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Mistry B, Morand M, Liu M, Chan AW. Repair of a Large Infraorbital Cheek Defect. Dermatol Surg 2024; 50:477-479. [PMID: 37962123 DOI: 10.1097/dss.0000000000004021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Affiliation(s)
| | - Meggie Morand
- Centre hospitalier de l'Université de Montréal, University of Montreal, Montreal, Quebec, Canada
| | - Michael Liu
- Luminous Dermatology, Santa Barbara, California
| | - An-Wen Chan
- Division of Dermatology, Women's College Hospital, University of Toronto, Toronto, Ontario, Canada
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2
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Brijnath B, Muoio R, Feldman P, Ghersi D, Chan AW, Welch V, Treweek S, Green H, Orkin AM, Owusu-Addo E. "We are not invited": Australian focus group results on how to improve ethnic diversity in trials. J Clin Epidemiol 2024:111366. [PMID: 38631530 DOI: 10.1016/j.jclinepi.2024.111366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 03/26/2024] [Accepted: 04/09/2024] [Indexed: 04/19/2024]
Abstract
OBJECTIVE Lack of ethnic diversity in trials may contribute to health disparities and to inequity in health outcomes. The primary objective was to investigate the experiences and perspectives of ethnically diverse populations about how to improve ethnic diversity in trials. STUDY DESIGN AND SETTING Qualitative data were collected via 16 focus groups with participants from 21 ethnically diverse communities in Australia. Data collection took place between August and September 2022 in community-based settings in six capital cities: Sydney, Melbourne, Perth, Adelaide, Brisbane, and Darwin and one rural town: Bordertown (South Australia). RESULTS One hundred and fifty eight purposively sampled adults (aged 18-85, 49% women), participated in groups speaking Tamil, Greek, Punjabi, Italian, Mandarin, Cantonese, Karin, Vietnamese, Nepalese, and Arabic; or English-language groups (comprising Fijian, Filipino, African, and 2 multicultural groups). Only 10 participants had previously taken part in medical research including three in trials. There was support for medical research, including trials, however, most participants had never been invited to participate. To increase ethnic diversity in trial populations, participants recommended recruitment via partnering with communities, translating trial materials and making them culturally accessible using audiovisual ways, promoting retention by minimizing participant burden, establishing trust and rapport between participants and researchers, and sharing individual results. Participants were reluctant to join studies on taboo topics in their communities (e.g., sexual health) or in which physical specimens (e.g., blood) were needed. Participants said these barriers could be mitigated by communicating about the topic in more culturally cognizant and safe ways, explaining how data would be securely stored, and reinforcing the benefit of medical research to humanity. CONCLUSION Participants recognized the principal benefits of trials and other medical research, were prepared to take part, and offered suggestions on recruitment, consent, data collection mechanisms, and retention to enable this to occur. Researchers should consider these community insights when designing and conducting trials; and government, regulators, funders, and publishers should allow for greater innovation and flexibility in their processes to enable ethnic diversity in trials to improve.
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Affiliation(s)
- Bianca Brijnath
- Social Gerontology, National Ageing Research Institute; School of Social Sciences, University of Western Australia; Melbourne School of Population and Global Health, University of Melbourne.
| | - Rachel Muoio
- Social Gerontology, National Ageing Research Institute
| | - Peter Feldman
- Social Gerontology, National Ageing Research Institute
| | - Davina Ghersi
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; NHMRC Clinical Trials Centre, University of Sydney, Australia
| | - An-Wen Chan
- Institute of Health Policy, Management and Evaluation, University of Toronto
| | - Vivian Welch
- School of Epidemiology and Public Health, University of Ottawa
| | - Shaun Treweek
- Health Services Research Unit, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen
| | - Heidi Green
- Health Services Research Unit, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen; Research and Insights Team, COUCH Health, UK
| | - Aaron M Orkin
- Department of Family and Community Medicine, University of Toronto; Dalla Lana School of Public Health, University of Toronto; Li Ka Shing Knowledge Institute of Unity Health, Toronto
| | - Ebenezer Owusu-Addo
- Social Gerontology, National Ageing Research Institute; Bureau of Integrated Rural Development, Kwame Nkrumah University of Science & Technology, Kumasi, Ghana
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Lee EY, Turchin I, Chan AW, Beecker J, Bissonnette R, Catherall H, Cresswell-Melville A, Gooderham M, Hawkins N, Hong HCH, Levell NJ, Lapointe McKenzie JA, Manion R, Papp K, Drucker AM. Current Practices of Allergy Testing in Adults With Atopic Dermatitis in Canada: A National Survey. J Cutan Med Surg 2024:12034754241239260. [PMID: 38504147 DOI: 10.1177/12034754241239260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Affiliation(s)
- Erika Y Lee
- Department of Medicine, Division of Clinical Immunology and Allergy, University of Toronto, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Division of Dermatology, Department of Medicine and Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada
| | - Irina Turchin
- Brunswick Dermatology Center, Fredericton, NB, Canada
- Dalhousie University, Halifax, NS, Canada
- Probity Medical Research, Waterloo, ON, Canada
| | - An-Wen Chan
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Division of Dermatology, Department of Medicine and Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Jennifer Beecker
- Division of Dermatology, The Ottawa Hospital, The Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | | | | | | | - Melinda Gooderham
- SKiN Centre for Dermatology, Peterborough, ON, Canada
- Queen's University, Kingston, ON, Canada
- Probity Medical Research, Peterborough, ON, Canada
| | - Nicole Hawkins
- Department of Medicine, Division of Dermatology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - H Chih-Ho Hong
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada
- Probity Medical Research, Surrey, BC, Canada
| | - Nick J Levell
- Dermatology Department, Norfolk and Norwich University Hospital, Norwich, Norfolk, UK
| | | | | | - Kim Papp
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, ON, Canada
- Alliance Clinical Trials and Probity Medical Research, Waterloo, ON, Canada
| | - Aaron M Drucker
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Division of Dermatology, Department of Medicine and Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, ON, Canada
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Tunn R, Boutron I, Chan AW, Collins GS, Hróbjartsson A, Moher D, Schulz KF, de Beyer JA, Hansen Nejstgaard C, Østengaard L, Hopewell S. Methods used to develop the SPIRIT 2024 and CONSORT 2024 Statements. J Clin Epidemiol 2024; 169:111309. [PMID: 38428538 DOI: 10.1016/j.jclinepi.2024.111309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 02/19/2024] [Accepted: 02/22/2024] [Indexed: 03/03/2024]
Abstract
OBJECTIVES To describe, and explain the rationale for, the methods used and decisions made during development of the updated SPIRIT 2024 and CONSORT 2024 reporting guidelines. METHODS We developed SPIRIT 2024 and CONSORT 2024 together to facilitate harmonization of the two guidelines, and incorporated content from key extensions. We conducted a scoping review of comments suggesting changes to SPIRIT 2013 and CONSORT 2010, and compiled a list of other possible revisions based on existing SPIRIT and CONSORT extensions, other reporting guidelines, and personal communications. From this, we generated a list of potential modifications or additions to SPIRIT and CONSORT, which we presented to stakeholders for feedback in an international online Delphi survey. The Delphi survey results were discussed at an online expert consensus meeting attended by 30 invited international participants. We then drafted the updated SPIRIT and CONSORT checklists and revised them based on further feedback from meeting attendees. RESULTS We compiled 83 suggestions for revisions or additions to SPIRIT and/or CONSORT from the scoping review and 85 from other sources, from which we generated 33 potential changes to SPIRIT (n = 5) or CONSORT (n = 28). Of 463 participants invited to take part in the Delphi survey, 317 (68%) responded to Round 1, 303 (65%) to Round 2 and 290 (63%) to Round 3. Two additional potential checklist changes were added to the Delphi survey based on Round 1 comments. Overall, 14/35 (SPIRIT n = 0; CONSORT n = 14) proposed changes reached the predefined consensus threshold (≥80% agreement), and participants provided 3580 free-text comments. The consensus meeting participants agreed with implementing 11/14 of the proposed changes that reached consensus in the Delphi and supported implementing a further 4/21 changes (SPIRIT n = 2; CONSORT n = 2) that had not reached the Delphi threshold. They also recommended further changes to refine key concepts and for clarity. CONCLUSION The forthcoming SPIRIT 2024 and CONSORT 2024 Statements will provide updated, harmonized guidance for reporting randomized controlled trial protocols and results, respectively. The simultaneous development of the SPIRIT and CONSORT checklists has been informed by current empirical evidence and extensive input from stakeholders. We hope that this report of the methods used will be helpful for developers of future reporting guidelines.
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Affiliation(s)
- Ruth Tunn
- Oxford Clinical Trials Research Unit, University of Oxford, Oxford, UK; Centre for Statistics in Medicine, University of Oxford, Oxford, UK
| | - Isabelle Boutron
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Centre for Research in Epidemiology and Statistics (CRESS), F-75004 Paris, France; Centre d'Epidémiologie Clinique, AP-HP, Hôpital Hôtel Dieu, Paris, France
| | - An-Wen Chan
- Department of Medicine, Women's College Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Gary S Collins
- Centre for Statistics in Medicine, University of Oxford, Oxford, UK; UK EQUATOR Centre, University of Oxford, Oxford, UK
| | - Asbjørn Hróbjartsson
- Centre for Evidence-Based Medicine Odense and Cochrane Denmark, Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Open Patient data Explorative Network, Odense University Hospital, Odense, Denmark
| | - David Moher
- Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Kenneth F Schulz
- Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jennifer A de Beyer
- Centre for Statistics in Medicine, University of Oxford, Oxford, UK; UK EQUATOR Centre, University of Oxford, Oxford, UK
| | - Camilla Hansen Nejstgaard
- Centre for Evidence-Based Medicine Odense and Cochrane Denmark, Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Open Patient data Explorative Network, Odense University Hospital, Odense, Denmark
| | - Lasse Østengaard
- Centre for Evidence-Based Medicine Odense and Cochrane Denmark, Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Open Patient data Explorative Network, Odense University Hospital, Odense, Denmark
| | - Sally Hopewell
- Oxford Clinical Trials Research Unit, University of Oxford, Oxford, UK; Centre for Statistics in Medicine, University of Oxford, Oxford, UK.
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Martindale APL, Ng B, Ngai V, Kale AU, Ferrante di Ruffano L, Golub RM, Collins GS, Moher D, McCradden MD, Oakden-Rayner L, Rivera SC, Calvert M, Kelly CJ, Lee CS, Yau C, Chan AW, Keane PA, Beam AL, Denniston AK, Liu X. Concordance of randomised controlled trials for artificial intelligence interventions with the CONSORT-AI reporting guidelines. Nat Commun 2024; 15:1619. [PMID: 38388497 PMCID: PMC10883966 DOI: 10.1038/s41467-024-45355-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 01/22/2024] [Indexed: 02/24/2024] Open
Abstract
The Consolidated Standards of Reporting Trials extension for Artificial Intelligence interventions (CONSORT-AI) was published in September 2020. Since its publication, several randomised controlled trials (RCTs) of AI interventions have been published but their completeness and transparency of reporting is unknown. This systematic review assesses the completeness of reporting of AI RCTs following publication of CONSORT-AI and provides a comprehensive summary of RCTs published in recent years. 65 RCTs were identified, mostly conducted in China (37%) and USA (18%). Median concordance with CONSORT-AI reporting was 90% (IQR 77-94%), although only 10 RCTs explicitly reported its use. Several items were consistently under-reported, including algorithm version, accessibility of the AI intervention or code, and references to a study protocol. Only 3 of 52 included journals explicitly endorsed or mandated CONSORT-AI. Despite a generally high concordance amongst recent AI RCTs, some AI-specific considerations remain systematically poorly reported. Further encouragement of CONSORT-AI adoption by journals and funders may enable more complete adoption of the full CONSORT-AI guidelines.
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Affiliation(s)
| | - Benjamin Ng
- Birmingham and Midland Eye Centre, Sandwell and West Birmingham NHS Trust, Birmingham, UK
- Christ Church, University of Oxford, Oxford, UK
| | - Victoria Ngai
- University College London Medical School, London, UK
| | - Aditya U Kale
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, University of Birmingham, Birmingham, UK
| | | | - Robert M Golub
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Gary S Collins
- Centre for Statistics in Medicine//UK EQUATOR Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - David Moher
- Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottowa, ON, Canada
| | - Melissa D McCradden
- Department of Bioethics, The Hospital for Sick Children, Toronto, ON, Canada
- Genetics & Genome Biology Research Program, Peter Gilgan Centre for Research & Learning, Toronto, ON, Canada
- Division of Clinical and Public Health, Dalla Lana School of Public Health, Toronto, ON, Canada
| | - Lauren Oakden-Rayner
- Australian Institute for Machine Learning, University of Adelaide, Adelaide, SA, Australia
| | - Samantha Cruz Rivera
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
- Centre for Patient Reported Outcomes Research (CPROR), Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Melanie Calvert
- National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, University of Birmingham, Birmingham, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
- Centre for Patient Reported Outcomes Research (CPROR), Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
- NIHR Applied Research Collaboration (ARC) West Midlands, University of Birmingham, Birmingham, UK
- NIHR Blood and Transplant Research Unit (BTRU) in Precision Transplant and Cellular Therapeutics, University of Birmingham, Birmingham, UK
| | | | | | - Christopher Yau
- Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK
- Health Data Research UK, London, UK
| | - An-Wen Chan
- Department of Medicine, Women's College Hospital. University of Toronto, Toronto, ON, Canada
| | - Pearse A Keane
- NIHR Biomedical Research Centre at Moorfields, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Andrew L Beam
- Department of Epidemiology, Harvard. T.H. Chan School of Public Health, Boston, MA, USA
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA
| | - Alastair K Denniston
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, University of Birmingham, Birmingham, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
- NIHR Biomedical Research Centre at Moorfields, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Xiaoxuan Liu
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK.
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Huang Y, Fleming P, Fung K, Chan AW. Association between dermatology follow-up and melanoma survival: A population-based cohort study. J Am Acad Dermatol 2024:S0190-9622(24)00372-4. [PMID: 38368952 DOI: 10.1016/j.jaad.2024.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 01/29/2024] [Accepted: 02/12/2024] [Indexed: 02/20/2024]
Abstract
BACKGROUND Guidelines recommend that patients with melanoma undergo dermatologic examination at least annually. Adherence to follow-up and its impact on survival are unclear. OBJECTIVE To determine the level of adherence to annual dermatologic follow-up in patients with primary cutaneous melanoma, identify predictors for better adherence, and evaluate whether adherence was associated with melanoma-related mortality. METHODS Retrospective inception cohort analysis of adults with primary invasive melanoma in Ontario, Canada from 2010 to 2013 with follow-up until December 31, 2018. RESULTS Adherence to dermatologic follow-up was variable with only 28.0% of patients seeing a dermatologist at least annually (median follow-up 5.0 years). Younger age, female sex, higher income, greater access to dermatology care, stage 2/3 melanoma, prior keratinocyte carcinoma, fewer comorbidities, and any outpatient visit in the 12 months prior to melanoma diagnosis were predictors for adherence. Greater adherence to annual dermatology visits was associated with reduced melanoma-specific mortality compared with lower levels of adherence (adjusted hazard ratio 0.64, 95% CI 0.52-0.78). LIMITATIONS Observational study design and inability to identify skin examinations performed by non-dermatologists. CONCLUSION Adherence to annual dermatology visits after melanoma diagnosis was low. Greater adherence may promote better patient survival but warrants confirmation in further research including randomized trials.
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Affiliation(s)
- Yuanshen Huang
- Division of Dermatology, Department of Medicine, Queen's University, Kingston, Ontario, Canada.
| | - Patrick Fleming
- Division of Dermatology, University of Toronto, Toronto, Ontario, Canada
| | | | - An-Wen Chan
- Division of Dermatology, University of Toronto, Toronto, Ontario, Canada; Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
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Lefrançois P, Doueidari Z, Kleiner O, Manion R, Dutz J, Philip A, Chan AW. Top 10 research priorities for cutaneous squamous cell carcinoma: results of the Skin Investigation Network of Canada Priority Setting Initiative. Br J Dermatol 2024; 190:431-432. [PMID: 38114099 PMCID: PMC10873564 DOI: 10.1093/bjd/ljad387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 09/26/2023] [Accepted: 09/30/2023] [Indexed: 12/21/2023]
Abstract
The Skin Investigation Network of Canada (SkIN Canada) completed a national priority-setting initiative to identify the top 10 knowledge uncertainties for SCC based on the James Lind Alliance principles. Overall, 64 patients, clinicians and researchers provided input in two survey rounds and one workshop. The top 10 list of research priorities will help the skin research community, funders and policymakers to address key knowledge uncertainties for the benefit of patients with SCC.
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Affiliation(s)
- Philippe Lefrançois
- Division of Dermatology, Department of Medicine, McGill University, Montréal, QC, Canada
| | - Zein Doueidari
- Division of Dermatology, Department of Medicine, McGill University, Montréal, QC, Canada
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Bourkas AN, Sibbald C, Chan AW, Schechter T, Ali M, Pullattayil AK, Levy R. Characterizing the cutaneous late effects of allogeneic hematopoietic stem cell transplantation: A systematic review. Pediatr Transplant 2024; 28:e14618. [PMID: 37786978 DOI: 10.1111/petr.14618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 07/14/2023] [Accepted: 09/18/2023] [Indexed: 10/04/2023]
Abstract
BACKGROUND There is a well-documented risk of secondary cutaneous malignancies following allogeneic hematopoietic stem cell transplant (HSCT), but data on risk in pediatric populations are limited. The objective of this study is to perform a systematic review of reported features and outcomes of skin cancers in pediatric allogeneic HSCT recipients. METHODS MEDLINE, EMBASE, CINAHL, Cochrane, and Web of Science were systematically searched (Prospero CRD42022342139). Studies reporting cutaneous cancer outcomes were included if the age at transplant was ≤19 years. Titles, abstracts, and full-text articles were screened in duplicate. RESULTS Out of 824 citations that were screened, 12 articles were selected for analysis. The final sample included 67 pediatric HSCT recipients, comprising 65 allogeneic transplant recipients and 2 cases of HSCT with an unknown donor type. The median age at transplant and skin cancer diagnosis were 7.4 and 13 years, respectively. Out of the 67 pediatric HSCT recipients, some patients developed more than one lesion, resulting in 71 lesions. The most common skin cancer type was cutaneous squamous cell carcinoma (32 lesions), followed by basal cell carcinoma (25 lesions). The median latency period between HSCT and skin cancer diagnosis ranged from 0 to 29 years. Identified risk factors for skin cancers included younger age at the time of transplant, exposure to total body irradiation, prolonged post-transplant immunosuppression, graft versus host disease, and sunburn. CONCLUSION Skin cancers are reported in pediatric allogeneic HSCT recipients, and the risk appears to be increased. More data are needed to better characterize this risk.
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Affiliation(s)
- Adrienn N Bourkas
- Department of Medicine, Queen's University, Kingston, Ontario, Canada
- Division of Dermatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Cathryn Sibbald
- Division of Dermatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Canada
| | - An-Wen Chan
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Canada
| | - Tal Schechter
- Division of Haematology/Oncology/BMT, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Muhammad Ali
- Division of Haematology/Oncology/BMT, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | | | - Rebecca Levy
- Division of Dermatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
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9
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Baba A, Smith M, Potter BK, Chan AW, Moher D, Offringa M. Guidelines for reporting pediatric and child health clinical trial protocols and reports: study protocol for SPIRIT-Children and CONSORT-Children. Trials 2024; 25:96. [PMID: 38287439 PMCID: PMC10826142 DOI: 10.1186/s13063-024-07948-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 01/22/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Despite the critical importance of clinical trials to provide evidence about the effects of intervention for children and youth, a paucity of published high-quality pediatric clinical trials persists. Sub-optimal reporting of key trial elements necessary to critically appraise and synthesize findings is prevalent. To harmonize and provide guidance for reporting in pediatric controlled clinical trial protocols and reports, reporting guideline extensions to the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) and Consolidated Standards of Reporting Trials (CONSORT) guidelines specific to pediatrics are being developed: SPIRIT-Children (SPIRIT-C) and CONSORT-Children (CONSORT-C). METHODS The development of SPIRIT-C/CONSORT-C will be informed by the Enhancing the Quality and Transparency of Health Research Quality (EQUATOR) method for reporting guideline development in the following stages: (1) generation of a preliminary list of candidate items, informed by (a) items developed during initial development efforts and child relevant items from recent published SPIRIT and CONSORT extensions; (b) two systematic reviews and environmental scan of the literature; (c) workshops with young people; (2) an international Delphi study, where a wide range of panelists will vote on the inclusion or exclusion of candidate items on a nine-point Likert scale; (3) a consensus meeting to discuss items that have not reached consensus in the Delphi study and to "lock" the checklist items; (4) pilot testing of items and definitions to ensure that they are understandable, useful, and applicable; and (5) a final project meeting to discuss each item in the context of pilot test results. Key partners, including young people (ages 12-24 years) and family caregivers (e.g., parents) with lived experiences with pediatric clinical trials, and individuals with expertise and involvement in pediatric trials will be involved throughout the project. SPIRIT-C/CONSORT-C will be disseminated through publications, academic conferences, and endorsement by pediatric journals and relevant research networks and organizations. DISCUSSION SPIRIT/CONSORT-C may serve as resources to facilitate comprehensive reporting needed to understand pediatric clinical trial protocols and reports, which may improve transparency within pediatric clinical trials and reduce research waste. TRIAL REGISTRATION The development of these reporting guidelines is registered with the EQUATOR Network: SPIRIT-Children ( https://www.equator-network.org/library/reporting-guidelines-under-development/reporting-guidelines-under-development-for-clinical-trials-protocols/#35 ) and CONSORT-Children ( https://www.equator-network.org/library/reporting-guidelines-under-development/reporting-guidelines-under-development-for-clinical-trials/#CHILD ).
