prospective clinical studies involving OACs. MATERIALS AND METHODS We searched MEDLINE, EMBASE, and CINAHL databases from January 2009 to July 2019 for prospective studies with an intervention or control group that included one or more oral anticoagulants. We abstracted details about each included study and the outcomes used from the study report and its accompanying protocol. Using the Core Outcome Measures in Effectiveness Trials (COMET) Initiative recommendations, we categorised each outcome into one of five domains (mortality/survival, physiological/clinical, life impact, resource use, and adverse events). Our primary outcome was the prevalence of use of an outcome domain across studies. RESULTS We included 70 prospective studies, including 52 randomized controlled trials and 18 prospective cohort studies. A total of 121 different outcomes were reported. The COMET domains were represented in the 70 studies as follows: mortality (63/70, 90.0%); physiological/clinical domain (70/70, 100%), life impact domain (43/70, 61.4%), resource use domain (26/70, 37.1%), and adverse events domain (55/70, 78.6%). CONCLUSION Outcome reporting in prospective studies of OACs more frequently concentrates on mortality, physiological/clinical domains, and adverse events compared to life impact and resource utilization domains, the latter uncommonly used. A priority for future research includes developing a core outcome set (COS) for OAC research that represents all domains.
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Affiliation(s)
- Mei Wang
- Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, 1280 Main Street West, Hamilton L8S 4K1, ON, Canada; Father Sean O'Sullivan Research Centre, St. Joseph's Healthcare Hamilton, 50 Charlton Avenue East, Hamilton L8N 4A6, ON, Canada.
| | - Zhiyuan Chen
- Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, 1280 Main Street West, Hamilton L8S 4K1, ON, Canada
| | - Michael Wong
- Bachelor Life Sciences Program, Faculty of Health Sciences, McMaster University, 1280 Main Street West, Hamilton L8S 4K1, ON, Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, 1280 Main Street West, Hamilton L8S 4K1, ON, Canada; Father Sean O'Sullivan Research Centre, St. Joseph's Healthcare Hamilton, 50 Charlton Avenue East, Hamilton L8N 4A6, ON, Canada
| | - Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, 1280 Main Street West, Hamilton L8S 4K1, ON, Canada; Father Sean O'Sullivan Research Centre, St. Joseph's Healthcare Hamilton, 50 Charlton Avenue East, Hamilton L8N 4A6, ON, Canada
| | - Deborah Siegal
- Division of Hematology and Thromboembolism, Department of Medicine, McMaster University, 1280 Main Street West, Hamilton L8S 4K1, ON, Canada
| | - Gregoire Le Gal
- Department of Medicine, Ottawa Hospital Research Institute, University of Ottawa, 501 Smyth, Ottawa K1H 8L6, ON, Canada
| | - Anne Holbrook
- Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, 1280 Main Street West, Hamilton L8S 4K1, ON, Canada; Father Sean O'Sullivan Research Centre, St. Joseph's Healthcare Hamilton, 50 Charlton Avenue East, Hamilton L8N 4A6, ON, Canada; Division of Clinical Pharmacology & Toxicology, Department of Medicine, McMaster University, 1280 Main Street West, Hamilton L8S 4K1, ON, Canada
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Systematic Review of Behaviour Change Theories Implementation in Dietary Interventions for People Who Have Survived Cancer. Nutrients 2021; 13:nu13020612. [PMID: 33668596 PMCID: PMC7917689 DOI: 10.3390/nu13020612] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 02/10/2021] [Indexed: 12/26/2022] Open
Abstract
Background: An increasing number of dietary interventions for cancer survivors have been based on the behaviour change theory framework. The purpose of this study is to review the use and implementation of behaviour change theories in dietary interventions for people after cancer and assess their effects on the reported outcomes. Methods: The search strategy from a Cochrane review on dietary interventions for cancer survivors was expanded to incorporate an additional criterion on the use of behaviour change theory and updated to September 2020. Randomised controlled trials (RCT) testing a dietary intervention compared to the control were included. Standard Cochrane methodological procedures were used. Results: Nineteen RCTs, with 6261 participants (age range 44.6 to 73.1 years), were included in the review. The Social Cognitive Theory was the most frequently used theory (15 studies, 79%). Studies included between 4 to 17 behaviour change techniques. Due to limited information on the mediators of intervention and large heterogeneity between studies, no meta-analyses was conducted to assess which theoretical components of the interventions are effective. Conclusions: Whilst researchers have incorporated behaviour change theories into dietary interventions for cancer survivors, due to inconsistencies in design, evaluation and reporting, the effect of theories on survivors’ outcomes remains unclear.
