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Zapotocka E, Batorova A, Bilic E, Boban A, Ettingshausen CE, Kotnik BF, Hrdlickova R, Laguna P, Máchal J, Nemes L, Zupan IP, Puras G, Zombori M. florio ® HAEMO: A Longitudinal Survey of Patient Preference, Adherence and Wearable Functionality in Central Europe. Adv Ther 2024; 41:2791-2807. [PMID: 38753106 PMCID: PMC11213760 DOI: 10.1007/s12325-024-02872-3] [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: 02/26/2024] [Accepted: 04/05/2024] [Indexed: 06/29/2024]
Abstract
INTRODUCTION florio® HAEMO is a hemophilia treatment monitoring application (app) offering activity tracking and wearable device connectivity. Its use might support everyday activities for people with hemophilia. The aim of this study was to evaluate user satisfaction, long-term usage and the impact on data entry when pairing a wearable with a hemophilia monitoring app. METHODS This is a follow-up of a two-part user survey conducted in Central Europe. People with hemophilia and parents/caregivers of children with hemophilia using florio HAEMO and who completed part one were invited to complete a second online questionnaire at least 4 months later. RESULTS Fifty participants (83.3%) who completed part one of the survey continued to use the florio HAEMO app and completed part two. Of 14 participants who chose to use the app with a wearable, more than half (57.1%) were aged between 13 and 25 years. Overall, the results demonstrated that florio HAEMO is very easy or rather easy to use, especially for individuals pairing the app with a wearable. Most people using a wearable indicated that florio HAEMO was very or rather important in bringing certainty to daily activities (85.7%). Notably, 14 of 36 (38.9%) non-wearable users indicated that they would prefer to pair the app with a wearable in the future. CONCLUSIONS Adherence to the florio HAEMO app is maintained over an extended period of use. Pairing the app with a wearable might enable easier access to app features, increase data entry motivation and provide more certainty about daily activities for people with hemophilia.
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Affiliation(s)
- Ester Zapotocka
- Department of Pediatric Hematology/Oncology, University Hospital Motol, V Úvalu 84, 150 06, Prague, Czech Republic.
- Secondary Faculty of Medicine, Charles University, Prague, Czech Republic.
| | - Angelika Batorova
- Department of Hematology and Transfusion Medicine, National Hemophilia Center, Faculty of Medicine of Comenius University and University Hospital, Bratislava, Slovakia
| | - Ernest Bilic
- Division of Hematology and Oncology, Department of Pediatrics, University Hospital Center Zagreb, Zagreb, Croatia
| | - Ana Boban
- Division of Hematology, Department of Internal Medicine, University Hospital Center Zagreb, University of Zagreb, Zagreb, Croatia
- School of Medicine, Zagreb, Croatia
| | | | - Barbara Faganel Kotnik
- Department of Hematology and Oncology, University Children's Hospital, University Medical Center Ljubljana, Ljubljana, Slovenia
| | | | - Pawel Laguna
- Department of Pediatric, Oncology, Hematology and Transplantology, Warsaw Medical University, Warsaw, Poland
| | - Jan Máchal
- Department of Pediatric Hematology and Biochemistry, Masaryk University, Brno, Czech Republic
- Department of Pediatric Hematology and Biochemistry, University Hospital Brno, Brno, Czech Republic
| | - Laszlo Nemes
- National Hemophilia Centre and Haemostasis Department, Central Hospital of Northern Pest-Military Hospital, Budapest, Hungary
| | - Irena Preloznik Zupan
- Department of Hematology, University Medical Center Ljubljana, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | | | - Marianna Zombori
- Department of Onco-Hematology, Heim Pál Nationale Institute of Pediatrics, Budapest, Hungary
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Weiß M, Gründahl M, Jachnik A, Lampe EC, Malik I, Rittner HL, Sommer C, Hein G. The Effect of Everyday-Life Social Contact on Pain. J Med Internet Res 2024; 26:e53830. [PMID: 38687594 PMCID: PMC11094601 DOI: 10.2196/53830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 02/01/2024] [Accepted: 03/13/2024] [Indexed: 05/02/2024] Open
Abstract
Pain is a biopsychosocial phenomenon, resulting from the interplay between physiological and psychological processes and social factors. Given that humans constantly interact with others, the effect of social factors is particularly relevant. Documenting the significance of the social modulation of pain, an increasing number of studies have investigated the effect of social contact on subjective pain intensity and pain-related physiological changes. While evidence suggests that social contact can alleviate pain, contradictory findings indicate an increase in pain intensity and a deterioration of pain coping strategies. This evidence primarily stems from studies examining the effect of social contact on pain within highly controlled laboratory conditions. Moreover, pain assessments often rely on one-time subjective reports of average pain intensity across a predefined period. Ecological momentary assessments (EMAs) can circumvent these problems, as they can capture diverse aspects of behavior and experiences multiple times a day, in real time, with high resolution, and within naturalistic and ecologically valid settings. These multiple measures allow for the examination of fluctuations of pain symptoms throughout the day in relation to affective, cognitive, behavioral, and social factors. In this opinion paper, we review the current state and future relevance of EMA-based social pain research in daily life. Specifically, we examine whether everyday-life social support reduces or enhances pain. The first part of the paper provides a comprehensive overview of the use of EMA in pain research and summarizes the main findings. The review of the relatively limited number of existing EMA studies shows that the association between pain and social contact in everyday life depends on numerous factors, including pain syndromes, temporal dynamics, the nature of social interactions, and characteristics of the interaction partners. In line with laboratory research, there is evidence that everyday-life social contact can alleviate, but also intensify pain, depending on the type of social support. Everyday-life emotional support seems to reduce pain, while extensive solicitous support was found to have opposite effects. Moreover, positive short-term effects of social support can be overshadowed by other symptoms such as fatigue. Overall, gathering and integrating experiences from a patient's social environment can offer valuable insights. These insights can help interpret dynamics in pain intensity and accompanying symptoms such as depression or fatigue. We conclude that factors determining the reducing versus enhancing effects of social contact on pain need to be investigated more thoroughly. We advocate EMA as the assessment method of the future and highlight open questions that should be addressed in future EMA studies on pain and the potential of ecological momentary interventions for pain treatment.