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Affiliation(s)
- Ami Baba
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada
| | - Maureen Smith
- Patient Partner, Canadian Organization for Rare Disorders, Ottawa, ON, Canada
| | - Beth K Potter
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - An-Wen Chan
- Department of Medicine, Women's College Research Institute, University of Toronto, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - David Moher
- Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Martin Offringa
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada.
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
- Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, 686 Bay Street, Toronto, ON, M5G 0A4, Canada.
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10
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Shoimer I, Kleiner O, Manion R, Dutz J, Philip A, Chan AW. Top 10 research priorities for basal cell carcinoma: results of the Skin Investigation Network of Canada Priority Setting Initiative. Br J Dermatol 2024; 190:276-277. [PMID: 38184850 PMCID: PMC10805524 DOI: 10.1093/bjd/ljad391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 09/26/2023] [Indexed: 01/09/2024]
Abstract
The Skin Investigation Network of Canada (SkIN Canada) completed a national priority setting initiative to identify the top 10 knowledge uncertainties for BCC based on the James Lind Alliance principles. Overall, 91 patients, clinicians and researchers provided input in two survey rounds and one workshop. The top 10 list of research priorities will help the skin research community, funders and policymakers to address key knowledge uncertainties for the benefit of patients with BCC.
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Affiliation(s)
- Ilya Shoimer
- University of Calgary, Division of Dermatology, Calgary, AB
| | - Omer Kleiner
- Skin Investigation Network of Canada (SkIN Canada), Toronto, ON
- Women’s College Research Institute, Women’s College Hospital, Toronto, ON
| | - Rachael Manion
- Skin Investigation Network of Canada (SkIN Canada), Toronto, ON
- Canadian Skin Patient Alliance, Ottawa, ON
| | - Jan Dutz
- Skin Investigation Network of Canada (SkIN Canada), Toronto, ON
- Department of Dermatology and Skin Science, BC Children’s Research Institute, University of British Columbia, Vancouver, BC
- BC Children’s Hospital Research Institute, Vancouver, BC
| | - Anie Philip
- Skin Investigation Network of Canada (SkIN Canada), Toronto, ON
- Research Institute of the McGill University Health Centre, Montréal, QC
- Divisions of Plastic Surgery, Dermatology, and Experimental Medicine, Department of Surgery, Faculty of Medicine, McGill University, Montréal, QC
| | - An-Wen Chan
- Skin Investigation Network of Canada (SkIN Canada), Toronto, ON
- Women’s College Research Institute, Women’s College Hospital, Toronto, ON
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, ON, Canada
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11
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Bergeron A, Nessim C, Kleiner O, Manion R, Dutz J, Philip A, Chan AW. Skin Investigation Network of Canada (SkIN Canada) Priority Setting Initiative ranks the top 10 evidence uncertainties for Merkel cell carcinoma. Br J Dermatol 2024; 190:281-282. [PMID: 37864824 PMCID: PMC10805522 DOI: 10.1093/bjd/ljad398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 10/06/2023] [Indexed: 10/23/2023]
Abstract
The Skin Investigation Network of Canada (SkIN Canada) completed a national Priority Setting Initiative to identify the top 10 knowledge uncertainties for Merkel cell carcinoma based on the James Lind Alliance principles. Overall, 48 patients, clinicians and researchers provided input in two survey rounds and one workshop. The top 10 list of research priorities will help the skin research community, funders and policymakers to address key knowledge uncertainties for the benefit of patients with Merkel cell carcinoma.
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Affiliation(s)
| | - Carolyn Nessim
- Department of Surgery, The Ottawa Hospital, Ottawa, ON, Canada
| | - Omer Kleiner
- Skin Investigation Network of Canada (SkIN Canada), Toronto, ON, Canada(the full list of members is available in File S1)
- Women’s College Research Institute, Women’s College Hospital, Toronto, ON, Canada
| | - Rachael Manion
- Skin Investigation Network of Canada (SkIN Canada), Toronto, ON, Canada(the full list of members is available in File S1)
- Canadian Skin Patient Alliance, Ottawa, ON, Canada
| | - Jan Dutz
- Skin Investigation Network of Canada (SkIN Canada), Toronto, ON, Canada(the full list of members is available in File S1)
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada
- BC Children’s Hospital Research Institute, Vancouver, BC, Canada
| | - Anie Philip
- Skin Investigation Network of Canada (SkIN Canada), Toronto, ON, Canada(the full list of members is available in File S1)
- Research Institute of the McGill University Health Centre, Montréal, QC, Canada
- Division of Plastic Surgery, Department of Surgery, and Division of Dermatology, Department of Medicine, McGill University, Montréal, QC, Canada
| | - An-Wen Chan
- Skin Investigation Network of Canada (SkIN Canada), Toronto, ON, Canada(the full list of members is available in File S1)
- Women’s College Research Institute, Women’s College Hospital, Toronto, ON, Canada
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, ON, Canada
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12
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Kahan BC, Hall SS, Beller EM, Birchenall M, Chan AW, Elbourne D, Little P, Fletcher J, Golub RM, Goulao B, Hopewell S, Islam N, Zwarenstein M, Juszczak E, Montgomery AA. Reporting of Factorial Randomized Trials: Extension of the CONSORT 2010 Statement. JAMA 2023; 330:2106-2114. [PMID: 38051324 DOI: 10.1001/jama.2023.19793] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
Importance Transparent reporting of randomized trials is essential to facilitate critical appraisal and interpretation of results. Factorial trials, in which 2 or more interventions are assessed in the same set of participants, have unique methodological considerations. However, reporting of factorial trials is suboptimal. Objective To develop a consensus-based extension to the Consolidated Standards of Reporting Trials (CONSORT) 2010 Statement for factorial trials. Design Using the Enhancing the Quality and Transparency of Health Research (EQUATOR) methodological framework, the CONSORT extension for factorial trials was developed by (1) generating a list of reporting recommendations for factorial trials using a scoping review of methodological articles identified using a MEDLINE search (from inception to May 2019) and supplemented with relevant articles from the personal collections of the authors; (2) a 3-round Delphi survey between January and June 2022 to identify additional items and assess the importance of each item, completed by 104 panelists from 14 countries; and (3) a hybrid consensus meeting attended by 15 panelists to finalize the selection and wording of items for the checklist. Findings This CONSORT extension for factorial trials modifies 16 of the 37 items in the CONSORT 2010 checklist and adds 1 new item. The rationale for the importance of each item is provided. Key recommendations are (1) the reason for using a factorial design should be reported, including whether an interaction is hypothesized, (2) the treatment groups that form the main comparisons should be clearly identified, and (3) for each main comparison, the estimated interaction effect and its precision should be reported. Conclusions and Relevance This extension of the CONSORT 2010 Statement provides guidance on the reporting of factorial randomized trials and should facilitate greater understanding of and transparency in their reporting.
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Affiliation(s)
| | - Sophie S Hall
- Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Elaine M Beller
- Institute for Evidence-Based Healthcare, Bond University, Queensland, Australia
| | - Megan Birchenall
- Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - An-Wen Chan
- Women's College Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Diana Elbourne
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Paul Little
- Primary Care Research Centre, School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - John Fletcher
- The BMJ, BMA House, Tavistock Square, London, United Kingdom
| | - Robert M Golub
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Beatriz Goulao
- Health Services Research Unit, University of Aberdeen, Aberdeen, Scotland
| | - Sally Hopewell
- Oxford Clinical Trials Research Unit, University of Oxford, Oxford, United Kingdom
| | - Nazrul Islam
- Primary Care Research Centre, School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
- The BMJ, BMA House, Tavistock Square, London, United Kingdom
| | - Merrick Zwarenstein
- Centre For Studies in Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Edmund Juszczak
- Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Alan A Montgomery
- Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, United Kingdom
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13
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Kahan BC, Hall SS, Beller EM, Birchenall M, Elbourne D, Juszczak E, Little P, Fletcher J, Golub RM, Goulao B, Hopewell S, Islam N, Zwarenstein M, Chan AW, Montgomery AA. Consensus Statement for Protocols of Factorial Randomized Trials: Extension of the SPIRIT 2013 Statement. JAMA Netw Open 2023; 6:e2346121. [PMID: 38051535 DOI: 10.1001/jamanetworkopen.2023.46121] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/07/2023] Open
Abstract
Importance Trial protocols outline a trial's objectives as well as the methods (design, conduct, and analysis) that will be used to meet those objectives, and transparent reporting of trial protocols ensures objectives are clear and facilitates appraisal regarding the suitability of study methods. Factorial trials, in which 2 or more interventions are assessed in the same set of participants, have unique methodological considerations. However, no extension of the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) 2013 Statement, which provides guidance on reporting of trial protocols, for factorial trials is available. Objective To develop a consensus-based extension to the SPIRIT 2013 Statement for factorial trials. Evidence Review The SPIRIT extension for factorial trials was developed using the Enhancing the Quality and Transparency of Health Research (EQUATOR) methodological framework. First, a list of reporting recommendations was generated using a scoping review of methodological articles identified using a MEDLINE search (inception to May 2019), which was supplemented with relevant articles from the personal collections of the authors. Second, a 3-round Delphi survey (January to June 2022, completed by 104 panelists from 14 countries) was conducted to assess the importance of items and identify additional recommendations. Third, a hybrid consensus meeting was held, attended by 15 panelists to finalize selection and wording of the checklist. Findings This SPIRIT extension for factorial trials modified 9 of the 33 items in the SPIRIT 2013 checklist. Key reporting recommendations were that the rationale for using a factorial design should be provided, including whether an interaction is hypothesized; the treatment groups that will form the main comparisons should be identified; and statistical methods for each main comparison should be provided, including how interactions will be assessed. Conclusions and Relevance In this consensus statement, 9 factorial-specific items were provided that should be addressed in all protocols of factorial trials to increase the trial's utility and transparency.
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Affiliation(s)
| | - Sophie S Hall
- Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Elaine M Beller
- Institute for Evidence-Based Healthcare, Bond University, Robina, Australia
| | - Megan Birchenall
- Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Diana Elbourne
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Edmund Juszczak
- Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Paul Little
- Primary Care Research Centre, School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | | | - Robert M Golub
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Beatriz Goulao
- Health Services Research Unit, University of Aberdeen, Aberdeen, Scotland
| | - Sally Hopewell
- Oxford Clinical Trials Research Unit, University of Oxford, Oxford, United Kingdom
| | - Nazrul Islam
- Primary Care Research Centre, School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
- The BMJ, London, United Kingdom
| | - Merrick Zwarenstein
- Centre For Studies in Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - An-Wen Chan
- Women's College Research Institute, University of Toronto, Toronto, Canada
| | - Alan A Montgomery
- Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, United Kingdom
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14
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Ciani O, Manyara AM, Davies P, Stewart D, Weir CJ, Young AE, Blazeby J, Butcher NJ, Bujkiewicz S, Chan AW, Dawoud D, Offringa M, Ouwens M, Hróbjartssson A, Amstutz A, Bertolaccini L, Bruno VD, Devane D, Faria CD, Gilbert PB, Harris R, Lassere M, Marinelli L, Markham S, Powers JH, Rezaei Y, Richert L, Schwendicke F, Tereshchenko LG, Thoma A, Turan A, Worrall A, Christensen R, Collins GS, Ross JS, Taylor RS. A framework for the definition and interpretation of the use of surrogate endpoints in interventional trials. EClinicalMedicine 2023; 65:102283. [PMID: 37877001 PMCID: PMC10590868 DOI: 10.1016/j.eclinm.2023.102283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 10/03/2023] [Accepted: 10/03/2023] [Indexed: 10/26/2023] Open
Abstract
Background Interventional trials that evaluate treatment effects using surrogate endpoints have become increasingly common. This paper describes four linked empirical studies and the development of a framework for defining, interpreting and reporting surrogate endpoints in trials. Methods As part of developing the CONSORT (Consolidated Standards of Reporting Trials) and SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) extensions for randomised trials reporting surrogate endpoints, we undertook a scoping review, e-Delphi study, consensus meeting, and a web survey to examine current definitions and stakeholder (including clinicians, trial investigators, patients and public partners, journal editors, and health technology experts) interpretations of surrogate endpoints as primary outcome measures in trials. Findings Current surrogate endpoint definitional frameworks are inconsistent and unclear. Surrogate endpoints are used in trials as a substitute of the treatment effects of an intervention on the target outcome(s) of ultimate interest, events measuring how patients feel, function, or survive. Traditionally the consideration of surrogate endpoints in trials has focused on biomarkers (e.g., HDL cholesterol, blood pressure, tumour response), especially in the medical product regulatory setting. Nevertheless, the concept of surrogacy in trials is potentially broader. Intermediate outcomes that include a measure of function or symptoms (e.g., angina frequency, exercise tolerance) can also be used as substitute for target outcomes (e.g., all-cause mortality)-thereby acting as surrogate endpoints. However, we found a lack of consensus among stakeholders on accepting and interpreting intermediate outcomes in trials as surrogate endpoints or target outcomes. In our assessment, patients and health technology assessment experts appeared more likely to consider intermediate outcomes to be surrogate endpoints than clinicians and regulators. Interpretation There is an urgent need for better understanding and reporting on the use of surrogate endpoints, especially in the setting of interventional trials. We provide a framework for the definition of surrogate endpoints (biomarkers and intermediate outcomes) and target outcomes in trials to improve future reporting and aid stakeholders' interpretation and use of trial surrogate endpoint evidence. Funding SPIRIT-SURROGATE/CONSORT-SURROGATE project is Medical Research Council Better Research Better Health (MR/V038400/1) funded.
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Affiliation(s)
- Oriana Ciani
- Centre for Research on Health and Social Care Management, SDA Bocconi School of Management, Milan, Italy
| | - Anthony M. Manyara
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Philippa Davies
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Christopher J. Weir
- Edinburgh Clinical Trials Unit, Usher Institute, University of Edinburgh, Edinburgh, UK
| | | | - Jane Blazeby
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Bristol NIHR Biomedical Research Centre, Bristol, UK
- University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Nancy J. Butcher
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Sylwia Bujkiewicz
- Biostatistics Research Group, Department of Population Health Sciences, University of Leicester, Leicester, UK
| | - An-Wen Chan
- Women's College Research Institute, Toronto, Canada
- Department of Medicine, University of Toronto, Toronto, Canada
| | - Dalia Dawoud
- Science, Evidence and Analytics Directorate, Science Policy and Research Programme, National Institute for Health and Care Excellence, London, UK
| | - Martin Offringa
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Canada
- Department of Paediatrics, University of Toronto, Toronto, Canada
| | | | - Asbjørn Hróbjartssson
- Centre for Evidence-Based Medicine Odense (CEBMO) and Cochrane Denmark, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Open Patient Data Explorative Network (OPEN), Odense University Hospital, Odense, Denmark
| | - Alain Amstutz
- CLEAR Methods Center, Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Luca Bertolaccini
- Department of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Vito Domenico Bruno
- Department of Minimally Invasive Cardiac Surgery, IRCCS Galeazzi – Sant’Ambrogio Hospital, Milan, Italy
| | - Declan Devane
- University of Galway, Galway, Ireland
- Health Research Board-Trials Methodology Research Network, University of Galway, Galway, Ireland
| | - Christina D.C.M. Faria
- Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Ray Harris
- Patient and Public Involvement Partner, UK
| | - Marissa Lassere
- St George Hospital and School of Population Health, The University of New South Wales, Sydney, Australia
| | - Lucio Marinelli
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Sarah Markham
- Department of Biostatistics, King's College London, London, UK
| | - John H. Powers
- George Washington University School of Medicine, Washington, USA
| | - Yousef Rezaei
- Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
- Ardabil University of Medical Sciences, Ardabil, Iran
- Behyan Clinic, Pardis New Town, Tehran, Iran
| | - Laura Richert
- University Bordeaux, INSERM, Institut Bergonié, CHU Bordeaux, BPH U1219, CIC-EC 1401, RECaP and Euclid/F-CRIN, Bordeaux, France
| | | | - Larisa G. Tereshchenko
- Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | | | - Alparslan Turan
- Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, OH, USA
| | | | - Robin Christensen
- Section for Biostatistics and Evidence-Based Research, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen & Research Unit of Rheumatology, Department of Clinical Research, University of Southern Denmark, Odense University Hospital, Odense, Denmark
| | - Gary S. Collins
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Joseph S. Ross
- Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA
- Section of General Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Rod S. Taylor
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
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15
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Mohsen ST, Price EL, Chan AW, Hanna TP, Limacher JJ, Nessim C, Shiers JE, Tron V, Wright FC, Drucker AM. Incidence, Mortality, and Survival of Merkel Cell Carcinoma: A Systematic Review of Population Based-Studies. Br J Dermatol 2023:ljad404. [PMID: 37874770 DOI: 10.1093/bjd/ljad404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 09/23/2023] [Accepted: 10/20/2023] [Indexed: 10/26/2023]
Abstract
BACKGROUND Merkel Cell Carcinoma (MCC) is a rare, aggressive skin cancer that most commonly occurs in UV-exposed body sites. Its epidemiology in different geographies and populations is not well characterised. OBJECTIVE The objective of this systematic review is to summarize evidence on the incidence, mortality, and survival rates of MCC from population-based studies. METHODS We searched MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials from database inception to June 6th, 2023. No geographic, age or date exclusions were applied. We included population-based studies of MCC that reported the incidence, survival, or mortality rate, and considered systematic reviews. A data-charting form was created and validated to identify variables to extract. Two reviewers then independently charted the data for each included study with patient characteristics, and estimates of incidence rate, mortality rate, and survival rate and assessed the quality of included studies using the Joanna Briggs Institute Checklist for Prevalence studies, Newcastle-Ottawa Scale and Assessment of Multiple Systematic Reviews. We abstracted age-, sex-, stage- and race-stratified outcomes, and synthesized comparisons between strata narratively and using vote counting. We assessed the certainty of evidence for those comparisons using the Grading of Recommendations, Assessments, Developments and Evaluations framework. RESULTS We identified 11,472 citations, of which 52 studies from 24 countries met our inclusion criteria. Stage 1 and the head and neck were the most frequently reported stage and location at diagnosis. The incidence of MCC is increasing over time (high certainty), with the highest reported incidences reported in Southern hemisphere countries (Australia [2.5 per 100,000], New Zealand [0.96 per 100,000]) (high certainty). Male patients generally had higher incidence rates compared to female patients (high certainty), although there were some variations over time periods. Survival rates varied, with lower survival and/or higher mortality associated with male sex (moderate certainty), higher stage at diagnosis (moderate-to-high certainty), older age (moderate certainty), and immunosuppression (low-to-moderate certainty). CONCLUSIONS MCC is increasing in incidence and may increase further given the ageing population of many countries. The prognosis of MCC is poor, particularly for males, those who are immunosuppressed, and patients diagnosed at higher stages or at an older age.
