Impact of STROBE statement publication on quality of observational study reporting: interrupted time series versus before-after analysis

Effectiveness of screening for foot complications in people with diabetes - A systematic review

BACKGROUND

A quarter of people with diabetes develop foot ulcer in their lifetime and are six times more likely to require a major lower limb amputation compared to the general population. Risk stratification tools can reliably identify those at the highest risk of ulceration, but it remains unclear if screening for foot complications can prevent limb loss in people with diabetes.

AIMS

The aim of this systematic review was to determine whether population-based foot screening in people with diabetes reduces lower limb complications as assessed by development of foot ulceration, minor and major lower limb amputations, hospitalisation, or death.

METHODS

MEDLINE, Embase, Emcare and CINAHL databases were searched to identify randomised and non-randomised controlled trials and observational studies (cohort, case-control and cross-sectional surveys). The screening process, study quality assessment and data extraction were performed by two independent reviewers.

RESULTS

Following abstract screening and assessment for eligibility, five out of 10,771 identified studies were included in the analysis. Of these studies, one demonstrated 24 % reduction in development of new ulceration following introduction of screening. Major amputations decreased by between 17 and 96 % in three studies. Hospitalisation rates were contradictory, with one study showing doubling in hospital admissions and another one reduction by 33 %. One study demonstrated no impact of screening on minor or major amputation rates. None of the studies addressed the effect of foot screening on all-cause mortality.

CONCLUSIONS

The number and quality of studies to support population-based foot screening to prevent lower limb complications in people with diabetes is low. Current evidence suggests variable impact of screening on important clinical outcomes.

Quality Assessment of Traditional Persian Medicine Observational Studies

Background

Although observational studies are valuable sources of scientific evidence, they are prone to bias and confounding. This study aimed to assess the quality of observational studies in Traditional Persian medicine (TPM).

Methods

A systematic search was conducted in national and international databases up to the end of 2022 to identify observational studies on TPM. The quality of articles was evaluated using the STROBE checklist and CARE guidelines.

Results

Out of the 192 articles identified, 109 met the eligible criteria for quality assessment. Cross-sectional and case-control studies had a mean STROBE score of 1.2±0.51 out of 2, with the introduction section scoring highest and the results and methods sections scoring lowest. The worst reported items in the method section involved sensitivity analyses, bias control, and management of missing data. Case reports and case series had a mean score of 1.4±0.55 out of 2, with the section on therapeutic interventions scoring the highest. Other sections like keywords, follow-up and outcomes, diagnostic assessment, patient perspective, and informed consent scored below one.

Conclusion

Many reviewed articles did not adhere to the recommended formatting in the evaluation tools, making it challenging to assess their quality. Having said that, the quality of observational studies in the field of TPM is a point of concern.

Adherence of SARS-CoV-2 Seroepidemiologic Studies to the ROSES-S Reporting Guideline During the COVID-19 Pandemic

BACKGROUND

Complete reporting of seroepidemiologic studies is critical to their utility in evidence synthesis and public health decision making. The Reporting of Seroepidemiologic studies-SARS-CoV-2 (ROSES-S) guideline is a checklist that aims to improve reporting in SARS-CoV-2 seroepidemiologic studies. Adherence to the ROSES-S guideline has not yet been evaluated.

OBJECTIVES

This study aims to evaluate the completeness of SARS-CoV-2 seroepidemiologic study reporting by the ROSES-S guideline during the COVID-19 pandemic, determine whether guideline publication was associated with reporting completeness, and identify study characteristics associated with reporting completeness.

METHODS

A random sample from the SeroTracker living systematic review database was evaluated. For each reporting item in the guideline, the percentage of studies that were adherent was calculated, as well as median and interquartile range (IQR) adherence across all items and by item domain. Beta regression analyses were used to evaluate predictors of adherence to ROSES-S.

RESULTS

One hundred and ninety-nine studies were analyzed. Median adherence was 48.1% (IQR 40.0%-55.2%) per study, with overall adherence ranging from 8.8% to 72.7%. The laboratory methods domain had the lowest median adherence (33.3% [IQR 25.0%-41.7%]). The discussion domain had the highest median adherence (75.0% [IQR 50.0%-100.0%]). Reporting adherence to ROSES-S before and after guideline publication did not significantly change. Publication source (p < 0.001), study risk of bias (p = 0.001), and sampling method (p = 0.004) were significantly associated with adherence.

CONCLUSIONS

Completeness of reporting in SARS-CoV-2 seroepidemiologic studies was suboptimal. Publication of the ROSES-S guideline was not associated with changes in reporting practices. Authors should improve adherence to the ROSES-S guideline with support from stakeholders.

Risk of permanent medical impairment after road traffic crashes: A systematic review

PURPOSE

To systematically review the risk of permanent disability related to road traffic injuries (RTIs) and to determine the implications for future research regarding permanent impairment following road traffic crashes.

METHODS

We conducted this systematic review according to the preferred reporting items for systematic reviews and meta-analysis statement. An extended search of the literature was carried out in 4 major electronic databases for scientific research papers published from January 1980 to February 2020. Two teams include 2 reviewers each, screened independently the titles/abstracts, and after that, reviewed the full text of the included studies. The quality of the studies was assessed using the strengthening the reporting of observational studies in epidemiology (STROBE) checklist. A third reviewer was assessed any discrepancy and all data of included studies were extracted. Finally, the data were systematically analyzed, and the related data were interpreted.

RESULTS

Five out of 16 studies were evaluated as high-quality according to the STROBE checklist. Fifteen studies ranked the initial injuries according to the abbreviated injury scale 2005. Five studies reported the total risk of permanent medical impairment following RTIs which varied from 2% to 23% for car occupants and 2.8% to 46% for cyclists. Seven studies reported the risk of permanent medical impairment of the different body regions. Eleven studies stated the most common body region to develop permanent impairment, of which 6 studies demonstrated that injuries of the cervical spine and neck were at the highest risk of becoming permanent injured.

CONCLUSION

The finding of this review revealed the necessity of providing a globally validated method to evaluate permanent medical impairment following RTIs across the world. This would facilitate decision-making about traffic injuries and efficient management to reduce the financial and psychological burdens for individuals and communities.

Effect of mandibular bone atrophy on maxillary and mandibular bone remodeling and quality of life with an implant-retained mandibular overdenture after 3 years

STATEMENT OF PROBLEM

The medium-term effect of an implant-retained mandibular overdenture on bone remodeling in the maxilla and posterior mandible of edentulous patients and the effects on quality of life have not been established.

PURPOSE

The purpose of this prospective observational clinical study was to evaluate the 3-year effects of implant-retained mandibular overdentures on oral-health-related quality of life (OHRQoL) and bone remodeling in different regions of the maxilla and mandible in participants with atrophic or nonatrophic mandibles.

MATERIAL AND METHODS

Twenty-six edentulous participants received 2 narrow-diameter implants in the anterior mandible. Mandibular bone atrophy was categorized from presurgical panoramic radiographs according to the Cawood and Howell criteria. OHRQoL was assessed by using the OHIP-EDENT questionnaire. Participants were evaluated annually for 3 years to measure the marginal bone loss and bone area of the posterior mandible, and the anterior and posterior regions of the maxilla were assessed annually through panoramic radiographs. The data were analyzed by using a mixed-effects linear regression to estimate time-dependent trends and a mixed-effect linear regression model to verify differences between groups. The Pearson correlation coefficients between bone variables and 3-year OHIP-EDENT outcomes were calculated.

RESULTS

In the third year, atrophic participants had a significantly lower marginal bone loss (0.02 mm) than nonatrophic participants (-0.39 mm) (P=.030). Differences were also found in the functional limitation (nonatrophic=1.82 ±1.75, atrophic participants=1.92 ±1.54; P=.018) and handicap domains (nonatrophic=0.36 ±0.54, atrophic participants=0.08 ±0.27; P=.003). For nonatrophic participants, comparisons between baseline and 3-year outcomes showed significant bone resorption as indicated by the area ratio in the anterior maxilla (P=.035), posterior maxilla (P=.022), and posterior mandible (P=.009). Conversely, the bone area of the anterior maxilla (P=.019) decreased in atrophic participants between baseline and year 1, while the bone area of the anterior maxilla and posterior mandible increased (P<.001) between years 1 and 3. Higher effect sizes were observed in the OHRQoL domains of the atrophic participants.