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Kamonseki DH, Calixtre LB, Barreto RPG, Camargo PR. Effects of electromyographic biofeedback interventions for shoulder pain and function: Systematic review and meta-analysis. Clin Rehabil 2021; 35:952-963. [PMID: 33517777 DOI: 10.1177/0269215521990950] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To systematically review the effectiveness of electromyographic biofeedback interventions to improve pain and function of patients with shoulder pain. DESIGN Systematic review of controlled clinical trials. LITERATURE SEARCH Databases (Medline, EMBASE, CINAHL, PEDro, CENTRAL, Web of Science, and SCOPUS) were searched in December 2020. STUDY SELECTION CRITERIA Randomized clinical trials that investigated the effects of electromyographic biofeedback for individuals with shoulder pain. Patient-reported pain and functional outcomes were collected and synthesized. DATA SYNTHESIS The level of evidence was synthesized using GRADE and Standardized Mean Differences and 95% confidence interval were calculated using a random-effects inverse variance model for meta-analysis. RESULTS Five studies were included with a total sample of 272 individuals with shoulder pain. Very-low quality of evidence indicated that electromyographic biofeedback was not superior to control for reducing shoulder pain (standardized mean differences = -0.21, 95% confidence interval: -0.67 to 0.24, P = 0.36). Very-low quality of evidence indicated that electromyographic biofeedback interventions were not superior to control for improving shoulder function (standardized mean differences = -0.11, 95% confidence interval: -0.41 to 0.19, P = 0.48). CONCLUSION Electromyographic biofeedback may be not effective for improving shoulder pain and function. However, the limited number of included studies and very low quality of evidence does not support a definitive recommendation about the effectiveness of electromyographic biofeedback to treat individuals with shoulder pain.
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Affiliation(s)
- Danilo Harudy Kamonseki
- Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos (UFSCar), São Carlos, São Paulo, Brazil
| | - Letícia Bojikian Calixtre
- Department of Dental Materials and Prosthodontics, Araraquara Dental School, Universidade Estadual Paulista (UNESP), Araraquara, São Paulo, Brazil
| | - Rodrigo Py Gonçalves Barreto
- Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos (UFSCar), São Carlos, São Paulo, Brazil
| | - Paula Rezende Camargo
- Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos (UFSCar), São Carlos, São Paulo, Brazil
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Hepprich M, Donath MY, Hemkens LG. Patient involvement to inform the design of a clinical trial in postbariatric hypoglycaemia. BMC Med Res Methodol 2020; 20:290. [PMID: 33256627 PMCID: PMC7706264 DOI: 10.1186/s12874-020-01171-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 11/19/2020] [Indexed: 12/29/2022] Open
Abstract
Background Bariatric surgery may lead to symptomatic postprandial hypoglycaemia as a major side effect without established therapy so far. We aimed to develop an evidence-based study design of a clinical trial that tests treatment options and can provide useful patient-relevant evidence. Methods We searched systematically for guidance of core outcome sets to determine the most relevant types of outcomes and duration of such a trial. Our search comprised literature databases, a database of core outcome sets and self-help organizations. We then developed a simple online questionnaire based on interviews with German-speaking patients with postprandial hypoglycaemia after bariatric surgery. We recruited participants by reaching out to all German speaking endocrinologists in Switzerland and large Swiss bariatric centres. We asked for preferences regarding outcome types and acceptable duration of being included in a corresponding clinical trial. Results The literature search did not identify evidence-based guidance for informing our study design. Experience of clinical and research routine as well as patient interviews helped in identifying potential outcomes and the design of an online questionnaire. Therein, a total of 29 persons started the questionnaire and 22 answered questions related to the primary outcome. Of these, 17 (77.3%) deemed quality of life more relevant as primary outcome than the rate of hypoglycaemic episodes. A trial length of four weeks or longer was regarded as acceptable for 19 of 21 respondents to this question (91.4%) and of six months or longer for 12 respondents (56%). Conclusions In situations with no other guidance, a simple questionnaire may help to inform trial design decisions. This study identifies a patient preference for “quality of life” as a primary outcome and supports the evidence-based conception of a patient-centred clinical trial in postbariatric hypoglycaemia. Supplementary Information Supplementary information accompanies this paper at 10.1186/s12874-020-01171-z.
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Affiliation(s)
- Matthias Hepprich
- Division of Endocrinology, Diabetology and Metabolism, University Hospital Basel, Petersgraben 4, 4053, Basel, Switzerland. .,Clinic of Endocrinology, Cantonal Hospital Olten, Basler Strasse 150, 4600, Olten, Switzerland.
| | - Marc Y Donath
- Division of Endocrinology, Diabetology and Metabolism, University Hospital Basel, Petersgraben 4, 4053, Basel, Switzerland
| | - Lars G Hemkens
- Basel Institute for Clinical Epidemiology and Biostatistics, Department of Clinical Research, University of Basel and University Hospital Basel, Basel, Switzerland.,Meta-Research Innovation Center Berlin (METRIC-B), Berlin Institute of Health, Berlin, Germany.,Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, USA
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Fandim JV, Nitzsche R, Michaleff ZA, Pena Costa LO, Saragiotto B. The contemporary management of neck pain in adults. Pain Manag 2020; 11:75-87. [PMID: 33234017 DOI: 10.2217/pmt-2020-0046] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Neck pain is a common condition with a high prevalence worldwide. Neck pain is associated with significant levels of disability and is widely considered an important public health problem. Neck pain is defined as pain perceived between the superior nuchal line and the spinous process of the first thoracic vertebra. In some types of neck conditions, the pain can be referred to the head, trunk and upper limbs. This article aims to provide an overview of the available evidence on prevalence, costs, diagnosis, prognosis, risk factors, prevention and management of patients with neck pain.
