1
|
Kelly SE, Brooks SPJ, Benkhedda K, MacFarlane AJ, Greene-Finestone LS, Skidmore B, Clifford TJ, Wells GA. A scoping review shows that no single existing risk of bias assessment tool considers all sources of bias for cross-sectional studies. J Clin Epidemiol 2024; 172:111408. [PMID: 38844117 DOI: 10.1016/j.jclinepi.2024.111408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 05/27/2024] [Accepted: 05/28/2024] [Indexed: 07/09/2024]
Abstract
OBJECTIVES Different tools to assess the potential risk of bias (RoB) for cross-sectional studies have been developed, but it is unclear whether all pertinent bias concepts are addressed. We aimed to identify RoB concepts applicable to cross-sectional research validity and to explore coverage for each in existing appraisal tools. STUDY DESIGN AND SETTING This scoping review followed the Joanna Briggs Institute methodology. We included records of any study design describing or reporting methods, concepts or tools used to consider RoB in health research reported to be descriptive/prevalence survey or analytic/association (cross-sectional) study designs. Synthesis included quantitative and qualitative analysis. RESULTS Of the 4556 records screened, 90 were selected for inclusion; 67 (74%) described the development of, or validation process for, appraisal tools, 15 (17%) described methodological content or theory relevant to RoB for cross-sectional studies and 8 (9%) records of methodological systematic reviews. Review of methodological reports identified important RoB concepts for both descriptive/prevalence and analytic/association studies. Tools identified (n = 64 unique tools) were either intended to appraise quality or assess RoB in multiple study designs including cross-sectional studies (n = 21; 33%) or cross-sectional designs alone (n = 43; 67%). Several existing tools were modified (n = 17; 27%) for application to cross-sectional studies. The RoB items most frequently addressed in the RoB tools were validity and reliability of the exposure (53%) or outcome (65%) measurement and representativeness of the study population (59%). Most tools did not consider nonresponse or missingness appropriately or at all. CONCLUSION Assessing cross-sectional studies involve unique RoB considerations. We identified RoB tools designed for broad applicability across various study designs as well as those specifically tailored for cross-sectional studies. However, none of the identified tools comprehensively address all potential biases pertinent to cross-sectional studies. Our findings indicate a need for continued improvement of RoB tools and suggest that the development of context-specific or more precise tools for this study design may be necessary.
Collapse
Affiliation(s)
- Shannon E Kelly
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
| | | | - Karima Benkhedda
- Bureau of Nutritional Sciences, Health Canada, Ottawa, Ontario, Canada
| | - Amanda J MacFarlane
- Department of Biology, Carleton University, Ottawa, Ontario, Canada; Texas A&M Agriculture, Food, and Nutrition Evidence Center, Fort Worth, Texas, USA
| | | | | | - Tammy J Clifford
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - George A Wells
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| |
Collapse
|
2
|
Fenton C, Holmes J, Taylor A, Jackson Z. A Systematic Review of the Use, Acceptability, Perceived Effectiveness and Effectiveness of Self-Help Toolkits. Issues Ment Health Nurs 2024; 45:868-880. [PMID: 39121499 DOI: 10.1080/01612840.2024.2377229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/11/2024]
Abstract
Self-harming behaviours can include cutting the skin, ligaturing and taking overdoses. These actions can result in infection, blood loss, or even death. A young person's risk of dying by suicide increases if they engage in self-harm. Self-help empowers people to utilise different coping strategies and implement life changes without reliance on a clinical intervention, "helping people to help themselves". Self-help toolkits contain a variety of items that are selected by the person to help them manage the urge to self-harm. The items included sensory objects, distractions, prompts to seek help and creative prompts such as colouring books and pens and personal items that trigger positive memories. AMED, EMBASE, APA Psycinfo and MEDLINE were searched with no language restriction or date restriction. Of the 368 studies screened, 13 met the inclusion criteria. The studies were mainly small scale or case studies pertaining to the use of self-help toolkits or similar. They described the need for a flexible and/or individualised approach to self-help toolkits. Abstracts and studies were screened separately by two members of the research team for inclusion. Qualitative data was analysed using Grounded Theory. Nine themes were identified: Creativity, Hope, Social contact/help seeking, calming/relaxing, sensory items, reflection, distractions, therapeutic prompts and emotional release. Self-efficacy and self-awareness were the two main mechanisms identified. Self-help toolkits were found to be acceptable and helpful, but the limited evidence base means their efficacy for reducing self-harm episodes has not been established.