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Affiliation(s)
- Samiha T Mohsen
- Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Emma L Price
- Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - An-Wen Chan
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Canada
- Women's College Research Institute and Division of Dermatology, Department of Medicine, Women's College Hospital, Toronto, Canada
| | - Timothy P Hanna
- Department of Oncology, Queen's University, Kingston, Canada
| | - James J Limacher
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Canada
- Women's College Research Institute and Division of Dermatology, Department of Medicine, Women's College Hospital, Toronto, Canada
| | - Carolyn Nessim
- The Ottawa Hospital & Ottawa Hospital Research Institute, Ottawa, Canada
| | - Jessica E Shiers
- University of Toronto Libraries, University of Toronto, Toronto, Canada
| | - Victor Tron
- University of Toronto & LifeLabs, Toronto, Canada
| | | | - Aaron M Drucker
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Canada
- Women's College Research Institute and Division of Dermatology, Department of Medicine, Women's College Hospital, Toronto, Canada
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16
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Yap C, Solovyeva O, de Bono J, Rekowski J, Patel D, Jaki T, Mander A, Evans TRJ, Peck R, Hayward KS, Hopewell S, Ursino M, Rantell KR, Calvert M, Lee S, Kightley A, Ashby D, Chan AW, Garrett-Mayer E, Isaacs JD, Golub R, Kholmanskikh O, Richards D, Boix O, Matcham J, Seymour L, Ivy SP, Marshall LV, Hommais A, Liu R, Tanaka Y, Berlin J, Espinasse A, Dimairo M, Weir CJ. Enhancing reporting quality and impact of early phase dose-finding clinical trials: CONSORT Dose-finding Extension (CONSORT-DEFINE) guidance. BMJ 2023; 383:e076387. [PMID: 37863501 PMCID: PMC10583500 DOI: 10.1136/bmj-2023-076387] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/05/2023] [Indexed: 10/22/2023]
Affiliation(s)
| | | | - Johann de Bono
- Institute of Cancer Research, London SM2 5NG, UK
- Royal Marsden NHS Foundation Trust, London, UK
| | - Jan Rekowski
- Institute of Cancer Research, London SM2 5NG, UK
| | | | - Thomas Jaki
- MRC Biostatistics Unit, Cambridge University, Cambridge, UK
- Computational Statistics Group, University of Regensburg, Regensburg, Germany
| | - Adrian Mander
- Centre For Trials Research, Cardiff University, Heath Park, Cardiff, UK
| | - Thomas R Jeffry Evans
- Institute of Cancer Sciences, CR-UK Beatson Institute, University of Glasgow, Glasgow, UK
| | - Richard Peck
- Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool, UK
- Hoffmann-La Roche, Basel, Switzerland
| | - Kathryn S Hayward
- Departments of Physiotherapy, and Medicine (Royal Melbourne Hospital), University of Melbourne, VIC, Australia
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Sally Hopewell
- Oxford Clinical Research Unit, NDORMS, University of Oxford, Oxford, UK
| | - Moreno Ursino
- ReCAP/F CRIN, INSERM, Paris, France
- Unit of Clinical Epidemiology, CHU Robert Debré, APHP, URC, INSERM CIC-EC 1426, Reims, France
- INSERM Centre de Recherche des Cordeliers, Sorbonne University, Paris Cité University, Paris, France
- Health data and model driven approaches for Knowledge Acquisition team, Centre Inria, Paris, France
| | | | - Melanie Calvert
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration West Midlands, University of Birmingham, Birmingham, UK
- NIHR Research Blood and Transplant Research Unit in Precision Transplant and Cellular Therapeutics, University of Birmingham, Edgbaston, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre, Institute of Translational Medicine, University Hospital NHS Foundation Trust, Birmingham, UK
| | - Shing Lee
- Columbia University Mailman School of Public Health, New York, NY, USA
| | | | - Deborah Ashby
- School of Public Health, Imperial College London, London, UK
| | - An-Wen Chan
- Department of Medicine, Women's College Research Institute, University of Toronto, Toronto, ON, Canada
| | - Elizabeth Garrett-Mayer
- Center for Research and Analytics, American Society of Clinical Oncology, Alexandria, VA, USA
| | - John D Isaacs
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
- Musculoskeletal Unit, Newcastle upon Tyne Hospitals NHS Foundation Trust, Freeman Hospital, Newcastle upon Tyne, UK
| | - Robert Golub
- Department of Medicine, Northwestern University Feinberg School of Medicine, 633 Clark Street, Evanston, IL, USA
| | - Olga Kholmanskikh
- Federal Agency for Medicines and Health Products, Brussels, Belgium
- European Medicines Agency, Amsterdam, Netherlands
| | - Dawn Richards
- Clinical Trials Ontario, MaRS Centre, Toronto, ON, Canada
| | | | - James Matcham
- Strategic Consulting, Cytel (Australia), Perth, WA, Australia
| | - Lesley Seymour
- Investigational New Drug Programme, Canadian Cancer Trials Group, Cancer Research Institute, Queen's University, Kingston, ON, Canada
| | - S Percy Ivy
- Investigational Drug Branch, Cancer Therapy Evaluation Program, Division of Cancer Treatment and Diagnosis, National Institute of Health, Bethesda, MD, USA
| | - Lynley V Marshall
- Institute of Cancer Research, London SM2 5NG, UK
- Royal Marsden NHS Foundation Trust, London, UK
| | - Antoine Hommais
- Department of Clinical Research, National Cancer Institute, Boulogne-Billancourt, France
| | - Rong Liu
- Bristol Myers Squibb, New York, NY, USA
| | - Yoshiya Tanaka
- First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | | | | | - Munyaradzi Dimairo
- Division of Population Health, Sheffield Centre for Health and Related Research, University of Sheffield, Sheffield, UK
| | - Christopher J Weir
- Edinburgh Clinical Trials Unit, Usher Institute, University of Edinburgh, Edinburgh, UK
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17
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Yap C, Rekowski J, Ursino M, Solovyeva O, Patel D, Dimairo M, Weir CJ, Chan AW, Jaki T, Mander A, Evans TRJ, Peck R, Hayward KS, Calvert M, Rantell KR, Lee S, Kightley A, Hopewell S, Ashby D, Garrett-Mayer E, Isaacs J, Golub R, Kholmanskikh O, Richards DP, Boix O, Matcham J, Seymour L, Ivy SP, Marshall LV, Hommais A, Liu R, Tanaka Y, Berlin J, Espinasse A, de Bono J. Enhancing quality and impact of early phase dose-finding clinical trial protocols: SPIRIT Dose-finding Extension (SPIRIT-DEFINE) guidance. BMJ 2023; 383:e076386. [PMID: 37863491 DOI: 10.1136/bmj-2023-076386] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2023]
Affiliation(s)
| | - Jan Rekowski
- Institute of Cancer Research, London SM2 5NG, UK
| | - Moreno Ursino
- ReCAP/F CRIN, INSERM, Paris, France
- Unit of Clinical Epidemiology, University Hospital Centre Robert Debré, Reims, France
- INSERM Centre de Recherche des Cordeliers, Sorbonne University, Paris, France
- Health data and model driven approaches for Knowledge Acquisition team, Centre Inria, Paris, France
| | | | | | - Munyaradzi Dimairo
- Division of Population Health, Sheffield Centre for Health and Related Research, University of Sheffield, Sheffield, UK
| | - Christopher J Weir
- Edinburgh Clinical Trials Unit, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - An-Wen Chan
- Department of Medicine, Women's College Research Institute, University of Toronto, Toronto, Canada
| | - Thomas Jaki
- MRC Biostatistics Unit, Cambridge University, Cambridge, UK
- Computational Statistics Group, University of Regensburg, Regensburg, Germany
| | - Adrian Mander
- Centre For Trials Research, Cardiff University, Cardiff, UK
| | - Thomas R Jeffry Evans
- Institute of Cancer Sciences, CR-UK Beatson Institute, University of Glasgow, Glasgow, UK
| | - Richard Peck
- Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool, UK
- Hoffmann-La Roche, Basel, Switzerland
| | - Kathryn S Hayward
- Departments of Physiotherapy, and Medicine (Royal Melbourne Hospital), University of Melbourne, Parkville, VIC, Australia
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Melanie Calvert
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
- National Institute for Health and Care Research Applied Research Collaboration West Midlands, University of Birmingham, Birmingham, UK
- National Institute for Health and Care Research Blood and Transplant Research Unit in Precision Transplant and Cellular Therapeutics, University of Birmingham, Birmingham, UK
- National Institute for Health and Care Research Birmingham Biomedical Research Centre, NIHR Birmingham Biomedical Research Centre, Institute of Translational Medicine, University Hospital NHS Foundation Trust, Birmingham, UK
| | | | - Shing Lee
- Columbia University Mailman School of Public Health, New York, NY, USA
| | | | - Sally Hopewell
- Oxford Clinical Research Unit, NDORMS, University of Oxford, Oxford, UK
| | - Deborah Ashby
- School of Public Health, Imperial College London, St Mary's Hospital, London, UK
| | - Elizabeth Garrett-Mayer
- Center for Research and Analytics, American Society of Clinical Oncology, Alexandria, VA, USA
| | - John Isaacs
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
- Musculoskeletal Unit, Newcastle upon Tyne Hospitals NHS Foundation Trust, Freeman Hospital, Newcastle upon Tyne, UK
| | - Robert Golub
- Department of Medicine, Northwestern University Feinberg School of Medicine, Evanston, IL, USA
| | | | | | | | - James Matcham
- Strategic Consulting, Cytel (Australia), Perth, WA, Australia
| | - Lesley Seymour
- Investigational New Drug Programme, Canadian Cancer Trials Group, Cancer Research Institute, Queen's University, Kingston, ON, Canada
| | - S Percy Ivy
- Investigational Drug Branch, Cancer Therapy Evaluation Program, Division of Cancer Treatment and Diagnosis, National Institute of Health, Bethesda, MD, USA
| | - Lynley V Marshall
- Institute of Cancer Research, London SM2 5NG, UK
- Royal Marsden NHS Foundation Trust, London, UK
| | - Antoine Hommais
- Department of Clinical Research, National Cancer Institute, Boulogne-Billancourt, France
| | - Rong Liu
- Bristol Myers Squibb, New York, NY, USA
| | - Yoshiya Tanaka
- First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | | | | | - Johann de Bono
- Institute of Cancer Research, London SM2 5NG, UK
- Royal Marsden NHS Foundation Trust, London, UK
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18
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Paul R, Goldberg SI, Chan AW. Demystifying the Role of Radiation Dose Bath in Brain Injury Using Machine Learning. Int J Radiat Oncol Biol Phys 2023; 117:e460. [PMID: 37785474 DOI: 10.1016/j.ijrobp.2023.06.1656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) It is well known that high-dose radiation results in brain injury, the long-term effects of low-dose radiation, however, is uncertain. The purpose of this study was to investigate the role of low-dose bath on MRI changes, on both clinical and micro-architectural levels, using machine learning and computational methods. MATERIALS/METHODS Six hundreds and fifty-six temporal lobe and 45 whole brain DVHs from patients treated for nasopharyngeal cancer (NPC) with IMRT or proton were included in this study. Temporal lobe injury (TLI) was defined as development of new T1 enhancement on MRI with or without surrounding T2 edema. Patients were divided randomly into train (50%) and test (50%) sets. Accuracy and AUC were used to evaluate the model performance. Minimum redundancy maximum relevance (MRMR) or SHAP algorithms was employed for feature selection. Support vector machine or random forest was used for classification. Automated cortical region segmentation using FreeSurfer v6 was performed in 33 patients with a minimum follow-up of 4 years. Architectural and biological MRI changes were determined in 34 different brain regions for each individual patient. RESULTS The top-ranked temporal lobe features predicting TLI were V66/V38 for IMRT patients and V10 for proton patients with an AUC of 0.95 and 0.74, respectively. For whole brain, the top features were V16 and V13 with an AUC of 0.70. The rates of TLI at 5 years for V10-20(whole brain) ≥ 180cc and V10-20(whole brain) < 180 were 39.5% and 6.2%, respectively (HR = 5.5, 95% CI 1.4-22.0, p = 0.02). There were global changes in gray matter thickness, with most pronounced changes occurred in parietal lobe (-4.79%, p = 0.007) and occipital lobe (-5.68%, p = 0.03). Similarly, there were diffuse changes in white matter and subcortical volume. After radiation, the frontal lobe increased by 17.5% (p = 0.04), lateral ventricle 41% (p = 0.03), and choroid plexus 34.3% (p = 0.03). CONCLUSION Low-dose radiation bath is associated with increased risk of temporal lobe injury and global disruption in brain architecture in NPC survivors.
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Affiliation(s)
- R Paul
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | | | - A W Chan
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
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19
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Manyara AM, Davies P, Stewart D, Weir CJ, Young AE, Wells V, Blazeby J, Butcher NJ, Bujkiewicz S, Chan AW, Collins GS, Dawoud D, Offringa M, Ouwens M, Ross JS, Taylor RS, Ciani O. Definitions, acceptability, limitations, and guidance in the use and reporting of surrogate end points in trials: a scoping review. J Clin Epidemiol 2023; 160:83-99. [PMID: 37380118 DOI: 10.1016/j.jclinepi.2023.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 06/09/2023] [Accepted: 06/20/2023] [Indexed: 06/30/2023]
Abstract
OBJECTIVE To synthesize the current literature on the use of surrogate end points, including definitions, acceptability, and limitations of surrogate end points and guidance for their design/reporting, into trial reporting items. STUDY DESIGN AND SETTING Literature was identified through searching bibliographic databases (until March 1, 2022) and gray literature sources (until May 27, 2022). Data were thematically analyzed into four categories: (1) definitions, (2) acceptability, (3) limitations and challenges, and (4) guidance, and synthesized into reporting guidance items. RESULTS After screening, 90 documents were included: 79% (n = 71) had data on definitions, 77% (n = 69) on acceptability, 72% (n = 65) on limitations and challenges, and 61% (n = 55) on guidance. Data were synthesized into 17 potential trial reporting items: explicit statements on the use of surrogate end point(s) and justification for their use (items 1-6); methodological considerations, including whether sample size calculations were informed by surrogate validity (items 7-9); reporting of results for composite outcomes containing a surrogate end point (item 10); discussion and interpretation of findings (items 11-14); plans for confirmatory studies, collecting data on the surrogate end point and target outcome, and data sharing (items 15-16); and informing trial participants about using surrogate end points (item 17). CONCLUSION The review identified and synthesized items on the use of surrogate end points in trials; these will inform the development of the Standard Protocol Items: Recommendations for Interventional Trials-SURROGATE and Consolidated Standards of Reporting Trials-SURROGATE extensions.
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Affiliation(s)
- Anthony Muchai Manyara
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, UK.
| | - Philippa Davies
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Christopher J Weir
- Edinburgh Clinical Trials Unit, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Amber E Young
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Valerie Wells
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Jane Blazeby
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; Bristol NIHR Biomedical Research Centre, Bristol, UK; University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Nancy J Butcher
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Sylwia Bujkiewicz
- Biostatistics Research Group, Department of Population Health Sciences, University of Leicester, Leicester, UK
| | - An-Wen Chan
- Women's College Research Institute, Toronto, Canada; Department of Medicine, University of Toronto, Toronto, Canada
| | - Gary S Collins
- Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences, Centre for Statistics in Medicine, University of Oxford, Oxford, UK
| | - Dalia Dawoud
- Science, Evidence and Analytics Directorate, Science Policy and Research Programme, National Institute for Health and Care Excellence, London, UK
| | - Martin Offringa
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Canada; Department of Paediatrics, University of Toronto, Toronto, Canada
| | | | - Joseph S Ross
- Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA; Section of General Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Rod S Taylor
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, UK; Robertson Centre for Biostatistics, School of Health and Well Being, University of Glasgow, Glasgow, UK
| | - Oriana Ciani
- Centre for Research on Health and Social Care Management, SDA Bocconi School of Management, Milan, Italy
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20
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Solovyeva O, Dimairo M, Weir CJ, Hee SW, Espinasse A, Ursino M, Patel D, Kightley A, Hughes S, Jaki T, Mander A, Evans TRJ, Lee S, Hopewell S, Rantell KR, Chan AW, Bedding A, Stephens R, Richards D, Roberts L, Kirkpatrick J, de Bono J, Yap C. Development of consensus-driven SPIRIT and CONSORT extensions for early phase dose-finding trials: the DEFINE study. BMC Med 2023; 21:246. [PMID: 37408015 PMCID: PMC10324137 DOI: 10.1186/s12916-023-02937-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 06/12/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Early phase dose-finding (EPDF) trials are crucial for the development of a new intervention and influence whether it should be investigated in further trials. Guidance exists for clinical trial protocols and completed trial reports in the SPIRIT and CONSORT guidelines, respectively. However, both guidelines and their extensions do not adequately address the characteristics of EPDF trials. Building on the SPIRIT and CONSORT checklists, the DEFINE study aims to develop international consensus-driven guidelines for EPDF trial protocols (SPIRIT-DEFINE) and reports (CONSORT-DEFINE). METHODS The initial generation of candidate items was informed by reviewing published EPDF trial reports. The early draft items were refined further through a review of the published and grey literature, analysis of real-world examples, citation and reference searches, and expert recommendations, followed by a two-round modified Delphi process. Patient and public involvement and engagement (PPIE) was pursued concurrently with the quantitative and thematic analysis of Delphi participants' feedback. RESULTS The Delphi survey included 79 new or modified SPIRIT-DEFINE (n = 36) and CONSORT-DEFINE (n = 43) extension candidate items. In Round One, 206 interdisciplinary stakeholders from 24 countries voted and 151 stakeholders voted in Round Two. Following Round One feedback, one item for CONSORT-DEFINE was added in Round Two. Of the 80 items, 60 met the threshold for inclusion (≥ 70% of respondents voted critical: 26 SPIRIT-DEFINE, 34 CONSORT-DEFINE), with the remaining 20 items to be further discussed at the consensus meeting. The parallel PPIE work resulted in the development of an EPDF lay summary toolkit consisting of a template with guidance notes and an exemplar. CONCLUSIONS By detailing the development journey of the DEFINE study and the decisions undertaken, we envision that this will enhance understanding and help researchers in the development of future guidelines. The SPIRIT-DEFINE and CONSORT-DEFINE guidelines will allow investigators to effectively address essential items that should be present in EPDF trial protocols and reports, thereby promoting transparency, comprehensiveness, and reproducibility. TRIAL REGISTRATION SPIRIT-DEFINE and CONSORT-DEFINE are registered with the EQUATOR Network ( https://www.equator-network.org/ ).
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Affiliation(s)
| | - Munyaradzi Dimairo
- Clinical Trials Research Unit, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Christopher J Weir
- Edinburgh Clinical Trials Unit, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Siew Wan Hee
- University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK
- University of Warwick, Coventry, UK
| | | | - Moreno Ursino
- Inserm, Centre de Recherche Des Cordeliers, Sorbonne UniversitéUniversité Paris Cité, 75006, Paris, France
- HeKA, Inria Paris, 75015, Paris, France
- Unit of Clinical Epidemiology, AP-HP, CHU Robert Debré, CIC-EC 1426, Paris, France
- RECaP/F-CRIN, Inserm, 5400, Nancy, France
| | | | - Andrew Kightley
- Patient and Public Involvement and Engagement (PPIE) Lead, Lichfield, UK
| | | | - Thomas Jaki
- MRC Biostatistics Unit, University of Cambridge, Cambridge, UK
- University of Regensburg, Regensburg, Germany
| | | | | | - Shing Lee
- Columbia University, Mailman School of Public Health, New York, USA
| | - Sally Hopewell
- Oxford Clinical Trials Research Unit, University of Oxford, Oxford, UK
| | | | - An-Wen Chan
- Department of Medicine, Women's College Research Institute, University of Toronto, Toronto, Canada
| | | | | | | | | | | | - Johann de Bono
- The Institute of Cancer Research, London, UK
- The Royal Marsden NHS Foundation Trust, London, UK
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21
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Speich B, Mann E, Schönenberger CM, Mellor K, Griessbach AN, Dhiman P, Gandhi P, Lohner S, Agarwal A, Odutayo A, Puebla I, Clark A, Chan AW, Schlussel MM, Ravaud P, Moher D, Briel M, Boutron I, Schroter S, Hopewell S. Reminding Peer Reviewers of Reporting Guideline Items to Improve Completeness in Published Articles: Primary Results of 2 Randomized Trials. JAMA Netw Open 2023; 6:e2317651. [PMID: 37294569 PMCID: PMC10257091 DOI: 10.1001/jamanetworkopen.2023.17651] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 04/21/2023] [Indexed: 06/10/2023] Open
Abstract
Importance Numerous studies have shown that adherence to reporting guidelines is suboptimal. Objective To evaluate whether asking peer reviewers to check if specific reporting guideline items were adequately reported would improve adherence to reporting guidelines in published articles. Design, Setting, and Participants Two parallel-group, superiority randomized trials were performed using manuscripts submitted to 7 biomedical journals (5 from the BMJ Publishing Group and 2 from the Public Library of Science) as the unit of randomization, with peer reviewers allocated to the intervention or control group. Interventions The first trial (CONSORT-PR) focused on manuscripts that presented randomized clinical trial (RCT) results and reported following the Consolidated Standards of Reporting Trials (CONSORT) guideline, and the second trial (SPIRIT-PR) focused on manuscripts that presented RCT protocols and reported following the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) guideline. The CONSORT-PR trial included manuscripts that described RCT primary results (submitted July 2019 to July 2021). The SPIRIT-PR trial included manuscripts that contained RCT protocols (submitted June 2020 to May 2021). Manuscripts in both trials were randomized (1:1) to the intervention or control group; the control group received usual journal practice. In the intervention group of both trials, peer reviewers received an email from the journal that asked them to check whether the 10 most important and poorly reported CONSORT (for CONSORT-PR) or SPIRIT (for SPIRIT-PR) items were adequately reported in the manuscript. Peer reviewers and authors were not informed of the purpose of the study, and outcome assessors were blinded. Main Outcomes and Measures The difference in the mean proportion of adequately reported 10 CONSORT or SPIRIT items between the intervention and control groups in published articles. Results In the CONSORT-PR trial, 510 manuscripts were randomized. Of those, 243 were published (122 in the intervention group and 121 in the control group). A mean proportion of 69.3% (95% CI, 66.0%-72.7%) of the 10 CONSORT items were adequately reported in the intervention group and 66.6% (95% CI, 62.5%-70.7%) in the control group (mean difference, 2.7%; 95% CI, -2.6% to 8.0%). In the SPIRIT-PR trial, of the 244 randomized manuscripts, 178 were published (90 in the intervention group and 88 in the control group). A mean proportion of 46.1% (95% CI, 41.8%-50.4%) of the 10 SPIRIT items were adequately reported in the intervention group and 45.6% (95% CI, 41.7% to 49.4%) in the control group (mean difference, 0.5%; 95% CI, -5.2% to 6.3%). Conclusions and Relevance These 2 randomized trials found that it was not useful to implement the tested intervention to increase reporting completeness in published articles. Other interventions should be assessed and considered in the future. Trial Registration ClinicalTrials.gov Identifiers: NCT05820971 (CONSORT-PR) and NCT05820984 (SPIRIT-PR).