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Affiliation(s)
- Martin Weiß
- University Hospital Würzburg, Center of Mental Health, Department of Psychiatry, Psychosomatic and Psychotherapy, Translational Social Neuroscience Unit, Würzburg, Germany
| | - Marthe Gründahl
- University Hospital Würzburg, Center of Mental Health, Department of Psychiatry, Psychosomatic and Psychotherapy, Translational Social Neuroscience Unit, Würzburg, Germany
| | - Annalena Jachnik
- University Hospital Würzburg, Center of Mental Health, Department of Psychiatry, Psychosomatic and Psychotherapy, Translational Social Neuroscience Unit, Würzburg, Germany
| | - Emilia Caya Lampe
- University Hospital Würzburg, Center of Mental Health, Department of Psychiatry, Psychosomatic and Psychotherapy, Translational Social Neuroscience Unit, Würzburg, Germany
| | - Ishitaa Malik
- University Hospital Würzburg, Center of Mental Health, Department of Psychiatry, Psychosomatic and Psychotherapy, Translational Social Neuroscience Unit, Würzburg, Germany
| | - Heike Lydia Rittner
- University Hospital Würzburg, Center for Interdisciplinary Medicine, Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, Würzburg, Germany
| | - Claudia Sommer
- University Hospital Würzburg, Department of Neurology, Würzburg, Germany
| | - Grit Hein
- University Hospital Würzburg, Center of Mental Health, Department of Psychiatry, Psychosomatic and Psychotherapy, Translational Social Neuroscience Unit, Würzburg, Germany
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Kaneyasu T, Hoshino E, Naito M, Suzukamo Y, Miyazaki K, Kojima S, Yamaguchi T, Kawaguchi T, Miyaji T, Nakajima TE, Shimozuma K. How to select and understand guidelines for patient-reported outcomes: a scoping review of existing guidance. BMC Health Serv Res 2024; 24:334. [PMID: 38481204 PMCID: PMC10938752 DOI: 10.1186/s12913-024-10707-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 02/12/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Over the past few decades, patient-reported outcomes (PROs) have been used to understand patient health conditions better. Therefore, numerous PRO measures (questionnaires) and guidelines or guidance have been developed. However, it is challenging to select target guidance from among the many available guidance and to understand the chosen guidance. This study comprehensively collected the existing PRO guidance for clinical trials or studies and practices to support novice PRO users in academia, industry, clinical practice, and regulatory and reimbursement decision-making. METHODS For the scoping review, we searched the MEDLINE, Embase, Google Books, WorldCat, and the National Library of Medicine (NLM) Bookshelf databases from 2009 to 2023. The eligibility criteria were PRO guidance for clinical trials, clinical practice, or application such as health technology assessment. Those guidance cover aspects such as quality of life (QOL), PRO, health-related QOL, health state utilities, psychometric requirements, implementation methods, analysis and interpretation, or clinical practice applications. After the systematic search, three researchers individually reviewed the collected data, and the reviewed articles and books were scrutinized using the same criteria. RESULTS We collected the PRO guidance published in articles and books between 2009 and 2023. From the database searches, 1,455 articles and 387 books were identified, of which one book and 33 articles were finally selected. The collected PRO guidance was categorized into the adoption of PRO measures, design and reporting of trials or studies using PROs, implementation of PRO evaluation in clinical trials or studies or clinical practice, analysis and interpretation of PROs, and application of PRO evaluation. Based on this categorization, we suggest the following for novices: When selecting guidance, novices should clarify the "place" and "purpose" where the guidance will be used. Additionally, they should know that the terminology related to PRO and the scope and expectations of PROs vary by "places" and "purposes". CONCLUSIONS From this scoping review of existing PRO guidance, we provided summaries and caveats to assist novices in selecting guidance that fits their purpose and understanding it.
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Affiliation(s)
- Takako Kaneyasu
- College of Life Sciences, Department of Biomedical Sciences, Ritsumeikan University, 1-1-1, Noji-Higashi, Kusatsu, Shiga, 525-8577, Japan.
- Comprehensive Unit for Health Economic Evidence Review and Decision Support, Research Organization of Science and Technology, Ritsumeikan University, Kyoto, Japan.