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Affiliation(s)
- Junior V Fandim
- Masters & Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
| | - Renato Nitzsche
- Masters & Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
| | - Zoe A Michaleff
- Faculty of Health Sciences & Medicine, Institute for Evidence-Based Healthcare, Bond University, Gold Coast, QLD, Australia
| | | | - Bruno Saragiotto
- Masters & Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
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García-Martín M, Amezcua-Prieto C, H Al Wattar B, Jørgensen JS, Bueno-Cavanillas A, Khan KS. Patient and Public Involvement in Sexual and Reproductive Health: Time to Properly Integrate Citizen's Input into Science. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218048. [PMID: 33142916 PMCID: PMC7663614 DOI: 10.3390/ijerph17218048] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 10/26/2020] [Accepted: 10/28/2020] [Indexed: 12/17/2022]
Abstract
Evidence-based sexual and reproductive health is a global endeavor without borders. Inter-sectorial collaboration is essential for identifying and addressing gaps in evidence. Health research funders and regulators are promoting patient and public involvement in research, but there is a lack of quality tools for involving patients. Partnerships with patients are necessary to produce and promote robust, relevant and timely research. Without the active participation of women as stakeholders, not just as research subjects, the societal benefits of research cannot be realized. Creating and developing platforms and opportunities for public involvement in sexual and reproductive health research should be a key international objective. Cooperation between healthcare professionals, academic institutions and the community is essential to promote quality research and significant developments in women's health. This cooperation will be improved when involvement of citizens in the research process becomes standard.
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Affiliation(s)
- Miguel García-Martín
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, 18016 Granada, Spain; (M.G.-M.); (A.B.-C.); (K.S.K.)
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Instituto de Investigación Biosanitaria (ibs.Granada), 18014 Granada, Spain
| | - Carmen Amezcua-Prieto
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, 18016 Granada, Spain; (M.G.-M.); (A.B.-C.); (K.S.K.)
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Instituto de Investigación Biosanitaria (ibs.Granada), 18014 Granada, Spain
- Correspondence: ; Tel.: +34-95824100 (ext. 20287)
| | - Bassel H Al Wattar
- Reproductive Medicine Unit, Institute for Women’s Health, University College London Hospitals, London WC1E 6BT, UK;
- Warwick Medical School, University of Warwick, Coventry CV4 7 AL, UK
| | - Jan Stener Jørgensen
- Department of Obstetrics and Gynaecology CIMT-Centre for Innovative Medical Technologies Odense University Hospital, 5000 Odense C, Denmark;
| | - Aurora Bueno-Cavanillas
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, 18016 Granada, Spain; (M.G.-M.); (A.B.-C.); (K.S.K.)
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Instituto de Investigación Biosanitaria (ibs.Granada), 18014 Granada, Spain
| | - Khalid Saeed Khan
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, 18016 Granada, Spain; (M.G.-M.); (A.B.-C.); (K.S.K.)
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
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Meissner Y, Fischer-Betz R, Andreoli L, Costedoat-Chalumeau N, De Cock D, Dolhain RJEM, Forger F, Goll D, Molto A, Nelson-Piercy C, Özdemir R, Raio L, Rodríguez-García SC, Sciascia S, Wallenius M, Zbinden A, Zink A, Strangfeld A. EULAR recommendations for a core data set for pregnancy registries in rheumatology. Ann Rheum Dis 2020; 80:49-56. [PMID: 33055080 PMCID: PMC7788063 DOI: 10.1136/annrheumdis-2020-218356] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 09/01/2020] [Accepted: 09/07/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND AND OBJECTIVE There is an urgent need for robust data on the trajectories and outcomes of pregnancies in women with inflammatory rheumatic diseases (IRD). In particular when rare outcomes or rare diseases are to be investigated, collaborative approaches are required. However, joint data analyses are often limited by the heterogeneity of the different data sources.To facilitate future research collaboration, a European League Against Rheumatism (EULAR) Task Force defined a core data set with a minimum of items to be collected by pregnancy registries in rheumatology covering the period of pregnancy and the 28-day neonatal phase in women with any underlying IRD. METHODS A stepwise process included a two-round Delphi survey and a face-to-face meeting to achieve consensus about relevant items. RESULTS A total of 64 multidisciplinary stakeholders from 14 different countries participated in the two rounds of the Delphi process. During the following face-to-face meeting of the EULAR Task Force, consensus was reached on 51 main items covering 'maternal information', 'pregnancy' and 'treatment'. Generic instruments for assessment are recommended for every item. Furthermore, for the five most frequent IRDs rheumatoid arthritis, spondyloarthritis, juvenile idiopathic arthritis, systemic lupus erythematosus and other connective tissue diseases, disease-specific laboratory markers and disease activity measurements are proposed. CONCLUSION This is the first consensus-based core data set for prospective pregnancy registries in rheumatology. Its purpose is to stimulate and facilitate multinational collaborations that aim to increase the knowledge about pregnancy course and safety of treatment in women with IRDs during pregnancy.