CONCLUSIONS

Bone atrophy influenced both the OHRQoL profile and bone remodeling profile in different regions of the mandible and maxilla in mandibular overdenture users. In atrophic participants, bone tissue in both jaws responded positively to overdenture use, with bone apposition after the first year and bone area preservation in the anterior maxilla, posterior mandible, and peri-implant regions after 3 years of follow-up.

Potential Role of Occupational Therapist Intervention in Elementary School for Children with Additional Support Needs: A Systematic Review

(1) Background: The main activity children engage with is learning through play or formal education. The aim of this systematic review is to analyze the role of occupational therapy in the school setting for children with additional support needs or disabilities. (2) Method: We conducted a systematic review using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. This systematic review was registered in PROSPERO (CDR42022314271). The search was performed in the following databases: ERIC, Dialnet Plus, PubMed, OTseeker, Cochrane, Scopus, CINAHL, and PsycINFO. (3) Results: In total, 1954 studies were identified, from which 18 articles were selected. These studies were heterogeneous and showed different types of intervention of the occupational therapist in school environments. (4) Conclusions: The main conclusions highlighted the effectiveness of the occupational therapist within the school environment, the importance of an interdisciplinary team to cover the special needs students within the school and the need for intrinsic motivation for an active and inclusive participation of the students with special needs. However, there is a need for more homogeneous studies with a larger sample size that specifically focus on the school context and include the involvement of occupational therapists in order to replicate the findings obtained.

15-Year Retrospective Study on the Success Rate of Maxillary Sinus Augmentation and Implants: Influence of Bone Substitute Type, Presurgical Bone Height, and Membrane Perforation during Sinus Lift

Objectives

To evaluate the success rate of bone grafts and implants carried out at the Latin American Institute for Research and Dental Education (ILAPEO), considering the following: (i) the different pure bone substitutes (autogenous, xenogeneic, and alloplastic), (ii) the presurgical bone height, and (iii) how the treatment is compromised when membrane perforation occurs during sinus lift in maxillary sinus surgeries. Material and Methods. The initial sample comprised 1040 records of maxillary sinus lifting surgeries. After evaluation, the final sample retained 472 grafts performed using the lateral window technique with a total of 757 implants. The grafts were divided into 3 groups: (i) autogenous bone (n = 197), (ii) xenogenous bovine bone (n = 182), and (iii) alloplastic material (n = 93). One calibrated examiner classified the sample into two groups based on the residual bone height (<4 mm and ≥4 mm) of the area of interest measured on parasagittal sections of tomographic images. Data on membrane perforation occurrences in each group were collected; qualitative variables were described using frequency, expressed as percentages. The Chi-square test was used to analyze the success of the graft types and the survival rate of the implants as a function of the grafted material and the residual bone height. The Kaplan-Meier survival analysis was used to calculate the survival rate of bone grafts and implants according to the classifications adopted in this retrospective study.

Results

The success rate of grafts and implants was 98.3% and 97.2%, respectively. There was no statistically significant difference in the success rate among the different bone substitutes (p = 0.140). Only 8 grafts (1.7%) and 21 implants (2.8%) failed. There was a greater success rate for both grafts (96.5%) and implants (97.4%) when the bone height was ≥4 mm. The success rate in the 49 sinuses in which the membrane was perforated was 97.96% for the grafts and 96.2% for the implants. The follow-up periods after rehabilitation ranged from 3 months to 13 years.

Conclusions

Within the limitations of the data analyzed in this retrospective study, maxillary sinus lift was a viable surgical technique that enabled implant placement with a predictable long-term success rate, regardless of the type of material used. The presence of membrane perforation did not interfere with the success rate obtained for grafts and implants.

Impacts of the zero mark-up policy on hospitalization expenses of T2DM and cholecystolithiasis inpatients in SC province, western China: an interrupted time series analysis

Background

Since 2009, a series of ambitious health system reforms have been launched in China, including the zero mark-up drug policy (ZMDP); the policy was intended to reduce substantial medicine expenses for patients by abolishing the 15% mark-up on drugs. This study aims to evaluate the impacts of ZMDP on medical expenditures from the perspective of disease burden disparities in western China.

Method

Two typical diseases including Type 2 diabetes mellitus (T2DM) in internal medicine and cholecystolithiasis (CS) in surgery were selected from medical records in a large tertiary level-A hospital in SC Province. The monthly average medical expenses of patients from May 2015 to August 2018 were extracted to construct an interrupted time series (ITS) model to evaluate the impact of policy implementation on the economic burden.

Results

A total of 5,764 cases were enrolled in our study. The medicine expenses for T2DM patients maintained a negative trend both before and after the intervention of ZMDP. It had declined by 74.3 CNY (P < 0.001) per month on average in the pre-policy period and subsequently dropped to 704.4 CNY (P = 0.028) immediately after the policy. The level change of hospitalization expenses was insignificant (P = 0.197), with a reduction of 677.7 CNY after the policy, while the post-policy long-term trend was significantly increased by 97.7 CNY (P = 0.035) per month contrasted with the pre-policy period. In addition, the anesthesia expenses of T2DM patients had a significant increase in the level under the impact of the policy. In comparison, the medicine expenses of CS patients significantly decreased by 1,014.2 CNY (P < 0.001) after the policy, while the total hospitalization expenses had no significant change in level and slope under the influence of ZMDP. Furthermore, the expenses of surgery and anesthesia for CS patients significantly increased by 320.9 CNY and 331.4 CNY immediately after the policy intervention.

Conclusion

Our study indicated that the ZMDP has been an effective intervention to reduce the excessive medicine expenses for both researched medical and surgical diseases, but failed to show any long-term advantage. Moreover, the policy has no significant impact on relieving the overall hospitalization burden for either condition.

Effects of exposure to per- and polyfluoroalkyl substances on vaccine antibodies: A systematic review and meta-analysis based on epidemiological studies

Vaccines are essential for children to defend against infection. Per- and polyfluoroalkyl substances (PFAS) are emerging contaminants with the characteristics of persistence and bioaccumulation. PFAS exposure can affect the function of the nervous, endocrine, and immune system of animals and humans. We aimed to conduct a systematic review and meta-analysis of the epidemiological studies investigating potential relationships between PFAS exposure and vaccine antibody levels, and assessed whether PFAS would affect vaccine response in healthy children. A literature search was conducted in PubMed, Web of Science, and Scopus databases up to February 2022. We chose studies that measured serum vaccines antibodies and PFAS concentrations of the participants. Essential information, including mean difference of percentage change, regression coefficient, odds ratio, Spearman correlation coefficient, and 95% confidence intervals, were extracted from the selected studies to conduct descriptive analysis and meta-analysis where appropriate. The qualities of these studies were evaluated as well. Finally, nine epidemiological studies about children met our inclusion criteria. A high degree of heterogeneity is observed in terms of breastfeeding time, confounder control, and detection method. Exposure to perfluorooctanoic acid and perfluorohexane sulfonic acid is negatively associated with tetanus antibody level in children without heterogeneity by Cochran's Q test (p = 0.26; p = 0.55), and exposure to perfluorohexane sulfonate is negatively associated with tetanus antibody level but with heterogeneity (p = 0.04). This comprehensive review suggests that PFAS can have adverse health effects on children by hindering the production of vaccine antibodies. There are some consistent and negative associations between children exposure to certain PFAS and tetanus antibody level. The association of the other four vaccines (measles, rubella, mumps, and influenza) with PFAS remains uncertain, because very few studies are available. Further studies are needed to validate the possible associations.

Regional and demographic variations of Carotid artery Intima and Media Thickness (CIMT): A Systematic review and meta-analysis

Background and objective

Carotid artery intima media thickness (CIMT) is a strong predictor of Coronary Heart Disease (CHD) and independent phenotype of early atherosclerosis. The global variation of CIMT and its demographic association is yet unclear. We evaluated regional variations of CIMT based on WHO regions and assessed the differences by age and sex.