| | - Eri Hoshino
- Comprehensive Unit for Health Economic Evidence Review and Decision Support, Research Organization of Science and Technology, Ritsumeikan University, Kyoto, Japan
- Division of Policy Evaluation, Department of Health Policy, Research Institute, National Center for Child Health and Development, Tokyo, Japan
| | - Mariko Naito
- Department of Oral Epidemiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | | | - Kikuko Miyazaki
- Department of Health Informatics, School of Public Health, Kyoto University, Kyoto, Japan
| | - Satomi Kojima
- Comprehensive Unit for Health Economic Evidence Review and Decision Support, Research Organization of Science and Technology, Ritsumeikan University, Kyoto, Japan
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Tohoku University, Miyagi, Japan
| | - Takashi Kawaguchi
- Department of Practical Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Tempei Miyaji
- Research Center for Advanced Science and Technology, The University of Tokyo, Tokyo, Japan
| | - Takako Eguchi Nakajima
- Department of Early Clinical Development, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kojiro Shimozuma
- College of Life Sciences, Department of Biomedical Sciences, Ritsumeikan University, 1-1-1, Noji-Higashi, Kusatsu, Shiga, 525-8577, Japan
- Comprehensive Unit for Health Economic Evidence Review and Decision Support, Research Organization of Science and Technology, Ritsumeikan University, Kyoto, Japan
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Vardić A, Puljak L, Galić T, Viskić J, Kuliš E, Poklepović Peričić T. Heterogeneity of outcomes in randomized controlled trials on implant prosthodontic therapy is hindering comparative effectiveness research: meta-research study. BMC Oral Health 2023; 23:908. [PMID: 37993826 PMCID: PMC10666438 DOI: 10.1186/s12903-023-03658-9] [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: 01/03/2023] [Accepted: 11/12/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Consistency in outcomes across clinical trials allows for comparing and combining results from different studies. A core outcome set (COS), representing a minimally agreed standardized group of outcomes that should be monitored and measured through research in a specific field of medicine, is not yet available for trials in implant prosthodontic (dental implant) therapy. This meta-research study aimed to analyze outcomes used in clinical trials on implant prosthodontic therapy. METHODS We searched the Cochrane Oral Health Group (COHG) register to identify systematic reviews of interventions in implant prosthodontic therapy published by October 2023. From the randomized controlled trials (RCTs) included in the relevant reviews, we extracted data on the characteristics of the included trials and the outcomes used. We categorized outcomes into domains. RESULTS From 182 systematic reviews in the COHG register, we included 11 systematic reviews on dental implant therapy. The reviews included 117 unique RCTs with 4725 participants, published from 1995 to 2020, which analyzed 74 different outcomes. Using different definitions, implant failure was analyzed in 73 RCTs. Seventeen RCTs did not define implant failure. Failure was most often (30 RCTs) followed up for one year. Only one RCT assessed implant failure after five years. Trials used 17 definitions of implant failure, while 17 trials did not report on the criteria of implant failure. Complications were analyzed in 48 RCTs, although they were not clearly defined in 12 RCTs. Failure of prosthodontic supra-structure was analyzed in 74 RCTs, with definitions of failure and criteria not clearly defined in 44 RCTs. Trials considered adverse events, peri-implant tissue health, patient attitudes, and other outcomes, including cost, aesthetics, or procedure duration. These outcomes were often different between trials. Twenty-six outcomes were used only once per study. CONCLUSIONS Clinical trials in implant prosthodontics used different outcomes, different definitions of outcomes and used different times to monitor them. Standardization of outcomes is necessary to allow comparability and evidence synthesis about the effectiveness of implant prosthodontic therapy.
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Affiliation(s)
- Ante Vardić
- Study of Dental Medicine, University of Split School of Medicine, Split, Croatia
| | - Livia Puljak
- Center for Evidence-Based Medicine and Health Care, Catholic University of Croatia, Zagreb, Croatia.
| | - Tea Galić
- Department of Prosthodontics, Study of Dental Medicine, University of Split School of Medicine, Split, Croatia
| | - Joško Viskić
- Department of Fixed Prosthodontics, University of Zagreb School of Dental Medicine, Zagreb, Croatia
| | - Ena Kuliš
- Study of Dental Medicine, University of Split School of Medicine, Split, Croatia
| | - Tina Poklepović Peričić
- Department of Prosthodontics, Study of Dental Medicine, University of Split School of Medicine, Split, Croatia
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Sachau J, Sendel M, Péchard M, Schnabel K, Schmieg I, Medkour T, Ecochard L, Woischnik M, Liedgens H, Pogatzki-Zahn E, Baron R, Bouhassira D. Patient Reported Outcome Measures in Chronic Neuropathic Pain Clinical Trials - A Systematic Literature Review. THE JOURNAL OF PAIN 2023; 24:38-54. [PMID: 36216128 DOI: 10.1016/j.jpain.2022.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 08/22/2022] [Accepted: 09/01/2022] [Indexed: 11/05/2022]
Abstract
In neuropathic pain clinical trials, the patient's perspective is often insufficiently reflected focusing mainly on pain intensity. Comparability of outcome assessment is limited due to heterogenous patient reported outcome measures (PROMs). The MEDLINE, CENTRAL, and Embase databases and reference lists of published meta-analyses were searched. Randomized controlled studies assessing treatment efficacy of drugs for chronic neuropathic pain were included. PROMs were assigned to recommended IMMPACT/NeuPSIG domains: pain intensity, pain other aspects, physical functioning, emotional functioning, global improvement and satisfaction, adverse events, participant disposition. Domains and PROMs were compared regarding the publication year and methodological quality of the studies. Within the 251 included studies 200 PROMs were used with 27 being recommended by IMMPACT/NeuPSIG. The number of domains was higher in high/moderate quality studies. The (sub-) domains 'physical functioning', 'global improvement and satisfaction', and 'neuropathic pain quality' were assessed more frequently in high/moderate quality studies and those published after 2011. Recent studies and those of better quality more often used the recommended PROMs. Although neuropathic assessment via PROMs has improved, there is still a high heterogeneity. A standardized core set of outcome domains and should be defined to improve neuropathic pain treatment and to achieve better comparability of clinical trials. Perspective: This systematic literature review assesses the use of patient reported outcome measures (PROMs) in chronic neuropathic pain. The results show that there is still a high heterogeneity, highlighting the need for a standardized core set of outcome domains and PROMs to improve comparability of clinical trials and neuropathic pain treatment.