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Affiliation(s)
- Yvette Meissner
- Epidemiology and Health Care Research, German Rheumatism Research Center Berlin, Berlin, Germany
| | - Rebecca Fischer-Betz
- Department for Rheumatology and Hiller Research Institute, Heinrich Heine University Düsseldorf, Dusseldorf, Germany
| | - Laura Andreoli
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.,Unit of Rheumatology and Clinical Immunology, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Nathalie Costedoat-Chalumeau
- Internal Medicine Department, Referral Center for Rare Autoimmune and Systemic Diseases, Hospital Cochin, Paris, France.,CRESS, INSERM, INRA, Université de Paris, Paris, France
| | - Diederik De Cock
- Department of Development and Regeneration KU, KU Leuven, Leuven, Belgium
| | - Radboud J E M Dolhain
- Medical Centre, Department of Rheumatology, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Frauke Forger
- Department of Rheumatology, Immunology and Allergology, Inselspital University Hospital Bern, Bern, Switzerland
| | | | - Anna Molto
- Rheumatology Department, Hospital Cochin, Paris, France.,U-1153, INSERM, University of Paris, Paris, France
| | - Catherine Nelson-Piercy
- Obstetric Medicine Service, Queen Charlotte's and Chelsea Hospital, London, UK.,Department of Women and Children's Health, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | | | - Luigi Raio
- Department of Obstetrics and Gynaecology, Inselspital University Hospital Bern, Bern, Switzerland
| | | | - Savino Sciascia
- Dipartimento di Malattie Rare, Immunologiche, Ematologiche ed Immunoematologiche. Centro di Ricerche di Immunopatologia e Documentazione su Malattie Rare (CMID). Struttura Complessa a Direzione Universitaria di Immunologia Clinica, Ospedale Torino Nord Emergenza San G. Bosco ed Università di Torino, Torino, Italy
| | - Marianne Wallenius
- Institute of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.,Norwegian National Advisory Unit on Pregnancy and Rheumatic Diseases, Dept of Rheumatology, St Olavs Hospital University Hospital in Trondheim, Trondheim, Norway
| | - Astrid Zbinden
- Department of Rheumatology, Immunology and Allergology, Inselspital University Hospital Bern, Bern, Switzerland
| | - Angela Zink
- Epidemiology and Health Care Research, German Rheumatism Research Center Berlin, Berlin, Germany
| | - Anja Strangfeld
- Epidemiology and Health Care Research, German Rheumatism Research Center Berlin, Berlin, Germany
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Ramsey I, Eckert M, Hutchinson AD, Marker J, Corsini N. Core outcome sets in cancer and their approaches to identifying and selecting patient-reported outcome measures: a systematic review. J Patient Rep Outcomes 2020; 4:77. [PMID: 32930891 PMCID: PMC7492323 DOI: 10.1186/s41687-020-00244-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Accepted: 08/26/2020] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES Issues arising from a lack of outcome standardisation in health research may be addressed by the use of core outcome sets (COS), which represent agreed-upon recommendations regarding what outcomes should be measured as a minimum in studies of a health condition. This review investigated the scope, outcomes, and development methods of consensus-based COS for cancer, and their approaches and criteria for selecting instruments to assess core patient-reported outcomes (PROs). METHODS Studies that used a consensus-driven approach to develop a COS containing PROs, for use in research with cancer populations, were sought via MEDLINE, CINAHL, Embase, Cochrane Library, and grey literature. RESULTS Seventeen studies met the inclusion criteria. Most COS (82%) were specific to a cancer type (prostate, esophageal, head and neck, pancreatic, breast, ovarian, lung, or colorectal) and not specific to an intervention or treatment (76%). Conducting a systematic review was the most common approach to identifying outcomes (88%) and administering a Delphi survey was the most common approach to prioritising outcomes (71%). The included COS contained 90 PROs, of which the most common were physical function, sexual (dys) function, pain, fatigue, and emotional function. Most studies (59%) did not address how to assess the core PROs included in a set, while 7 studies (41%) recommended specific instruments. Their approaches to instrument appraisal and selection varied. CONCLUSION Efforts to standardise outcome assessment via the development of COS may be undermined by a lack of recommendations on how to measure core PROs. To optimise COS usefulness and adoption, valid and reliable instruments for the assessment of core PROs should be recommended with the aid of resources designed to facilitate this process.
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Affiliation(s)
- Imogen Ramsey
- Rosemary Bryant AO Research Centre, UniSA Clinical & Health Sciences, University of South Australia, Adelaide, Australia.
| | - Marion Eckert
- Rosemary Bryant AO Research Centre, UniSA Clinical & Health Sciences, University of South Australia, Adelaide, Australia
| | | | - Julie Marker
- Cancer Voices South Australia, Adelaide, Australia
| | - Nadia Corsini
- Rosemary Bryant AO Research Centre, UniSA Clinical & Health Sciences, University of South Australia, Adelaide, Australia
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Michalk K, Schöttker-Königer T, Probst A, Lüdtke K. Entwicklung eines Konsenses zu wichtigen Zielgrößen in der Physiotherapie bei Nackenschmerzen – Eine Delphi-Studie. PHYSIOSCIENCE 2020. [DOI: 10.1055/a-1110-2096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Zusammenfassung
Hintergrund Nackenschmerzen sind in der Physiotherapie ein häufiger Behandlungsanlass. Die Messung von Behandlungsergebnissen findet im Praxisalltag oftmals nur unzureichend statt. Ein Core Outcome Set (COS) für die physiotherapeutische Praxis fehlt derzeit.
Ziel Einen Konsens zu wichtigen Zielgrößen zu entwickeln, die in der physiotherapeutischen Praxis für die Messung der Behandlungsergebnisse bei Patienten mit unspezifischen Nackenschmerzen verwendet werden sollten.
Methode Zur Identifizierung von Zielgrößen wurde zunächst eine systematische Recherche durchgeführt. Anschließend fand eine Delphi-Befragung von Physiotherapeuten und Patienten statt, bei der die Teilnehmenden die Wichtigkeit der Zielgrößen anhand einer 9-Punkte-Ratingskala beurteilten. Es wurden Lage- und Streuungsmaße für jede Zielgröße berechnet.