Methods

A systematic search was conducted on studies published between 1980 January up to December 2020. PubMed, Oxford Medicine Online, EBSCO, Taylor & Francis, Oxford University Press and Embase data bases were used for searching. Supplementary searches were conducted on the Web of Science and Google Scholar. Grey literature was searched in “Open Grey” website. The two major criteria used were “adults” and “carotid intima media”. The search strategy for PubMed was created first and then adapted for the Oxford Medicine Online, EBSCO, Taylor & Francis, Oxford University Press and Embase databases. Covidence software (Veritas Health Innovation, Melbourne, Australia; http://www.covidence.org) was used to manage the study selection process. Meta-analyses were done using the random-effects model. An I2 ≥ 50% or p< 0:05 were considered to indicate significant heterogeneity.

Results

Of 2847 potential articles, 46 eligible articles were included in the review contributing data for 49 381 individuals (mean age: 55.6 years, male: 55.8%). The pooled mean CIMT for the non-CHD group was 0.65mm (95%CI: 0.62–0.69). There was a significant difference in the mean CIMT between regions (p = 0.04). Countries in the African (0.72mm), American (0.71mm) and European (0.71mm) regions had a higher pooled mean CIMT compared to those in the South East Asian (0.62mm), West Pacific (0.60mm) and Eastern Mediterranean (0.60mm) regions. Males had a higher pooled mean CIMT of 0.06mm than females in the non CHD group (p = 0.001); there were also regional differences. The CHD group had a significantly higher mean CIMT than the non-CHD group (difference = 0.23mm, p = 0.001) with regional variations. Carotid artery segment-specific-CIMT variations are present in this population. Older persons and those having CHD group had significantly thicker CIMTs.

Conclusions

CIMT varies according to region, age, sex and whether a person having CHD. There are significant regional differences of mean CIMT between CHD and non-CHD groups. Segment specific CIMT variations exist among regions. There is an association between CHD and CIMT values.

Poor reporting quality of observational clinical studies comparing treatments of COVID-19 – a retrospective cross-sectional study

Background

During the COVID-19 pandemic, the scientific world is in urgent need for new evidence on the treatment of COVID patients. The reporting quality is crucial for transparent scientific publication. Concerns of data integrity, methodology and transparency were raised. Here, we assessed the adherence of observational studies comparing treatments of COVID 19 to the STROBE checklist in 2020.

Methods

Design: We performed a retrospective, cross-sectional study. Setting: We conducted a systematic literature search in the Medline database. This study was performed at the RWTH Aachen University Hospital, Department of Anaesthesiology Participants: We extracted all observational studies on the treatment of COVID-19 patients from the year 2020. Main outcome measures: The adherence of each publication to the STROBE checklist items was analysed. The journals’ impact factor (IF), the country of origin, the kind of investigated treatment and the month of publication were assessed.

Results

We analysed 147 observational studies and found a mean adherence of 45.6% to the STROBE checklist items. The percentage adherence per publication correlated significantly with the journals’ IF (point estimate for the difference between 1^st and 4^th quartile 11.07%, 95% CI 5.12 to 17.02, p < 0.001). U.S. American authors gained significantly higher adherence to the checklist than Chinese authors, mean difference 9.10% (SD 2.85%, p = 0.023).

Conclusions

We conclude a poor reporting quality of observational studies on the treatment of COVID-19 throughout the year 2020. A considerable improvement is mandatory.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12874-021-01501-9.

Circumferential bone level and bone remodeling in the posterior mandible of edentulous mandibular overdenture wearers: influence of mandibular bone atrophy in a 3-year cohort study

OBJECTIVES

Evaluate circumferential bone level and morphological alterations in the posterior mandibular ridge of atrophic (AP) and non-atrophic (NAP) patients using implant-retained mandibular overdentures (MO) over 3 years.

MATERIALS AND METHODS

Twenty-six edentulous patients categorized according to mandibular atrophy (AP = 13/NAP = 13) received two narrow diameter implants (Facility, 2.9 × 10 mm) in the anterior region of mandible. The vertical and horizontal bone level was measured along with bone remodeling at 4 distances from the mental foramen in the posterior region of the mandible (L1-L4) via CBCT.

RESULTS

NAP showed significantly higher total height and medullary height in all posterior regions at 1 and 3 years (p ≤ 0.01). Cortical height and width were significantly higher (p ≤ 0.05) in this group at distances L1 and L4, respectively, in year 1. NAP shows a significantly higher % of medullary height at distances L1 (p ≤ 0.05), L2 (p ≤ 0.01), and L3 (p ≤ 0.05) after 1 year, and at all distances (p ≤ 0.05) after 3 years. Bone remodeling in the groups differed significantly (p ≤ 0.05) in terms of cortical width and % medullary width at L3.

CONCLUSION

AP and NAP showed similar vertical and horizontal bone level. Bone resorption in the posterior ridge was stabilized by MO over 3 years; however, AP are more susceptible to the long-term substitution of medullary bone by cortical bone.

CLINICAL RELEVANCE

This study is the first to longitudinally evaluate bone dimensions in atrophic and non-atrophic two-implant MO users by CBCT and revealed that MO is a predictable treatment based on the stabilization of the posterior bone resorption.

Prosthetic aftercare, mastication, and quality of life in mandibular overdenture wearers with narrow implants: A 3-year cohort study

OBJECTIVES

This cohort study investigated clinical, functional, and quality of life outcomes, along with prosthetic maintenance events in mandibular overdenture (MO) wearers for 3 years.

METHODS

Thirty MO wearers with narrow diameter implants (NDIs) and locking taper stud abutments (Facility-Equator system) were annually monitored by registering the visible plaque index (VPI), peri‑implant inflammation (PI), calculus presence (CP), probing depth (PD), bleeding on probing (BOP), secondary implant stability (ISQ), marginal bone loss (MBL), masticatory performance and dental impact in daily life (DIDL) questionnaire domains. Multilevel mixed-effects linear regression was performed to analyse changes over time. Chi-square tests were performed to analyse the relationship between the appearance of prosthetic complications and maintenance occurrences. The survival rate of patients with NDIs was calculated using the Kaplan-Meier test.

RESULTS

Twenty-six individuals attended all follow-ups, the survival rate of 83.3% in the first year was maintained, and no one implant was lost over the 3-year period. There were significant differences for PD between 1 and 3 years (p ≤ 0.01) and between 2 and 3 years for PI (p ≤ 0.01), GI (p ≤ 0.01), ISQ (p = 0.02), and MBL (p ≤ 0.01). All masticatory performance outcomes showed significant differences (p ≤.01). Prosthetic maintenance events decreased significantly over time. Appearance, general performance, and eating and chewing domains presented high effect sizes.

CONCLUSION

Continued changes were observed in the clinical parameters of MO users over the 3-year period. In addition, most functional parameters, except for particle homogenization, improved significantly over time. The positive impact on quality of life is likely related to the significant reduction in prosthetic maintenance events.

CLINICAL SIGNIFICANCE

Periodic returns to assess peri‑implant tissues and MO maintenance should be performed to ensure the success of rehabilitation to assure improvements in masticatory function and oral health-related quality of life.

A meta-review demonstrates improved reporting quality of qualitative reviews following the publication of COREQ- and ENTREQ-checklists, regardless of modest uptake

BACKGROUND

Reviews of qualitative studies allow for deeper understanding of concepts and findings beyond the single qualitative studies. Concerns on study reporting quality led to the publication of the COREQ-guidelines for qualitative studies in 2007, followed by the ENTREQ-guidelines for qualitative reviews in 2012. The aim of this meta-review is to: 1) investigate the uptake of the COREQ- and ENTREQ- checklists in qualitative reviews; and 2) compare the quality of reporting of the primary qualitative studies included within these reviews prior- and post COREQ-publication.

METHODS

Reviews were searched on 02-Sept-2020 and categorized as (1) COREQ- or (2) ENTREQ-using, (3) using both, or (4) non-COREQ/ENTREQ. Proportions of usage were calculated over time. COREQ-scores of the primary studies included in these reviews were compared prior- and post COREQ-publication using T-test with Bonferroni correction.

RESULTS

1.695 qualitative reviews were included (222 COREQ, 369 ENTREQ, 62 both COREQ/ENTREQ and 1.042 non-COREQ/ENTREQ), spanning 12 years (2007-2019) demonstrating an exponential publication rate. The uptake of the ENTREQ in reviews is higher than the COREQ (respectively 28% and 17%), and increases over time. COREQ-scores could be extracted from 139 reviews (including 2.775 appraisals). Reporting quality improved following the COREQ-publication with 13 of the 32 signalling questions showing improvement; the average total score increased from 15.15 to 17.74 (p-value < 0.001).