Collapse
Affiliation(s)
- Clare Fenton
- COMIC Research, Leeds and York Partnership NHS Foundation Trust, York, UK
| | - Jannah Holmes
- General Medicine, Mid Yorkshire Teaching Hospitals NHS Trust, Wakefield, UK
| | - Amelia Taylor
- COMIC Research, Leeds and York Partnership NHS Foundation Trust, York, UK
| | - Zoe Jackson
- COMIC Research, Leeds and York Partnership NHS Foundation Trust, York, UK
| |
Collapse
|
3
|
Zuelch ML, Radtke MD, Holt RR, Basu A, Burton-Freeman B, Ferruzzi MG, Li Z, Shay NF, Shukitt-Hale B, Keen CL, Steinberg FM, Hackman RM. Perspective: Challenges and Future Directions in Clinical Research with Nuts and Berries. Adv Nutr 2023; 14:1005-1028. [PMID: 37536565 PMCID: PMC10509432 DOI: 10.1016/j.advnut.2023.07.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 07/11/2023] [Accepted: 07/31/2023] [Indexed: 08/05/2023] Open
Abstract
Consumption of nuts and berries are considered part of a healthy eating pattern. Nuts and berries contain a complex nutrient profile consisting of essential vitamins and minerals, fiber, polyunsaturated fatty acids, and phenolics in quantities that improve physiological outcomes. The spectrum of health outcomes that may be impacted by the consumptions of nuts and berries includes cardiovascular, gut microbiome, and cognitive, among others. Recently, new insights regarding the bioactive compounds found in both nuts and berries have reinforced their role for use in precision nutrition efforts. However, challenges exist that can affect the generalizability of outcomes from clinical studies, including inconsistency in study designs, homogeneity of test populations, variability in test products and control foods, and assessing realistic portion sizes. Future research centered on precision nutrition and multi-omics technologies will yield new insights. These and other topics such as funding streams and perceived risk-of-bias were explored at an international nutrition conference focused on the role of nuts and berries in clinical nutrition. Successes, challenges, and future directions with these foods are presented here.
Collapse
Affiliation(s)
- Michelle L Zuelch
- Department of Nutrition, University of California, Davis, CA, United States
| | - Marcela D Radtke
- Department of Nutrition, University of California, Davis, CA, United States
| | - Roberta R Holt
- Department of Nutrition, University of California, Davis, CA, United States
| | - Arpita Basu
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada, Las Vegas, NV, United States
| | - Britt Burton-Freeman
- Department of Food Science and Nutrition, Illinois Institute of Technology, Chicago, IL, United States
| | - Mario G Ferruzzi
- Department of Pediatrics, Arkansas Children's Nutrition Center, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Zhaoping Li
- UCLA Center for Human Nutrition, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Neil F Shay
- Department of Food Science and Technology, Oregon State University, Corvallis, OR, United States
| | - Barbara Shukitt-Hale
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, United States
| | - Carl L Keen
- Department of Nutrition, University of California, Davis, CA, United States; Department of Internal Medicine, University of California, Davis, CA, United States
| | | | - Robert M Hackman
- Department of Nutrition, University of California, Davis, CA, United States.