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Affiliation(s)
- Benjamin Speich
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
- CLEAR Methods Center, Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Erika Mann
- PLOS, Public Library of Science, San Francisco, California
| | - Christof M. Schönenberger
- CLEAR Methods Center, Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Katie Mellor
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
| | - Alexandra N. Griessbach
- CLEAR Methods Center, Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Paula Dhiman
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
- The EQUATOR Network, Oxford, United Kingdom
| | - Pooja Gandhi
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- Swallowing Rehabilitation Research Laboratory, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Szimonetta Lohner
- Cochrane Hungary, Clinical Centre of the University of Pécs, Medical School, University of Pécs, Pécs, Hungary
- Department of Public Health Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Arnav Agarwal
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Division of General Internal Medicine, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Ayodele Odutayo
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
- Division of Nephrology, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
| | - Iratxe Puebla
- PLOS, Public Library of Science, San Francisco, California
- ASAPbio, Cambridge, United Kingdom
- PLOS ONE, Public Library of Science, Cambridge, United Kingdom
| | | | - An-Wen Chan
- Department of Medicine, Women’s College Research Institute, Women’s College Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Michael M. Schlussel
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
- The EQUATOR Network, Oxford, United Kingdom
| | - Philippe Ravaud
- Centre d’Épidémiologie Clinique, Hôpital Hôtel-Dieu, Assistance Publique Hôpitaux de Paris, Paris, France
- Université de Paris, CRESS, Inserm, INRA, Paris, France
| | - David Moher
- Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Matthias Briel
- CLEAR Methods Center, Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Isabelle Boutron
- Centre d’Épidémiologie Clinique, Hôpital Hôtel-Dieu, Assistance Publique Hôpitaux de Paris, Paris, France
- Université de Paris, CRESS, Inserm, INRA, Paris, France
| | - Sara Schroter
- The BMJ, London, United Kingdom
- Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Sally Hopewell
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
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22
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Azoulay L, St-Jean A, Dahl M, Quail J, Aibibula W, Brophy JM, Chan AW, Bresee L, Carney G, Eltonsy S, Tamim H, Paterson JM, Platt RW. Hydrochlorothiazide use and risk of keratinocyte carcinoma and melanoma: A multi-site population-based cohort study. J Am Acad Dermatol 2023:S0190-9622(23)00735-1. [PMID: 37105517 DOI: 10.1016/j.jaad.2023.04.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 03/30/2023] [Accepted: 04/07/2023] [Indexed: 04/29/2023]
Abstract
BACKGROUND The association between hydrochlorothiazide (HCTZ) and skin cancer remains controversial. OBJECTIVE To determine whether HCTZ is associated with an increased risk of skin cancer compared with angiotensin-converting enzyme inhibitors (ACEIs) and calcium channel blockers (CCBs). METHODS Two new-user, active comparator cohorts were assembled using six Canadian databases. Site-specific hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using standardized morbidity ratio weighted Cox proportional hazard models and pooled using random-effects meta-analysis. RESULTS HCTZ was not associated with an overall increased risk of keratinocyte carcinoma compared with ACEIs or CCBs, although increased risks were observed with longer durations (≥10 years; HR: 1.12; 95% CI: 1.03-1.21) and higher cumulative doses (≥100,000 mg; HR: 1.49; 95% CI: 1.27-1.76). For melanoma, there was no association with ACEIs, but a 32% increased risk with CCBs (crude incidence rates: 64.2 vs. 58.4 per 100,000 person-years; HR: 1.32; 95% CI: 1.19-1.46; estimated number needed to harm at 5 years of follow-up: 1,627 patients), with increased risks with longer durations and cumulative doses. LIMITATIONS Residual confounding due to the observational design. CONCLUSIONS Increased risks of keratinocyte carcinoma and melanoma were observed with longer durations of use and higher cumulative doses of HCTZ.
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Affiliation(s)
- Laurent Azoulay
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada; Gerald Bronfman Department of Oncology, McGill University, Montreal, Quebec, Canada; Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada.
| | - Audray St-Jean
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada
| | - Matthew Dahl
- Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Manitoba, Canada
| | | | | | - James M Brophy
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada; Division of Clinical Epidemiology, McGill University Health Centre, Montreal, Quebec, Canada; Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - An-Wen Chan
- Division of Dermatology, Department of Medicine, Women's College Research Institute, University of Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada
| | - Lauren Bresee
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Greg Carney
- Department of Anesthesiology, Pharmacology and Therapeutics, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sherif Eltonsy
- College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Hala Tamim
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada; Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | - Robert W Platt
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada; Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada; Department of Pediatrics, McGill University, Montreal, Quebec, Canada
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23
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Haykal S, Juvet S, Chan AW, O’Neill A, Pal P, Cypel M, Keshavjee S. Assessment of Acute Rejection in a Lung Transplant Recipient Using a Sentinel Skin Flap. Transpl Int 2023; 36:11166. [PMID: 37077407 PMCID: PMC10106558 DOI: 10.3389/ti.2023.11166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 03/21/2023] [Indexed: 04/05/2023]
Affiliation(s)
- Siba Haykal
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University Healthy Network, Toronto, ON, Canada
- *Correspondence: Siba Haykal,
| | - Stephen Juvet
- Division of Medicine, Division of Respirology, University Healthy Network, Toronto, ON, Canada
| | - An-Wen Chan
- Department of Dermatology, University Healthy Network, Toronto, ON, Canada
| | - Anne O’Neill
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University Healthy Network, Toronto, ON, Canada
| | - Prodipto Pal
- Department of Pathology, University Healthy Network, Toronto, ON, Canada
| | - Marcelo Cypel
- Division of Thoracic Surgery, Department of Surgery, University Healthy Network, Toronto, ON, Canada
| | - Shaf Keshavjee
- Division of Thoracic Surgery, Department of Surgery, University Healthy Network, Toronto, ON, Canada
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24
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Espinasse A, Solovyeva O, Dimairo M, Weir C, Jaki T, Mander A, Kightley A, Evans J, Lee S, Bedding A, Hopewell S, Rantell K, Liu R, Chan AW, De Bono J, Yap C. SPIRIT and CONSORT extensions for early phase dose-finding clinical trials: the DEFINE (DosE-FIndiNg Extensions) study protocol. BMJ Open 2023; 13:e068173. [PMID: 36990492 PMCID: PMC10069529 DOI: 10.1136/bmjopen-2022-068173] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 03/13/2023] [Indexed: 03/31/2023] Open
Abstract
INTRODUCTION Early phase dose-finding (EPDF) studies are critical for the development of new treatments, directly influencing whether compounds or interventions can be investigated in further trials to confirm their safety and efficacy. There exists guidance for clinical trial protocols and reporting of completed trials in the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) 2013 and CONsolidated Standards Of Reporting Randomised Trials (CONSORT) 2010 statements. However, neither the original statements nor their extensions adequately cover the specific features of EPDF trials. The DEFINE (DosE-FIndiNg Extensions) study aims to enhance transparency, completeness, reproducibility and interpretation of EPDF trial protocols (SPIRIT-DEFINE) and their reports once completed (CONSORT-DEFINE), across all disease areas, building on the original SPIRIT 2013 and CONSORT 2010 statements. METHODS AND ANALYSIS A methodological review of published EPDF trials will be conducted to identify features and deficiencies in reporting and inform the initial generation of the candidate items. The early draft checklists will be enriched through a review of published and grey literature, real-world examples analysis, citation and reference searches and consultation with international experts, including regulators and journal editors. Development of CONSORT-DEFINE commenced in March 2021, followed by SPIRIT-DEFINE from January 2022. A modified Delphi process, involving worldwide, multidisciplinary and cross-sector key stakeholders, will be run to refine the checklists. An international consensus meeting in autumn 2022 will finalise the list of items to be included in both guidance extensions. ETHICS AND DISSEMINATION This project was approved by ICR's Committee for Clinical Research. The Health Research Authority confirmed Research Ethics Approval is not required. The dissemination strategy aims to maximise guideline awareness and uptake, including but not limited to dissemination in stakeholder meetings, conferences, peer-reviewed publications and on the EQUATOR Network and DEFINE study websites. REGISTRATION DETAILS SPIRIT-DEFINE and CONSORT-DEFINE are registered with the EQUATOR Network.
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Affiliation(s)
- Aude Espinasse
- Clinical Trial and Statistical Unit, Institute of Cancer Research Sutton, London, UK
| | - Olga Solovyeva
- Clinical Trial and Statistical Unit, Institute of Cancer Research Sutton, London, UK
| | - Munyaradzi Dimairo
- School of Health and Related Research, The University of Sheffield, Sheffield, UK
| | - Christopher Weir
- Edinburgh Clinical Trials Unit, University of Edinburgh, Usher Institute, Edinburgh, UK
| | - Thomas Jaki
- Computational Statistics Group, Department of Informatics and Data Science, University of Regensburg, Regensburg, Germany
- MRC Biostatistics Unit, University of Cambridge, Cambridge, UK
| | - Adrian Mander
- Cardiff University Centre for Trials Research, Cardiff, UK
| | | | - Jeffry Evans
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - Shing Lee
- Columbia University, New York, New York, USA
| | - Alun Bedding
- Data and Statistical Sciences Department, Roche Products Ltd, Welwyn Garden City, UK
| | - Sally Hopewell
- Centre for Statistics in Medicine, Oxford Clinical Trials Unit, University of Oxford, Oxford, UK
| | - Khadija Rantell
- Medicines and Healthcare Products Regulatory Agency, London, UK
| | - Rong Liu
- Biostatistics Department, Bristol-Myers Squibb Co, New York, New York, USA
| | - An-Wen Chan
- Department of Medicine, Women's College Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Johann De Bono
- Institute of Cancer Research, London, UK
- Royal Marsden Hospital, London, UK
| | - Christina Yap
- Clinical Trial and Statistical Unit, Institute of Cancer Research Sutton, London, UK
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Drucker AM, Kleiner O, Manion R, Philip A, Dutz J, Barnard K, Fradette J, Germain L, Gniadecki R, Litvinov I, Logsetty S, Manolson M, Mydlarski PR, Piguet V, Ward D, Zhou Y, Chan AW, Abbas M, Alhusayen R, Cenedese L, Chen T, Cheng YS, Cole T, Iuliis JD, Desaulniers K, Duffy C, Ferris T, Hanna S, Humeny R, Joseph M, Khan U, Lynde C, Morrison S, Ogunyemi B, Prajapati V, Ramien M, Reynolds L, Rosen C, Seguin K, Sibbald C, Swan J, Timgren J, Turchin I, Verner V, Walsh S, Weston V. Top Ten Research Priorities for Psoriasis, Atopic Dermatitis and Hidradenitis Suppurativa: The SkIN Canada Priority Setting Initiative. J Cutan Med Surg 2023; 27:133-139. [PMID: 36995350 PMCID: PMC10068398 DOI: 10.1177/12034754231156103] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Background The Skin Investigation Network of Canada (SkIN Canada) is a new national skin research network. To shape the research landscape and ensure its value to patient care, research priorities that are important to patients, caregivers, and health care providers must be identified. Objectives To identify the Top Ten research priorities for 9 key skin conditions. Methods We first surveyed health care providers and researchers to select the top skin conditions for future research within the categories of inflammatory skin disease, skin cancers (other than melanoma), and wound healing. For those selected skin conditions, we conducted scoping reviews to identify previous priority setting exercises. We combined the results of those scoping reviews with a survey of patients, health care providers, and researchers to generate lists of knowledge gaps for each condition. We then surveyed patients and health care providers to create preliminary rankings to prioritize those knowledge gaps. Finally, we conducted workshops of patients and health care providers to create the final Top Ten lists of research priorities for each condition. Results Overall, 538 patients, health care providers, and researchers participated in at least one survey or workshop. Psoriasis, atopic dermatitis and hidradenitis suppurativa (inflammatory skin disease); chronic wounds, burns and scars (wound healing); and basal cell, squamous cell and Merkel cell carcinoma (skin cancer) were selected as priority skin conditions. Top Ten lists of knowledge gaps for inflammatory skin conditions encompassed a range of issues relevant to patient care, including questions on pathogenesis, prevention, non-pharmacologic and pharmacologic management. Conclusions Research priorities derived from patients and health care providers should be used to guide multidisciplinary research networks, funders, and policymakers in Canada and internationally.
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Affiliation(s)
- Aaron M. Drucker
- Division of Dermatology, Department of Medicine, University of Toronto, Ontario, Canada
- Women’s College Research Institute, Women’s College Hospital, Toronto, ON, Canada
| | - Omer Kleiner
- Women’s College Research Institute, Women’s College Hospital, Toronto, ON, Canada
| | - Rachael Manion
- Patient Research Partner, Skin Investigation Network of Canada (SkIN Canada), Toronto, ON, Canada
- Canadian Association of Psoriasis Patients, Ottawa, ON, Canada
- Canadian Skin Patient Alliance, Ottawa, ON, Canada
| | - Anie Philip
- Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
- Divisions of Plastic Surgery, Dermatology, and Experimental Medicine, Department of Surgery, Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Jan Dutz
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada
- Division of Rheumatology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kathleen Barnard
- Patient Research Partner, Skin Investigation Network of Canada (SkIN Canada), Toronto, ON, Canada
- Save Your Skin Foundation, Penticton, British Columbia, Canada
| | - Julie Fradette
- Centre de Recherche en Organogénèse Expérimentale de l'Université Laval/LOEX, Centre de Recherche du CHU de Québec-Université Laval, Axe Médecine Régénératrice, Québec, Canada
- Department of Surgery, Faculty of Medicine, Université Laval, Québec, Canada
| | - Lucie Germain
- Centre de Recherche en Organogénèse Expérimentale de l'Université Laval/LOEX, Centre de Recherche du CHU de Québec-Université Laval, Axe Médecine Régénératrice, Québec, Canada
- Department of Surgery, Faculty of Medicine, Université Laval, Québec, Canada
| | - Robert Gniadecki
- Division of Dermatology, University of Alberta, Edmonton, Alberta, Canada
| | - Ivan Litvinov
- Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
- Division of Dermatology, Department of Medicine, McGill University, Montréal, Québec, Canada
| | - Sarvesh Logsetty
- Departments of Surgery, Psychiatry, and Children’s Health, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Morris Manolson
- Patient Research Partner, Skin Investigation Network of Canada (SkIN Canada), Toronto, ON, Canada
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | - P. Régine Mydlarski
- Division of Dermatology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Vincent Piguet
- Division of Dermatology, Department of Medicine, University of Toronto, Ontario, Canada
- Women’s College Research Institute, Women’s College Hospital, Toronto, ON, Canada
| | - Debbie Ward
- Patient Research Partner, Skin Investigation Network of Canada (SkIN Canada), Toronto, ON, Canada
| | - Youwen Zhou
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada
| | - An-Wen Chan
- Division of Dermatology, Department of Medicine, University of Toronto, Ontario, Canada
- Women’s College Research Institute, Women’s College Hospital, Toronto, ON, Canada
| | - Mariam Abbas
- Division of Dermatology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Raed Alhusayen
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Lisa Cenedese
- Patient Research Partner, Skin Investigation Network of Canada (SkIN Canada), Toronto, Ontario, Canada
| | - Tiffany Chen
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Yee Sing Cheng
- Patient Research Partner, Skin Investigation Network of Canada (SkIN Canada), Toronto, Ontario, Canada
- Canadian Association of Psoriasis Patients, Ottawa, Ontario, Canada
| | - Trish Cole
- Patient Research Partner, Skin Investigation Network of Canada (SkIN Canada), Toronto, Ontario, Canada
| | - Jacob De Iuliis
- Patient Research Partner, Skin Investigation Network of Canada (SkIN Canada), Toronto, Ontario, Canada
| | - Katherine Desaulniers
- Patient Research Partner, Skin Investigation Network of Canada (SkIN Canada), Toronto, Ontario, Canada
| | - Catherine Duffy
- Patient Research Partner, Skin Investigation Network of Canada (SkIN Canada), Toronto, Ontario, Canada
| | - Tracy Ferris
- Patient Research Partner, Skin Investigation Network of Canada (SkIN Canada), Toronto, Ontario, Canada
| | - Sameh Hanna
- Dermatology on Bloor, Toronto, Ontario, Canada
| | - Rhiannon Humeny
- Patient Research Partner, Skin Investigation Network of Canada (SkIN Canada), Toronto, Ontario, Canada
| | - Marissa Joseph
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Women’s College Research Institute, Women’s College Hospital, Toronto, Ontario, Canada
| | - Ushra Khan
- Patient Research Partner, Skin Investigation Network of Canada (SkIN Canada), Toronto, Ontario, Canada
| | - Charles Lynde
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Lynde Institute for Dermatology, Markham, Ontario, Canada
| | - Steven Morrison
- Patient Research Partner, Skin Investigation Network of Canada (SkIN Canada), Toronto, Ontario, Canada
| | - Boluwaji Ogunyemi
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - Vimal Prajapati
- Division of Dermatology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Michele Ramien
- Division of Dermatology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada
- Division of Community Pediatrics, Department of Pediatrics, Alberta Children’s Hospital, Calgary, Alberta, Canada
| | - Lauren Reynolds
- Patient Research Partner, Skin Investigation Network of Canada (SkIN Canada), Toronto, Ontario, Canada
| | - Cheryl Rosen
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of Dermatology, Department of Medicine, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Kimberly Seguin
- Patient Research Partner, Skin Investigation Network of Canada (SkIN Canada), Toronto, Ontario, Canada
- Canadian Association of Psoriasis Patients, Ottawa, Ontario, Canada
| | - Cathryn Sibbald
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of Paediatric Dermatology, Department of Paediatrics, SickKids Hospital, Toronto, Ontario, Canada
| | - Jennifer Swan
- Patient Research Partner, Skin Investigation Network of Canada (SkIN Canada), Toronto, Ontario, Canada
| | - Jodi Timgren
- Patient Research Partner, Skin Investigation Network of Canada (SkIN Canada), Toronto, Ontario, Canada
| | - Irina Turchin
- Division of Dermatology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Vicky Verner
- Patient Research Partner, Skin Investigation Network of Canada (SkIN Canada), Toronto, Ontario, Canada
| | - Sandra Walsh
- Division of Dermatology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Veronica Weston
- Patient Research Partner, Skin Investigation Network of Canada (SkIN Canada), Toronto, Ontario, Canada
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Cruz Rivera S, Liu X, Chan AW, Denniston AK, Calvert MJ. [Guidelines for clinical trial protocols for interventions involving artificial intelligence: the SPIRIT-AI extensionDiretrizes para protocolos de ensaios clínicos com intervenções que utilizam inteligência artificial: a extensão SPIRIT-AI]. Rev Panam Salud Publica 2023; 48:e12. [PMID: 38304411 PMCID: PMC10832304 DOI: 10.26633/rpsp.2024.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 07/23/2020] [Indexed: 02/03/2024] Open
Abstract
The SPIRIT 2013 statement aims to improve the completeness of clinical trial protocol reporting by providing evidence-based recommendations for the minimum set of items to be addressed. This guidance has been instrumental in promoting transparent evaluation of new interventions. More recently, there has been a growing recognition that interventions involving artificial intelligence (AI) need to undergo rigorous, prospective evaluation to demonstrate their impact on health outcomes. The SPIRIT-AI (Standard Protocol Items: Recommendations for Interventional Trials-Artificial Intelligence) extension is a new reporting guideline for clinical trial protocols evaluating interventions with an AI component. It was developed in parallel with its companion statement for trial reports: CONSORT-AI (Consolidated Standards of Reporting Trials-Artificial Intelligence). Both guidelines were developed through a staged consensus process involving literature review and expert consultation to generate 26 candidate items, which were consulted upon by an international multi-stakeholder group in a two-stage Delphi survey (103 stakeholders), agreed upon in a consensus meeting (31 stakeholders) and refined through a checklist pilot (34 participants). The SPIRIT-AI extension includes 15 new items that were considered sufficiently important for clinical trial protocols of AI interventions. These new items should be routinely reported in addition to the core SPIRIT 2013 items. SPIRIT-AI recommends that investigators provide clear descriptions of the AI intervention, including instructions and skills required for use, the setting in which the AI intervention will be integrated, considerations for the handling of input and output data, the human-AI interaction and analysis of error cases. SPIRIT-AI will help promote transparency and completeness for clinical trial protocols for AI interventions. Its use will assist editors and peer reviewers, as well as the general readership, to understand, interpret and critically appraise the design and risk of bias for a planned clinical trial.