CONCLUSION

The number of qualitative reviews increased exponentially, but the uptake of the COREQ and ENTREQ was modest overall. Primary qualitative studies show a positive trend in reporting quality, which may have been facilitated by the publication of the COREQ.

CONSIDER Statement: Consolidated Recommendations for Sharing Individual Participant Data from Human Clinical Studies

Many research sponsors require sharing of data from human clinical trials. We created the CONSIDER statement, a set of recommendations to improve data sharing practices and increase the availability and re-usability of individual participant data from clinical trials. We developed the recommendations by reviewing shared individual participant data and study artifacts from a set of completed studies, as well as study data deposited on ClinicalTrials.gov and on several data sharing platforms. The CONSIDER statement is comprised of seven sections including: format, data sharing, study design, case report forms, data dictionary, data de-identification and choice of data sharing platform. We developed several different forms of CONSIDER which includes a brief form (the checklist), a full form (detailed descriptions and examples), and a scoring methodology. The checklist can be used to evaluate adherence to various progressive data sharing recommendations. We are currently in Phase 2 of collecting feedback on the CONSIDER statement.

Reporting practices for genomic epidemiology of tuberculosis: a systematic review of the literature using STROME-ID guidelines as a benchmark

BACKGROUND

Pathogen genomics have become increasingly important in infectious disease epidemiology and public health. The Strengthening the Reporting of Molecular Epidemiology for Infectious Diseases (STROME-ID) guidelines were developed to outline a minimum set of criteria that should be reported in genomic epidemiology studies to facilitate assessment of study quality. We evaluate such reporting practices, using tuberculosis as an example.

METHODS

For this systematic review, we initially searched MEDLINE, Embase Classic, and Embase on May 3, 2017, using the search terms "tuberculosis" and "genom* sequencing". We updated this initial search on April 23, 2019, and also included a search of bioRxiv at this time. We included studies in English, French, or Spanish that recruited patients with microbiologically confirmed tuberculosis and used whole genome sequencing for typing of strains. Non-human studies, conference abstracts, and literature reviews were excluded. For each included study, the number and proportion of fulfilled STROME-ID criteria were recorded by two reviewers. A comparison of the mean proportion of fulfilled STROME-ID criteria before and after publication of the STROME-ID guidelines (in 2014) was done using a two-tailed t test. Quasi-Poisson regression and tobit regression were used to examine associations between study characteristics and the number and proportion of fulfilled STROME-ID criteria. This study was registered with PROSPERO, CRD42017064395.

FINDINGS

976 titles and abstracts were identified by our primary search, with an additional 16 studies identified in bioRxiv. 114 full texts (published between 2009 and 2019) were eligible for inclusion. The mean proportion of STROME-ID criteria fulfilled was 50% (SD 12; range 16-75). The proportion of criteria fulfilled was similar before and after STROME-ID publication (51% [SD 11] vs 46% [14], p=0·26). The number of criteria reported (among those applicable to all studies) was not associated with impact factor, h-index, country of affiliation of senior author, or sample size of isolates. Similarly, the proportion of criteria fulfilled was not associated with these characteristics, with the exception of a sample size of isolates of 277 or more (the highest quartile). In terms of reproducibility, 100 (88%) studies reported which bioinformatic tools were used, but only 33 (33%) reported corresponding version numbers. Sequencing data were available for 86 (75%) studies.

INTERPRETATION

The reporting of STROME-ID criteria in genomic epidemiology studies of tuberculosis between 2009 and 2019 was low, with implications for assessment of study quality. The considerable proportion of studies without bioinformatics version numbers or sequencing data available highlights a key concern for reproducibility.

Completeness of Intervention Reporting of Clinical Trials Published in Highly Ranked Obesity Journals

OBJECTIVE

Randomized controlled trials (RCTs) play a crucial role in the research and advancement of medical treatment. A cross-sectional study design was utilized to analyze the completeness of intervention reporting using the Template for Intervention Description and Replication (TIDieR) checklist and to evaluate factors associated with intervention reporting. A comparison of the completeness of intervention reporting before and after the publication of TIDieR was sought.

METHODS

PubMed was searched for RCTs in the top 10 obesity journals per the Google h5-index. After excluding non-RCTs, 300 articles were randomly sampled. After assessing each publication for eligibility, two authors (SLR and DT) extracted data related to intervention reporting from records in an independent, masked fashion. Data were then verified and analyzed.

RESULTS

The analysis revealed that the quality of intervention reporting is quite variable. Overall, no statistically significant difference in the quality of intervention reporting before and after the release of TIDieR guidelines was found. In general, obesity research has good intervention reporting in areas such as the mode of delivery, material lists for intervention, and procedure lists. However, four main areas in which obesity researchers can improve reporting quality were determined. These include providing the expertise and background of intervention providers and providing statements regarding the assessment of fidelity of the intervention.

CONCLUSIONS

Urgent intervention is warranted to improve the quality of research reporting in obesity research, which is a fundamental component of obesity management. This will likely require a unified approach from researchers, journals, and funding sources.

Reporting of methodological studies in health research: a protocol for the development of the MethodologIcal STudy reportIng Checklist (MISTIC)

INTRODUCTION

Methodological studies (ie, studies that evaluate the design, conduct, analysis or reporting of other studies in health research) address various facets of health research including, for instance, data collection techniques, differences in approaches to analyses, reporting quality, adherence to guidelines or publication bias. As a result, methodological studies can help to identify knowledge gaps in the methodology of health research and strategies for improvement in research practices. Differences in methodological study names and a lack of reporting guidance contribute to lack of comparability across studies and difficulties in identifying relevant previous methodological studies. This paper outlines the methods we will use to develop an evidence-based tool-the MethodologIcal STudy reportIng Checklist-to harmonise naming conventions and improve the reporting of methodological studies.

METHODS AND ANALYSIS

We will search for methodological studies in the Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Embase, MEDLINE, Web of Science, check reference lists and contact experts in the field. We will extract and summarise data on the study names, design and reporting features of the included methodological studies. Consensus on study terms and recommended reporting items will be achieved via video conference meetings with a panel of experts including researchers who have published methodological studies.

ETHICS AND DISSEMINATION

The consensus study has been exempt from ethics review by the Hamilton Integrated Research Ethics Board. The results of the review and the reporting guideline will be disseminated in stakeholder meetings, conferences, peer-reviewed publications, in requests to journal editors (to endorse or make the guideline a requirement for authors), and on the Enhancing the QUAlity and Transparency Of health Research (EQUATOR) Network and reporting guideline websites.

REGISTRATION

We have registered the development of the reporting guideline with the EQUATOR Network and publicly posted this project on the Open Science Framework (www.osf.io/9hgbq).

Long-term outcome of patients with Marfan syndrome with previous aortic surgery but native aortic roots

OBJECTIVES

The goal of this study was to report the long-term outcomes of patients with Marfan syndrome who had aortic surgery on any aortic segment except for the replacement of the aortic root itself.

METHODS

An observational retrospective single-centre study was conducted with 115 Marfan syndrome patients who underwent 189 major aortic interventions from 1995 until 2018. Patients without aortic root replacement were identified and aortic root growth was analysed over time.

RESULTS

Eleven of 115 patients (9.5%) did not have aortic root replacement during a follow-up of 10.5 [standard deviation (SD) 5.7] years and a mean age at last follow-up of 53.9 (SD 13.4) years. Patients without root replacement did not suffer less frequently from any type of acute aortic dissection (type A 27% vs 25%, P = 0.999; type B 36% vs 25%, P = 0.474). Patients with native aortic roots did not undergo fewer aortic interventions than those with aortic root replacement [12/11, mean 1.09 (SD 0.54) operations/patient vs 177/104, mean 1.7 (SD 1.3); P = 0.128]. Progression of the aortic root dimension was 0.5 (SD 0.3) mm/year in the group of patients with native aortic roots.

CONCLUSIONS

Current data suggest that 10% of patients with Marfan syndrome with previous aortic surgery will be free from aortic root replacement until the sixth decade of life.

Adherence to the Strengthening the Reporting of Observational Studies in Epidemiology Statement in Observational Studies Published in Iranian Medical Journals

Background

Although much medical knowledge comes from observational research, such studies are more prone to confounding and bias than others. This study was conducted to evaluate the adherence of the observational studies published in Iranian medical journals to the STROBE (strengthening the reporting of observational studies in epidemiology) statement.