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Affiliation(s)
- Juliane Sachau
- Division of Neurological Pain Research and Therapy, Department of Neurology, University Hospital Schleswig-Holstein Campus Kiel, Kiel, Germany.
| | - Manon Sendel
- Division of Neurological Pain Research and Therapy, Department of Neurology, University Hospital Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - Marie Péchard
- Inserm U987, APHP, UVSQ, Paris-Saclay University, CHU Ambroise Paré, Boulogne-Billancourt, France
| | - Kathrin Schnabel
- Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital of Muenster, Münster
| | - Iris Schmieg
- Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital of Muenster, Münster
| | - Terkia Medkour
- Inserm U987, APHP, UVSQ, Paris-Saclay University, CHU Ambroise Paré, Boulogne-Billancourt, France
| | | | | | | | - Esther Pogatzki-Zahn
- Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital of Muenster, Münster
| | - Ralf Baron
- Division of Neurological Pain Research and Therapy, Department of Neurology, University Hospital Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - Didier Bouhassira
- Inserm U987, APHP, UVSQ, Paris-Saclay University, CHU Ambroise Paré, Boulogne-Billancourt, France
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Runjic R, Plenkovic M, Pirosca S, Clarke M, Treweek S, Puljak L. Recommendations from Cochrane reviews for improving future trials on anesthesia and pain: a meta-research study. J Comp Eff Res 2022; 11:669-677. [PMID: 35549352 DOI: 10.2217/cer-2022-0042] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Background: Cochrane systematic reviews (CSRs) have a section 'Implications for research' where authors make suggestions for improving future research. The authors of the present study assessed the prevalence and time dynamics of different recommendations in the CSRs about anesthesia and pain. Methods: The authors included all CSRs published by the Cochrane Anaesthesia Group and Cochrane Pain and Palliative Care Group before 17 July 2020. The authors analyzed recommendations for improving future research listed in the 'Implications for research' section of these CSRs and categorized recommendations for improvements. Results: They analyzed 370 reviews. Four categories of recommendations were present in more than 40% of the reviews. Most reviews recommended a larger sample size and better outcome choice, study design and choice of future intervention. These recommendations gradually increased in frequency in the Cochrane Pain and Palliative Care Group and mainly decreased in the Cochrane Anaesthesia Group. Conclusion: Recommendations from CSRs offer useful advice for trialists designing new trials.
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Affiliation(s)
- Renata Runjic
- University of Split School of Medicine, Split, Croatia
| | - Mia Plenkovic
- Center for Evidence-Based Medicine, Catholic University of Croatia, Zagreb, Croatia
| | - Stefania Pirosca
- School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, UK
| | - Mike Clarke
- Northern Ireland Methodology Hub, Queen's University Belfast, Belfast, UK
| | - Shaun Treweek
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Livia Puljak
- Center for Evidence-Based Medicine, Catholic University of Croatia, Zagreb, Croatia
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Hughes KL, Williamson PR, Young B. In-depth qualitative interviews identified barriers and facilitators that influenced chief investigators' use of core outcome sets in randomised controlled trials. J Clin Epidemiol 2021; 144:111-120. [PMID: 34896233 PMCID: PMC9094758 DOI: 10.1016/j.jclinepi.2021.12.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 11/15/2021] [Accepted: 12/02/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVE This study aimed to investigate barriers and facilitators to core outcome set (COS) uptake in randomised controlled trials to inform the first steps in developing interventions to improve the uptake of COS. STUDY DESIGN AND SETTING Semi-structured qualitative interviews with a purposive sample of UK chief investigators were audio-recorded, transcribed and analysed thematically. Where appropriate, barriers and facilitators were mapped to components of behaviour informed by the COM-B model of behaviour. RESULTS Thirteen chief investigators were interviewed. Facilitators to uptake included: the behaviour of investigators, for example, their awareness and understanding of COS; and the wider research system, for example, recommendations to use COS from funders and journals. Barriers to uptake included: the perceived characteristics of COS, for example, increasing patient burden and recommendations becoming outdated; and the COS development process, for example, not including all specialties who will use the COS. CONCLUSIONS Based on the barriers and facilitators identified, recommendations to improve COS uptake include ensuring engagement with the research community who will use the COS, involving patients in the development of COS and ensuring COS remain up to date.
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Affiliation(s)
- Karen L Hughes
- MRC North West Hub for Trials Methodology Research, Department for Health Data Science, University of Liverpool, Block F Waterhouse Building, 1-5 Brownlow Street, Liverpool L69 3GL, United Kingdom.
| | - Paula R Williamson
- MRC North West Hub for Trials Methodology Research, Department for Health Data Science, University of Liverpool, Block F Waterhouse Building, 1-5 Brownlow Street, Liverpool L69 3GL, United Kingdom; MRC-NIHR Trials Methodology Research Partnership, Department for Health Data Science, University of Liverpool, Block F Waterhouse Building, 1-5 Brownlow Street, Liverpool L69 3GL, United Kingdom.
| | - Bridget Young
- Department of Public Health, Policy and Systems, University of Liverpool, Whelan Building, Liverpool L69 3GL, United Kingdom.
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Maeßen TV, Austenfeld E, Kaiser U, Bigalke S, Meyer-Frießem CH, Liedgens H, Zahn PK, Pogatzki-Zahn EM. Systematic Review on Pain-Related Outcome Domains After Sternotomy: A First Step Toward the Development of a Core Outcome Set. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2021; 24:1203-1212. [PMID: 34372986 DOI: 10.1016/j.jval.2021.01.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 12/03/2020] [Accepted: 01/26/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES Pain after surgery has a major impact on acute and long-term recovery and quality of life, but its management is often insufficient. To enhance the quality of research and to allow for better comparability between studies, it is important to harmonize outcomes for assessing the efficacy and effectiveness of pain management interventions after surgery. As a first step in developing a core outcome set, this study aimed to systematically search for outcome domains assessed in research regarding acute pain management after sternotomy as an example of a typically painful surgical procedure. METHODS A systematic literature review was performed using MEDLINE, Embase, and CENTRAL. Eligibility criteria consisted of randomized controlled trials and observational trials targeting pain management after sternotomy in adults in the acute postoperative setting (≤2 weeks). After duplicate removal and title and abstract screening by 2 independent reviewers, study characteristics and outcome domains were identified, which were extracted from full texts and summarized qualitatively. RESULTS Of 1350 studies retrieved by database searching, 156 studies were included for full-text extraction. A total of 80 different outcome domains were identified: pain intensity, analgesic consumption, physiological function, and adverse events were the most frequent ones. Outcome domains were often not explicitly reported, and the combination of domains and assessment tools was heterogeneous. The choice of outcomes is commonly made within clinicians; patients' perspectives are not considered. CONCLUSIONS The wide variety of commonly applied outcome domains, the nonexplicit wording, and the heterogeneous combination of the domains indicating treatment benefit demonstrate the need for harmonization of outcomes assessing perioperative pain management after surgery.