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Affiliation(s)
- Samantha Cruz Rivera
- Centre for Patient Reported Outcomes ResearchInstitute of Applied Health ResearchUniversity of BirminghamBirminghamReino UnidoCentre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham, Reino Unido.
- Institute of Applied Health ResearchUniversity of BirminghamBirminghamReino UnidoInstitute of Applied Health Research, University of Birmingham, Birmingham, Reino Unido.
- Birmingham Health Partners Centre for Regulatory Science and InnovationUniversity of BirminghamBirminghamReino UnidoBirmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, Reino Unido.
| | - Xiaoxuan Liu
- Birmingham Health Partners Centre for Regulatory Science and InnovationUniversity of BirminghamBirminghamReino UnidoBirmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, Reino Unido.
- Academic Unit of OphthalmologyInstitute of Inflammation and AgeingUniversity of BirminghamBirminghamReino UnidoAcademic Unit of Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, Reino Unido.
- University Hospitals Birmingham NHS Foundation TrustBirminghamReino UnidoUniversity Hospitals Birmingham NHS Foundation Trust, Birmingham, Reino Unido.
- Health Data Research UKLondresReino UnidoHealth Data Research UK, Londres, Reino Unido.
- Moorfields Eye Hospital NHS Foundation TrustLondresReino UnidoMoorfields Eye Hospital NHS Foundation Trust, Londres, Reino Unido.
| | - An-Wen Chan
- Department of Medicine, Women’s College Research InstituteWomen’s College HospitalUniversity of TorontoOntarioCanadáDepartment of Medicine, Women’s College Research Institute, Women’s College Hospital, University of Toronto, Ontario, Canadá.
| | - Alastair K. Denniston
- Centre for Patient Reported Outcomes ResearchInstitute of Applied Health ResearchUniversity of BirminghamBirminghamReino UnidoCentre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham, Reino Unido.
- Birmingham Health Partners Centre for Regulatory Science and InnovationUniversity of BirminghamBirminghamReino UnidoBirmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, Reino Unido.
- Academic Unit of OphthalmologyInstitute of Inflammation and AgeingUniversity of BirminghamBirminghamReino UnidoAcademic Unit of Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, Reino Unido.
- University Hospitals Birmingham NHS Foundation TrustBirminghamReino UnidoUniversity Hospitals Birmingham NHS Foundation Trust, Birmingham, Reino Unido.
- Health Data Research UKLondresReino UnidoHealth Data Research UK, Londres, Reino Unido.
- National Institute of Health Research Biomedical Research Centre for OphthalmologyMoorfields Hospital London NHS Foundation Trust and University College LondonInstitute of OphthalmologyLondresReino UnidoNational Institute of Health Research Biomedical Research Centre for Ophthalmology, Moorfields Hospital London NHS Foundation Trust and University College London, Institute of Ophthalmology, Londres, Reino Unido.
| | - Melanie J. Calvert
- Centre for Patient Reported Outcomes ResearchInstitute of Applied Health ResearchUniversity of BirminghamBirminghamReino UnidoCentre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham, Reino Unido.
- Institute of Applied Health ResearchUniversity of BirminghamBirminghamReino UnidoInstitute of Applied Health Research, University of Birmingham, Birmingham, Reino Unido.
- Birmingham Health Partners Centre for Regulatory Science and InnovationUniversity of BirminghamBirminghamReino UnidoBirmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, Reino Unido.
- Health Data Research UKLondresReino UnidoHealth Data Research UK, Londres, Reino Unido.
- National Institute of Health Research Birmingham Biomedical Research CentreUniversity of Birmingham and University Hospitals Birmingham NHS Foundation TrustBirminghamReino UnidoNational Institute of Health Research Birmingham Biomedical Research Centre, University of Birmingham and University Hospitals Birmingham NHS Foundation Trust, Birmingham, Reino Unido.
- National Institute of Health Research Applied Research Collaborative West MidlandsCoventryReino UnidoNational Institute of Health Research Applied Research Collaborative West Midlands, Coventry, Reino Unido.
- National Institute of Health Research Surgical Reconstruction and Microbiology CentreUniversity of Birmingham and University Hospitals Birmingham NHS Foundation TrustBirminghamReino UnidoNational Institute of Health Research Surgical Reconstruction and Microbiology Centre, University of Birmingham and University Hospitals Birmingham NHS Foundation Trust, Birmingham, Reino Unido.
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Nejstgaard CH, Boutron I, Chan AW, Chow R, Hopewell S, Masalkhi M, Moher D, Schulz KF, Shlobin NA, Østengaard L, Hróbjartsson A. A scoping review identifies multiple comments suggesting modifications to SPIRIT 2013 and CONSORT 2010. J Clin Epidemiol 2023; 155:48-63. [PMID: 36669708 DOI: 10.1016/j.jclinepi.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 01/12/2023] [Indexed: 01/19/2023]
Abstract
OBJECTIVES To identify, summarize, and analyse comments on the core reporting guidelines for protocols of randomized trials (Standard Protocol Items: Recommendations for Interventional Trials [SPIRIT] 2013) and for completed trials (Consolidated Standards of Reporting Trials [CONSORT] 2010), with special emphasis on suggestions for guideline modifications. METHODS We included documents written in English and published after 2010 that explicitly commented on SPIRIT 2013 or CONSORT 2010. We searched four bibliographic databases (Embase and MEDLINE to June 2022; Web of Science and Google Scholar to April 2022) and other sources (e.g., the EQUATOR Network website, the BMC Blog Network, and the BMJ rapid response section). Two authors independently assessed documents for eligibility and extracted data on basic characteristics and the wording of the main comments. We categorized comments as 'suggestion for modification to the wording of an existing guideline item,' 'suggestion for a new item,' or 'reflections on challenges or strengths.' We provided a summary and examples of the proposed suggestions and categorized comments into those that were directly linked to empirical investigations, were continuations of previous methodological discussions, or reflected new methodological developments. RESULTS We assessed full text of 2,320 potentially eligible documents and included 93 documents with 114 comments. In total, 37 comments suggested modifications to existing guideline items. The participant flow section of CONSORT 2010 received the most comments (eight comments made different suggestions, e.g., one comment suggested to add numbers on nonrandomized screened participants). There were 46 comments suggesting new items. Multiple suggestions were related to trial interventions (eight comments made different suggestions, e.g., one comment suggested to add content on cointerventions), blinding (six comments suggested to add content on risk of unblinding), statistical methods (five comments made different suggestions, e.g., one comment suggested to add content on blinding of statisticians), and participant flow (seven comments made different suggestions, e.g., three comments suggested to add content on missing data). Half (53%) of the suggestions were directly linked to empirical investigations. Six (7%) suggestions were continuations of previous methodological discussions and five (6%) suggestions reflected new methodological developments related to conflicts of interest and funding, data sharing, and patient and public involvement. CONCLUSION The issues raised provide context to authors, peer reviewers, editors, and readers of trials using SPIRIT 2013 and CONSORT 2010 and inform the planned updates of the core guidelines.
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Affiliation(s)
- Camilla H Nejstgaard
- Centre for Evidence-Based Medicine Odense (CEBMO) and Cochrane Denmark, Department of Clinical Research, University of Southern Denmark, Denmark; Open Patient Data Explorative Network (OPEN), Odense University Hospital, Denmark.
| | - Isabelle Boutron
- Université Paris Cité, Centre of Research in Epidemiology and Statistics (CRESS), Inserm, France; Cochrane France, France
| | - An-Wen Chan
- Department of Medicine, Women's College Research Institute, University of Toronto, Canada
| | - Ryan Chow
- Faculty of Medicine, University of Ottawa, Canada
| | - Sally Hopewell
- Oxford Clinical Trials Research Unit/Centre for Statistics in Medicine, University of Oxford, Oxford, UK
| | | | - David Moher
- Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Canada
| | - Kenneth F Schulz
- Department of Obstetrics and Gynecology, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Nathan A Shlobin
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Lasse Østengaard
- Centre for Evidence-Based Medicine Odense (CEBMO) and Cochrane Denmark, Department of Clinical Research, University of Southern Denmark, Denmark; Open Patient Data Explorative Network (OPEN), Odense University Hospital, Denmark; University Library of Southern Denmark, University of Southern Denmark, Odense, Denmark
| | - Asbjørn Hróbjartsson
- Centre for Evidence-Based Medicine Odense (CEBMO) and Cochrane Denmark, Department of Clinical Research, University of Southern Denmark, Denmark; Open Patient Data Explorative Network (OPEN), Odense University Hospital, Denmark
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Mirali S, Tang E, Drucker AM, Turchin I, Gooderham M, Levell N, Beecker J, Bissonnette R, Catherall H, Lapointe McKenzie JA, Hawkins N, Hong CH, Kalia S, Papp K, Chan AW. Follow-up of Patients With Keratinocyte Carcinoma: A Systematic Review of Clinical Practice Guidelines. JAMA Dermatol 2023; 159:87-94. [PMID: 36322063 DOI: 10.1001/jamadermatol.2022.4590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Importance Patients treated for cutaneous squamous cell carcinoma (SCC) and basal cell carcinoma (BCC), collectively called keratinocyte carcinoma (KC), are at risk for recurrence, metastasis, and additional primary cutaneous malignant neoplasms. It is unclear how often patients should be seen for follow-up skin examination after initial treatment of KC. Objective To summarize the recommendations and evaluate the methodological quality of clinical practice guidelines for dermatologic follow-up of patients with BCC and invasive SCC. Evidence Review PubMed, MEDLINE, and Embase were searched for relevant articles published from January 2010 to March 2022. Search terms included guideline, squamous cell carcinoma, and basal cell carcinoma. National or international guidelines containing recommendations for follow-up frequency after a diagnosis of localized cutaneous KC were included. Quality was assessed using the 6 domains of the Appraisal of Guidelines Research and Evaluation II (AGREE II) tool: (1) scope and purpose; (2) stakeholder development; (3) rigor of development; (4) clarity of presentation; (5) applicability; and (6) editorial independence. The Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA-P) was used to guide study reporting. Findings Among the 14 guidelines meeting eligibility criteria, there was little consensus on the appropriate follow-up frequency after initial KC treatment. Overall duration of follow-up ranged from a single posttreatment visit to lifelong surveillance. Most guidelines stratified their recommendations by recurrence risk. For low-risk BCC and guidelines that did not stratify by risk, follow-up recommendations ranged from every 6 to 12 months. For high-risk BCC, 1 guideline suggested follow-up every 3 months, while 4 recommended every 6 months. For low-risk SCC, 5 guidelines recommended annual follow-up; 3 guidelines, every 6 months; and 1 guideline, every 3 months. For high-risk SCC, recommendations included a range of follow-up frequencies, spanning every 3 months (n = 5 guidelines), 4 months (n = 1), 6 months (n = 6), or annually (n = 4). One guideline did not use risk stratification and recommended annual screening. The highest scoring AGREE II domain was "scope and purpose," which assessed the guideline's overall objectives, and the lowest scoring was "applicability," which assessed barriers and facilitators to implementation. Conclusions and Relevance The findings of this systemic review highlight variations in follow-up recommendations for patients after initial treatment for KC. Randomized clinical trials are needed to define an optimal follow-up regimen.
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Affiliation(s)
- Sara Mirali
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Women's College Research Institute, Toronto, Ontario, Canada
- Skin Investigation Network of Canada (SkIN Canada), Toronto, Ontario, Canada
| | - Evan Tang
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Women's College Research Institute, Toronto, Ontario, Canada
- Skin Investigation Network of Canada (SkIN Canada), Toronto, Ontario, Canada
| | - Aaron M Drucker
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Women's College Research Institute, Toronto, Ontario, Canada
- Skin Investigation Network of Canada (SkIN Canada), Toronto, Ontario, Canada
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Irina Turchin
- Skin Investigation Network of Canada (SkIN Canada), Toronto, Ontario, Canada
- Brunswick Dermatology Center, Fredericton, New Brunswick, Canada
- Probity Medical Research, Waterloo, Ontario, Canada
| | - Melinda Gooderham
- Skin Investigation Network of Canada (SkIN Canada), Toronto, Ontario, Canada
- Probity Medical Research, Waterloo, Ontario, Canada
- SKiN Centre for Dermatology, Peterborough, Ontario, Canada
- Department of Medicine, Queens University, Kingston, Ontario, Canada
| | - Nick Levell
- Skin Investigation Network of Canada (SkIN Canada), Toronto, Ontario, Canada
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
- Department of Dermatology, Norfolk and Norwich University Hospital, Norwich, United Kingdom
| | - Jennifer Beecker
- Skin Investigation Network of Canada (SkIN Canada), Toronto, Ontario, Canada
- Division of Dermatology, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Robert Bissonnette
- Skin Investigation Network of Canada (SkIN Canada), Toronto, Ontario, Canada
- Innovaderm Research, Montreal, Quebec, Canada
| | - Helen Catherall
- Skin Investigation Network of Canada (SkIN Canada), Toronto, Ontario, Canada
| | - Jo-Ann Lapointe McKenzie
- Skin Investigation Network of Canada (SkIN Canada), Toronto, Ontario, Canada
- Save Your Skin Foundation, Penticton, British Columbia, Canada
| | - Nicole Hawkins
- Skin Investigation Network of Canada (SkIN Canada), Toronto, Ontario, Canada
- Peak Medical Specialty Clinic, Okotoks, Alberta, Canada
- Division of Dermatology, University of Calgary, Calgary, Alberta, Canada
| | - Chih-Ho Hong
- Skin Investigation Network of Canada (SkIN Canada), Toronto, Ontario, Canada
- Probity Medical Research, Waterloo, Ontario, Canada
- Department of Dermatology and Skin Science, University of British Columbia, Surrey, British Columbia, Canada
| | - Sunil Kalia
- Skin Investigation Network of Canada (SkIN Canada), Toronto, Ontario, Canada
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kim Papp
- Skin Investigation Network of Canada (SkIN Canada), Toronto, Ontario, Canada
- Probity Medical Research, Waterloo, Ontario, Canada
- K Papp Clinical Research, Waterloo, Ontario, Canada
| | - An-Wen Chan
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Women's College Research Institute, Toronto, Ontario, Canada
- Skin Investigation Network of Canada (SkIN Canada), Toronto, Ontario, Canada
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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Butcher NJ, Monsour A, Mew EJ, Chan AW, Moher D, Mayo-Wilson E, Terwee CB, Chee-A-Tow A, Baba A, Gavin F, Grimshaw JM, Kelly LE, Saeed L, Thabane L, Askie L, Smith M, Farid-Kapadia M, Williamson PR, Szatmari P, Tugwell P, Golub RM, Monga S, Vohra S, Marlin S, Ungar WJ, Offringa M. Guidelines for Reporting Outcomes in Trial Protocols: The SPIRIT-Outcomes 2022 Extension. JAMA 2022; 328:2345-2356. [PMID: 36512367 DOI: 10.1001/jama.2022.21243] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
IMPORTANCE Complete information in a trial protocol regarding study outcomes is crucial for obtaining regulatory approvals, ensuring standardized trial conduct, reducing research waste, and providing transparency of methods to facilitate trial replication, critical appraisal, accurate reporting and interpretation of trial results, and knowledge synthesis. However, recommendations on what outcome-specific information should be included are diverse and inconsistent. To improve reporting practices promoting transparent and reproducible outcome selection, assessment, and analysis, a need for specific and harmonized guidance as to what outcome-specific information should be addressed in clinical trial protocols exists. OBJECTIVE To develop harmonized, evidence- and consensus-based standards for describing outcomes in clinical trial protocols through integration with the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) 2013 statement. EVIDENCE REVIEW Using the Enhancing the Quality and Transparency of Health Research (EQUATOR) methodological framework, the SPIRIT-Outcomes 2022 extension of the SPIRIT 2013 statement was developed by (1) generation and evaluation of candidate outcome reporting items via consultation with experts and a scoping review of existing guidance for reporting trial outcomes (published within the 10 years prior to March 19, 2018) identified through expert solicitation, electronic database searches of MEDLINE and the Cochrane Methodology Register, gray literature searches, and reference list searches; (2) a 3-round international Delphi voting process (November 2018-February 2019) completed by 124 panelists from 22 countries to rate and identify additional items; and (3) an in-person consensus meeting (April 9-10, 2019) attended by 25 panelists to identify essential items for outcome-specific reporting to be addressed in clinical trial protocols. FINDINGS The scoping review and consultation with experts identified 108 recommendations relevant to outcome-specific reporting to be addressed in trial protocols, the majority (72%) of which were not included in the SPIRIT 2013 statement. All recommendations were consolidated into 56 items for Delphi voting; after the Delphi survey process, 19 items met criteria for further evaluation at the consensus meeting and possible inclusion in the SPIRIT-Outcomes 2022 extension. The discussions during and after the consensus meeting yielded 9 items that elaborate on the SPIRIT 2013 statement checklist items and are related to completely defining and justifying the choice of primary, secondary, and other outcomes (SPIRIT 2013 statement checklist item 12) prospectively in the trial protocol, defining and justifying the target difference between treatment groups for the primary outcome used in the sample size calculations (SPIRIT 2013 statement checklist item 14), describing the responsiveness of the study instruments used to assess the outcome and providing details on the outcome assessors (SPIRIT 2013 statement checklist item 18a), and describing any planned methods to account for multiplicity relating to the analyses or interpretation of the results (SPIRIT 2013 statement checklist item 20a). CONCLUSIONS AND RELEVANCE This SPIRIT-Outcomes 2022 extension of the SPIRIT 2013 statement provides 9 outcome-specific items that should be addressed in all trial protocols and may help increase trial utility, replicability, and transparency and may minimize the risk of selective nonreporting of trial results.
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Affiliation(s)
- Nancy J Butcher
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Andrea Monsour
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Emma J Mew
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
- Department of Chronic Disease Epidemiology, School of Public Health, Yale University, New Haven, Connecticut
| | - An-Wen Chan
- Department of Medicine, Women's College Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - David Moher
- Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Evan Mayo-Wilson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill
| | - Caroline B Terwee
- Amsterdam University Medical Centers, Vrije Universiteit, Department of Epidemiology and Data Science, Amsterdam, the Netherlands
- Department of Methodology, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Alyssandra Chee-A-Tow
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Ami Baba
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Frank Gavin
- public panel member, Toronto, Ontario, Canada
| | - Jeremy M Grimshaw
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Lauren E Kelly
- Department of Pharmacology and Therapeutics, University of Manitoba, Winnipeg, Canada
- Children's Hospital Research Institute of Manitoba, Winnipeg, Canada
| | - Leena Saeed
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Lehana Thabane
- Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Lisa Askie
- NHMRC Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia
| | | | - Mufiza Farid-Kapadia
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Paula R Williamson
- MRC-NIHR Trials Methodology Research Partnership, Department of Health Data Science, University of Liverpool, Liverpool, England
| | - Peter Szatmari
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Peter Tugwell
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Bruyère Research Institute, Ottawa, Ontario, Canada
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Robert M Golub
- Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Suneeta Monga
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Sunita Vohra
- Departments of Pediatrics and Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Susan Marlin
- Clinical Trials Ontario, Toronto, Canada
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Wendy J Ungar
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Martin Offringa
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Division of Neonatology, The Hospital for Sick Children, Toronto, Ontario, Canada
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Butcher NJ, Monsour A, Mew EJ, Chan AW, Moher D, Mayo-Wilson E, Terwee CB, Chee-A-Tow A, Baba A, Gavin F, Grimshaw JM, Kelly LE, Saeed L, Thabane L, Askie L, Smith M, Farid-Kapadia M, Williamson PR, Szatmari P, Tugwell P, Golub RM, Monga S, Vohra S, Marlin S, Ungar WJ, Offringa M. Guidelines for Reporting Outcomes in Trial Reports: The CONSORT-Outcomes 2022 Extension. JAMA 2022; 328:2252-2264. [PMID: 36511921 DOI: 10.1001/jama.2022.21022] [Citation(s) in RCA: 86] [Impact Index Per Article: 43.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
IMPORTANCE Clinicians, patients, and policy makers rely on published results from clinical trials to help make evidence-informed decisions. To critically evaluate and use trial results, readers require complete and transparent information regarding what was planned, done, and found. Specific and harmonized guidance as to what outcome-specific information should be reported in publications of clinical trials is needed to reduce deficient reporting practices that obscure issues with outcome selection, assessment, and analysis. OBJECTIVE To develop harmonized, evidence- and consensus-based standards for reporting outcomes in clinical trial reports through integration with the Consolidated Standards of Reporting Trials (CONSORT) 2010 statement. EVIDENCE REVIEW Using the Enhancing the Quality and Transparency of Health Research (EQUATOR) methodological framework, the CONSORT-Outcomes 2022 extension of the CONSORT 2010 statement was developed by (1) generation and evaluation of candidate outcome reporting items via consultation with experts and a scoping review of existing guidance for reporting trial outcomes (published within the 10 years prior to March 19, 2018) identified through expert solicitation, electronic database searches of MEDLINE and the Cochrane Methodology Register, gray literature searches, and reference list searches; (2) a 3-round international Delphi voting process (November 2018-February 2019) completed by 124 panelists from 22 countries to rate and identify additional items; and (3) an in-person consensus meeting (April 9-10, 2019) attended by 25 panelists to identify essential items for the reporting of outcomes in clinical trial reports. FINDINGS The scoping review and consultation with experts identified 128 recommendations relevant to reporting outcomes in trial reports, the majority (83%) of which were not included in the CONSORT 2010 statement. All recommendations were consolidated into 64 items for Delphi voting; after the Delphi survey process, 30 items met criteria for further evaluation at the consensus meeting and possible inclusion in the CONSORT-Outcomes 2022 extension. The discussions during and after the consensus meeting yielded 17 items that elaborate on the CONSORT 2010 statement checklist items and are related to completely defining and justifying the trial outcomes, including how and when they were assessed (CONSORT 2010 statement checklist item 6a), defining and justifying the target difference between treatment groups during sample size calculations (CONSORT 2010 statement checklist item 7a), describing the statistical methods used to compare groups for the primary and secondary outcomes (CONSORT 2010 statement checklist item 12a), and describing the prespecified analyses and any outcome analyses not prespecified (CONSORT 2010 statement checklist item 18). CONCLUSIONS AND RELEVANCE This CONSORT-Outcomes 2022 extension of the CONSORT 2010 statement provides 17 outcome-specific items that should be addressed in all published clinical trial reports and may help increase trial utility, replicability, and transparency and may minimize the risk of selective nonreporting of trial results.