Methods

In this cross-sectional study, we selected 150 articles of Iranian medical journals, using multistage sampling from Aug 2016 to Jun 2017. The reported items of the STROBE statement in the articles was determined and considered as the adherence of the articles to the statement. The adherence of the articles with different characteristics was compared.

Results

The adherence of the articles to the statement varied from 24% to 68% with a mean score of 48%±9%. The lowest mean scores were found in the Result (36%) and Method (49%) sections. The adherence was significantly better in the articles published in the journals indexed in PubMed or Web of Knowledge (ISI) databases (P<0.001) and those written by cooperation of the authors from other countries (P=0.044).

Conclusion

The evaluated articles in our study had not adequately reported the items recommended by the STROBE statement. This indicates deficiency in key elements for readers to assess the validity and applicability of a study.

TRIPOD statement: a preliminary pre-post analysis of reporting and methods of prediction models

OBJECTIVES

To assess the difference in completeness of reporting and methodological conduct of published prediction models before and after publication of the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD) statement.

METHODS

In the seven general medicine journals with the highest impact factor, we compared the completeness of the reporting and the quality of the methodology of prediction model studies published between 2012 and 2014 (pre-TRIPOD) with studies published between 2016 and 2017 (post-TRIPOD). For articles published in the post-TRIPOD period, we examined whether there was improved reporting for articles (1) citing the TRIPOD statement, and (2) published in journals that published the TRIPOD statement.

RESULTS

A total of 70 articles was included (pre-TRIPOD: 32, post-TRIPOD: 38). No improvement was seen for the overall percentage of reported items after the publication of the TRIPOD statement (pre-TRIPOD 74%, post-TRIPOD 76%, 95% CI of absolute difference: -4% to 7%). For the individual TRIPOD items, an improvement was seen for 16 (44%) items, while 3 (8%) items showed no improvement and 17 (47%) items showed a deterioration. Post-TRIPOD, there was no improved reporting for articles citing the TRIPOD statement, nor for articles published in journals that published the TRIPOD statement. The methodological quality improved in the post-TRIPOD period. More models were externally validated in the same article (absolute difference 8%, post-TRIPOD: 39%), used measures of calibration (21%, post-TRIPOD: 87%) and discrimination (9%, post-TRIPOD: 100%), and used multiple imputation for handling missing data (12%, post-TRIPOD: 50%).

CONCLUSIONS

Since the publication of the TRIPOD statement, some reporting and methodological aspects have improved. Prediction models are still often poorly developed and validated and many aspects remain poorly reported, hindering optimal clinical application of these models. Long-term effects of the TRIPOD statement publication should be evaluated in future studies.

Do implant-retained mandibular overdentures maintain radiographic, functional, and patient-centered outcomes after 3 years of loading?

OBJECTIVES

Analyzing whether radiographic, functional, and oral health-related quality of life (OHRQoL) outcomes are maintained over 3 years of implant-retained mandibular overdenture (IMO) function and investigating the bite force associations in the 3rd year of function.

MATERIAL AND METHODS

A longitudinal clinical study in which 24 IMO users were evaluated during a 3-year follow-up period. Patients' posterior area index, masticatory function, OHRQoL and bite force were assessed. The masticatory function parameter ST_X50 reflects the opening through which 50% of the crushed particles would pass, ST_B describes the homogeneity of the bolus, and the masticatory efficiency parameters ME_5.6 and ME_2.8 represent the % of material retained in the 5.6 and 2.8 mm sieves, respectively.

RESULTS

A significant increase in posterior area index (p ≤ .01) was found in all evaluated periods. Minor deteriorations in ST_X50 (p ≤ .01) and ME_5.6 (p ≤ .01) between the 2nd and the 3rd year coincided with improvements in ST_B (p ≤ .01), number of cycles (p ≤ .01), and cycle time (p = .02). The global OHIP-Edent score (p = .02) and the scores in the functional limitation (p = .02), psychological discomfort (p ≤ .01), and handicap domains (p ≤ .01) increased significantly between the 2nd and the 3rd year. Correlations between bite force and cycle time (p = .03) and between posterior area index and ST_X50 (p ≤ .01) and ME_2.8 (p = .02) were also found.

CONCLUSION

Changes in posterior area index, masticatory function, and OHRQoL are still ongoing during the 3rd year of IMO function. Bite force and posterior area index influence the masticatory function outcomes in the 3rd year of IMO function.

The effect of cooling vests on physiological and perceptual responses: a systematic review

Humans in hot environments are exposed to health risks and thermal discomfort which seriously affect their physical, physiological and mental workload. This study aimed to assess the effects of using cooling vests (CVs) on physiological and perceptual responses in the workplace. Three main databases were searched using subject headings and appropriate Mesh terms. The article has been written according to the preferred reporting items for systematic reviews checklist. A total of 23,837 studies were identified for screening and 63 studies were eligible for data extraction. A statistically significant difference was observed in body temperature among hybrid cooling garments (HBCGs), phase-change materials (PCMs) and air-cooled garments (ACGs) at 31.56-37 °C (60% relative humidity), evaporative cooling garments at 25.8-28.1 °C and liquid cooling garments at 35 °C (49% relative humidity) compared to without CVs (p < 0.001). HBCGs (PCMs and ACGs) are effective means in hot, moderate, humid or dry environments.

Facial aesthetic evaluation of rehabilitation effects in edentulous patients with varying degrees of residual ridge resorption by 3D stereophotogrammetry

BACKGROUND

Residual ridge resorption impairs patients' satisfaction with complete denture (CD) treatment, but influence of bone resorption on the aesthetic rehabilitation of edentulous patients still remains unclear due to insufficient quantitative investigations.

OBJECTIVES

To quantitatively evaluate the effects of residual ridge resorption on facial aesthetic reconstruction in elderly edentulous patients.

METHODS

According to radiological examination, a total of 19 edentulous subjects were categorised into two groups, atrophic patients (APs) and non-atrophic patients (NAPs). Before CD treatment and 3 months after treatment, patients were asked to complete the Orofacial Esthetic Scale (OES). The changes in facial appearance were measured by 3D stereophotogrammetry, and the facial parameters of two groups were compared.

RESULTS

The patient's subjective satisfaction of oro-facial aesthetics and 3D objective assessment of facial appearance improved after CD treatment. Subnasale-gnathion (Sn-Gn) significantly increased from 60.13 ± 3.91 mm to 62.27 ± 3.82 mm. After rehabilitation, glabella-subnasale (G-Sn)/Sn-Gn, nasolabial (Cm-Sn-Ls) and mentolabial (Li-Sm-Pg) significantly decreased and were closer to normal values. Moreover, the subtraction value between G-Sn/Sn-Gn and normal value before treatment of APs and NAPs was 14.47 ± 8.04% and 6.94 ± 3.69%, respectively (P = .026), while after treatment, the values decreased to 10.61 ± 6.33% and 3.86 ± 2.31% (P = .013), respectively.

CONCLUSION

The increased volume of lips and cheeks played an important role in the facial aesthetic reconstruction of edentulous patients. NAPs tended to have more attractive faces after CD treatment, as their facial profile parameters (G-Sn/Sn-Gn and Cm-Sn-Ls) were closer to normal Chinese with well-balanced faces.

Completeness of reporting of case reports in high-impact medical journals

INTRODUCTION

Case reports represent a relevant, timely and important study design in advancing medical scientific knowledge. They allow integration between clinical practice and clinical epidemiology. We aimed to assess the completeness of reporting (COR) of case reports published in high-impact journals. We assessed the COR of case reports using the CARE guidelines.

MATERIALS AND METHODS

We selected three high-impact journals and one journal specialized in publishing case reports, in which we included all published case reports from July to December 2017. Median COR score was calculated per study, and CORs were compared between journals with and without endorsement of CARE guidelines.

RESULTS

One hundred and fourteen case reports were included. Overall median COR was 81%, IQR [63%-96%]. Sections with the highest COR (84%-100%) were patient information, clinical findings, therapeutic intervention, follow-up and outcomes, discussion and informed consent. Sections with the lowest COR were title, keywords, timeline and patient perspective (2%-34%). COR was higher in journals endorsing in comparison to those not endorsing CARE guidelines (77% vs 65%), respectively, median difference = -12% 95% CI [-16% to -7%].