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Affiliation(s)
- T V Maeßen
- Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital of Münster, Münster, Germany
| | - E Austenfeld
- University Hospital of Münster, Münster, Germany
| | - U Kaiser
- Comprehensive Pain Center at the University Hospital Carl Gustav Carus Dresden, Germany
| | - S Bigalke
- Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital of Münster, Münster, Germany; Department of Anaesthesiology, Intensive Care Medicine and Pain Management, Medical Faculty of Ruhr-University, Bochum, Germany
| | - C H Meyer-Frießem
- Department of Anaesthesiology, Intensive Care Medicine and Pain Management, Medical Faculty of Ruhr-University, Bochum, Germany
| | | | - P K Zahn
- Department of Anaesthesiology, Intensive Care Medicine and Pain Management, Medical Faculty of Ruhr-University, Bochum, Germany
| | - E M Pogatzki-Zahn
- Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital of Münster, Münster, Germany.
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Leroux A, Rzasa-Lynn R, Crainiceanu C, Sharma T. Wearable Devices: Current Status and Opportunities in Pain Assessment and Management. Digit Biomark 2021; 5:89-102. [PMID: 34056519 PMCID: PMC8138140 DOI: 10.1159/000515576] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 03/01/2021] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION We investigated the possibilities and opportunities for using wearable devices that measure physical activity and physiometric signals in conjunction with ecological momentary assessment (EMA) data to improve the assessment and treatment of pain. METHODS We considered studies with cross-sectional and longitudinal designs as well as interventional or observational studies correlating pain scores with measures derived from wearable devices. A search was also performed on studies that investigated physical activity and physiometric signals among patients with pain. RESULTS Few studies have assessed the possibility of incorporating wearable devices as objective tools for contextualizing pain and physical function in free-living environments. Of the studies that have been conducted, most focus solely on physical activity and functional outcomes as measured by a wearable accelerometer. Several studies report promising correlations between pain scores and signals derived from wearable devices, objectively measured physical activity, and physical function. In addition, there is a known association between physiologic signals that can be measured by wearable devices and pain, though studies using wearable devices to measure these signals and associate them with pain in free-living environments are limited. CONCLUSION There exists a great opportunity to study the complex interplay between physiometric signals, physical function, and pain in a real-time fashion in free-living environments. The literature supports the hypothesis that wearable devices can be used to develop reproducible biosignals that correlate with pain. The combination of wearable devices and EMA will likely lead to the development of clinically meaningful endpoints that will transform how we understand and treat pain patients.
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Affiliation(s)
- Andrew Leroux
- Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, Colorado, USA
| | - Rachael Rzasa-Lynn
- Department of Anesthesiology, University of Colorado, Aurora, Colorado, USA
| | - Ciprian Crainiceanu
- Department of Biostatistics, Johns Hopkins University, Baltimore, Maryland, USA
| | - Tushar Sharma
- Department of Anesthesiology, University of Colorado, Aurora, Colorado, USA
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10
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Hughes KL, Clarke M, Williamson PR. A systematic review finds Core Outcome Set uptake varies widely across different areas of health. J Clin Epidemiol 2021; 129:114-123. [PMID: 32987162 PMCID: PMC7815247 DOI: 10.1016/j.jclinepi.2020.09.029] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 08/11/2020] [Accepted: 09/09/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The aim of our review was to bring together studies that had assessed the uptake of core outcome sets (COS) to explore the level of uptake across different COS and areas of health. STUDY DESIGN AND SETTING We examined the citations of 337 COS reports to identify studies that had assessed the uptake of a particular COS in randomized controlled trials (RCTs) or systematic reviews (SRs). RESULTS We identified 24 studies that had assessed uptake in RCTs and two studies that had assessed uptake in SRs. The studies covered a total of 17/337 (5%) COS. Uptake rates reported for RCTs varied from 0% of RCTs (gout) to 82% RCTs (rheumatoid arthritis) measuring the full COS. Studies that assessed uptake of individual core outcomes showed a wide variation in uptake between the outcomes. Suggested barriers to uptake included lack of validated measures, lack of patient and other key stakeholder involvement in COS development, and lack of awareness of the COS. CONCLUSIONS Few studies have been undertaken to assess the uptake of COS in RCTs and SRs. Further studies are needed to assess whether COS have been implemented across a wider range of disease categories and to explore the barriers and facilitators to COS uptake.