Ergebnisse Es nahmen 62 Physiotherapeuten und neun Patienten an der ersten Fragerunde teil. Weitere Fragerunden mit den Patienten wurden aufgrund der geringen Teilnehmerzahl eingestellt. Die Patienten erachten das „Bewegungsausmaß der Halswirbelsäule in verschiedene Bewegungsrichtungen“ sowie die „gesundheitsbezogene Lebensqualität“ als wichtige Zielgrößen. 50 (81 %) bzw. 37 (74 %) Physiotherapeuten beendeten die zweite bzw. dritte Fragerunde. Für sie sind wichtige Zielgrößen „Beschwerden und Probleme bei alltäglichen Aktivitäten durch die Nackenschmerzen“ und die „Fähigkeit zum selbstverantwortlichen Umgang mit den Nackenschmerzen“.
Schlussfolgerung Es wurde ein erster Konsens zu wichtigen Zielgrößen aus Sicht der Physiotherapeuten erreicht. In Zukunft sind aufbauende Studien für die Entwicklung eines COS erforderlich, um u. a. die benannten Zielgrößen zu bestätigen und die Sicht der Patienten mit einzubeziehen.
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Affiliation(s)
- Katrin Michalk
- HAWK Hochschule für angewandte Wissenschaft und Kunst, Fakultät Soziale Arbeit und Gesundheit, Bachelor- und Masterstudiengang Ergotherapie, Logopädie und Physiotherapie, Hildesheim, Deutschland
- Ostbayerische Technische Hochschule Regensburg (OTH Regensburg), Fakultät Angewandte Sozial- und Gesundheitswissenschaften, Fachbereich Physiotherapie Regensburg, Deutschland
| | - Thomas Schöttker-Königer
- HAWK Hochschule für angewandte Wissenschaft und Kunst, Fakultät Soziale Arbeit und Gesundheit, Bachelor- und Masterstudiengang Ergotherapie, Logopädie und Physiotherapie, Hildesheim, Deutschland
| | - Annette Probst
- HAWK Hochschule für angewandte Wissenschaft und Kunst, Fakultät Soziale Arbeit und Gesundheit, Bachelor- und Masterstudiengang Ergotherapie, Logopädie und Physiotherapie, Hildesheim, Deutschland
| | - Kerstin Lüdtke
- Universität zu Lübeck, Bachelorstudiengang Physiotherapie, Lübeck, Deutschland
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Using PROMIS-29 to predict Neck Disability Index (NDI) scores using a national sample of cervical spine surgery patients. Spine J 2020; 20:1305-1315. [PMID: 32413486 DOI: 10.1016/j.spinee.2020.04.028] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 04/29/2020] [Accepted: 04/29/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Patient reported outcome measures (PROMs) are valuable tools for evaluating the success of spine surgery, with the Neck Disability Index (NDI) commonly used to assess pain-related disability. Recently, patient-reported outcomes measurement information system (PROMIS) has gained attention in its ability to measure PROs across general patient populations. However, PROMIS is not condition-specific so spine researchers are reluctant to incorporate it in place of common legacy measures. PURPOSE To compare the PROMIS-29 (v2.0) to the NDI and compute a conversion equation. STUDY DESIGN This study retrospectively analyzes prospectively collected data from the cervical module of national spine registry, the Quality Outcomes Database (QOD). PATIENT SAMPLE The QOD was queried for cervical spine surgery patients with PROMIS-29 and NDI scores. The cervical module of QOD includes patients undergoing primary or revision surgery for cervical degenerative spine diseases. Exclusion criteria included age under 18 years and diagnoses of infection, tumor, or trauma as the cause of cervical-related pain. OUTCOME MEASURES The outcome of interest for this study was a conversion equation from PROMIS-29 to NDI. METHODS The PROMIS-29 includes seven 4-item domains each rated on a 5-point scale: Physical function, depression, anxiety, fatigue, sleep disturbance, ability to participate in social roles and activities (social roles), and pain interference plus one stand-alone pain intensity item. The NDI contains 10 pain-related questions scored from 0 (no pain) to 5 (most severe pain). Outcomes were collected prior to surgery and at 3- and 12-month post surgery. Patients were included in the current analysis if they had outcome data available at one or more time points. Multivariable mixed effects regression models predicting NDI scores from PROMIS-29 domains were conducted in a development data set and validated in a separate data set. Predicted NDI scores were plotted against NDI scores to determine how well PROMIS-29 domains predicted NDI. Conversion equations were created from the PROMIS-29 regression coefficients. RESULTS 2,018 patients from 18 US hospitals were included (mean age=57 years (SD=12)) with 48% female, 87% Caucasian, and 11% had revision surgery. Strong correlations were found between NDI and pain interference (r=0.79), pain intensity (r=0.74), social roles (r=-0.71), physical function (r=-0.69), sleep disturbance (r=0.63), fatigue (r=0.63), and anxiety (r=0.54). Correlation between NDI and depression (r=0.49) was slightly weaker. The pattern of correlations was consistent across timepoints. Four conversion equations were created for NDI using (1) only pain interference, (2) only physical function, (3) pain interference and physical function, and (4) the five statistically significant domains of pain interference, physical function, social roles, sleep disturbance, and anxiety, plus the pain intensity item. Equations 1, 3, and 4 were the best predictors of NDI, predicting approximately 80% of NDI scores within 15 points in the validation data set. Equation 4 (NDI%=18.897+0.855*[pain interferenceraw]-0.694*[physical functionraw]+2.010*[pain intensityraw]-0.663*[social rolesraw]+0.732*[sleep disturbanceraw]+0.426*[anxietyraw]) predicted NDI most accurately with an R2 between the predicted and actual NDI scores of 0.72. Model 1 (R2 = 0.62; NDI%=-4.055+3.164*[pain interferenceraw])) and Model 3 (R2=0.65; NDI%=17.321+2.543*[pain interferenceraw]-1.012*[physical functionraw]) also had good accuracy. CONCLUSIONS Findings suggest accurate NDI scores can be derived from PROMIS-29 domains. Clinicians who want to move from NDI to PROMIS-29 can use this equation to obtain estimated NDI scores when only collecting PROMIS-29. These results support the use of PROMIS-29 in cervical surgery populations and underscore the idea that PROMIS-29 domains have the potential to replace disease-specific traditional PROMs.