DISCUSSION

Overall completeness of case reports in included journals is high especially for CARE endorsing and dedicated journals but reporting of some items could be improved. Ongoing and future evaluations of endorsement status of reporting guidelines in medical journals should be assessed to improve completeness and reduce waste of clinical research, including case reports.

Use of the STROBE Checklist to Evaluate the Reporting Quality of Observational Research in Obstetrics

OBJECTIVE

To evaluate observational research manuscripts submitted to Obstetrics & Gynecology to determine the level of adherence to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist and highlight specific areas that could be improved.

METHODS

A scoring system based on the STROBE checklist was developed and validated for consistency by volunteer medical students or doctors. Using this scoring system, we performed a cross-sectional analysis on 198 observational research manuscripts submitted to Obstetrics & Gynecology from 2008 to 2016. Each manuscript was given a score based on the STROBE checklist. Comparisons were made among acceptance status, country of origin, and study type. Descriptive statistics (means, medians, and frequencies) were calculated for each manuscript category. The t test or Wilcoxon rank-sum test was used to compare differences between two groups and analysis of variance or the Kruskal-Wallis test was used to compare differences among three or more groups.

RESULTS

There was a statistically significant difference between the mean score for accepted (23.2±2.7) compared with rejected (19.7±4.1) manuscripts (P<.001). This difference was not seen when comparing country of origin and study type. Poor reporting was seen among all manuscript categories for objectives, study size, missing data, study participants, and translation of risk. Additionally, rejected manuscripts had poor reporting for eligibility criteria, variables, bias and confounding, statistical methods, unadjusted and adjusted estimates, and category boundaries.

CONCLUSION

Overall, accepted manuscripts show better adherence to the STROBE checklist, but there are several critical items that are poorly reported in all manuscripts.

Reporting quality in systematic reviews of in vitro studies: a systematic review

Background: Systematic reviews (SRs) and/or meta-analyses of in vitro research have an important role in establishing the foundation for clinical studies. In this study, we aimed to evaluate the reporting quality of SRs of in vitro studies using the PRISMA checklist.Method: Four databases were searched including PubMed, Virtual Health Library (VHL), Web of Science (ISI) and Scopus. The search was limited from 2006 to 2016 to include all SRs and/or meta-analyses (MAs) of pure in vitro studies. The evaluation of reporting quality was done using the PRISMA checklist.Results: Out of 7702 search results, 65 SRs were included and evaluated with the PRISMA checklist. Overall, the mean overall quality score of reported items of the PRISMA checklist was 68%. We have noticed an increasing pattern in the numbers of published SRs of in vitro studies over the last 10 years. In contrast, the reporting quality was not significantly improved over the same period (p = .363). There was a positive but not significant correlation between the overall quality score and the journal impact factor of the included studies.Conclusions: The adherence of SRs of in vitro studies to the PRISMA guidelines was poor. Therefore, we believe that using reporting guidelines and journals paying attention to this fact will improve the quality of SRs of in vitro studies.

Mapping of inflammatory biomarkers in the peri-implant crevicular fluid before and after the occlusal loading of narrow diameter implants

OBJECTIVE

To monitor the cytokine release patterns in the peri-implant crevicular fluid (PICF) and to investigate which factors affect the success rate of narrow diameter implants (NDI) during the first year.

MATERIAL AND METHODS

Mandibular implant overdentures (IOD) retained by 2 NDI were installed in 16 clinically atrophic edentulous patients. The following parameters were monitored during the first year: (i) peri-implant health parameters (plaque index (PI), calculus presence (CP), gingival index (GI), probing depth (PD) and bleeding on probing (BoP); (ii) cytokine concentrations in the PICF (TNF-α, IL-1β, IL-6, IL-10); (iii) implant stability quotient (ISQ); (iv) marginal bone level (MBL) and bone level change (BLC); (v) implant success. The insertion torque, bone type, mandibular atrophy, time since edentulism, and smoking habits were also recorded. All data were analyzed using multivariable multilevel mixed-effects regression models.

RESULTS

The variability in the TNF-α release patterns temporarily reduced at weeks (w) 8-12, while the IL-1β concentrations remained low until they peaked at w48 [p < 0.05; + 177.55 pg/μl (+ 96.13 - + 258.97)]. Conversely, IL-10 release decreased significantly at w48 [p < 0.05; - 456.24 pg/μl (- 644.41 - - 268.07)]. The PD and ISQ decreased significantly (p < 0.05) over the follow-up period, while the MBL was stable after w48 with a BLC of 0.12 ± 0.71 mm. The overall success rate was 81.3%, and was influenced by TNF-α, IL-1β, IL-10, PI, GI, PD, smoking, and time since edentulism.

CONCLUSION

Pro- and anti-inflammatory cytokine release was balanced during the first 24 weeks. The GI, smoking, and time since edentulism are the most important factors determining the implant success.

CLINICAL RELEVANCE

The study contributes to the understanding of the osseointegration process in a clinically atrophic population rehabilitated with IOD, and highlights the importance of monitoring clinical peri-implant health-related parameters, smoking habit, and time since edentulism to predict implant success rates.

Influence of facial patterns on the masticatory function and quality of life of completely edentulous patients during the transition to implant-retained mandibular overdentures

STATEMENT OF PROBLEM

Although implant-retained mandibular overdentures (IMOs) provide functional benefits, the influence of the vertical facial pattern (FP) and the anteroposterior skeletal discrepancy (ASD) on the masticatory function and patient-centered outcomes during the transition to IMOs is still uncertain.

PURPOSE

The purpose of this interventional clinical study was to evaluate the influence of the FP and ASD on the masticatory function, oral health-related quality of life (OHRQoL), and satisfaction of completely edentulous patients before and after transition to IMOs.

MATERIAL AND METHODS

Cephalometric analysis was performed on 42 participants before treatment. Ricketts analysis was used to classify the FP, and the maxillomandibular relationship to the base of the skull determined the ASD. Masticatory performance (MP) and swallowing threshold (ST) test results were evaluated by the multiple sieve method by using artificial test food (Optocal cubes) to determine the median particle size (×50), homogenization index (B), and masticatory efficiency based on sieves 5.6 (ME: 5.6) and 2.8 (ME: 2.8). OHRQoL and satisfaction were evaluated by using the Dental Impact on Daily Living questionnaire. The data were analyzed using mixed-effects linear regression models to estimate the effect of time, FP, ASD, age, and sex on MP, ST, and OHRQoL.

RESULTS

The MP, ST, OHRQoL, and satisfaction improved significantly after IMO loading, irrespective of FP and ASD. However, MP outcomes were most negatively affected mainly among dolichofacial (B and ME: 2.8), class II, and class III (×50, B, and ME: 2.8) participants. The ST test showed that class II participants still showed inferior ×50 values and performed a lower number of cycles than class I and class III participants. Women presented reduced masticatory function for all MP and ST outcomes and reported lower coefficients for appearance and general performance domains than men.

CONCLUSIONS

The MP test detected more subtle improvements than the ST test, especially in class III participants. The class II participants benefited the least from the IMO installation according to the ST test. The IMO treatment improved the OHRQoL and satisfaction of edentulous patients, irrespective of the FP or ASD.

Requirements for trial registration and adherence to reporting guidelines in critical care journals: a meta-epidemiological study of journals' instructions for authors

BACKGROUND

The purpose of this study was to investigate the policies of critical care journals with regard to guideline adoption and clinical trial registration to understand the extent to which journals use these mechanisms to improve reporting practices.

METHODS

The current study's sample comprised 37 critical care journals cataloged in the Expanded Science Citation Index of the 2015 Journal Citation Reports and Google Scholar Metrics h5-index critical care subcategory. A web-based data abstraction was performed to identify which journals required, recommended, or made no mention of 17 different reporting guidelines. We also extracted whether journals required or recommended trial registration. Authors were blinded to one another's ratings until completion of the data validation. Cross tabulations and descriptive statistics were calculated by using STATA 13.