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Affiliation(s)
- Karen L Hughes
- MRC North West Hub for Trials Methodology Research, Department of Health Data Science, University of Liverpool, Block F Waterhouse Building, 1-5 Brownlow Street, Liverpool L69 3GL, United Kingdom.
| | - Mike Clarke
- Centre for Public Health, Institute of Clinical Sciences, Block B, Queen's University Belfast, Royal Victoria Hospital, Grosvenor Road, Belfast BT12 6BA, United Kingdom
| | - Paula R Williamson
- MRC North West Hub for Trials Methodology Research, Department of Health Data Science, University of Liverpool, Block F Waterhouse Building, 1-5 Brownlow Street, Liverpool L69 3GL, United Kingdom
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11
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Puljak L, Boric K, Dosenovic S. Pain assessment in clinical trials: a narrative review. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:188. [PMID: 33569490 PMCID: PMC7867958 DOI: 10.21037/atm-20-3451] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Pain is a symptom measured in many clinical trials. For pain as an outcome domain, trialists need to choose adequate outcome measure(s), as there are myriad outcome measures for pain to choose from. To ensure consistency and uniformity in clinical trials and systematic reviews, core outcome sets (COS) have been defined; COS includes a predefined minimal list of core outcomes that should be measured within a trial, to ensure their consistency and comparability. COS is defined via consensus procedure, which includes relevant stakeholders such as experts from a specific field and patients. Along with outcomes, outcome measures for each outcome need to be defined to make sure that the outcomes will be measured consistently and uniformly. Hereby we reviewed studies that have examined use of recommended core outcome domains and outcome measures in clinical trials that would be expected to measure pain. Despite the existence of COS and defined core outcome measures (COMs), multiple studies have shown that these are not necessarily used in clinical trials, or in the relevant systematic reviews, which further increases heterogeneity of existing evidence, hinders evidence synthesis and trial comparability, and assessment of comparative effectiveness of interventions. Trialists are encouraged to use COS and COMs when designing clinical trials. Research community is encouraged to design interventions that will help with identifying barriers for using COS and COMs and interventions to foster their uptake. Use of consistent pain outcomes and pain outcome measures is in the interest of patients, research community, healthcare workers and decision-makers. For clinical conditions for which there are no COS and COMs, efforts to design them would be beneficial.
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Affiliation(s)
- Livia Puljak
- Center for Evidence-Based Medicine and Health Care, Catholic University of Croatia, Zagreb, Croatia
| | - Krste Boric
- Department of Surgery, University Hospital Center Split, Split, Croatia
| | - Svjetlana Dosenovic
- Department of Anesthesiology and Intensive Care, University Hospital Center Split, Split, Croatia
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12
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Dosenovic S, Dujmic A, Nujic D, Vuka I, Tintor G, Kadic AJ, Puljak L. Reasons and factors associated with inconclusiveness of systematic reviews about interventions for neuropathic pain. J Comp Eff Res 2020; 10:67-75. [PMID: 33355481 DOI: 10.2217/cer-2020-0165] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Aim: Systematic reviews (SRs) are frequently inconclusive. The aim of this study was to analyze factors associated with conclusiveness of SRs about efficacy and safety of interventions for neuropathic pain (NeuP). Materials & methods: The study protocol was registered in the PROSPERO database (No. CRD42015025831). Five electronic databases (Medical Literature Analysis and Retrieval System Online, Cochrane Database of Systematic Reviews, Cumulative Index for Nursing and Allied Health Literature, Database of Abstracts of Reviews of Effects and Psychological Information Database) were searched until July 2018 for SRs about NeuP management. Conclusion statements for efficacy and safety, and characteristics of SRs were analyzed. Conclusiveness was defined as explicit statement by the SR authors that one intervention is better/similar to the other in terms of efficacy and safety. Methodological quality of SRs was assessed with the AMSTAR (A MeaSurement Tool to Assess systematic Reviews) tool. Results: Of 160 SRs, 37 (23%) were conclusive for efficacy and/or safety. In the SRs, conclusions about safety were missing in half of the analyzed abstracts, and a third of the full texts. Conclusive SRs included significantly more trials and participants, searched more databases, had more authors, conducted meta-analysis, analyzed quality of evidence, and had lower methodological quality than inconclusive SRs. The most common reasons for the lack of conclusiveness indicated by the SR authors were the small number of participants and trials, and the high heterogeneity of included studies. Conclusion: Most SRs about NeuP treatment were inconclusive. Sources of inconclusiveness of NeuP reviews need to be further studied, and SR authors need to provide conclusions about both safety and efficacy of interventions.
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Affiliation(s)
- Svjetlana Dosenovic
- Department of Anesthesiology & Intensive Care Medicine, University Hospital Split, Split, Croatia
| | - Andria Dujmic
- University of Split School of Medicine, Split, Croatia
| | - Danijela Nujic
- Department of Public Health, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Croatia.,Department of Public Health, Humanities & Social Sciences in Biomedicine, Faculty of Dental Medicine & Health, Josip Juraj Strossmayer University of Osijek, Croatia
| | - Ivana Vuka
- Laboratory for Pain Research, University of Split School of Medicine, Split, Croatia
| | - Goran Tintor
- Department of Surgery, University Hospital Split, Split, Croatia
| | | | - Livia Puljak
- Center for Evidence-Based Medicine & Health Care, Catholic University of Croatia, Zagreb, Croatia
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13
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Overall bias methods and their use in sensitivity analysis of Cochrane reviews were not consistent. J Clin Epidemiol 2019; 119:57-64. [PMID: 31734347 DOI: 10.1016/j.jclinepi.2019.11.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 10/29/2019] [Accepted: 11/12/2019] [Indexed: 12/29/2022]
Abstract
OBJECTIVE The objective of the study was to analyze methods of assessing "overall bias" in Cochrane reviews of interventions published in the Cochrane Database of Systematic Reviews and sensitivity analyses related to overall risk of bias (RoB). STUDY DESIGN AND SETTING From Cochrane reviews published within 3 years, from July 2015 to June 2018, we extracted data regarding methods of judging overall bias for a single trial, as well as details regarding methods used in frequency of RoB in sensitivity analyses. RESULTS Of the 1,452 analyzed Cochrane reviews, 409 mentioned assessment of overall RoB on a study level. In 107 reviews, authors clearly specified key domains that determined the overall RoB, whereas in the remaining reviews, assessment of overall bias was not in line with the Cochrane Handbook. Among 268 Cochrane reviews that had any RoB-related sensitivity analysis, in 56 (21%) reviews, the authors reported a significant change for at least one outcome compared with the initial analysis. CONCLUSION Highly heterogeneous approaches to summarizing overall RoB on a study level and using RoB for sensitivity analyses may yield inconsistent and incomparable results across Cochrane reviews.