| |
Collapse
|
4
|
Larrick BM, Dwyer JT, Erdman JW, D'Aloisio RF, Jones W. An Updated Framework for Industry Funding of Food and Nutrition Research: Managing Financial Conflicts and Scientific Integrity. J Nutr 2022; 152:1812-1818. [PMID: 35751567 PMCID: PMC9361736 DOI: 10.1093/jn/nxac106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/13/2022] [Accepted: 05/06/2022] [Indexed: 11/15/2022] Open
Abstract
Although the food and beverage industry plays a critical role in advancing food and nutrition science, industry-funded research is subject to intense scrutiny as a result of various perceived and real biases related to funding sources. To address this, the Institute for the Advancement of Food and Nutrition Sciences (IAFNS) Assembly on Scientific Integrity has updated its Guiding Principles for Funding Food Science and Nutrition Research to provide a modernized framework for minimizing bias and promoting integrity in industry-funded research. Existing best practices for managing conflicts and maintaining trust in science, as well as coverage related to conflicts in industry-funded research, were reviewed to inform the development of the updated Guiding Principles. The updated Guiding Principles continue to provide conflict-of-interest guidelines to protect the integrity and credibility of the scientific record. These updates provide clarification, strengthen the guardrails that separate the funding from the science, and reflect the shift within the scientific community toward increased transparency and open science. If the principles are followed as intended, there should be little reason to dispute the results of industry-funded studies, other than to debate the science itself. This article issues a challenge to the research community to strive for just that.
Collapse
Affiliation(s)
- Brienna M Larrick
- Institute for the Advancement of Food and Nutrition Sciences, Washington, DC, USA
| | - Johanna T Dwyer
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
- Tufts Medical Center, Boston, MA, USA
| | - John W Erdman
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | | | - Wendelyn Jones
- Institute for the Advancement of Food and Nutrition Sciences, Washington, DC, USA
| |
Collapse
|
5
|
Reis CEG, Saunders B, da Costa THM. Absence of dietary control precludes solid conclusions for sport nutrition trials. J Sci Med Sport 2021; 24:518-519. [PMID: 33380379 DOI: 10.1016/j.jsams.2020.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 11/25/2020] [Indexed: 10/22/2022]
Affiliation(s)
- Caio E G Reis
- Department of Nutrition, Universidade de Brasília, Brazil.
| | - Bryan Saunders
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina FMUSP, University of São Paulo (USP), Brazil
| | | |
Collapse
|
6
|
Arnesen EK, Christensen JJ, Andersen R, Eneroth H, Erkkola M, Høyer A, Lemming EW, Meltzer HM, Halldórsson ÞI, Þórsdóttir I, Schwab U, Trolle E, Blomhoff R. The Nordic Nutrition Recommendations 2022 - handbook for qualified systematic reviews. Food Nutr Res 2020; 64:4404. [PMID: 32612492 PMCID: PMC7307435 DOI: 10.29219/fnr.v64.4404] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 04/18/2020] [Accepted: 04/18/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Systematic reviews (SRs) constitute a major part of the Nordic Nutrition Recommendations (NNRs). The step-by-step procedure used to develop SRs has evolved considerably over time and is often tailored to fit the exposure and outcomes in focus. OBJECTIVE To describe a detailed procedure for developing qualified SRs commissioned by the NNR2022 project. DESIGN Scrutinizing procedures of recent SRs commissioned by leading national food and health authorities or international food and health organizations. RESULTS The following eight steps must be included when developing qualified SRs for the NNR2022 project: 1) define research question, 2) protocol development, 3) literature search, 4) screening and selection of studies, 5) data extraction, 6) assessing risk of bias, 7) synthesis and grading of total strength of evidence, and 8) reporting according to certain standards. DISCUSSION This guide is based on the guidelines developed for the fifth edition of NNR but includes some important new domains in order to adhere to more recent, authoritative standards. CONCLUSION All qualified SRs in the NNR2022 project will follow the protocol described here.