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Guan M, Gresham G, Shinde A, Lapite I, Gong J, Placencio-Hickok VR, Forrest CB, Hendifar AE. Priority Rankings of Patient-Reported Outcomes for Pancreatic Ductal Adenocarcinoma: A Comparison of Patient and Physician Perspectives. J Natl Compr Canc Netw 2020; 18:1075-1083. [DOI: 10.6004/jnccn.2020.7548] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 02/18/2020] [Indexed: 11/17/2022]
Abstract
Background: Pancreatic ductal adenocarcinoma (PDAC) is associated with high symptom burden. However, treatment decisions currently depend heavily on physician interpretation of clinical parameters and may not consider patients’ health preferences. The NIH Patient-Reported Outcomes Measurement Information System (PROMIS) initiative standardized a set of patient-reported outcomes for use in chronic diseases. This study identifies preference rankings among patients with PDAC and physicians for PROMIS domains and compares the priorities of patients and their providers. Methods: We condensed the 96 NIH PROMIS adult domains into 31 domains and created a Maximum Difference Scaling questionnaire. Domain preference scores were generated from the responses of patients with PDAC and physicians, which were compared using Maximum Difference Scaling software across demographic and clinical variables. Results: Participants included 135 patients with PDAC (53% male; median age, 68 years) and 54 physicians (76% male; median years of experience, 10). Patients selected physical functioning (PF) as their top priority, whereas physicians identified pain as most important. PF, ability to perform activities of daily living, and symptom management were within the top 5 domains for both patients and physicians, and varied only slightly across age, sex, and ethnicity. However, several domains were ranked significantly higher by patients than by physicians, including but not limited to PF; ability to do things for yourself, family, and friends; ability to interact with others to obtain help; and sleep quality. Physicians ranked pain, anxiety, and depression higher than patients did. Conclusions: Our findings suggest that patients with PDAC value PF and engaging in daily and social activities the most, whereas physicians prioritize symptoms such as pain. Patient-reported outcomes need to become more integrated into PDAC care and research to better identify unmet patient needs, inform treatment decisions, and develop therapies that address outcomes valued by patients.
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Affiliation(s)
- Michelle Guan
- 1Cedars-Sinai Samuel Oschin Comprehensive Cancer Institute, Los Angeles, California
| | - Gillian Gresham
- 1Cedars-Sinai Samuel Oschin Comprehensive Cancer Institute, Los Angeles, California
| | - Arvind Shinde
- 2Department of Hematology and Oncology, Transplant and Hepatopancreatobiliary Institute, St. Vincent Medical Center, Los Angeles, California; and
| | - Isaac Lapite
- 1Cedars-Sinai Samuel Oschin Comprehensive Cancer Institute, Los Angeles, California
| | - Jun Gong
- 1Cedars-Sinai Samuel Oschin Comprehensive Cancer Institute, Los Angeles, California
| | | | - Christopher B. Forrest
- 3Applied Clinical Research Center, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Andrew E. Hendifar
- 1Cedars-Sinai Samuel Oschin Comprehensive Cancer Institute, Los Angeles, California
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Bijker L, Sleijser-Koehorst M, Coppieters M, Cuijpers P, Scholten-Peeters G. Preferred Self-Administered Questionnaires to Assess Depression, Anxiety and Somatization in People With Musculoskeletal Pain – A Modified Delphi Study. THE JOURNAL OF PAIN 2020; 21:409-417. [DOI: 10.1016/j.jpain.2019.08.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 05/17/2019] [Accepted: 08/29/2019] [Indexed: 12/29/2022]
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Ramsey I, Corsini N, Hutchinson AD, Marker J, Eckert M. Development of a Core Set of Patient-Reported Outcomes for Population-Based Cancer Survivorship Research: Protocol for an Australian Consensus Study. JMIR Res Protoc 2020; 9:e14544. [PMID: 32012089 PMCID: PMC7013638 DOI: 10.2196/14544] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 10/15/2019] [Accepted: 10/15/2019] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Core outcome sets seek to improve the consistency and quality of research by providing agreed-upon recommendations regarding what outcomes should be measured as a minimum for a population and setting. The problems arising from a lack of outcome standardization in population-based cancer survivorship research indicate the need for agreement on a core set of patient-reported outcomes (PROs) to enhance data quality, consistency, and comparability. OBJECTIVE This study aims to identify a core set of PROs, representing the most important issues impacting on cancer survivors' long-term health, functioning and quality of life, to inform population-based research on cancer survivorship. METHODS In Phase I, a list of all potentially important outcomes will be generated through focus group discussions with cancer survivors and a review of measures for assessing quality of life in cancer survivorship. The consolidated list will be advanced to Phase II, where a stakeholder consensus process will be conducted with national experts in cancer survivorship to refine and prioritize the outcomes into a core outcome set. The process will consist of a two-round Delphi survey and a consensus meeting. Cancer survivors, oncology health care professionals, and potential end users of the core outcome set with expertise in cancer survivorship research or policy will be invited to participate. In Phase III, recommended measures for assessment of the core outcome set will be selected with advice from experts on the assessment, analysis, and interpretation of PROs. RESULTS As of April 2019, data collection for Phase I is complete and data analysis is underway. These data will inform the list of outcomes to be advanced into Phase II. Recruitment for Phase II will commence in June 2019, and it is anticipated that it will take 6 months to complete the three-step consensus process and identify a provisional core outcome set. The study results are expected to be published in early 2020. CONCLUSIONS Expert consensus-driven recommendations on outcome measurement will facilitate the inclusion of survivorship outcomes considered important by cancer survivors and health professionals in future research. Adoption of the core outcome set will enable comparison and synthesis of evidence across studies and enhance the quality of PRO data collected in cancer survivorship research, particularly when applied to address macro-level questions. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/14544.