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14
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Krsticevic M, Saric D, Saric F, Slapnicar E, Boric K, Dosenovic S, Kadic AJ, Kegalj MJ, Puljak L. Selective reporting bias due to discrepancies between registered and published outcomes in osteoarthritis trials. J Comp Eff Res 2019; 8:1265-1273. [DOI: 10.2217/cer-2019-0068] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Aim: Outcome reporting bias (ORB) occurs when outcomes planned in a study protocol are subsequently not reported or are partially reported. Our aim was to analyze ORB in randomized controlled trials (RCTs) about conservative interventions for osteoarthritis (OA) by comparing registered protocols and published manuscripts, as well as association between study funding type and intervention type, and ORB in those RCTs. Materials & methods: We analyzed RCTs that were published in a peer-review journal and analyzed any type of conservative intervention for treatment of OA in humans that reported in the manuscript registration in a public clinical trial registry and provided unique registration identifier. We extracted data indicating ORB by comparing outcomes in protocol and published article, and characteristics of trials. Results: In 190 (57%) of 334 included RCTs, it was indicated in the manuscript that a trial was registered. In 48% of trials we found discrepancies in number, type or time point of primary efficacy outcome between protocol and manuscript. Significantly less discrepancies in primary efficacy outcomes between protocols and published articles were found in trials funded by a commercial sponsor (p = 0.0062) and trials of pharmacological interventions (p = 0.0016). Conclusion: Trials about conservative therapies for OA have high prevalence of discrepancies between protocol and publication, and frequent ORB. This may mislead readers of published results because it has been shown that ORB can lead to both overestimation and underestimation of effects of interventions, depending on the intervention and outcome. Efforts to prevent nonregistration of protocols and selective reporting are needed.
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Affiliation(s)
- Miso Krsticevic
- Department of Orthopaedics, University Hospital Split, Spinciceva 1, Split 21000, Croatia
| | - Dragica Saric
- Health Center Dr. Ante Franulovic Vela Luka, Kale 1, Vela Luka 20270, Croatia
| | - Frano Saric
- Department of Radiology, University Hospital Split, Spinciceva 1, Split 21000, Croatia
| | - Ema Slapnicar
- Medical Studies, University of Split School of Medicine, Soltanska 2, Split 21000, Croatia
| | - Krste Boric
- Department of Orthopaedics, University Hospital Split, Spinciceva 1, Split 21000, Croatia
| | - Svjetlana Dosenovic
- Department of Anesthesiology & Intensive Care Medicine, University Hospital Split, Spinciceva 1, Split 21000, Croatia
| | - Antonia Jelicic Kadic
- Department of Pediatrics, University Hospital Split, Spinciceva 1, Split 21000, Croatia
| | - Milka Jeric Kegalj
- Department of Dermatovenerology, General Hospital Zadar, Boze Pericica 5, Zadar 23000, Croatia
| | - Livia Puljak
- Department of Evidence-Based Medicine and Health Care, Catholic University of Croatia, Ilica 242, 10000 Zagreb, Croatia
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15
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16
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Dosenovic S, Nikolic Z, Ivancev B, Jelicic Kadic A, Puljak L. Awareness and acceptability of Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials core outcome set for chronic pain among surveyed neuropathic pain authors. J Comp Eff Res 2019; 8:671-683. [PMID: 31290689 DOI: 10.2217/cer-2018-0123] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Aim: We assessed the knowledge and adoption of Initiative on Methods, Measurement and Pain Assessment in Clinical Trials (IMMPACT)-recommended core outcome set (COS) and core outcome measures (COM) among authors of systematic reviews (SR) and randomized controlled trials (RCT) about interventions for neuropathic pain (NeuP). Methods: NeuP SR and RCT authors identified via a systematic literature search were surveyed. Results: The response rate was low. Although majority of respondents were familiar with the IMMPACT COS, only 61% of SR authors and 40% of RCT authors used the COS. The main perceived obstacle that prevented the adoption of the COS was the lack of awareness of the full IMMPACT COS. Conclusion: The adoption of IMMPACT-recommended COS and COM among NeuP authors was inadequate and their appropriateness needs to be further evaluated.