RESULTS

Of the 37 critical care journals, 15 (15/37, 40.5%) did not mention a single guideline within their instructions for authors, whereas the remaining 22 (22/37, 59.5%) mentioned one or more guidelines. The Quality of Reporting of Meta-analyses statement and Standards for Reporting Qualitative Research were not mentioned by any journals, whereas the International Committee of Medical Journal Editors Uniform Requirements for Manuscripts (26/37, 70.3%) and Consolidated Standards of Reporting Trials statement (17/37, 45.9%) were mentioned most often. Of the 37 critical care journals, 21 (21/37, 56.8%) did not mention trial or review registration, but the remaining 16 (16/37, 43.2%) mentioned at least one of the two. Trial registration through ClinicalTrials.gov was mentioned by six (6/37, 16.2%) journals, whereas the WHO registry was mentioned by five (5/37, 13.5%). Sixteen (16/37, 43.2%) journals mentioned trial registration through a registry platform.

CONCLUSION

Nearly half of the journals in our sample did not mention a reporting guideline, and only a small percentage of journals required the registration of clinical trials as a condition for publication. Implementing these two mechanisms may limit bias, and their adoption should be considered by journal editors in critical care.

TRIAL REGISTRATION

UMIN000024081.

Trends in hospitalization rates for psoriasis flares since the introduction of biologics: a time series in France between 2005 and 2015

BACKGROUND

In the late 2000s, the introduction of biologics transformed the prognosis for patients with moderate-to-severe psoriasis. We hypothesized that treatment with biologics may associate with a reduction in the hospitalization rate for psoriasis flares.

OBJECTIVE

To analyse changes over time in the hospitalization rate for psoriasis flares.

METHODS

We included inpatient stays in any of nine French hospitals between 2005 and 2015 for a psoriasis flare, as documented in the national inpatient database. In two centres, we also analysed data from the individual patients' electronic medical records.

RESULTS

A total of 3572 stays were included. The introduction of biologics was not associated with a decrease in the number of hospitalizations for a psoriasis flare; on the contrary, we observed a non-significant increase in the number of hospitalizations (13 hospitalizations for psoriasis flares per quarter per 10 000 beds). In the two-centre study, the introduction of biologics was associated with a significant increase in the hospitalization of patients receiving topical treatments only (520 hospitalizations per year per 10 000 beds) and those with a first psoriasis flare.

CONCLUSION

The number of hospitalizations for a psoriasis flare tended to increase between 2005 and 2015. The availability of additional treatment options might have increased patient demand and/or broadened the indications in clinical practice.

One-year clinical outcomes of locking taper Equator attachments retaining mandibular overdentures to narrow diameter implants

BACKGROUND

Narrow diameter implants (NDI) are recommended to retain mandibular overdentures (MOs) in cases of limited bone thickness. It is necessary to evaluate the clinical behavior of NDI as MO retainers connected to a new screwless locking taper abutments, their predictability and maintenance problems.

OBJECTIVES

To evaluate the peri-implant tissue behavior around NDI and the performance of locking taper stud abutments as MO retainers.

METHODOLOGY

Thirty patients (average age of 67.5 years) received 2 NDI implants (2.9 × 10 mm) loaded after 12 weeks using Equator stud attachments. The plaque index (PI), calculus index (CI), gingival index (GI), probing depth (PD), bleeding on probing (BOP), and implant stability quotient (ISQ) were monitored during osseointegration at 0, 4, 8, and 12 weeks and postloading at 24, 48, and 60 weeks. The marginal bone level (MBL) and bone level changes (BLC) were determined at baseline and 60 weeks.

RESULTS

The cumulative success rate was 83.3%. The PI oscillated in the first 24 weeks and decreased from 48 weeks onward, while the CI score showed significantly higher values at week 8 (22%). The GI also peaked at week 8 (18.6%) and decreased from week 12 onward. The PD decreased gradually over time, but no significant differences were found between weeks 8 and 12. The ISQ decreased significantly between 0 and 12 weeks. After MO loading, the ISQ values increased linearly and significantly between 12 and 24, 24 and 48, and 48 and 60 weeks and reached values similar to the primary stability after 60 weeks [56.1(42.0-65.3)]. No significant MBL was observed at 60 weeks, with an average BLC of -0.06 ± 0.64 mm.

CONCLUSION

NDI connected to locking taper Equator attachments showed a stable clinical behavior as an MO retainer for edentulous patients with clinical mandibular atrophy.

Effectiveness of employer financial incentives in reducing time to report worker injury: an interrupted time series study of two Australian workers' compensation jurisdictions

Background

Early intervention following occupational injury can improve health outcomes and reduce the duration and cost of workers’ compensation claims. Financial early reporting incentives (ERIs) for employers may shorten the time between injury and access to compensation benefits and services. We examined ERI effect on time spent in the claim lodgement process in two Australian states: South Australia (SA), which introduced them in January 2009, and Tasmania (TAS), which introduced them in July 2010.

Methods

Using administrative records of 1.47 million claims lodged between July 2006 and June 2012, we conducted an interrupted time series study of ERI impact on monthly median days in the claim lodgement process. Time periods included claim reporting, insurer decision, and total time. The 18-month gap in implementation between the states allowed for a multiple baseline design. In SA, we analysed periods within claim reporting: worker and employer reporting times (similar data were not available in TAS). To account for external threats to validity, we examined impact in reference to a comparator of other Australian workers’ compensation jurisdictions.

Results

Total time in the process did not immediately change, though trend significantly decreased in both jurisdictions (SA: −0.36 days per month, 95% CI −0.63 to −0.09; TAS: 0.35, −0.50 to −0.20). Claim reporting time also decreased in both (SA: −1.6 days, −2.4 to −0.8; TAS: -5.4, −7.4 to −3.3). In TAS, there was a significant increase in insurer decision time (4.6, 3.9 to 5.4) and a similar but non-significant pattern in SA. In SA, worker reporting time significantly decreased (−4.7, −5.8 to −3.5), but employer reporting time did not (−0.3, −0.8 to 0.2).

Conclusions

The results suggest that ERIs reduced claim lodgement time and, in the long-term, reduced total time in the claim lodgement process. However, only worker reporting time significantly decreased in SA, indicating that ERIs may not have shortened the process through the intended target of employer reporting time. Lack of similar data in Tasmania limited our ability to determine whether this was a result of ERIs or another component of the legislative changes. Further, increases in insurer decision time highlight possible unintended negative effects.

Electronic supplementary material

The online version of this article (10.1186/s12889-017-4998-9) contains supplementary material, which is available to authorized users.

Systematic review and meta-analysis on Schistosoma mansoni infection prevalence, and associated risk factors in Brazil

We performed a systematic review and meta-analysis on the prevalence and factors associated with Schistosoma mansoni infection in Brazil. We searched the PubMed, Web of Science and Latin-American and Caribbean System on Health Sciences Information (LILACS) databases, scientific publications articles, according to The PRISMA Statement, from 2000 to 2016. A total of 27 studies were included according to the established criteria. The prevalence of S. mansoni infection varied widely, from 0·1 to 73·1%, based on Kato-Katz technique. Of the identified studies, 42·9% were performed in the state of Minas Gerais, and 33·3% were performed in the northeast region of Brazil. We identified sex, age, education level, family income, contact with water and the presence of the intermediate host snail as major risk factors associated with infection. The meta-analysis summarized a high prevalence rate pooled for Schistosoma mansoni. On the other hand, the analysis of the subgroup showed a highly significant reduction of the prevalence rate after control measures. The epidemiological factors evidenced in the studies show the influence of environmental and social conditions on the occurrence of schistosomiasis.

How fast can treatment with overdentures improve the masticatory function and OHRQoL of atrophic edentulous patients? A 1-year longitudinal clinical study

OBJECTIVES

The aim of this prospective clinical study was to evaluate the masticatory function (MF) and subjective perception of patients with poor denture-bearing tissue in relation to change and the time required to identify an improvement in these parameters after rehabilitation with mandibular overdentures (MO) by two narrow-diameter two-piece implants.

MATERIAL AND METHODS

Twenty-three edentulous patients were selected for MO installation. The masticatory function (MF) was evaluated with the masticatory performance (MP) and swallowing threshold (ST) tests. In the MP test, each volunteer was instructed to masticate a portion of Optocal (standardized artificial test food) for 40 masticatory cycles. During the swallowing threshold test, the patients were instructed to chew a new portion of Optocal cubes until they felt the desire to swallow. The MF tests were performed while complete denture (CD) wearers (baseline) and 1, 3, 6, and 12 months after MO loading. In addition, the subjective perception was assessed through the questionnaires Dental Impact on Daily Living (DIDL), Geriatric Oral Health Assessment Index (GOHAI), and Oral Health Impact Profile in Edentulous (OHIP- EDENT) at the baseline and 3, 6, and 12 months after MO loading.