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Affiliation(s)
- Imogen Ramsey
- Rosemary Bryant AO Research Centre, School of Nursing and Midwifery and UniSA Cancer Research Institute, University of South Australia, Adelaide, Australia
| | - Nadia Corsini
- Rosemary Bryant AO Research Centre, School of Nursing and Midwifery and UniSA Cancer Research Institute, University of South Australia, Adelaide, Australia
| | - Amanda D Hutchinson
- School of Psychology, Social Work and Social Policy, University of South Australia, Adelaide, Australia
| | - Julie Marker
- Cancer Voices South Australia, Adelaide, Australia
| | - Marion Eckert
- Rosemary Bryant AO Research Centre, School of Nursing and Midwifery and UniSA Cancer Research Institute, University of South Australia, Adelaide, Australia
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Multidimensional screening for predicting pain problems in adults: a systematic review of screening tools and validation studies. Pain Rep 2019; 4:e775. [PMID: 31875182 PMCID: PMC6882575 DOI: 10.1097/pr9.0000000000000775] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 06/11/2019] [Accepted: 06/26/2019] [Indexed: 12/14/2022] Open
Abstract
Screening tools allowing to predict poor pain outcomes are widely used. Often these screening tools contain psychosocial risk factors. This review (1) identifies multidimensional screening tools that include psychosocial risk factors for the development or maintenance of pain, pain-related distress, and pain-related disability across pain problems in adults, (2) evaluates the quality of the validation studies using Prediction model Risk Of Bias ASsessment Tool (PROBAST), and (3) synthesizes methodological concerns. We identified 32 articles, across 42 study samples, validating 7 screening tools. All tools were developed in the context of musculoskeletal pain, most often back pain, and aimed to predict the maintenance of pain or pain-related disability, not pain-related distress. Although more recent studies design, conduct, analyze, and report according to best practices in prognosis research, risk of bias was most often moderate. Common methodological concerns were identified, related to participant selection (eg, mixed populations), predictors (eg, predictors were administered differently to predictors in the development study), outcomes (eg, overlap between predictors and outcomes), sample size and participant flow (eg, unknown or inappropriate handling of missing data), and analysis (eg, wide variety of performance measures). Recommendations for future research are provided.
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Bhagat M, Neelapala YVR, Gangavelli R. Immediate effects of Mulligan's techniques on pain and functional mobility in individuals with knee osteoarthritis: A randomized control trial. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2019; 25:e1812. [PMID: 31502354 DOI: 10.1002/pri.1812] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 07/24/2019] [Accepted: 08/25/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND PURPOSE Mulligan's mobilization with movement was shown to be effective when implemented in multimodal therapy for knee osteoarthritis. However, no study has evaluated the Mulligan's technique in isolation and compared the relative effectiveness with sham-controlled interventions. Hence, the present study examined the immediate effects of Mulligan's techniques with sham mobilization on the numerical pain rating scale (NPRS) and timed up and go (TUG) test in individuals with knee osteoarthritis. METHODS Thirty participants (mean age: 55.3 ± 8.3 years) with symptoms at the knee and radiographic diagnosis of knee osteoarthritis were randomized into sham (n = 15) and intervention (n = 15) groups. The intervention (I) group received Mulligan's mobilization glides that resulted in relative pain relief for three sets of 10 repetitions. For the sham (S) group, the therapist's hand was placed over the joint surfaces mimicking the pain-relieving glides, without providing the gliding force. The outcome measures NPRS and TUG were recorded by a blinded assessor pre- and post-intervention. RESULTS Statistically significant differences were identified between the groups in post-intervention median (interquartile range) NPRS (I group: 4.00 [2.00-5.00]; S group: 6.00 [4.00-7.00]) and TUG scores (I group: 10.9 [9.43-10.45]; S group: 13.18 [10.38-16.00]) with the intervention group demonstrating better outcomes (p < .05). Within-group, the post-intervention scores of NPRS and TUG were significantly lower (p < .05) compared to the pre-intervention scores in the intervention group. In the sham group, a statistically significant pre-post change was noticed only in the NPRS scores but not in the TUG scores. CONCLUSION Mulligan's techniques were effective in improving pain and functional mobility in individuals with knee osteoarthritis. The underlying mechanisms for observed effects must be examined further, as participants reported pain relief following sham mobilization.