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Affiliation(s)
- Nancy J Butcher
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Andrea Monsour
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Emma J Mew
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
- Department of Chronic Disease Epidemiology, School of Public Health, Yale University, New Haven, Connecticut
| | - An-Wen Chan
- Department of Medicine, Women's College Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - David Moher
- Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Evan Mayo-Wilson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill
| | - Caroline B Terwee
- Amsterdam University Medical Centers, Vrije Universiteit, Department of Epidemiology and Data Science, Amsterdam, the Netherlands
- Department of Methodology, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Alyssandra Chee-A-Tow
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Ami Baba
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Frank Gavin
- public panel member, Toronto, Ontario, Canada
| | - Jeremy M Grimshaw
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Lauren E Kelly
- Department of Pharmacology and Therapeutics, University of Manitoba, Winnipeg, Canada
- Children's Hospital Research Institute of Manitoba, Winnipeg, Canada
| | - Leena Saeed
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Lehana Thabane
- Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Lisa Askie
- NHMRC Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia
| | | | - Mufiza Farid-Kapadia
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Paula R Williamson
- MRC-NIHR Trials Methodology Research Partnership, Department of Health Data Science, University of Liverpool, Liverpool, England
| | - Peter Szatmari
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Peter Tugwell
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Bruyère Research Institute, Ottawa, Ontario, Canada
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Robert M Golub
- Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Suneeta Monga
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Sunita Vohra
- Departments of Pediatrics and Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Susan Marlin
- Clinical Trials Ontario, Toronto, Canada
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Wendy J Ungar
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Martin Offringa
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Division of Neonatology, The Hospital for Sick Children, Toronto, Ontario, Canada
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Ciani O, Manyara AM, Chan AW, Taylor RS. Surrogate endpoints in trials: a call for better reporting. Trials 2022; 23:991. [PMID: 36503559 PMCID: PMC9743760 DOI: 10.1186/s13063-022-06904-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 11/08/2022] [Indexed: 12/14/2022] Open
Abstract
Using a surrogate endpoint as a substitute for a patient-relevant final outcome enables randomised controlled trials (RCTs) to be conducted more efficiently. However, the use of surrogates remains controversial and there is currently no guideline for the reporting of RCTs using surrogate endpoints; therefore, we seek to develop SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) and CONSORT (Consolidated Standards of Reporting Trials) extensions to improve the reporting of these trials. We would like to invite interested individuals (trial methodologists, journal editors, healthcare industry, regulators and payers, and patient/public representative groups), particularly those with experience in the use of surrogate endpoints in trials.
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Affiliation(s)
- Oriana Ciani
- grid.7945.f0000 0001 2165 6939SDA Bocconi School of Management, Milan, Italy
| | - Anthony M. Manyara
- grid.416221.20000 0000 8625 3965MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - An-Wen Chan
- grid.17063.330000 0001 2157 2938Women’s College Institute Research Institute and Department of Medicine, University of Toronto, Toronto, Canada
| | - Rod S. Taylor
- grid.8756.c0000 0001 2193 314XMRC/CSO Social and Public Health Sciences Unit & Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Berkeley Square, 99 Berkeley St, Glasgow, G3 7HR Scotland, UK
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Brooks SG, Pawluk MA, Litvinov IV, Fradette J, Chan AW, Philip A, Croitoru D, Richardson KC. Informing a Canadian Skin Science Trainee Program Based on the State of Trainee Programs Offered by International Academic Societies. J Cutan Med Surg 2022; 27:20-27. [PMID: 36408849 PMCID: PMC9902982 DOI: 10.1177/12034754221137570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND For dermatology to effectively address the ever-growing medical needs, longstanding communication barriers across investigators working in different research pillars and practicing clinicians must be improved. To address this problem, trainee-specific programs are now evolving to align their educational landscape across basic science, translational and clinical research programs. OBJECTIVES To establish a Skin Investigation Network of Canada (SkIN Canada) training roadmap for the career and skill development of future clinicians, clinican scientists and basic scientists in Canada. This Working Group aims to strengthen and harmonize collaborations and capacity across the skin research community. METHODS The Working Group conducted a search of established international academic societies which offered trainee programs with mandates similar to SkIN Canada. Societies' program items and meetings were evaluated by use of an interview survey and/or the collection of publicly available data. Program logistics, objectives and feedback were assessed for commonalities and factors reported or determined to improve trainee experience. RESULTS Through the various factors explored, the Working Group discovered the need for increasing program accessibility, creating opportunities for soft skill development, emphasizing the importance of current challenges, collecting and responding to feedback, and improving knowledge sharing to bridge pillars of skin research. CONCLUSIONS Although improvements have been made to trainee education in recent years, a plurality of approaches exist and many of the underlying roadblocks remain unresolved. To establish fundamental clinician-basic scientist collaboration and training efforts, this Working Group highlights important factors to include and consider in building a trainee program and emphasizes the importance of trainee education.
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Affiliation(s)
- Stephanie G. Brooks
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Megan A. Pawluk
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada, International Collaboration on Repair Discoveries (ICORD), Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, BC, Canada
| | - Ivan V. Litvinov
- SkIN Canada Training Committee, Canada, Division of Dermatology, Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Julie Fradette
- Department of Surgery, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada, CHU de Québec-Université Laval Research Center, Quebec City, Quebec, Canada, Centre de Recherche en Organogénèse Expérimentale de l’Université Laval/LOEX, Québec City, Québec, Canada
| | - An-Wen Chan
- SkIN Canada Training Committee, Canada, Women’s College Research Institute, Department of Medicine, University of Toronto, Toronto, Ontario, Canada, Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Anie Philip
- SkIN Canada Training Committee, Canada, Division of Plastic Surgery, Department of Surgery, McGill University, Montreal, Quebec, Canada
| | - David Croitoru
- SkIN Canada Training Committee, Canada, Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada,David Croitoru, Women’s College Hospital, 76 Grenville St., Toronto, Ontario M5S 1B2, Canada;
| | - Katlyn C. Richardson
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada, International Collaboration on Repair Discoveries (ICORD), Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, BC, Canada, SkIN Canada Training Committee, Canada,Katlyn C. Richardson, ICORD Centre, Blusson Spinal Cord Centre, 818 West 10th Ave. Vancouver, BC V5Z 1M9, Canada;
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Katz L, Woolman M, Kiyota T, Pires L, Zaidi M, Hofer SO, Leong W, Wouters BG, Ghazarian D, Chan AW, Ginsberg HJ, Aman A, Wilson BC, Berman HK, Zarrine-Afsar A. Picosecond Infrared Laser Mass Spectrometry Identifies a Metabolite Array for 10 s Diagnosis of Select Skin Cancer Types: A Proof-of-Concept Feasibility Study. Anal Chem 2022; 94:16821-16830. [DOI: 10.1021/acs.analchem.2c03918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Lauren Katz
- Techna Institute for the Advancement of Technology for Health, University Health Network, 100 College Street, Toronto, Ontario M5G 1P5, Canada
- Department of Medical Biophysics, University of Toronto, 101 College Street, Toronto, Ontario M5G 1L7, Canada
| | - Michael Woolman
- Techna Institute for the Advancement of Technology for Health, University Health Network, 100 College Street, Toronto, Ontario M5G 1P5, Canada
- Department of Medical Biophysics, University of Toronto, 101 College Street, Toronto, Ontario M5G 1L7, Canada
| | - Taira Kiyota
- Ontario Institute for Cancer Research (OICR), 661 University Ave Suite 510, Toronto, Ontario M5G 0A3, Canada
| | - Layla Pires
- Department of Medical Biophysics, University of Toronto, 101 College Street, Toronto, Ontario M5G 1L7, Canada
- Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, Toronto, Ontario M5G 2C1, Canada
| | - Mark Zaidi
- Department of Medical Biophysics, University of Toronto, 101 College Street, Toronto, Ontario M5G 1L7, Canada
| | - Stefan O.P. Hofer
- Techna Institute for the Advancement of Technology for Health, University Health Network, 100 College Street, Toronto, Ontario M5G 1P5, Canada
- Department of Surgery, University of Toronto, 149 College Street, Toronto, Ontario M5T 1P5, Canada
- Division of Plastic and Reconstructive Surgery, Department of Surgery and Surgical Oncology, University Health Network, University of Toronto. Toronto General Hospital, 200 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada
| | - Wey Leong
- Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, Toronto, Ontario M5G 2C1, Canada
- Department of Surgery, University of Toronto, 149 College Street, Toronto, Ontario M5T 1P5, Canada
- Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto Ontario M5G 2C1, Canada
| | - Brad G. Wouters
- Techna Institute for the Advancement of Technology for Health, University Health Network, 100 College Street, Toronto, Ontario M5G 1P5, Canada
- Department of Medical Biophysics, University of Toronto, 101 College Street, Toronto, Ontario M5G 1L7, Canada
- Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, Toronto, Ontario M5G 2C1, Canada
| | - Danny Ghazarian
- Department of Laboratory Medicine and Pathobiology, University of Toronto and University Health Network, 200 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada
| | - An-Wen Chan
- Division of Dermatology, Department of Medicine, University of Toronto, Canada and Women’s College Research Institute, Women’s College Hospital, 76 Grenville St, Toronto, Ontario M5S 1B2, Canada
| | - Howard J. Ginsberg
- Techna Institute for the Advancement of Technology for Health, University Health Network, 100 College Street, Toronto, Ontario M5G 1P5, Canada
- Department of Surgery, University of Toronto, 149 College Street, Toronto, Ontario M5T 1P5, Canada
- Keenan Research Center for Biomedical Science & the Li Ka Shing Knowledge Institute, St. Michael’s Hospital, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada
| | - Ahmed Aman
- Ontario Institute for Cancer Research (OICR), 661 University Ave Suite 510, Toronto, Ontario M5G 0A3, Canada
- Leslie Dan, Faculty of Pharmacy, University of Toronto, 144 College St, Toronto, Ontario M5S 3M2, Canada
| | - Brian C. Wilson
- Department of Medical Biophysics, University of Toronto, 101 College Street, Toronto, Ontario M5G 1L7, Canada
- Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, Toronto, Ontario M5G 2C1, Canada
| | - Hal K. Berman
- Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, Toronto, Ontario M5G 2C1, Canada
- Laboratory Medicine Program, University Health Network, 200 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada
| | - Arash Zarrine-Afsar
- Techna Institute for the Advancement of Technology for Health, University Health Network, 100 College Street, Toronto, Ontario M5G 1P5, Canada
- Department of Medical Biophysics, University of Toronto, 101 College Street, Toronto, Ontario M5G 1L7, Canada
- Department of Surgery, University of Toronto, 149 College Street, Toronto, Ontario M5T 1P5, Canada
- Keenan Research Center for Biomedical Science & the Li Ka Shing Knowledge Institute, St. Michael’s Hospital, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada
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Manyara AM, Davies P, Stewart D, Weir CJ, Young A, Butcher NJ, Bujkiewicz S, Chan AW, Collins GS, Dawoud D, Offringa M, Ouwens M, Ross JS, Taylor RS, Ciani O. Protocol for the development of SPIRIT and CONSORT extensions for randomised controlled trials with surrogate primary endpoints: SPIRIT-SURROGATE and CONSORT-SURROGATE. BMJ Open 2022; 12:e064304. [PMID: 36220321 PMCID: PMC9557267 DOI: 10.1136/bmjopen-2022-064304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 09/27/2022] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Randomised controlled trials (RCTs) may use surrogate endpoints as substitutes and predictors of patient-relevant/participant-relevant final outcomes (eg, survival, health-related quality of life). Translation of effects measured on a surrogate endpoint into health benefits for patients/participants is dependent on the validity of the surrogate; hence, more accurate and transparent reporting on surrogate endpoints is needed to limit misleading interpretation of trial findings. However, there is currently no explicit guidance for the reporting of such trials. Therefore, we aim to develop extensions to the SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) and CONSORT (Consolidated Standards of Reporting Trials) reporting guidelines to improve the design and completeness of reporting of RCTs and their protocols using a surrogate endpoint as a primary outcome. METHODS AND ANALYSIS The project will have four phases: phase 1 (literature reviews) to identify candidate reporting items to be rated in a Delphi study; phase 2 (Delphi study) to rate the importance of items identified in phase 1 and receive suggestions for additional items; phase 3 (consensus meeting) to agree on final set of items for inclusion in the extensions and phase 4 (knowledge translation) to engage stakeholders and disseminate the project outputs through various strategies including peer-reviewed publications. Patient and public involvement will be embedded into all project phases. ETHICS AND DISSEMINATION The study has received ethical approval from the University of Glasgow College of Medical, Veterinary and Life Sciences Ethics Committee (project no: 200210051). The findings will be published in open-access peer-reviewed publications and presented in conferences, meetings and relevant forums.
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Affiliation(s)
- Anthony Muchai Manyara
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, Glasgow, UK, University of Glasgow, Glasgow, UK
| | - Philippa Davies
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Christopher J Weir
- Edinburgh Clinical Trials Unit, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Amber Young
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Nancy J Butcher
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Child Health Evaluation Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Sylwia Bujkiewicz
- Biostatistics Research Group, Department of Health Sciences, University of Leicester, Leicester, UK
| | - An-Wen Chan
- Women's College Institute Research Institute, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Gary S Collins
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences, Oxford University, Oxford, UK
| | - Dalia Dawoud
- National Institute for Health and Care Excellence, London, UK
| | - Martin Offringa
- Child Health Evaluation Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
| | | | - Joseph S Ross
- Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut, USA
- Section of General Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Rod S Taylor
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, Glasgow, UK, University of Glasgow, Glasgow, UK
- Robertson Centre for Biostatistics, School of Health and Well Being, University of Glasgow, Glasgow, UK
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Hopewell S, Boutron I, Chan AW, Collins GS, de Beyer JA, Hróbjartsson A, Nejstgaard CH, Østengaard L, Schulz KF, Tunn R, Moher D. An update to SPIRIT and CONSORT reporting guidelines to enhance transparency in randomized trials. Nat Med 2022; 28:1740-1743. [PMID: 36109642 DOI: 10.1038/s41591-022-01989-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Sally Hopewell
- Oxford Clinical Trials Research Unit / Centre for Statistics in Medicine, University of Oxford, Oxford, UK.
| | - Isabelle Boutron
- Université Paris Cité, Inserm, INRAE, Centre de Recherche Epidémiologie et Statistiques, Université Paris Cité, Paris, France
- Centre d'Epidémiologie Clinique, AP-HP, Hôpital Hôtel Dieu, Paris, France
| | - An-Wen Chan
- Department of Medicine, Women's College Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Gary S Collins
- UK EQUATOR Centre/Centre for Statistics in Medicine, University of Oxford, Oxford, UK
| | - Jennifer A de Beyer
- UK EQUATOR Centre/Centre for Statistics in Medicine, University of Oxford, Oxford, UK
| | - Asbjørn Hróbjartsson
- Centre for Evidence-Based Medicine Odense and Cochrane Denmark, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Open Patient Data Explorative Network, Odense University Hospital, Odense, Denmark
| | - Camilla Hansen Nejstgaard
- Centre for Evidence-Based Medicine Odense and Cochrane Denmark, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Open Patient Data Explorative Network, Odense University Hospital, Odense, Denmark
| | - Lasse Østengaard
- Centre for Evidence-Based Medicine Odense and Cochrane Denmark, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Open Patient Data Explorative Network, Odense University Hospital, Odense, Denmark
| | - Kenneth F Schulz
- Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ruth Tunn
- Oxford Clinical Trials Research Unit / Centre for Statistics in Medicine, University of Oxford, Oxford, UK
| | - David Moher
- Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
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Lam M, Monaghan C, Chan AW, Drucker AM. BT16: Telephone consultations in the
COVID
‐19 era versus
pre‐COVID
face‐to‐face consultations: a survey of secondary care dermatology patient perceptions. Br J Dermatol 2022. [PMID: 35060632 PMCID: PMC9349846 DOI: 10.1111/bjd.21389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Megan Lam
- Michael G. DeGroote School of Medicine, Faculty of Medicine, McMaster University, Hamilton, ON, Canada
| | - Caitlin Monaghan
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - An-Wen Chan
- Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada
- Division of Dermatology, University of Toronto, Toronto, ON, Canada
| | - Aaron M Drucker
- Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada
- Division of Dermatology, University of Toronto, Toronto, ON, Canada
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Kim KS, Chan AW, Belley-Côté EP, Drucker AM. Noninferiority Randomized Controlled Trials. J Invest Dermatol 2022; 142:1773-1777. [PMID: 35715156 DOI: 10.1016/j.jid.2022.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 04/08/2022] [Accepted: 04/25/2022] [Indexed: 12/01/2022]
Abstract
From 2005 to 2015, the publication of noninferiority trials increased by six-fold. Noninferiority trials assess whether a new treatment's efficacy is comparable with that of the standard of care and have several appeals. Noninferiority trials can evaluate for both noninferiority and superiority of a new treatment. In addition, multiple treatment modalities exist, and new treatments may be advantageous for reasons beyond efficacy. Common elements of trial design such as the research question, outcomes, statistical analysis, and interpretation of results differ meaningfully between noninferiority trials and superiority trials. The noninferiority margin, constancy assumption, and assay sensitivity are unique aspects of noninferiority trials. As with all randomized controlled trials, patient engagement in and reporting of noninferiority trials are also important. In this review, we discuss the methodological considerations and limitations of noninferiority trials.