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Affiliation(s)
- Svjetlana Dosenovic
- Department of Anesthesiology & Intensive Care Medicine, University Hospital Split, Split, Croatia.,Laboratory for Pain Research, University of Split School of Medicine, Split, Croatia
| | - Zrinka Nikolic
- Laboratory for Pain Research, University of Split School of Medicine, Split, Croatia
| | - Bozena Ivancev
- Department of Anesthesiology & Intensive Care Medicine, University Hospital Split, Split, Croatia
| | - Antonia Jelicic Kadic
- Laboratory for Pain Research, University of Split School of Medicine, Split, Croatia.,Department of Pediatrics, University Hospital Split, Split, Croatia
| | - Livia Puljak
- Center for Evidence-Based Medicine and Health Care, Catholic University of Croatia, Zagreb, Croatia
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Wuytack F, Gutke A, Stuge B, Mørkved S, Olsson C, Robinson HS, Vøllestad NK, Öberg B, Wikmar LN, Mena JJS, Smith V. Protocol for the development of a core outcome set for pelvic girdle pain, including methods for measuring the outcomes: the PGP-COS study. BMC Med Res Methodol 2018; 18:158. [PMID: 30509216 PMCID: PMC6276248 DOI: 10.1186/s12874-018-0624-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Accepted: 11/19/2018] [Indexed: 12/18/2022] Open
Abstract
Background Pelvic Girdle Pain (PGP) is an important cause of disability and economic cost worldwide. There is a need for effective preventative and management strategies. Emerging studies measure a variety of outcomes rendering synthesis and translation to clinical practice difficult. A Core Outcome Set (COS) can address this problem by ensuring that data are relevant, useful and usable for making well-informed healthcare choices. The aim of this study is to develop a consensus-based PGP-COS, including agreement on methods (e.g. instruments) for measuring the construct outcomes in the COS for use in research and clinical practice. Furthermore, as there is uncertainty as to whether incorporating stakeholder interviews in addition to conducting a systematic review to determine an initial list of outcomes for the Delphi survey, or, whether using different rating scales in a Delphi survey impacts on the final COS, we propose to embed two methodological studies within the PGP-COS development process to address these questions. Methods The PGP-COS study will include five phases: (1) A systematic review of the literature and semi-structured interviews with 15 patients (three countries) to form the initial list of outcomes for the Delphi survey; (2) A 3-round Delphi including patients, clinicians, researchers and service providers; (3) A systematic review of methods for measuring the outcomes in the preliminary PGP-COS identified in the Delphi survey; (4) A face-to-face consensus meeting to agree on the final PGP-COS and methods for measuring the COS; (5) Global dissemination. To address the methodological questions, we will assess the number and type of outcomes, in the final PGP-COS, that were exclusively derived from the interviews. Secondly, we will randomise Delphi survey participants to either a 5-point or 9-point importance rating scale, and examine potential differences in ‘important’ ratings between the groups. Discussion There is currently no COS for measuring/monitoring PGP in trials and clinical practice. A PGP-COS will ensure that relevant outcomes are measured using appropriate measurement instruments for patients with PGP globally. Core outcome set registration This PGP-COS was registered with COMET (Core Outcome Measures for Effectiveness Trials) in January 2017 (http://www.comet-initiative.org/studies/details/958). Electronic supplementary material The online version of this article (10.1186/s12874-018-0624-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Francesca Wuytack
- School of Nursing & Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin 2, Ireland.
| | - Annelie Gutke
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, University of Gothenburg, Box 455, 40530, Göteborg, Sweden
| | - Britt Stuge
- Division for Neuroscience and Musculoskeletal Medicine, Oslo University Hospital, Oslo, Norway
| | - Siv Mørkved
- Department of Public Health and General Practice, Norwegian University of Science and Technology, Medisinsk teknisk forskningssenter, N-7489, Trondheim, Norway
| | - Christina Olsson
- Mörby Academic Primary Healthcare Centre, Golfvägen 8, 182 31, Danderyd, Sweden
| | - Hilde Stendal Robinson
- Department of Health Sciences, Institute of Health and Society, University of Oslo, Postboks 1089 Blindern, 0318, Oslo, Norway
| | - Nina K Vøllestad
- Institute of Health and Society, University of Oslo, Box 1133 Blindern, N-0318, Oslo, Norway
| | - Birgitta Öberg
- Department of Medicine and Health, Linköping University, 581 85, Linköping, Sweden
| | - Lena Nilsson Wikmar
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden
| | - Juan Jose Saldaña Mena
- Universidad Estatal del Valle de Ecatepec, Calle León Guzmán #60 Col Valle de Anáhuac CP, 55210, Ecatepec de Morelos, Mexico
| | - Valerie Smith
- School of Nursing & Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin 2, Ireland
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Li T, Mayo-Wilson E, Fusco N, Hong H, Dickersin K. Caveat emptor: the combined effects of multiplicity and selective reporting. Trials 2018; 19:497. [PMID: 30223876 PMCID: PMC6142307 DOI: 10.1186/s13063-018-2888-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 08/30/2018] [Indexed: 02/08/2023] Open
Abstract
Clinical trials and systematic reviews of clinical trials inform healthcare decisions. There is growing concern, however, about results from clinical trials that cannot be reproduced. Reasons for nonreproducibility include that outcomes are defined in multiple ways, results can be obtained using multiple methods of analysis, and trial findings are reported in multiple sources ("multiplicity"). Multiplicity combined with selective reporting can influence dissemination of trial findings and decision-making. In particular, users of evidence might be misled by exposure to selected sources and overly optimistic representations of intervention effects. In this commentary, drawing from our experience in the Multiple Data Sources in Systematic Reviews (MUDS) study and evidence from previous research, we offer practical recommendations to enhance the reproducibility of clinical trials and systematic reviews.
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Affiliation(s)
- Tianjing Li
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205 USA
| | - Evan Mayo-Wilson
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205 USA
| | - Nicole Fusco
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205 USA
| | - Hwanhee Hong
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, 2424 Erwin Road, Suite 1105, 11041 Hock Plaza, Durham, NC 27705 USA
| | - Kay Dickersin
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205 USA
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Puljak L, Dosenovic S, Boric K. Importance of consistent outcomes in randomized controlled trials and systematic reviews about anesthesiology and pain. Pain Manag 2018; 8:251-253. [DOI: 10.2217/pmt-2018-0023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Affiliation(s)
- Livia Puljak
- Laboratory for Pain Research, University of Split School of Medicine, Split, Croatia
- Agency for Quality & Accreditation in Health Care & Social Welfare, Zagreb, Croatia
| | - Svjetlana Dosenovic
- Department of Anesthesiology & Intensive Care Medicine, University Hospital Split, Split, Croatia
| | - Krste Boric
- Department of Surgery, University Hospital Split, Split, Croatia
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