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Affiliation(s)
- Madhura Bhagat
- Department of Physiotherapy, School of Allied Health Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Y V Raghava Neelapala
- Department of Physiotherapy, School of Allied Health Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Ranganath Gangavelli
- Department of Physiotherapy, School of Allied Health Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Pulles ANTD, Köke AJA, Strackke RP, Smeets RJEM. The responsiveness and interpretability of psychosocial patient-reported outcome measures in chronic musculoskeletal pain rehabilitation. Eur J Pain 2019; 24:134-144. [PMID: 31408556 DOI: 10.1002/ejp.1470] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 07/31/2019] [Accepted: 08/08/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND For several widely used patient-reported outcome measures (PROMs) in chronic musculoskeletal pain (CMSP) rehabilitation, it is still not known whether they are responsive to change, and what the smallest detectable change (SDC) and minimal clinically important change (MCIC) are. Knowledge of these values can be used to accurately interpret change scores in research and clinical practice. METHODS In this retrospective cohort study, the responsiveness, the SDC and the MCIC of the mental components of the Research and Development 36-Item Health Survey (RAND-36), the Pain Catastrophizing Scale (PCS) and the Tampa Scale of Kinesiophobia (TSK) were investigated in CMSP patients. Responsiveness, the SDC and MCIC were determined by using both anchor and distribution-based methods. RESULTS For all outcome measures, there was a progression from smallest to largest mean change scores between participants who did not perceive change and those who reported change after treatment. However, correlations of the Global Perceived Effect (GPE) with the change scores on the outcome measures were low. For all outcome measures, the SDC was larger than the MCIC. CONCLUSIONS For this population, the questionnaires were shown not to be responsive. Furthermore, the questionnaires appeared not to be able to distinguish clinically important change from measurement error in individual patients. The finding of large measurement errors of PROMs is in line with previous research in pain rehabilitation. Using generic PROMs only, to examine changes in psychosocial status due to a pain rehabilitation programme, is therefore questionable. SIGNIFICANCE This study shows that widely used generic psychosocial PROMs might not be responsive and not able to distinguish clinically important change from measurement error in individual chronic musculoskeletal pain patients. It therefore seems reasonable to reconsider the (compulsory) use of these PROMs for assessing the quality of pain rehabilitation programmes, and necessary to consider other, more objective, outcome measures for this purpose in this population.
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Affiliation(s)
- Alexandra N T D Pulles
- Department of Rehabilitation Medicine, CAPHRI, Maastricht University, Maastricht, The Netherlands
| | - Albère J A Köke
- Department of Rehabilitation Medicine, CAPHRI, Maastricht University, Maastricht, The Netherlands.,Adelante Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, The Netherlands.,Zuyd University for Applied Sciences, faculty Health and Technology, Heerlen, The Netherlands
| | - Robin P Strackke
- Adelante Centre of Expertise in Rehabilitation and Audiology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Rob J E M Smeets
- Department of Rehabilitation Medicine, CAPHRI, Maastricht University, Maastricht, The Netherlands.,CIR Revalidatie, Eindhoven/Zwolle, The Netherlands
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Elhennawy K, Krois J, Jost-Brinkmann PG, Schwendicke F. Outcome and comparator choice in molar incisor hypomineralisation (MIH) intervention studies: a systematic review and social network analysis. BMJ Open 2019; 9:e028352. [PMID: 31377700 PMCID: PMC6687020 DOI: 10.1136/bmjopen-2018-028352] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Outcome and comparator choice strongly determine the validity and implementation of clinical trial results. We aimed to assess outcome and comparator choice in intervention studies on molar incisor hypomineralisation (MIH) using systematic review and social network analysis (SNA). DESIGN AND DATA SOURCES Medline, Embase, Cochrane Central, Google Scholar, opengrey.eu as well as DRKS.de and Clinicaltrials.gov were searched for MIH intervention studies. The search covered the period from 1980 to 2019. ELIGIBILITY CRITERIA Clinical single-arm/multiarm, controlled/uncontrolled studies reporting on the management of MIH were included. Reported outcomes and comparators were extracted and categorised. SNA was used to evaluate comparator choice and the resulting trial networks. DATA EXTRACTION Of the 7979 identified records, 100 were evaluated in full text and 35 studies (17 randomised controlled trials, 14 prospective and 4 retrospective cohort studies) were included. RESULTS In total, 2124 patients with a mean age of 11 years (min/max 6/70 years) were included. Outcomes fell in one of 11 different outcome categories: restoration success, aesthetic improvement, pain/hypersensitivity/discomfort, mineral gain, space management, anaesthesia effectiveness, preventive success, efficiency, quality of life, gingival and periodontal health and patient satisfaction. Comparators were mainly restorative interventions (17 studies), remineralisation (3), treatment of hypersensitivity (10), aesthetic interventions (5) and orthodontic interventions (3). Two highly clustered comparator networks emerged; many interventions were not robustly linked to these networks. CONCLUSIONS MIH intervention studies recorded both clinically centred and patient-centred outcomes. Core outcome set development should consider these and supplement them with outcomes on, for example, applicability. The high number of compared interventions tested in only few studies and our SNA results implicate that the current evidence may not be robust.
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Affiliation(s)
- Karim Elhennawy
- Department of Orthodontics, Dentofacial Orthopedics and Pedodontics, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Joachim Krois
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Paul-Georg Jost-Brinkmann
- Department of Orthodontics, Dentofacial Orthopedics and Pedodontics, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Falk Schwendicke
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Berlin, Germany
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