Collapse
Affiliation(s)
| | - Jacob Juel Christensen
- Department of Nutrition, University of Oslo, Oslo, Norway
- Norwegian National Advisory Unit on Familial Hypercholesterolemia, Oslo University Hospital, Oslo, Norway
| | - Rikke Andersen
- National Food Institute, Technical University of Denmark (DTU), Kgs. Lyngby, Denmark
| | | | - Maijaliisa Erkkola
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Anne Høyer
- The Norwegian Directorate of Health, Oslo, Norway
| | | | | | | | - Inga Þórsdóttir
- School of Health Sciences, University of Iceland, Reykjavík, Iceland
| | - Ursula Schwab
- Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, Kuopio, Finland, and Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Campus, Kuopio, Finland
| | - Ellen Trolle
- National Food Institute, Technical University of Denmark (DTU), Kgs. Lyngby, Denmark
| | - Rune Blomhoff
- Department of Nutrition, University of Oslo, Oslo, Norway
- The Norwegian Directorate of Health, Oslo, Norway
- Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
| |
Collapse
|
7
|
Arnesen EK, Christensen JJ, Andersen R, Eneroth H, Erkkola M, Høyer A, Lemming EW, Meltzer HM, Halldórsson ÞI, Þórsdóttir I, Schwab U, Trolle E, Blomhoff R. The Nordic Nutrition Recommendations 2022 - structure and rationale of qualified systematic reviews. Food Nutr Res 2020; 64:4403. [PMID: 32612488 PMCID: PMC7307429 DOI: 10.29219/fnr.v64.4403] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 04/18/2020] [Accepted: 04/18/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Qualified systematic reviews (SRs) will form the main basis for evaluating causal effects of nutrients or food groups on health outcomes in the sixth edition of Nordic Nutrition Recommendations to be published in 2022 (NNR2022). OBJECTIVE To describe rationale and structure of SRs used in NNR2022. DESIGN The SR methodologies of the previous edition of NNR were used as a starting point. Methodologies of recent SRs commissioned by leading national food and health authorities or international food and health organizations were examined and scrutinized. Methodologies for developing SRs were agreed by the NNR2022 Committee in a consensus-driven process. RESULTS Qualified SRs will be developed by a cross-disciplinary group of experts and reported according to the requirements of the EQUATOR network. A number of additional requirements must also be fulfilled, including 1) a clearly stated set of objectives and research questions with pre-defined eligibility criteria for the studies, 2) an explicit, reproducible methodology, 3) a systematic search that attempts to identify all studies that would meet the eligibility criteria, 4) an assessment of the validity of the findings of the included studies through an assessment of 'risk of bias' of the studies, 5) a systematic presentation and synthesis of the characteristics and findings of the included studies, and 6) a grading of the overall evidence. The complete definition and requirements of a qualified SR are described. DISCUSSION Most SRs published in scientific journals do not fulfill all criteria of the qualified SRs in the NNR2022 project. This article discusses the structure and rationale for requirements of qualified SRs in NNR2022. National food and health authorities have only recently begun to use qualified SRs as a basis for nutrition recommendations. CONCLUSION Qualified SRs will be used to inform dietary reference values (DRVs) and food-based dietary guidelines (FBDGs) in the NNR2022 project.
Collapse
Affiliation(s)
| | - Jacob Juel Christensen
- Department of Nutrition, University of Oslo, Oslo, Norway
- Norwegian National Advisory Unit on Familial Hypercholesterolemia, Oslo University Hospital, Oslo, Norway
| | - Rikke Andersen
- National Food Institute, Technical University of Denmark (DTU), Kgs. Lyngby, Denmark
| | | | - Maijaliisa Erkkola
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Anne Høyer
- The Norwegian Directorate of Health, Oslo, Norway
| | | | | | | | - Inga Þórsdóttir
- School of Health Sciences, University of Iceland, Reykjavík, Iceland
| | - Ursula Schwab
- Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, Kuopio, Finland, and Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Campus, Kuopio, Finland
| | - Ellen Trolle
- National Food Institute, Technical University of Denmark (DTU), Kgs. Lyngby, Denmark
| | - Rune Blomhoff
- Department of Nutrition, University of Oslo, Oslo, Norway
- The Norwegian Directorate of Health, Oslo, Norway
- Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
| |
Collapse
|