RESULTS

A significant improvement in masticatory function (p < .05) was observed already in the first month of loading. Three months after MO loading, a significant improvement (p < .05) was found in the subjective perception of patients. The effect size indicates that the MO had the greatest impact on the domains related to function and comfort of all questionnaires and in relation to psychosocial domain of the GOHAI. The level of patient satisfaction increased significantly after the MO loading and reached >90% satisfied patients at 12 months.

CONCLUSION

The MO improved both the MF of the patient and their oral health-related quality of life and satisfaction regarding the prosthesis in a short time period.

Assessment of continuous pain in newborns admitted to NICUs in 18 European countries

AIM

Continuous pain occurs routinely, even after invasive procedures, or inflammation and surgery, but clinical practices associated with assessments of continuous pain remain unknown.

METHODS

A prospective cohort study in 243 neonatal intensive care units (NICUs) from 18 European countries recorded the frequency of pain assessments, use of mechanical ventilation, sedation, analgesia or neuromuscular blockade for each neonate for up to 28 days after NICU admission.

RESULTS

Only 2113 of 6648 (31.8%) of neonates received assessments of continuous pain, occurring variably among tracheal ventilation (TrV, 46.0%), noninvasive ventilation (NiV, 35.0%) and no ventilation (NoV, 20.1%) groups (p < 0.001). Daily assessments for continuous pain occurred in only 10.4% of all neonates (TrV: 14.0%, NiV: 10.7%, NoV: 7.6%; p < 0.001). More frequent assessments of continuous pain occurred in NICUs with pain guidelines, nursing champions and surgical admissions (all p < 0.01), and for newborns <32 weeks gestational age, those requiring ventilation, or opioids, sedatives-hypnotics, general anaesthetics (O-SH-GA) (all p < 0.001), or surgery (p = 0.028). Use of O-SH-GA drugs increased the odds for pain assessment in the TrV (OR:1.60, p < 0.001) and NiV groups (OR:1.40, p < 0.001).

CONCLUSION

Assessments of continuous pain occurred in less than one-third of NICU admissions and daily in only 10% of neonates. NICU clinical practices should consider including routine assessments of continuous pain in newborns.

Narrative Review of Statistical Reporting Checklists, Mandatory Statistical Editing, and Rectifying Common Problems in the Reporting of Scientific Articles

Considerable attention has been drawn to poor reproducibility in the biomedical literature. One explanation is inadequate reporting of statistical methods by authors and inadequate assessment of statistical reporting and methods during peer review. In this narrative review, we examine scientific studies of several well-publicized efforts to improve statistical reporting. We also review several retrospective assessments of the impact of these efforts. These studies show that instructions to authors and statistical checklists are not sufficient; no findings suggested that either improves the quality of statistical methods and reporting. Second, even basic statistics, such as power analyses, are frequently missing or incorrectly performed. Third, statistical review is needed for all papers that involve data analysis. A consistent finding in the studies was that nonstatistical reviewers (eg, "scientific reviewers") and journal editors generally poorly assess statistical quality. We finish by discussing our experience with statistical review at Anesthesia & Analgesia from 2006 to 2016.

Therapy options in deep sternal wound infection: Sternal plating versus muscle flap

Background

Management of deep sternal wound infection (DSWI) in cardiac surgical patients still remains challenging. A variety of treatment strategies has been described. Aim of this cohort study was to analyse two different treatment strategies for DSWI: titanium sternal plating system (TSFS) and muscle flap coverage (MFC).

Methods

Between January 2007 and December 2011, from 3122 patients undergoing cardiac surgery 42 were identified with DSWI and treated with one of the above mentioned strategies. In-hospital data were collected, follow-up performed by telephone and assessment of Quality of Life (QoL) using the SF-12 Health Survey Questionnaire.

Results

20 patients with deep sternal wound infection were stabilized with TSFS and 22 patients treated with MFC. Preoperative demographics and risk factors did not reveal any significant differences. Patients treated with TSFS had a significantly shorter operation time (p<0.05) and shorter hospitalization (p<0.05). A tendency towards lower mortality rate (p = n.s.) and less re-interventions were also noted (plating 0.6 vs. flap 1.17 per patient, n.s.). Quality of Life in the TSFS group for the physical-summary-score was significantly elevated compared to the MFC group (p<0.05). Relating to chest stability and cosmetic result the treatment with TSFS showed superior results, but the usage of MFC gave the patients more freedom in breathing and less chest pain.

Conclusion

Our results demonstrate that the use of TSFS is a feasible and safe alternative in DSWI. However, MFC remains an absolutely essential option for complicated DSWI since the amount of perfused tissue can be the key for infection control.

Did the reporting of prognostic studies of tumour markers improve since the introduction of REMARK guideline? A comparison of reporting in published articles

Although biomarkers are perceived as highly relevant for future clinical practice, few biomarkers reach clinical utility for several reasons. Among them, poor reporting of studies is one of the major problems. To aid improvement, reporting guidelines like REMARK for tumour marker prognostic (TMP) studies were introduced several years ago. The aims of this project were to assess whether reporting quality of TMP-studies improved in comparison to a previously conducted study assessing reporting quality of TMP-studies (PRE-study) and to assess whether articles citing REMARK (citing group) are better reported, in comparison to articles not citing REMARK (not-citing group). For the POST-study, recent articles citing and not citing REMARK (53 each) were identified in selected journals through systematic literature search and evaluated in same way as in the PRE-study. Ten of the 20 items of the REMARK checklist were evaluated and used to define an overall score of reporting quality. The observed overall scores were 53.4% (range: 10%-90%) for the PRE-study, 57.7% (range: 20%-100%) for the not-citing group and 58.1% (range: 30%-100%) for the citing group of the POST-study. While there is no difference between the two groups of the POST-study, the POST-study shows a slight but not relevant improvement in reporting relative to the PRE-study. Not all the articles of the citing group, cited REMARK appropriately. Irrespective of whether REMARK was cited, the overall score was slightly higher for articles published in journals requesting adherence to REMARK than for those published in journals not requesting it: 59.9% versus 51.9%, respectively. Several years after the introduction of REMARK, many key items of TMP-studies are still very poorly reported. A combined effort is needed from authors, editors, reviewers and methodologists to improve the current situation. Good reporting is not just nice to have but is essential for any research to be useful.

The quality of reports of medical and public health research from Palestinian institutions: a systematic review

OBJECTIVE

Over the past decade, there has been an increase in reports of health research from Palestine, but no assessment of their quality. We have assessed the quality of reports of Palestinian health research and factors associated with it.

DESIGN

This is a systematic review.

INCLUSION CRITERIA

We searched Medline and Scopus for reports of original research relevant to human health or healthcare authored by researchers affiliated with Palestinian institutions and published between January 2000 and August 2015 inclusive.

OUTCOMES

We used international guidelines to assess report quality, classifying as adequate those with ≥50% of items completely addressed.

RESULTS

Of 2383 reports identified, 497 met our inclusion criteria. Just over half (264; 55%) of these were published after 2010. 354 (71%) of first authors were affiliated with Palestinian institutions; 261 (53%) reports had coauthors from outside Palestine. The majority of the reports in our study were inadequately reported (342; 69%), and none had adequately reported all items. Of 439 observational studies, 11 (2.5%) reports provided adequate descriptions of eligibility criteria and selection procedures; 35 (8%) reported efforts to address potential sources of bias; 50 (11.4%) reported the basis for the study sample size; and funding sources were mentioned in 74 reports (17%). Higher reporting quality was associated with international affiliation of the first author (prevalence ratio (PR) 1.6 (95% CI 1.2 to 2.1)), international collaboration (PR 2.9 (95% CI 1.7 to 5.0)), international funding (PR 1.9 (95% CI1.5 to 2.5)), publication after 2005 (PR 3.9 (95% CI 1.8 to 8.5)) and four or more coauthors (PR 1.5 (95% CI 1.1 to 2.1)).

CONCLUSION

Although the quality of reports of Palestinian research has improved in recent years, it remains well below an acceptable standard. International reporting guidelines should be used to guide research design and improve the quality of reports of research.

TRIAL REGISTRATION NUMBER

The systematic review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) registery (registration number: CRD42015027553).