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Affiliation(s)
- Kevin S Kim
- Department of Health Research Methodology, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada; Population Health Research Institute, Hamilton, Ontario, Canada.
| | - An-Wen Chan
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
| | - Emilie P Belley-Côté
- Population Health Research Institute, Hamilton, Ontario, Canada; Division of Cardiology, Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Aaron M Drucker
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
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38
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Sachdeva M, Lara-Corrales I, Pope E, Chan AW, Parekh RS, Kitchlu A, Sibbald C. Incidence of and Risk Factors for Keratinocyte Carcinoma After Pediatric Solid Organ Transplant. JAMA Dermatol 2022; 158:828-831. [PMID: 35675056 DOI: 10.1001/jamadermatol.2022.1960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
| | - Irene Lara-Corrales
- Division of Pediatric Dermatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Elena Pope
- Division of Pediatric Dermatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - An-Wen Chan
- Division of Dermatology, Department of Medicine, Women's College Hospital, Toronto, Canada.,Division of Nephrology, University Health Network, Toronto, Ontario, Canada
| | - Rulan S Parekh
- Division of Nephrology, University Health Network, Toronto, Ontario, Canada.,Division of Pediatric Nephrology, Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Medicine, Women's College Hospital Toronto, Ontario, Canada.,Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Abhijat Kitchlu
- Division of Nephrology, University Health Network, Toronto, Ontario, Canada
| | - Cathryn Sibbald
- Division of Pediatric Dermatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.,Division of Dermatology, Department of Medicine, Women's College Hospital, Toronto, Canada
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Drucker AM, Bai L, Eder L, Chan AW, Pope E, Tu K, Jaakkimainen L. Sociodemographic characteristics and emergency department visits and inpatient hospitalizations for atopic dermatitis in Ontario: a cross-sectional study. CMAJ Open 2022; 10:E491-E499. [PMID: 35672041 PMCID: PMC9177197 DOI: 10.9778/cmajo.20210194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Some jurisdictions experience sociodemographic disparities in atopic dermatitis care, including emergency department visits, but data from Canada are limited. Our objectives were to estimate the prevalence of atopic dermatitis in Ontario and to identify sociodemographic factors associated with emergency department visits and hospitalizations for this condition. METHODS We conducted a cross-sectional analysis of patients in the Electronic Medical Record Primary Care database linked with administrative health data for Ontario, Canada. We estimated period prevalence and health service utilization for atopic dermatitis from 2005 to 2015. We used multivariable log-binomial regression to calculate adjusted risk ratios (RRs) and 95% confidence intervals (CIs) for associations between local dermatologist density and the proportion of emergency department visits and hospitalizations for atopic dermatitis. RESULTS Among 249 984 patients, we identified 7812 with atopic dermatitis (period prevalence 2005-2015: 3.1%). Almost all physician visits for atopic dermatitis were to primary care physicians (> 99%). For every additional dermatologist per 100 000 population, the proportions of emergency department visits and hospitalizations for atopic dermatitis increased by 29% (RR 1.29, 95% CI 1.05-1.57). This relationship occurred in and around Toronto but was not consistent across the province. INTERPRETATION In Ontario, higher dermatologist density was not associated with lower emergency department utilization and hospitalization for atopic dermatitis; the association varied in different locales with similar dermatologist densities. Strategies to improve access to care for atopic dermatitis should be tailored to local contexts.
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Affiliation(s)
- Aaron M Drucker
- Department of Medicine (Drucker, Eder, Chan), University of Toronto; Women's College Research Institute (Drucker, Eder, Chan), Women's College Hospital; ICES Central (Drucker, Bai, Chan, Jaakkimainen); Department of Pediatrics (Pope), University of Toronto; Section of Pediatric Dermatology (Pope), Department of Pediatrics, Hospital for Sick Children; North York General Hospital (Tu), Toronto Western Hospital Family Health Team (Tu), University Health Network; Department of Family and Community Medicine (Tu, Jaakkimainen), University of Toronto; Sunnybrook Health Sciences Centre (Jaakkimainen), Toronto, Ont.
| | - Li Bai
- Department of Medicine (Drucker, Eder, Chan), University of Toronto; Women's College Research Institute (Drucker, Eder, Chan), Women's College Hospital; ICES Central (Drucker, Bai, Chan, Jaakkimainen); Department of Pediatrics (Pope), University of Toronto; Section of Pediatric Dermatology (Pope), Department of Pediatrics, Hospital for Sick Children; North York General Hospital (Tu), Toronto Western Hospital Family Health Team (Tu), University Health Network; Department of Family and Community Medicine (Tu, Jaakkimainen), University of Toronto; Sunnybrook Health Sciences Centre (Jaakkimainen), Toronto, Ont
| | - Lihi Eder
- Department of Medicine (Drucker, Eder, Chan), University of Toronto; Women's College Research Institute (Drucker, Eder, Chan), Women's College Hospital; ICES Central (Drucker, Bai, Chan, Jaakkimainen); Department of Pediatrics (Pope), University of Toronto; Section of Pediatric Dermatology (Pope), Department of Pediatrics, Hospital for Sick Children; North York General Hospital (Tu), Toronto Western Hospital Family Health Team (Tu), University Health Network; Department of Family and Community Medicine (Tu, Jaakkimainen), University of Toronto; Sunnybrook Health Sciences Centre (Jaakkimainen), Toronto, Ont
| | - An-Wen Chan
- Department of Medicine (Drucker, Eder, Chan), University of Toronto; Women's College Research Institute (Drucker, Eder, Chan), Women's College Hospital; ICES Central (Drucker, Bai, Chan, Jaakkimainen); Department of Pediatrics (Pope), University of Toronto; Section of Pediatric Dermatology (Pope), Department of Pediatrics, Hospital for Sick Children; North York General Hospital (Tu), Toronto Western Hospital Family Health Team (Tu), University Health Network; Department of Family and Community Medicine (Tu, Jaakkimainen), University of Toronto; Sunnybrook Health Sciences Centre (Jaakkimainen), Toronto, Ont
| | - Elena Pope
- Department of Medicine (Drucker, Eder, Chan), University of Toronto; Women's College Research Institute (Drucker, Eder, Chan), Women's College Hospital; ICES Central (Drucker, Bai, Chan, Jaakkimainen); Department of Pediatrics (Pope), University of Toronto; Section of Pediatric Dermatology (Pope), Department of Pediatrics, Hospital for Sick Children; North York General Hospital (Tu), Toronto Western Hospital Family Health Team (Tu), University Health Network; Department of Family and Community Medicine (Tu, Jaakkimainen), University of Toronto; Sunnybrook Health Sciences Centre (Jaakkimainen), Toronto, Ont
| | - Karen Tu
- Department of Medicine (Drucker, Eder, Chan), University of Toronto; Women's College Research Institute (Drucker, Eder, Chan), Women's College Hospital; ICES Central (Drucker, Bai, Chan, Jaakkimainen); Department of Pediatrics (Pope), University of Toronto; Section of Pediatric Dermatology (Pope), Department of Pediatrics, Hospital for Sick Children; North York General Hospital (Tu), Toronto Western Hospital Family Health Team (Tu), University Health Network; Department of Family and Community Medicine (Tu, Jaakkimainen), University of Toronto; Sunnybrook Health Sciences Centre (Jaakkimainen), Toronto, Ont
| | - Liisa Jaakkimainen
- Department of Medicine (Drucker, Eder, Chan), University of Toronto; Women's College Research Institute (Drucker, Eder, Chan), Women's College Hospital; ICES Central (Drucker, Bai, Chan, Jaakkimainen); Department of Pediatrics (Pope), University of Toronto; Section of Pediatric Dermatology (Pope), Department of Pediatrics, Hospital for Sick Children; North York General Hospital (Tu), Toronto Western Hospital Family Health Team (Tu), University Health Network; Department of Family and Community Medicine (Tu, Jaakkimainen), University of Toronto; Sunnybrook Health Sciences Centre (Jaakkimainen), Toronto, Ont
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Lancee M, Schuring M, Tijdink JK, Chan AW, Vinkers CH, Luykx JJ. Selective outcome reporting across psychopharmacotherapy randomized controlled trials. Int J Methods Psychiatr Res 2022; 31:e1900. [PMID: 34766419 PMCID: PMC8886282 DOI: 10.1002/mpr.1900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 09/11/2021] [Accepted: 10/27/2021] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE Selective reporting impairs the valid interpretation of trials and leads to bias with regards to the clinical evidence. We aimed to examine factors associated with selective reporting in psychopharmacotherapy trials and thus enable solutions to prevent such selective reporting in the future. METHODS We retrieved all registry records of trials investigating medication for depressive, bipolar and psychotic disorders. Multivariate logistic regression was performed with selective reporting as outcome, and funding source, psychiatric disorder, year of study start date, participating centers, and anticipated sample size as explanatory variables, after testing for multicollinearity. Adjusted odds ratios (AOR) were calculated. Two-sided Fisher exact test was used to compare the proportions of newly added positive primary outcomes with the proportions of positive results in the overall group of primary outcomes. RESULTS Of 151 included trials (N = 94,303 participants), 21 (14%) showed irregularities between registered and published primary outcomes. Higher odds of such irregularities were associated with non-industry-funded RCTs (AOR 5.3; p = 0.014) and trials investigating major depressive disorder (AOR 12.7; p = 0.024) or schizophrenia (AOR 14.5; p = 0.016; Table 1). CONCLUSION We demonstrate discrepancies between trial registrations and publications across RCTs investigating debilitating psychiatric disorders, especially in non-industry funded RCTs.
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Affiliation(s)
- Michelle Lancee
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht (UMCU), Utrecht University, Utrecht, The Netherlands
| | - Marleen Schuring
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht (UMCU), Utrecht University, Utrecht, The Netherlands
| | - Joeri K Tijdink
- Department of Philosophy, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - An-Wen Chan
- Department of Medicine, Women's College Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Christiaan H Vinkers
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute and Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Jurjen J Luykx
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht (UMCU), Utrecht University, Utrecht, The Netherlands.,Second Opinion Outpatient Clinic, GGnet Mental Health, Warnsveld, The Netherlands.,Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
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41
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Sachdeva M, Lara-Corrales I, Pope E, Chan AW, Parekh RS, Kitchlu A, Sibbald C. Outcomes of skin cancers in pediatric solid organ transplant patients: A systematic review. Pediatr Transplant 2022; 26:e14146. [PMID: 34562053 DOI: 10.1111/petr.14146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 09/02/2021] [Accepted: 09/08/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND The most frequently reported malignancies after solid organ transplant are cutaneous, but data on the risk in pediatric populations varies across studies. OBJECTIVES To perform a systematic review including reported features and outcomes of skin cancers in pediatric solid organ transplant recipients. METHODS EMBASE and MEDLINE were systematically searched (Prospero CRD42020201659). RESULTS The review summarizes data from 20 studies on 337 patients, with a median age ranging from 15.0 to 19.5 years as reported in 4 studies, who developed skin malignancies after pediatric solid organ transplantation. Median ages at transplant and skin cancer diagnosis ranged from 1.5 to 17.0 years and 15.3 to 33.5 years, respectively. Squamous cell carcinoma (SCC) was most commonly reported (218 cases), followed by basal cell carcinoma (BCC) (91 cases), melanoma (18 cases), and unspecified keratinocyte carcinomas (2 cases). The median latency period between transplantation and cancer diagnosis ranged from 2.2 to 21.0 years. Overall, 4 studies reported 17 cases of metastasis in total, and recurrence was reported in one case. Six deaths were reported in one study related to SCC and melanoma metastases. The incidence rate of skin cancer after pediatric transplantation per 100 person-years of follow-up was 2.1 based on 5 studies. CONCLUSION The most frequent post-transplant malignancy in pediatric organ transplant recipients was SCC.
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Affiliation(s)
| | - Irene Lara-Corrales
- Division of Dermatology, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Elena Pope
- Division of Dermatology, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - An-Wen Chan
- Division of Dermatology, Department of Medicine, Women's College Hospital, Toronto, ON, Canada
| | - Rulan S Parekh
- Division of Pediatric Nephrology, Department of Pediatrics, Hospital for Sick Children, Toronto, ON, Canada.,Division of Nephrology, Department of Medicine, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Abhijat Kitchlu
- Division of Nephrology, Department of Medicine, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Cathryn Sibbald
- Division of Dermatology, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.,Division of Dermatology, Department of Medicine, Women's College Hospital, Toronto, ON, Canada
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Bridgman AC, McPhie ML, Voineskos SH, Chan AW, Drucker AM. Reporting of primary outcome measures and sample size calculations in randomized controlled trials in dermatology journals. J Am Acad Dermatol 2021; 87:912-914. [PMID: 34933040 DOI: 10.1016/j.jaad.2021.12.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 12/03/2021] [Accepted: 12/11/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Alanna C Bridgman
- Division of Dermatology, Department of Medicine, University of Toronto, Ontario, Canada
| | - Meghan L McPhie
- Department of Family and Community Medicine, University of Toronto, Ontario, Canada
| | - Sophocles H Voineskos
- Division of Plastic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada; Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada
| | - An-Wen Chan
- Division of Dermatology, Department of Medicine, University of Toronto, Ontario, Canada; Division of Dermatology, Department of Medicine and Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
| | - Aaron M Drucker
- Division of Dermatology, Department of Medicine, University of Toronto, Ontario, Canada; Division of Dermatology, Department of Medicine and Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.
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Speich B, Gloy VL, Klatte K, Gryaznov D, Taji Heravi A, Ghosh N, Marian IR, Lee H, Mansouri A, Lohner S, Saccilotto R, Nury E, Chan AW, Blümle A, Odutayo A, Hopewell S, Briel M. Reliability of Trial Information Across Registries for Trials With Multiple Registrations: A Systematic Review. JAMA Netw Open 2021; 4:e2128898. [PMID: 34724557 PMCID: PMC8561329 DOI: 10.1001/jamanetworkopen.2021.28898] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Clinical trial registries are important for gaining an overview of ongoing research efforts and for deterring and identifying publication bias and selective outcome reporting. The reliability of the information in trial registries is uncertain. OBJECTIVE To assess the reliability of information across registries for trials with multiple registrations. EVIDENCE REVIEW For this systematic review, 360 protocols of randomized clinical trials (RCTs) approved by research ethics committees in Switzerland, the UK, Canada, and Germany in 2012 were evaluated. Clinical trial registries were searched from March to September 2019 for corresponding registrations of these RCTs. For RCTS that were recorded in more than 1 clinical trial registry, key trial characteristics that should be identical among all trial registries (ie, sponsor, funding source, primary outcome, target sample size, trial status, date of first patient enrollment, results available, and main publication indexed) were extracted in duplicate. Agreement between the different trial registries for these key characteristics was analyzed descriptively. Data analyses were conducted from May 1 to November 30, 2020. Representatives from clinical trial registries were interviewed to discuss the study findings between February 1 and March 31, 2021. FINDINGS The analysis included 197 RCTs registered in more than 1 trial registry (151 in 2 registries and 46 in 3 registries), with 188 trials in ClinicalTrials.gov, 185 in the European Union Drug Regulating Authorities Clinical Trials Database (EudraCT), 20 in ISRCTN, and 47 in other registries. The agreement of key information across all registries was as follows: 178 of 197 RCTs (90%; 95% CI, 85%-94%) for sponsor, 18 of 20 (90%; 95% CI, 68%-99%) for funding source (funding was not reported on ClinicalTrials.gov), 154 of 197 (78%; 95% CI, 72%-84%) for primary outcome, 90 of 197 (46%; 95% CI, 39%-53%) for trial status, 122 of 194 (63%; 95% CI, 56%-70%) for target sample size, and 43 of 57 (75%; 95% CI, 62%-86%) for the date of first patient enrollment when the comparison time was increased to 30 days (date of first patient enrollment was not reported on EudraCT). For results availability in trial registries, agreement was 122 of 197 RCTs (62%; 95% CI, 55%-69%) for summary data reported in the registry and 91 of 197 (46%; 95% CI, 39%-53%) for whether a published article with the main results was indexed. Different legal requirements were stated as the main reason for inconsistencies by representatives of clinical trial registries. CONCLUSIONS AND RELEVANCE In this systematic review, for a substantial proportion of registered RCTs, information about key trial characteristics was inconsistent across trial registries, raising concerns about the reliability of the information provided in these registries. Further harmonization across clinical trial registries may be necessary to increase their usefulness.
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Affiliation(s)
- Benjamin Speich
- Basel Institute for Clinical Epidemiology and Biostatistics, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
| | - Viktoria L. Gloy
- Basel Institute for Clinical Epidemiology and Biostatistics, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Katharina Klatte
- Clinical Trial Unit, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Dmitry Gryaznov
- Basel Institute for Clinical Epidemiology and Biostatistics, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Ala Taji Heravi
- Basel Institute for Clinical Epidemiology and Biostatistics, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Nilabh Ghosh
- Department of Neurosurgery and Department of Biomedicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Ioana R. Marian
- Oxford Clinical Trials Research Unit, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
| | - Hopin Lee
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
| | - Anita Mansouri
- Oxford Clinical Trials Research Unit, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
| | - Szimonetta Lohner
- Cochrane Hungary, Clinical Centre of the University of Pécs, Medical School, University of Pécs, Pécs, Hungary
| | - Ramon Saccilotto
- Clinical Trial Unit, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Edris Nury
- Institute for Evidence in Medicine (for Cochrane Germany Foundation), Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - An-Wen Chan
- Department of Medicine, Women’s College Research Institute, Women’s College Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Anette Blümle
- Institute for Evidence in Medicine (for Cochrane Germany Foundation), Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Ayodele Odutayo
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
- Applied Health Research Centre, Li Ka Shing Knowledge Institute of St Michael's Hospital, Toronto, Ontario, Canada
| | - Sally Hopewell
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
| | - Matthias Briel
- Basel Institute for Clinical Epidemiology and Biostatistics, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
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Tang E, Fung K, Chan AW. Incidence and mortality rates of keratinocyte carcinoma from 1998-2017: a population-based study of sex differences in Ontario, Canada. CMAJ 2021; 193:E1516-E1524. [PMID: 34607845 PMCID: PMC8568084 DOI: 10.1503/cmaj.210595] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2021] [Indexed: 01/10/2023] Open
Abstract
Background: Keratinocyte carcinoma is the most common malignant disease, but it is not captured in major registries. We aimed to describe differences by sex in the incidence and mortality rates of keratinocyte carcinoma in Ontario, Canada. Methods: We conducted a population-based retrospective study of adults residing in Ontario between Jan. 1, 1998, and Dec. 31, 2017, using linked health administrative databases. We identified the first diagnosis of keratinocyte carcinoma using a validated algorithm of health insurance claims, and deaths related to keratinocyte carcinoma from death certificates. We calculated the incidence and mortality rates of keratinocyte carcinoma, stratified by sex, age and income quintile. We evaluated trends using the average annual percentage change (AAPC) based on joinpoint regression. Results: After decreasing from 1998 to 2003, the incidence rate of keratinocyte carcinoma increased by 30% to 369 per 100 000 males and 345 per 100 000 females in 2017 (AAPC 1.9%, 95% confidence interval [CI] 1.7 to 2.1 from 2003 to 2017). The incidence rate was higher in females younger than 55 years, but higher in males aged 55 years or older. Between 2008 and 2017, the incidence rate rose faster in females than males aged 45–54 years (AAPC 1.2% v. 0.5%, p = 0.01) and 55–64 years (1.2% v. 0.1%, p < 0.01). The incidence was higher in males than females in the higher income quintiles. Between 1998 and 2017, the mortality rate of keratinocyte carcinoma was 1.8 times higher in males than females, on average, and rose 4.8-fold overall (AAPC 8.9%, 95% CI 6.4 to 11.4 in males; 8.0%, 95% CI 5.3–10.8 in females). Interpretation: The population burden of keratinocyte carcinoma is growing, and the incidence and mortality rates rose disproportionately among certain sex- and age-specific groups. This warrants further investigation into causal factors and renewed preventive public health measures.
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Affiliation(s)
- Evan Tang
- Faculty of Medicine (Tang), University of Toronto; ICES (Fung, Chan); Division of Dermatology, Department of Medicine (Tang, Chan), Women's College Research Institute, Women's College Hospital, Toronto, Ont
| | - Kinwah Fung
- Faculty of Medicine (Tang), University of Toronto; ICES (Fung, Chan); Division of Dermatology, Department of Medicine (Tang, Chan), Women's College Research Institute, Women's College Hospital, Toronto, Ont
| | - An-Wen Chan
- Faculty of Medicine (Tang), University of Toronto; ICES (Fung, Chan); Division of Dermatology, Department of Medicine (Tang, Chan), Women's College Research Institute, Women's College Hospital, Toronto, Ont.
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Kendall TJ, Robinson M, Brierley DJ, Lim SJ, O'Connor DJ, Shaaban AM, Lewis I, Chan AW, Harrison DJ. Guidelines for cellular and molecular pathology content in clinical trial protocols: the SPIRIT-Path extension. Lancet Oncol 2021; 22:e435-e445. [PMID: 34592193 DOI: 10.1016/s1470-2045(21)00344-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/04/2021] [Accepted: 06/07/2021] [Indexed: 01/12/2023]
Abstract
The 2013 SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) Statement provides evidence-based recommendations for the minimum content to be included in a clinical trial protocol. Assessment of biospecimens is often required for trial eligibility or as part of an outcome evaluation, and precision molecular approaches are increasingly used in trial design. However, cellular and molecular pathology practices within trials have not been codified or formalised. We developed international consensus reporting guidelines for cellular and molecular pathology content in clinical trial protocols (the SPIRIT-Path extension) using an international Delphi process, which assesses candidate items generated from a previous systematic review, followed by an expert consensus meeting. 74 individuals from five continents responded, including clinicians, statisticians, laboratory scientists, patient advocates, funders, industry representatives, journal editors, and regulators. The SPIRIT-Path guidelines recommend 14 additional items (seven extensions to the SPIRIT checklist and seven elaborations) that should be addressed in trial protocols containing pathology content, alongside the SPIRIT 2013 Statement items. SPIRIT-Path recommends that protocols should document the individuals, processes, and standards for all cellular and molecular pathology components of the trial, including all stages of the specimen pathway and any digital pathology methods, with specific consideration of the value of trial data and biological tissues for additional translational studies.
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Affiliation(s)
- Timothy J Kendall
- Centre for Inflammation Research, University of Edinburgh, Edinburgh, UK.
| | - Max Robinson
- Department of Cellular Pathology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK
| | - Daniel J Brierley
- Unit of Oral and Maxillofacial Pathology, University of Sheffield, Sheffield, UK
| | - Shujing Jane Lim
- Department of Cellular Pathology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK
| | | | - Abeer M Shaaban
- Queen Elizabeth Hospital Birmingham, Birmingham, UK; University of Birmingham, Birmingham, UK
| | - Ian Lewis
- National Cancer Research Institute, London, UK
| | - An-Wen Chan
- Department of Medicine, Women's College Research Institute, University of Toronto, Toronto, ON, Canada
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McCarthy M, O'Keeffe L, Williamson PR, Sydes MR, Farrin A, Lugg-Widger F, Davies G, Avery K, Chan AW, Kwakkenbos L, Thombs BD, Watkins A, Hemkens LG, Gale C, Zwarenstein M, Langan SM, Thabane L, Juszczak E, Moher D, Kearney PM. A study protocol for the development of a SPIRIT extension for trials conducted using cohorts and routinely collected data (SPIRIT-ROUTINE). HRB Open Res 2021; 4:82. [PMID: 34877471 PMCID: PMC8609390 DOI: 10.12688/hrbopenres.13314.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2021] [Indexed: 11/23/2022] Open
Abstract
Background: Protocols are an essential document for conducting randomised controlled trials (RCTs). However, the completeness of the information provided is often inadequate. To help improve the content of trial protocols, an international group of stakeholders published the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) Initiative in 2013. Presently, there is increasing use of cohorts and routinely collected data (RCD) for RCTs because these data have the potential to improve efficiencies by facilitating recruitment, simplifying, and reducing the cost of data collection. Reporting guidelines have been shown to improve the quality of reporting, but there is currently no specific SPIRIT guidance on protocols for trials conducted using cohorts and RCD. This protocol outlines steps for developing SPIRIT-ROUTINE, which aims to address this gap by extending the SPIRIT guidance to protocols for trials conducted using cohorts and RCD. Methods: The development of the SPIRIT-ROUTINE extension comprises five stages. Stage 1 consists of a project launch and a meeting to finalise the membership of the steering group and scope of the extension. In Stage 2, a rapid review will be performed to identify possible modifications to the original SPIRIT 2013 checklist. Other key reporting guidelines will be reviewed to identify areas where additional items may be needed, such as the Consolidated Standards of Reporting Trials (CONSORT) extension for trials conducted using cohorts and RCD (CONSORT-ROUTINE). Stage 3 will involve an online Delphi exercise, consisting of two rounds and involving key international stakeholders to gather feedback on the preliminary checklist items. In Stage 4, a consensus meeting of the SPIRIT-ROUTINE steering group will finalise the items to include in the extension. Stage 5 will involve the publication preparation and dissemination of the final checklist. Conclusion: The SPIRIT-ROUTINE extension will contribute to improving design of trials using cohorts and RCD and transparency of reporting.
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Affiliation(s)
- Megan McCarthy
- School of Public Health, University College Cork, Cork, T12 XF62, Ireland
| | - Linda O'Keeffe
- School of Public Health, University College Cork, Cork, T12 XF62, Ireland
| | - Paula R. Williamson
- MRC/NIHR Trials Methodology Research Partnership, Department of Health Data Science, a member of Liverpool Health Partners, University of Liverpool, Liverpool, L69 3BX, UK
| | - Matthew R. Sydes
- MRC Clinical Trials Unit at UCL, University College London, London, WC1V 6LJ, UK
| | - Amanda Farrin
- CTRU at Leeds Institute for Clinical Trials Research, University of Leeds, Leeds, LS2 9JT, UK
| | - Fiona Lugg-Widger
- Centre for Trials Research, Cardiff University, Cardiff, CF14 4YS, UK
| | - Gwyneth Davies
- UCL Great Ormond Street Institute of Child Health, University College London, London, WC1N 1EH, UK
| | - Kerry Avery
- National Institute for Health Research Bristol Biomedical Research Centre and Bristol Centre for Surgical Research, Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, 1QU BS8, UK
| | - An-Wen Chan
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada
| | - Linda Kwakkenbos
- Department of Psychology, Radboud University, Nijmegen, 6525 XZ, The Netherlands
| | - Brett D. Thombs
- Faculty of Medicine, McGill University, Lady Davis Institute of Medical Research, Jewish General Hospital, Montreal, H3T 1E2, Canada
| | - Alan Watkins
- Swansea University Medical School, Swansea University, Swansea, SA2 8QA, UK
| | - Lars G. Hemkens
- Department of Clinical Research, University of Basel, Basel, Switzerland
| | - Chris Gale
- Neonatal Medicine, School of Public Health, Imperial College London, Chelsea and Westminster campus, London, SW7 2AZ, UK
| | | | - Sinead M. Langan
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Lehana Thabane
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, L8S 4K1, Canada
| | - Edmund Juszczak
- Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, NG7 2RD, UK
| | - David Moher
- Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON K1H 8L6, Canada
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Orkin AM, Gill PJ, Ghersi D, Campbell L, Sugarman J, Emsley R, Steg PG, Weijer C, Simes J, Rombey T, Williams HC, Wittes J, Moher D, Richards DP, Kasamon Y, Getz K, Hopewell S, Dickersin K, Wu T, Ayala AP, Schulz KF, Calleja S, Boutron I, Ross JS, Golub RM, Khan KM, Mulrow C, Siegfried N, Heber J, Lee N, Kearney PR, Wanyenze RK, Hróbjartsson A, Williams R, Bhandari N, Jüni P, Chan AW. Guidelines for Reporting Trial Protocols and Completed Trials Modified Due to the COVID-19 Pandemic and Other Extenuating Circumstances: The CONSERVE 2021 Statement. JAMA 2021; 326:257-265. [PMID: 34152382 DOI: 10.1001/jama.2021.9941] [Citation(s) in RCA: 134] [Impact Index Per Article: 44.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
IMPORTANCE Extenuating circumstances can trigger unplanned changes to randomized trials and introduce methodological, ethical, feasibility, and analytical challenges that can potentially compromise the validity of findings. Numerous randomized trials have required changes in response to the COVID-19 pandemic, but guidance for reporting such modifications is incomplete. OBJECTIVE As a joint extension for the CONSORT and SPIRIT reporting guidelines, CONSERVE (CONSORT and SPIRIT Extension for RCTs Revised in Extenuating Circumstances) aims to improve reporting of trial protocols and completed trials that undergo important modifications in response to extenuating circumstances. EVIDENCE A panel of 37 international trial investigators, patient representatives, methodologists and statisticians, ethicists, funders, regulators, and journal editors convened to develop the guideline. The panel developed CONSERVE following an accelerated, iterative process between June 2020 and February 2021 involving (1) a rapid literature review of multiple databases (OVID Medline, OVID EMBASE, and EBSCO CINAHL) and gray literature sources from 2003 to March 2021; (2) consensus-based panelist meetings using a modified Delphi process and surveys; and (3) a global survey of trial stakeholders. FINDINGS The rapid review yielded 41 673 citations, of which 38 titles were relevant, including emerging guidance from regulatory and funding agencies for managing the effects of the COVID-19 pandemic on trials. However, no generalizable guidance for all circumstances in which trials and trial protocols might face unanticipated modifications were identified. The CONSERVE panel used these findings to develop a consensus reporting guidelines following 4 rounds of meetings and surveys. Responses were received from 198 professionals from 34 countries, of whom 90% (n = 178) indicated that they understood the concept definitions and 85.4% (n = 169) indicated that they understood and could use the implementation tool. Feedback from survey respondents was used to finalize the guideline and confirm that the guideline's core concepts were applicable and had utility for the trial community. CONSERVE incorporates an implementation tool and checklists tailored to trial reports and trial protocols for which extenuating circumstances have resulted in important modifications to the intended study procedures. The checklists include 4 sections capturing extenuating circumstances, important modifications, responsible parties, and interim data analyses. CONCLUSIONS AND RELEVANCE CONSERVE offers an extension to CONSORT and SPIRIT that could improve the transparency, quality, and completeness of reporting important modifications to trials in extenuating circumstances such as COVID-19.
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Affiliation(s)
- Aaron M Orkin
- Division of Emergency Medicine, Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Peter J Gill
- Hospital for Sick Children, Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Davina Ghersi
- National Health and Medical Research Council, Canberra, Australia
| | - Lisa Campbell
- Clinical Trials Unit, Medicines and Healthcare Products Regulatory Agency, London, England
| | - Jeremy Sugarman
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland
| | - Richard Emsley
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, England
| | | | - Charles Weijer
- Departments of Medicine, Epidemiology and Biostatistics, and Philosophy, Western University, London, Ontario, Canada
| | - John Simes
- National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney, Australia
| | - Tanja Rombey
- Department of Health Care Management, Technische Universität Berlin, Berlin, Germany
| | - Hywel C Williams
- University of Nottingham, Nottingham, England
- National Institute for Health Research, Nottingham, England
| | | | - David Moher
- Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Yvette Kasamon
- Office of Oncologic Diseases, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland
| | - Kenneth Getz
- Tufts Center for the Study of Drug Development, Boston, Massachusetts
| | - Sally Hopewell
- Oxford Clinical Trials Research Unit, Centre for Statistics in Medicine, University of Oxford, Oxford, England
| | - Kay Dickersin
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Taixiang Wu
- Chinese Clinical Trial Registry, Sichuan University, Chengdu, China
| | - Ana Patricia Ayala
- Gerstein Science Information Centre, University of Toronto, Toronto, Ontario, Canada
| | - Kenneth F Schulz
- FHI 360, Durham, North Carolina
- School of Medicine, University of North Carolina at Chapel Hill
| | - Sabine Calleja
- Gerstein Science Information Centre, University of Toronto, Toronto, Ontario, Canada
| | - Isabelle Boutron
- Centre of Research in Epidemiology and Statistics, Université de Paris, Inserm, Paris, France
| | - Joseph S Ross
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
- The BMJ , London, England
| | - Robert M Golub
- Deputy Editor, JAMA
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Karim M Khan
- Canadian Institutes of Health Research Institute of Musculoskeletal Health and Arthritis, Ottawa, Ontario, Canada
| | - Cindy Mulrow
- University of Texas Health Science Center, San Antonio
| | - Nandi Siegfried
- Alcohol, Tobacco, and Other Drugs Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Joerg Heber
- Lawrence Berkeley National Laboratory, Berkeley, California
| | | | - Pamela Reed Kearney
- Office of Extramural Research, Division of Human Subjects Research, National Institutes of Health, Bethesda, Maryland
| | - Rhoda K Wanyenze
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University, Kampala, Uganda
| | - Asbjørn Hróbjartsson
- Centre for Evidence-Based Medicine Odense (CEBMO) and Cochrane Denmark, University of Southern Denmark, Odense, Denmark
| | - Rebecca Williams
- ClinicalTrials.gov, National Library of Medicine, National Institutes of Health, Bethesda, Maryland
| | - Nita Bhandari
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Peter Jüni
- Applied Health Research Centre, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - An-Wen Chan
- Women's College Research Institute, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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Misra V, Safi F, Brewerton KA, Wu W, Mason R, Chan AW, Rochon PA, Lega IC, Abdel-Qadir H. Gender disparity between authors in leading medical journals during the COVID-19 pandemic: a cross-sectional review. BMJ Open 2021; 11:e051224. [PMID: 34261692 PMCID: PMC8282422 DOI: 10.1136/bmjopen-2021-051224] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES Evaluate gender differences in authorship of COVID-19 articles in high-impact medical journals compared with other topics. DESIGN Cross-sectional review. DATA SOURCES Medline database. ELIGIBILITY CRITERIA Articles published from 1 January to 31 December 2020 in the seven leading general medical journals by impact factor. Article types included primary research, reviews, editorials and commentaries. DATA EXTRACTION Key data elements were whether the study topic was related to COVID-19 and names of the principal and the senior authors. A hierarchical approach was used to determine the likely gender of authors. Logistic regression assessed the association of study characteristics, including COVID-19 status, with authors' likely gender; this was quantified using adjusted ORs (aORs). RESULTS We included 2252 articles, of which 748 (33.2%) were COVID-19-related and 1504 (66.8%) covered other topics. A likely gender was determined for 2138 (94.9%) principal authors and 1890 (83.9%) senior authors. Men were significantly more likely to be both principal (1364 men; 63.8%) and senior (1332 men; 70.5%) authors. COVID-19-related articles were not associated with the odds of men being principal (aOR 0.99; 95% CI 0.81 to 1.21; p=0.89) or senior authors (aOR 0.96; 95% CI 0.78 to 1.19; p=0.71) relative to other topics. Articles with men as senior authors were more likely to have men as principal authors (aOR 1.49; 95% CI 1.21 to 1.83; p<0.001). Men were more likely to author articles reporting original research and those with corresponding authors based outside the USA and Europe. CONCLUSIONS Women were substantially under-represented as authors among articles in leading medical journals; this was not significantly different for COVID-19-related articles. Study limitations include potential for misclassification bias due to the name-based analysis. Results suggest that barriers to women's authorship in high-impact journals during COVID-19 are not significantly larger than barriers that preceded the pandemic and that are likely to continue beyond it. PROSPERO REGISTRATION NUMBER CRD42020186702.
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Affiliation(s)
- Vaidehi Misra
- Women's College Research Institute (WCRI), Women's College Hospital, Toronto, Ontario, Canada
| | - Frozan Safi
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | - Wei Wu
- Women's College Research Institute (WCRI), Women's College Hospital, Toronto, Ontario, Canada
| | - Robin Mason
- Women's College Research Institute (WCRI), Women's College Hospital, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - An-Wen Chan
- Women's College Research Institute (WCRI), Women's College Hospital, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation (IHPME), University of Toronto, Toronto, Ontario, Canada
| | - Paula A Rochon
- Women's College Research Institute (WCRI), Women's College Hospital, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation (IHPME), University of Toronto, Toronto, Ontario, Canada
| | - Iliana C Lega
- Women's College Research Institute (WCRI), Women's College Hospital, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
| | - Husam Abdel-Qadir
- Women's College Research Institute (WCRI), Women's College Hospital, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation (IHPME), University of Toronto, Toronto, Ontario, Canada
- Peter Munk Cardiac Centre (PMCC), University Health Network (UHN), Toronto, Ontario, Canada
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Calvert M, King M, Mercieca-Bebber R, Aiyegbusi O, Kyte D, Slade A, Chan AW, Basch E, Bell J, Bennett A, Bhatnagar V, Blazeby J, Bottomley A, Brown J, Brundage M, Campbell L, Cappelleri JC, Draper H, Dueck AC, Ells C, Frank L, Golub RM, Griebsch I, Haywood K, Hunn A, King-Kallimanis B, Martin L, Mitchell S, Morel T, Nelson L, Norquist J, O'Connor D, Palmer M, Patrick D, Price G, Regnault A, Retzer A, Revicki D, Scott J, Stephens R, Turner G, Valakas A, Velikova G, von Hildebrand M, Walker A, Wenzel L. SPIRIT-PRO Extension explanation and elaboration: guidelines for inclusion of patient-reported outcomes in protocols of clinical trials. BMJ Open 2021; 11:e045105. [PMID: 34193486 PMCID: PMC8246371 DOI: 10.1136/bmjopen-2020-045105] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 12/21/2020] [Accepted: 01/08/2021] [Indexed: 01/21/2023] Open
Abstract
Patient-reported outcomes (PROs) are used in clinical trials to provide valuable evidence on the impact of disease and treatment on patients' symptoms, function and quality of life. High-quality PRO data from trials can inform shared decision-making, regulatory and economic analyses and health policy. Recent evidence suggests the PRO content of past trial protocols was often incomplete or unclear, leading to research waste. To address this issue, international, consensus-based, PRO-specific guidelines were developed: the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT)-PRO Extension. The SPIRIT-PRO Extension is a 16-item checklist which aims to improve the content and quality of aspects of clinical trial protocols relating to PRO data collection to minimise research waste, and ultimately better inform patient-centred care. This SPIRIT-PRO explanation and elaboration (E&E) paper provides information to promote understanding and facilitate uptake of the recommended checklist items, including a comprehensive protocol template. For each SPIRIT-PRO item, we provide a detailed description, one or more examples from existing trial protocols and supporting empirical evidence of the item's importance. We recommend this paper and protocol template be used alongside the SPIRIT 2013 and SPIRIT-PRO Extension paper to optimise the transparent development and review of trial protocols with PROs.
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Affiliation(s)
- Melanie Calvert
- Centre for Patient Reported Outcome Research, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
- NIHR Biomedical Research Centre, Institute of Translational Medicine, Birmingham, UK
- NIHR Surgical Reconstruction and Microbiology Research Centre, Birmingham, UK
- NIHR Applied Research Collaboration West Midlands, University of Birmingham, Birmingham, UK
| | - Madeleine King
- Faculty of Science, School of Psychology, University of Sydney, Sydney, New South Wales, Australia
| | - Rebecca Mercieca-Bebber
- Faculty of Medicine and Health, NHMRC Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Olalekan Aiyegbusi
- Centre for Patient Reported Outcome Research, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- NIHR Biomedical Research Centre, Institute of Translational Medicine, Birmingham, UK
| | - Derek Kyte
- Centre for Patient Reported Outcome Research, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Anita Slade
- Centre for Patient Reported Outcome Research, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- NIHR Surgical Reconstruction and Microbiology Research Centre, Birmingham, UK
| | - An-Wen Chan
- Women's College Research Institute, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - E Basch
- University of North Carolina, Chapel Hill, North Carolina, USA
| | - Jill Bell
- Oncology Digital Health, AstraZeneca, Gaithersburg, Maryland, USA
| | - Antonia Bennett
- Cancer Outcomes Research Program, University of North Carolina, Chapel Hill, North Carolina, USA
| | | | - Jane Blazeby
- NIHR Bristol Biomedical Research Centre, University of Bristol, Bristol, UK
- Division of Surgery, Head and Neck, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Andrew Bottomley
- Department of Quality of Life, European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - Julia Brown
- Clinical Trials Research Unit, University of Leeds, Leeds, UK
| | - Michael Brundage
- Department of Oncology, Queen's University Cancer Research Institute, Kingston, Ontario, Canada
| | - Lisa Campbell
- Medicines and Healthcare Products Regulatory Agency, London, UK
| | - Joseph C Cappelleri
- Global Biometrics & Data Management-Statistics, Pfizer Inc, New York City, New York, USA
| | | | - Amylou C Dueck
- Department of Health Sciences Research, Mayo Clinic, Scottsdale, Arizona, USA
| | - Carolyn Ells
- School of Population and Global Health, McGill University, Montreal, Quebec, Canada
| | - Lori Frank
- Patient-Centered Outcomes Research Institute, Washington, DC, USA
| | | | | | - Kirstie Haywood
- Warwick Research in Nursing, University of Warwick, Warwick Medical School, Coventry, UK
| | | | | | | | | | - Thomas Morel
- Patient-Centered Outcomes Research, UCB Pharma, Brussels, Belgium
| | - Linda Nelson
- Value Evidence and Outcomes-Patient Centered Outcomes, GSK, Collegeville, Pennsylvania, USA
| | - Josephine Norquist
- Center for Observational Real-world Evidence (CORE), Patient-Centered Endpoints & Strategy, Merck & Co Inc, Kenilworth, New Jersey, USA
| | - Daniel O'Connor
- Medicines and Healthcare Products Regulatory Agency, London, UK
| | - Michael Palmer
- Cancer Research Institute, Queen's University, Kingston, Ontario, Canada
| | - Donald Patrick
- Department of Health Services, University of Washington, Seattle, Washington, USA
| | - Gary Price
- Centre for Patient Reported Outcome Research, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | | | - Ameeta Retzer
- Centre for Patient Reported Outcome Research, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | | | - Jane Scott
- Johnson and Johnson, Janssen Global Services LLC, High Wycombe, UK
| | | | - Grace Turner
- Centre for Patient Reported Outcome Research, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- NIHR Surgical Reconstruction and Microbiology Research Centre, Birmingham, UK
| | - Antonia Valakas
- EMD Serono Inc, Healthcare Business of Merck KGaA, Darmstadt, Germany
| | - Galina Velikova
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
| | - Maria von Hildebrand
- Centre for Patient Reported Outcome Research, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Anita Walker
- Centre for Patient Reported Outcome Research, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Lari Wenzel
- University of California, Irvine, California, USA
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50
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Drucker AM, Chan AW. The authors reply to: "Antihypertensives and skin cancer" and "Association between thiazide diuretics and skin cancer: still nebulous". CMAJ 2021; 193:E964. [PMID: 34155050 PMCID: PMC8248467 DOI: 10.1503/cmaj.79145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Aaron M Drucker
- Clinician scientist, University of Toronto, Women's College Hospital and ICES, Toronto, Ont
| | - An-Wen Chan
- Clinician scientist, University of Toronto, Women's College Hospital and ICES, Toronto, Ont
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